scholarly journals Cost-effectiveness of meningococcal vaccination of infants in the Russian Federation

2021 ◽  
Vol 13 (4) ◽  
pp. 113-120
Author(s):  
A. V. Rudakova ◽  
A. A. Vilnits ◽  
S. M. Kharit ◽  
Yu. V. Lobzin
Keyword(s):  
Cost Effectiveness ◽  
Life Expectancy ◽  
Incremental Cost ◽  
Russian Federation ◽  
Base Case ◽  
Average Lifetime ◽  
Social Perspective ◽  
The Social ◽  
The Russian Federation ◽  
The Cost

Generalized forms of invasive meningococcal desease (IMD) are very dangerous because they have a high mortality rate.The aim of the work was to assess the cost-effectiveness of meningococcal vaccination of infants with the 4-valent MenACWY-D conjugate vaccine in the Russian Federation.Material and methods. Cost-effectiveness analysis based on epidemiological data for the Russian Federation was carried out by a modeling method with a horizon of 80 years from the position of the healthcare system and taking into account the social perspective. Vaccination costs were calculated on the basis of the registered price of the vaccine, including VAT, the costs of GFMI therapy and patient rehabilitation – based on the compulsory medical insurance tariffs in St. Petersburg for 2021. Indirect costs due to temporary disability of patients’ parents, disability of patients and premature death were estimated by the lost GDP. In the base case, costs were discounted by 3,5% per year, life expectancy – by 1,5% per year.Results. Given the assumptions made, the average lifetime burden of a child’s illness is 17,556 million rubles. (no discounting). In the base case, the incremental cost per LYG from the payer perspective – 7,821 million rubles, and from the social perspective – 3,328 million rubles. Incremental cost per QALY – 5,350 million rubles and 2,277 million rubles, respectively. The most important factors that have a significant impact on the cost-effectiveness of vaccination are the incidence of IMD, the price of the vaccine, and the value of the discounting of costs and life expectancy.Conclusions. Given the assumptions made, meningococcal vaccination of infants with 4-valent meningococcal vaccine can be considered as a viable option. 

scholarly journals Sustained acoustic medicine as a non-surgical and non-opioid knee osteoarthritis treatment option: a health economic cost-effectiveness analysis for symptom management

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Thomas M. Best ◽  
Stephanie Petterson ◽  
Kevin Plancher
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Symptom Management ◽  
Treatment Options ◽  
Base Case ◽  
Treatment Pathways ◽  
Knee Oa ◽  
Cost Effective Treatment ◽  
The Cost

Abstract Background Patients diagnosed with osteoarthritis (OA) and presenting with symptoms are seeking conservative treatment options to reduce pain, improve function, and avoid surgery. Sustained acoustic medicine (SAM), a multi-hour treatment has demonstrated improved clinical outcomes for patients with knee OA. The purpose of this analysis was to compare the costs and effectiveness of multi-hour SAM treatment versus the standard of care (SOC) over a 6-month timeframe for OA symptom management. Methods A decision tree analysis was used to compare the costs and effectiveness of SAM treatment versus SOC in patients with OA. Probabilities of success for OA treatment and effectiveness were derived from the literature using systematic reviews and meta-analyses. Costs were derived from Medicare payment rates and manufacturer prices. Functional effectiveness was measured as the effect size of a therapy and treatment pathways compared to a SOC treatment pathway. A sensitivity analysis was performed to determine which cost variables had the greatest effect on deciding which option was the least costly. An incremental cost-effectiveness plot comparing SAM treatment vs. SOC was also generated using 1000 iterations of the model. Lastly, the incremental cost-effectiveness ratio (ICER) was calculated as the (cost of SAM minus cost of SOC) divided by (functional effectiveness of SAM minus functional effectiveness of SOC). Results Base case demonstrated that over 6 months, the cost and functional effectiveness of SAM was $8641 and 0.52 versus SOC at: $6281 and 0.39, respectively. Sensitivity analysis demonstrated that in order for SAM to be the less expensive option, the cost per 15-min session of PT would need to be greater than $88, or SAM would need to be priced at less than or equal to $2276. Incremental cost-effectiveness demonstrated that most of the time (84%) SAM treatment resulted in improved functional effectiveness but at a higher cost than SOC. Conclusion In patients with osteoarthritis, SAM treatment demonstrated improved pain and functional gains compared to SOC but at an increased cost. Based on the SAM treatment ICER score being ≤ $50,000, it appears that SAM is a cost-effective treatment for knee OA.

Economic Evaluation of Posaconazole Versus Standard Azole Prophylaxis in High Risk Neutropenic Patients in The Netherlands.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3335-3335
Author(s):  
Wiro B. Stam ◽  
Amy K. O’Sullivan ◽  
Bart Rijnders ◽  
Elly Lugtenburg ◽  
Lambert F. Span ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
High Risk ◽  
Life Expectancy ◽  
Decision Tree ◽  
Incremental Cost ◽  
Fungal Infections ◽  
Intensive Chemotherapy ◽  
Neutropenic Patients ◽  
The Cost

Abstract Background: Acute leukemia and high risk myelodysplastic syndrome patients experience prolonged neutropenia after treatment with intensive chemotherapy, leading to a high risk of acquiring potentially fatal invasive fungal infections (IFI). Pharmacoeconomic analysis is considered a valuable tool to justify the significant costs involved in managing these fungal infections. The present study evaluates the cost-effectiveness of posaconazole versus standard azoles for the prevention of IFIs in neutropenic patients in the Netherlands. Methods: A decision-tree model was developed that starts with the choice of antifungal prophylaxis: posaconazole or standard azole treatment (fluconazole or itraconazole). The decision tree was estimated using data from a recently published prospective, randomized, double blind, multi-center trial that compared both treatments in neutropenic patients receiving remission-induction chemotherapy for AML/MDS (Cornely et al., 2007). Following initiation of prophylaxis, clinical events are modeled with chance nodes reflecting probabilities of IFIs, IFI related death, and death from other causes. It is assumed that patients surviving the prophylactic period will have a life expectancy that reflects that of the underlying condition. This allows translation of the trial outcomes to a lifetime horizon. Data on life expectancy, quality of life, medical resource consumption and costs were obtained from the literature. Model outcomes include incremental cost per IFI avoided, incremental cost per life years saved and incremental cost per QALYs gained. Results: The total cost (treatment of breakthrough IFI + prophylaxis) for posaconazole amounted to €4,566 (95% uncertainty interval €3,574 –€5,769), which is €63 (−€1,552 - €1,903) less than costs with standard azoles. Posaconazole prophylaxis resulted in 0.1 (0.03 – 0.15) QALYs gained in comparison to prophylaxis with standard azoles. Results from a probabilistic sensitivity analysis indicate that there is a 87% probability that the cost per QALY gained with posaconazole is below €20,000, a commonly accepted threshold for cost-effectiveness. Additional scenario analyses with different assumptions confirmed these findings. Conclusion: Given the underlying data and assumptions, our economic evaluation demonstrated that posaconazole prophylaxis is cost and QALY saving compared to fluconazole / itraconazole in neutropenic AML/MDS patients after intensive chemotherapy.

scholarly journals Evaluation of the Cost-Effectiveness of Vaccination of Children with 5-valent Vaccine against Rotavirus Infection in the Russian Federation

2017 ◽  
Vol 14 (6) ◽  
pp. 501-507 ◽  
Author(s):  
Alla V. Rudakova ◽  
Susanna M. Kharit ◽  
Aleksandr T. Podkolzin ◽  
Aleksandr N. Uskov ◽  
Yurii V. Lobzin
Keyword(s):  
Cost Effectiveness ◽  
Russian Federation ◽  
Rotavirus Infection ◽  
The Russian Federation ◽  
The Cost

Cost-effectiveness of measures against rabies

2020 ◽  
Vol 1 (12) ◽  
pp. 78-83
Author(s):  
K. M. Abramov ◽  
◽  
O. V. Liseykina ◽  
I. K. Abramova ◽  
◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Russian Federation ◽  
Economic Effectiveness ◽  
Moscow Region ◽  
The Russian Federation ◽  
The Cost ◽  
Rabies Vaccination

The article presents material on current problems of rabies vaccination: the epizootic situation of rabies in the Russian Federation is considered, the analysis of the dynamics of the number of cases of animal rabies, the population's appeal for anti-rabies care is given. Based on data on preventive rabies vaccination in the Moscow region and the cost of such measures, the economic effectiveness of anti-rabies measures is evaluated.

Cost-effectiveness of immune checkpoint inhibition in metastatic gastric and esophageal tumors.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 56-56 ◽  
Author(s):  
Sassan Ostvar ◽  
Jin G. Choi ◽  
Jacqueline N. Chu ◽  
Michael Lawrence Dougan ◽  
Justin F. Gainor ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Combination Therapy ◽  
Adverse Events ◽  
Incremental Cost ◽  
Immune Checkpoint ◽  
Base Case ◽  
Checkpoint Inhibition ◽  
Immune Checkpoint Inhibition ◽  
Life Years ◽  
The Cost

56 Background: Immune checkpoint inhibition has shown early promising results in patients with chemotherapy-refractory metastatic or advanced tumors of the esophagus, gastroesophageal junction, and stomach. We explore the cost-effectiveness of checkpoint inhibitors as second-line treatment agents for this group of patients using a decision analytic approach. Methods: A Markov model was developed to simulate the course of a virtual cohort of patients treated by (i) nivolumab 3 mg/kg, (ii) combination of ipilimumab 3 mg/kg and nivolumab 1 mg/kg, and (iii) best supportive care (BSC). Patients in the hypothetical cohort were 55-year-olds in an advanced/metastatic stage who had received at least one prior line of chemotherapy. Patients who remained stable in treatment were monitored for adverse events until death. Rates of cancer-specific mortality, disease progression, and drug-related adverse events were estimated using results from the CheckMate 032 clinical trial. The primary endpoints were survival, measured in life-years (LY), quality adjusted life years (QALY), and incremental cost-effectiveness ratios (ICER). Cost-effectiveness of each strategy was evaluated from a US-payer perspective considering costs of drugs, treatment, and management of immune-related adverse events. Cost-effectiveness was defined with a willingness to pay threshold of $100,000/QALY. Results: Combination therapy with nivolumab and ipilimumab yielded the highest effectiveness (QALYs = 0.47, LYs = 1.09) in our base case modeling results, compared with nivolumab (QALYs = 0.43, LYs = 1.03), and BSC (QALYs = 0.19, LYs = 0.42). Nivolumab had an incremental cost of $84,555/QALY compared with BSC, while nivolumab with ipilimumab resulted in an incremental cost of $1.1M/QALY compared with nivolumab alone. The cost gap between the two was associated with the higher price of ipilimumab, and costs of managing increased toxicity. Conclusions: Our modeling analysis finds that combination therapy of ipilimumab and nivolumab is the most effective, but from a cost-effectiveness perspective, it is expensive, making nivolumab monotherapy the cost-effective option. Additional clinical data are needed to confirm our modeling results.

scholarly journals Cost Effectiveness Analysis of Azithromycin and Doxycycline forChlamydia TrachomatisInfection in Women: A Canadian Perspective

1997 ◽  
Vol 8 (4) ◽  
pp. 202-208 ◽  
Author(s):  
Fawziah Marra ◽  
Carlo A Marra ◽  
David M Patrick
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Hypothetical Cohort ◽  
Chlamydia Infection ◽  
Economic Evaluations ◽  
Base Case ◽  
Diagnostic Strategies ◽  
The Cost

OBJECTIVE: To assess the cost effectiveness of azithromycin versus doxycycline therapy for cervicalChlamydia trachomatisinfections in Canada.DESIGN: A predictive decision analytic model using previously published clinical and economic evaluations, expert opinion and costs of medical care in Canada.POPULATION: A hypothetical cohort of 5000 women followed over 10 years.INTERVENTIONS: Two diagnostic strategies were compared, laboratory confirmed diagnosis (LCD) and presumptive diagnosis (PD) ofC trachomatisinfection. Under each strategy, two treatment alternatives were analyzed, a single 1 g dose of azithromycin and a seven-day course of doxycycline as 100 mg twice daily.RESULTS: Despite a fourfold higher acquisition cost, under base case conditions, for both diagnostic strategies, the azithromycin treatment alternative was more cost effective than the doxycycline alternative. For the LCD model, the cost per cure for patients receiving azithromycin was $184.76 compared with $240.59 for patients receiving doxycycline, resulting in an incremental cost of $55.83. For the PD model, the cost per cure for patients treated with azithromycin was $51.48 compared with $51.82, resulting in an incremental cost of $0.34. For the hypothetical cohort of 5000 women, the use of azithromycin translates into a projected annual cost savings of $279,150 and $1,700 for the LCD and PD models, respectively. In one-way sensitivity analyses for the LCD model, no clinically plausible changes in the base case estimates changed the results of the cost effectiveness outcome. In the PD model, clinically plausible changes in the probabilities of doxycycline cure, pelvic inflammatory disease, sequelae and chlamydia infection were found to alter the cost effectiveness outcome.CONCLUSIONS: Based on the results from our model, the azithromycin strategy should be employed for the treatment of laboratory confirmed cases. However, for presumptive cases, azithromycin should be used only if the probabilities ofC trachomatisand pelvic inflammatory disease are more than 19%, doxycycline effectiveness is less than 78%, or the cost of azithromycin is less than $19.00.

scholarly journals Economic and social aspects of pituitary dwarfism treatment with recombinant growth hormone

2017 ◽  
Vol 63 (2) ◽  
pp. 82-91 ◽  
Author(s):  
Maria V. Vorontsova ◽  
Elena V. Nagaeva ◽  
Nelli B. Naygovzina
Keyword(s):  
Growth Hormone ◽  
Incremental Cost ◽  
Russian Federation ◽  
Medical Examination ◽  
Median Cost ◽  
Cost Of Treatment ◽  
Recombinant Growth Hormone ◽  
Pituitary Dwarfism ◽  
The Russian Federation ◽  
The Cost

Rationale. Pituitary dwarfism is an orphan disease requiring pathogenetic treatment. The domestic literature lacks studies devoted to the medical and economic effectiveness of treatment for growth hormone deficiency (GHD) using recombinant growth hormone (rGH) drugs. Aim. To analyze the cost effectiveness of rGH therapy in GHD children in the Russian Federation under the Program «7 High-Cost Nosologies». Material and methods. We analyzed data of 50 GHD children living in 4 regions of the Russian Federation and receiving rGH therapy under the Program «7 High-Cost Nosologies». We evaluated the amount of drug consumption and the economic component: the cost of treatment and monitoring for ≥ 6 years. The incremental cost was calculated as the difference between a program providing a GHD child with rGH treatment and monitoring and an alternative program providing a GHD child with financial and social assistance and medical examination. Results. The median cost of treatment of a single child with rGH at a dose of 0.033 mg/kg/day was 437.5 thousand rubles or 8.12 thousand US dollars for the entire analyzed period (mean, 6.95 years). The median cost of treatment per child per year was 63.6 thousand rubles/year or 1.09 thousand USD/year. Given the cost of treatment and monitoring, the integrated management of one patient cost 68.4 thousand rubles per year (470.7 thousand rubles for 6.95 years), on average, with monitoring accounting for 7.05%. The total cost of all benefits and examinations for one disabled child was 178.97 thousand rubles per year or 1,243.86 thousand rubles for 6.95 years (medical examinations accounted for 1.2%). Upon calculating the cost difference between the program providing a GHD child with treatment and monitoring and the alternative program when a GHD child was not provided with treatment, but received appropriate disability payments and medical examination, the incremental cost amounted to 110.6 thousand rubles per child per year (773.18 thousand rubles for 6.95 years). Conclusion. The study demonstrates that treatment of GHD children under Program «7 High-Cost Nosologies» is cost-effective for both the patient and society and the state in general. For example, the incremental cost between the two programs is 110.6 thousand rubles for a year or 773.18 thousand rubles for 6.95 years. The study results indicate the importance of thorough analysis of the effects and costs in assessing the effectiveness of medical programs, especially in the case of orphan diseases.

scholarly journals Cost effectiveness analysis of universal varicella vaccination in the Russian Federation

2021 ◽  
Vol 13 (3) ◽  
pp. 114-119
Author(s):  
A. V. Rudakova ◽  
S. M. Kharit ◽  
I. V. Babachenko ◽  
L. N. Konovalova ◽  
S. V. Rychkova ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Healthcare System ◽  
Russian Federation ◽  
Weighted Average ◽  
Indirect Costs ◽  
Epidemiological Data ◽  
Varicella Vaccination ◽  
The Russian Federation ◽  
Sick Children ◽  
The Cost

Varicella is a significant burden on society and the healthcare system.Objective: to analyze the cost effectiveness of universal vaccination of children against varicella.Material and methods. The analysis was carried out from the perspective of the healthcare system and societal perspective, based on epidemiological data for the Russian Federation. The effect was taken into account only in the vaccinated population. The time horizon of the study is 10 years. The amount of direct medical costs for treatment of varicella was calculated based on the rates of compulsory medical insurance in St. Petersburg in 2020. The cost of drug therapy in outpatient settings was calculated based on the weighted average retail price of prescribed drugs. The analysis of direct nonmedical and indirect costs was carried out taking into account statistical data on the Russian Federation and duration of temporary disability of family members of sick children. Costs and quality-adjusted life expectancy were discounted by 3.5% per year.Results. The average cost due to the disease in the Russian Federation is 43,139 rubles / patient, of which 8,5% is direct cost. Vaccination of 100,000 children will prevent 38,551 cases of varicella in 10 years. When analyzing from a social perspective, vaccination provides a reduction in costs compared to no vaccination, and the savings will amount to 10.1 thousand rubles per 1 vaccinated person.If vaccination coverage is 90%, taking into account the fact that the cohort of children in the Russian Federation at the age of 1 year is about 1.9 million people, the cost of vaccination will amount to about 8.1 billion rubles annually. At the same time, already 6 years after vaccination, the volume of averted budgetary costs will exceed the costs of vaccination.Conclusion. Universal varicella vaccination of children will reduce the incidence of the disease and reduce the budget costs associated with this disease.

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