Factors influencing the application of cost-utility analysis in assessing disease management among Asian patients

Abstract

I aimed to investigate factors influencing the application of cost-utility analysis (CUA) in assessing disease management among Asian patients. First, I explored whether there is any linguistic or cultural barrier in the adaptation of an English Health-related quality of life or utility instrument into a non-English version by using a "universalist approach" to ensure the achievement of all important equivalences. Second, I did a systematic literature review and identified altogether 20 influential factors, which could be used as a reference check-list by Asian researchers and decision-makers when conducting cost-utility analysis. Third, I explored other new factors, and focused on the investigation of response shift, expectancy-value, health literacy and disease knowledge. I also developed patient's trust in pharmacists scale and generic functional health literacy test for future investigation of their respective impact on CUA. In conclusion, the factors identified in this thesis are suggested to be considered when conducting CUA.