Evidence of Chinese Herbal Medicine Use From an Economic Perspective: A Systematic Review of Pharmacoeconomics Studies Over Two Decades

Abstract

Objectives: Pharmacoeconomics evaluation (PE) is increasingly used in the healthcare decision-making process in China. Little is known about PE conducted in Chinese Herbal Medicines (CHMs). We aimed to systematically review trends, characteristics, and quality of PE of CHMS.Methods: We systematically searched both Chinese (CNKI, WanFang, and VIP) and English (Pubmed) databases. Studies were included if they were PE studies comparing both costs and outcomes between two or more interventions published in Chinese or English. Assessment of the quality of studies was conducted using the Quality of Health Economic Analyses (QHES) instrument. T-test and Chi-square tests were used to compare the studies before and after the first edition of China Guidelines for PE published in 2011, and between studies published in Chinese and English.Results: A total of 201 articles were included. There was an increasing trend of PE studies on CHMs during the study period. The top three studied diseases were central nervous system (CNS), mental, and behavioral disorders; cardiovascular diseases; and blood, immune and endocrine diseases. The average QHES score for the included studies was 63.37. Cost-effectiveness analysis (CEA) accounted for the majority (76.6%) of the included studies. Only a quarter of the articles (27.4%) were funded, and there were significantly more studies funded after the publication of China guidelines for PE. About 96.5% of studies did not specify evaluation perspectives and 89.6% of studies had a sample size of less than 300. Around half of the studies (55%) used incremental analysis, but only a few of them considered using a threshold. Half of the studies lacked sensitivity analysis. There was no significant improvement in the quality of studies published after the publication of China Guidelines for PE, and English articles had significantly higher quality than Chinese articles.Conclusion: This study identified several problems in PE studies on CHMs, including having small sample sizes, lacking necessary research elements, and using single evaluation methods. The quality of PE studies on CHMs was not sufficient. Researchers need to understand the standardized way to conduct PE studies and improve the quality and level of PE studies on CHMs.

Visualizing research trends and identifying hotspots of herbal components for treating cardiovascular diseases: A bibliometric analysis from 2000 to 2023

“…[8,[12][13][14][15][16][17][18] Several studies have also examined the application of Chinese herbal medicine ingredients in CVD. [19][20][21][22] However, few studies have comprehensively analyzed and summarized the research hotspots and trends in this area.…”

Medicinal uses of the Asteraceae family in Zimbabwe: A historical and ecological perspective

“…Medicinal plants have been the basis of treatment and management of various diseases in traditional medicine as well as other forms of treatment from diverse cultures and indigenous knowledge systems of the world (Okoye et al 2014). Several plant species have been utilized as medicines for thousands of years in African traditional pharmacopoeias (Devine 2022, Sifuna 2022, American traditional medicine (Geck et al 2020, Redvers & Blondin 2020, Rojas et al 2022, Australian traditional medicine (Oliver 2013, Bhuyan et al 2022, Southeast Asian traditional medicine (Ahmad 2002, WHO 2020, Ayurvedic (Junaid et al 2017, Mukherjee et al 2017, Chinese traditional medicine (Liu et al 2022, Xiong et al 2022, European traditional medicine (Micke & Hühner 2009, Leonti & Verpoorte 2017, classical Arabic and North African traditional medicine (Azaizeh et al 2008, Al Rawi et al 2017, Dehyab et al 2020. Therefore, medicinal plants are an important component of the traditional medicine which refers to the health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being (Fokunang et al 2011, Dzoyem et al 2013.…”