scholarly journals Economic Evaluation of Severe Anaemia: Review-Based Recommendations and a Conceptual Framework

2020 ◽  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Blood Cell ◽  
Conceptual Framework ◽  
Red Blood Cell ◽  
Budget Impact ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Economic Analyses ◽  
Impact Models

Objective: Novel anaemia treatments have greatly improved patient outcomes in the last decade and have also undergone economic evaluations in various settings using heterogenous model structures, costs, and inputs. The objectives were to review published economic evaluation studies in major red blood cell disorders, identify limitations in the applied methodology, provide a set of recommendations, and produce a conceptual framework for future economic research in this disease area. Methods: A targeted search was conducted for economic literature evaluating treatments in major red blood cell disorders related to anaemia. Disorders included autoimmune haemolytic anaemia, β-thalassaemia, chemotherapy-induced anaemia, anaemia in chronic kidney disease, and severe aplastic anaemia. Budget impact models and cost-effectiveness and cost-utility analyses were considered. Modelling assumptions regarding the model structure, time horizon, perspective, and type of costs were reviewed and recommendations and a conceptual framework for future economic analyses were created. Results: A total of four budget impact models, nine cost-utility analyses, and four cost-effectiveness analyses were investigated. A major limitation was that the included costs varied significantly across studies. Costs which were rarely included, and generally should be considered, were related to adverse events, mortality, and productivity. Additionally, relationships between levels of serum ferritin, hepatic or total body iron, and haemoglobin with long-term complications and mortality were rarely included. Conclusion: Published economic analyses evaluating treatments for major red blood cell disorders frequently exclude vital costs. A set of recommendations and a conceptual framework will aid researchers in applying a more comprehensive approach for economic evaluations in major red blood cell disorders.

scholarly journals Economics of gastroenteropancreatic neuroendocrine tumors: a systematic review

2019 ◽  
Vol 10 ◽  
pp. 204201881982821 ◽  
Author(s):  
Enrique Grande ◽  
Ángel Díaz ◽  
Carlos López ◽  
Javier Munarriz ◽  
Juan-José Reina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Resource Utilization ◽  
Neuroendocrine Tumors ◽  
Cost Of Illness ◽  
Budget Impact ◽  
The United States ◽  
Economic Evaluations

Background: Despite current interest, enthusiasm and progress in the development of therapies for gastroenteropancreatic (GEP) neuroendocrine tumors (NETs), there are substantial gaps in the published literature regarding cost-of-illness analyses, economic evaluation and budget impact analyses. Compounding the issue is that data on resource utilization and cost-effectiveness of different diagnostic and therapeutic modalities for GEP-NETs are scarce. Methods: A systematic review on the economic impact of GEP-NETs was carried out using four databases: EMBASE, PubMed, the National Health Service Economic Evaluation Database and Cochrane review. Fully published articles from January 2000 to May 2017, in English and Spanish, were included. All articles that satisfied the inclusion criteria were included in the systematic review; summary descriptive statistics were used to describe the methodological characteristics. Results: The 14 studies selected included cost-of-illness analyses ( n = 4), economic evaluations ( n = 7) and budget impact analyses ( n = 3). Almost all studies were performed in the United States. Healthcare costs for patients with NETs included medication, outpatient visits, hospitalizations, and check-ups/tests. Reducing adverse events is an area where cost savings could be achieved; however, there was not enough evidence on the cost impact of adverse events. Conclusion: There is a lack of data related to resource utilization in the field of GEP-NETs. Therefore, cost-effectiveness and budget impact studies of existing and emerging treatments are urgently needed to help the decision-making process for patients with NETs.

scholarly journals Economic Evaluation of Carbetocin as Prophylaxis for Postpartum Hemorrhage in the Philippines

2020 ◽  
Author(s):  
Jamaica Roanne Briones ◽  
Pattarawalai Talungchit ◽  
Montarat Thavorncharoensap ◽  
Usa Chaikledkaew
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Postpartum Hemorrhage ◽  
Budget Impact ◽  
Hospital Setting ◽  
Cost Effective ◽  
The Philippines ◽  
Cost Utility ◽  
Third Party ◽  
Additional Costs

Abstract Background: Cost-effectiveness and budget impact of carbetocin was evaluated as an alternative to oxytocin for postpartum hemorrhage (PPH) prophylaxis in the Philippines.Methods: A model-based economic evaluation was employed to assess cost-effectiveness of carbetocin compared to oxytocin for PPH. Population of interest were women undergoing either vaginal delivery (VD) or cesarean section (CS) in a public hospital setting with costs and outcomes evaluated in six weeks. Cost-utility was analyzed using a government and societal perspectives while the budget impact was determined using a third party payer’s perspective. Incremental Cost Effectiveness Ratio (ICER) was evaluated using the set threshold in the country of 150,000 PhP per QALY gained.Results: Carbetocin was not cost-effective in the Philippines. Deterministic results in a government perspective for CS was at 724,081 PhP while for VD was over 2 million PhP. Deterministic and probabilistic results in the societal perspective for CS and VD were near these respective ICER values and did not also favor carbetocin use. Moreover, the treatment effects of carbetocin in reference to oxytocin were identified as the most sensitive parameter used. On budget impact, if 50% of deliveries would switch to carbetocin for the fiscal years assessed, additional incremental cumulative costs of 1.08 billion PhP for VD and 1.86 billion PhP for CS would be needed.Conclusion: The incremental benefit of carbetocin does not justify the additional costs incurred from purchasing the drug given a Philippine context. Price reduction of carbetocin is recommended if the drug would be publicly reimbursed in the country.

Economic evaluations of videoconference and telephone consultations in primary care: A systematic review

2021 ◽  
pp. 1357633X2110433
Author(s):  
Keshia R De Guzman ◽  
Centaine L Snoswell ◽  
Liam J Caffery ◽  
Anthony C Smith
Keyword(s):  
Primary Care ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cost Minimization ◽  
Health Economic Evaluation ◽  
Reporting Quality ◽  
Cost Effective ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Published Evidence

Introduction Telehealth services using videoconference and telephone modalities have been increasing exponentially in primary care since the coronavirus pandemic. The challenge now is ensuring that these services remain sustainable. This review investigates the cost-effectiveness of videoconference and telephone consultations in primary care settings, by summarizing the available published evidence. Methods A systematic search of PubMed, Embase, Scopus, and CINAHL databases was used to identify articles published from January 2000 to July 2020, using keyword synonyms for telehealth, primary care, and economic evaluation. Databases were searched, and title, abstract, and full-text reviews were conducted. Article reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. Results Twenty articles were selected for inclusion, with 12 describing telephone triage services, seven describing telehealth substitution services, and one describing another telehealth service in primary care. These services were delivered by nurses, doctors, and allied health clinicians. Of the 20 included studies, 11 used cost analyses, five used cost-minimization analyses, and four used one or more methods, including either a cost–consequence analysis, a cost–utility analysis, or a cost-effectiveness analysis. Conclusions Telephone and videoconference consultations in primary care were cost-effective to the health system when deemed clinically appropriate, clinician when time was used efficiently, and when overall demand on health services was reduced. The societal benefits of telehealth consultations should be considered an important part of telehealth planning and should influence funding reform decisions for telehealth services in primary care.

Gezondheidseconomische evaluaties binnen een preventief beleid: een kritische introductie

2021 ◽  
Author(s):  
A. WERBROUCK ◽  
L. ANNEMANS ◽  
N. VERHAEGHE ◽  
S. SIMOENS
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Health Effects ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Decision Analytic Model ◽  
To Come ◽  
Economic Analyses ◽  
Preventive Policy

Health-economic evaluations in preventive policy: a critical introduction. The Flemish prevention decree specifies that policy initiatives should maximize health gains at a socially acceptable cost. As health-economic evaluations aim to evaluate the expected health effects as well as the expected costs of interventions, this type of studies can be considered indispensable to come to evidence-based policy. The goal of this paper is to introduce the basic aspects of health-economic evaluations, with a focus on preventive interventions. Although the term cost-effectiveness is often used as an umbrella term, technically speaking there is a distinction between cost-effectiveness studies and cost-utility studies. In the latter case, Belgium and many other countries often use the quality-adjusted life year (QALY) to assess health effects. Health-economic analyses can either be performed alongside a clinical trial, or by the use of a decision-analytic model in which different sources are combined to estimate long-term costs and health effects. How do we handle the effects of prevention in the (sometimes far) future? What is the optimal target group? What about the uncertainty within cost-effectiveness analyses? Can health inequity be incorporated? Several aspects of health-economic evaluations require sufficient attention when analysing preventive policy.

Adjuvant trastuzumab for breast cancer outside of clinical trials: Cardiotoxicity and economic evaluation

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6585-6585
Author(s):  
S. Snow ◽  
C. Skedgel ◽  
D. Rayson ◽  
K. Thompson ◽  
M. Sellon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Economic Evaluation ◽  
Budget Impact ◽  
Population Based ◽  
Cost Utility ◽  
Stage I ◽  
Economic Evaluations ◽  
Adjuvant Trastuzumab ◽  
The Cost

6585 Background: Clinical and economic evaluations of adjuvant trastuzumab (aTZ) in breast cancer (BC) are based on clinical trial outcomes. Population based studies however provide unique opportunities to examine outcomes in a real world setting. We previously examined aTZ uptake in all patients diagnosed with stage I-III BC over one year in Nova Scotia, Canada (Snow et al SABCS 2007). We now report cardiotoxic events (CE) and an economic evaluation based on our previous cohort. Methods: A retrospective chart review of all patients treated with aTZ was conducted to abstract clinical-pathological characteristics, treatment details, CEs/significant LVEF declines, and associated medical resource utilization (MRU). Cardiac risk scores (CRS) (Rastogi et al ASCO 2007) were also computed for all patients. Biserial correlation was performed to detect differences in CRS scores among subgroups. Costs associated with aTZ were based on MRU; unit costs were derived from the literature and local resources. A probabilistic model (Skedgel et al ASCO 2008) was utilized to examine the cost per quality adjusted life year gained (QALYG) at a 25-year horizon with budget impact calculated in 2009 Cdn $. Results: Of a total population of 630 patients with stage I-III BC, 37 (5.9%) received aTZ as per HERA trial treatment schedule; two (5.4%) had a CE (one death) and five (13.5%) experienced significant LVEF decline. CEs and LVEF declines were higher in patients with baseline LVEF 50–55% vs. > 55% (10% vs. 4% and 20% vs. 11%, respectively). CRS accurately predicted the observed CE rate, and was also predictive of significant LVEF decline (p = 0.056). Compared to previous estimates, the mean cost per patient of $46,070 (95%CI: $38,541-$54,422) was lower and the cost-utility of $60,439/QALYG was more favourable. Based on the observed aTZ utilization rate, a budget impact of $59.9m (95%CI: 42.5 m-79.9 m) for 2009 in Canada is expected. Conclusions: CEs and significant LVEF declines in this population based cohort appear comparable to that reported in clinical trials. Based on the aTZ costs per patient in this study, the cost-utility of aTZ is more favourable than previous estimates although the associated budget impact remains substantial. No significant financial relationships to disclose.

scholarly journals Cost-effectiveness of prehabilitation prior to elective surgery compared to usual preoperative care: protocol for a systematic review of economic evaluations

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040262
Author(s):  
Tanja Rombey ◽  
Helene Eckhardt ◽  
Wilm Quentin
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Functional Capacity ◽  
Elective Surgery ◽  
Cost Utility ◽  
Preoperative Care ◽  
Postoperative Outcomes ◽  
Economic Evaluations ◽  
Care Protocol

IntroductionPreoperative functional capacity is an important predictor of postoperative outcomes. Prehabilitation aims to optimise patients’ functional capacity before surgery to improve postoperative outcomes. As prolonged hospital stay and postoperative complications present an avoidable use of healthcare resources, prehabilitation might also save costs.The aim of this systematic review is to investigate the cost-effectiveness of prehabilitation programmes for patients awaiting elective surgery compared with usual preoperative care. The results will be useful to inform decisions about the implementation of prehabilitation programmes and the design of future economic evaluations of prehabilitation programmes.Methods and analysisWe will search PubMed, Embase, the Centre for Reviews and Dissemination Database, the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for full or partial economic evaluations of preoperative prehabilitation programmes conducted in any population compared with usual preoperative care. Studies will be included regardless of the type, design and perspective of the economic evaluation, and their publication year, language or status. Initial searches were performed between 30 April and 4 May 2020.Study selection, data extraction and assessment of the included studies’ risk of bias and methodological quality will initially be performed by two independent reviewers and, if agreement was sufficiently high, by one reviewer. We will extract data regarding the included studies’ basic characteristics, economic evaluation methods and cost-effectiveness results.A narrative synthesis will be performed. The primary endpoint will be cost-effectiveness based on cost–utility analyses. We will discuss heterogeneity between the studies and assess the risk of publication bias. The certainty of the evidence will be determined using the Grading of Recommendations, Assessment, Development and Evaluation approach.Ethics and disseminationEthics approval is not required as the systematic review will not involve human participants. We plan to present our findings at scientific conferences, pass them on to relevant stakeholder organisations and publish them in a peer-reviewed journal.PROSPERO registration numberCRD42020182813

scholarly journals Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult population: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032176 ◽  
Author(s):  
Andrea Natalie Natsky ◽  
Andrew Vakulin ◽  
Ching Li Chai-Coetzer ◽  
Leon Lack ◽  
R. Doug McEvoy ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Adult Population ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Primary Data ◽  
Economic Evaluations ◽  
Cost Minimisation Analysis ◽  
Cognitive Behavioural

IntroductionInsomnia is associated with a number of adverse consequences that place a substantial economic burden on individuals and society. Cognitive behavioural therapy for insomnia (CBT-I) is a promising intervention that can improve outcomes in people who suffer from insomnia. However, evidence of its cost-effectiveness remains unclear. In this study, we will systematically review studies that report on economic evaluations of CBT-I and investigate the potential economic benefit of CBT-I as a treatment for insomnia.Methods and analysisThe search will include studies that use full economic evaluation methods (ie, cost-effectiveness, cost-utility, cost-benefit, cost-consequences and cost-minimisation analysis) and those that apply partial economic evaluation approaches (ie, cost description, cost-outcome description and cost analysis). We will conduct a preliminary search in MEDLINE, Google Scholar, MedNar and ProQuest dissertation and theses to build the searching terms. A full search strategy using all identified keywords and index terms will then be undertaken in several databases including MEDLINE, Psychinfo, Proquest, Cochrane, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and EMBASE. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for protocol guidelines in this review. Only articles in the English language and those reporting on adult populations will be included. We will use standardised data extraction tools for economic evaluations to retrieve and synthesise information from selected studies into themes and summarised in a Joanna Briggs Institute dominance ranking matrix.Ethics and disseminationNo formal ethics approval will be required as we will not be collecting primary data. Review findings will be disseminated through a peer-reviewed publication, workshops, conference presentations and a media release.PROSPERO registration numberCRD42019133554.

Economic evaluation and priority setting: an overview

2017 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Benefit Analysis ◽  
Utility Analysis ◽  
The Cost ◽  
Evaluation Techniques

This chapter provides an overview of the methodologies that come under the umbrella term of economic evaluation in healthcare. Economic evaluations seek to identify, measure, value, and compare alternative programmes. A taxonomy is developed to distinguish economic evaluation techniques depending on whether benefits have been measured in money terms or not, and whether benefits are based on preferences or not. When benefits are measured in money terms, it is referred to as a cost–benefit analysis (CBA). If benefits are measured in health terms, some sort of cost-effectiveness analysis (CEA) is being used. An important class of CEA is what has come to be labelled ‘cost-utility-analysis’ (CUA). The chapter explains the incremental cost-effectiveness ratio (ICER) and illustrates the cost-effectiveness plane. Finally, the idea of discounting health is discussed.

Assessing the Quality of Economic Evaluations of FDA Novel Drug Approvals

2016 ◽  
Vol 50 (12) ◽  
pp. 1028-1040
Author(s):  
Alex L. Woersching ◽  
Matthew E. Borrego ◽  
Dennis W. Raisch
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Study Design ◽  
Cost Minimization ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Study Quality ◽  
Novel Drugs ◽  
Quality Aspects

Objective: To systematically review and assess the quality of the novel drugs’ economic evaluation literature in print during the drugs’ early commercial availability following US regulatory approval. Data Sources: MEDLINE and the United Kingdom National Health Service Economic Evaluation Database were searched from 1946 through December 2011 for economic evaluations of the 50 novel drugs approved by the FDA in 2008 and 2009. Study Selection and Data Extraction: The inclusion criteria were English-language, peer-reviewed, original economic evaluations (cost-utility, cost-effectiveness, cost-minimization, and cost-benefit analyses). We extracted and analyzed data from 36 articles considering 19 of the 50 drugs. Two reviewers assessed each publication’s quality using the Quality of Health Economic Studies (QHES) instrument and summarized study quality on a 100-point scale. Data Synthesis: Study quality had a mean of 70.0 ± 16.2 QHES points. The only study characteristics associated with QHES score (with P < 0.05) were having used modeling or advanced statistics, 75.1 versus 61.9 without; using quality-adjusted life years as an outcome, 75.9 versus 64.7 without; and cost-utility versus cost-minimization analysis, 75.9 versus 58.7. Studies most often satisfied quality aspects about stating study design choices and least often satisfied aspects about justifying design choices. Conclusion: The reviewed literature considered a minority of the 2008-2009 novel drugs and had mixed study quality. Cost-effectiveness stakeholders might benefit from efforts to improve the quality and quantity of literature examining novel drugs. Editors and reviewers may support quality improvement by stringently imposing economic evaluation guidelines about justifying study design choices.

scholarly journals A Systematic Review of Economic Evaluations of Health-Promoting Food Retail-Based Interventions

2021 ◽  
Vol 18 (3) ◽  
pp. 1356
Author(s):  
Huong Ngoc Quynh Tran ◽  
Emma McMahon ◽  
Marj Moodie ◽  
Jaithri Ananthapavan
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Future Health ◽  
Food Retail ◽  
Sales Data ◽  
Health Promoting ◽  
The Cost

Background: While the number of retail interventions with impacts on diet- and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations. Methods: A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption. Conclusion: The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption.

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