Strengthening Health Economics Evidence for India

A review of a pilot-initiative led by the National Health Authority (NHA) to inform differential pricing of reimbursement rates for Health Benefit Packages (HBPs) under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) was undertaken. The findings highlighted concerns regarding the sustainability of the cost surveillance pilot and the quality of the information being generated, emphasizing the necessity of establishing a viable and scalable healthcare cost surveillance system. Additionally, a methods guide to systematize the processes for revising and updating HBPs under PM-JAY, and a CPHC process manual for undertaking adaptive HTA for timely generation of evidence were developed.

Evaluation of implementation of Beti Bachao Beti Padhao (B3P) Programme in Haryana state, India.

Over the past decade, India has implemented numerous programs aimed at improving child survival and development, with a focus on bringing social change. To ensure the effectiveness of these initiatives, a thorough evaluation of their outcomes is crucial to inform program and policy decisions. The project "Evaluation of Implementation of Beti Bachao Beti Padhao Programme, Women and Child Development Scheme and Validation of Civil Registration System in Haryana" aimed to assess the impact of various government schemes on child survival and development. The study evaluated the Beti Bachao Beti Padhao (B3P) program's effect on the sex ratio at birth, the accuracy and coverage of Civil Registration System (CRS) records, and the utilization of maternal and infant health services under ICDS. Additionally, the study assessed the awareness, coverage, and utilization of other schemes like Mukhya Mantri Doodh Uphaar Yojana, Pradhan Mantri Matru Vandana Yojana, and Apki Beti Hamari Beti.

Exploring The Content Validity of the EQ-5D Across Cultures Using Standardized Qualitative Methods

This project was the first attempt to fill a long-standing knowledge gap in relation to EQ-5D and its cultural relevance outside Europe. The purpose of this research was to understand the general public?s view of what characterizes ?poor health?. These are seen as ?characteristics of poor health?. Members of the general public were also asked to think about aspects of ?good health? that contribute to positive quality of life, or ?characteristics of good health?. This research also analysed that how do these health perceptions compare to the dimensions covered by the EQ-5D across all participating countries (Netherlands, Spain, USA, Argentina, China, India and Indonesia). It provided evidence, which was scientifically relevant, and strategically important to the EuroQoL Group. The information it generated has deepened the EuroQoL Group?s understanding of those aspects of health which are important to people in different areas of the world, help to better understand and explain the appropriateness of the instrument in those regions, and provide a strong foundation for future research in this direction

Intra-Partum Care Bundle to Prevent Epilepsy Caused by Birth

The Prevention Task Force of the International League Against Epilepsy estimated that perinatal brain insults accounted for the largest attributable fraction of paediatric and adult epilepsy in LMICs. It is hypothesized that epilepsy from perinatal brain injury can be reduced by the use of a pragmatic, evidenced based and generalisable intrapartum care bundle that involves birth companions, intelligent foetal heart rate monitoring, an e- partogram and brain oriented neonatal resuscitation, in Indian public sector hospitals. The study aimed to estimate the health system costs and out-of-pocket expenditure for intrapartum care, treating brain injury and epilepsy; followed by estimating the incremental cost per quality adjusted life year gained using the intrapartum care bundle as compared to current standards of care.

Price Regulation and Value Based Pricing for anti-cancer Drugs: Implications for Patients, Industry, Insurer and Regulator

The rising economic burden of cancer on health-care system and patients in India has led to the increased demand for evidence in order to inform policy decisions such as drug price regulation, setting reimbursement package rates under publicly financed health insurance schemes and prioritizing available resources to maximize value of investments in health. Economic evaluations are an integral component of this important evidence. In order to facilitate such analyses, strong information systems are needed to be put in place. High out-of-pocket payments and the indirect costs associated with cancer treatment, often result in financial toxicity. Therefore, characterization and prediction of these costs, alongside other health outcomes such as both quantity and quality of life, is important for planning strategies to mitigate the financial hardship due to cancer treatment. Several types of specific cancers do not even have a single case. Thus, another important evidence for conducting HTA is robust data for OOPE among cancer patients, which can be stratified by type of cancer, its health states, levels of severity and type of treatment. Considering the increasing costs of diagnostics and therapeutic interventions for cancer, their formal assessment is imperative to inform value-based standard treatment guidelines. Therefore, the present study aimed to evaluate the value-based prices for 42 anticancer drugs, which have come under price regulation

Identification of Factors Contributing to out-of-Pocket Expenditure on Medicine

The share of expenditure on medicines as part of the total out-of-pocket (OOP) expenditure on healthcare services has been reported to be much higher in India than in other countries. This study was conducted to ascertain the extent of this share of medicine expenditure using a novel methodology.

Comprehensive Primary Health Care: Innovation and Learning Centre (CPHC-ILC) 1.0

In order to understand how the roll-out of the Ayushman Bharat- Health and Wellness Centre programme takes place in Punjab, a support centre for testing innovations and generating learnings for scaling up of the programme, was established in the Department of Community Medicine and School of Public Health, PGIMER, Chandigarh in collaboration with the National Health Systems Resource Centre, New Delhi and the State Health Society, Punjab. The ?Innovation and Learning 2022 New Delhi Centre for comprehensive primary healthcare (CPHC-ILC)? supports the state implementation team for change management through technical inputs on the components of CPHC, training and capacity building, and works closely at the ground level to address implementation issues in service delivery of CPHC.

Developing a EQ5D5L Quality of Life Value Set for Indian Population

This is the largest 5-level version EQ-5D (EQ-5D-5L) valuation study conducted so far/worldwide and the first preference-based valuation study in South Asia. The study was conducted using a novel design in around 3500 respondents across six states of India. By developing the EQ-5D-5L value set for India, this study fills the long-existing evidence gap in the field of health technology assessment (HTA) in India. The value set generated as a part of this study will help to correctly assess the quality-adjusted life-years (QALYs) in Indian studies.

Support to Conduct Online Courses in Basic Health Economics and Economic Evaluation for HTA

Online courses in health economics are envisaged to promulgate the principles of basic health economics and economic evaluation for health technology assessment (HTA). These courses are being delivered with the ?Support to Conduct Online Courses in Basic Health Economics and Economic Evaluation for Health Technology Assessment? by the HRD Scheme of the Department of Health Research. The online course in basic health economics is of three months duration while the advanced course is of five months duration. Each course comprises six modules that cover topics pertinent to sensitise policymakers, program implementers, researchers, academicians, clinicians, and other health-related professionals. These users are from varied educational and professional backgrounds ranging from researchers and clinicians to top-level policy & decision-makers. These courses orient the audience towards the dynamics behind resource allocation decisions using economic evidence as the mainstay. The salient feature is enabling this understanding to be contextualised to the Indian health system.

Impact Evaluation of National Rural Health Mission in India