P0505COST ANALYSIS OF SCREENING FOR IGA NEPHROPATHY USING NOVEL BIOMARKERS

Abstract Background and Aims IgA nephropathy (IgAN) is the most common primary chronic glomerulonephritis and a major cause of end-stage kidney disease worldwide. Recently, novel biomarkers including aberrantly glycosylated IgA1 and the glycan-specific antibodies can be measured and will predict the IgAN. However, little is known about the cost-effectiveness of this screening method from the societal perspective. This is the cost analysis of additional novel biomarkers to the conventional IgAN screening strategy. Method Cost analysis was carried out to compare the two diagnostic strategies with or without biomarkers. We developed an analytical decision model to estimate the lifetime medical expense of each strategy. The decision tree was started at forty years old with first time hematuria, and simulated the clinical strategy after the screening using the novel biomarkers (Group N: N), and conventional strategy (Group C: C). The result of the analysis is presented as the lifetime medical expenses from societal perspective. Discount was not considered. Results Lifetime medical expenses per person during forty years were calculated as 31.6 million JPY (≈287,270 USD) for using the novel biomarkers, 33.9 million JPY (≈307,903 USD) for conventional strategy. They were lower by 2.3 million JPY (≈20,633 USD) in Group N. Moreover, by using the novel biomarkers, the expected value of IgAN led to increase by 5.67 percent points (N: 48.44%, C: 42.77%), and the expected value of the dialysis led to decrease by 0.85 percent points (N: 19.91%, C: 19.06%). One-way sensitive analysis showed that the prevalence of IgAN was the most influential variable. In the sensitivity analysis, the rate of tonsillectomy with steroid pulse therapy and achieved clinical remission was higher, the expected lifetime expenses were reduced by 3.3 million JPY (≈30,355 USD) and the expected value of the dialysis led to decrease by 1.76 percent points (N: 11.80%, C: 13.56%). Conclusion Screening for IgAN using novel biomarkers is expected to reduce the lifetime medical expenses.

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Cost Analysis of Screening for IgA Nephropathy Using Novel Biomarkers

Value in Health Regional Issues ◽

10.1016/j.vhri.2021.07.011 ◽

2022 ◽

Vol 29 ◽

pp. 8-15

Author(s):

Mami Ishida ◽

Keiichi Matsuzaki ◽

Hiroshi Ikai ◽

Hitoshi Suzuki ◽

Takashi Kawamura ◽

...

Keyword(s):

Cost Analysis ◽

Iga Nephropathy ◽

Novel Biomarkers

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Identyfikacja kosztów pogorszenia reputacji przedsiębiorstwa z perspektywy interesariuszy

Przegląd Organizacji ◽

10.33141/po.2014.04.02 ◽

2014 ◽

pp. 10-15

Author(s):

Danuta Szwajca ◽

Alina Rydzewska ◽

Tomasz Nawrocki

Keyword(s):

Cost Analysis ◽

Economic Costs ◽

Crisis Situation ◽

Modern Economy ◽

The Cost ◽

A Company ◽

Crisis Situations

In the realities of modern economy even the best-managed company is not able to avoid threats and bad decisions, that can cause a crisis. Each crisis situation, that a company experiences, generates not only measurable economic costs, but also more difficult to assess and measure costs of a deteriorated reputation. These costs are the result of infringement of interests or failing to satisfy different stakeholders expectations. The aim of this article is an attempt to identify the cost of reputation deterioration in the context of the various interests of stakeholders groups. In the first part, the paper presents the effects of good and bad reputation, the reputation "contamination" path in a crisis situation and a cost analysis caused by it. The second part is empirical, where the identification of crisis situations measurable costs and reputation deterioration based on the examples of three selected companies was performed.

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Insights into Transdermal Drug Delivery: Approaches for Redressal of a Burgeoning Issue of Osteoporosis

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200520100327 ◽

2020 ◽

Vol 20 (10) ◽

pp. 1682-1695

Author(s):

Foziyah Zakir ◽

Kanchan Kohli ◽

Farhan J. Ahmad ◽

Zeenat Iqbal ◽

Adil Ahmad

Keyword(s):

Drug Delivery ◽

Transdermal Delivery ◽

Oral Delivery ◽

Calcium Absorption ◽

Early Stage ◽

Osteoporotic Fractures ◽

The Novel ◽

Systemic Delivery ◽

Primary Focus ◽

The Cost

Osteoporosis is a progressive bone disease that remains unnoticed until a fracture occurs. It is more predominant in the older age population, particularly in females due to reduced estrogen levels and ultimately limited calcium absorption. The cost burden of treating osteoporotic fractures is too high, therefore, primary focus should be treatment at an early stage. Most of the marketed drugs are available as oral delivery dosage forms. The complications, as well as patient non-compliance, limit the use of oral therapy for prolonged drug delivery. Transdermal delivery systems seem to be a promising approach for the delivery of anti-osteoporotic active moieties. One of the confronting barriers is the passage of drugs through the SC layers followed by penetration to deeper dermal layers. The review focuses on how anti-osteoporotic drugs can be molded through different approaches so that they can be exploited for the skin to systemic delivery. Insights into the various challenges in transdermal delivery and how the novel delivery system can be used to overcome these have also been detailed.

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Costs and the cost-effectiveness threshold

10.1093/oso/9780198794837.003.0019 ◽

2017 ◽

Author(s):

Jan Abel Olsen

Keyword(s):

Societal Perspective ◽

Threshold Value ◽

Quality Adjusted Life Year ◽

Healthcare Sector ◽

The Difference ◽

The Cost ◽

Qaly Threshold ◽

Cost Effectiveness Threshold ◽

Effectiveness Threshold ◽

Quality Adjusted Life

Chapter 19 starts by distinguishing between the two contrasting perspectives that an economic evaluation would take: the healthcare sector perspective versus the societal perspective. The former is considered a ‘narrow analysis’ which includes only the costs accruing within the healthcare sector, while the latter represents a ‘broad analysis’ that accounts for all resource implications in all sectors of the economy. After an investigation into various types of costs, a ‘limited societal perspective’ is suggested to be more appropriate than either of the two ‘extreme perspectives’. The chapter continues with a discussion of the cost per quality-adjusted life year (QALY) threshold and explains the difference between a demand side- versus a supply-side approach to determining a threshold value for a QALY.

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Economic impact of the use of the National Surgical Quality Improvement Program

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320000616 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Alvine Fansi ◽

Angela Ly ◽

Julie Mayrand ◽

Maggy Wassef ◽

Aldanie Rho ◽

...

Keyword(s):

Quality Improvement ◽

Cost Analysis ◽

Economic Impact ◽

Quality Improvement Program ◽

Economic Evaluations ◽

Complication Rates ◽

Improvement Program ◽

Surgical Quality ◽

Acs Nsqip ◽

The Cost

Objectives The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) is a validated, risk-adjusted database for improving the quality and security of surgical care. ACS NSQIP can help participating hospitals target areas that need improvement. The aim of this study was to systematically review the literature analyzing the economic impact of using NSQIP. This paper also provides an estimation of annual cost savings following the implementation of NSQIP and quality improvement (QI) activities in two hospitals in Quebec. Methods In June 2018, we searched in seven databases, including PubMed, Embase, and NHSEED for economic evaluations based on NSQIP data. Contextual NSQIP databases from two hospitals were collected and analyzed. A cost analysis was conducted from the hospital care perspective, comparing complication costs before and after 1 year of the implementation of NSQIP and QI activities. The number and the cost of complications are measured. Costs are presented in 2018 Canadian dollars. Results Out of 1,612 studies, 11 were selected. The level of overall evidence was judged to be of moderate to high quality. In general, data showed that, following the implementation of NSQIP and QI activities, a significant decrease in complications and associated costs was observed, which improved with time. In the cost analysis of contextual data, the reduction in complication costs outweighed the cost of implementing NSQIP. However, this cost analysis did not take into account the costs of QI activities. Conclusions NSQIP improves complication rates and associated costs when QI activities are implemented.

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A cost analysis to address issues of budget constraints on the implementation of the indoor residual spray programme in two districts of Maputo Province, Mozambique

Malaria Journal ◽

10.1186/s12936-020-03556-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Neide Canana

Keyword(s):

Sensitivity Analysis ◽

Cost Analysis ◽

Financial Analysis ◽

Indoor Residual Spraying ◽

Economic Cost ◽

Cost Information ◽

Financial Cost ◽

Provider Perspective ◽

The Government ◽

The Cost

Abstract Background It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions. Methods Cost information was collected retrospectively from the provider perspective, and both economic and financial costs were calculated. A “one-way” deterministic sensitivity analysis was performed. Results The average economic costs totaled US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. The average financial cost totaled US$69,174.83, with an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Vehicle, salary, and insecticide costs were the greatest contributors to overall cost in the economic and financial analysis, corresponding to 52%, 17%, and 13% in the economic analysis and 21%, 27%, and 22% in the financial analysis, respectively. The sensitivity analysis was adapted to a range of ± (above and under) 25% change. There was an approximate change of 14% in the average economic cost when vehicle costs were decreased by 25%. In the financial analysis, the average financial cost was lowered by 7% when salary costs were decreased by 25%. Conclusions Altogether, the current cost analysis provides an impetus for the consideration of targeted IRS operationalization within the available governmental budget, by using locally-available human resources as spray operators to decrease costs and having IRS rounds be correctly timed to coincide with the build-up of vector populations.

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Cost-Effectiveness of Colorectal Cancer Genetic Testing

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168330 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8330

Author(s):

Abdul Rahman Ramdzan ◽

Mohd Rizal Abdul Manaf ◽

Azimatun Noor Aizuddin ◽

Zarina A. Latiff ◽

Keng Wee Teik ◽

...

Keyword(s):

Colorectal Cancer ◽

Genetic Testing ◽

Cost Effectiveness ◽

Cancer Survival ◽

Screening Method ◽

Targeted Prevention ◽

Activity Based Costing ◽

Cross Sectional ◽

Increased Risk ◽

The Cost

Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths worldwide. Approximately 3–5% of CRCs are associated with hereditary cancer syndromes. Individuals who harbor germline mutations are at an increased risk of developing early onset CRC, as well as extracolonic tumors. Genetic testing can identify genes that cause these syndromes. Early detection could facilitate the initiation of targeted prevention strategies and surveillance for CRC patients and their families. The aim of this study was to determine the cost-effectiveness of CRC genetic testing. We utilized a cross-sectional design to determine the cost-effectiveness of CRC genetic testing as compared to the usual screening method (iFOBT) from the provider’s perspective. Data on costs and health-related quality of life (HRQoL) of 200 CRC patients from three specialist general hospitals were collected. A mixed-methods approach of activity-based costing, top-down costing, and extracted information from a clinical pathway was used to estimate provider costs. Patients and family members’ HRQoL were measured using the EQ-5D-5L questionnaire. Data from the Malaysian Study on Cancer Survival (MySCan) were used to calculate patient survival. Cost-effectiveness was measured as cost per life-year (LY) and cost per quality-adjusted life-year (QALY). The provider cost for CRC genetic testing was high as compared to that for the current screening method. The current practice for screening is cost-saving as compared to genetic testing. Using a 10-year survival analysis, the estimated number of LYs gained for CRC patients through genetic testing was 0.92 years, and the number of QALYs gained was 1.53 years. The cost per LY gained and cost per QALY gained were calculated. The incremental cost-effectiveness ratio (ICER) showed that genetic testing dominates iFOBT testing. CRC genetic testing is cost-effective and could be considered as routine CRC screening for clinical practice.

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Modeling the cost-effectiveness of a new treatment for MS (natalizumab) compared with current standard practice in Sweden

Multiple Sclerosis Journal ◽

10.1177/1352458507086667 ◽

2008 ◽

Vol 14 (5) ◽

pp. 679-690 ◽

Cited By ~ 31

Author(s):

G Kobelt ◽

J Berg ◽

P Lindgren ◽

B Jonsson ◽

L Stawiarz ◽

...

Keyword(s):

Clinical Trial ◽

Cost Effectiveness ◽

Societal Perspective ◽

Functional Disability ◽

Health Benefit ◽

Base Case ◽

Current Standard ◽

Disease Modifying Drugs ◽

New Treatment ◽

The Cost

Objective To estimate the cost-effectiveness of a new treatment (natalizumab) for multiple sclerosis (MS) compared with current standard therapy with disease-modifying drugs (DMDs) in Sweden. Methods A Markov model was constructed to illustrate disease progression based on functional disability (the Expanded Disability Status Scale (EDSS)). The effectiveness of natalizumab was based on a 2-year clinical trial in 942 patients (AFFIRM). The effectiveness of current DMDs was estimated from a matched sample of 512 patients in the Stockholm MS registry. Patients withdrawing from treatment were assumed to follow the disease course of 824 patients with relapsing–remitting disease at onset in the Ontario natural history cohort. Costs and utilities are based on a recent observational study in 1339 patients. All data sets were available at the patient level. Main results are presented from the societal perspective, over a 20-year time frame, in 2005 Euros (€1 = 9.25 SEK). Results In the base case, treatment with natalizumab was less expensive and more effective than treatment with current DMDs. When only healthcare costs were considered, the cost per quality-adjusted life year gained with natalizumab was €38 145. Results are sensitive only to the time horizon of the analysis and assumptions about effectiveness of natalizumab beyond the trial. Conclusions This cost-effectiveness analysis used registry data, cohort and observational studies to extrapolate the efficacy findings of natalizumab from the AFFIRM clinical trial to measure effectiveness in clinical practice. The analysis results suggest that for the population considered, natalizumab provides an additional health benefit at a similar cost to current DMDs from a societal perspective.

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National Economic Burden Associated with Management of Periodontitis in Malaysia

International Journal of Dentistry ◽

10.1155/2016/1891074 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Tuti Ningseh Mohd Dom ◽

Rasidah Ayob ◽

Khairiyah Abd Muttalib ◽

Syed Mohamed Aljunid

Keyword(s):

Societal Perspective ◽

Economic Burden ◽

Census Data ◽

Adult Population ◽

National Level ◽

Indirect Costs ◽

Treatment Costs ◽

High Prevalence ◽

National Economic ◽

The Cost

Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective.Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis.Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis.Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

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