scholarly journals Economics of gastroenteropancreatic neuroendocrine tumors: a systematic review

2019 ◽  
Vol 10 ◽  
pp. 204201881982821 ◽  
Author(s):  
Enrique Grande ◽  
Ángel Díaz ◽  
Carlos López ◽  
Javier Munarriz ◽  
Juan-José Reina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Resource Utilization ◽  
Neuroendocrine Tumors ◽  
Cost Of Illness ◽  
Budget Impact ◽  
The United States ◽  
Economic Evaluations

Background: Despite current interest, enthusiasm and progress in the development of therapies for gastroenteropancreatic (GEP) neuroendocrine tumors (NETs), there are substantial gaps in the published literature regarding cost-of-illness analyses, economic evaluation and budget impact analyses. Compounding the issue is that data on resource utilization and cost-effectiveness of different diagnostic and therapeutic modalities for GEP-NETs are scarce. Methods: A systematic review on the economic impact of GEP-NETs was carried out using four databases: EMBASE, PubMed, the National Health Service Economic Evaluation Database and Cochrane review. Fully published articles from January 2000 to May 2017, in English and Spanish, were included. All articles that satisfied the inclusion criteria were included in the systematic review; summary descriptive statistics were used to describe the methodological characteristics. Results: The 14 studies selected included cost-of-illness analyses ( n = 4), economic evaluations ( n = 7) and budget impact analyses ( n = 3). Almost all studies were performed in the United States. Healthcare costs for patients with NETs included medication, outpatient visits, hospitalizations, and check-ups/tests. Reducing adverse events is an area where cost savings could be achieved; however, there was not enough evidence on the cost impact of adverse events. Conclusion: There is a lack of data related to resource utilization in the field of GEP-NETs. Therefore, cost-effectiveness and budget impact studies of existing and emerging treatments are urgently needed to help the decision-making process for patients with NETs.

scholarly journals Economic evaluations of health care interventions in Oropharyngeal Dysphagia after Stroke: Protocol for a Systematic Review.

2021 ◽  
Author(s):  
Sergio Marin ◽  
Mateu Serra-Prat ◽  
Omar Ortega ◽  
Pere Clavé
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Oropharyngeal Dysphagia ◽  
Cost Savings ◽  
Economic Evaluations ◽  
Stroke Patients ◽  
Post Stroke ◽  
Healthcare Interventions ◽  
The Cost

Abstract Background and purpose: Oropharyngeal Dysphagia (OD) affects 40-81% of patients after stroke. A recent systematic review on the costs of OD and it’s main complications showed higher acute and long-term costs for those patients who developed OD, malnutrition and pneumonia after stroke. These results suggest that appropriate management of post-stroke OD could lead to reduction of clinical complications and significant cost savings. The purpose of this systematic review is to assess the available literature exploring the efficiency or cost-effectiveness of available healthcare interventions on the appropriate management of OD. Methods: A systematic review on economic evaluations of health care interventions on post-stroke patients with OD following PRISMA recommendations will be performed. MEDLINE, Embase, the National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry Database will be searched and a subsequent reference check will be done. English and Spanish literature will be included without date restrictions. Studies will be included if they refer to economic evaluations or studies in which cost savings were reported in post-stroke patients suffering OD. Studies will be excluded if they are partial economic evaluation studies, if they refer to esophageal dysphagia, or if OD is caused by causes different from stroke. Evidence will be presented and synthetized with a narrative method and using tables. Quality evaluation will be done using Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement. Discussion: The protocol for this systematic review is the first step to assess the cost-effectiveness of the healthcare interventions that have been described as potential treatments for post-stroke OD. This systematic review will summarize the current evidence on the relation between cost and benefits associated with the appropriate management of OD in post-stroke patients. Systematic review registration: PROSPERO CRD42020136245

scholarly journals A Systematic Review of Methods, Study Quality, and Results of Economic Evaluation for Childhood and Adolescent Obesity Intervention

2019 ◽  
Vol 16 (3) ◽  
pp. 485 ◽  
Author(s):  
Mandana Zanganeh ◽  
Peymane Adab ◽  
Bai Li ◽  
Emma Frew
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Evidence Synthesis ◽  
Evaluation Studies ◽  
Cost Effective ◽  
Adolescent Obesity ◽  
Economic Evaluations ◽  
Full Economic Evaluation ◽  
Childhood And Adolescent Obesity

Many suggested policy interventions for childhood and adolescent obesity have costs and effects that fall outside the health care sector. These cross-sectorial costs and consequences have implications for how economic evaluation is applied and although previous systematic reviews have provided a summary of cost-effectiveness, very few have conducted a review of methods applied. We undertook this comprehensive review of economic evaluations, appraising the methods used, assessing the quality of the economic evaluations, and summarising cost-effectiveness. Nine electronic databases were searched for full-economic evaluation studies published between January 2001 and April 2017 with no language or country restrictions. 39 economic evaluation studies were reviewed and quality assessed. Almost all the studies were from Western countries and methods were found to vary by country, setting and type of intervention. The majority, particularly “behavioural and policy” preventive interventions, were cost-effective, even cost-saving. Only four interventions were not cost effective. This systematic review suggests that economic evaluation of obesity interventions is an expanding area of research. However, methodological heterogeneity makes evidence synthesis challenging. Whilst upstream interventions show promise, an expanded and consistent approach to evaluate cost-effectiveness is needed to capture health and non-health costs and consequences.

Economic evaluation and costs of telepsychiatry programmes: A systematic review

2020 ◽  
pp. 1357633X2093891 ◽  
Author(s):  
John A Naslund ◽  
Lauren M Mitchell ◽  
Udita Joshi ◽  
Dipal Nagda ◽  
Chunling Lu
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Mental Disorders ◽  
Clinical Care ◽  
Mental Illnesses ◽  
Economic Evaluations ◽  
Schizophrenia Spectrum Disorders ◽  
Post Traumatic Stress

Objective Telepsychiatry involves use of telecommunications technology to deliver psychiatric care and offers promise to reduce costs and increase access to mental health services. This systematic review examined cost reporting of telepsychiatry programmes for mental healthcare. Methods We systematically searched electronic databases for studies reporting costs, including economic evaluations such as cost-effectiveness analyses, or costs of developing telepsychiatry programmes for clinical care of mental disorders. Included studies enrolled participants with mental disorders and involved telepsychiatry for depression, anxiety disorders, serious mental illnesses including schizophrenia spectrum disorders and bipolar disorder, post-traumatic stress disorder, dementia or epilepsy. Results Twenty-six unique studies met inclusion criteria (17,967 participants), with most targeting depression ( n = 7; 27%), general mental disorders and screening ( n = 7; 27%), child mental health ( n = 4; 15%) and geriatric mental health ( n = 4; 15%). Nearly all studies ( n = 25; 96%) compared telepsychiatry programme costs with either standard in-person consultation or usual care, with 15 (60%) reporting that telepsychiatry programmes were less expensive, and 8 (32%) showing telepsychiatry programmes were more expensive. Three studies reported cost-effectiveness analyses, favouring telepsychiatry programmes, but at highly elevated cost-effectiveness thresholds. Few studies reported costs of developing or delivering telepsychiatry programmes. Conclusion Costs of telepsychiatry programmes varied widely, with substantial heterogeneity in how costs were defined and reported. Some programmes cost less than in-person services while others cost more. Therefore, rigorous cost-effectiveness studies following established standards in economic evaluation are needed to inform implementation and sustainability of these programmes in health systems.

scholarly journals Neuropsychological rehabilitation interventions for people with an acquired brain injury and their caregivers. A protocol for a systematic review of economic evaluation

2020 ◽  
Vol 3 ◽  
pp. 83
Author(s):  
Eileen Mitchell ◽  
Elayne Ahern ◽  
Sanjib Saha ◽  
Dominic Trepel
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Brain Injury ◽  
Evaluation Studies ◽  
Cost Benefit ◽  
Acquired Brain Injury ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Systematic Review Methodology

Background: New emerging evidence has demonstrated the need for effective interventions to help people living with an acquired brain injury (ABI). Evidence on cost-effectiveness, which can help inform use of limited resources, is scarce in this area and therefore the purpose of this systematic review is to critically appraise and consolidate the current evidence on economic evaluations of ABI rehabilitation interventions. Methods: Systematic review methodology will be applied to identify, select and extract data from published economic evaluation studies (trial-based, non-trial based, simulation-based, decision model and trial-based model economic evaluations) of ABI treatment interventions in adults. A systematic literature search will be conducted on the following electronic databases: EMBASE, Econlit, CINAHL, Medline, Econlit, the National Health Service Economic Evaluation Database and PsyclNFO. This review will only include cost-effectiveness analysis studies (e.g., cost per life year gained), cost-benefit and cost minimisation analyses in which the designs were randomised controlled trials (RCTs), non-RCT studies, cost-utility analyses (e.g., cost per quality-adjusted life year (QALY) gained or cost per disability-adjusted life year averted), cohort studies, and modeling studies. Only studies that were published in English, associated with adults who have an ABI will be included. There will be no restrictions on perspective, sample size, country, follow-up duration or setting. The search strategy terms will include the following: acquired brain injury, brain*; cost*; or cost–benefit analysis*. Following data extraction, a narrative summary and tables will be used to summarize the characteristics and results of included studies. Discussion: The findings from this review will be beneficial to health policy decision makers when examining the evidence of economic evaluations in this field. In addition, it is anticipated that this review will identify gaps in the current economic literature to inform future-related research. Systematic review registration: PROSPERO CRD42020187469 (25th June 2020).

Quality of economic evaluations of ventricular assist devices: A systematic review

2020 ◽  
Vol 36 (4) ◽  
pp. 380-387
Author(s):  
Sarah Fontenay ◽  
Lionel Catarino ◽  
Soumeya Snoussi ◽  
Hélène van den Brink ◽  
Judith Pineau ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Economic ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Health Economic Evaluation ◽  
Ventricular Assist Devices ◽  
Economic Evaluations ◽  
Level Of Evidence ◽  
Ventricular Assist

ObjectiveBecause of a lack of suitable heart donors, alternatives to transplantation are required. These alternatives can have high costs. The aim of this study was to perform a systematic review of cost-effectiveness studies of ventricular assist devices (VADs) and to assess the level of evidence of relevant studies. The purpose was not to present economic findings.MethodsA systematic review was performed using four electronic databases to identify health economic evaluation studies dealing with VADs. The methodological quality and reporting quality of the studies was assessed using three different tools, the Drummond, Cooper, and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklists.ResultsOf the 1,258 publications identified, thirteen articles were included in this review. Twelve studies were cost–utility analyses and one was a cost-effectiveness analysis. According to the Cooper hierarchy scale, the quality of the data used was heterogeneous. The level of evidence used for clinical effect sizes, safety data, and baseline clinical data was of poor quality. In contrast, cost data were of high quality in most studies. Quality of reporting varied between studies, with an average score of 17.4 (range 15–19) according to the CHEERS checklist.ConclusionThe current study shows that the quality of clinical data used in economic evaluations of VADs is rather poor in general. This is a concern that deserves greater attention in the process of health technology assessment of medical devices.

Health plan budget impact of introducing everolimus for treatment of advanced progressive pancreatic neuroendocrine tumors in the United States.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 229-229
Author(s):  
Roman Casciano ◽  
Maruit Chulikavit ◽  
Michelle Sriprasert ◽  
Zhimei Liu ◽  
Xufang Wang ◽  
...  
Keyword(s):  
United States ◽  
Resource Utilization ◽  
Neuroendocrine Tumors ◽  
Health Plan ◽  
Surgical Procedures ◽  
Budget Impact ◽  
The United States ◽  
Medical Procedure ◽  
Pancreatic Neuroendocrine Tumors ◽  
Hospitalization Costs

229 Background: Everolimus was recently approved for treatment of patients with advanced progressive pancreatic neuroendocrine tumors (pNET) based on a clinically meaningful and statistically significant increase in progression-free survival. To understand the financial impact of introducing everolimus into the market, a model was developed to simulate a typical health plan in the United States (US). Methods: A cross-sectional budget impact model with a one-year time horizon was developed. Disease prevalence and drug usage data were derived from a real-world data source. Costs for anti-tumor therapy and underlying care included concomitant medications, physician visits, treatment infusion, surgical procedures, tests, hospitalizations, and adverse event (AE) management. Resource utilization rates were derived from a physician survey-based resource utilization study; treatment-related AE rates were taken from secondary literature. Drug costs were Wholesale Acquisition Costs (2011). Medical procedure and hospitalization costs were based on Medicare fee schedules for current procedure terminology and diagnosis-related group codes. AE costs were obtained from the literature. The model assessed the initial annual budget impact, under the assumption that everolimus and sunitinib, another recently approved targeted therapy, replace most currently available chemotherapy treatments. Results: Based on published prevalence rates, for a health plan with 1,000,000 members, an annual count of 12 advanced pNET patients was projected. The model estimated a $22,657 budget increase ($0.0019 per member per month or $0.0227 per member per year [PMPY]). The largest percent increase in budget was associated with anti-tumor treatments; infusions and surgical procedures represented the largest percent decrease in costs. Scenario analyses indicated that increasing the percentage of everolimus use (by reducing that of sunitinib) resulted in a decrease in the overall budget compared to baseline. Conclusions: Our model predicts that treating pNET patients with everolimus will have a minimal budget impact on US health plans, amounting to about $0.027 PMPY.

scholarly journals Health economic evaluation of stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma: a systematic review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Haiyin Wang ◽  
Chunlin Jin ◽  
Liang Fang ◽  
Hui Sun ◽  
Wendi Cheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Stereotactic Body Radiotherapy ◽  
Health Economic Evaluation ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Advanced Hepatocellular Carcinoma ◽  
Noninvasive Treatment

AbstractStereotactic body radiotherapy (SBRT) is a novel noninvasive treatment for hepatocellular carcinoma. SBRT can achieve effective local control, but it requires a relatively high input of resources; this systematic review was performed to assess the cost effectiveness of SBRT in the treatment of hepatocellular carcinoma to provide a basis for government pricing and medical insurance decision-making. The PubMed, EMBASE, Cochrane Library, CNKI, Wanfang and SinoMed databases were searched to collect economic evaluations of SBRT for the treatment of hepatocellular carcinoma from the date of database inception through December 31, 2018. Two reviewers independently screened the studies, extracted the data and performed a descriptive analysis of the basic characteristics, methods of economic evaluation and main results, as well as the quality and heterogeneity of the reports. A total of 5 studies were included. Among them, the level of heterogeneity was relatively acceptable, with a median score of 90%. Four studies were cost-utility analyses (CUAs), and 1 was a cost-effectiveness analysis (CEA). The incremental cost effectiveness ratio (ICER) for sorafenib compared to SBRT was US $114,795 per quality-adjusted life year gained (cost/QALY) in patients with advanced hepatocellular carcinoma. The ICER for proton beam therapy compared to SBRT was US $6465 in patients with inoperable advanced hepatocellular carcinoma. The ICER for SBRT compared to RFA was US $164,660 for patients with unresectable colorectal cancer (CRC) with liver metastases and US $56,301 for patients with early-stage hepatocellular carcinoma. For patients with inoperable localized hepatocellular carcinoma, compared with RFA–SBRT therapy, the ICERs for SBRT–SBRT and SBRT–RFA were US $558,679 and US $2197,000, respectively; RFA–RFA was dominated. In conclusion, there is limited evidence suggesting that SBRT could be cost-effective for highly specific subpopulations of HCC patients, and further economic evaluations based on randomized controlled trials (RCTs) or cohort studies are needed.

scholarly journals Economic evaluation of HIV testing options for low-prevalence high-income countries: a systematic review

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Olanrewaju Medu ◽  
Adegboyega Lawal ◽  
Doug Coyle ◽  
Kevin Pottie
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Hiv Testing ◽  
High Income ◽  
Economic Evaluations ◽  
Rapid Hiv Testing ◽  
The Cost ◽  
Low Prevalence

Abstract Introduction This study reviewed the economic evidence of rapid HIV testing versus conventional HIV testing in low-prevalence high-income countries; evaluated the methodological quality of existing economic evaluations of HIV testing studies; and made recommendations on future economic evaluation directions of HIV testing approaches. Methods A systematic search of selected databases for relevant English language studies published between Jan 1, 2001, and Jan 30, 2019, was conducted. The methodological design quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) and the Drummond tool. We reported the systematic review according to the PRISMA guidelines. Results Five economic evaluations met the eligibility criteria but varied in comparators, evaluation type, perspective, and design. The methodologic quality of the included studies ranged from medium to high. We found evidence to support the cost-effectiveness of rapid HIV testing approaches in low-prevalence high-income countries. Rapid HIV testing was associated with cost per adjusted life year (QALY), ranging from $42,768 to $90,498. Additionally, regardless of HIV prevalence, rapid HIV testing approaches were the most cost-effective option. Conclusions There is evidence for the cost-effectiveness of rapid HIV testing, including the use of saliva-based testing compared to usual care or hospital-based serum testing. Further studies are needed to draw evidence on the relative cost-effectiveness of the distinct options and contexts of rapid HIV testing.

scholarly journals Economic Evaluation of Severe Anaemia: Review-Based Recommendations and a Conceptual Framework

2020 ◽  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Blood Cell ◽  
Conceptual Framework ◽  
Red Blood Cell ◽  
Budget Impact ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Economic Analyses ◽  
Impact Models

Objective: Novel anaemia treatments have greatly improved patient outcomes in the last decade and have also undergone economic evaluations in various settings using heterogenous model structures, costs, and inputs. The objectives were to review published economic evaluation studies in major red blood cell disorders, identify limitations in the applied methodology, provide a set of recommendations, and produce a conceptual framework for future economic research in this disease area. Methods: A targeted search was conducted for economic literature evaluating treatments in major red blood cell disorders related to anaemia. Disorders included autoimmune haemolytic anaemia, β-thalassaemia, chemotherapy-induced anaemia, anaemia in chronic kidney disease, and severe aplastic anaemia. Budget impact models and cost-effectiveness and cost-utility analyses were considered. Modelling assumptions regarding the model structure, time horizon, perspective, and type of costs were reviewed and recommendations and a conceptual framework for future economic analyses were created. Results: A total of four budget impact models, nine cost-utility analyses, and four cost-effectiveness analyses were investigated. A major limitation was that the included costs varied significantly across studies. Costs which were rarely included, and generally should be considered, were related to adverse events, mortality, and productivity. Additionally, relationships between levels of serum ferritin, hepatic or total body iron, and haemoglobin with long-term complications and mortality were rarely included. Conclusion: Published economic analyses evaluating treatments for major red blood cell disorders frequently exclude vital costs. A set of recommendations and a conceptual framework will aid researchers in applying a more comprehensive approach for economic evaluations in major red blood cell disorders.

scholarly journals Cost-effectiveness of prehabilitation prior to elective surgery compared to usual preoperative care: protocol for a systematic review of economic evaluations

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040262
Author(s):  
Tanja Rombey ◽  
Helene Eckhardt ◽  
Wilm Quentin
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Functional Capacity ◽  
Elective Surgery ◽  
Cost Utility ◽  
Preoperative Care ◽  
Postoperative Outcomes ◽  
Economic Evaluations ◽  
Care Protocol

IntroductionPreoperative functional capacity is an important predictor of postoperative outcomes. Prehabilitation aims to optimise patients’ functional capacity before surgery to improve postoperative outcomes. As prolonged hospital stay and postoperative complications present an avoidable use of healthcare resources, prehabilitation might also save costs.The aim of this systematic review is to investigate the cost-effectiveness of prehabilitation programmes for patients awaiting elective surgery compared with usual preoperative care. The results will be useful to inform decisions about the implementation of prehabilitation programmes and the design of future economic evaluations of prehabilitation programmes.Methods and analysisWe will search PubMed, Embase, the Centre for Reviews and Dissemination Database, the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for full or partial economic evaluations of preoperative prehabilitation programmes conducted in any population compared with usual preoperative care. Studies will be included regardless of the type, design and perspective of the economic evaluation, and their publication year, language or status. Initial searches were performed between 30 April and 4 May 2020.Study selection, data extraction and assessment of the included studies’ risk of bias and methodological quality will initially be performed by two independent reviewers and, if agreement was sufficiently high, by one reviewer. We will extract data regarding the included studies’ basic characteristics, economic evaluation methods and cost-effectiveness results.A narrative synthesis will be performed. The primary endpoint will be cost-effectiveness based on cost–utility analyses. We will discuss heterogeneity between the studies and assess the risk of publication bias. The certainty of the evidence will be determined using the Grading of Recommendations, Assessment, Development and Evaluation approach.Ethics and disseminationEthics approval is not required as the systematic review will not involve human participants. We plan to present our findings at scientific conferences, pass them on to relevant stakeholder organisations and publish them in a peer-reviewed journal.PROSPERO registration numberCRD42020182813

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