scholarly journals Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK

BDJ ◽  
2016 ◽  
Vol 220 (3) ◽  
pp. 121-127 ◽  
Author(s):  
L. Claxton ◽  
M. Taylor ◽  
E. Kay
Keyword(s):  
Oral Health ◽  
Cost Savings ◽  
Economic Benefits ◽  
Sensitivity Analyses ◽  
General Anaesthetic ◽  
Oral Health Promotion ◽  
Potential Cost ◽  
Primary Care Settings ◽  
One Year ◽  
The Uk

Abstract Introduction The effect of sugarfree gum (SFG) on the prevention of dental caries has been established for some time. With increased constraints placed on healthcare budgets, the importance of economic considerations in decision-making about oral health interventions has increased. The aim of this study was to demonstrate the potential cost savings in dental care associated with increased levels of SFG usage. Methods The analysis examined the amount of money which would hypothetically be saved if the UK 12-year-old population chewed more SFG. The number of sticks chewed per year and the caries risk reduction were modelled to create a dose response curve. The costs of tooth restoration, tooth extraction in primary care settings and under general anaesthetic were considered, and the effects of caries reduction on these costs calculated. Results If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year. Sensitivity analyses of the key parameters demonstrated that cost savings would still be likely to be observed even in scenarios with less significant increases in SFG use. Conclusion This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved.

scholarly journals Potential cost-savings from the use of the biosimilars filgrastim, infliximab and insulin glargine in Canada: a retrospective analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kerry Mansell ◽  
Hishaam Bhimji ◽  
Dean Eurich ◽  
Holly Mansell
Keyword(s):  
Insulin Glargine ◽  
Retrospective Analysis ◽  
Healthcare System ◽  
Healthcare Providers ◽  
Cost Savings ◽  
Sensitivity Analyses ◽  
Potential Cost ◽  
Biologic Drugs ◽  
Cross Sectional ◽  
Time Period

Abstract Background In 2014 and 2015, biosimilars for the drugs filgrastim, infliximab, and insulin glargine were approved for use in Canada. The introduction of biosimilars in Canada could provide significant cost savings for the Canadian healthcare system over originator biologic drugs, however it is known that the use of biosimilars varies widely across the world. The aim of this study was to estimate the use of biosimilars in Canada and potential cost-savings from their use. Methods We performed a retrospective analysis of Canadian drug purchases for filgrastim, infliximab, and insulin glargine from July 2016 to June 2018. This was a cross-sectional study and the time horizon was limited to the study period. As a result, no discounting of effects over time was included. Canadian drugstore and hospital purchases data, obtained from IQVIA™, were used to estimate the costs per unit and unit volume for biosimilars and originator biologic drugs within each province. Potential cost-savings were calculated as a product of the units of reference originator product purchased and the cost difference between the originator biologic and its corresponding biosimilar. Results The purchase of biosimilars varied by each province in Canada, ranging from a low of 0.1% to a high of 81.6% of purchases. In total, $1,048,663,876 Canadian dollars in savings could have been realized with 100% use of biosimilars over the originator products during this 2 year time period. The potential savings are highest in the province of Ontario ($349 million); however, even in smaller markets (PEI and Newfoundland), $28 million could have potentially been saved. Infliximab accounted for the vast majority of the potential cost-savings, whereas the purchases of the biosimilar filgrastim outpaced that of the originator drug in some provinces. In sensitivity analyses assuming only 80% of originator units would be eligible for use as a biosimilar, $838 million dollars in cost savings over this two-year time period would still have been realized. Conclusions The overall use of biosimilar drugs in Canada is low. Policy makers, healthcare providers, and patients need to be informed of potential savings by increased use of biosimilars, particularly in an increasingly costly healthcare system.

scholarly journals 2694. Incidence of Pneumocytis jiroveci (PJP) Infection with 3-Month Prophylaxis of Aerosolized Pentamidine (AP) in Autologous Hematopoietic Stem Cell Transplantation (HSCT)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S947-S947
Author(s):  
Sarah Perreault ◽  
Dayna McManus ◽  
Rebecca Pulk ◽  
Jeffrey E Topal ◽  
Francine Foss ◽  
...  
Keyword(s):  
Cost Savings ◽  
Cost Comparison ◽  
High Dose ◽  
Potential Cost ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
One Year ◽  
Relapsed Disease ◽  
The Cost ◽  
Autologous Hsct

Abstract Background HSCT patients are at an increased risk of developing PJP after transplant due to treatment induced immunosuppression. Given the risk of cytopenias with co-trimoxazole, AP is utilized as an alternative for PJP prophylaxis. A prior study revealed a 0% (0/19 patients) incidence when AP prophylaxis was given for one year post autologous HSCT. Current guidelines recommend a duration of 3 – 6 months for PJP prophylaxis in autologous HSCT. The primary endpoint of this study was to assess the incidence of PJP infection within one year post autologous HSCT in patients who received 3 months of AP. Secondary endpoint was a cost comparison of 3 months compared with 6 months of AP. Methods A single-center, retrospective study of adult autologous HSCT patients at Yale New Haven Hospital between February 2013 and December 2017 was performed. Patients were excluded if: <18 years of age, received < or >3 months of AP, changed to alternative PJP prophylactic agent or received no PJP prophylaxis, received tandem HSCT, deceased prior to one year post-transplant from a non PJP-related infection, HIV positive, or lost to follow-up. Pentamidine was given as a 300 mg inhalation monthly for 3 months starting Day +15 after autologous HSCT. Results A total of 288 patients were analyzed, no PJP infections occurred within one year post HSCT. Additionally, 187 (65%) patients received treatment post HSCT with 135/215 (63%) receiving maintenance immunomodulatory drugs for myeloma and 40/288 (14%) patients developing relapsed disease. 43% of the chemotherapy regimens for relapsed disease included high dose corticosteroids. The cost difference of using 3 months vs. 6 months of AP is $790, reflecting the cost of drug and its administration. Applying our incidence of 0%, potential cost savings of 3 months vs. 6 months of AP would be $330,000 over 5 years or $66,000 per year. Conclusion Three months of AP for PJP prophylaxis in autologous HSCT patients is safe and effective as well as cost-effective compared with a 6 month regimen. Disclosures All authors: No reported disclosures.

Who Gains from and who Pays for Channel Deepening?

2005 ◽  
Vol 1909 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Thomas A. Grigalunas ◽  
James J. Opaluch ◽  
Young Tae Chang
Keyword(s):  
Net Present Value ◽  
Cost Savings ◽  
Economic Benefits ◽  
The State ◽  
Sensitivity Analyses ◽  
Cost Ratio ◽  
Benefit Cost Ratio ◽  
Net Benefits ◽  
Benefit Cost ◽  
Benefits And Costs

Port dredging to accommodate larger vessels can create substantial national economic benefits. However, how affected individual states fare economically with dredging is often unclear and can be an important issue. The benefits and the costs to Delaware residents of dredging—with the recent proposed deepening of the Delaware Bay and River main federal channel as a case study—are examined. Benefits include ( a) lower transportation costs that residents might receive on imported goods, ( b) profits that residents would realize if cost savings (e.g., on refinery products) were not passed forward to Delaware users, ( c) project costs that residents would bear as federal taxpayers, and ( d) benefits that residents would realize if the use of dredged sediments for planned beach renourishment created savings to the state. Sensitivity analyses are used to reflect uncertainty in outcomes. The estimated net present value to Delaware today of all future annual quantifiable benefits and costs ranges between $15,528,393 and $14,195,700 over 50 years at 5.875%. Stated another way, the quantified net benefits for Delaware imply a benefit-cost ratio between 2.07 and 1.89. Hence, for every dollar of the $7.5 million that Delaware would pay as a nonfederal cosponsor, estimated quantifiable net benefits to the state are $2.07 to $1.89. Some benefit and cost estimates are vehemently debated between interested parties, and not all benefits and costs can be quantified.

scholarly journals Reducing vitamin D requests in a primary care cohort: a quality improvement study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101090
Author(s):  
Veena Patel ◽  
Clare Gillies ◽  
Prashanth Patel ◽  
Timothy Davies ◽  
Sajeda Hansdot ◽  
...  
Keyword(s):  
Primary Care ◽  
Vitamin D ◽  
Cost Savings ◽  
Request Form ◽  
Post Intervention ◽  
Potential Cost ◽  
Cost Modelling ◽  
Clinically Significant ◽  
Primary Care Practitioners ◽  
The Uk

BackgroundSince 2000, vitamin D requests have increased 2–6 fold with no evidence of a corresponding improvement in the health of the population. The ease of vitamin D requesting may contribue to the rapid rise in its demand and, hence, pragmatic interventions to reduce vitamin D test ordering are warranted.AimTo study the effect on vitamin D requests following a redesign of the electronic forms used in primary care. In addition, any potential harms were studied and the potential cost-savings associated with the intervention were evaluated.Design & settingAn interventional study took place within primary care across Leicestershire, England.MethodThe intervention was a redesign of the electronic laboratory request form for primary care practitioners across the county. Data were collected on vitamin D requests for a 6-month period prior to the change (October 2016 to March 2017) and the corresponding 6-month period post-intervention (October 2017 to March 2018), data were also collected on vitamin D, calcium, and phosphate levels.ResultsThe number of requests for vitamin D decreased by 14 918 (36.2%) following the intervention. Changes in the median calcium and phosphate were not clinically significant. Cost-modelling suggested that if such an intervention was implemented across primary care in the UK, there would be a potential annual saving to the NHS of £38 712 606.ConclusionA simple pragmatic redesign of the electronic request form for vitamin D test led to a significant reduction in vitamin D requests without any adverse effect on the quality of care.

scholarly journals Estimating the Impact of Novel Digital Therapeutics in Type 2 Diabetes and Hypertension: Health Economic Analysis

10.2196/15814 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e15814 ◽  
Author(s):  
Robert J Nordyke ◽  
Kevin Appelbaum ◽  
Mark A Berman
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Cohort Studies ◽  
Cost Savings ◽  
Economic Benefits ◽  
Sensitivity Analyses ◽  
Clinical Inertia ◽  
Health Resource ◽  
The Impact

Background Behavioral interventions can meaningfully improve cardiometabolic conditions. Digital therapeutics (DTxs) delivering these interventions may provide benefits comparable to pharmacologic therapies, displacing medications for some patients. Objective Our objective was to estimate the economic impact of a digital behavioral intervention in type 2 diabetes mellitus (T2DM) and hypertension (HTN) and estimate the impact of clinical inertia on deprescribing medications. Methods Decision analytic models estimated health resource savings and cost effectiveness from a US commercial payer perspective. A 3-year time horizon was most relevant to the intervention and payer. Effectiveness of the DTx in improving clinical outcomes was based on cohort studies and published literature. Health resource utilization (HRU), health state utilities, and costs were drawn from the literature with costs adjusted to 2018 dollars. Future costs and quality-adjusted life years (QALYs) were discounted at 3%. Sensitivity analyses assessed uncertainty. Results Average HRU savings ranged from $97 to $145 per patient per month, with higher potential benefits in T2DM. Cost-effectiveness acceptability analyses using a willingness-to-pay of $50,000/QALY indicated that the intervention would be cost effective at total 3-year program costs of $6468 and $6620 for T2DM and HTN, respectively. Sensitivity analyses showed that reduced medication costs are a primary driver of potential HRU savings, and the results were robust within values tested. A resistance to deprescribe medications when a patient’s clinical outcomes improve can substantially reduce the estimated economic benefits. Our models rely on estimates of clinical effectiveness drawn from limited cohort studies with DTxs and cannot account for other disease management programs that may be implemented. Performance of DTxs in real-world settings is required to further validate their economic benefits. Conclusions The DTxs studied may provide substantial cost savings, in part by reducing the use of conventional medications. Clinical inertia may limit the full cost savings of DTxs.

Oral health promotion: Right person, right time prevention

2019 ◽  
Vol 7 (8) ◽  
pp. 394-398
Author(s):  
Laura Warrilow ◽  
Roshni Dave ◽  
Sheridan McDonald
Keyword(s):  
Health Promotion ◽  
Oral Health ◽  
Oral Hygiene ◽  
Evidence Based ◽  
Oral Health Promotion ◽  
Dental Decay ◽  
Balanced Diet ◽  
Health Visitors ◽  
Huge Impact ◽  
The Uk

Dental decay is one of the most common conditions affecting children in the UK; but it can be prevented with a balanced diet and good oral hygiene. Often, this advice comes too late, with many families only registering with a dentist when problems have occurred. Research has shown that health visitors who provide appropriate dental advice can have a huge impact on children's dental and overall health. This article aims to provide evidence-based preventive advice to support health visitors with dental interventions.

scholarly journals Maximum potential cost-savings attributable to generic substitution of antipsychotics 2008 to 2013

2016 ◽  
Vol 21 ◽  
pp. 356-363
Author(s):  
D. Husselmann ◽  
R. Joubert ◽  
J. R. Burger ◽  
M. S. Lubbe ◽  
M. Cockeran
Keyword(s):  
Cost Saving ◽  
Generic Substitution ◽  
Cost Savings ◽  
Economic Benefits ◽  
Community Treatment ◽  
Prescribing Patterns ◽  
Potential Cost Saving ◽  
Potential Cost ◽  
Total Potential ◽  
Nationally Representative

Background: Schizophrenia is a costly illness to treat, especially during a time of escalating medicine inflation costs, putting a large economic strain on patients, their families and the community. Treatment, however, can become more affordable through generic substitution.Objective: To determine the maximum potential cost-saving through generic substitution for both originator and more expensive generic items while observing the prescribing patterns of antipsychotics.Method: Antipsychotic medicine usage was analysed retrospectively during the study period 2008 to 2013 using data obtained from a nationally representative Pharmaceutical Benefit Management Company. The study population consisted of 4410 patients with ICD-10 codes (F20-F20.9) who had paid claims for an antipsychotic reimbursed from their prescribed minimum benefits. Active ingredients were identified using the MIMS classification system. Maximum potential cost savings were determined by substituting all originator and more expensive generic antipsychotic items with the cost of the least expensive generic antipsychotic item available.Results: Through generic substitution, a total potential cost-saving of ZAR4 642 685.45 could be possible from 2008 to 2013. Average cost per items increased from ZAR600.53 ± ZAR435.00 (median ZAR 539.82) in 2008 to ZAR1 196.59 ± ZAR 942.16 (median ZAR 940.72) in 2013 and had a significant effect on patients' contribution, which increased with 726.94% from 2005 to 2008. Psychiatrists prescribed the majority of antipsychotics. Although generic items claimed increased by 60.31% during the study period, psychiatrist still favoured non-generic prescribing (40.63%).Conclusions: Potential economic benefits can be generated with generic substitution.

P27 Introduction of oral caffeine rounds on the neonatal units

2018 ◽  
Vol 103 (2) ◽  
pp. e2.30-e2 ◽  
Author(s):  
Fiona Robertson ◽  
Adriece Al Rifai ◽  
Jenny Machell
Keyword(s):  
Preterm Infants ◽  
Respiratory Control ◽  
Cost Savings ◽  
Fold Increase ◽  
Average Dose ◽  
List Type ◽  
Cochrane Database ◽  
One Year ◽  
The Uk ◽  
Apnea Of Prematurity

AimApnoea of prematurity is common in babies born at less than 34 weeks gestation due to immature respiratory control systems.1–4 The current mainstay of treatment in the UK is a methylxanthine – caffeine – which acts as a respiratory stimulant. Our local guideline follows the Caffeine for Apnea of Prematurity (CAP) study with a single loading dose followed by 24-hourly maintenance doses, given either intravenously or orally1.In August 2012 a UK licenced oral caffeine product was launched, however various safety concerns were raised over this product and its presentation which led to delays in use on our Neonatal Units (NNUs). Unfortunately the single patient, single use product would also lead to a massive increase in our oral caffeine spend – with the cost of an average dose of oral caffeine rising from just £0.13 to £24.41. This equates to an annual cost increase of approximately £53,140 – around a 150-fold increase from the previous £360 per annum. We have therefore considered and implemented a new initiative to avoid unacceptable cost pressures within the neonatal service.MethodsConsideration was made to administering caffeine doses in ‘rounds’ on NNU to allow doses for more than one patient from a single bottle.However, there were a number of issues to overcome – the oral caffeine rounds would require the product to be used outside of its licence. We also needed to be sure that limiting the timing of caffeine administration to standard times on the NNUs – provisionally twice daily rounds at 10:00 and 22:00 – would not affect its therapeutic and potentially toxic effects in this vulnerable patient group.Savings as a result of this initiative were to be tracked for one year post implementation.ResultsTotal savings in the first 10 months following implementation were £15,945 – a projected saving of £19 134 per annum. There have been no reports of any adverse clinical outcomes related to timing of caffeine doses.ConclusionGiven the success of this initiative we plan to move towards a once daily oral caffeine round on our NNUs at 10:00. The majority of babies currently receive their dose at this time but formal implementation will lead to further cost savings. A morning oral caffeine round will also help to minimise the at least theoretical risk of the CNS stimulant effects and cardiac effects of caffeine, principally tachycardia, disrupting a baby’s sleep pattern. There is some evidence of this in the literature although these effects are more common at supratherapeutic levels.ReferencesNottingham Neonatal Service. Clinical guideline B7 – Use of caffeine in apnoea of prematurityMay 2016.Schmidt B, Roberts RS, Davis P, et al. Caffeine for Apnea of Prematurity Trial Group. Caffeine therapy for apnea of prematurity. N Engl J Med2006;354(20):2112–21.Henderson-Smart DJ, Steer PA. Caffeine versus theophylline for apnea in preterm infants. Cochrane Database of Systematic Reviews2010:Issue 1.Art No:CD000273.Henderson-Smart DJ, De Paoli AG. Methylxanthine treatment for apnea in preterm infants. Cochrane Database of Systematic Reviews2010:Issue 12.Art. No:CD0001.

scholarly journals Cost–consequence analysis of fluticasone furoate/vilanterol for asthma management in Spain: an analysis based on the Salford Lung Study in asthma

2019 ◽  
Vol 21 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Laura Amanda Vallejo-Aparicio ◽  
Jesús Molina ◽  
Iñigo Ojanguren ◽  
Ana Viejo Casas ◽  
Alicia Huerta ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
National Health System ◽  
Cost Savings ◽  
Sensitivity Analyses ◽  
Base Case ◽  
Fluticasone Furoate ◽  
Potential Cost ◽  
Asthmatic Patients ◽  
Cost Consequence

Abstract Objectives The Salford Lung Study in asthma (SLS asthma) is a 12-month, open-label randomised clinical trial comparing clinical effectiveness of initiating once-daily inhaled combination of fluticasone furoate/vilanterol (FF/VI) 184/22 mcg or 92/22 mcg, with continuing optimized usual care (UC) with inhaled corticosteroids (ICS) alone, or in combination with a long-acting β2-agonist (ICS/LABA), in asthmatic patients followed in primary care in the UK. The objective of the analysis is to estimate the economic impact of these results when applied in Spain. Methods A 1-year cost–consequence model was populated with SLS asthma, adopting the Spanish National Health System (NHS) perspective. 775,900 of diagnosed asthmatic patients ≥ 18 years old currently managed with UC in Spain were included in the analysis. Effectiveness data included the percentage of patients per Asthma Control Test (ACT) category at 24 and 52 weeks from SLS asthma. Direct costs (pharmacological and per ACT category) were estimated from Spanish public sources and literature (€, 2018). Base case analysis assumed an increased use of FF/VI from 10 to 20% within 1 year. One-way sensitivity analyses were performed. Results Within the 775,900 asthmatic patients analysed, substitution of UC with FF/VI was associated with reduced costs due to ACT improvement, leading to potential total annual savings of €4,927,672. Sensitivity analyses ranged from €6,012,975 to €14,783,015 cost savings associated with FF/VI. An analysis considering patients only on ICS/LABA showed potential cost savings of €8,207,448. Conclusions The improved asthma control for FF/VI compared with UC observed in SLS asthma could be translated into potential savings for the Spanish NHS. These results may be useful for decision makers.

scholarly journals Potential economic impacts from improving breastfeeding rates in the UK

2014 ◽  
Vol 100 (4) ◽  
pp. 334-340 ◽  
Author(s):  
S Pokhrel ◽  
M A Quigley ◽  
J Fox-Rushby ◽  
F McCormick ◽  
A Williams ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Disease Model ◽  
Acute Otitis Media ◽  
Health Benefit ◽  
Cost Savings ◽  
Potential Cost ◽  
Breast Feed ◽  
Breastfeeding Rates ◽  
The Uk ◽  
Tract Infections

RationaleStudies suggest that increased breastfeeding rates can provide substantial financial savings, but the scale of such savings in the UK is not known.ObjectiveTo calculate potential cost savings attributable to increases in breastfeeding rates from the National Health Service perspective.Design and settingsCost savings focussed on where evidence of health benefit is strongest: reductions in gastrointestinal and lower respiratory tract infections, acute otitis media in infants, necrotising enterocolitis in preterm babies and breast cancer (BC) in women. Savings were estimated using a seven-step framework in which an incidence-based disease model determined the number of cases that could have been avoided if breastfeeding rates were increased. Point estimates of cost savings were subject to a deterministic sensitivity analysis.ResultsTreating the four acute diseases in children costs the UK at least £89 million annually. The 2009–2010 value of lifetime costs of treating maternal BC is estimated at £959 million. Supporting mothers who are exclusively breast feeding at 1 week to continue breast feeding until 4 months can be expected to reduce the incidence of three childhood infectious diseases and save at least £11 million annually. Doubling the proportion of mothers currently breast feeding for 7–18 months in their lifetime is likely to reduce the incidence of maternal BC and save at least £31 million at 2009–2010 value.ConclusionsThe economic impact of low breastfeeding rates is substantial. Investing in services that support women who want to breast feed for longer is potentially cost saving.

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