The cost-effectiveness of bimatoprost 0.03% in the treatment of glaucoma in adult patients - a European perspective

ABSTRACT Background Adults with short bowel syndrome have a high mortality and significant morbidity due to unsuccessful attempts at rehabilitation that necessitate chronic use of parenteral nutrition (PN). Teduglutide is a novel therapy that promotes intestinal adaptation to improve rehabilitation but with a price >$400,000/y. Objective The current study evaluated the cost-effectiveness of using teduglutide in US adult patients with short bowel syndrome. Methods A Markov model evaluated the costs (in US dollars) and effectiveness (in quality-adjusted life years, or QALYs) of treatment compared with no teduglutide use, with a presumed starting age of 40 y. Parameters were obtained from published data or estimation. The primary effect modeled was the increased likelihood of reduced PN days per week when using teduglutide, leading to greater quality of life and lower PN costs. Sensitivity analyses were performed on all model parameters. Results In the base scenario, teduglutide cost $949,910/QALY gained. In 1-way sensitivity analyses, only reducing teduglutide cost decreased the cost/QALY gained to below the typical threshold of $100,000/QALY gained. Specifically, teduglutide cost would need to be reduced by >65% for it to reach the threshold value. Probabilistic sensitivity analysis favored no teduglutide use in 80% of iterations at a $100,000/QALY threshold. However, teduglutide therapy was cost-saving in 13% of model iterations. Conclusions Teduglutide does not meet a traditional cost-effectiveness threshold as treatment for PN reduction in adult patients with short bowel syndrome compared with standard intestinal rehabilitation. Subpopulations that demonstrate maximum benefit could be cost-saving, and complete nonuse could lead to financial loss. Teduglutide becomes economically reasonable only if its cost is substantially reduced.

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PRP8 THE COST-EFFECTIVENESS OF DIFFERENT INHALED COMBINATION THERAPIES IN ADULT PATIENTS WITH MODERATE-TO-SEVERE ASTHMA—A MODELING STUDY FROM HEALTH CARE PAYER PERSPECTIVE IN POLAND

Value in Health ◽

10.1016/s1098-3015(10)61983-3 ◽

2003 ◽

Vol 6 (6) ◽

pp. 778-779

Author(s):

CA Glogowski ◽

JM Gierczynski

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Severe Asthma ◽

Adult Patients ◽

Combination Therapies ◽

Payer Perspective ◽

Care Payer ◽

The Cost ◽

Modeling Study

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A European perspective of the cost effectiveness of facial composite tissue allotransplantation

European Journal of Plastic Surgery ◽

10.1007/s00238-019-01598-8 ◽

2019 ◽

Vol 43 (3) ◽

pp. 219-224 ◽

Cited By ~ 2

Author(s):

Tiffanie-Marie Borg ◽

Seema Yalamanchili ◽

Shadi Ghali ◽

Simon Myers ◽

Simon Holmes ◽

...

Keyword(s):

Cost Effectiveness ◽

European Perspective ◽

Composite Tissue Allotransplantation ◽

Composite Tissue ◽

The Cost ◽

Facial Composite

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Health economic evaluations of sepsis interventions in critically ill adult patients: a systematic review

Journal of Intensive Care ◽

10.1186/s40560-019-0412-2 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Alisa M. Higgins ◽

Joanne E. Brooker ◽

Michael Mackie ◽

D. Jamie Cooper ◽

Anthony H. Harris

Keyword(s):

Health Economic ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Critically Ill ◽

Reporting Quality ◽

Adult Patients ◽

Economic Evaluations ◽

Goal Directed Therapy ◽

Early Goal Directed Therapy ◽

The Cost

Abstract Background Sepsis is a global health priority. Interventions to reduce the burden of sepsis need to be both effective and cost-effective. We performed a systematic review of the literature on health economic evaluations of sepsis treatments in critically ill adult patients and summarised the evidence for cost-effectiveness. Methods We systematically searched MEDLINE, Embase, and the Cochrane Library using thesaurus (e.g. MeSH) and free-text terms related to sepsis and economic evaluations. We included all articles that reported, in any language, an economic evaluation of an intervention for the management of sepsis in critically ill adult patients. Data extracted included study details, intervention details, economic evaluation methodology, and outcomes. Included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results We identified 50 records representing 46 economic evaluations for a variety of interventions including antibiotics (n = 5), fluid therapy (n = 2), early goal-directed therapy and other resuscitation protocols (n = 8), immunoglobulins (n = 2), and interventions no longer in clinical use such as monoclonal antibodies (n = 7) and drotrecogin alfa (n = 13). Twelve (26%) evaluations were of excellent reporting quality. Incremental cost-effectiveness ratios (ICERs) ranged from dominant (lower costs and higher effectiveness) for early goal-directed therapy, albumin, and a multifaceted sepsis education program to dominated (higher costs and lower effectiveness) for polymerase chain reaction assays (LightCycler SeptiFast testing MGRADE®, SepsiTest™, and IRIDICA BAC BSI assay). ICERs varied widely across evaluations, particularly in subgroup analyses. Conclusions There is wide variation in the cost-effectiveness of sepsis interventions. There remain important gaps in the literature, with no economic evaluations identified for several interventions routinely used in sepsis. Given the high economic and social burden of sepsis, high-quality economic evaluations are needed to increase our understanding of the cost-effectiveness of these interventions in routine clinical practice and to inform decision makers. Trial registration PROSPERO CRD42018095980

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Efficacy and Cost Effectiveness of Intravenous Ferric Carboxymaltose Versus Iron Sucrose in Adult Patients with Iron Deficiency Anemia

Blood ◽

10.1182/blood-2020-134537 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 19-20

Author(s):

Ahmed Basha ◽

Mohamed Izham ◽

Anas Hamad ◽

Prem Chandra ◽

Nabil E Omar ◽

...

Keyword(s):

Cost Effectiveness ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Transferrin Saturation ◽

Adult Patients ◽

Deficiency Anemia ◽

Ferric Carboxymaltose ◽

Surrogate Outcomes ◽

Before And After ◽

The Cost

Abstract: Objectives: Iron deficiency anemia (IDA) is a major health issues and common type of nutritional deficiency worldwide. For IDA treatment, IV iron is a useful therapy. Many intravenous (IV) iron preparations are used for treatment of iron-deficiency anemia (IDA). The purpose of this study is to evaluate the efficacy of ferric carboxymaltose (FCM) in comparison to iron sucrose (IS) in treatment of IDA adult patients; considering cost-effectiveness (CE) for IDA patients from Qatar healthcare system perspective. We evaluated both treatments considering their response outcomes at 12 months period as well their respective acquisition costs. Methods: This was a cross sectional study with retrospective data performed on 764 IDA adult patients who were treated either with FCM or IS for IDA linking clinical efficacy (defined as improvement in hemoglobin (HB), ferritin and transferrin saturation levels) utility, and CE evaluation, including Incremental Cost-Effectiveness Ratio (ICER) over a 12-months period. The response to treatment was the primary outcomes. As the clinical laboratory data were collected before and after the first injection of the medications. The cost i.e. resources consumed were also the main outcome in our study. The cost effectiveness of FCM and IS was the secondary outcome. Direct healthcare costs were derived from the national healthcare payer system. Both descriptive and differential statistics were applied for data analysis. Alpha = 0.05. Results: Patients in the IS group used significantly higher number of injections, ampoules of medication, NS 0.9% bags and visits to the IV suite compared to FCM group. There were significant changes of laboratory tests between the FCM and IS groups. Further analysis in the change of effectiveness, indicated that the changes of hemoglobin and MCH levels in the IS group were significantly higher than the FCM group. The overall cost of IS therapy was significantly slightly higher than FCM. The medication cost for FCM was approximately 6.5 times higher than IS but cheaper in terms of bed cost and nursing cost. CE ratio illustrated that FCM and IS were significantly different in terms of HB, ferritin and MCH levels. Further, ICER indicated that further justifications and decisions need to be made for FCM when using HB, iron, transferrin saturation, MCH and MCV levels as the surrogate outcomes. Conclusions: The higher cost of FCM versus IS can be offset by savings in healthcare personnel time and bed space. ICER indicated that further justifications and decisions need to be made for FCM when using HB, iron, transferrin saturation, MCH and MCV levels as the surrogate outcomes. Limitations and strengths: Limited data is available with respect to comparison of safety and adverse effects of FCM and IS. The data is reliable as it was collected and documented before and after the treatment. Patients were monitored 30 min after the infusion to ensure keen observation and maximum safety. Disclosures No relevant conflicts of interest to declare.

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