scholarly journals ON OPTIMAL CONTROL AND COST-EFFECTIVENESS ANALYSIS FOR TYPHOID FEVER MODEL

2020 ◽  
Vol 4 (3) ◽  
pp. 437-445
Author(s):  
Patrick Okolo ◽  
Onoja Abu
Keyword(s):  
Optimal Control ◽  
Cost Effectiveness ◽  
Maximum Principle ◽  
Typhoid Fever ◽  
Cost Effective ◽  
Control Model ◽  
Cost Effectiveness Analysis ◽  
Optimality System ◽  
Effective Strategy ◽  
Effectiveness Analysis

Abstract Typhoid fever is a disease of a major concern in the developing world because it adversely affects on health and finance of a large chunk of people in this part of the world. This paper is aim to develop an extend and improve the optimal control model of typhoid transmission dynamics that can select the best cost-effective strategy for some interventions. Thus, an optimal control model for typhoid, incorporating control functions representing measures of personal hygiene and sanitation, diagnosis and treatment, and vaccination, was formulated. The corresponding optimality system was characterized via the Pontryagin’s maximum principle. The optimality system was numerically simulated for all possible strategies using Runge-Kutta method of order four. For cost-effectiveness analysis, the method of incremental cost-effectiveness ratio (ICER) was employed. The results show that the model is able to select the most cost-effective strategy for any given set of parameter values and initial conditions. Key words:  Optimal control, Pontryagin’s maximum principle, cost-effectiveness

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).

scholarly journals COST-EFFECTIVENESS ANALYSIS OF CEFTRIAXONE AND NON-CEFTRIAXONE ON TYPHOID FEVER PATIENTS

2018 ◽  
Vol 10 (1) ◽  
pp. 87
Author(s):  
Citra Sari Purbandini ◽  
Rani Sauriasari
Keyword(s):  
Cost Effectiveness ◽  
Typhoid Fever ◽  
Health Care Services ◽  
Cost Effective ◽  
Analysis Data ◽  
Cost Effectiveness Analysis ◽  
Care Services ◽  
Effectiveness Analysis ◽  
Study Results ◽  
The Cost

Objective: This study aimed to evaluate the cost-effectiveness of ceftriaxone and non-ceftriaxone therapies in patients with typhoid fever.Methods: The applied method was a cost-effectiveness analysis. Data were retrospectively collected, and sampling was performed using totalsampling based on medical records and hospital information systems. Subjects were limited to patients diagnosed with typhoid fever and usingceftriaxone or non-ceftriaxone antibiotics. A total of 15 patients were investigated, comprising 10 patients on ceftriaxone and five patients using nonceftriaxoneantibiotics. Effectiveness was evaluated by the length of hospitalization. The cost was a median of total costs, consisting of the cost of thedrug, concomitant drugs, medical equipment, laboratory tests, doctor, health-care services, and hospitalization.Results: The results showed the effectiveness of ceftriaxone (3.80±0.789 days) did not differ with the non-ceftriaxone drugs (3.40±1.635 days).However, the total cost of ceftriaxone (Rp 1,929,355) was less than that of non-ceftriaxone antibiotics (Rp 2,787,003). The average cost-effectivenessratio of ceftriaxone group (Rp 507,725/effectiveness) was lower compared to the non-ceftriaxone (Rp 819,707/effectiveness).Conclusions: This study results showed that ceftriaxone was more cost-effective than non-ceftriaxone antibiotics.

scholarly journals Cost-Effectiveness Analysis of the Prophylactic Use of Ertapenem for the Prevention of Surgical Site Infections after Elective Colorectal Surgery

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 259
Author(s):  
Costanza Vicentini ◽  
Maria Michela Gianino ◽  
Alessio Corradi ◽  
Noemi Marengo ◽  
Valerio Bordino ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Colorectal Surgery ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effective Strategy ◽  
Elective Colorectal Surgery ◽  
Effectiveness Analysis ◽  
Amoxicillin Clavulanate

Standard surgical antimicrobial prophylaxis (SAP) regimens are less effective in preventing surgical site infections (SSIs) due to rising antimicrobial resistance (AMR) rates, particularly for patients undergoing colorectal surgery. This study aimed to evaluate whether ertapenem should be a preferred strategy for the prevention of SSIs following elective colorectal surgery compared to three standard SAP regimens: amoxicillin-clavulanate, cefoxitin, and cefazolin plus metronidazole. A cost-effectiveness analysis was conducted using decision tree models. Probabilities of SSIs and AMR-SSIs, costs, and effects (in terms of quality-adjusted life-years) were considered in the assessment of the alternative strategies. Input parameters integrated real data from the Italian surveillance system for SSIs with data from the published literature. A sensitivity analysis was conducted to assess the potential impact of the decreasing efficacy of standard SAP regimens in preventing SSIs. According to our models, ertapenem was the most cost-effective strategy only when compared to amoxicillin-clavulanate, but it did not prove to be superior to cefoxitin and cefazolin plus metronidazole. The sensitivity analysis found ertapenem would be the most cost-effective strategy compared to these agents if their failure rate was more than doubled. The findings of this study suggest ertapenem should not be a preferred strategy for SAP in elective colorectal surgery.

Screening and Vaccination Against Measles and Varicella Among Health Care Workers: A Cost-effectiveness Analysis

2021 ◽  
pp. 101053952110264
Author(s):  
Ji-Suk Lee ◽  
Oh Jeong ◽  
Hyunju Yang
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Health Care Facilities ◽  
Effective Strategy ◽  
Cost Effective Strategy ◽  
Effectiveness Analysis ◽  
Care Workers

The aim of this study was to examine the most cost-effective strategy of screening and vaccinating measles- and varicella-susceptible health care workers (HCWs). A retrospective cost-effectiveness analysis was conducted at a tertiary hospital in Korea with 300 HCWs who were at high risk of infection. Self-reported histories of vaccinations, infectious diseases, and contact with such cases were collected. Serological tests for immunoglobulin G titers of measles and varicella were performed. Data were analyzed using analysis of variance, Kruskal-Wallis test, χ2 test, and Fisher exact test. Seropositivity rates were 96.3% for measles and 95.7% for varicella. Four different strategies (cases) for vaccination were investigated. Considering the progressive decline in antibody concentrations and the false-positive responses in self-reported histories, case 3, which involved administering 2-dose vaccinations to susceptible HCWs demonstrated by antibody screening tests for both measles and varicella, was the most cost-effective strategy. Health care facilities should establish mandatory immunization policies that reduce the risk of transmission of vaccine-preventable diseases.

Twin Vaginal Deliveries in Labor Rooms: A Cost-Effectiveness Analysis

2021 ◽  
Author(s):  
Jenny Y. Mei ◽  
Divya Mallampati ◽  
Ilina D. Pluym ◽  
Christina S. Han ◽  
Yalda Afshar
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Sensitivity Analyses ◽  
Base Case ◽  
Decision Analysis Model ◽  
Effective Strategy ◽  
Cost Effective Strategy ◽  
Effectiveness Analysis ◽  
Vaginal Deliveries

Objective Twin vaginal deliveries (VDs) are often performed in the operating room (OR) given the theoretical risk of conversion to cesarean delivery (CD) for the aftercoming twin. We aim to evaluate the cost-effectiveness of performing VDs for twin gestations in the labor and delivery room (LDR) versus OR. Study Design We conducted a cost-effectiveness analysis using a decision-analysis model that compared the costs and effectiveness of two strategies of twin deliveries undergoing a trial of labor: (1) intended delivery in the LDR and 2) delivery in the OR. Sensitivity analyses were performed to assess strength and validity of the model. Primary outcome was incremental cost-effectiveness ratio (ICER) defined as cost needed to gain 1 quality-adjusted life year (QALY). Results In the base-case scenario, where 7% of deliveries resulted in conversion to CD for twin B, attempting to deliver twins in the LDR was the most cost-effective strategy. For every QALY gained by delivering in the OR, 243,335 USD would need to be spent (ICER). In univariate sensitivity analyses, the most cost-effective strategy shifted to delivering in the OR when the following was true: (1) probability of successful VD was less than 86%, (2) probability of neonatal morbidity after emergent CD exceeded 3.5%, (3) cost of VD in an LDR exceeded 10,500 USD, (4) cost of CD was less than 10,000 USD, or (5) probability of neonatal death from emergent CD exceeded 2.8%. Assuming a willingness to pay of 100,000 USD per neonatal QALY gained, attempted VD in the LDR was cost effective in 51% of simulations in the Monte Carlo analysis. Conclusion Twin VDs in the LDR are cost effective based on current neonatal outcome data, taking into account gestational age and associated morbidity. Further investigation is needed to elucidate impact of cost and outcomes on optimal utilization of resources. Key Points

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.

scholarly journals Very-low-dose aspirin and surveillance colonoscopy is cost-effective in secondary prevention of colorectal cancer in individuals with advanced adenomas: network meta-analysis and cost-effectiveness analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajesh K. Veettil ◽  
Siang Tong Kew ◽  
Kean Ghee Lim ◽  
Pochamana Phisalprapa ◽  
Suresh Kumar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Secondary Prevention ◽  
Low Dose ◽  
Meta Analysis ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Surveillance Colonoscopy ◽  
Combination Strategy ◽  
Effectiveness Analysis

Abstract Background Individuals with advanced colorectal adenomas (ACAs) are at high risk for colorectal cancer (CRC), and it is unclear which chemopreventive agent (CPA) is safe and cost-effective for secondary prevention. We aimed to determine, firstly, the most suitable CPA using network meta-analysis (NMA) and secondly, cost-effectiveness of CPA with or without surveillance colonoscopy (SC). Methods Systematic review and NMA of randomised controlled trials were performed, and the most suitable CPA was chosen based on efficacy and the most favourable risk–benefit profile. The economic benefits of CPA alone, 3 yearly SC alone, and a combination of CPA and SC were determined using the cost-effectiveness analysis (CEA) in the Malaysian health-care perspective. Outcomes were reported as incremental cost-effectiveness ratios (ICERs) in 2018 US Dollars ($) per quality-adjusted life-year (QALY), and life-years (LYs) gained. Results According to NMA, the risk–benefit profile favours the use of aspirin at very-low-dose (ASAVLD, ≤ 100 mg/day) for secondary prevention in individuals with previous ACAs. Celecoxib is the most effective CPA but the cardiovascular adverse events are of concern. According to CEA, the combination strategy (ASAVLD with 3-yearly SC) was cost-saving and dominates its competitors as the best buy option. The probability of being cost-effective for ASAVLD alone, 3-yearly SC alone, and combination strategy were 22%, 26%, and 53%, respectively. Extending the SC interval to five years in combination strategy was more cost-effective when compared to 3-yearly SC alone (ICER of $484/LY gain and $1875/QALY). However, extending to ten years in combination strategy was not cost-effective. Conclusion ASAVLD combined with 3-yearly SC in individuals with ACAs may be a cost-effective strategy for CRC prevention. An extension of SC intervals to five years can be considered in resource-limited countries.

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