The Cost-Effectiveness Analysis of Laparoscopic Hepatectomy Compared with Open Liver Resection in the Early Stage of Hepatocellular Carcinoma: A Decision-Analysis Model in Thailand

HPB ◽  
2021 ◽  
Author(s):  
Jumpol Singhirunnusorn ◽  
Siwaporn Niyomsri ◽  
Piyameth Dilokthornsakul
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cost Effectiveness ◽  
Liver Resection ◽  
Early Stage ◽  
Laparoscopic Hepatectomy ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Open Liver Resection ◽  
Effectiveness Analysis ◽  
The Cost

Meta-analysis and cost-effectiveness of second-line antiepileptic drugs for status epilepticus

Neurology ◽  
2019 ◽  
Vol 92 (20) ◽  
pp. e2339-e2348 ◽  
Author(s):  
Iván Sánchez Fernández ◽  
Marina Gaínza-Lein ◽  
Nathan Lamb ◽  
Tobias Loddenkemper
Keyword(s):  
Status Epilepticus ◽  
Cost Effectiveness ◽  
Antiepileptic Drugs ◽  
Meta Analysis ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Convulsive Status Epilepticus ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
The Cost

ObjectiveCompare the cost and effectiveness of nonbenzodiazepine antiepileptic drugs (non-BZD AEDs) for treatment of BZD-resistant convulsive status epilepticus (SE).MethodsDecision analysis model populated with effectiveness data from a systematic review and meta-analysis of the literature, and cost data from publicly available prices. The primary outcome was cost per seizure stopped ($/SS). Sensitivity analyses evaluated the robustness of the results across a wide variation of the input parameters.ResultsWe included 24 studies with 1,185 SE episodes. The most effective non-BZD AED was phenobarbital (PB) with a probability of SS of 0.8 (95% confidence interval [CI]: 0.69–0.88), followed by valproate (VPA) (0.71 [95% CI: 0.61–0.79]), lacosamide (0.66 [95% CI: 0.51–0.79]), levetiracetam (LEV) (0.62 [95% CI: 0.5–0.73]), and phenytoin/fosphenytoin (PHT) (0.53 [95% CI: 0.39–0.67]). In pairwise comparisons, PB was more effective than PHT (p = 0.002), VPA was more effective than PHT (p = 0.043), and PB was more effective than LEV (p = 0.018). The most cost-effective non-BZD AED was LEV (incremental cost-effectiveness ratio [ICER]: $18.55/SS), followed by VPA (ICER: $94.44/SS), and lastly PB (ICER: $847.22/SS). PHT and lacosamide were not cost-effective compared to the other options. Sensitivity analyses showed marked overlap in cost-effectiveness, but PHT was consistently less cost-effective than LEV, VPA, and PB.ConclusionVPA and PB were more effective than PHT for SE. There is substantial overlap in the cost-effectiveness of non-BZD AEDs for SE, but available evidence does not support the preeminence of PHT, neither in terms of effectiveness nor in terms of cost-effectiveness.

scholarly journals Assessment of the Clinical and Economic Impact of Different Immunization Protocols of Measles, Mumps, Rubella and Varicella in Internationally Adopted Children

Vaccines ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 60 ◽  
Author(s):  
Sara Boccalini ◽  
Angela Bechini ◽  
Cecilia Maria Alimenti ◽  
Paolo Bonanni ◽  
Luisa Galli ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Economic Impact ◽  
Minimum Cost ◽  
Point Of View ◽  
Decision Analysis Model ◽  
Adopted Children ◽  
Analysis Model ◽  
Internationally Adopted Children ◽  
The Cost ◽  
Internationally Adopted

The appropriate immunization of internationally adopted children (IAC) is currently under debate and different approaches have been suggested. The aim of this study is to evaluate the clinical and economic impact of different strategies of measles, mumps, rubella, and varicella (MMRV) immunization in IAC in Italy. A decision analysis model was developed to compare three strategies: presumptive immunization, pre-vaccination serotesting and vaccination based on documentation of previous immunization. Main outcomes were the cost of strategy, number of protected IAC, and cost per child protected against MMRV. Moreover, the incremental cost-effectiveness ratio (ICER) was calculated. The strategy currently recommended in Italy (immunize based on documentation) is less expensive. On the other hand, the pre-vaccination serotesting strategy against MMRV together, improves outcomes with a minimum cost increase, compared with the presumptive immunization strategy and compared with the comparator strategy. From a cost-effectiveness point of view, vaccination based on serotesting results in being the most advantageous strategy compared to presumptive vaccination. By applying a chemiluminescent immunoassay test, the serology strategy resulted to be clinically and economically advantageous. Similar results were obtained excluding children aged <1 year for both serology methods. In conclusion, based on our analyses, considering MMRV vaccine, serotesting strategy appears to be the preferred option in IAC.

PROBABILISTIC SENSITIVITY ANALYSIS IN COST-EFFECTIVENESS

1999 ◽  
Vol 15 (3) ◽  
pp. 563-572 ◽  
Author(s):  
William Whang ◽  
Jane E. Sisk ◽  
Daniel F. Heitjan ◽  
Alan J. Moskowitz
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Probabilistic Sensitivity Analysis ◽  
Probabilistic Methods ◽  
Policy Implications ◽  
Sensitivity Analyses ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Worst Case ◽  
The Cost

Objectives: We explore the policy implications of probabilistic sensitivity analysis in cost-effectiveness analysis by applying simulation methods to a decision model.Methods: We present the multiway sensitivity analysis results of a study of the cost-effectiveness of vaccination against pneumococcal bacteremia in the elderly. We then execute a probabilistic sensitivity analysis of the cost-effectiveness ratio by specifying posterior distributions for the uncertain parameters in our decision analysis model. In order to estimate probability intervals, we rank the numerical values of the simulated incremental cost-effectiveness ratios (ICERs) to take into account preferences along the cost-effectiveness plane.Results: The 95% probability intervals for the ICER were generally much narrower than the difference between the best case and worst case results from a multiway sensitivity analysis. Although the multiway sensitivity analysis had indicated that, in the worst case, vaccination in the 85 and older age group was not acceptable from a policy standpoint, probabilistic methods indicated that the cost-effectiveness of vaccination was below $50,000 per quality-adjusted life-year in greater than 92% of the simulations and below $100,000 in greater than 95% of the simulations.Conclusions: Probabilistic methods can supplement multiway sensitivity analyses to provide a more comprehensive picture of the uncertainty associated with cost-effectiveness ratios and thereby inform policy decisions.

scholarly journals Enhanced recovery programme for open liver resection improves hospital costs and two-year survival without increasing costs in primary care. (Preprint)

2019 ◽  
Author(s):  
Chris N Jones ◽  
Ben L Morrison ◽  
Leigh J S Kelliher ◽  
Matthew Dickinson ◽  
Michael Scott ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Liver Resection ◽  
Standard Care ◽  
Enhanced Recovery ◽  
Study Endpoint ◽  
Term Survival ◽  
System Perspective ◽  
Open Liver Resection ◽  
Life Years ◽  
The Cost

BACKGROUND The clinical benefits of enhanced recovery programmes [ERPs] have been extensively researched, but few studies have evaluated the cost-effectiveness of programmes. This study follows on from a previous randomised controlled trial. OBJECTIVE To evaluate the cost-effectiveness and impaxct upon long-term survival of an enhanced recovery after surgery programme for patients undergoing open liver resection surgery. METHODS A decision-analytic model was used to compare the study endpoint Enhanced Recovery versus standard care provided to patient with open liver resection. Outcomes obtained were costs per life-years gained. Resource use and costs were estimated from the National Health System perspective. The Decision tree and Markov Model were constructed using the original results and augmented by external data of published clinical trials. RESULTS Patients receiving Enhanced Recovery had an average life expectancy of 6.9 years versus 6.1 years in the standard group. Costs were 9538.279 GBP for ERP and 14793.05 GBP for standard treatment. This results in a cost-effectiveness ratio of -6748.33 GBP/QALY. Patients required fewer visits to their GP (p=0.006) and required less help at home with day to day activities (p=0.036). Survival at 2 years was 91.3% (ERP) vs 71.3% for the standard care group (p=0.03). CONCLUSIONS Enhanced Recovery for open liver resection can improve medium-term survival and is cost effective for both hospital and community settings. CLINICALTRIAL ISRCTN03274575 - http://www.controlled-trials.com

scholarly journals The cost-effectiveness of palivizumab in infants with cystic fibrosis in the Canadian setting: A decision analysis model

2016 ◽  
Vol 13 (3) ◽  
pp. 599-606 ◽  
Author(s):  
Ashleigh A. McGirr ◽  
Kevin L. Schwartz ◽  
Upton Allen ◽  
Melinda Solomon ◽  
Beate Sander
Keyword(s):  
Cystic Fibrosis ◽  
Cost Effectiveness ◽  
Decision Analysis ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Canadian Setting ◽  
The Cost

scholarly journals Analysis Model of Cost-Effectiveness for Value Evaluation of Building Elements

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Jongsik Lee
Keyword(s):  
Cost Effectiveness ◽  
Physical Performance ◽  
Evaluation Method ◽  
Cost Effectiveness Analysis ◽  
Analysis Model ◽  
Value Evaluation ◽  
Effectiveness Analysis ◽  
Physical Performances ◽  
The Cost ◽  
Building Elements

As various building materials have been developed, the combination of materials that make up the building elements has also increased exponentially. The materials making up the elements of the building will affect the performance of the building and the LCC. In order to improve the value of buildings in Korea, value engineering has been mandated in public construction projects with a project cost of over 10 billion won since 2000. The value index for systems (materials, elements, facilities, etc.) constituting buildings is calculated. However, the method for calculating the value index has not yet been normalized. The performance evaluation of the building systems (materials, elements, facilities, etc.) used in the current work and the method of calculating the value index for converting the LCC into a grade may vary depending on how the range of the grade is set. Even if the objects being evaluated are the same, there arises a problem that the results change depending on the value evaluation method. Therefore, this study tried to develop a value evaluation method that could draw consistent value evaluation results. For this purpose, this study presents a cost-effectiveness analysis model for the physical performance of the building elements and the value evaluation of LCC. Since the various physical performances of the building elements have different properties, normalization is required for comparison of physical performance values. In order to normalize the LCC and the 14 different physical performances of the building elements, a numerical model was designed using a linear transformation method and a vector normalization method. The cost-effectiveness analysis model proposed in this study was applied to two types of floor elements applicable to apartments in Korea, in order to evaluate the value and verify the consistency of this study’s model. The cost-effectiveness analysis model proposed in this study can help to derive reliable results when it comes to value evaluation for various existing building element compositions.

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