Abstract
Background
Menopausal women often experience both physical and psychological symptoms, including depression, which significantly impairs quality of life (QOL). While hormone replacement therapy (HRT) and antidepressants are common treatments, concerns over side effects have increased interest in Traditional Korean Medicine (TKM), especially acupuncture. However, real-world evidence comparing integrative treatment strategies is limited.
Methods
We conducted a retrospective cohort study using Korean National Health Insurance claims data (2015–2023) to evaluate the cost–utility of four treatment strategies for menopausal disorders, categorized by recorded claims for acupuncture (AP) and/or Western medicine (WM): TKM care without acupuncture claims (reference), TKM care with acupuncture claims, TKM care plus Western medicine without acupuncture claims, and TKM care plus Western medicine with acupuncture claims. Depression incidence and quality-adjusted life years (QALYs) were assessed over a 3-year horizon. Incremental cost-effectiveness ratios (ICERs) were estimated using inverse probability of treatment weighting (IPTW). Sensitivity analyses varied discount rates and utility values.
Results
Among 32,941 women, the TKM care without acupuncture claims group demonstrated the lowest costs and relatively higher QALYs (2.11). All other strategies—TKM care with acupuncture claims (TKM+AP), TKM care plus Western medicine without acupuncture claims (TKM+WM), and TKM care plus Western medicine with acupuncture claims (TKM+WM+AP)—were dominated, with higher costs but slightly lower QALYs. Acupuncture users exhibited longer episode durations, higher comorbidity rates, and greater healthcare utilization, suggesting a more severe underlying patient population. Sensitivity analyses confirmed that the dominance of TKM care without acupuncture claims persisted across all scenarios.
Conclusion
In this nationwide cohort, TKM care without acupuncture claims emerged as the most economically favorable strategy for managing menopausal disorders. However, the higher utilization and costs observed in integrative care groups likely reflect greater disease severity rather than inefficacy. These findings highlight the need for individualized treatment strategies and further prospective research to clarify the comparative effectiveness and cost-effectiveness of integrative approaches.
Keywords: Menopause, Acupuncture, Depression, Cost-utility analysis, Traditional Korean medicine, Integrative Medicine
1. Introduction
Menopause is a critical transition in a woman’s life, often accompanied by physical symptoms such as vasomotor instability and joint pain, as well as psychological challenges including depression.1,2 Approximately 20–30 % of postmenopausal women experience depressive symptoms,3 which significantly impair quality of life (QOL) and increase the economic burden on the healthcare system.4 While hormone replacement therapy (HRT) and antidepressants are standard treatments, their long-term use is often limited by safety concerns. HRT has been associated with an increased risk of breast cancer and cardiovascular disease,5 whereas antidepressants are frequently discontinued due to poor adherence and side effects such as weight gain or sexual dysfunction.6
Given these limitations, Traditional Korean Medicine (TKM) has emerged as a widely utilized alternative, emphasizing holistic balance and symptom management.7 In clinical practice, TKM encompasses herbal medicine, which addresses underlying physiological imbalances, and acupuncture, which regulates the autonomic nervous system to relieve emotional instability and insomnia.8 Increasing evidence supports the efficacy of these modalities. Standardized acupuncture has been shown to reduce the frequency and severity of menopausal vasomotor symptoms9 while integrative approaches combining acupuncture with herbal medicine or conventional care have demonstrated synergistic improvements in sleep quality, anxiety, and depression.10
Despite the clinical popularity of these interventions, economic evaluations of TKM-based strategies for menopausal disorders remain scarce. However, although some studies have suggested that acupuncture may be cost-effective for general depression,11 few have specifically compared the cost-utility of TKM care without acupuncture claims versus integrative strategies involving acupuncture and Western medicine in a real-world menopausal cohort. In routine practice, treatment choices-such as the decision to add acupuncture to herbal regimens or combine TKM with Western medicine-vary widely and likely have distinct economic and clinical implications.12
This study aimed to bridge this gap by evaluating the real-world cost-utility of four distinct treatment strategies for menopausal disorders: TKM care without acupuncture claims, TKM care with acupuncture claims, and their respective combinations with Western medicine. Using nationwide health insurance claims data, we assessed the 3-year Incremental Cost-Effectiveness Ratios (ICERs) and depression outcomes to inform evidence-based decision-making.
2. Methods
2.1. Study design and population
This retrospective cohort study evaluated the cost-utility analysis (CUA) of treatment strategies for depression prevention based on health insurance claims data. The study population consisted of women with a diagnosis code (N95) for menopausal disorders at a TKM medical center, with the index date being defined as the date of the first diagnosis. Follow-up was conducted for 3 years from the index date to assess medical expenditures related to menopausal disorders and the occurrence of depression, using national health insurance claims data from 2015 to 2023. The data were obtained from the Health Insurance Review and Assessment Service (project number: M20250121001). The study was exempt from review by the Institutional Review Board (IRB), as it used de-identified secondary data (IRB No. I-2403/003–001). The study was reported in accordance with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 statement. A completed CHEERS checklist, indicating where each item is addressed in the manuscript, is provided as supplementary material (Supplement 1).
2.2. Episode definition and treatment group categorization
Women diagnosed with menopausal disorders were identified using the Korean Standard Classification of Diseases (KCD) code N95. The first diagnosis date was defined as the index date, and the duration of menopausal disorder was defined for each patient based on repeated medical visits with the same diagnosis. If the same diagnosis code was not recorded within 1 year, the episode was considered closed. Thus, each patient contributed a single observation, and the analysis was conducted at the patient level.
Participants were categorized into four groups based on recorded claims for acupuncture and Western medicine: (1) TKM care without acupuncture claims (reference), (2) TKM care with acupuncture claims, (3) TKM care plus Western medicine without acupuncture claims, and (4) TKM care plus Western medicine with acupuncture claims.
In this context, standard TKM care typically involves a multimodal approach including acupuncture, herbal medicine, and moxibustion. However, for the purpose of this analysis, we defined the reference arm as "TKM care without acupuncture claims" (i.e., those with claims for TKM treatments exclusive of acupuncture) to isolate the specific incremental impact of acupuncture. The four-group classification was operationally defined to compare the economic and clinical profiles of TKM care without acupuncture against strategies involving acupuncture and/or Western medicine integration.
2.3. Economic evaluation methodology
Economic evaluation of health services for menopausal depression was conducted using a CUA. QALYs were used as the health outcome measures, and an ICER was calculated to compare the cost-effectiveness of the treatment groups. In the base-case analysis, both costs and effects were discounted at an annual rate of 4.5 % in accordance with the Korean Guidelines for Pharmacoeconomic Evaluations. To assess the robustness of the ICER, sensitivity analyses were performed using variations in utility values and discount rates. To assess parameter uncertainty, both deterministic sensitivity analyses (varying utility values and discount rates) and a probabilistic sensitivity analysis (PSA) using 1000 Monte Carlo simulations were performed. PSA incorporated probability distributions for costs (gamma distribution) and event probabilities (beta distribution), and results were presented with a cost-effectiveness acceptability curve (CEAC).
Treatment costs for acupuncture-related complications were not included in the base-case analysis, as the claims data did not allow reliable identification of expenditures specifically attributable to acupuncture complications. However, serious complications of acupuncture are extremely rare in clinical practice, and no relevant claims were identified in the present dataset. Therefore, the exclusion of such costs is unlikely to have materially affected the results.
2.4. Outcome measures
The outcome variable was defined as the occurrence of depression during the 3-year follow-up period from the index date. Depression was defined as a diagnosis corresponding to International Classification of Diseases-10 codes F32x and F33x, and the event time was calculated as the period from the index date to the date of the first depression diagnosis.
2.5. Health outcome measures (QALYs)
We estimated QALYs-a composite measure of life expectancy and quality of life-using a time-to-event approach. Since QOL measures such as EQ-5D were not available in the claims database, utility values were derived from the existing literature. A utility weight of 0.85 was assigned for the "non-depressed" state (menopausal women without depression) and 0.65 for the "depressed" state. These values were used for the base-case binary utility specification (non-depressed vs depressed). In additional analyses, we applied a severity-informed mapping using antidepressant use to distinguish mild and severe depression. For QALY calculation, individuals were assumed to remain in the "non-depressed" state from the index date until incident depression (if any), and in the "depressed" state from the date of depression onset until the end of follow-up (or censoring).
2.6. Measuring costs
Medical costs during the 3-year follow-up period were measured as follows: the analysis included all medical expenditures related to menopausal disorders and subsequent depression. For patients who developed comorbid conditions (e.g., hypertension, diabetes, fracture), related medical expenditures were also included in the cost analysis. This approach was intended to comprehensively capture the economic burden of treatment strategies, reflecting both the initial management of menopausal disorders and the downstream impact of depression as a clinical outcome. In the base-case analysis, both costs and QALYs were discounted at an annual rate of 4.5 %, in accordance with the Korean Guidelines for Pharmacoeconomic Evaluations. Sensitivity analyses were performed with alternative discount rates of 0 %, 3 %, and 7.5 % to assess the robustness of the results.
2.7. Cost-effectiveness analysis
Based on the mean cost and QALYs gained for each treatment strategy, ICERs were calculated through pairwise comparisons between all arms. The ICER is calculated using the standard formula below and is expressed as the additional cost per unit increase in the QALYs gained (cost/QALY)13,15:
ICER = (average cost in the comparison group - average cost in the reference group) / (average QALY in the comparison group - average QALY in the reference group)
For the CUA, the strategies were categorized according to the following criteria based on ICER values between each treatment strategy:
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Dominated (inferior strategy): Higher cost and equal or lower effectiveness (QALYs).
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Cost-saving strategy: Lower cost and higher QALYs gained.
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Cost-effective: Both cost and benefits increase, and the ICER is below the WTP threshold.
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Not cost-effective: Both cost and effectiveness increase, but the ICER exceeds the WTP threshold.
In this study, 30,000,000 South Korean won (KRW) per QALY, a commonly used WTP threshold in Korean health economic evaluations, was applied.14,16
To comprehensively compare the cost and QALY outcomes of the four groups, an extended cost-effectiveness analysis was performed. The inferior strategies were first eliminated based on the dominance rule, and then incremental analysis was applied to the remaining strategies.
2.8. Statistical analysis
All analyses were performed using R (version 3.5.3) (R Core Team, 2019). Baseline characteristics were compared using one-way analysis of variance (ANOVA) for continuous variables and Chi-squared tests for categorical variables. Because of the non-randomized nature of the study, inverse probability of treatment weighting (IPTW) was used to balance baseline covariates between groups. The propensity score was estimated using a multinomial logistic regression model including all baseline covariates (age, CCI, insurance type, index year, prior resource use, etc.). After weighting, the balance of covariates was assessed using standardized mean differences (SMD), where an absolute SMD < 0.1 was considered indicative of negligible imbalance. Statistical significance was set at p < 0.05.
Sensitivity analyses were performed on key variables to verify the robustness of the base-case analysis results. Utility values were varied by ±20 % of the base utility values, and discount rates were varied between 0 %, 3 % and 7.5 % in accordance with the Korean Guidelines for Pharmacoeconomic Evaluations. Each sensitivity analysis assessed the impact on the ICER by varying only specific variables while maintaining the cost estimates from the base-case scenario. Additionally, a probabilistic sensitivity analysis (PSA) was performed using 1000 iterations to propagate uncertainty in both costs and QALY estimates, utilizing cost-effectiveness planes and acceptability curves.
2.9. Costing and standardization
All costs were adjusted to 2024 values using the Consumer Price Index (CPI). To enhance international comparability, costs were expressed in both Korean won (KRW) and U.S. dollars (USD). A fixed 2024 KRW–USD conversion rate was applied (annaul avaerage of 1 USD = 1363 KRW), acknowledging potential fluctuations in exchange rates.
Annual CPI values (2020=100) were obtained from the Korean Statistical Information Service (KOSIS). For analysis, all costs were converted into 2024 Korean Won values by rescaling the CPI so that 2024 was set as the reference year (CPI=100).
3. Results
3.1. Trends in care utilization and inflation-adjusted costs by year
From 2015 to 2023, approximately 81,200 women were diagnosed with menopausal disorders annually, and the total number of visits per year exceeded 45,000. Over the same period, inflation-adjusted total medical expenditures (2024 KRW values, CPI 2020=100) increased from KRW 14.0 billion (USD 10.3 million) in 2015 to KRW 14.4 billion (USD 10.6 million) in 2023, reflecting a relatively modest overall rise despite fluctuations in patient volume. The number of patients declined steadily from over 12,000 in 2016 to below 8000 in 2023.
In contrast, the average annual cost per patient (CPI-adjusted) rose substantially, and the average cost per visit also increased, indicating an intensifying financial burden per patient and per encounter over time (Fig. 1).
Fig. 1.
Annual trends in healthcare utilization and costs among women diagnosed with menopausal disorders in Korea (2015–2023). All costs were adjusted to 2024 values using the Korean Consumer Price Index (CPI, 2020=100).
3.2. Baseline characteristics of study participants
Table 1 summarizes the baseline characteristics. The majority of patients were aged 50–59 years, though the TKM+WM group included a higher proportion of younger patients (<50 years). Hormone replacement therapy (HRT) use was most prevalent in the TKM+WM+AP group but negligible in the non-Western medicine groups.
Table 1.
Baseline characteristics of study participants according to acupuncture use.
| Characteristic | Total (n = 32,941) |
TKM+AP (n = 26,059) |
TKM (n = 2832) |
TKM+WM+AP (n = 3867) |
TKM+WM (n = 183) |
SMD Unweighted | SMD Weighted |
|---|---|---|---|---|---|---|---|
| Age group, n (%) | 0.229 | 0.085 | |||||
| ≤39 | 159 (0.5) | 116 (0.4) | 25 (0.9) | 9 (0.2) | 0 (0.0) | ||
| 40–49 | 10,045 (30.5) | 7674 (29.4) | 1007 (35.6) | 1280 (33.1) | 84 (45.9) | ||
| 50–59 | 20,595 (62.5) | 16,421 (63.0) | 1642 (58.0) | 2439 (63.1) | 93 (50.8) | ||
| 60+ | 2142 (6.5) | 1848 (7.1) | 158 (5.6) | 139 (3.6) | 6 (3.3) | ||
| HRT use, n (%) | 2411 (7.3) | 103 (0.4) | 5 (0.2) | 2248 (58.1) | 55 (30.1) | 0.959 | 0.327 |
| MED, mean (SD), days | 164.57 (461.45) | 59.92 (156.62) | 17.39 (84.18) | 966.38 (943.42) | 400.32 (624.62) | 0.902 | 0.428 |
| Visit count, mean (SD) | 7.23 (13.71) | 6.05 (12.09) | 1.47 (2.22) | 19.49 (20.59) | 6.28 (9.13) | 0.688 | 0.338 |
| Diabetes, n (%) | 3683 (11.2) | 2944 (11.3) | 290 (10.2) | 436 (11.3) | 13 (7.1) | 0.078 | 0.069 |
| Hyperlipidemia, n (%) | 11,206 (34.2) | 8979 (34.5) | 823 (29.1) | 1408 (36.4) | 50 (27.3) | 0.117 | 0.025 |
| Hypertension, n (%) | 5552 (16.9) | 4527 (17.4) | 432 (15.3) | 572 (14.8) | 21 (11.5) | 0.086 | 0.028 |
| Musculoskeletal symptoms, n (%) | 26,275 (79.8) | 20,933 (80.3) | 1944 (68.6) | 3256 (84.2) | 142 (77.6) | 0.197 | 0.031 |
| Osteoporosis, n (%) | 3768 (11.4) | 2905 (11.1) | 262 (9.3) | 579 (15.0) | 22 (12.0) | 0.093 | 0.052 |
| Sleep disorder, n (%) | 4151 (12.6) | 3242 (12.4) | 215 (7.6) | 669 (17.3) | 25 (13.7) | 0.155 | 0.039 |
Values are presented as mean (standard deviation) for continuous variables and number (percentage) for categorical variables. AP: acupuncture. HRT: hormone replacement therapy. MED: menopausal disorder episode duration, defined as the number of days between the first and last visit within an episode of menopausal disorder. An episode was considered closed if no additional visit with the same diagnosis code (N95) occurred within 1 year. SD: standard deviation. SMD: standardized mean difference; values <0.1 were considered indicative of good balance. TKM: traditional Korean medicine. Unweighted: before applying inverse probability of treatment weighting (IPTW). Weighted: after applying IPTW. WM: Western medicine.
Menopausal disorder episode duration and visit counts varied substantially; the TKM+WM+AP group exhibited the longest duration and most frequent visits, whereas the TKM care without acupuncture claims group had the shortest duration and fewest visits. Comorbidities were common across all groups, particularly musculoskeletal symptoms.
Standardized mean differences (SMDs) initially indicated imbalances (e.g., HRT use, visit counts), but these achieved good balance (SMD < 0.1) after applying inverse probability of treatment weighting (IPTW).
3.3. Cost and effectiveness comparison of the four treatment strategies
Table 2 presents the cost–utility analysis outcomes (4.5 % discount rate). Using IPTW-adjusted estimates, the TKM care without acupuncture claims group (reference) demonstrated the lowest costs and highest QALYs. All other treatment strategies (TKM+AP, TKM+WM, TKM+WM+AP) were associated with higher costs and lower QALYs, classifying them as “dominated” strategies. Detailed sensitivity analysis results, demonstrating the robustness of these findings under varying assumptions, are provided in Supplement 2.
Table 2.
Cost-utility analysis of four treatment strategies based on Korean medicine, Western medicine, and acupuncture use (3-year horizon, 4.5 % discount applied).
| Group | N | Mean Cost (KRW, USD) | Mean QALY | Δ Cost (KRW, USD) | Δ QALY | ICER (KRW/QALY, USD/QALY) |
|---|---|---|---|---|---|---|
| TKM (Ref) | 2832 | 62,267 (45.7) | 2.11 | Reference | Ref | Reference |
| TKM+AP | 26,059 | 147,087 (108.0) | 2.08 | 84,820 (62.3) | –0.0222 | Dominated |
| TKM+WM | 183 | 162,734 (119.6) | 2.10 | 100,467 (73.9) | –0.0101 | Dominated |
| TKM+WM+AP | 3867 | 248,174 (182.4) | 2.03 | 185,907 (136.7) | –0.0718 | Dominated |
Mean costs and QALYs were estimated using inverse probability of treatment weighting (IPTW).
3.4. Sensitivity analysis
Sensitivity analyses varying discount rates (0 %, 3 %, and 7.5 %) and utility values (±20 %) produced results consistent with the base-case (4.5 % discount rate, base-case utility). Across all scenarios, TKM care without acupuncture claims remained the dominant strategy, while the other three strategies were consistently dominated. Detailed results are provided in Supplement 2.
3.5. Uncertainty analysis: bootstrap and probabilistic sensitivity analysis
The bootstrap cost-effectiveness plane (Fig. 2A) showed that most replications for the TKM care without acupuncture claims strategy constituted a dominant cluster (lower costs, higher QALYs). The bootstrap acceptability curves (Fig. 2B) indicated that this strategy maintained the highest probability of cost-effectiveness across a wide range of willingness-to-pay (WTP) thresholds (up to KRW 30 million/QALY). PSA results were consistent with these findings: the PSA cost-effectiveness plane (Fig. 2C) and the PSA-derived CEAC (Fig. 2D) further confirmed the dominance of TKM care without acupuncture claims across all WTP thresholds. These probabilistic results quantify the uncertainty surrounding the parameter estimates and reinforce the robustness of the base-case conclusion.
Fig. 2.
Uncertainty analysis of cost-effectiveness for menopausal disorder treatment strategies. (A) Cost-effectiveness plane based on nonparametric bootstrap replications. (B) Cost-effectiveness acceptability curves (CEACs) derived from bootstrap replications. (C) PSA cost-effectiveness plane based on 1000 Monte Carlo simulations. (D) CEACs generated from PSA simulations. AP, Acupuncture; CEAC, Cost-Effectiveness Acceptability Curve; PSA, Probabilistic Sensitivity Analysis; QALY, Quality-Adjusted Life Year; TKM, Traditional Korean Medicine; WM, Western Medicine; WTP, Willingness-to-Pay.
4. Discussion
4.1. Summary of key findings
This study utilized real-world claims data to evaluate the cost-utility of four TKM-based strategies for menopausal disorders. TKM care without acupuncture claims was associated with lower overall costs and comparable QALY estimates relative to integrative strategies. However, the absolute differences in QALYs across groups were small, and the observed economic advantage should be interpreted cautiously. Integrative approaches involving acupuncture and/or Western medicine were associated with higher costs and slightly lower QALY estimates, a pattern likely reflecting their preferential use in patients with greater symptom severity or comorbidity burdens rather than inferior effectiveness.
4.2. Comparison with previous studies
While the clinical efficacy of acupuncture for menopausal symptoms is well-supported by meta-analyses,17, 18, 19, 20 economic evidence remains limited. Our findings differ from the UK-based “Acupuncture for Depression” trial, which reported acupuncture to be cost-effective (£4560/QALY).11,21 This difference may be largely explained by comparator choice: the UK study evaluated acupuncture against standard Western care, whereas our analysis compared acupuncture-inclusive TKM with an active TKM control. This suggests that while acupuncture may add value compared with standard care,15,22 its incremental cost-utility within an already comprehensive TKM framework may be more modest in routine practice.
4.3. Clinical and policy implications
These findings highlight the importance of stratified treatment models in menopausal care. The higher resource utilization observed in integrative treatment groups likely reflects a severity-driven allocation pattern, whereby combination therapies are selectively applied to patients with more refractory symptoms or greater clinical complexity.23,24
From a policy perspective, this supports the development of differentiated reimbursement systems that allow conservative TKM approaches to be used as initial management options, while preserving access to integrative care for patients with higher clinical need. Clinically, such an approach aligns with patient-centered care principles, emphasizing treatment individualization based on symptom burden rather than uniform escalation.
4.4. Strengths and limitations
This study is the first to systematically evaluate the cost-utility of four integrative treatment strategies using large-scale real-world data (N = 32,941). A key strength is the use of probabilistic sensitivity analysis and bootstrap resampling to characterize uncertainty around costs and QALYs, which is considered more appropriate for economic evaluations than reliance on single-point estimates or hypothesis testing.13,25
Several limitations should be noted. First, QALYs were derived from literature-based utility values rather than direct patient-reported measures (e.g., EQ-5D or MENQOL), which may underestimate subtle quality-of-life benefits associated with acupuncture.4,26 Second, the absence of a Western medicine–only comparator limits broader generalizability. Third, despite IPTW adjustment, residual confounding by disease severity likely remains, suggesting that the lower effectiveness observed in integrative groups may reflect confounding by indication rather than true inferiority.27
4.5. Conclusion
In this nationwide cohort study, TKM care without acupuncture claims was associated with lower costs and similar health outcomes compared with integrative treatment strategies for menopausal disorders. However, the economic advantage observed should not be interpreted as a strictly dominant effect, given the small absolute differences in QALYs and the likelihood of severity-driven treatment allocation. Future research should prioritize prospective studies incorporating patient-reported outcomes and explicit stratification by symptom severity to more definitively inform clinical and policy decision-making.
Funding
This study was supported by the Korea Institute of Oriental Medicine (KIOM) (Grant No. KSN2512012) and by grants from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (Grant Nos. NHN2312060, RS-2023-KH139021, RS-2020-KH088006).
Ethics statement
This study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the Institutional Review Board of the Korea Institute of Oriental Medicine (IRB approval number: I-2403/003–001). The requirement for informed consent was waived due to the retrospective design and use of anonymized data.
Data availability
The data that support the findings of this study are available from the National Health Insurance Service (NHIS) of Korea. However, restrictions apply to the availability of these data, which were used under license for the current study and are not publicly available. Researchers may request access to the data directly from the NHIS subject to approval.
Use of generative AI
During the preparation of this work, the authors used ChatGPT (OpenAI) to improve the clarity, structure, and language of the manuscript. Subsequently, the manuscript was professionally edited for English language by Editage (Cactus Communications). The authors reviewed and edited the content as needed and take full responsibility for the content of the publication.
Declaration of competing interest
The authors have no conflicts of interest to declare.
Acknowledgments
The data used in this study were obtained from the Health Insurance Review and Assessment Service (HIRA) under project number M20250121001. We also thank our colleagues at the Korea Institute of Oriental Medicine for their administrative and technical support throughout the study.
Footnotes
Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.imr.2026.101315.
Supplement 1. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist.
Supplement 2. Sensitivity analyses of cost–utility outcomes across discount rates and utility scenarios.
Supplement 3. Annual Consumer Price Index (CPI) in Korea.
Appendix. Supplementary materials
References
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The data that support the findings of this study are available from the National Health Insurance Service (NHIS) of Korea. However, restrictions apply to the availability of these data, which were used under license for the current study and are not publicly available. Researchers may request access to the data directly from the NHIS subject to approval.