scholarly journals Cost-Utility Analysis of Antibiotics Compared with Operative Treatment in Uncomplicated Acute Appendicitis.

2021 ◽  
Author(s):  
Napaphat Poprom ◽  
Oraluck Pattanaprateep ◽  
Chumpon Wilasrusmee ◽  
Sasivimol Rattanasiri ◽  
Gareth McKay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Acute Appendicitis ◽  
Operative Treatment ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Net Benefit ◽  
Uncomplicated Acute Appendicitis

Abstract Background: Appendicitis is the most common acute abdominal condition affecting general surgical practice. Although appendectomy has been considered the “gold standard” treatment, it has been associated with post-operative complications. Recently, conservative treatment with antibiotics has been considered as an alternative. Therefore, this study was conducted to evaluate if antibiotics could be cost-effective when compared to laparoscopic appendectomy (LA) or open appendectomy (OA).Methods: A prospective study was undertaken to estimate health-related quality of life using a European Quality of Life–5 Dimensions questionnaire for antibiotic and operative treatment and to ascertain indirect and direct non-medical costs in a cohort between November 2018 and October 2019. An incremental cost-effectiveness ratio (ICER) at 1 month and a net benefit at 1 year after surgery were estimated. A Tornado diagram was plotted to determine one-way and probabilistic sensitivity analyses; a cost-effectiveness (CE) scatter plot and CE acceptability curve were also generated.Results: ICERs were estimated from cost-utility analysis comparisons between individual antibiotics (beta-lactam, quinolone, and cephalosporin + metronidazole), LA, and OA in uncomplicated acute appendicitis. Antibiotics showed improved cost utility compared to operative treatments with an ICER of -9,585.66 USD per utility gained at 1 month, and the net benefit at 1 year was 3,250.08 USD. Conclusions: Base on short term evaluation, antibiotics might represent a lower cost treatment option with better cost utility compared to operative treatment options in uncomplicated acute appendicitis patients. As such, antibiotic treatment might be considered as an alternative option where resources are limited to minimize complication rates associated with operative treatments.

scholarly journals Influence of Patient Preferences on the Cost-Effectiveness of Screening for Lynch Syndrome

2012 ◽  
Vol 8 (3S) ◽  
pp. e24s-e30s ◽  
Author(s):  
Grace Wang ◽  
Miriam Kuppermann ◽  
Benjamin Kim ◽  
Kathryn A. Phillips ◽  
Uri Ladabaum
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Lynch Syndrome ◽  
Patient Preferences ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
The Cost

This cost-utility analysis reports on the effect of quality of life on the value of screening all new patients with colorectal cancer for Lynch syndrome.

scholarly journals Rituximab in generalized myasthenia gravis: Clinical, quality of life and cost–utility analysis

2017 ◽  
Vol 2 (3) ◽  
pp. 81-85 ◽  
Author(s):  
João Peres ◽  
Rita Martins ◽  
José Delgado Alves ◽  
Ana Valverde
Keyword(s):  
Quality Of Life ◽  
Myasthenia Gravis ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Clinical Quality

Change in Quality of Life and Cost/Utility Analysis in Open Stage-related Surgical Treatment of Elbow Stiffness

Orthopedics ◽  
2013 ◽  
Vol 36 (7) ◽  
pp. e923-e930 ◽  
Author(s):  
Giuseppe Giannicola ◽  
Gianluca Bullitta ◽  
Federico M. Sacchetti ◽  
Marco Scacchi ◽  
David Polimanti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Elbow Stiffness

Health-Related Quality of Life and Cost–Utility Analysis of Employees With Musculoskeletal Disorders Receiving Vocational Physiotherapy

2020 ◽  
Vol 68 (10) ◽  
pp. 476-479
Author(s):  
Laran Chetty
Keyword(s):  
Quality Of Life ◽  
Musculoskeletal Disorders ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Health Related Quality ◽  
Utility Analysis ◽  
Related Quality ◽  
Health Related ◽  
The Cost

Background: The purpose of this project was to evaluate both health-related quality of life (HRQoL) and cost-utility associated with care for employees with musculoskeletal disorders who received vocational physiotherapy at a North London National Health Service (NHS) Foundation Trust in the United Kingdom. Methods: A pre- and post-physiotherapy EuroQol 5 Dimension (EQ-5D) questionnaire was administered to employees presenting to the vocational physiotherapy service (VPS) with musculoskeletal disorders. The cost-utility analysis of the physiotherapy service was calculated using cost data provided by VPS billing information and benefits measured using Quality-Adjusted Life Years (QALYs). Findings: Overall, there was a significant improvement in the EQ-5D index from baseline to discharge in all HRQoL domains. The visual analog scale (VAS) improved from a mean of 31.5 (SD = 18.3) at baseline to 73.2 (SD = 18.5) at discharge. A cost-utility analysis indicated that the VPS would continue to be cost-effective until the cost per employee increased by 82.5%. Conclusion/Application to Practice: The project supports integration of vocational physiotherapy services into an occupational health department.

scholarly journals Cost-Utility Analysis of Saxagliptin/Dapagliflozin Versus Gliclazide and Insulin Glargine: Economic Implications of the Outcomes of the CVD-Real Studies I and II

2020 ◽  
Vol 13 ◽  
pp. 117863292092998
Author(s):  
Enrico Torre ◽  
Giacomo Matteo Bruno ◽  
Sergio Di Matteo ◽  
Chiara Martinotti ◽  
Maria Chiara Valentino ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sensitivity Analysis ◽  
Insulin Glargine ◽  
Annual Cost ◽  
Basal Insulin ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Bodyweight Loss ◽  
Utility Analysis

Diabetes treatment cost represents an ever-growing problem. The adoption of new drugs in therapy, although they can guarantee an improvement in patient’s quality of life, can meet obstacles when it involves an increase in costs. We decided to compare the costs and benefits of the new saxagliptin and dapagliflozin combination versus traditional therapies. Bodyweight loss and the sharp reduction in hypoglycemic episodes were the 2 main clinical outcomes that emerged from registered studies of saxagliptin and dapagliflozin compared with the sulfonylureas. These results, combined with the good cardiovascular risk profile, led to develop a cost-utility analysis. We aimed to show the economic value of this new association therapy. We carried out a cost-utility analysis from the Italian National Healthcare System (NHS) perspective, focused on direct costs related to the treatment and management of main diabetes complications. Utility scores adopted have been measured based on the patient’s perception of weight changes. In light of the better durability profile of saxagliptin/dapagliflozin compared with gliclazide, we also considered a simulation scenario to assess the impact on costs of switching to basal insulin, starting from gliclazide and the fixed combination, respectively, and based on the related probabilities to switch. To assess the robustness of the results, a 1-way sensitivity analysis was performed by changing the main parameters by ±20%. Furthermore, the sensitivity of the results was tested considering the addition of a percent discount, because the purchase costs of drugs are usually subject to hidden discounts. We calculated the total direct annual cost per patient of saxagliptin/dapagliflozin versus gliclazide and insulin glargine for patients with type 2 diabetes mellitus not achieving glycemic control on metformin plus saxagliptin alone, dapagliflozin alone, or gliclazide at a lower dosage. Total treatment costs have been obtained adding the direct cost of the drug, needles, glycemic self-monitoring, hypoglycemic events, cardiovascular complications, and effect on consumption of other drugs. The total direct cost of saxagliptin/dapagliflozin fixed dose combination was €414.62 higher than gliclazide (€1.067.72 vs €653.10), and greater than basal insulin, with a difference of €166.99 (€1067.72 vs €900.72). Despite the higher annual direct total cost, the additional cost per quality-adjusted life year (QALY) gained, compared with gliclazide, has been €11 517, and €4639, when compared with insulin glargine in the base-case scenario, and the robustness of the results has been shown in the sensitivity analysis. The results of our cost-utility analysis, expressed as incremental cost-effectiveness ratios, were fully compliant with the threshold adopted for Italy. Then, saxagliptin/dapagliflozin can be considered a cost-effective oral hypoglycemic agent. The positive effect of this drug on the quality of life, induced by the bodyweight loss, has allowed this outcome, despite the higher annual cost per patient, mainly determined by the drug purchase cost.

Comparison of four strategies of follow-up in thyroid cancer patients: A cost-utility analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6606-6606
Author(s):  
G. de Pouvourville ◽  
I. Borget ◽  
M. Allyn ◽  
M. Schlumberger
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Patients ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Whole Body ◽  
Utility Analysis

6606 Background: In thyroid cancer patients, follow-up is designed to detect recurrent disease and consists of neck- ultrasonography (US), thyroglobulin measurement (Tg) and radioiodine whole body scan (WBS). Recent guidelines have restricted the use of WBS to suspicious cases. To insure diagnostic accuracy, follow-up control requires TSH stimulation, either with thyroid hormone withdrawal (THW) or rhTSH, which have demonstrated similar diagnostic accuracy. THW induces significant morbidity associated with hypothyroidism, leading to a decrease in patient quality of life and ability to work, whereas rhTSH is an innovative costly drug that avoids such patient burden. A societal cost-utility analysis was conducted to compare 4 follow-up strategies, combining a method of stimulation (rhTSH or THW) and a testing protocol (US+Tg+WBS or US+Tg alone). Methods: A Markov model was built to describe the follow-up of thyroid cancer patients first treated by thyroidectomy and radioiodine ablation, over 5 years. Estimates for diagnostic accuracy values and recurrence rate were extracted from a French multicenter randomized trial. Costs were computed from the perspective of the society, including medical resources consumed (hospitalisation, rhTSH, tests, treatment of recurrence). The model also incorporated the benefits of rhTSH in terms of quality of life (utility scores derived from SF36) and the reduction in duration and overall cost of sick leave. Results: Among the 753 patients included, 13 patients presented recurrence. rhTSH stimulation resulted in a higher utility score (0.802 vs. 0.637) over the period of stimulation and a reduction of 1083 € of absenteeism costs in active patients. As compared to the THW+Tg+US+WBS strategy, the incremental cost-utility ratios (ICER) showed economic dominance for the rhTSH strategies with ratios of −16,876 and −19,297 €/QALY with and without WBS respectively. The ICER for the strategy THW+US+Tg reached 29,333 €/QALY, as compared to THW+Tg+US+WBS strategy. Conclusions: the recommended strategy combining Tg determination and US after rhTSH stimulation appears the most cost-effective in the follow-up of thyroid cancer patients, as it is the strategy the less costly and associated with improved patient quality of life. No significant financial relationships to disclose.

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