scholarly journals Cost-effectiveness analysis of an intervention project engaging Traditional and Religious Leaders to improve uptake of childhood immunization in southern Nigeria

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257277
Author(s):  
Angela E. Oyo-Ita ◽  
Patrick Hanlon ◽  
Ogonna Nwankwo ◽  
Xavier Bosch-Capblanch ◽  
Dachi Arikpo ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Religious Leaders ◽  
Cross River ◽  
Cross River State ◽  
Effectiveness Analysis ◽  
Southern Nigeria ◽  
The Cost

Vaccination is a cost-effective public health intervention, yet evidence abounds that vaccination uptake is still poor in many low- and middle-income countries. Traditional and Religious Leaders play a substantial role in improving the uptake of health services such as immunization. However, there is paucity of evidence on the cost-effectiveness of using such strategies. This study aimed to assess the cost-effectiveness of using a multi-faceted intervention that included traditional and religious leaders for community engagement to improve uptake of routine immunisation services in communities in Cross River State, Southern Nigeria. The target population for the intervention was traditional and religious leaders in randomly selected communities in Cross River State. The impact of the intervention on the uptake of routine vaccination among children 0 to 23 months was assessed using a cluster randomized trials. Outcome assessments were performed at the end of the project (36 months).The cost of the intervention was obtained from the accounting records for expenditures incurred in the course of implementing the intervention. Costs were assessed from the health provider perspective. The cost-effectiveness analysis showed that the incremental cost of the initial implementation of the intervention was US$19,357and that the incremental effect was 323 measles cases averted, resulting in an incremental cost-effectiveness ratio (ICER) of US$60/measles case averted. However, for subsequent scale-up of the interventions to new areas not requiring a repeat expenditure of some of the initial capital expenditure the ICER was estimated to be US$34 per measles case averted. Involving the traditional and religious leaders in vaccination is a cost-effective strategy for improving the uptake of childhood routine vaccinations.

Retrospective Cost-Effectiveness Analysis of Treatments for Aphasia: An Approach Using Experimental Data

2014 ◽  
Vol 23 (2) ◽  
pp. 186-195 ◽  
Author(s):  
Charles Ellis ◽  
Richard C. Lindrooth ◽  
Jennifer Horner
Keyword(s):  
Experimental Data ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Published Data ◽  
Effectiveness Analysis ◽  
Aphasia Treatment ◽  
Proficiency Scores ◽  
The Cost

Purpose Evidence supports the effectiveness of speech-language treatment for individuals with aphasia, yet less is known about the cost-effectiveness of such treatments. The purpose of this study was to examine the incremental cost and cost-effectiveness of aphasia treatment using previously published data. Method The authors completed a retrospective cost-effectiveness analysis using experimental data that they extracted from 19 previously published aphasia treatment studies. Average and incremental cost-effectiveness ratios were calculated based on participants' pre- and posttreatment proficiency scores. Results The average cost-effectiveness ratio for all sessions was $9.54 for each 1% increase in the outcome of interest. Measures of incremental cost-effectiveness indicated that aphasia treatments resulted in statistically significant improvements up to and including 17 treatment sessions. Increases in proficiency occurred at a cost of approximately $7.00 per 1% increase for the first 3 sessions to more than $20.00 in the 14th session; the ratio was either not statistically significant or dominated (more costly and less effective) in later sessions. Conclusions This cost-effectiveness analysis demonstrated that initial aphasia treatment sessions resulted in relatively larger and more cost-effective benefits than did later aphasia treatment sessions. The findings reported here are preliminary and have limitations. Prospective studies are needed to examine the cost-effectiveness of speech-language treatment for individuals with aphasia.

Cost-effectiveness analysis of chemoradiation compared to radiation alone in the treatment of nonmetastatic oropharyngeal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6075-6075
Author(s):  
Husam Albarmawi ◽  
Ebere Onukwugha ◽  
Kevin J. Cullen ◽  
Olga G. Goloubeva
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Oropharyngeal Cancer ◽  
Survival Benefit ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Limited Information ◽  
Effectiveness Analysis ◽  
Effective Option ◽  
The Cost

6075 Background: Using concurrent chemoradiation (CRT) to treat oropharyngeal cancer (OPC) has increased since 2000. However, there is limited information regarding the cost-effectiveness of CRT compared to radiation alone (RT) especially given the approval of cetuximab (cetux) in 2006. We conducted a cost-effectiveness analysis of 1) platinum-based CRT compared to RT and 2) cetuximab plus RT (cetux+RT) compared to RT to determine the value of CRT over time. Methods: In this retrospective cohort study, we identified non-metastatic OPC patients aged 66 years or older diagnosed between 2000-2011 using the linked Surveillance, Epidemiology and End Results -Medicare dataset. We defined two cohorts based on the diagnosis period: 2000-2005 (Cohort I) and 2006-2011 (Cohort II). Cetux+RT was identified in Cohort II only. We matched the platinum-based CRT and cetux+RT groups to the RT groups using propensity score models that included age, race, marital status, income, Charlson Comorbidity Index and stage at diagnosis. The outcomes were incremental cost, incremental life-year gained (LYG) and incremental cost-effectiveness ratio (ICER) during the 3 years after diagnosis. Costs were estimated from the Medicare perspective and using 2017 USD. Results: 2,646 OPC patients were eligible for the study. The estimated parameters with the corresponding 95% confidence intervals (CI) are shown in the table. Conclusions: From 2000-2005, platinum-based CRT was a cost-effective option compared to RT. From 2006-2011 and compared to RT, platinum-based CRT provided a survival benefit at higher costs while cetux+RT patients incurred higher costs with no survival benefit. [Table: see text]

Cost-effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

2021 ◽  
pp. 019459982110268
Author(s):  
Joseph R. Acevedo ◽  
Ashley C. Hsu ◽  
Jeffrey C. Yu ◽  
Dale H. Rice ◽  
Daniel I. Kwon ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Submandibular Gland ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Probability Of Success ◽  
Markov Decision Model ◽  
The Cost

Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.

Cost-Effectiveness Analysis of Non-Mydriatic Ultrawide- Field Fundus Photography versus Pharmacological Pupil Dilatation in Diabetic Retinopathy Screening Program

2021 ◽  
Vol 104 (5) ◽  
pp. 818-824
Keyword(s):  
Diabetic Retinopathy ◽  
Cost Effectiveness ◽  
Screening Program ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Fundus Photography ◽  
Diabetic Retinopathy Screening ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Retinopathy Screening

Background: Diabetic retinopathy (DR) causes blindness of the population in many countries worldwide. Early detection and treatment of this disease via a DR screening program is the best way to secure the vision. An annual screening program using pharmacological pupil dilatation becomes the standard method. Recently, non-mydriatic ultrawide-field fundus photography (UWF) has been proposed as a choice for DR screening. However, there was no cost-effectiveness study between the standard DR screening and this UWF approach. Objective: To compare the cost-effectiveness between UWF and pharmacological pupil dilatation in terms of hospital and societal perspectives. Materials and Methods: Patients with type 2 diabetes mellitus that visited the ophthalmology clinic at Chulabhorn Hospital for DR screening were randomized using simple randomization method. The patients were interviewed by a trained interviewer for general and economic information. The clinical characteristics of DR and staging were recorded. Direct medical costs, direct non-medical costs, and informal care costs due to DR screening were recorded. Cost analyses were calculated for the hospital and societal perspectives. Results: The present study presented the cost-effectiveness analyses of UWF versus pharmacological pupil dilatation. Cost-effectiveness analysis from the hospital perspective showed the incremental cost-effectiveness ratio (ICER) of UWF to be –13.87. UWF was a cost-effective mean in DR screening in the societal perspective when compared with pharmacologically pupil dilatation with the ICER of 76.46, under the threshold of willingness to pay. Conclusion: The UWF was a cost-effective mean in DR screening. It can reduce screening duration and bypass post-screening blurred vision. The results suggested that UWF could be a viable option for DR screening. Keywords: Diabetic retinopathy, Diabetic retinopathy screening, Non-mydriatic ultrawide-field fundus photography, Cost-effectiveness analysis

Cost-effectiveness analysis of neoadjuvant immune checkpoint inhibition (ICI) versus cisplatin-based chemotherapy (CBC) in muscle-invasive bladder cancer (MIBC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 419-419
Author(s):  
Ali Raza Khaki ◽  
Yong Shan ◽  
Richard Nelson ◽  
Sapna Kaul ◽  
John L. Gore ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Randomized Clinical Trials ◽  
Pathologic Complete Response ◽  
Weighted Average ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Sensitivity Analyses ◽  
Effectiveness Analysis

419 Background: Multiple single-arm clinical trials have shown promising pathologic complete response (pCR) rates with neoadjuvant ICIs in MIBC. However, ICIs remain costly. We conducted a cost-effectiveness analysis comparing neoadjuvant ICIs with CBC. Methods: We applied a decision analytic simulation model with a health care payer perspective and two-year time horizon to compare neoadjuvant ICIs vs CBC. For the primary analysis we compared pembrolizumab with dose dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC). We performed a secondary analysis with gemcitabine/cisplatin (GC) as CBC and exploratory analyses with atezolizumab or nivolumab/ipilimumab as ICIs (vs both ddMVAC and GC). We input pCR rates from trials (ICIs) or a weighted average of prior studies (CBC) and costs from average sales price. Outcomes of interest included costs, 2-year recurrence-free survival (RFS), and incremental cost-effectiveness ratio (ICER) of cost per 2-year RFS. A threshold analysis estimated a pCR rate or price reduction for ICI to be cost-effective and one-way and probabilistic sensitivity analyses were performed. Results: Results of the cost effectiveness analysis are shown in the table. The incremental cost of pembrolizumab compared with ddMVAC was $8,042 resulting in an incremental improvement of 0.66% in 2-year RFS for an ICER of $1,218,485 per 2-year RFS. A pCR of 71% or a 26% reduction in cost of pembrolizumab would render it more cost-effective with an ICER of $100,000 per 2-year RFS. GC required a 96% pembrolizumab cost reduction to achieve an ICER of $100,000 per 2-year RFS. Atezolizumab appeared to be more cost-effective than ddMVAC, even though the 2yr RFS was 0.66% worse. Conclusions: ICIs were not cost-effective as neoadjuvant therapies, except when atezolizumab was compared with ddMVAC. Pembrolizumab would approach cost-effective thresholds with 26% or 96% reduction in cost when compared to ddMVAC and GC, respectively. Randomized clinical trials, larger sample sizes and longer follow-up are required to better understand the value of ICIs as neoadjuvant treatments. [Table: see text]

Cost-effectiveness analysis for preventing hepatitis B virus reactivation-related death in Japan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Fujita ◽  
S Kusumoto ◽  
M Sugiyama ◽  
T Fujisawa ◽  
M Mizokami ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Hbv Dna ◽  
Hbv Reactivation ◽  
Monitoring Strategy ◽  
Effectiveness Analysis ◽  
B Virus ◽  
Tenofovir Alafenamide ◽  
The Cost

Abstract Background There is no worldwide standard recommendation for preventing hepatitis B virus (HBV) reactivation for patients with resolved infection treated with an anti-CD20 antibody for B-cell non-Hodgkin lymphoma. This study aims to compare the cost-effectiveness between two commonly used strategies to prevent HBV reactivation-related death. Methods The two strategies compared were prophylactic antiviral therapy (Pro NAT) and HBV DNA monitoring followed by on-demand antiviral therapy (HBV DNA monitoring) using entecavir (Entecavir, a generic drug for Baraclude). Effectiveness was defined as the prevention of death due to HBV reactivation and costs were calculated under the health insurance system of Japan as of April 2018 using Markov model. A cost-minimization analysis, one of the cost-effectiveness analyses, was applied, since the effectiveness was the same between the two strategies according to a meta-analysis. To consider the effect of uncertainty for each parameter, probabilistic sensitivity analysis (PSA) was performed. In the scenario analysis, costs were calculated using lamivudine (Zefix) or tenofovir alafenamide (Vemlidy) instead of entecavir. All analyses were done using TreeAge Pro 2019 (TreeAge Software, Inc., MA, USA). Results Estimated costs per patient during the 30 months after initiation of chemotherapy for lymphoma were 1,513 USD with Pro NAT and 1,265 USD with HBV DNA monitoring. A PSA revealed that HBV DNA monitoring was more consistently cost-effective compared with Pro NAT when some parameters were set randomly according to probability distributions. In our scenario analysis, costs of Pro NAT and HBV DNA monitoring were calculated as 2,762 and 1,401 USD using lamivudine, 4,857 and 1,629 USD using tenofovir alafenamide. Conclusions Our cost-effectiveness analysis shows that an HBV DNA monitoring strategy using entecavir should be recommended for preventing HBV reactivation-related death in Japan. Key messages Cost-effectiveness analysis demonstrated that HBV DNA monitoring was more cost-effective compared to Pro NAT; this result was consistent with PSA. HBV DNA monitoring strategy should be recommended to prevent HBV reactivation-related death for the patients with resolved HBV infection in Japan.

scholarly journals Interpreting cost-effectiveness ratios in a cost-effectiveness analysis of risk-tailored prostate screening: A critique of Callender et al.

2020 ◽  
Vol 3 ◽  
pp. 23
Author(s):  
James F. O'Mahony
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Disease Risk ◽  
Prostate Cancer Screening ◽  
Absolute Risk ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
The Cost

Callender et al. recently published a model-based cost-effectiveness analysis of a risk-tailored approach to prostate cancer screening. It considers the costs and effects of prostate cancer screening offered to all men aged 55-69 without any risk selection and, alternatively, over a range of risk-tailored strategies in which screen eligibility is determined by a varying threshold of disease risk. The analysis finds that the strategy of screening men once they reach a 10-year absolute risk of disease of 5% or more is cost-effective in a UK context. I believe there are several problems with the study, mostly stemming from an incorrect interpretation of the cost-effectiveness estimates. I show that one reinterpretation of their results indicates that screening is much less cost-effective than the original analysis suggests, indicating that screening should be restricted to a much smaller group of higher risk men. More broadly, I explain the challenges of attempting to meaningfully reinterpret the originally published results due to the simulation of non-mutually exclusive intervention strategies. Finally, I consider the relevance of considering sufficient alternative screening intensities. This critique highlights the need for appropriate interpretation of cost-effectiveness results for policymakers, especially as risk stratification within screening becomes increasingly feasible.

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 ANALISIS EFEKTIVITAS BIAYA PADA PASIEN ANAK DEMAM TIFOID DI RUMAH SAKIT BHAYANGKARA MANADO

PHARMACON ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 335
Author(s):  
Agatha Agnes ◽  
Gayatri Citraningtyas ◽  
Sri Sudewi
Keyword(s):  
Cost Effectiveness ◽  
Typhoid Fever ◽  
Incremental Cost ◽  
Pediatric Patients ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Record Data

ABSTRACT Typhoid fever is an endemic disease which it incidence rate is still high in Indonesian. Administering antibiotic therapy can do treatment of typhoid fever. This study was conducted since there are several pediatric patients diagnosed with typhoid fever but have different antibiotic therapies, namely cefotaxime and ceftriaxone therapy, so it is necessary to do calculations to determine the comparison and determine which treatment is more efficient in cost and effectiveness. The method used in this study is CEA (Cost-Effectiveness Analysis) with the design of retrieving medical record data of children with typhoid fever in Bhayangkara Manado Hospital retrospectively from January to December 2018. The samples  obtained were 28 pediatric patients, cinsisting of 12 patients using cefotaxime therapy and 16 patients using ceftriaxone therapy. The result of ACER (An Avarage Cost Effective Ratio) obtained by ceftriaxone were Rp. 526.609,-/day and cefotaxime Rp. 484.789,-/day. In this study, if patients under cefotaxime therapy want to swich treatment to ceftriaxone therapy, ICER calculation (Incremental Cost-Effectiveness Ratio) is carried out the result are Rp.340.528,-. Keyword: Typhoid fever, Antibiotics, CEA (Cost-Effectiveness Analysis) ABSTRAK Demam tifoid merupakan penyakit endemik yang angka kejadiannya masih tinggi di Indonesia. Pengobatan demam tifoid dapat diobati dengan cara pemberian terapi antibiotik. Penelitian ini dilakukan karena ada beberapa pasien anak yang di diagnosa demam tifoid tetapi memiliki terapi antibiotik yang berbeda, yaitu terapi sefotaksim dan seftriakson  sehingga perlu dilakukan perhitungan untuk mengetahui perbandingan dan menentukan pemilihan pengobatan mana yang lebih efisien dalam biaya maupun efektivitas. Metode yang digunakan dalam penelitian ini adalah CEA (Cost-Effectiveness Analysis) dengan rancangan pengambilan data rekam medik pasien anak demam tifoid di RS. Bhayangkara Manado secara retrospektif pada periode Januari – Desember 2018. Sampel yang didapat sebanyak 28 pasien anak, yang terdiri dari 12 pasien pengguna terapi sefotaksim dan 16 pasien pengguna terapi seftriakson. Hasil ACER (An Avarage Cost Effective Ratio) yang diperoleh sefotaksim Rp.526.609,-/hari dan seftriakson Rp.484.789,-/hari. Pada penelitian ini jika pasien terapi sefotaksim ingin berpindah pengobatan ke terapi seftriakson maka dilakukan perhitungan ICER (Incremental Cost-Effectiveness Ratio) dan didapat hasil Rp.340.582,-, sehingga jika ingin berpindah pengobatan maka perlu penambahan biaya sesuai nilaI ICER.Kata Kunci : Demam Tifoid, Antibiotik, CEA (Cost-Effectiveness Analysis).

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