Economic evaluations of leukemia: A review of the literature

Objectives:Leukemia, together with lymphoma and multiple myeloma, are hematological malignancies, malignancies of the blood-forming organs. There are four major types of leukemia: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). There is a growing amount of literature of the health economic aspects of leukemia. However, no comprehensive review is yet performed on the health economic evidence for the disease. Hence, our aim was to review and analyze the existing literature on economic evaluations of the different types of leukemia.Methods:A systematic literature search used electronic databases to identify published cost analyses and economic evaluations of leukemia treatments. After reviewing all identified studies, sixty studies were considered relevant for the purpose of the review.Results:The identified studies were published after 1990, with a few exceptions. Many of the identified economic evaluations in leukemia, particularly for ALL and AML, may be defined as cost-minimization analyses, where only the costs of different treatment strategies are compared. In CML, a new treatment, imatinib, was introduced in 2001 and several cost-effectiveness analyses have since then been conducted comparing imatinib with previous first line treatments.Conclusions:This review indicates that there is a shortage of cost-effectiveness information in leukemia. The introduction of new therapies will stress the need for new economic evaluations in this group of diseases. More information about the total costs, that is, including indirect costs, and quality of life effects would be valuable in future evaluations in leukemia.

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Quality of economic evaluations of ventricular assist devices: A systematic review

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320000409 ◽

2020 ◽

Vol 36 (4) ◽

pp. 380-387

Author(s):

Sarah Fontenay ◽

Lionel Catarino ◽

Soumeya Snoussi ◽

Hélène van den Brink ◽

Judith Pineau ◽

...

Keyword(s):

Systematic Review ◽

Health Economic ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Health Economic Evaluation ◽

Ventricular Assist Devices ◽

Economic Evaluations ◽

Level Of Evidence ◽

Ventricular Assist

ObjectiveBecause of a lack of suitable heart donors, alternatives to transplantation are required. These alternatives can have high costs. The aim of this study was to perform a systematic review of cost-effectiveness studies of ventricular assist devices (VADs) and to assess the level of evidence of relevant studies. The purpose was not to present economic findings.MethodsA systematic review was performed using four electronic databases to identify health economic evaluation studies dealing with VADs. The methodological quality and reporting quality of the studies was assessed using three different tools, the Drummond, Cooper, and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklists.ResultsOf the 1,258 publications identified, thirteen articles were included in this review. Twelve studies were cost–utility analyses and one was a cost-effectiveness analysis. According to the Cooper hierarchy scale, the quality of the data used was heterogeneous. The level of evidence used for clinical effect sizes, safety data, and baseline clinical data was of poor quality. In contrast, cost data were of high quality in most studies. Quality of reporting varied between studies, with an average score of 17.4 (range 15–19) according to the CHEERS checklist.ConclusionThe current study shows that the quality of clinical data used in economic evaluations of VADs is rather poor in general. This is a concern that deserves greater attention in the process of health technology assessment of medical devices.

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A Systematic Review of Models Used in Cost-Effectiveness of Treatments in Spondyloarthritis

Medical Research Archives ◽

10.18103/mra.v9i6.2446 ◽

2021 ◽

Vol 9 (6) ◽

Author(s):

Liudan Tu ◽

Ya Xie ◽

Jieruo Gu

Keyword(s):

Systematic Review ◽

Health Economic ◽

Cost Effectiveness ◽

Time Horizon ◽

Evaluation Studies ◽

Health Economic Evaluation ◽

Indirect Costs ◽

Economic Models ◽

Economic Evaluations

This review was aimed to evaluate health economic models used in evaluations of different treatment strategies in spondyloarthritis (SpA). Model-based health economic evaluation studies are increasing and complex models with short-term and long-term horizon are applied to investigate the cost-effectiveness of SpA treatments. The objective of this study was to carry out a systematic review of the evolution of health economic models used in the treatment of SpA. Electronic searches within MEDLINE and EMBASE were carried out using a predefined search strategy. Inclusion and exclusion criteria were used to select relevant studies. Data on country, intervention, evaluation perspective, type of model, time horizon, types of costs and effectiveness measurement were extracted. Eighteen models were described in 22 publications, of which 81.8% were European. Study perspectives included the societal (n=6), healthcare system and payer (n=14), or patient and government (n=1). Time horizon ranged from 52 weeks to lifetime. Markov model was the most frequently used model, only one individual patient simulation models accounting for uncertainty in multiple parameters was reported. Most studies compared different biologics (including different TNFi/biosimilar and IL-17A antibody) with conventional care (NSAIDs) because of the high prize. Only half of studies took indirect costs into account. Modeling is of importance in health economic evaluations of SpA treatment. Long-term costs especially indirect costs should be considered when comparing different treatment alternatives in order to provide more information for policy makers and clinicians.

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Assessing the Quality of Economic Evaluations of FDA Novel Drug Approvals

Annals of Pharmacotherapy ◽

10.1177/1060028016662893 ◽

2016 ◽

Vol 50 (12) ◽

pp. 1028-1040

Author(s):

Alex L. Woersching ◽

Matthew E. Borrego ◽

Dennis W. Raisch

Keyword(s):

Economic Evaluation ◽

Cost Effectiveness ◽

Study Design ◽

Cost Minimization ◽

Cost Utility ◽

Economic Evaluations ◽

Study Quality ◽

Novel Drugs ◽

Quality Aspects

Objective: To systematically review and assess the quality of the novel drugs’ economic evaluation literature in print during the drugs’ early commercial availability following US regulatory approval. Data Sources: MEDLINE and the United Kingdom National Health Service Economic Evaluation Database were searched from 1946 through December 2011 for economic evaluations of the 50 novel drugs approved by the FDA in 2008 and 2009. Study Selection and Data Extraction: The inclusion criteria were English-language, peer-reviewed, original economic evaluations (cost-utility, cost-effectiveness, cost-minimization, and cost-benefit analyses). We extracted and analyzed data from 36 articles considering 19 of the 50 drugs. Two reviewers assessed each publication’s quality using the Quality of Health Economic Studies (QHES) instrument and summarized study quality on a 100-point scale. Data Synthesis: Study quality had a mean of 70.0 ± 16.2 QHES points. The only study characteristics associated with QHES score (with P < 0.05) were having used modeling or advanced statistics, 75.1 versus 61.9 without; using quality-adjusted life years as an outcome, 75.9 versus 64.7 without; and cost-utility versus cost-minimization analysis, 75.9 versus 58.7. Studies most often satisfied quality aspects about stating study design choices and least often satisfied aspects about justifying design choices. Conclusion: The reviewed literature considered a minority of the 2008-2009 novel drugs and had mixed study quality. Cost-effectiveness stakeholders might benefit from efforts to improve the quality and quantity of literature examining novel drugs. Editors and reviewers may support quality improvement by stringently imposing economic evaluation guidelines about justifying study design choices.

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Health economics

10.1093/med/9780199642489.003.0031 ◽

2013 ◽

Cited By ~ 2

Author(s):

Sonja Merkesdal ◽

Wilfried Mau

Keyword(s):

Health Economic ◽

Cost Effectiveness ◽

Lupus Erythematosus ◽

Treatment Strategies ◽

Indirect Costs ◽

Cost Effective ◽

Economic Evidence ◽

Biological Drugs ◽

Rheumatologic Diseases ◽

Life Years

The economic burden of rheumatic diseases for society, various payers, and last but not least the individual patient has been increasingly recognized. In addition to the well-known impact of back pain and osteoarthritis, the upcoming new and expensive therapies have made this issue especially intriguing in the treatment of rheumatoid arthritis (RA). A mean international estimate of the total annual costs of RA, mainly consisting of direct resource consumption and indirect costs due to productivity losses relating to paid work, comes to about €5600. Other inflammatory rheumatologic diseases (ankylosing spondylitis, psoriatic arthritis, lupus erythematosus) generate similar costs. The implementation of expensive biological drugs in rheumatic care has also led to the pressing need to determine the relation of their costs and clinical outcome (e.g. quality-adjusted life-years, QALYs) in order to compare different treatment strategies in defined patient groups. In RA the health-economic evidence for the cost-effectiveness of biologicals is already quite substantial in terms of treatment of early and advanced RA, as last option treatment of patients refractory to TNF inhibitors. Their cost-effectiveness as first line treatment is less clear. All biologicals have proved their cost-effectiveness in various settings depending on patient selection. It has been clearly demonstrated that adherence to the current guidelines, including monitoring of their effectiveness. leads to cost-effective scenarios. In TNF-refractory RA, abatacept and rituximab have proved to be economically favourable strategies. Economic data on other inflammatory rheumatic entities is relatively sparse. Incomplete long-term and observational data are still the most prominent gaps in health-economic evidence relating to rheumatic disorders.

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Health economics

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0031_update_001 ◽

2013 ◽

pp. 237-242

Author(s):

Sonja Merkesdal ◽

Wilfried Mau

Keyword(s):

Health Economic ◽

Cost Effectiveness ◽

Lupus Erythematosus ◽

Treatment Strategies ◽

Indirect Costs ◽

Economic Evidence ◽

Biological Drugs ◽

Productivity Losses ◽

Rheumatologic Diseases ◽

The Individual

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Protocol for a systematic review of economic evaluations of preoperative smoking cessation interventions for preventing surgical complications

BMJ Open ◽

10.1136/bmjopen-2021-057171 ◽

2021 ◽

Vol 11 (11) ◽

pp. e057171

Author(s):

Nikki McCaffrey ◽

Julie Higgins ◽

Anita Lal

Keyword(s):

Systematic Review ◽

Health Economic ◽

Smoking Cessation ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Tobacco Control ◽

Surgical Complications ◽

Best Practice ◽

Economic Evaluations

IntroductionThe short-term economic benefit of embedding best practice tobacco dependence treatment (TDT) into healthcare services prior to surgery across different populations and jurisdictions is largely unknown. The aim of this systematic review is to summarise the cost-effectiveness of preoperative smoking cessation interventions for preventing surgical complications compared with usual care. The results will provide hospital managers, clinicians, healthcare professionals and policymakers with a critical summary of the economic evidence on providing TDT routinely before surgery, aiding the development and dissemination of unified, best practice guidelines, that is, implementation of article 14 of the WHO Framework Convention on Tobacco Control.Methods and analysisA comprehensive search of peer-reviewed literature will be conducted from database inception until 23 June 2021 (Cochrane, Econlit, Embase, Health Technology Assessment, Medline Complete, Scopus). Published, English-language articles describing economic evaluations of preoperative smoking cessation interventions for preventing surgical complications will be included. One researcher will complete the searches and two researchers will independently screen results for eligible studies. Any disagreement will be resolved by the third researcher. A narrative summary of included studies will be provided. Study characteristics, economic evaluation methods and cost-effectiveness results will be extracted by one reviewer and descriptive analyses will be undertaken. A second reviewer will review data extracted for accuracy from 10% of the included studies. Reporting and methodological quality of the included studies will be evaluated independently by two reviewers using the Consolidated Health Economic Evaluation Reporting Standards statement and the Quality of Health Economic Studies Instrument checklist, respectively.Ethics and disseminationThis research does not require ethics approval because the study is a planned systematic review of published literature. Findings will be presented at health economic, public health and tobacco control conferences, published in a peer-reviewed journal and disseminated via social media.Trial registration numberCRD42021257740.

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Cost-effectiveness of treatment optimisation with biomarkers for immunotherapy in solid tumours: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-048141 ◽

2021 ◽

Vol 11 (9) ◽

pp. e048141

Author(s):

Sara Mucherino ◽

Valentina Lorenzoni ◽

Valentina Orlando ◽

Isotta Triulzi ◽

Marzia Del Re ◽

...

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Immune Checkpoint ◽

Cost Utility ◽

Solid Tumours ◽

Economic Evaluations ◽

Monetary Benefit ◽

The Cost ◽

Net Monetary Benefit

IntroductionThe combination of biomarkers and drugs is the subject of growing interest both from regulators, physicians and companies. This study protocol of a systematic review is aimed to describe available literature evidences about the cost-effectiveness, cost-utility or net-monetary benefit of the use of biomarkers in solid tumour as tools for customising immunotherapy to identify what further research needs.Methods and analysisA systematic review of the literature will be carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. PubMed and Embase will be queried from June 2010 to June 2021. The PICOS model will be applied: target population (P) will be patients with solid tumours treated with immune checkpoint inhibitors (ICIs); the interventions (I) will be test of the immune checkpoint predictive biomarkers; the comparator (C) will be any other targeted or non-targeted therapy; outcomes (O) evaluated will be health economic and clinical implications assessed in terms of incremental cost-effectiveness ratio, net health benefit, net monetary benefit, life years gained, quality of life, etc; study (S) considered will be economic evaluations reporting cost-effectiveness analysis, cost-utility analysis, net-monetary benefit. The quality of the evidence will be graded according to Grading of Recommendations Assessment, Development and Evaluation.Ethics and disseminationThis systematic review will assess the cost-effectiveness implications of using biomarkers in the immunotherapy with ICIs, which may help to understand whether this approach is widespread in real clinical practice. This research is exempt from ethics approval because the work is carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal.PROSPERO registration numberCRD42020201549.

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Comparison of (Partial) economic evaluations of transforaminal lumbar interbody fusion (TLIF) versus Posterior lumbar interbody fusion (PLIF) in adults with lumbar spondylolisthesis: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0245963 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0245963

Author(s):

Inge J. M. H. Caelers ◽

Suzanne L. de Kunder ◽

Kim Rijkers ◽

Wouter L. W. van Hemert ◽

Rob A. de Bie ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Cost Effectiveness ◽

Interbody Fusion ◽

Posterior Lumbar Interbody Fusion ◽

Transforaminal Lumbar Interbody Fusion ◽

Economic Evaluations ◽

Lumbar Interbody Fusion ◽

Lumbar Spondylolisthesis

Introduction The demand for spinal fusion surgery has increased over the last decades. Health care providers should take costs and cost-effectiveness of these surgeries into account. Open transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) are two widely used techniques for spinal fusion. Earlier research revealed that TLIF is associated with less blood loss, shorter surgical time and sometimes shorter length of hospital stay, while effectiveness of both techniques on back and/or leg pain are equal. Therefore, TLIF could result in lower costs and be more cost-effective than PLIF. This is the first systematic review comparing direct and indirect (partial) economic evaluations of TLIF with PLIF in adults with lumbar spondylolisthesis. Furthermore, methodological quality of included studies was assessed. Methods Searches were conducted in eight databases for reporting on eligibility criteria; TLIF or PLIF, lumbar spondylolisthesis or lumbar instability, and cost. Costs were converted to United States Dollars with reference year 2020. Study quality was assessed using the bias assessment tool of the Cochrane Handbook for Systematic Reviews of Interventions, the Level of Evidence guidelines of the Oxford Centre for Evidence-based Medicine and the Consensus Health Economic Criteria (CHEC) list. Results Of a total of 693 studies, 16 studies were included. Comparison of TLIF and PLIF could only be made indirectly, since no study compared TLIF and PLIF directly. There was a large heterogeneity in health care and societal perspective costs due to different in-, and exclusion criteria, baseline characteristics and the use of costs or charges in calculations. Health care perspective costs, calculated with hospital costs, ranged from $15,867-$43,217 in TLIF-studies and $32,662 in one PLIF-study. Calculated with hospital charges, it ranged from $8,964-$51,469 in TLIF-studies and $21,838-$93,609 in two PLIF-studies. Societal perspective costs and cost-effectiveness, only mentioned in TLIF-studies, ranged from $5,702/QALY-$48,538/QALY and $50,092/QALY-$90,977/QALY, respectively. Overall quality of studies was low. Conclusions This systematic review shows that TLIF and PLIF are expensive techniques. Moreover, firm conclusions about the preferable technique, based on (partial) economic evaluations, cannot be drawn due to limited studies and heterogeneity. Randomized prospective trials and full economical evaluations with direct TLIF and PLIF comparison are needed to obtain high levels of evidence. Furthermore, development of guidelines to perform adequate economic evaluations, specified for the field of interest, will be useful to minimize heterogeneity and maximize transferability of results. Trial registration Prospero-database registration number: CRD42020196869.

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