Health Outcomes and Direct Healthcare Costs in Patients with Melanoma: Associations with Level of Education

PurposeThe aim of this research is to estimate lifetime costs and health consequences for Korean adult women who were exposed to secondhand smoke (SHS) at home.MethodsA Markov model was developed to project the lifetime healthcare costs and health outcomes of a hypothetical cohort of Korean women who are 40 years old and were married to current smokers. The Korean epidemiological data were used to reflect the natural history of SHS-exposed and non-exposed women. The direct healthcare costs (in 2014 US dollars) and quality-adjusted life years (QALYs) were annually discounted at 5% to reflect time preference. The time horizon of the analysis was lifetime and the cycle length was 1 year. Deterministic and probabilistic sensitivity analyses were conducted.ResultsIn the absence of SHS exposure, Korean women will live 41.32 years or 34.56 QALYs before discount, which corresponded to 17.29 years or 15.35 QALYs after discount. The SHS-exposed women were predicted to live 37.91 years and 31.08 QALYs before discount and 16.76 years and 14.62 QALYs after discount. The estimated lifetime healthcare cost per woman in the SHS non-exposed group was US$11 214 before the discount and US$2465 after discount. The negative impact of SHS exposure on health outcomes and healthcare costs escalated as the time horizon increased, suggesting that the adverse impact of SHS exposure may have higher impact on the later part of the lifetime. The result was consistent across a wide range of assumptions.ConclusionLife expectancy might underestimate the impact of SHS exposure on health outcomes, especially if the time horizon of the analysis is not long enough. Early intervention on smoking behaviour could substantially reduce direct healthcare costs and improve quality of life attributable to SHS exposure.

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PCN76 Evaluating Trends In Direct Healthcare Costs In The Last Year Of Life Among Patients With Lung Cancer In Germany

Value in Health ◽

10.1016/j.jval.2020.08.213 ◽

2020 ◽

Vol 23 ◽

pp. S435

Author(s):

R. Knapp ◽

F. Hardtstock ◽

U. Maywald ◽

T. Wilke

Keyword(s):

Lung Cancer ◽

Healthcare Costs ◽

Direct Healthcare Costs

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Frailty Phenotype and Healthcare Costs in Women in Late Life: The SOF study

Innovation in Aging ◽

10.1093/geroni/igaa057.2814 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 778-778

Author(s):

Lisa Langsetmo ◽

Allyson Kats ◽

John Schousboe ◽

Tien Vo ◽

Brent Taylor ◽

...

Keyword(s):

Healthcare Costs ◽

Functional Limitations ◽

Late Life ◽

Cost Ratio ◽

Deficit Accumulation ◽

Frailty Phenotype ◽

Medicare Claims ◽

Accumulation Index ◽

Direct Healthcare Costs ◽

Frailty Indicator

Abstract We used data from 1324 women (mean age 83) at the 2002-2004 exam linked with their Medicare claims to determine the association of the frailty phenotype with healthcare costs. The frailty phenotype was categorized as robust, pre-frail or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims. Functional limitations were assessed by asking about difficulty performing IADL. Total direct healthcare costs were ascertained during 36 months following the exam. Compared with robust, pre-frailty and frailty were associated with higher costs after accounting for demographics, multimorbidity, functional limitations and the frailty indicator (cost ratio 1.37 [1.10-1.71] among pre-frail and 1.63 [1.28-2.08] among frail). Discrimination of high-cost (top decile) women was improved by adding the phenotype and functional limitations to a model containing demographics and the claims-based measures. Findings suggest that assessment of the phenotype may improve identification of individuals at higher risk of costly care.

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1228 Real-world direct healthcare costs for metastatic colorectal cancer patients treated with cetuximab vs. bevacizumab containing regimen in first-line, or sequentially in first- and second-line, from a US private payer perspective

European Journal of Cancer ◽

10.1016/s0959-8049(16)30532-9 ◽

2015 ◽

Vol 51 ◽

pp. S182

Author(s):

S. Johnston ◽

K. Wilson ◽

E. Riehle ◽

H. Varker ◽

P. Juneau ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Real World ◽

Healthcare Costs ◽

Second Line ◽

First Line ◽

Payer Perspective ◽

Direct Healthcare Costs ◽

Colorectal Cancer Patients ◽

Private Payer

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MO545INSIDE ANEMIA OF CKD: ESTIMATING THE IMPACT OF POLICY INTERVENTIONS ON ANAEMIA OF CKD IN THE USA BY MICROSIMULATION MODELLING

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab085.008 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Lise Retat ◽

Laura Webber ◽

Juan Jose Garcia Sanchez ◽

Claudia Cabrera ◽

Susan Grandy ◽

...

Keyword(s):

Healthcare Costs ◽

Severe Anaemia ◽

Service Planning ◽

Microsimulation Model ◽

Model Framework ◽

The Us ◽

The Usa ◽

Direct Healthcare Costs ◽

The Impact ◽

Intervention Scenario

Abstract Background and Aims Anaemia is a common complication in patients with chronic kidney disease (CKD) and is associated with increased mortality, cardiovascular complications, reduced quality of life and increased use of healthcare resources. Mathematical modelling based on robust epidemiological and clinical data is a useful approach for predicting the future burden of disease and the impact of different intervention scenarios; this is important for health service planning. This analysis uses a microsimulation model, Inside ANEMIA of CKD, to predict the effects of a hypothetical intervention scenario that reduces the prevalence of anaemia of CKD on related healthcare costs in the USA from 2020 to 2025. Method A virtual cohort representing the US population was created within the Inside ANEMIA of CKD microsimulation model framework using demographics and epidemiological data drawn from the US Census Bureau, the Centers for Disease Control and Prevention, and the National Health and Nutrition Examination Survey. In the cohort, virtual individuals were ascribed an age–sex-stratified CKD status (defined by estimated glomerular filtration rate and albuminuria levels, as per international guidelines) and anaemia status (defined by haemoglobin level as mild, moderate or severe, as per WHO criteria) based on US prevalence data. Key comorbidities (type 2 diabetes, heart failure and hypertension) were also assigned, reflecting US-specific population statistics. Healthcare costs related to CKD and anaemia of CKD were taken from the published literature. The study modelled the effects on healthcare costs of a hypothetical intervention scenario in which the prevalence of moderate and severe anaemia is reduced by 20% per year from 2020 to 2025 compared with no intervention (baseline). In each scenario (i.e. intervention or baseline), the modelling analysis estimated healthcare costs related to CKD and anaemia (including inpatient, outpatient, pharmacy costs) for patients with moderate or severe anaemia of CKD. The model did not adjust for the potential costs of the intervention. Results Preliminary results predict that, with the hypothetical intervention, there could be 1.40 million fewer patients with moderate or severe anaemia of CKD in the USA in 2025 compared with no intervention (1.45 million versus 2.85 million). This represents a 49% reduction in cases of moderate or severe anaemia of CKD in 2025 with the intervention versus no intervention. The intervention is projected to lead to a reduction of approximately US$18 billion in annual direct healthcare costs in 2025 for patients with moderate or severe anaemia of CKD compared with no intervention (US$26 billion versus US$44 billion). Conclusion The Inside ANEMIA of CKD microsimulation model predicts that a hypothetical intervention which reduces the prevalence of moderate and severe anaemia of CKD would reduce direct healthcare costs. This suggests that interventions effective at reducing the prevalence of anaemia of CKD would help to reduce the economic burden on healthcare services.

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Direct costs of overdiagnosed asthma: a longitudinal, population-based cohort study in British Columbia, Canada

BMJ Open ◽

10.1136/bmjopen-2019-031306 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031306 ◽

Cited By ~ 1

Author(s):

Bryan Ng ◽

Mohsen Sadatsafavi ◽

Abdollah Safari ◽

J Mark FitzGerald ◽

Kate M Johnson

Keyword(s):

Cohort Study ◽

Resource Use ◽

Healthcare Costs ◽

Challenge Test ◽

Medication Use ◽

Population Based ◽

Methacholine Challenge ◽

Physician Visits ◽

Direct Healthcare Costs ◽

Physician Diagnosis

ObjectivesA current diagnosis of asthma cannot be objectively confirmed in many patients with physician-diagnosed asthma. Estimates of resource use in overdiagnosed cases of asthma are necessary to measure the burden of overdiagnosis and to evaluate strategies to reduce this burden. We assessed differences in asthma-related healthcare resource use between patients with a confirmed asthma diagnosis and those with asthma ruled out.DesignPopulation-based, prospective cohort study.SettingParticipants were recruited through random-digit dialling of both landlines and mobile phones in the province of British Columbia, Canada.ParticipantsWe included 345 individuals ≥12 years of age with a self-reported physician diagnosis of asthma. The diagnosis of asthma was reassessed at the end of 12 months of follow-up using a structured algorithm, which included a bronchodilator reversibility test, methacholine challenge test, and if necessary medication tapering and a second methacholine challenge test.Primary and secondary outcome measuresSelf-reported annual asthma-related direct healthcare costs (2017 Canadian dollars), outpatient physician visits and medication use from the perspective of the Canadian healthcare system.ResultsAsthma was ruled out in 86 (24.9%) participants. The average annual asthma-related direct healthcare costs for participants with confirmed asthma were $C497.9 (SD $C677.9) and for participants with asthma ruled out, $C307.7 (SD $C424.1). In the adjusted analyses, a confirmed diagnosis was associated with higher direct healthcare costs (relative ratio (RR)=1.60, 95% CI 1.14 to 2.22), increased rate of specialist visits (RR=2.41, 95% CI 1.05 to 5.40) and reliever medication use (RR=1.62, 95% CI 1.09 to 2.35), but not primary care physician visits (p=0.10) or controller medication use (p=0.11).ConclusionsA quarter of individuals with a physician diagnosis of asthma did not have asthma after objective re-evaluation. These participants still consumed a significant amount of asthma-related healthcare resources. The population-level economic burden of asthma overdiagnosis could be substantial.

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