scholarly journals Exploratory comparison of Healthcare costs and benefits of the UK’s Covid-19 response with four European countries

2021 ◽  
Author(s):  
Howard Thom ◽  
Josephine Walker ◽  
Peter Vickerman ◽  
Will Hollingworth
Keyword(s):  
Healthcare Costs ◽  
Population Characteristics ◽  
Economic Losses ◽  
Quality Adjusted Life Years ◽  
Net Benefit ◽  
Payer Perspective ◽  
Life Years ◽  
Health Related ◽  
Per Capita ◽  
The Uk

Abstract Background In responding to Covid-19, governments have tried to balance protecting health while minimizing gross domestic product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalizations and deaths under ‘mitigation’ to modelled events under ‘no mitigation’ to 20 July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at £20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared with Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Results The UK saved 3.17 (0.32–3.65) million QALYs, £33 (8–38) billion healthcare costs and £1416 (220–1637) HRNB per capita at £20,000/QALY. Per capita, this is comparable to £1455 GDP loss using Sweden as comparator and offsets 46.1 (7.1–53.2)% of total £3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Conclusions Our exploratory analysis indicates the benefit of government Covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency.

scholarly journals Comparison of Healthcare costs and benefits of the UK's Covid-19 response with four European countries: Decision Modelling Study

2020 ◽  
Author(s):  
Howard Thom ◽  
Josephine Walker ◽  
Peter Vickerman ◽  
Will Hollingworth
Keyword(s):  
Healthcare Costs ◽  
Population Characteristics ◽  
Economic Losses ◽  
Quality Adjusted Life Years ◽  
Net Benefit ◽  
Payer Perspective ◽  
Life Years ◽  
Health Related ◽  
Per Capita ◽  
The Uk

Background In responding to covid-19, governments have tried to balance protecting health while minimising Gross Domestic Product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain, and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalisations, and deaths under "mitigation" to modelled events under "no mitigation" to 20th July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at GBP 20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared to Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Findings The UK saved 3.17 (0.32-3.65) million QALYs, GBP 33 (8-38) billion healthcare costs, and GBP 1416 (220-1637) HRNB per capita at GBP 20,000/QALY. Per capita, this is comparable to GBP 1,455 GDP loss using Sweden as comparator and offsets 46.1 (7.1-53.2)% of total GBP 3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Interpretation The benefit of government covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. Funding Elizabeth Blackwell Institute; UK MRC; UK NIHR.

scholarly journals Estimating the potential impact of the UK government’s sugar reduction programme on child and adult health: modelling study

BMJ ◽  
2019 ◽  
pp. l1417 ◽  
Author(s):  
Ben Amies-Cull ◽  
Adam D M Briggs ◽  
Peter Scarborough
Keyword(s):  
Weight Change ◽  
Healthcare Costs ◽  
Disease Burden ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Sugar Reduction ◽  
The Uk ◽  
The Impact ◽  
Quality Adjusted Life ◽  
Modelling Study

AbstractObjectiveTo estimate the impact of the UK government’s sugar reduction programme on child and adult obesity, adult disease burden, and healthcare costs.DesignModelling study.SettingSimulated scenario based on National Diet and Nutrition Survey waves 5 and 6, England.Participants1508 survey respondents were used to model weight change among the population of England aged 4-80 years.Main outcome measuresCalorie change, weight change, and body mass index change were estimated for children and adults. Impact on non-communicable disease incidence, quality adjusted life years, and healthcare costs were estimated for adults. Changes to disease burden were modelled with the PRIMEtime-CE Model, based on the 2014 population in England aged 18-80.ResultsIf the sugar reduction programme was achieved in its entirety and resulted in the planned sugar reduction, then the calorie reduction was estimated to be 25 kcal/day (1 kcal=4.18 kJ=0.00418 MJ) for 4-10 year olds (95% confidence interval 23 to 26), 25 kcal/day (24 to 28) for 11-18 year olds, and 19 kcal/day (17 to 20) for adults. The reduction in obesity could represent 5.5% of the baseline obese population of 4-10 year olds, 2.2% of obese 11-18 year olds, and 5.5% of obese 19-80 year olds. A modelled 51 729 quality adjusted life years (95% uncertainty interval 45 768 to 57 242) were saved over 10 years, including 154 550 (132 623 to 174 604) cases of diabetes and relating to a net healthcare saving of £285.8m (€332.5m, $373.5m; £249.7m to £319.8m).ConclusionsThe UK government’s sugar reduction programme could reduce the burden of obesity and obesity related disease, provided that reductions in sugar levels and portion sizes do not prompt unanticipated changes in eating patterns or product formulation.

Cost-effectiveness of zoledronic acid in the prevention of skeletal-related events in patients with bone metastases from renal cell carcinoma: Comparison between France, Germany, and the United Kingdom

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5106-5106
Author(s):  
M. F. Botteman ◽  
S. Kaura
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Life Years ◽  
Health Related ◽  
Skeletal Related Events ◽  
The Uk

5106 Background: Zoledronic acid (ZOL) significantly reduces the risk of new skeletal-related events (SREs) in patients (pts) with bone metastases from RCC. This study assessed and compared the cost-effectiveness of ZOL in pts with RCC from French, German, and United Kingdom (UK) societal perspectives. Methods: This analysis was based on a retrospective analysis of RCC pts with bone metastases who were enrolled in a 9-mo trial of ZOL or placebo (PBO) plus concomitant antineoplastic therapy. A model was developed to simulate costs and quality-adjusted life-years (QALYs) experienced by study pts. The model included data and assumptions regarding SRE incidence, mortality, drug and administration costs, SRE costs, reduced quality of life (QOL) because of SREs and bone pain, and therapy duration. SRE costs were estimated using diagnosis-related group tariff information and published literature. Consistent with similar economic analyses, it was assumed that QOL decreased 20% to 80% (depending on SRE type) for 1 mo after each SRE experienced. Sensitivity analyses were performed to test the effects of alternate assumptions, with < 30,000/QALY considered cost-effective. Results: Compared with PBO-treated pts (n = 19), ZOL-treated pts (n = 27) experienced 1.07 fewer SREs/pt and gained discounted QALYs of approximately 0.1563 in France and Germany and 0.1575 in the UK. Discounted SRE-related costs were substantially lower among pts treated with ZOL vs PBO (-4,196 in France, -3,880 in Germany, and -3,355 in the UK). After including drug therapy costs, ZOL saved 1,358, 1,223, and 719 per pt in France, Germany, and the UK, respectively. In multivariate sensitivity analyses, ZOL saved costs in 67% to 77% of cases, depending on the country. ZOL resulted in a cost per QALY gained < 30,000 in approximately 93% of cases. Conclusions: Treatment with ZOL reduces SREs, improves QOL, and lowers health-related costs compared with PBO in French, German, and UK pts with bone metastases from RCC. Use of ZOL in these populations therefore provides health-related cost savings and is a cost-effective use of healthcare resources. [Table: see text]

Benefit of treatment of latent tuberculosis infection in individual patients

2015 ◽  
Vol 46 (5) ◽  
pp. 1397-1406 ◽  
Author(s):  
Claudia C. Dobler ◽  
Andrew Martin ◽  
Guy B. Marks
Keyword(s):  
Decision Aid ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Quality Adjusted Life Years ◽  
Net Benefit ◽  
Ltbi Treatment ◽  
Life Years ◽  
Numbers Needed To Treat ◽  
Quality Adjusted Life

We aimed to develop a decision aid that estimates whether treatment of latent tuberculosis infection (LTBI) is likely to have a net gain in quality-adjusted life-years for an individual.A Markov model was developed which incorporated personalised estimates for risk of tuberculosis (TB) reactivation, TB death, quality-of-life impairments and treatment side-effects. The net effect of LTBI treatment was quantified in terms of quality-adjusted life-years gained or lost. Analyses were conducted for a representative set of hypothetical patients.LTBI treatment was estimated to be beneficial when the annual risk of TB reactivation exceeded 13/100 000 to 93/100 000 for females aged 10–75 years and 15/100 000 to 119/100 000 for males aged 10–75 years; the numbers needed to treat to avoid one case of TB were 93, 77, 85 and 72, respectively, at these threshold levels.LTBI treatment was estimated to confer a positive net benefit across a broad range of patients with characteristics typically seen in a low incidence setting for TB. Use of the decision aid has the potential to facilitate and increase confidence with LTBI treatment decisions by providing clinicians and patients with personalised estimates of likely net benefit.

QUALITY-ADJUSTED LIFE-YEARS FOR THE ESTIMATION OF EFFECTIVENESS OF SCREENING PROGRAMS: A SYSTEMATIC LITERATURE REVIEW

2012 ◽  
Vol 28 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Suvi Mäklin ◽  
Pirjo Räsänen ◽  
Riikka Laitinen ◽  
Niina Kovanen ◽  
Ilona Autti-Rämö ◽  
...  
Keyword(s):  
Full Text ◽  
Screening Program ◽  
Cost Effective ◽  
Quality Adjusted Life Years ◽  
Screening Programs ◽  
Hrqol Data ◽  
Life Years ◽  
Related Quality ◽  
Health Related ◽  
Quality Adjusted Life

Objectives: The aim of this study was to identify and characterize studies that have used quality-adjusted life-years (QALYs) based on measurements of patients’ health-related quality of life (HRQoL) as an indicator of effectiveness of screening programs.Methods: Systematic search of the literature until March 2010, using several electronic databases. Initial screening of articles based on abstracts, and evaluation of full-text articles were done by at least two of the authors.Results: The search identified 1,610 articles. Based on review of abstracts, 431 full-text articles were obtained for closer inspection and, of these, 81 reported QALYs based on patient-derived data using a valid HRQoL assessment. The most frequently used method to assess HRQoL was Time Trade-Off (55 percent) followed by EQ-5D (26 percent). The most frequently studied medical conditions were malignant diseases (23 percent) followed by cardiovascular diseases (19 percent). All studies employed some kind of modeling with the Markov model being the most prevalent type (65 percent). Majority of the articles (59 percent) concluded that the screening program studied was cost-effective.Conclusions: The use of QALYs in the evaluation of screening programs has expanded during the last few years. However, only a minority of studies have used HRQoL data derived from patients, using direct or indirect valuation. Further investigation and harmonization of the methodology in evaluation of screening programs is needed to ensure better comparability across different screening programs.

scholarly journals A Cost-Effectiveness Analysis of Front-Line Treatment Strategies in Early Stage Follicular Lymphoma

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 54-55
Author(s):  
Joshua W.D. Tobin ◽  
Greg Hapgood ◽  
Maher K. Gandhi ◽  
Peter Mollee ◽  
Ti Ma ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Board Of Directors ◽  
Research Funding ◽  
Early Stage ◽  
Quality Adjusted Life Years ◽  
Front Line ◽  
Advisory Committees ◽  
Payer Perspective ◽  
Life Years ◽  
Quality Adjusted Life

Background: Radiation therapy (RT) has been considered the standard of care for front-line management for early-stage follicular lymphoma. Recent data suggests the use of RT is declining with more than half the patients receiving immunochemotherapy (ICT) with or without rituximab maintenance (RM). Cost-effectiveness analysis of these treatments has not been performed. Methods: We constructed a four-state partitioned survival model over a 15-year time horizon to compare RT alone, ICT and ICT+RM. The model was based on a real-world cohort of early-stage FL patients, staged using 18F-fluorodeoxyglucose positron emission tomography,from the Australasian Lymphoma Alliance. Lifetime direct health care costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated from an Australian tax-payer perspective. A pre-specified value of AUD $75,000 was defined as the willingness-to-pay (WTP) threshold reflecting recent approvals for therapeutics for indolent lymphoproliferative diseases in Australia. Results: Assuming 5% annual discounting the direct healthcare costs were: RT $14,480, ICT $22,171, ICT+RM $42,830 (Table 1). Compared with RT, ICT demonstrated an improvement in QALYs (+0.17) and an ICER of $44,879. Compared with RT, ICT+RM demonstrated a larger improvement in QALYs (+0.53) with an ICER of $53,062. Modelling a 25% cost reduction with a rituximab biosimilar led to further ICER reductions: ICT ($29,078); ICT+RM ($37,810). Conclusion: Although the initial healthcare-associated costs were higher than RT, over a 15-year horizon ICT and ICT+RM are cost-effective treatments in early stage FL from the Australian tax-payer perspective. Although the costs may differ internationally, the results remain broadly generalisable given the costs incurred related to time in the failure-free state. Table 1:Comparison of healthcare costs, quality-adjusted life-years and cost-effectiveness between front-line therapies in early stage FL Table 1 Disclosures Tobin: Gilead: Research Funding. Gandhi:Gilead Sciences: Honoraria; Mater Research: Current Employment; Janssen-Cilag: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Roche: Other: Travel, accommodation, expenses ; Genentech: Honoraria; Amgen: Honoraria; Merck Sharp & Dohme: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Research Funding; Celgene: Research Funding. Mollee:Amgen: Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Caelum: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; BMS/Celgene: Membership on an entity's Board of Directors or advisory committees.

The cost–effectiveness of low-dose budesonide as a Step 2 treatment for pediatric asthma in China

2020 ◽  
Vol 9 (16) ◽  
pp. 1141-1151
Author(s):  
Xiaoling Wang ◽  
Honghao Fang ◽  
Kunling Shen ◽  
Tianyi Liu ◽  
Jipan Xie ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Dose ◽  
Rescue Therapy ◽  
Chinese Patient ◽  
Severe Exacerbation ◽  
Quality Adjusted Life Years ◽  
Payer Perspective ◽  
Life Years ◽  
The Cost ◽  
Quality Adjusted Life

Aim: To compare the cost–effectiveness of low-dose budesonide versus montelukast among patients aged 1–5 years from a Chinese patient and healthcare payer perspective. Materials & methods: A Markov model based on exacerbation states was developed. Exacerbation was defined as the need for rescue therapy (mild exacerbation) or hoscopitalization (moderate-to-severe exacerbation). Inputs including efficacy (i.e., exacerbation rates), mortality, utilities, costs and treatment adherence were obtained from literature. Results: Compared with montelukast, low-dose budesonide led to fewer exacerbation events (1.44 vs 2.15), lower costs (¥3675 vs 4130) and slightly more quality-adjusted life years (0.974 vs 0.967) over 1 year. Conclusion: These findings may improve the use of low-dose budesonide, an economically and clinically preferable treatment to montelukast in pediatric patients.

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