scholarly journals Identifying The Most Cost-Effective Way of Diagnosing Asthma In Adults Using Multiple Tests – A Cost-Utility Analysis From The Nice Asthma Guideline

2015 ◽  
Vol 18 (7) ◽  
pp. A361
Author(s):  
A Haines ◽  
E Davies ◽  
B Higgins ◽  
A Menzies-Gow ◽  
M Thomas ◽  
...  
Keyword(s):  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Multiple Tests ◽  
Asthma Guideline

scholarly journals A one-year cost–utility analysis of REBOA versus RTACC for non-compressible torso haemorrhage

Trauma ◽  
2017 ◽  
Vol 21 (1) ◽  
pp. 45-54 ◽  
Author(s):  
Maxwell S Renna ◽  
Cristiano van Zeller ◽  
Farah Abu-Hijleh ◽  
Cherlyn Tong ◽  
Jasmine Gambini ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Cost Effectiveness Ratio ◽  
One Year ◽  
Quality Adjusted Life

Introduction Major trauma is a leading cause of death and disability in young adults, especially from massive non-compressible torso haemorrhage. The standard technique to control distal haemorrhage and maximise central perfusion is resuscitative thoracotomy with aortic cross-clamping (RTACC). More recently, the minimally invasive technique of resuscitative endovascular balloon occlusion of the aorta (REBOA) has been developed to similarly limit distal haemorrhage without the morbidity of thoracotomy; cost–utility studies on this intervention, however, are still lacking. The aim of this study was to perform a one-year cost–utility analysis of REBOA as an intervention for patients with major traumatic non-compressible abdominal haemorrhage, compared to RTACC within the U.K.’s National Health Service. Methods A retrospective analysis of the outcomes following REBOA and RTACC was conducted based on the published literature of survival and complication rates after intervention. Utility was obtained from studies that used the EQ-5D index and from self-conducted surveys. Costs were calculated using 2016/2017 National Health Service tariff data and supplemented from further literature. A cost–utility analysis was then conducted. Results A total of 12 studies for REBOA and 20 studies for RTACC were included. The mean injury severity scores for RTACC and REBOA were 34 and 39, and mean probability of death was 9.7 and 54%, respectively. The incremental cost-effectiveness ratio of REBOA when compared to RTACC was £44,617.44 per quality-adjusted life year. The incremental cost-effectiveness ratio, by exceeding the National Institute for Health and Clinical Effectiveness’s willingness-to-pay threshold of £30,000/quality-adjusted life year, suggests that this intervention is not cost-effective in comparison to RTACC. However, REBOA yielded a 157% improvement in utility with a comparatively small cost increase of 31.5%. Conclusion Although REBOA has not been found to be cost-effective when compared to RTACC, ultimately, clinical experience and expertise should be the main factor in driving the decision over which intervention to prioritise in the emergency context.

VALUE-BASED MEDICINE, COST-UTILITY ANALYSIS WHAT IS COST-EFFECTIVE?

2010 ◽  
Vol 11 (3) ◽  
pp. 180-186
Author(s):  
Gary C. Brown ◽  
Melissa M. Brown ◽  
Peter Kertes ◽  
Heidi B. Lieske ◽  
Philip Alex Lieske ◽  
...  
Keyword(s):  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Based Medicine

scholarly journals Cost-Utility Analysis of Tympanomastoidectomy for Adults with Chronic Suppurative Otitis Media

2005 ◽  
Vol 133 (3) ◽  
pp. 352-356 ◽  
Author(s):  
Pa-Chun Wang ◽  
Chul-Ho Jang ◽  
Yu-Hsiang Shu ◽  
Chih-Jaan Tai ◽  
Ko-Tsung Chu
Keyword(s):  
Otitis Media ◽  
Health Care Cost ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Chronic Suppurative Otitis Media ◽  
Total Direct Cost ◽  
Utility Analysis ◽  
Suppurative Otitis Media ◽  
Utility Gain

OBJECTIVE: To undertake cost-utility analysis for tympanomastoid surgery to analyze its cost-effectiveness in treating adult chronic suppurative otitis media (CSOM). METHODS: Seventy-seven patients with CSOM were evaluated with the Chronic Ear Survey (CES) before and 1 year after tympanomastoid surgery. Direct health care cost data during the 1st year after operation were retrieved. The utility gain was defined as change in the CES total score. The cost-utility ratio (CUR) was defined as cost per utility gain. Patients were stratified by disease type into wet-ear and dry-ear groups. RESULTS: The average total direct cost attributable to tympanomastoid surgery is (in New Taiwan dollars [NT$]) 45,716.3 in the 1st postoperative year, and the average CUR is NT$ 1850.9. The lower CUR of NT$ 1280.9 for the wet-ear group is due to the greater utility gain (37.6 ± 3.4 versus 24.4 ± 6.8, P >0.05) despite its higher cost (NT$ 48,163.2 versus NT$ 38,419.7, P >0.05). CONCLUSIONS: Treating continuously or intermittently draining ears is more cost-effective, as compared with managing a quiescent infection, because of its favorable utility gain.

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 Cost-utility analysis of an implant treatment in dentistry

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Johana Losenická ◽  
Ondřej Gajdoš ◽  
Vojtěch Kamenský
Keyword(s):  
Markov Models ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Dental Prosthesis ◽  
Utility Analysis ◽  
Fixed Dental Prosthesis ◽  
Single Crown ◽  
Implant Treatment ◽  
Missing Tooth

Abstract Background When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area. Methods Cost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon. Results Based on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD − 1434. Conclusion The results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.

scholarly journals Shunt surgery in iNPH patients is cost-effective – a cost-utility analysis in the Western Sweden setting

2015 ◽  
Vol 12 (Suppl 1) ◽  
pp. O50 ◽  
Author(s):  
Mats Tullberg ◽  
Jakob Petersen ◽  
Josefine Persson ◽  
Daniel Jaraj ◽  
Kerstin Andrén ◽  
...  
Keyword(s):  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Shunt Surgery ◽  
Utility Analysis

scholarly journals Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial)

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018640 ◽  
Author(s):  
Monica Panca ◽  
Deborah Christie ◽  
Tim J Cole ◽  
Silvia Costa ◽  
John Gregson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Resource Use ◽  
Standard Care ◽  
Controlled Trial ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Community Settings ◽  
Utility Analysis ◽  
Randomised Controlled

ObjectiveTo undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care.DesignCost-utility analysis alongside a randomised controlled trial.SettingCommunity settings in Greater London, England.Participants174 young people with obesity aged 12–19 years.InterventionsIntervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice.Main outcome measuresMean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC).ResultsMean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI −0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained.ConclusionsWe did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective.Trial registration numberISRCTN99840111.

scholarly journals Cost-utility analysis of mechanical thrombectomy between 6 and 24 hours in acute ischemic stroke

2019 ◽  
Vol 15 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Elena Pizzo ◽  
Maureen Dumba ◽  
Kyriakos Lobotesis
Keyword(s):  
Ischemic Stroke ◽  
Medical Treatment ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Life Years ◽  
The Uk

Background Recently, two randomized controlled trials demonstrated the benefit of mechanical thrombectomy performed between 6 and 24 h in acute ischemic stroke. The current economic evidence is supporting the intervention only within 6 h, but extended thrombectomy treatment times may result in better long-term outcomes for a larger cohort of patients. Aims We compared the cost-utility of mechanical thrombectomy in addition to medical treatment versus medical treatment alone performed beyond 6 h from stroke onset in the UK National Health Service (NHS). Methods A cost-utility analysis of mechanical thrombectomy compared to medical treatment was performed using a Markov model that estimates expected costs and quality-adjusted life years (QALYs) over a 20-year time horizon. We present the results of three models using the data from the DEFUSE 3 and DAWN trials and evidence from published sources. Results Over a 20-year period, the incremental cost per QALY of mechanical thrombectomy was $1564 (£1219) when performed after 12 h from onset, $5253 (£4096) after 16 h and $3712 (£2894) after 24 h. The probabilistic sensitivity analysis demonstrated that thrombectomy had a 99.9% probability of being cost-effective at the minimum willingness to pay for a QALY commonly used in the UK. Conclusions The results of this study demonstrate that performing mechanical thrombectomy up to 24 h from acute ischemic stroke symptom onset is still cost-effective, suggesting that this intervention should be implemented by the NHS on the basis of improvement in quality of life as well as economic grounds.

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