scholarly journals The cost-effectiveness and cost-utility analysis of the use of enoxaparin compared with heparin for venous thromboembolism prophylaxis in medical inpatients in Iran

2019 ◽  
Vol 27 (2) ◽  
pp. 627-634
Author(s):  
Mohammadreza Amirsadri ◽  
Sarah Mousavi ◽  
Ali Karimipour
Keyword(s):  
Venous Thromboembolism ◽  
Cost Effectiveness ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Thromboembolism Prophylaxis ◽  
Venous Thromboembolism Prophylaxis ◽  
Medical Inpatients ◽  
The Cost

scholarly journals Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mireia Massot Mesquida ◽  
Frans Folkvord ◽  
Gemma Seda ◽  
Francisco Lupiáñez-Villanueva ◽  
Pere Torán Monserrat
Keyword(s):  
Cost Effectiveness ◽  
Psychotropic Drugs ◽  
Medication Review ◽  
Standard Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Current Standard ◽  
Dementia Patients ◽  
The Cost

Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool. Methods The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months. Results The tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). Conclusions The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.

scholarly journals Economic Evaluation of an Internet-Based Stress Management Intervention Alongside a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Fanny Kählke ◽  
Claudia Buntrock ◽  
Filip Smit ◽  
Matthias Berking ◽  
Dirk Lehr ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Stress Management ◽  
Perceived Stress ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Management Interventions ◽  
Life Years ◽  
The Cost

BACKGROUND Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant. OBJECTIVE The aim of this study was to assess the cost-effectiveness of a guided iSMI for employees. METHODS A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000). RESULTS When the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained. CONCLUSIONS Offering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC. CLINICALTRIAL German Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749 INTERNATIONAL REGISTERED REPOR RR2-10.1186/1471-2458-13-655

scholarly journals 1-year cost-utility analysis of prostate artery embolization (PAE) versus transurethral resection of the prostate (TURP) in benign prostatic hyperplasia (BPH)

2021 ◽  
Vol 3 (1) ◽  
pp. e000071
Author(s):  
Nikisha Patel ◽  
Nathan Yung ◽  
Ganesh Vigneswaran ◽  
Laure de Preux ◽  
Drew Maclean ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Artery Embolization ◽  
Prostate Artery Embolization ◽  
Cost Effective Alternative ◽  
The Cost

ObjectiveTo determine whether prostate artery embolization (PAE) is a cost-effective alternative to transurethral resection of the prostate (TURP) in the management of benign prostate hyperplasia (BPH) after 1-year follow-up.Design, setting and main outcome measuresA retrospective cost-utility analysis over a 12-month time period was conducted to compare the two interventions from a National Health Service perspective. Effectiveness was measured as quality-adjusted life years (QALYs) derived from data collected during the observational UK Register of Prostate Embolisation (UK-ROPE) Study. Costs for both PAE and TURP were derived from University Hospital Southampton, a tertiary referral centre for BPH and the largest contributor to the UK-ROPE. An incremental cost-effectiveness ratio (ICER) was derived from cost and QALY values associated with both interventions to assess the cost-effectiveness of PAE versus TURP. Further sensitivity analyses involved a decision tree model to account for the impact of patient-reported complications on the cost-effectiveness of the interventions.ResultsThe mean patient age for TURP (n=31) and PAE (n=133) was 69 and 65.6 years, respectively. In comparison to TURP, PAE was cheaper due to shorter patient stays and the lack of necessity for an operating theatre. Analysis revealed an ICER of £64 798.10 saved per QALY lost when comparing PAE to TURP after 1-year follow-up.ConclusionOur findings suggest that PAE is initially a cost-effective alternative to TURP for the management of BPH after 1-year follow-up. Due to a higher reintervention rate in the PAE group, this benefit may be lost in subsequent years.Trial registration numberNCT02434575.

scholarly journals Influence of Patient Preferences on the Cost-Effectiveness of Screening for Lynch Syndrome

2012 ◽  
Vol 8 (3S) ◽  
pp. e24s-e30s ◽  
Author(s):  
Grace Wang ◽  
Miriam Kuppermann ◽  
Benjamin Kim ◽  
Kathryn A. Phillips ◽  
Uri Ladabaum
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Lynch Syndrome ◽  
Patient Preferences ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
The Cost

This cost-utility analysis reports on the effect of quality of life on the value of screening all new patients with colorectal cancer for Lynch syndrome.

scholarly journals Economic Evaluation of an Internet-Based Stress Management Intervention Alongside a Randomized Controlled Trial

10.2196/10866 ◽  
2019 ◽  
Vol 6 (5) ◽  
pp. e10866 ◽  
Author(s):  
Fanny Kählke ◽  
Claudia Buntrock ◽  
Filip Smit ◽  
Matthias Berking ◽  
Dirk Lehr ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Stress Management ◽  
Perceived Stress ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Management Interventions ◽  
Life Years ◽  
The Cost

Background Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant. Objective The aim of this study was to assess the cost-effectiveness of a guided iSMI for employees. Methods A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000). Results When the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained. Conclusions Offering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC. Trial Registration German Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749 International Registered Report Identifier (IRRID) RR2-10.1186/1471-2458-13-655

scholarly journals Cost-Utility Analysis of Hearing Aid Device for Older Adults in the Community: A Delayed Start Study

2020 ◽  
Author(s):  
Palvinder Kaur ◽  
Sheue Lih Chong ◽  
Palvannan Kannapiran ◽  
Kelvin WS Teo ◽  
Charis Ng Wei Ling ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cost Effectiveness ◽  
Healthcare Costs ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Index Visit ◽  
Life Years ◽  
The Cost

Abstract BackgroundHearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community based mobile hearing clinic (MHC).MethodsParticipants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years.ResultsThere were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8,996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased.ConclusionsHA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.

scholarly journals COST-UTILITY ANALYSIS OF ARTHROSCOPIC MATRIX-BASED MENISCUS REPAIR (AMMR) IN THE PERSPECTIVE OF POLISH NATIONAL HEALTH SERVICE AND PRIVATE PATIENTS – 10-YEAR HORIZON

2021 ◽  
Vol 35 (35) ◽  
pp. 17-30
Author(s):  
Kinga Ciemniewska-Gorzela ◽  
Tomasz Piontek ◽  
Jakub Naczk ◽  
Paweł Bąkowski ◽  
Justus Gille ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Cost Utility ◽  
Meniscus Repair ◽  
Cost Utility Analysis ◽  
Health State ◽  
Utility Analysis ◽  
The Cost

Introduction Clinical data has indicated that Arthroscopic Matrix-based Meniscus Repair (AMMR) offers a means to preserve the meniscus in patients who would otherwise be scheduled for meniscectomy, although AMMR has significant upfront costs. Aim The objective of this study was to estimate the cost-effectiveness of AMMR in Poland in both the National Health Service (PNHS) and from the perspective of private patients (PP). Material and methods A Markov health-state model was developed to evaluate the cost-utility analysis of AMMR compared to meniscectomy (ME) for patients with a complex meniscus tear, using a 10-years horizon, modelling a cohort of 1000 patients. Initial probabilities and clinical course were simulated based on previously published data. A literature review identified different clinical outcome probabilities and health-related utility scores associated with each health state. Cost-effectiveness was presented as an indicator of Incremental Cost-Utility Ratio (ICUR). Costs were taken from published sources for the perspective of PNHS and from a private clinic offers for the perspective of PP. Results In the 10-year horizon, AMMR was associated with an increase in discounted qualityadjusted life-years (QALYs) to 7 778.25 compared to 7 454.33 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than willingness to pay (WTP) parameter (PNHSICUR = 34.212.92 versus PP-ICUR = 29.897.36). Conclusions: Despite the increase in costs, the procedure is cost-effective at standard thresholds used in Poland for analyzed perspectives. Keywords: knee; meniscus; collagen matrix; cost-effectiveness; economic analysis; Markov model

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