A Model for Evaluating the Cost-Effectiveness of Cholesterol-Lowering Treatment

1992 ◽  
Vol 8 (4) ◽  
pp. 719-734 ◽  
Author(s):  
Henry Glick ◽  
Joseph F. Heyse ◽  
David Thompson ◽  
Robert S. Epstein ◽  
M. Eugene Smith ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Indirect Costs ◽  
Coronary Risk ◽  
Expected Loss ◽  
Cholesterol Lowering ◽  
Direct And Indirect Costs ◽  
Risk Functions ◽  
Risk Characteristics ◽  
Heart Study ◽  
The Cost

AbstractWe describe and illustrate the use of a generalizable model for evaluating the cost-effectiveness of alternative cholesterol-lowering treatments. We combine standard incidence-based techniques for measuring the cost of illness with logistic risk functions from the Framingham Heart Study to project, for persons with known coronary risk characteristics, the likelihood of developing coronary heart disease (CHD) over a lifetime as well as a number of related outcomes, including the expected loss of years of life due to CHD, the expected lifetime direct and indirect costs of CHD, and the changes in these outcomes that would result from cholesterol-lowering treatment.

scholarly journals Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045113
Author(s):  
Constantine Vardavas ◽  
Katerina Nikitara ◽  
Konstantinos Zisis ◽  
Konstantinos Athanasakis ◽  
Revati Phalkey ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Respiratory Disease ◽  
Disease Outbreaks ◽  
Indirect Costs ◽  
Direct And Indirect Costs ◽  
Infectious Disease Outbreaks ◽  
The Cost

ObjectivesRespiratory infectious disease outbreaks pose a threat for loss of life, economic instability and social disruption. We conducted a systematic review of published econometric analyses to assess the direct and indirect costs of infectious respiratory disease outbreaks that occurred between 2003 and 2019.SettingRespiratory infectious disease outbreaks or public health preparedness measures or interventions responding to respiratory outbreaks in OECD countries (excluding South Korea and Japan) so as to assess studies relevant to the European context. The cost-effectiveness of interventions was assessed through a dominance ranking matrix approach. All cost data were adjusted to the 2017 Euro, with interventions compared with the null. We included data from 17 econometric studies.Primary and secondary outcome measuresDirect and indirect costs for disease and preparedness and/or response or cost-benefit and cost-utility were measured.ResultsOverall, the economic burden of infectious respiratory disease outbreaks was found to be significant to healthcare systems and society. Indirect costs were greater than direct costs mainly due to losses of productivity. With regard to non-pharmaceutical strategies, prehospitalisation screening and the use of protective masks were identified as both an effective strategy and cost-saving. Community contact reduction was effective but had ambiguous results for cost saving. School closure was an effective measure, but not cost-saving in the long term. Targeted antiviral prophylaxis was the most cost-saving and effective pharmaceutical intervention.ConclusionsOur cost analysis results provide evidence to policymakers on the cost-effectiveness of pharmaceutical and non-pharmaceutical intervention strategies which may be applied to mitigate or respond to infectious respiratory disease outbreaks.

A Cost-Effectiveness Comparison of Surgical Treatments for Mitral Valve Disease

1988 ◽  
Vol 4 (3) ◽  
pp. 447-461
Author(s):  
Basil N. Papageorge ◽  
Stuart O. Schweitzer
Keyword(s):  
Cost Effectiveness ◽  
Mitral Valve ◽  
Cost Savings ◽  
Indirect Costs ◽  
Direct And Indirect Costs ◽  
Mitral Valve Reconstruction ◽  
Valve Reconstruction ◽  
Early Reconstruction ◽  
Surgical Treatments ◽  
The Cost

AbstractThis study compares the cost-effectiveness of mitral valve reconstruction and replacement. Published clinical data were used to determine the effectiveness of each procedure. Both direct and indirect costs were calculated. The findings indicate that reconstruction has lower costs per year of life extended than replacement due to better outcomes. Changing outcome probabilities and discount rates did not alter these results. Cost savings in excess of 40% may be achieved by early reconstruction for suitable patients. These results suggest that the prevailing practice of delaying surgery until replacement is needed should be reconsidered, especially for patients who could benefit from reconstruction.

scholarly journals Estimating the cost-effectiveness of screening a general population for cardiovascular risk with high-sensitivity troponin-I

2021 ◽  
Author(s):  
Paul Jülicher ◽  
Christos Varounis
Keyword(s):  
Cardiovascular Risk ◽  
Cost Effectiveness ◽  
General Population ◽  
Troponin I ◽  
Indirect Costs ◽  
High Sensitivity ◽  
Cost Effective ◽  
Direct And Indirect Costs ◽  
Life Years ◽  
The Cost

Abstract Aims  To estimate the cost-effectiveness of using the cardiac specific marker high-sensitivity troponin-I (hsTnI) for assessing cardiovascular disease (CVD) risk in a general population. Methods and results  A discrete-event simulation model was developed from a societal perspective of a low-risk (Germany) and a high-risk (Kazakhstan) country. The model compared a Screen&Prevent strategy guided by hsTnI against a do-nothing strategy. Risk functions were derived from published data of a prospective cohort study [Nord-Trøndelag Health (HUNT) Study]. The model assessed the number of CVD events and deaths, healthy life years, direct and indirect costs in PPP 2018 Dollar, and quality-adjusted life years (QALY) over a time horizon of 10 years. Screen&Prevent reduced the number of CVD events per 1000 subjects by 5.1 and 5.0, equal to a number-needed-to-screen of 195 and 191 in Kazakhstan and Germany. Screen&Prevent was cost saving in Kazakhstan and cost-effective in Germany with an incremental-cost-effectiveness ratio of $6755 ($2294; $24 054) per QALY gained at an opportunity-cost based willingness-to-pay threshold of $27 373. Varying input variables in univariate and probabilistic sensitivity analyses confirmed the robustness of the analysis. Conclusion  Assessing the cardiovascular risk with hsTnI in a general population and subsequently referring those at high risk to preventive means would very likely be cost-effective or cost-saving by avoiding CVD events and associated direct and indirect costs. This conclusion is retained even if only the direct costs or only the costs for screening and prevention are considered. Future studies should evaluate the incremental cost-effectiveness of hsTnI-guided assessment strategies against established risk algorithms.

The Direct and Indirect Costs of Treating the Victims of the 2016 Nice Terror Attacks in a Single Pediatric Hospital

2021 ◽  
pp. 1-4
Author(s):  
Federico Solla ◽  
Eytan Ellenberg ◽  
Virginie Rampal ◽  
Julien Margaine ◽  
Charles Musoff ◽  
...  
Keyword(s):  
Indirect Costs ◽  
Medical Costs ◽  
Pediatric Hospital ◽  
Terror Attack ◽  
Direct And Indirect Costs ◽  
Terror Attacks ◽  
Direct Medical Costs ◽  
Annual Budget ◽  
The Difference ◽  
The Cost

Abstract Objective: To analyze the cost of the terror attack in Nice in a single pediatric institution. Methods: We carried out descriptive analyses of the data coming from the Lenval University Children’s Hospital of Nice database after the July 14, 2016 terror attack. The medical cost for each patient was estimated from the invoice that the hospital sent to public insurance. The indirect costs were calculated from the hospital’s accounting, as the items that were previously absent or the difference between costs in 2016 versus the previous year. Results: The costs total 1.56 million USD, corresponding to 2% of Lenval Hospital’s 2016 annual budget. Direct medical costs represented 9% of the total cost. The indirect costs were related to human resources (overtime, sick leave), revenue shortfall, and security and psychiatric reinforcement. Conclusion: Indirect costs had a greater impact than did direct medical costs. Examining the level and variety of direct and indirect costs will lead to a better understanding of the consequences of terror acts and to improved preparation for future attacks.

scholarly journals Variations in cost calculations in spine surgery cost-effectiveness research

2014 ◽  
Vol 36 (6) ◽  
pp. E1 ◽  
Author(s):  
Matthew D. Alvin ◽  
Jacob A. Miller ◽  
Daniel Lubelski ◽  
Benjamin P. Rosenbaum ◽  
Kalil G. Abdullah ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Spine Surgery ◽  
Indirect Costs ◽  
Cost Calculation ◽  
Effectiveness Research ◽  
Reimbursement System ◽  
The United Kingdom ◽  
The Cost ◽  
Effectiveness Studies

Object Cost-effectiveness research in spine surgery has been a prominent focus over the last decade. However, there has yet to be a standardized method developed for calculation of costs in such studies. This lack of a standardized costing methodology may lead to conflicting conclusions on the cost-effectiveness of an intervention for a specific diagnosis. The primary objective of this study was to systematically review all cost-effectiveness studies published on spine surgery and compare and contrast various costing methodologies used. Methods The authors performed a systematic review of the cost-effectiveness literature related to spine surgery. All cost-effectiveness analyses pertaining to spine surgery were identified using the cost-effectiveness analysis registry database of the Tufts Medical Center Institute for Clinical Research and Health Policy, and the MEDLINE database. Each article was reviewed to determine the study subject, methodology, and results. Data were collected from each study, including costs, interventions, cost calculation method, perspective of cost calculation, and definitions of direct and indirect costs if available. Results Thirty-seven cost-effectiveness studies on spine surgery were included in the present study. Twenty-seven (73%) of the studies involved the lumbar spine and the remaining 10 (27%) involved the cervical spine. Of the 37 studies, 13 (35%) used Medicare reimbursements, 12 (32%) used a case-costing database, 3 (8%) used cost-to-charge ratios (CCRs), 2 (5%) used a combination of Medicare reimbursements and CCRs, 3 (8%) used the United Kingdom National Health Service reimbursement system, 2 (5%) used a Dutch reimbursement system, 1 (3%) used the United Kingdom Department of Health data, and 1 (3%) used the Tricare Military Reimbursement system. Nineteen (51%) studies completed their cost analysis from the societal perspective, 11 (30%) from the hospital perspective, and 7 (19%) from the payer perspective. Of those studies with a societal perspective, 14 (38%) reported actual indirect costs. Conclusions Changes in cost have a direct impact on the value equation for concluding whether an intervention is cost-effective. It is essential to develop a standardized, accurate means of calculating costs. Comparability and transparency are essential, such that studies can be compared properly and policy makers can be appropriately informed when making decisions for our health care system based on the results of these studies.

scholarly journals Urgent Care Costs of Uncontrolled Asthma in Canada, 2004

2005 ◽  
Vol 12 (8) ◽  
pp. 435-436 ◽  
Author(s):  
Soo Jin Seung ◽  
Nicole Mittmann
Keyword(s):  
Emergency Department ◽  
Indirect Costs ◽  
Emergency Department Visits ◽  
Urgent Care ◽  
Uncontrolled Asthma ◽  
Physician Visits ◽  
Direct And Indirect Costs ◽  
Drug Treatments ◽  
The Cost ◽  
Care Costs

It has been more than a decade since Krahn evaluated the direct and indirect costs of asthma in Canada. Asthma is often uncontrolled and the cost of providing urgent care has not been determined. Hospitalizations, unscheduled physician visits, emergency department visits, drug treatments and ambulance rides are resources used by the uncontrolled asthmatic population, resulting in $162 million in costs annually. Improved control of asthma could decrease these costs.

Animal production studies in Jamaica. IV. The costs of developing and maintaining pangola grass pastures

1964 ◽  
Vol 62 (2) ◽  
pp. 179-186 ◽  
Author(s):  
B. L. Nestel
Keyword(s):  
Indirect Cost ◽  
Direct Cost ◽  
Inverse Relationship ◽  
Indirect Costs ◽  
Animal Production ◽  
Direct And Indirect Costs ◽  
Production Studies ◽  
Total Range ◽  
The Cost

The cost of developing and maintaining pangola grass pastures has been examined under a range of conditions. The direct cost of improving pastures to the stage where they were established as 5–10 acre, fenced, watered units of pangola grass was about £30 per acre. Under favourable conditions this cost could be reduced to £20, but with difficult land or poor techniques the cost could rise to £40 or more per acre. In addition to the direct cost of establishment there was an indirect cost due to land being out of use or stock numbers having to be reduced. This indirect cost appeared to be highest on lands where planting costs were least. It was suggested that there might be an inverse relationship between direct and indirect costs which tended to narrow the total range of establishment costs.

Cost Effectiveness of Whole Exome Sequencing for Children with Developmental Delay in a Developing Country: A Study from Jordan

2021 ◽  
Author(s):  
Amira Masri ◽  
Hanan Hamamy
Keyword(s):  
Cost Effectiveness ◽  
Exome Sequencing ◽  
Developmental Delay ◽  
Developing Country ◽  
Whole Exome Sequencing ◽  
Financial Burden ◽  
Indirect Costs ◽  
Cost Effective ◽  
Whole Exome ◽  
The Cost

AbstractThis retrospective study was aiming to determine the cost effectiveness of whole exome sequencing (WES) in the diagnosis of children with developmental delay in a developing country. In this study of 40 patients, the average cost of traditional investigations and indirect costs related to rehabilitation and medications per child were USD847 and 6,585 per year, respectively. With a current cost for WES of approximately USD1,200, we concluded that performing WES could be cost effective, even in countries with limited resources, as it provides the option for genetic counseling in affected families with an ultimate reduction of overall financial burden to both parents and health care system.

Impact of bovine respiratory disease (BRD) from the perspective of the Canadian beef producer

2009 ◽  
Vol 10 (2) ◽  
pp. 109-110 ◽  
Author(s):  
Kee Jim
Keyword(s):  
Respiratory Disease ◽  
Bovine Respiratory Disease ◽  
Indirect Costs ◽  
Direct Costs ◽  
Production Costs ◽  
Direct And Indirect Costs ◽  
Carcass Disposal ◽  
The Cost

AbstractThe costs of bovine respiratory disease (BRD) to the beef producer can be estimated by identifying and summing the direct and indirect costs associated with the disease. The major direct costs are attributable to the cost of the feeder, production costs and carcass disposal. The indirect costs are mainly associated with infrastructure and labour.

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