scholarly journals Country-specific cost-effectiveness of early intervention with budesonide in mild asthma

2004 ◽  
Vol 24 (4) ◽  
pp. 568-574 ◽  
Author(s):  
M.J. Buxton
1998 ◽  
Vol 7 (6) ◽  
pp. 481-493 ◽  
Author(s):  
Richard J. Willke ◽  
Henry A. Glick ◽  
Daniel Polsky ◽  
Kevin Schulman

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049675
Author(s):  
Martine Hoogendoorn ◽  
Isaac Corro Ramos ◽  
Stéphane Soulard ◽  
Jennifer Cook ◽  
Erkki Soini ◽  
...  

ObjectivesChronic obstructive pulmonary disease (COPD) guidelines advocate treatment with combinations of long-acting bronchodilators for patients with COPD who have persistent symptoms or continue to have exacerbations while using a single bronchodilator. This study assessed the cost-utility of the fixed dose combination of the bronchodilators tiotropium and olodaterol versus two comparators, tiotropium monotherapy and long-acting β2 agonist/inhaled corticosteroid (LABA/ICS) combinations, in three European countries: Finland, Sweden and the Netherlands.MethodsA previously published COPD patient-level discrete event simulation model was updated with most recent evidence to estimate lifetime quality-adjusted life years (QALYs) and costs for COPD patients receiving either tiotropium/olodaterol, tiotropium monotherapy or LABA/ICS. Treatment efficacy covered impact on trough forced expiratory volume in 1 s (FEV1), total and severe exacerbations and pneumonias. The unit costs of medication, maintenance treatment, exacerbations and pneumonias were obtained for each country. The country-specific analyses adhered to the Finnish, Swedish and Dutch pharmacoeconomic guidelines, respectively.ResultsTreatment with tiotropium/olodaterol gained QALYs ranging from 0.09 (Finland and Sweden) to 0.11 (the Netherlands) versus tiotropium and 0.23 (Finland and Sweden) to 0.28 (the Netherlands) versus LABA/ICS. The Finnish payer’s incremental cost-effectiveness ratio (ICER) of tiotropium/olodaterol was €11 000/QALY versus tiotropium and dominant versus LABA/ICS. The Swedish ICERs were €6200/QALY and dominant, respectively (societal perspective). The Dutch ICERs were €14 400 and €9200, respectively (societal perspective). The probability that tiotropium/olodaterol was cost-effective compared with tiotropium at the country-specific (unofficial) threshold values for the maximum willingness to pay for a QALY was 84% for Finland, 98% for Sweden and 99% for the Netherlands. Compared with LABA/ICS, this probability was 100% for all three countries.ConclusionsBased on the simulations, tiotropium/olodaterol is a cost-effective treatment option versus tiotropium or LABA/ICS in all three countries. In both Finland and Sweden, tiotropium/olodaterol is more effective and cost saving (ie, dominant) in comparison with LABA/ICS.


Salud Mental ◽  
2020 ◽  
Vol 43 (2) ◽  
pp. 65-71
Author(s):  
Héctor Cabello-Rangel ◽  
Lina Díaz-Castro ◽  
Carlos Pineda-Antúnez

Introduction. To achieve universal coverage in mental health, it is necessary to demonstrate which interventions should be adopted. Objective. Analyze the alternatives of pharmacological and psychosocial treatment in Mexico for patients diagnosed with schizophrenia, as well as Early Intervention in Psychosis Program. Method. The Extended cost effectiveness analysis (ECEA), it is implemented under scenario the option of treatment in Mexico, which includes: typical or atypical antipsychotic medication plus psychosocial treatment, assuming that all the medications will be provided to the patient, a measure of effectiveness is the years of life adjusted to disability (DALYs). Results. The effect of Universal Public Financing (UPF) is reflected in avoiding 147 DALYs for every 1,000,000 habitants. In addition, has a positive effect in the avoided pocket expenditures from US $ 101,221 to US $ 787,498 according to the type of intervention. Increasing government spending has a greater impact on the poorest quintile, as a distributive effect of the budget is generated. Respect to the value of insurance, the quintile III is the one who is most willing to pay for having insurance, on the other hand, in the highest income quintile, the minimum assurance valuation was observed. Discussion and conclusion. The reduction in out-of-pocket spending is uniform across all quintiles; “Early Intervention in Psychosis Program” is not viable for middle income countries, as México. The ECEA is a convenient method to assess the feasibility and affordability of mental health interventions to generate information for decision makers.


Addiction ◽  
2010 ◽  
Vol 105 (2) ◽  
pp. 319-328 ◽  
Author(s):  
Lorna Guinness ◽  
Peter Vickerman ◽  
Zahidul Quayyum ◽  
Anna Foss ◽  
Charlotte Watts ◽  
...  

PEDIATRICS ◽  
1974 ◽  
Vol 54 (5) ◽  
pp. 616-619
Author(s):  
Charles R. Scriver

The "first law of screening" stresses that effective measures must reduce "costs." 1As in all ventures, those who pay the piper can expect to call the tune. Whether the concept of cost effectiveness should dominate all decisions about screening for hereditary metabolic disease has been challenged both by the pipers and by those who pay; but to ignore all together this position would be to live again in Hamelin town. Therefore, I will try to clarify several views of cost which are of interest to those who plan or engage in screening for genetic disease.2-5 THE ECONOMIC VIEW OF COSTS Cost avoidance receives the principal emphasis because the benefits of screening are hard to price. The monetary costs resulting from screening and treatment are to be weighed against those incurred when such preventive practices do not take place. We could, indeed, avert the monetary cost to society of phenylketonuria (PKU) by eliminating chronic care institutions for the mentally retarded; at one time PKU patients comprised 1% of their residents. Thankfully, no one has considered this to be an acceptable option. Instead we are pleased to find that one dollar spent for the screening and treatment of PKU is more than balanced by a saving of $4 in institutional and other care which would otherwise be given to non-screened, untreated, retarded PKU patients.6 In the economic view, only real costs are considered. These include the specific cost of screening and treatment which prevents the full expression of the disease; this cost should be weighed against the specific life cost of traditional or new methods of dealing with the disease without screening.


2019 ◽  
Vol 15 (10) ◽  
pp. 1309-1321 ◽  
Author(s):  
Colin Green ◽  
Ron Handels ◽  
Anders Gustavsson ◽  
Anders Wimo ◽  
Bengt Winblad ◽  
...  

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