scholarly journals PMS10 THE COST-EFFECTIVENESS OF ABATACEPT VERSUS RITUXIMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PERSPECTIVE OF THE CANADIAN PUBLICLY FUNDED HEALTH CARE SYSTEM

2008 ◽  
Vol 11 (3) ◽  
pp. A257
Author(s):  
Y Yuan ◽  
M Maier-Moldovan ◽  
R Maclean ◽  
GJ L'Italien
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care System ◽  
Publicly Funded ◽  
The Cost ◽  
Care System

Demographic Change and the Cost of Publicly Funded Health Care

1995 ◽  
Vol 14 (2) ◽  
pp. 174-192 ◽  
Author(s):  
Frank T. Denton ◽  
Byron G. Spencer
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Demographic Change ◽  
National Income ◽  
Integrated System ◽  
Publicly Funded ◽  
Computer Based ◽  
Growth And Aging ◽  
The Cost ◽  
Care System

ABSTRACTThis paper is concerned with questions relating to demographic change (population growth and aging) and its implications for operating a publicly funded health care system in a Canadian setting. It provides an assessment of how prospective population changes alone would affect the share of health care costs in total national income in Canada over the next several decades; it provides also an analysis of how actual patterns of hospital service provision changed in Ontario over the last decade in response to budgetary restrictions in a period of rising demand for services. Finally, a case is made for viewing health care as an integrated system; a description is provided of a set of computer-based models that have been developed to facilitate analysis of the health care system, and illustrative projections are discussed.

scholarly journals Determination of a willingness-to-pay threshold and decision-making in financing the healthcare technologies

2018 ◽  
Vol 11 (3) ◽  
pp. 13-22 ◽  
Author(s):  
T. S. Teptsova ◽  
T. P. Bezdenezhnyh ◽  
V. K. Fedyaeva ◽  
N. Z Musina ◽  
G. R. Hachatryan ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Willingness To Pay ◽  
Health Care System ◽  
Russian Federation ◽  
Threshold Value ◽  
Medical Technologies ◽  
The Russian Federation ◽  
The Cost ◽  
Care System

The aim was to develop a methodology for determining the willingness to pay threshold (WTPT) and its upper limit value within the Russian health care system.Materials and methods. WTPT was calculated based on the shadow budget price (i. e. determining the WTPT by the suppling party). This method is an empirical assessment of the cost-effectiveness threshold that reflects the utmost productivity of the health care system, as determined from the relationship between changes in healthcare expenditure and health outcomes achieved. The state’s willingness to pay for improving their citizens’ healthcare was evaluated considering the population of the Russian Federation, mortality and life expectancy in different age and gender groups, as well as the volume of government spending. The cost of disability-adjusted life-year prevented (DALY) and the cost of quality-adjusted life-year saved (QALY) were determined by the suppling party, that is, they reflect the cost the state is willing to pay for improving the health of their population under conditions of limited budget. The described approach considers the performance of the country’s healthcare system over a certain period and the costs incurred in functioning of the system.Results. As part of this study, it was found that the cost of one additionally prevented DALY would be 313,878.21 rubles, and the cost of one additionally saved QALY – 365,060.31 rubles.Conclusion. The WTPT for medical technologies in the Russian Federation, determined by estimating the shadow budget price will amount to 313,878.21 rubles for one prevented DALY and 365 060,31 rubles for one saved QALY. With regard to clinical and economic analysis, medical technologies with the incremental cost-effectiveness indicator not exceeding the one calculated in this study can be seen as cost-effective. The obtained threshold value is a recommendation. A medical technology can be approved even with a WTPT higher than the recommended level, because this specific technology may have additional  advantages other than WTPT when compared with the reference technologies. 

scholarly journals Cost-effectiveness of mammography from a publicly funded health care system perspective

CMAJ Open ◽  
2018 ◽  
Vol 6 (1) ◽  
pp. E77-E86 ◽  
Author(s):  
Nicole Mittmann ◽  
Natasha K. Stout ◽  
Anna N.A. Tosteson ◽  
Amy Trentham-Dietz ◽  
Oguzhan Alagoz ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care System ◽  
Publicly Funded ◽  
System Perspective ◽  
Care System

scholarly journals Adherence to guidelines in requesting Oncotype DX in a publicly funded health care system

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
S. Martel ◽  
M. Lambertini ◽  
R. Simon ◽  
C. Matte ◽  
C. Prady
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Recurrence Score ◽  
Treatment Decision ◽  
Oncotype Dx ◽  
Publicly Funded ◽  
Hormone Receptor Positive ◽  
Cost Impact ◽  
The Cost ◽  
Care System

Background Oncotype dx [odx (Genomic Health, Redwood City, CA, U.S.A.)] is an approved prognostic tool for women with node-negative, hormone receptor–positive, her2-negative breast cancer. Because of cost, optimal use of this test is crucial, especially in a publicly funded health care system. We evaluated adherence with our provincial guidelines for odx requests, the management of patients with an intermediate recurrence score (rs), and the cost impact of odx.Methods This retrospective study included 201 consecutive patients with an odx request from two university institutions in Quebec between May 2012 and December 2014. Concordance with provincial guidelines was estimated, with its 95% confidence interval (ci). For patients with an intermediate rs, factors influencing the final treatment decision were assessed. The cost impact of odx was derived from the proportion of patients for whom chemotherapy was not recommended.ResultsIn 93.0% of patients (95% ci: 89.5% to 96.6%), odx was ordered according to guidelines. The concordance was similar in both institutions (92.7%; 95% ci: 88.1% to 97.3%; and 93.6%; 95% ci: 88.2% to 99.0%). In 112 (55.7%), 78 (38.8%), and 9 (4.5%) patients, the rs suggested low, intermediate, and high risk respectively. In the intermediate-risk group, most patients (n = 58, 74.4%) did not receive chemotherapy, mainly because of patient preference and the absence of a clear proven benefit. Savings of CA$100,000 for the study period (2.5 years) were estimated to be associated with odx use.Conclusions In our experience, the use of odx was concordant with published recommendations and had a positive cost impact.

PP34 A Cost-Utility Analysis Of The Syncope: Pacing Or Recording Trial

2018 ◽  
Vol 34 (S1) ◽  
pp. 78-79
Author(s):  
Mark Hofmeister ◽  
Robert Sheldon ◽  
Eldon Spackman ◽  
Satish Raj ◽  
Mario Talajic ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Health Care System ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Additional Qaly ◽  
Life Years ◽  
The Cost ◽  
Care System

Introduction:For patients with bifascicular block and syncope of unknown origin, different American Heart Association guidelines give Class 2A recommendations for two treatments: the implantable loop recorder (ILR) and empiric pacemaker insertion (PM). Equipoise reflected in guidelines may contribute to uncertainty in management and inefficient resource use. The objective of this analysis is to determine the cost-effectiveness of ILR compared to PM in the management of older adults (age>50 years) with bifascicular block and syncope over two years, from the perspective of a Canadian publicly funded health care system, in the Syncope: Pacing or Recording In ThE Later Years (SPRITELY) trial.Methods:Resource utilization data was collected throughout the trial, and unit costs were assigned (2017 Canadian dollars). Utility was measured at baseline and annually with the EQ-5D-3L. Quality adjusted life years (QALYs) were calculated as area-under-the-curve, and adjusted for baseline imbalances in utility. Confidence intervals for the incremental cost effectiveness ratio were generated with non-parametric bootstrapping.Results:Mean cost in participants randomized to PM was CAD 9,759 (USD 7,400), compared to CAD 13,453 (USD 10,200) in participants randomized to ILR. The ILR strategy resulted in 0.020 QALYs more than the PM strategy. The incremental cost effectiveness ratio was CAD 186,553 (95% CI: −831,950–1,191,816) (USD 141,900, 95% CI: −632,740–906,440) per additional QALY. In 1,000 bootstrapped replicates, the cost of the ILR strategy was always greater than that of the PM strategy. At the threshold of CAD 50,000 (USD 38,000) per additional QALY, the probability that the ILR strategy is the cost effective option is 0.504.Conclusions:ILR costs were greater than PM costs, with little difference in QALY outcomes over two-years. Findings are generalizable to patients similar to SPRITELY participants, from the perspective of the Canadian health care system. However, practice pattern variation and payment systems inhibit generalizability to other countries. Future analysis will explore cost and QALY outcomes in countries that participated in the SPRITELY trial.

scholarly journals Cost Effectiveness of Infant Vaccination for Rotavirus in Canada

2012 ◽  
Vol 23 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Doug Coyle ◽  
Kathryn Coyle ◽  
Julie A Bettinger ◽  
Scott A Halperin ◽  
Wendy Vaudry ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Health Care System ◽  
Societal Perspective ◽  
Emergency Department Visits ◽  
System Perspective ◽  
The Cost ◽  
Care System

INTRODUCTION: Rotavirus is the main cause of gastroenteritis in Canadian children younger than five years of age, resulting in significant morbidity and cost. The present study provides evidence on the cost effectiveness of two alternative rotavirus vaccinations (RotaTeq [Merck Frosst Canada Ltd, Canada] and Rotarix [GlaxoSmithKline, Canada]) available in Canada.METHODS: Analysis was conducted through a Markov model that followed a cohort of children from birth to five years of age. Analysis used pertinent data on the natural history of rotavirus and the effects of vaccination. Estimates of heath care costs for children requiring hospitalizations and emergency department visits were derived from the Canadian Immunization Monitoring Program, Active (IMPACT) surveillance, emergency department studies, as well as other Canadian studies. The model estimated the effect of vaccination on costs and quality-adjusted life years (QALYs).RESULTS: The incremental cost per QALY gained from the health care system perspective was $122,000 for RotaTeq and $108,000 for Rotarix. From the societal perspective, both vaccination strategies were dominant – both cost saving and more effective. The cost-effectiveness of vaccination is dependent on the mode of administration, the perspective adopted and the cost of the vaccine.CONCLUSIONS: From a societal perspective, a universal vaccination program against rotavirus will be both cost saving and more effective than no vaccination. Becasue the majority of rotavirus infections do not require emergency department visits or hospital admission, from a health care system perspective, a program would not be considered cost effective.

scholarly journals Systematic Review of Cost-Effectiveness of Injury Prevention Interventions in Soccer—Evidence Why Health Agencies Should Address It

2021 ◽  
Vol 18 (22) ◽  
pp. 11901
Author(s):  
Monika Grygorowicz ◽  
Martyna Wiernicka ◽  
Marzena Wiernicka
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Injury Prevention ◽  
Health Care System ◽  
Peer Review Process ◽  
Cost Effective ◽  
Prevention Interventions ◽  
The Cost ◽  
Care System

Soccer injuries are a recognized problem worldwide. Several injury prevention programs have been confirmed to reduce the number of injuries in female and male players. Unfortunately, there is a lack of data about their cost, burden, and benefit for the health care system. In this paper we aim to systematically review the literature and critically evaluate the economic quality of injury prevention interventions implemented across different populations of soccer players. Web of Science, Medline, SPORTDiscus, Ovid, and other databases were searched from January 2011 through July 2021. Research articles were only selected for analysis if they focused on the cost-effectiveness of injury prevention, were experimental papers written in English, and were published following the peer-review process. Three cluster RCT and one retrospective study met the criteria. Cost data on incremental cost-effectiveness ratios (ICERs) were extracted. The included studies had a good/average quality of economic evaluation. Based on ICERs, injury prevention interventions were cost-effective in three out of the three comparisons. One study did not report the ICER value. However, since economic analyses were reported with varying methodological approaches and results, more data are required to recognize the cost-effectiveness of soccer-specific injury prevention interventions and their benefit for the health care system.

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