Financial incentives， as an intervention in behavioral therapy， have been proven to be beneficial in many health behaviors， such as drug addiction treatment， long-term antiviral therapy， and the prevention and treatment of chronic diseases. At present， typical financial incentive schemes mainly include commitment contracts and lottery-based models. Key factors in the design of such interventions include the adaptability of behavioral economic principles and medication behavior， the effectiveness and cost-effectiveness of design scheme， and the acceptability of intervention population. Although financial incentives have accumulated rich experience in health behavior interventions abroad， research on medication adherence remains limited， with existing intervention scheme design and mechanism constraints， and their effectiveness potentially varying across different cultural and social environments. China should explore practical models of financial incentives to enhance medication adherence, considering patients’ medication patterns and socio-cultural factors.

Medication adherence is an important indicator for assessing whether patients follow medical advice during treatment， and its level directly affects disease control and the quality of life of patients. Therefore， accurate and effective assessment is essential for chronic disease management and intervention. This paper takes chronic obstructive pulmonary disease （COPD） and asthma， two types of chronic respiratory diseases， as representative to review the existing measurement methods and current application status of medication adherence. It is found that the existing assessment methods for medication adherence can be categorized into objective measurement methods and subjective measurement methods. Objective measures include drug concentration monitoring， pill counting， and electronic medication devices， which generally offer high accuracy. Subjective measures include physician assessments， inhalation technique evaluations， and questionnaires. While these methods are straightforward and easy to implement， their accuracy is often influenced by the subjective factors of assessors of patients， which may lead to biased results. Currently， there is still a lack of a universally accepted “gold standard” for evaluating medication adherence. Selecting the appropriate measurement method requires a comprehensive consideration of factors such as research objectives， disease type， patient characteristics， and data availability to ensure the validity and reliability of the assessment results.

OBJECTIVE To systematically evaluate pharmacoeconomic studies on treatment strategies for transfusion- dependent β thalassemia （TDT） both in China and internationally， to inform clinical decision-making and health resource allocation， and provide methodological references for future domestic research in China. METHODS Databases including PubMed， Embase， Web of Science， the Cochrane Library， CNKI， Wanfang Data， and VIP were searched for pharmacoeconomic studies related to TDT treatments from inception to December 2024. Two researchers independently screened the literature， extracted data， and assessed risk of bias using the Consolidated Health Economic Evaluation Reporting Standards 2022 （CHEERS 2022） checklist. A qualitative systematic review was conducted focusing on model structure， costs， health outcomes， uncertainty analysis， and economic evaluation results. RESULTS A total of 1 685 articles were initially identified， and 13 pharmacoeconomic studies were ultimately included. The overall quality of the included studies was relatively high， covering interventions including blood transfusion and iron chelation therapy （BT-ICT）， hematopoietic stem cell transplantation （HSCT）， and gene therapy. All studies employed cost-utility analysis from societal， healthcare system， and payer perspectives. Markov models were most frequently used in model design. Most studies adopted a lifetime horizon with a cycle length of one year and a discount rate of 1.5% to 5%. Costs mainly focused on direct medical costs， sourced from national insurance databases and published literature. Utility values were primarily derived from literature or measured using techniques such as time trade-off. Most studies conducted both deterministic and probabilistic sensitivity analyses， identifying the costs of iron chelators and utility values as key influential parameters. Some studies also performed scenario analyses. CONCLUSIONS HSCT was likely more cost-effective than BT-ICT for pediatric/ adolescent patients. BT-ICT demonstrated superior cost-utility for adult patients， with the deferiprone regimen potentially being the most cost-effective option. Current domestic and international pharmacoeconomic evaluations for TDT remain limited. Future research should adopt a societal perspective， use a lifetime horizon， and strictly follow the CHEERS 2022 checklist when conducting pharmacoeconomic evaluations of treatments for TDT.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.

Objective:It explores critical issues of discounting in health technology assessment to provide a reference for improving discount rates in China.Methods:Based on literature review and empirical cases,it compares and analyzes the practical experience of the UK and Canada and the basis for discount rate setting in pharmacoeconomic evaluation and guidelines of various countries.Results:It is found that the social time preference and social opportunity cost approach provide research perspectives for discount rate calculation.How-ever,there are differences in the choice of discounting in international guidelines and pharmacoeconomic evaluation practices,which may reflect differences among countries regarding economic environment,healthcare systems,and values.Conclusion:It calls for more basic research on discounting and suggests the formulation of discount rates that align with our China's economic environment to provide deci-sion-makers with a reliable information foundation.