PCV21 Cost-Effectiveness of Atorvastatin Versus Simvastatin in Prevention of Cardiovascular Events from a Thailand Societal Perspective

Increasing attention is being paid to policy decisions in which shorter-term benefits may be eclipsed by longer-term harms, such as environmental damage. Health policy decisions have largely been spared this scrutiny, even though they too may contribute to longer-term harms. Any healthy population or society must sustain itself through reproduction, and therefore, transgenerational outcomes should be of intrinsic importance from a societal perspective. Yet, the discount rates typically employed in cost-effectiveness analyses have the effect of minimizing the importance of transgenerational health outcomes. We argue that, because cost-effectiveness analysis is based on foundational axioms of decision theory, it should value transgenerational outcomes consistently with those axioms, which require discount rates substantially lower than 3%. We discuss why such lower rates may not violate the Cretin-Keeler paradox.

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PCV55 Cost-Effectiveness of Icosapent Ethyl (IPE) for the Reduction of the Risk of Ischemic Cardiovascular Events in Canada.

Value in Health ◽

10.1016/j.jval.2020.08.546 ◽

2020 ◽

Vol 23 ◽

pp. S496

Author(s):

J. Lachaine ◽

J.N. Charron ◽

J.C. Gregoire ◽

R.A. Hegele ◽

L.A. Leiter

Keyword(s):

Cost Effectiveness ◽

Cardiovascular Events ◽

Icosapent Ethyl

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Cost-effectiveness analysis of ranibizumab for retinal vein occlusion patients in China from the societal perspective

BMC Ophthalmology ◽

10.1186/s12886-021-01997-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weiyi Ni ◽

Jia Liu ◽

Yawen Jiang ◽

Jing Wu

Keyword(s):

Cost Effectiveness ◽

Retinal Vein Occlusion ◽

Societal Perspective ◽

Laser Photocoagulation ◽

Cost Effective ◽

Sensitivity Analyses ◽

Gdp Per Capita ◽

Base Case ◽

Vein Occlusion ◽

Per Capita

Abstract Background Clinical trials in China have demonstrated that ranibizumab can improve the clinical outcomes of branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). However, no economic evaluation of ranibizumab has been conducted among Chinese patient population. Methods To provide insights into the economic profile of ranibizumab among Chinese RVO population, a Markov state-transition model was used to predict the outcomes of ranibizumab comparing to laser photocoagulation and observational-only care from the societal perspective. This model simulated changes in patient visuality, quality-adjusted of life years (QALY), medical costs, and direct non-medical costs of individuals with visual impairment due to BRVO or CRVO in lifetime. The base-case analysis used an annual discount rate of 5% for costs and benefits following the China Guidelines for Pharmacoeconomic Evaluations. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the model. Results The base-case incremental cost-effectiveness ratio (ICER) comparing ranibizumab to laser photocoagulation was ¥65,008/QALY among BRVO patients and was ¥65,815/QALY among CRVO patients, respectively. Comparing to the 2019 gross domestic product (GDP) per capita of ¥71,000, both two ICERs were far below the cost-effective threshold at three times of GDP per capita (¥213,000). The deterministic and probabilistic sensitivity analyses demonstrated the base-case results were robust in most of the simulation scenarios. Conclusion The current Markov model demonstrated that ranibizumab may be cost-effective compared with laser photocoagulation to treat BRVO and cost-effective compared to observation-only care to treat CRVO in China from the societal perspective.

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OP65 Pharmacoeconomic Evaluation Of Orphan Drugs: Impact Of Extra Criteria?

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319001260 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 16-16

Author(s):

Orla Maguire ◽

Laura McCullagh ◽

Cara Usher ◽

Michael Barry

Keyword(s):

Cost Effectiveness ◽

Orphan Drug ◽

Societal Perspective ◽

Evaluation Process ◽

Orphan Drugs ◽

Pharmacoeconomic Evaluation ◽

Qaly Gain ◽

Minor Effect ◽

Orphan Medicinal Products ◽

A Minor

IntroductionThere is ongoing debate as to whether conventional pharmacoeconomic evaluation (PE) methods are appropriate for orphan medicinal products (OMPs). The National Centre for Pharmacoeconomics (NCPE) in Ireland has a well-defined process for conducting pharmacoeconomic evaluations of pharmaceuticals, which is the same for OMPs and non-OMPs. The objective of this study was to identify whether supplementary criteria considered in the pharmacoeconomic evaluation of OMPs would affect final reimbursement recommendations.MethodsA literature search was conducted to identify criteria. Orphan drug pharmacoeconomic evaluations completed by the NCPE between January 2015 and December 2017 were identified and supplementary criteria, where feasible, were applied.ResultsFourteen pharmacoeconomic evaluations were included in the study. Three criteria that could feasibly be applied to the NCPE evaluation process were identified, all three of which essentially broadened the economic perspective of the pharmacoeconomic evaluation. Higher cost-effectiveness threshold: Despite being arbitrarily raised from EUR 45,000/QALY to EUR 100,000/QALY, only one orphan drug demonstrated cost-effectiveness at this higher threshold. Weighted QALY gain: here, a weighted gain of between one and three is applied to drugs demonstrating QALY gains between 10 and 30, respectively. No OMPs included in the study showed a QALY gain of more than 10. Thirteen demonstrated QALY gains less than 10 and one could not be evaluated. Societal perspective: six submissions incorporated societal perspective as a scenario analysis. Despite incremental cost-effectiveness ratios (ICERs) being reduced between 4 percent and 58 percent, only two OMPs demonstrated cost-effectiveness at the higher threshold (EUR 100,000/QALY).ConclusionsApplication of supplementary criteria to the pharmacoeconomic evaluation of OMPs had a minor effect on three products assessed. However, for the majority, the final cost-effectiveness outcomes remained the same. The study highlights that other criteria are being considered in the decision to reimburse.

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Modeling the cost-effectiveness of a new treatment for MS (natalizumab) compared with current standard practice in Sweden

Multiple Sclerosis Journal ◽

10.1177/1352458507086667 ◽

2008 ◽

Vol 14 (5) ◽

pp. 679-690 ◽

Cited By ~ 31

Author(s):

G Kobelt ◽

J Berg ◽

P Lindgren ◽

B Jonsson ◽

L Stawiarz ◽

...

Keyword(s):

Clinical Trial ◽

Cost Effectiveness ◽

Societal Perspective ◽

Functional Disability ◽

Health Benefit ◽

Base Case ◽

Current Standard ◽

Disease Modifying Drugs ◽

New Treatment ◽

The Cost

Objective To estimate the cost-effectiveness of a new treatment (natalizumab) for multiple sclerosis (MS) compared with current standard therapy with disease-modifying drugs (DMDs) in Sweden. Methods A Markov model was constructed to illustrate disease progression based on functional disability (the Expanded Disability Status Scale (EDSS)). The effectiveness of natalizumab was based on a 2-year clinical trial in 942 patients (AFFIRM). The effectiveness of current DMDs was estimated from a matched sample of 512 patients in the Stockholm MS registry. Patients withdrawing from treatment were assumed to follow the disease course of 824 patients with relapsing–remitting disease at onset in the Ontario natural history cohort. Costs and utilities are based on a recent observational study in 1339 patients. All data sets were available at the patient level. Main results are presented from the societal perspective, over a 20-year time frame, in 2005 Euros (€1 = 9.25 SEK). Results In the base case, treatment with natalizumab was less expensive and more effective than treatment with current DMDs. When only healthcare costs were considered, the cost per quality-adjusted life year gained with natalizumab was €38 145. Results are sensitive only to the time horizon of the analysis and assumptions about effectiveness of natalizumab beyond the trial. Conclusions This cost-effectiveness analysis used registry data, cohort and observational studies to extrapolate the efficacy findings of natalizumab from the AFFIRM clinical trial to measure effectiveness in clinical practice. The analysis results suggest that for the population considered, natalizumab provides an additional health benefit at a similar cost to current DMDs from a societal perspective.

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PND23 Cost-effectiveness of Fremanezumab from a Societal Perspective in England

Value in Health ◽

10.1016/j.jval.2021.04.807 ◽

2021 ◽

Vol 24 ◽

pp. S162-S163

Author(s):

A. Skroumpelos ◽

M. Freddi ◽

H. Akcicek ◽

J.M. Cohen ◽

M.T. Driessen

Keyword(s):

Cost Effectiveness ◽

Societal Perspective

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Diabetes Drugs and Cardiovascular Event Reduction: A Paradigm Shift

US Cardiology Review ◽

10.15420/usc.2017:35:1 ◽

2018 ◽

Vol 12 (1) ◽

pp. 46-50

Author(s):

Erik M Kelly ◽

Donald E Cutlip

Keyword(s):

Clinical Practice ◽

Cost Effectiveness ◽

Paradigm Shift ◽

Cardiovascular Events ◽

Outcome Data ◽

Review Article ◽

Sodium Glucose Cotransporter ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Effectiveness Data

This review article summarizes the recent cardiovascular outcome data for sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 analogues, which have been found to reduce cardiovascular events. We also detail the implications these new medications will have on clinical practice through a review of recent diabetes guidelines and cost-effectiveness data.

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Cost-Effectiveness Analysis of a Large-Scale Crèche Intervention to Prevent Child Drowning in Rural Bangladesh

10.21203/rs.3.rs-402414/v1 ◽

2021 ◽

Author(s):

Y. Natalia Alfonso ◽

Adnan A Hyder ◽

Olakunle Alonge ◽

Shumona Sharmin Salam ◽

Kamran Baset ◽

...

Keyword(s):

Cost Effectiveness ◽

Societal Perspective ◽

Large Scale ◽

Operating Cost ◽

Cost Effective ◽

Economic Benefits ◽

Program Cost ◽

Rural Bangladesh ◽

Life Years ◽

The Cost

Abstract Drowning is the leading cause of death among children 12-59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche intervention in preventing child drowning. Estimates of the effectiveness of the crèches was based on prior studies and the program cost was assessed using monthly program expenditures captured prospectively throughout the study period from two different implementing agencies. The study evaluated the cost-effectiveness from both a program and societal perspective. Results showed that from the program perspective the annual operating cost of a crèche was $416.35 (95%C.I.: $222 to $576), the annual cost per child was $16 (95%C.I.: $9 to $22) and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,803 (95%C.I.: $9,051 to $27,625). From the societal perspective (including parents time valued) the ICER per life saved was -$176,62 (95%C.I.: -$347,091 to -$67,684)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $2,020, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Based on the evidence, the creche intervention has great potential for reducing child drowning at a cost that is reasonable.

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