Public and private health insurers and payers

See comparative value and its assumptions before making a coverage decision.

Evaluate a defined product, service, or population, with separate assessments of effects, risks, costs, budgets, and implementation requirements. One-time assessments and ongoing evidence maintenance are commissioned separately.

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Illustrative scene: a fictional civic building for public-health and policy decisions — Illustrative scene

Service usersAssessment, coverage policy, actuarial, medical review, and expert committee teamsCommissioning partyAn authorized payer, insurer, or the entity procuring research on its behalf

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Inspect the value and deliverables, then agree scope, review and fees.

01 · DEDICATED

Decision appraisal

Effects, costs and implementation conditions are difficult to compare.

Core valueCompare effects, costs and the assumptions behind conclusions.

What you receiveCompare options under explicit assumptions and identify uncertainty.

Comparative effects and evidence-certainty table
Parameter sources and budget or option model
Implementation, applicability and equity conditions

Report, tables and agreed model; assumptions and parameters are reviewable.

How fees workPayer evidence package: CNY 200,000–500,000 reference; full HTA separately scoped

Quote stages by product, comparator, region and model depth; accept scope, draft and final delivery separately.

Scope limits

Excludes coverage or procurement outcomes and new clinical trials.

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02 · CUSTOM

Living decision evidence

After a baseline appraisal, when does new evidence require reconsideration?

Core valueExplain when material changes justify reappraisal.

What you receiveTrack defined questions and explain what changes the prior appraisal.

Incremental evidence register and reasons for change
Agreed model or evidence-table updates
Reappraisal triggers and decision memo

Accept by cadence and questions; record when no material change occurs.

How fees workScoped annual service from CNY 300,000 reference

Requires a usable baseline; contract questions, cadence, full-text limits and model updates, payable quarterly.

Scope limits

Excludes a new baseline HTA and unlimited model rebuilding.

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Payers Policy groups Guideline groups

Amounts are proposed references or examples. Formal quotes depend on inputs, questions, professional review and acceptance scope. Agree updates separately; the same work is not charged twice.

What inputs are needed?

What coverage decision is involved?: A coverage list, service programme, insurance benefit, or pilot conditions
Comparators and perspective: Target population, current care, region, evaluation horizon, and payer perspective
Are the data available?: Costs, utilization, local effects, and triggers for updates

More situations

Situations and deliverables

Public and private health insurers and payers

A service needs assessment. Are the effects and budget supported?

Comparative-effectiveness tables, parameter sources and budget scenarios that separate observed data, assumptions and local-data gaps.

Evidence package: CNY 200,000–500,000; full HTA: CNY 300,000–1,000,000+See the deliverable

Public and private health insurers and payers

An assessment and model exist. Does new evidence justify an update?

Quarterly evidence and parameter change logs with impact reasons and model versions. Models change only through approved work within scope.

CNY 300,000–1,000,000+ per yearSee the deliverable

NEXT STEP

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