Cost-effectiveness of Hepatitis A vaccination in a developed and developing country

2019 ◽  
Vol 32 (8) ◽  
pp. 1175-1199 ◽  
Author(s):  
Nidhi Ghildayal
Keyword(s):  
Cost Effectiveness ◽  
Rio De Janeiro ◽  
Hepatitis A ◽  
Cost Effective ◽  
Universal Vaccination ◽  
Vaccination Policy ◽  
Developing Regions ◽  
Developed Country ◽  
Content Type ◽  
The Usa

Purpose Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a “developed” area: the USA, and a less economically developed country (LEDC), generally known as a “developing” area: the state of Rio de Janeiro, Brazil. Design/methodology/approach This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected. Findings The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination. Originality/value This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study’s approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.

The cost-effectiveness of insulin analogs and regular insulin for diabetes control: a case study in Iran

2020 ◽  
Vol 33 (4/5) ◽  
pp. 323-331
Author(s):  
Mohsen pakdaman ◽  
Raheleh akbari ◽  
Hamid reza Dehghan ◽  
Asra Asgharzadeh ◽  
Mahdieh Namayandeh
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Regular Insulin ◽  
Diabetes Control ◽  
Diabetic Patients ◽  
Insulin Analogs ◽  
Content Type ◽  
Patients With Diabetes ◽  
The Government ◽  
The Cost

PurposeFor years, traditional techniques have been used for diabetes treatment. There are two major types of insulin: insulin analogs and regular insulin. Insulin analogs are similar to regular insulin and lead to changes in pharmacokinetic and pharmacodynamic properties. The purpose of the present research was to determine the cost-effectiveness of insulin analogs versus regular insulin for diabetes control in Yazd Diabetes Center in 2017.Design/methodology/approachIn this descriptive–analytical research, the cost-effectiveness index was used to compare insulin analogs and regular insulin (pen/vial) for treatment of diabetes. Data were analyzed in the TreeAge Software and a decision tree was constructed. A 10% discount rate was used for ICER sensitivity analysis. Cost-effectiveness was examined from a provider's perspective.FindingsQALY was calculated to be 0.2 for diabetic patients using insulin analogs and 0.05 for those using regular insulin. The average cost was $3.228 for analog users and $1.826 for regular insulin users. An ICER of $0.093506/QALY was obtained. The present findings suggest that insulin analogs are more cost-effective than regular insulin.Originality/valueThis study was conducted using a cost-effectiveness analysis to evaluate insulin analogs versus regular insulin in controlling diabetes. The results of study are helpful to the government to allocate more resources to apply the cost-effective method of the treatment and to protect patients with diabetes from the high cost of treatment.

scholarly journals Considerations on the Current Universal Vaccination Policy against Hepatitis A in Greece after Recent Outbreaks

PLoS ONE ◽  
2015 ◽  
Vol 10 (1) ◽  
pp. e0116939 ◽  
Author(s):  
Kassiani Mellou ◽  
Theologia Sideroglou ◽  
Vassiliki Papaevangelou ◽  
Anna Katsiaflaka ◽  
Nikolaos Bitsolas ◽  
...  
Keyword(s):  
Hepatitis A ◽  
Universal Vaccination ◽  
Vaccination Policy

Performance evaluations and junior auditors’ attitude to audit behavior: a gender and culture comparative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sandra Khalil ◽  
Rabih Nehme
Keyword(s):  
Performance Appraisal ◽  
Statistical Tests ◽  
Developed Countries ◽  
Developed Country ◽  
Content Type ◽  
The Usa ◽  
And Gender ◽  
Internship Programs ◽  
Educational Path ◽  
The Impact

Purpose The purpose of this paper is to shed light on factors leading to unethical acts committed by auditors from a cultural and gender perspectives. It investigates differences in junior auditors’ attitudes towards audit behavior when a performance evaluation (PE) is anticipated. The objective of this study is to aid academicians and audit executives in developing new models of PE and internship programs that should mitigate dysfunctional behavior. Design/methodology/approach A survey adapted from Big Four companies’ performance appraisal templates was administered to junior accountants who have completed their internship programs and their external audit course at accredited universities in Lebanon and the USA. Several statistical tests were conducted to analyze the relationship between the different variables. Findings This paper shows how PE affects junior auditors’ attitudes to dysfunctional audit behavior (DAB). From a cultural standpoint, American auditors express more negative views towards DAB than their Lebanese counterparts. This paper also demonstrates that female auditors are less inclined towards DAB than male auditors. Originality/value Previous studies on the topic have been mostly conducted in developed countries with a scarcity of studies examining multiple countries. This study focuses on two different cultural contexts, a developed country, the USA and an emerging country, poorly represented in the literature, Lebanon. This paper also observes variances between male and female auditors in DAB when expecting a PE. The originality of this paper stems from its concurrent examination of the impact of gender and culture on DAB by using a sample of less-experienced auditors at the end of their educational path.

scholarly journals Cost-effectiveness of single-dose zoledronic acid for nursing home residents with osteoporosis in the USA

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022585 ◽  
Author(s):  
Kouta Ito
Keyword(s):  
Nursing Home ◽  
Single Dose ◽  
Cost Effectiveness ◽  
Zoledronic Acid ◽  
Usual Care ◽  
Nursing Home Residents ◽  
Cost Effective ◽  
Routine Administration ◽  
The Usa ◽  
The Cost

ObjectiveTo evaluate the cost-effectiveness of routine administration of single-dose zoledronic acid for nursing home residents with osteoporosis in the USA.DesignMarkov cohort simulation model based on published literature from a healthcare sector perspective over a lifetime horizon.SettingNursing homes.ParticipantsA hypothetical cohort of nursing home residents aged 85 years with osteoporosis.InterventionsTwo strategies were compared: (1) a single intravenous dose of zoledronic acid 5 mg and (2) usual care (supplementation of calcium and vitamin D only).Primary and secondary outcome measuresIncremental cost-effectiveness ratio (ICER), as measured by cost per quality-adjusted life year (QALY) gained.ResultsCompared with usual care, zoledronic acid had an ICER of $207 400 per QALY gained and was not cost-effective at a conventional willingness-to-pay threshold of $100 000 per QALY gained. The results were robust to a reasonable range of assumptions about incidence, mortality, quality-of-life effects and the cost of hip fracture and the cost of zoledronic acid. Zoledronic acid had a potential to become cost-effective if a fracture risk reduction with zoledronic acid was higher than 23% or if 6-month mortality in nursing home residents was lower than 16%. Probabilistic sensitivity analysis showed that the zoledronic acid would be cost-effective in 14%, 27% and 44% of simulations at willingness-to-pay thresholds of $50 000, $100 000 or $200 000 per QALY gained, respectively.ConclusionsRoutine administration of single-dose zoledronic acid in nursing home residents with osteoporosis is not a cost-effective use of resources in the USA but could be justifiable in those with a favourable life expectancy.

scholarly journals Cost-effectiveness of TB treatments to Burmese and Laotian patients by Thai hospitals on the border with Myanmar and Laos

2019 ◽  
Vol 34 (1) ◽  
pp. 13-21
Author(s):  
Onn Laingoen ◽  
Tawatchai Apidechkul ◽  
Panupong Upala ◽  
Ratipark Tamornpark ◽  
Chaleerat Foungnual ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Care Program ◽  
Cost Effective ◽  
Cost Effectiveness Ratio ◽  
Content Type ◽  
Total Cost ◽  
Tb Treatment ◽  
Retrospective Data Collection ◽  
The Cost

Purpose The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos. Design/methodology/approach A retrospective data collection was conducted to analyze all costs relevant to TB treatment and care from Mae Sai and Chiang Sean Hospitals. The cost related to TB treatment and care and the number of successful TB treatment from January 1 to December 31, 2017 were used for the calculation. The cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER) were the outcomes. Findings In 2017, the total cost of the TB treatment and care program at Mae Sai Hospital was 482,728.94 baht for 57 TB patients. The cast per treated case per year was 8,468.93 baht. The C/E was 10,971.11 baht per successful TB treatment (44 successful cases). The total cost of the TB treatment and care program at Chiang Sean Hospital was 330,578.73 baht for 39 TB patients. The cost per treated case per year was 8,476.38 baht. The C/E was 22,038.58 baht per successful TB treatment (15 successful cases). The ICER was 5,246.56 baht. The Mae Sai Hospital model was more cost-effective in terms of the treatment and care provided to Burmese patients with TB than the Chiang Sean Hospital model for Laotian patients with TB. Originality/value To improve the cost-effectiveness of TB treatment and care programs for foreign patients in hospitals located on the Thai border, focus should be placed on patient follow-up at the community or village level.

Epidemiological shift of hepatitis A in EAGLE countries – a projection

2019 ◽  
Vol 33 (1) ◽  
pp. 110-119
Author(s):  
Nidhi Ghildayal
Keyword(s):  
Mortality Rate ◽  
Hepatitis A ◽  
Economic Status ◽  
Emerging Market ◽  
Rapid Development ◽  
Weighted Average ◽  
Prototype Model ◽  
Developed Country ◽  
Content Type ◽  
Productivity Costs

Purpose Many world regions are developing quickly and experiencing increasing levels of sanitation, causing an epidemiological shift of hepatitis A in these areas. The shift occurs when children avoid being infected with the disease until a later age due to cleaner water sources, food, and hygiene practices in their environment; but if they are infected at later age, the disease is much more severe and lost productivity costs are higher. The purpose of this paper is to examine what could occur if an epidemiological shift of the disease continues in these regions, and what type of future burden hepatitis A may have in a hypothetical rapidly developing country. Design/methodology/approach Initially, annual hepatitis A mortality was regressed on the Human Development Index (HDI) for each country classified as an emerging and growth-leading economy (EAGLE) to provide an overview of how economic development and hepatitis A mortality related. Data from the various EAGLE countries were also fit to a model of hepatitis A mortality rates in relation to HDI, which were both weighted by each country’s 1995–2010 population of available data, in order to create a model for a hypothetical emerging market country. A second regression model was fit for the weighted average annual hepatitis A mortality rate of all EAGLE countries from the years 1995 to 2010. Additionally, hepatitis A mortality rate was regressed on year. Findings Regression results show a constant decline of mortality as HDI increased. For each increase of one in HDI value in this hypothetical country, mortality rate declined by 2.3016 deaths per 100,000 people. The hypothetical country showed the HDI value increasing by 0.0073 each year. Also, results displayed a decrease in hepatitis A mortality rate of 0.0168 per 100,000 people per year. Finally, the mortality rate for hepatitis A in this hypothetical country is projected to be down to 0.11299 deaths per 100,000 people by 2030 and its economic status will fall just below the HDI criteria for a developed country by 2025. Originality/value The hypothetical country as a prototype model was created from the results of regressed data from EAGLE countries. It is aimed to display an example of the health and economic changes occurring in these rapidly developing regions in order to help understand potential hepatitis A trends, while underscoring the importance of informed and regular policy updates in the coming years. The author believes this regression provides insight into the patterns of hepatitis A mortality and HDI as these EAGLE countries undergo rapid development.

Comparative study of technological innovativeness between individuals in the USA and India

2016 ◽  
Vol 26 (1) ◽  
pp. 100-117 ◽  
Author(s):  
Andreas Klein ◽  
Parimal Bhagat
Keyword(s):  
Principal Component ◽  
Structural Factors ◽  
Thinking Style ◽  
Basic Study ◽  
Developed Country ◽  
Basic Premise ◽  
Content Type ◽  
The Usa ◽  
The Impact ◽  
Technological Products

Purpose – One of the key drivers of competitiveness and growth of emerging countries is their ability to innovate. While India has successfully implemented innovative processes for software development, many Western nations have led in new product designs. The purpose of this paper is to examine the basic premise that the underlying ability of a country to innovate, while being constrained by other situational and structural factors, depends on the innate ability of especially younger individuals in a society to be innovative. Recognizing this trait, companies have recently begun considering consumers as co-creators of technological products and services. Design/methodology/approach – Research has focused on the impact of innovativeness in the adoption and use of new technological products with limited research of its impact on the design and creation process. This basic study compares the technological innovativeness of young individuals between a developed country (USA) and an emerging economy (India) along several psychological and behavioral dimensions. Scale reliabilities, principal component analyses and regression analyses were conducted to find main influencers on technological innovativeness in both countries. Findings – While hypothesis were derived that creativity, passion, expertise, thinking style and psychographics influence innovativeness, results reveal first impressions that expertise and psychographics are the main influencers on the technological innovativeness of young individuals in both countries. Moreover, a decomposition of thinking style does not add further predictive power to the model. Originality/value – The paper helps to extend the understanding as well as to carve out main drivers of technological innovativeness of young individuals across countries. Implications on cross-cultural research and for managers as well as directions for further research are discussed.

scholarly journals Do return to work interventions for workers with disabilities and health conditions achieve employment outcomes and are they cost effective? A systematic narrative review

2018 ◽  
Vol 40 (6) ◽  
pp. 999-1014 ◽  
Author(s):  
Pauline Dibben ◽  
Geoffrey Wood ◽  
Rachel O’Hara
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Return To Work ◽  
Cost Effective ◽  
Employment Outcomes ◽  
Health Conditions ◽  
Content Type ◽  
Musculoskeletal Conditions ◽  
Mental Health Conditions ◽  
Lower Back

Purpose The purpose of this paper is to evaluate existing evidence on whether return to work interventions achieve employment outcomes and are cost effective in order to better inform those needing accommodations at work, as well as their line managers and trade union representatives, occupational health specialists and HR managers. Design/methodology/approach The paper uses a systematic narrative review to evaluate the evidence on the employment outcomes and cost effectiveness of return to work initiatives. Findings Evidence on interventions for musculoskeletal conditions such as lower back pain indicates that certain forms of intervention such as vocational rehabilitation and workplace-based rehabilitation facilitate outcomes such as employment, reduced sick leave and effective return to work. However, there is very little evidence on whether these interventions are cost effective. More generally there are glaring gaps in evidence on cardio-respiratory (heart and breathing) and mental health conditions with regard to both employment outcomes and the cost of interventions. Research limitations/implications This systematic review has critical and timely implications for both knowledge development and practice. While highlighting methodological limitations in the existing research base, it also presents avenues for further research on return work strategies and the factors inhibiting and facilitating their adoption and effective operation. Originality/value Although there is much existent literature on the return to work process, far less attention has been paid to the employment outcomes and cost effectiveness of interventions. This paper highlights the interventions for musculoskeletal conditions such as lower back conditions that may result in positive employment outcomes, with implications for practice. However, it also highlights gaps in evidence on the employment outcomes and cost effectiveness of interventions for cardio-respiratory (heart and breathing) and mental health conditions.

The cost-effectiveness of universal vaccination of children against hepatitis A in Argentina: results of a dynamic health–economic analysis

2007 ◽  
Vol 42 (2) ◽  
pp. 152-160 ◽  
Author(s):  
Eduardo Lopez ◽  
Roberto Debbag ◽  
Laurent Coudeville ◽  
Florence Baron-Papillon ◽  
Judith Armoni
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Economic Analysis ◽  
Hepatitis A ◽  
Universal Vaccination ◽  
Health Economic Analysis ◽  
The Cost

PP167 Cost Effectiveness Of Universal Childhood Vaccination Against Hepatitis A

2021 ◽  
Vol 37 (S1) ◽  
pp. 24-24
Author(s):  
Cristina Valcarcel-Nazco ◽  
Carmen Guirado-Fuentes ◽  
Lidia García-Pérez ◽  
Renata Linertová ◽  
Javier Mar ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis A ◽  
National Health System ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Childhood Vaccination ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Effective Option ◽  
Intermediate Endemicity

IntroductionHepatitis A (HA) is a liver disease with a low mortality rate, but it can cause debilitating symptoms and fulminant hepatitis in some cases. Its incidence is greater in geographical areas with poor sanitation and hygiene. Spain is considered a low-endemicity country, so universal childhood immunization against HA is currently not financed by the National Health System. The aim of this study was to synthesize the scientific evidence on the cost effectiveness of universal childhood vaccination against HA.MethodsFull economic evaluations, published in the English or Spanish languages, were included if they reported outcome measures related to the prevention of HA, adverse effects, or incremental cost-effectiveness ratios (ICERs). The Medline, Embase and Cochrane Library databases were searched for articles published from the beginning of the databases to April 2018.ResultsA total of 23 economic evaluations were included: one in a country of high endemicity, nine in countries of intermediate endemicity, and 13 in countries with low endemicity. Only one Spanish study, published in 1997, was found. Studies conducted in high- and intermediate- endemicity countries concluded that a universal childhood vaccination program against HA was a cost-effective option. However, in the case of countries with low endemicity the results were heterogeneous, although most agreed that a systematic vaccination strategy would not be a cost-effective option and that the adoption of such a strategy would not be justified given the limited benefits it would offer. The results of the economic evaluations depended on parameters such as the price and duration of the vaccine effect and the program coverage.ConclusionsIn countries with low endemicity the results were heterogeneous, although most studies concluded that the implementation of a universal vaccination strategy is not justified from the point of view of cost effectiveness.

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