Incremental Cost-effectiveness Analysis on Length of Stay of an Enhanced Recovery After Spine Surgery Program

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bhiken I. Naik ◽  
Lauren K. Dunn ◽  
Tanya N. Wanchek
Keyword(s):  
Cost Effectiveness ◽  
Length Of Stay ◽  
Incremental Cost ◽  
Spine Surgery ◽  
Enhanced Recovery ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis

Incremental Cost-Effectiveness Analysis

1999 ◽  
Vol 52 (6) ◽  
pp. 517-522 ◽  
Author(s):  
Scott B. Cantor ◽  
Theodore G. Ganiats
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis

Cost-effectiveness analysis of neoadjuvant immune checkpoint inhibition (ICI) versus cisplatin-based chemotherapy (CBC) in muscle-invasive bladder cancer (MIBC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 419-419
Author(s):  
Ali Raza Khaki ◽  
Yong Shan ◽  
Richard Nelson ◽  
Sapna Kaul ◽  
John L. Gore ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Randomized Clinical Trials ◽  
Pathologic Complete Response ◽  
Weighted Average ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Sensitivity Analyses ◽  
Effectiveness Analysis

419 Background: Multiple single-arm clinical trials have shown promising pathologic complete response (pCR) rates with neoadjuvant ICIs in MIBC. However, ICIs remain costly. We conducted a cost-effectiveness analysis comparing neoadjuvant ICIs with CBC. Methods: We applied a decision analytic simulation model with a health care payer perspective and two-year time horizon to compare neoadjuvant ICIs vs CBC. For the primary analysis we compared pembrolizumab with dose dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC). We performed a secondary analysis with gemcitabine/cisplatin (GC) as CBC and exploratory analyses with atezolizumab or nivolumab/ipilimumab as ICIs (vs both ddMVAC and GC). We input pCR rates from trials (ICIs) or a weighted average of prior studies (CBC) and costs from average sales price. Outcomes of interest included costs, 2-year recurrence-free survival (RFS), and incremental cost-effectiveness ratio (ICER) of cost per 2-year RFS. A threshold analysis estimated a pCR rate or price reduction for ICI to be cost-effective and one-way and probabilistic sensitivity analyses were performed. Results: Results of the cost effectiveness analysis are shown in the table. The incremental cost of pembrolizumab compared with ddMVAC was $8,042 resulting in an incremental improvement of 0.66% in 2-year RFS for an ICER of $1,218,485 per 2-year RFS. A pCR of 71% or a 26% reduction in cost of pembrolizumab would render it more cost-effective with an ICER of $100,000 per 2-year RFS. GC required a 96% pembrolizumab cost reduction to achieve an ICER of $100,000 per 2-year RFS. Atezolizumab appeared to be more cost-effective than ddMVAC, even though the 2yr RFS was 0.66% worse. Conclusions: ICIs were not cost-effective as neoadjuvant therapies, except when atezolizumab was compared with ddMVAC. Pembrolizumab would approach cost-effective thresholds with 26% or 96% reduction in cost when compared to ddMVAC and GC, respectively. Randomized clinical trials, larger sample sizes and longer follow-up are required to better understand the value of ICIs as neoadjuvant treatments. [Table: see text]

scholarly journals Patient-Controlled Intravenous Morphine Analgesia Combined with Transcranial Direct Current Stimulation for Post-Thoracotomy Pain: A Cost-Effectiveness Study and A Feasibility for Its Future Implementation

2020 ◽  
Vol 17 (3) ◽  
pp. 816 ◽  
Author(s):  
Nemanja Rancic ◽  
Katarina Mladenovic ◽  
Nela V. Ilic ◽  
Viktorija Dragojevic-Simic ◽  
Menelaos Karanikolas ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cost Effectiveness Analysis ◽  
Control Group ◽  
Morphine Analgesia ◽  
Direct Current Stimulation ◽  
Effectiveness Analysis ◽  
Intravenous Morphine

This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS, n = 27) received tDCS over the left primary motor cortex for five days, whereas patients assigned to the control group (sham-tDCS, n = 28) received sham tDCS stimulations. All patients received postoperative PCA-IV morphine. For cost-effectiveness analysis we used data about total amount of PCA-IV morphine and maximum visual analog pain scale with cough (VASP-Cmax). Direct costs of hospitalization were assumed as equal for both groups. Cost-effectiveness analysis was performed with the incremental cost-effectiveness ratio (ICER), expressed as the incremental cost (RSD or US$) per incremental gain in mm of VASP-Cmax reduction. Calculated ICER was 510.87 RSD per VASP-Cmax 1 mm reduction. Conversion on USA market (USA data 1.325 US$ for 1 mg of morphine) revealed ICER of 189.08 US$ or 18960.39 RSD/1 VASP-Cmax 1 mm reduction. Cost-effectiveness expressed through ICER showed significant reduction of PCA-IV morphine costs in the tDCS group. Further investigation of tDCS benefits with regards to reduction of postoperative pain treatment costs should also include the long-term benefits of reduced morphine use.

scholarly journals ANALISIS EFEKTIVITAS BIAYA PADA PASIEN ANAK DEMAM TIFOID DI RUMAH SAKIT BHAYANGKARA MANADO

PHARMACON ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 335
Author(s):  
Agatha Agnes ◽  
Gayatri Citraningtyas ◽  
Sri Sudewi
Keyword(s):  
Cost Effectiveness ◽  
Typhoid Fever ◽  
Incremental Cost ◽  
Pediatric Patients ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Record Data

ABSTRACT Typhoid fever is an endemic disease which it incidence rate is still high in Indonesian. Administering antibiotic therapy can do treatment of typhoid fever. This study was conducted since there are several pediatric patients diagnosed with typhoid fever but have different antibiotic therapies, namely cefotaxime and ceftriaxone therapy, so it is necessary to do calculations to determine the comparison and determine which treatment is more efficient in cost and effectiveness. The method used in this study is CEA (Cost-Effectiveness Analysis) with the design of retrieving medical record data of children with typhoid fever in Bhayangkara Manado Hospital retrospectively from January to December 2018. The samples  obtained were 28 pediatric patients, cinsisting of 12 patients using cefotaxime therapy and 16 patients using ceftriaxone therapy. The result of ACER (An Avarage Cost Effective Ratio) obtained by ceftriaxone were Rp. 526.609,-/day and cefotaxime Rp. 484.789,-/day. In this study, if patients under cefotaxime therapy want to swich treatment to ceftriaxone therapy, ICER calculation (Incremental Cost-Effectiveness Ratio) is carried out the result are Rp.340.528,-. Keyword: Typhoid fever, Antibiotics, CEA (Cost-Effectiveness Analysis) ABSTRAK Demam tifoid merupakan penyakit endemik yang angka kejadiannya masih tinggi di Indonesia. Pengobatan demam tifoid dapat diobati dengan cara pemberian terapi antibiotik. Penelitian ini dilakukan karena ada beberapa pasien anak yang di diagnosa demam tifoid tetapi memiliki terapi antibiotik yang berbeda, yaitu terapi sefotaksim dan seftriakson  sehingga perlu dilakukan perhitungan untuk mengetahui perbandingan dan menentukan pemilihan pengobatan mana yang lebih efisien dalam biaya maupun efektivitas. Metode yang digunakan dalam penelitian ini adalah CEA (Cost-Effectiveness Analysis) dengan rancangan pengambilan data rekam medik pasien anak demam tifoid di RS. Bhayangkara Manado secara retrospektif pada periode Januari – Desember 2018. Sampel yang didapat sebanyak 28 pasien anak, yang terdiri dari 12 pasien pengguna terapi sefotaksim dan 16 pasien pengguna terapi seftriakson. Hasil ACER (An Avarage Cost Effective Ratio) yang diperoleh sefotaksim Rp.526.609,-/hari dan seftriakson Rp.484.789,-/hari. Pada penelitian ini jika pasien terapi sefotaksim ingin berpindah pengobatan ke terapi seftriakson maka dilakukan perhitungan ICER (Incremental Cost-Effectiveness Ratio) dan didapat hasil Rp.340.582,-, sehingga jika ingin berpindah pengobatan maka perlu penambahan biaya sesuai nilaI ICER.Kata Kunci : Demam Tifoid, Antibiotik, CEA (Cost-Effectiveness Analysis).

Spinal vs General Anesthesia in Lumbar Spine Surgery: A Multicenter Cost-Effectiveness Analysis

2017 ◽  
Vol 17 (10) ◽  
pp. S200
Author(s):  
Matthew Morris ◽  
Jonathan Morris ◽  
Woojin Cho ◽  
Manal Abouelrigal ◽  
Camari Wallace ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lumbar Spine ◽  
General Anesthesia ◽  
Spine Surgery ◽  
Cost Effectiveness Analysis ◽  
Lumbar Spine Surgery ◽  
Effectiveness Analysis

scholarly journals Cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study: a protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050452
Author(s):  
Sarah Jane Stock ◽  
Amarnath Bhide ◽  
Heather Richardson ◽  
Mairead Black ◽  
Cassandra Yuill ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Process Evaluation ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cost Effectiveness Analysis ◽  
Cervical Ripening ◽  
Effectiveness Analysis ◽  
At Home

IntroductionThe aim of the cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study is to compare home versus in-hospital cervical ripening to determine whether home cervical ripening is safe (for the primary outcome of neonatal unit (NNU) admission), acceptable to women and cost-effective from the perspective of both women and the National Health Service (NHS).Methods and analysisWe will perform a prospective multicentre observational cohort study with an internal pilot phase. We will obtain data from electronic health records from at least 14 maternity units offering only in-hospital cervical ripening and 12 offering dinoprostone home cervical ripening. We will also conduct a cost-effectiveness analysis and a mixed methods study to evaluate processes and women/partner experiences. Our primary sample size is 8533 women with singleton pregnancies undergoing induction of labour (IOL) at 39+0 weeks’ gestation or more. To achieve this and contextualise our findings, we will collect data relating to a cohort of approximately 41 000 women undergoing IOL after 37 weeks. We will use mixed effects logistic regression for the non-inferiority comparison of NNU admission and propensity score matched adjustment to control for treatment indication bias. The economic analysis will be undertaken from the perspective of the NHS and Personal Social Services (PSS) and the pregnant woman. It will include a within-study cost-effectiveness analysis and a lifetime cost–utility analysis to account for any long-term impacts of the cervical ripening strategies. Outcomes will be reported as incremental cost per NNU admission avoided and incremental cost per quality adjusted life year gained.Research ethics approval and disseminationCHOICE has been funded and approved by the National Institute of Healthcare Research Health Technology and Assessment, and the results will be disseminated via publication in peer-reviewed journals.Trial registration numberISRCTN32652461.

Sign in / Sign up

Export Citation Format

Share Document