scholarly journals Economic Evaluations of Treatments for Inflammatory Bowel Diseases: A Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Lachaine Jean ◽  
Miron Audrey ◽  
Catherine Beauchemin ◽  
on behalf of the iGenoMed Consortium
Keyword(s):  
Cost Effectiveness ◽  
Literature Review ◽  
Treatment Options ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Comprehensive Overview ◽  
Eligibility Criteria ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Cost

Objective. The objective of this literature review was to evaluate the existing evidence regarding the cost-effectiveness of treatment options in IBD. Methods. A systematic review of the literature was conducted to identify economic evaluations of IBD therapy. The literature search was performed using electronic databases MEDLINE and EMBASE. Searches were limited to full economic evaluations published in English or French between 2004 and 2016. Results. A total of 5,403 potentially relevant studies were identified. After screening titles and abstracts, 48 studies were included, according to the eligibility criteria. A total of 56% and 42% of the studies were assessing treatments of UC or CD, respectively. Treatment options under evaluation included biological agents, mesalamine, immunosuppressants, and surgery. The majority of studies evaluated the cost-effectiveness of biological treatments. Biological therapies were dominant in 23% of the analyses and were cost-effective according to a $CAD50,000/QALY and $CAD100,000/QALY threshold in 41% and 62% of the analyses, respectively. Conclusion. This literature review provided a comprehensive overview of the economic evaluations for the different treatment options for IBD over the past 12 years and represents a helpful reference for future economic evaluations.

scholarly journals TECHNIQUES FOR DIAGNOSING OSTEOPOROSIS: A SYSTEMATIC REVIEW OF COST-EFFECTIVENESS STUDIES

2014 ◽  
Vol 30 (3) ◽  
pp. 273-281 ◽  
Author(s):  
Davide Minniti ◽  
Ottavio Davini ◽  
Maria Rosaria Gualano ◽  
Maria Michela Gianino
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Postmenopausal Women ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Clear Cut ◽  
Step Procedure ◽  
Database Research ◽  
The Cost ◽  
Effectiveness Studies

Objectives:The study question was whether dual-energy X-ray absorptiometry (DXA) alone is more cost-effective for identifying postmenopausal women with osteoporosis than a two-step procedure with quantitative ultrasound sonography (QUS) plus DXA. To answer this question, a systematic review was performed.Methods:Electronic databases (PubMed, INAHTA, Health Evidence Network, NIHR, the Health Technology Assessment program, the NHS Economic Evaluation Database, Research Papers in Economics, Web of Science, Scopus, and EconLit) were searched for cost-effectiveness publications. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using the Drummond checklist.Results:Seven journal articles and four reports were reviewed. The cost per true positive case diagnosed by DXA was found to be higher than that for diagnosis by QUS+DXA in two articles. In one article it was found to be lower. In three studies, the results were not conclusive. These articles were characterized by the differences in the types of devices, parameters and thresholds on the QUS and DXA tests and the unit costs of the DXA and QUS tests as well as by variability in the sensitivity and specificity of the techniques and the prevalence of osteoporosis.Conclusions:The publications reviewed did not provide clear-cut evidence for drawing conclusions about which screening test may be more cost-effective for identifying postmenopausal women with osteoporosis.

scholarly journals An Economic Evaluation of a Comprehensive School-Based Caries Prevention Program

2019 ◽  
Vol 4 (4) ◽  
pp. 378-387 ◽  
Author(s):  
S.S. Huang ◽  
R.R. Ruff ◽  
R. Niederman
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effective ◽  
Prevention Programs ◽  
Caries Prevention ◽  
Health Impacts ◽  
Economic Evaluations ◽  
Posterior Teeth ◽  
School Based ◽  
The Cost

Introduction: Current economic evaluations of school-based caries prevention programs (SCPPs) do not compare multiple types of SCPPs against each other and do not consider teeth beyond permanent first molars. Objectives: To assess the cost-effectiveness of a comprehensive SCPP relative to an SCPP focused on delivering sealants for permanent first molars only and to a default of no SCPP. Based on a societal perspective, a simulation model was used that compared the health and cost impacts on 1) permanent first molars only and 2) all posterior teeth. Methods: To calibrate the model, we used data from CariedAway, a comprehensive SCPP that used glass ionomer to prevent and arrest active decay among children. We then evaluated the incremental cost-effectiveness of implementing 3 alternate school-based approaches (comprehensive, sealant only, and no program) on only first molars and all posterior teeth. Probabilistic, 1-, and 2-way sensitivity analyses are included for robustness. Cost-effectiveness is assessed with a threshold of $54,639 per averted disability-adjusted life year (DALY). Results: We first compared the 3 programs under the assumption of treating only first molars. This assessment indicated that CariedAway was less cost-effective than school-based sealant programs (SSPs): the resulting incremental cost-effectiveness ratio (ICER) for CariedAway versus SSPs was $283,455 per averted DALY. However, when the model was extended to include CariedAway’s treatment of all posterior teeth, CariedAway was not only cost-effective but also cost-saving relative to SSPs (ICER, –$943,460.88 per averted DALY; net cost, –$261.45) and no SCPP (ICER, –$400,645.52 per averted DALY; net cost, –$239.77). Conclusions: This study finds that economic evaluations assessing only cost and health impacts on permanent first molars may underestimate the cost-effectiveness of comprehensive SCPPs 1) preventing and arresting decay and 2) treating all teeth. Hence, there is an urgent need for economic evaluations of SCPPs to assess cost and health impacts across teeth beyond only permanent first molars. Knowledge Transfer Statement: The results of this study can be used by policy makers to understand how to evaluate economic evaluations of school-based caries prevention programs and what factors to consider when deciding on what types of programs to implement.

scholarly journals Cost-Effectiveness Analysis of Lung Cancer Screening Accounting for the Effect of Indeterminate Findings

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Iakovos Toumazis ◽  
Emily B Tsai ◽  
S Ayca Erdogan ◽  
Summer S Han ◽  
Wenshuai Wan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Health Benefit ◽  
Lung Cancer Screening ◽  
Cost Effective ◽  
Eligibility Criteria ◽  
Screening Strategies ◽  
The Cost ◽  
The Impact

Abstract Background Numerous health policy organizations recommend lung cancer screening, but no consensus exists on the optimal policy. Moreover, the impact of the Lung CT screening reporting and data system guidelines to manage small pulmonary nodules of unknown significance (a.k.a. indeterminate nodules) on the cost-effectiveness of lung cancer screening is not well established. Methods We assess the cost-effectiveness of 199 screening strategies that vary in terms of age and smoking eligibility criteria, using a microsimulation model. We simulate lung cancer-related events throughout the lifetime of US-representative current and former smokers. We conduct sensitivity analyses to test key model inputs and assumptions. Results The cost-effectiveness efficiency frontier consists of both annual and biennial screening strategies. Current guidelines are not on the frontier. Assuming 4% disutility associated with indeterminate findings, biennial screening for smokers aged 50–70 years with at least 40 pack-years and less than 10 years since smoking cessation is the cost-effective strategy using $100 000 willingness-to-pay threshold yielding the highest health benefit. Among all health utilities, the cost-effectiveness of screening is most sensitive to changes in the disutility of indeterminate findings. As the disutility of indeterminate findings decreases, screening eligibility criteria become less stringent and eventually annual screening for smokers aged 50–70 years with at least 30 pack-years and less than 10 years since smoking cessation is the cost-effective strategy yielding the highest health benefit. Conclusions The disutility associated with indeterminate findings impacts the cost-effectiveness of lung cancer screening. Efforts to quantify and better understand the impact of indeterminate findings on the effectiveness and cost-effectiveness of lung cancer screening are warranted.

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 Cost-effectiveness of exercise therapy in patients with coronary heart disease, chronic heart failure and associated risk factors: A systematic review of economic evaluations of randomized clinical trials

2019 ◽  
Vol 27 (10) ◽  
pp. 1045-1055 ◽  
Author(s):  
Neil Oldridge ◽  
Rod S Taylor
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Intermittent Claudication ◽  
Exercise Therapy ◽  
Cost Effective ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Value For Money ◽  
The Cost

Aims Prescribed exercise is effective in adults with coronary heart disease (CHD), chronic heart failure (CHF), intermittent claudication, body mass index (BMI) ≥25 kg/m2, hypertension or type 2 diabetes mellitus (T2DM), but the evidence for its cost-effectiveness is limited, shows large variations and is partly contradictory. Using World Health Organization and American Heart Association/American College of Cardiology value for money thresholds, we report the cost-effectiveness of exercise therapy, exercise training and exercise-based cardiac rehabilitation. Methods Electronic databases were searched for incremental cost-effectiveness and incremental cost–utility ratios and/or the probability of cost-effectiveness of exercise prescribed as therapy in economic evaluations conducted alongside randomized controlled trials (RCTs) published between 1 July 2008 and 28 October 2018. Results Of 19 incremental cost–utility ratios reported in 15 RCTs in patients with CHD, CHF, intermittent claudication or BMI ≥25 kg/m2, 63% met both value for money thresholds as ‘highly cost-effective’ or ‘high value’, with 26% ‘not cost-effective’ or of ‘low value’. The probability of intervention cost-effectiveness ranged from 23 to 100%, probably due to the different populations, interventions and comparators reported in the individual RCTs. Confirmation with the Consolidated Health Economic Evaluation Reporting checklist varied widely across the included studies. Conclusions The findings of this review support the cost-effectiveness of exercise therapy in patients with CHD, CHF, BMI ≥25 kg/m2 or intermittent claudication, but, with concerns about reporting standards, need further confirmation. No eligible economic evaluation based on RCTs was identified in patients with hypertension or T2DM.

Strategies for the Management of Hypercholesterolaemia: A Systematic Review of the Cost-Effectiveness Literature

1997 ◽  
Vol 2 (4) ◽  
pp. 231-250 ◽  
Author(s):  
Stephen Morris ◽  
Alistair McGuire ◽  
Jaime Caro ◽  
Daniel Pettitt
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
The Elderly ◽  
Pharmacological Intervention ◽  
Dietary Advice ◽  
Economic Evaluations ◽  
Economic Modelling ◽  
Cholesterol Management ◽  
The Cost

Objective: To review research addressing the management of cholesterol in the prevention of coronary heart disease in order to assess the cost-effectiveness of such interventions. Methods: A systematic review of economic evaluations identified through searches of MEDLINE and the Social Sciences Citation Index revealed 38 studies addressing the cost-effectiveness of cholesterol management. They were distinguished according to screening approaches, dietary advice and drug treatment. Most studies were not associated directly with clinical trial results, but adopted economic modelling approaches. Results: Whilst there is general agreement among the majority of analyses, studies of cholesterol management concerned with screening strategies were extremely sensitive to changes in their assumptions; so much so that only a limited emphasis may be placed on specific cost-effectiveness ratios and the conclusions drawn from them. All studies considered direct costs, though many were limited to drug costs. The cost-effectiveness of primary prevention by cholesterol-lowering drugs is highly variable, depending on age at initiation of treatment and cardiovascular risk profile. Pharmacological intervention is least cost-effective in the young and the elderly. The cost-effectiveness of cholesterol-reducing agents improves when they are targeted at those at high risk. HMG-CoA reductase inhibitors are generally more effective and more cost-effective at reducing cholesterol-related coronary events than other medications. Conclusion: The methods and economic data upon which these studies are based need to be improved if robust policy conclusions are to be formulated.

scholarly journals How Are We Evaluating the Cost-Effectiveness of Companion Biomarkers for Targeted Cancer Therapies? A Systematic Review

2021 ◽  
Author(s):  
Mikyung Kelly Seo ◽  
John Cairns
Keyword(s):  
Cost Effectiveness ◽  
Economic Assessment ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Cancer Therapies ◽  
Pharmaceutical Drugs ◽  
Eligibility Criteria ◽  
Targeted Cancer Therapies ◽  
Biomarker Testing ◽  
The Cost

Abstract Background Despite the increasing economic assessment of biomarker-guided therapies, no clear agreement exists whether existing methods are sufficient or whether different methods might produce different cost-effectiveness results. This study aims to examine current practices of modeling companion biomarkers when assessing the cost-effectiveness of targeted cancer therapies. It highlights the challenges in methods and data requirements faced in the evaluation of biomarker tests which do not necessarily arise with the evaluation of pharmaceutical drugs.Methods A literature search was performed using Medline, Embase, EconLit, Cochrane library. Articles published from 2014 to 2018 were searched. Economic evaluations on biomarker-guided therapies with companion diagnostics in cancer were searched. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines followed. Studies were selected by pre-specified eligibility criteria using PICO framework. To make studies more comparable, data were synthesized under ten categories of key areas of methods where consensus deemed lacking.Results Eighteen papers were included in this review. Three out of eighteen studies found to be of good quality regarding incorporating the characteristics of companion biomarkers in economic evaluations. However, many evaluations focused on a pre-selected patient group with a specific biomarker status instead of including all patients with a disease regardless of their biomarker status. Companion biomarker characteristics captured in evaluations were often limited to the cost or the accuracy of the test. Often, only the costs of biomarker testing were modelled. Clinical outcomes or utilities were often difficult to include due to the limited data generated by clinical trials. We found that no consistency and consensus existed to the methods of existing economic evaluations of companion cancer biomarkers for targeted therapies. It was also shown that conflicting cost-effectiveness results were likely depending on what comparator arm was chosen and what comparison structure was designed in the model.Conclusion We found that there was no consistent approach applied in assessing the value of biomarkers and including the characteristics of biomarkers in an economic evaluation of targeted oncology therapies. Currently, many EEs fail to capture the full value of companion biomarkers beyond sensitivity/specificity and cost related to biomarker testing.

scholarly journals Cost-Effectiveness Assessment of Different Glucosamines in Patients with Knee Osteoarthritis: a Simulation Model Adapted to Germany

2021 ◽  
Vol 14 ◽  
Author(s):  
Olivier Bruyère ◽  
Johann Detilleux ◽  
Jean-Yves Reginster
Keyword(s):  
Cost Effectiveness ◽  
Simulation Model ◽  
Area Under The Curve ◽  
Cost Effective ◽  
Health Utility ◽  
Economic Evaluations ◽  
Individual Health ◽  
Life Years ◽  
The Cost ◽  
Utility Scores

Background: The use of symptomatic slow-acting drugs for osteoarthritis (OA) (e.g., glucosamine, chondroitin) is largely debated in the scientific literature. Indeed, multiple formulations of these agents are available, both as pharmaceutical-grade products and as nutritional supplements, but while all preparations may claim to deliver a therapeutic effect, not all are supported by clinical evidence. Moreover, few data are available regarding the cost-effectiveness of all these formulations. Usually, access to individual patient data is required to perform economic evaluations of treatments, but it can be difficult to obtain. We previously developed a model to simulate individual health utility scores from aggregated data obtained from published OA trials. Objective: In the present study, using our new simulation model, we investigated the cost-effectiveness of different glucosamines used in Germany. Methods: We used our validated model to simulate the utility scores of 10 published trials that used different glucosamine preparations. Using the simulated utility scores, the quality-adjusted life years (QALYs) were calculated using the area-under-the-curve method. We used the 2018 public costs of glucosamine products available in Germany to calculate the Incremental Cost/Effectiveness Ratio (ICER). We performed analyses for pharmaceutical-grade Crystalline Glucosamine Sulfate (pCGS) and other formulations of glucosamine (OFG). A cost-effectiveness cut-off of 30,000 €/QALY was considered. Results: Of 10 studies in which utility was simulated, four used pCGS, and six used OFG. The ICER analyses showed that pCGS was cost-effective compared to a placebo, with an ICER of 4489 €/QALY at month 3, 4112 €/QALY at month 6 and 9983 €/QALY at year 3. The use of OFG was not cost-effective at any of the time points considered. Conclusion: Using our previously published model to simulate the individual health utility scores of patients, we showed that, in the German context, the use of pCGS could be considered cost-effective, while the use of OFG could not. These results highlight the importance of the formulation of glucosamine.

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