scholarly journals COST-UTILITY ANALYSIS OF ARTHROSCOPIC MATRIX-BASED MENISCUS REPAIR (AMMR) IN THE PERSPECTIVE OF POLISH NATIONAL HEALTH SERVICE AND PRIVATE PATIENTS – 10-YEAR HORIZON

2021 ◽  
Vol 35 (35) ◽  
pp. 17-30
Author(s):  
Kinga Ciemniewska-Gorzela ◽  
Tomasz Piontek ◽  
Jakub Naczk ◽  
Paweł Bąkowski ◽  
Justus Gille ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Cost Utility ◽  
Meniscus Repair ◽  
Cost Utility Analysis ◽  
Health State ◽  
Utility Analysis ◽  
The Cost

Introduction Clinical data has indicated that Arthroscopic Matrix-based Meniscus Repair (AMMR) offers a means to preserve the meniscus in patients who would otherwise be scheduled for meniscectomy, although AMMR has significant upfront costs. Aim The objective of this study was to estimate the cost-effectiveness of AMMR in Poland in both the National Health Service (PNHS) and from the perspective of private patients (PP). Material and methods A Markov health-state model was developed to evaluate the cost-utility analysis of AMMR compared to meniscectomy (ME) for patients with a complex meniscus tear, using a 10-years horizon, modelling a cohort of 1000 patients. Initial probabilities and clinical course were simulated based on previously published data. A literature review identified different clinical outcome probabilities and health-related utility scores associated with each health state. Cost-effectiveness was presented as an indicator of Incremental Cost-Utility Ratio (ICUR). Costs were taken from published sources for the perspective of PNHS and from a private clinic offers for the perspective of PP. Results In the 10-year horizon, AMMR was associated with an increase in discounted qualityadjusted life-years (QALYs) to 7 778.25 compared to 7 454.33 for ME. In both perspectives, (PNHS and PP) the ICUR cost is smaller than willingness to pay (WTP) parameter (PNHSICUR = 34.212.92 versus PP-ICUR = 29.897.36). Conclusions: Despite the increase in costs, the procedure is cost-effective at standard thresholds used in Poland for analyzed perspectives. Keywords: knee; meniscus; collagen matrix; cost-effectiveness; economic analysis; Markov model

scholarly journals Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mireia Massot Mesquida ◽  
Frans Folkvord ◽  
Gemma Seda ◽  
Francisco Lupiáñez-Villanueva ◽  
Pere Torán Monserrat
Keyword(s):  
Cost Effectiveness ◽  
Psychotropic Drugs ◽  
Medication Review ◽  
Standard Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Current Standard ◽  
Dementia Patients ◽  
The Cost

Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool. Methods The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months. Results The tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). Conclusions The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.

scholarly journals Economic Evaluation of an Internet-Based Stress Management Intervention Alongside a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Fanny Kählke ◽  
Claudia Buntrock ◽  
Filip Smit ◽  
Matthias Berking ◽  
Dirk Lehr ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Stress Management ◽  
Perceived Stress ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Management Interventions ◽  
Life Years ◽  
The Cost

BACKGROUND Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant. OBJECTIVE The aim of this study was to assess the cost-effectiveness of a guided iSMI for employees. METHODS A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000). RESULTS When the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained. CONCLUSIONS Offering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC. CLINICALTRIAL German Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749 INTERNATIONAL REGISTERED REPOR RR2-10.1186/1471-2458-13-655

Cost-effectiveness of Coblation compared with cold steel tonsillectomies in the UK

2018 ◽  
Vol 132 (12) ◽  
pp. 1119-1127 ◽  
Author(s):  
J F Guest ◽  
K Rana ◽  
C Hopkins
Keyword(s):  
Cost Effectiveness ◽  
National Health Service ◽  
Health Service ◽  
Clinical Outcomes ◽  
National Health ◽  
Cost Effective ◽  
Case Scenario ◽  
Paediatric Patients ◽  
The Uk ◽  
The Cost

AbstractObjectiveThis study aimed to estimate the cost-effectiveness of Coblation compared with cold steel tonsillectomy in adult and paediatric patients in the UK.MethodDecision analysis was undertaken by combining published clinical outcomes with resource utilisation estimates derived from a panel of clinicians.ResultsUsing a cold steel procedure instead of Coblation is expected to generate an incremental cost of more than £2000 for each additional avoided haemorrhage, and the probability of cold steel being cost-effective was approximately 0.50. Therefore, the cost-effectiveness of the two techniques was comparable. When the published clinical outcomes were replaced with clinicians’ estimates of current practice, Coblation was found to improve outcome for less cost, and the probability of Coblation being cost-effective was at least 0.70.ConclusionA best-case scenario suggests Coblation affords the National Health Service a cost-effective intervention for tonsillectomy in adult and paediatric patients compared with cold steel procedures. A worst-case scenario suggests Coblation affords the National Health Service an equivalent cost-effective intervention for adult and paediatric patients.

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