scholarly journals Efficacy and Cost Effectiveness of the Acupuncture Treatment Using a New Skin Stimulus Tool CalledM-Test Which Is a Measure Based on Symptoms Accompanied with Body Movements: A Pragmatic RCT Targeting Hemodialysis Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Shuji Ono ◽  
Yoshito Mukaino
Keyword(s):  
Cost Effectiveness ◽  
Effective Treatment ◽  
Acupuncture Treatment ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Dialysis Patients ◽  
Body Movements ◽  
Noninvasive Treatment ◽  
Almost All ◽  
New Skin

M-Test can simultaneously reduce hemodialysis patients’ diverse symptoms. Its diagnosis and treatment are based on simple movements that can be performed by anyone and allow determining which meridians have problems by analyzing symptoms accompanied with movement. It also enables to conduct a safe and effective treatment with use of microcorn which is a noninvasive treatment tool. This time we conducted microcorn intervention on hemodialysis patients based on diagnosis ofM-Test. As a result, almost all of the dialysis patients’ complaints have been relieved while the score of HR-QOL increased. According to our calculation of cost effectiveness, it confirmed that it is very cost-effective.

scholarly journals Paranoia — is it cost effective?

1990 ◽  
Vol 14 (5) ◽  
pp. 296-297
Author(s):  
C. R. Whyte
Keyword(s):  
Cost Effectiveness ◽  
Effective Treatment ◽  
Cost Effective ◽  
The Cost ◽  
Major Consideration

The cost effectiveness of treatment has to be a major consideration in any well managed service. It is, therefore, the job of management to ensure that effective treatment is delivered efficiently.

scholarly journals ANALISIS EFEKTIVITAS BIAYA PASIEN PNEUMONIA BALITA RAWAT INAP DI RUMAH SAKIT BHAYANGKARA MANADO

PHARMACON ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 968
Author(s):  
Monica D. Lestari ◽  
Gayatri Citraningtyas ◽  
Hosea Jaya Edi
Keyword(s):  
Cost Effectiveness ◽  
Effective Treatment ◽  
Treatment Options ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Cost Effective Treatment ◽  
Retrospective Data Collection ◽  
Keywords Antibiotics ◽  
The Cost

ABSTRACTPneumonia is an infectious disease in the lower respiratory tract that affects the lung tissue. Ceftriaxone and Gentamicin antibiotics are the most numerous and good for use in the treatment of pneumonia, but of the two antibiotics is not yet known the options for more cost effective treatment, so it needs to be done the cost effectiveness analysis in order to facilitate the selection of more cost-effective treatment options especially in toddler. This study aims to determine which therapies are more cost-effective than the use of antibiotics Ceftriaxone and Gentamicin in pneumonia patients in the January-December 2018 period in the Bhayangkara Manado Hospital using descriptive research methods with retrospective data collection. The sample in this study were 22 patients, 12 patients using ceftriaxone antibiotics and 10 patients using gentamicin antibiotics. The results showed that pneumonia treatment in infants using Ceftriaxone antibiotics was more cost-effective with ACER ceftriaxone value of Rp. 503,872 / day and ICER value of Rp. 145,588 / day. Keywords : Antibiotics, CEA (Cost-Effectiveness Analysis), Pharmacoeconomy, Toddler Pneumonia. ABSTRAKPneumonia merupakan penyakit infeksi pada saluran pernapasan bagian bawah yang mengenai jaringan paru. Antibiotik Seftriakson dan Gentamisim yang paling banyak dan baik untuk digunakan dalam pengobatan pneumonia, namun dari kedua antibiotik tersebut belum diketahui pilihan terapi yang lebih cost-effective, sehingga perlu dilakukan analisis efektivitas biaya agar dapat mempermudah dalam pemilihan alternatif pengobatan yang lebih cost-effective khususnya pada balita. Penelitian ini bertujuan untuk menentukan terapi yang lebih cost-effective dari penggunaan antibiotik Seftriakson dan Gentamisin pada pasien pneumonia rawat inap periode Januari-Desember 2018 di Rumah Sakit Bhayangkara Manado dengan menggunakan metode penelitian deskriptif dengan pengambilan data secara retrospektif. Sampel pada penelitian ini sebanyak 22 pasien yaitu 12 pasien menggunakan antibiotik Seftriakson dan 10 pasien menggunakan antibiotik Gentamisin. Hasil penelitian menunjukkan pengobatan pneumonia pada balita menggunakan antibiotik Seftriakson lebih cost-effective dengan nilai ACER seftriakson sebesar Rp. 503,872/hari dan nilai ICER sebesar Rp. 145.588/hari. Kata Kunci : Pneumonia Balita, Antibiotik, CEA (Cost-Effectiveness Analysis), Farmakoekonomi

scholarly journals Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

2015 ◽  
Vol 45 (14) ◽  
pp. 3019-3031 ◽  
Author(s):  
L. Koeser ◽  
V. Donisi ◽  
D. P. Goldberg ◽  
P. McCrone
Keyword(s):  
Cost Effectiveness ◽  
Effective Treatment ◽  
Combination Treatment ◽  
Severe Depression ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Effective Treatment Option ◽  
Cognitive Behavioural ◽  
Cost Effective Treatment ◽  
The Cost

Background.The National Institute of Health and Care Excellence (NICE) in England and Wales recommends the combination of pharmacotherapy and psychotherapy for the treatment of moderate to severe depression. However, the cost-effectiveness analysis on which these recommendations are based has not included psychotherapy as monotherapy as a potential option. For this reason, we aimed to update, augment and refine the existing economic evaluation.Method.We constructed a decision analytic model with a 27-month time horizon. We compared pharmacotherapy with cognitive–behavioural therapy (CBT) and combination treatment for moderate to severe depression in secondary care from a healthcare service perspective. We reviewed the literature to identify relevant evidence and, where possible, synthesized evidence from clinical trials in a meta-analysis to inform model parameters.Results.The model suggested that CBT as monotherapy was most likely to be the most cost-effective treatment option above a threshold of £22 000 per quality-adjusted life year (QALY). It dominated combination treatment and had an incremental cost-effectiveness ratio of £20 039 per QALY compared with pharmacotherapy. There was significant decision uncertainty in the probabilistic and deterministic sensitivity analyses.Conclusions.Contrary to previous NICE guidance, the results indicated that even for those patients for whom pharmacotherapy is acceptable, CBT as monotherapy may be a cost-effective treatment option. However, this conclusion was based on a limited evidence base, particularly for combination treatment. In addition, this evidence cannot easily be transferred to a primary care setting.

scholarly journals Cost-effectiveness analysis of MR-guided focused ultrasound thalamotomy for tremor-dominant Parkinson’s disease

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Ying Meng ◽  
Christopher B. Pople ◽  
Suneil K. Kalia ◽  
Lorraine V. Kalia ◽  
Benjamin Davidson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Health Economic ◽  
Sensitivity Analysis ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Effective Treatment ◽  
Medical Therapy ◽  
Focused Ultrasound ◽  
Cost Effective ◽  
Cost Effective Treatment

OBJECTIVEThe development of transcranial MR-guided focused ultrasound (MRgFUS) has revitalized the practice of lesioning procedures in functional neurosurgery. Previous health economic analysis found MRgFUS thalamotomy to be a cost-effective treatment for patients with essential tremor, supporting its reimbursement. With the publication of level I evidence in support of MRgFUS thalamotomy for patients with tremor-dominant Parkinson’s disease (TDPD), the authors performed a health economic comparison between MRgFUS, deep brain stimulation (DBS), and medical therapy.METHODSThe authors used a decision tree model with rollback analysis and one-factor sensitivity analysis. Literature searches of MRgFUS thalamotomy and unilateral DBS of the ventrointermediate nucleus of the thalamus for TDPD were performed to determine the utility and probabilities for the model. Costs in Canadian dollars (CAD) were derived from the Schedule of Benefits and Fees in Ontario, Canada, and expert opinion on usage.RESULTSMRgFUS was associated with an expected cost of $14,831 CAD. Adding MRgFUS to continued medical therapy resulted in an incremental cost-effectiveness ratio of $30,078 per quality-adjusted life year (QALY), which remained cost-effective under various scenarios in the sensitivity analysis. Comparing DBS to MRgFUS, while DBS did not achieve the willingness-to-pay threshold ($56,503 per QALY) in the base case scenario, it did so under several scenarios in the sensitivity analysis.CONCLUSIONSMRgFUS thalamotomy is a cost-effective treatment for patients with TDPD, particularly over continued medical therapy. While MRgFUS remains competitive with DBS, the cost-effectiveness advantage is less substantial. These results will help inform the integration of this technology in the healthcare system.

scholarly journals Cost-effectiveness of amphotericin B deoxycholate versus itraconazole for induction therapy of talaromycosis in HIV-infected adults in Vietnam

2021 ◽  
Author(s):  
James Buchanan ◽  
James Altunkaya ◽  
Nguyen Van Kinh ◽  
Nguyen Van Vinh Chau ◽  
Vo Trieu Ly ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Service ◽  
Effective Treatment ◽  
Amphotericin B ◽  
Induction Therapy ◽  
Cost Effective ◽  
Value For Money ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Amphotericin B Deoxycholate

Abstract Background Talaromycosis (penicilliosis) is an invasive fungal infection and a major cause of HIV-related deaths in Southeast Asia. Guidelines recommend induction therapy with amphotericin B deoxycholate, however treatment with itraconazole has fewer toxic effects, is easier to administer and is less expensive. Our recent randomized controlled trial in Vietnam found amphotericin B was superior to itraconazole with respect to six-month mortality. We undertook an economic evaluation alongside this trial to determine whether the more effective treatment is cost-effective. Methods Resource use, direct and indirect costs, health and quality of life outcomes (measured using quality-adjusted life-years; QALYs) were evaluated for 405 trial participants from 2012 to 2016. Both a Vietnamese health service and a broader societal costing perspective were considered. Mean costs and QALYs were combined to calculate the within-trial cost-effectiveness of amphotericin versus itraconazole from both perspectives. Results From a Vietnamese health service perspective, amphotericin increases costs but improves health outcomes compared to itraconazole, at a cost of $3,013/QALY gained. The probability that amphotericin is cost-effective at a conventional (WHO-CHOICE) threshold of value for money is 46%. From a societal perspective, amphotericin is cost-reducing and improves outcomes compared to itraconazole, and is likely to be a cost-effective strategy at any value for money threshold greater than $0. Conclusions Our analysis indicates that induction therapy with amphotericin is a cost-effective treatment strategy for HIV-infected adults diagnosed with talaromycosis in Vietnam. These results provide the evidence base for healthcare providers and policy makers to improve access to and use of amphotericin.

Cost-Effectiveness of Acupuncture Treatment in Patients With Headache

Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 334-345 ◽  
Author(s):  
CM Witt ◽  
T Reinhold ◽  
S Jena ◽  
B Brinkhaus ◽  
SN Willich
Keyword(s):  
Cost Effectiveness ◽  
Acupuncture Treatment ◽  
Short Form ◽  
Controlled Trial ◽  
Indirect Costs ◽  
Primary Headache ◽  
Cost Effective ◽  
Routine Care ◽  
Cost Effective Treatment

The aim was to assess costs and cost-effectiveness of additional acupuncture treatment in patients with headache compared with patients receiving routine care alone. A randomized, controlled trial was conducted, including patients (≥18 years old) with primary headache (more than 12 months, at least two headaches/month). Outcome parameters were quality of life (Short Form 36), direct and indirect costs differences during the 3-month study period and the incremental cost-effectiveness ratio (ICER) of acupuncture treatment. A total of 3182 patients (1613 acupuncture; 1569 controls) with headache were included (77.4% women, mean age and standard deviation 42.6 ± 12.3; 22.6% men, 47.2 ± 13.4). Over 3 months costs were higher in the acupuncture group compared with the control [€857.47; 95% confidence interval 790.86, 924.07, vs. €527.34 (459.81, 594.88), P < 0.001, mean difference: €330.12 (235.27, 424.98)]. This cost increase was primarily due to costs of acupuncture [€365.64 (362.19, 369.10)]. The ICER was €11 657 per QALY gained. According to international cost-effectiveness threshold values, acupuncture is a cost-effective treatment in patients with primary headache.

scholarly journals Cost-effectiveness of antibiotic treatment of uncomplicated urinary tract infection in women: a comparison of four antibiotics

BJGP Open ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. bjgpopen17X101097
Author(s):  
Susannah Sadler ◽  
Michael Holmes ◽  
Shijie Ren ◽  
Stephen Holden ◽  
Swati Jha ◽  
...  
Keyword(s):  
Primary Care ◽  
Urinary Tract ◽  
Cost Effectiveness ◽  
Effective Treatment ◽  
Cost Effective ◽  
Uncomplicated Urinary Tract Infection ◽  
Adult Women ◽  
Effective Treatment Option ◽  
Cost Effective Treatment ◽  
Tract Infections

BackgroundUrinary tract infections (UTIs) are one of the most common reasons for women to attend primary care. There are four different antibiotics currently recommended in England for treatment of uncomplicated UTI but little evidence on their comparative cost-effectiveness.AimTo assess the relative cost-effectiveness of the four antibiotics currently recommended in England for treatment of uncomplicated UTI in adult women.Design & settingA cost-effectiveness model in adult women with signs and symptoms of uncomplicated UTI in primary care in England treated with fosfomycin, nitrofurantoin, pivmecillinam, or trimethoprim.MethodA decision tree economic model of the treatment pathway encompassed up to two rounds of treatment, accounting for different resistance levels. End points included recovery, persistence, pyelonephritis, and/or hospitalisation. Prescription, primary and secondary care treatment, and diagnostic testing costs were aggregated. Cost-effectiveness was assessed as cost per UTI resolved.ResultsTrimethoprim 200 mg twice daily (for 3 or 7 days) was estimated to be the most cost-effective treatment (£70 per UTI resolved) when resistance was <30%. However, if resistance to trimethoprim was ≥30%, fosfomycin 3 g once became more cost-effective; at resistance levels of ≥35% for trimethoprim, both fosfomycin 3 g once and nitrofurantoin 100 mg twice daily for 7 days were shown to be more cost-effective.ConclusionKnowing local resistance levels is key to effective and cost-effective empirical prescribing. Recent estimates of trimethoprim resistance rates are close to 50%, in which case a single 3 g dose of fosfomycin is likely to be the most cost-effective treatment option.

scholarly journals Surgery is cost-effective treatment for young patients with vestibular schwannomas: decision tree modeling of surgery, radiation, and observation

2014 ◽  
Vol 37 (5) ◽  
pp. E8 ◽  
Author(s):  
Corinna C. Zygourakis ◽  
Taemin Oh ◽  
Matthew Z. Sun ◽  
Igor Barani ◽  
James G. Kahn ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Decision Tree ◽  
Incremental Cost ◽  
Effective Treatment ◽  
Cost Effective ◽  
Incremental Cost Effectiveness Ratio ◽  
Vestibular Schwannomas ◽  
Cost Effectiveness Ratio ◽  
Total Hospital ◽  
Cost Effective Treatment

Object Vestibular schwannomas (VSs) are managed in 3 ways: observation (“wait and scan”); Gamma Knife surgery (GKS); or microsurgery. Whereas there is considerable literature regarding which management approach is superior, there are only a few studies addressing the cost of treating VSs, and there are no cost-utility analyses in the US to date. Methods In this study, the authors used the University of California at San Francisco medical record and hospital accounting databases to determine total hospital charges and costs for 33 patients who underwent open surgery, 42 patients who had GKS, and 12 patients who were observed between 2010 and 2013. The authors then performed decision-tree analysis to determine which treatment paradigm produces the highest quality-adjusted life years and to calculate the incremental cost-effectiveness ratio, depending on the patient's age at VS diagnosis. Results The average total hospital cost over a 3-year period for surgically treated patients was $80,074 (± $49,678) versus $9737 (± $5522) for patients receiving radiosurgery and $1746 (± $2792) for patients who were observed. When modeling the most debilitating symptoms and worst outcomes of VSs (vertigo and death) at different ages at diagnosis, radiation is dominant to observation at all ages up to 70 years. Surgery is cost-effective when compared with radiation (incremental cost-effectiveness ratio < $150,000) at younger ages at diagnosis (< 45 years old). Conclusions In this model, surgery is a cost-effective alternative to radiation when VS is diagnosed in patients at < 45 years. For patients ≥ 45 years, radiation is the most cost-effective treatment option.

Abstract 104: Cost-Effectiveness of Edoxaban vs. Rivaroxaban for Stroke Prevention in Patients with Non-Valvular Atrial Fibrillation (NVAF) in the US

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Jeffrey D Miller ◽  
Xin Ye ◽  
Gregory M Lenhart ◽  
Amanda M Farr ◽  
Oth V Tran ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effectiveness ◽  
Effective Treatment ◽  
Healthcare Cost ◽  
Major Bleeding ◽  
Stroke Prevention ◽  
Cost Effective ◽  
Base Case ◽  
Once Daily ◽  
Cost Effective Treatment

Background: Edoxaban and rivaroxaban for stroke prevention in non-valvular atrial fibrillation (NVAF) patients with CHADS 2 ≥2 have been evaluated in pivotal trials versus warfarin. This study assessed the cost-effectiveness of once-daily edoxaban (60 mg/30 mg dose-reduced) regimen versus rivaroxaban (20 mg/15 mg dose-reduced) for stroke prevention in patients with NVAF patients from a US health plan perspective. Methods: A Markov model simulated lifetime risk and treatment of stroke, systemic embolism, major bleeding, clinically relevant non-major bleeding, myocardial infarction, and death in NVAF patients treated with edoxaban or rivaroxaban. Efficacy and safety data were from a network meta-analysis using data from patients enrolled in ENGAGE AF-TIMI 48 and ROCKET-AF that were presented previously. 2015 wholesale acquisition cost (WAC) was used for edoxaban and rivaroxaban in the analysis. Healthcare cost and utility data were from published sources. Incremental cost-effectiveness ratios of <$50,000, $50,000-$150,000, and >$150,000 per quality-adjusted life year (QALY) gained were used as thresholds for highly cost-effective, cost-effective, and not cost-effective treatment option per guidance from the AHA/ACC statement on cost/value methodology in clinical practice guidelines and performance measures. Results: Edoxaban was dominant relative to rivaroxaban, such that it was associated with lower total healthcare cost and better effectiveness in terms of QALYs in the base case analysis (Table). Results were supported by probabilistic sensitivity analyses that showed edoxaban as either dominant or a highly cost-effective alternative (ICER<$50,000) to rivaroxaban 88.4% of the time. Conclusions: These results showed that once-daily edoxaban (60mg/30mg dose-reduced) regimen is a highly cost-effective treatment relative to rivaroxaban (20mg/15mg dose-reduced) for stroke prevention in NVAF patients.

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