scholarly journals Modeling SF-6D Health Utilities: Is Bayesian Approach Appropriate?

2021 ◽  
Vol 18 (16) ◽  
pp. 8409
Author(s):  
Samer A. Kharroubi
Keyword(s):  
Prior Information ◽  
Standard Gamble ◽  
Health States ◽  
Middle Income ◽  
Value Set ◽  
Middle Income Countries ◽  
Health Measures ◽  
Value Sets ◽  
The Uk ◽  
The Cost

Background: Valuation studies of preference-based health measures like SF6D have been conducted in many countries. However, the cost of conducting such studies in countries with small populations or low- and middle-income countries (LMICs) can be prohibitive. There is potential to use results from readily available countries’ valuations to produce better valuation estimates. Methods: Data from Lebanon and UK SF-6D value sets were analyzed, where values for 49 and 249 health states were extracted from samples of Lebanon and UK populations, respectively, using standard gamble techniques. A nonparametric Bayesian model was used to estimate a Lebanon value set using the UK data as informative priors. The resulting estimates were then compared to a Lebanon value set obtained using Lebanon data by itself via various prediction criterions. Results: The findings permit the UK evidence to contribute potential prior information to the Lebanon analysis by producing more precise valuation estimates than analyzing Lebanon data only under all criterions used. Conclusions: The positive findings suggest that existing valuation studies can be merged with a small valuation set in another country to produce value sets, thereby making own country value sets more attainable for LMICs.

scholarly journals Valuation of EQ-5D-3l Health States in Slovenia: VAS based and TTO based Value Sets

2019 ◽  
Vol 59 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Valentina Prevolnik Rupel ◽  
Andrej Srakar ◽  
Kim Rand
Keyword(s):  
Eastern Europe ◽  
Central And Eastern Europe ◽  
Predictive Accuracy ◽  
Health Study ◽  
Health States ◽  
Value Set ◽  
Constrained Regression ◽  
Out Of Sample ◽  
Value Sets ◽  
The Uk

Abstract Introduction The two primary objectives of this paper were (a) to develop first logically consistent TTO based EQ-5D-3L value sets for Slovenia and (b) to revisit earlier developed VAS based EQ-5D-3L value sets. Methods Between September 2005 and April 2006, face-to-face interviews with 225 individuals in Slovenia were conducted. Protocols from the Measurement and Value of Health study were followed closely. Each respondent valued 15 health states out of a total of 23. Model selection was informed by the criteria monotonicity/logical consistency. Predictive accuracy was assessed in terms of mean square difference between out-of-sample predictions and corresponding observed means, as well as Lin’s Concordance Correlation Coefficient. Results Modelling was based on 2,717 VAS and 2,831 TTO values elicited from 225 respondents. A 6-parameter constrained regression model with a supplementary power term was selected for VAS and TTO value sets, as it produces monotonic values, and proved superior in terms of out-of-sample predictive accuracy over the tested alternatives. Conclusion This is the first EQ-5D-3L TTO based value set in Slovenia and the second in Central and Eastern Europe (besides Poland). It is also the first monotonic and logically consistent VAS value set in Central and Eastern Europe. Comparisons with Polish and UK TTO values show considerable differences, mostly due to mobility with having a substantially greater weight in Slovenia. The UK value set generally produces lower values and the Polish value set higher values for mild states.

From Malawi to Middlesex: the case of the Arbutus Drill Cover System as an example of the cost-saving potential of frugal innovations for the UK NHS

2018 ◽  
Vol 4 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Matthew Prime ◽  
Ibtehal Attaelmanan ◽  
Arjuna Imbuldeniya ◽  
Matthew Harris ◽  
Ara Darzi ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Cost Savings ◽  
Middle Income ◽  
Case Study Methodology ◽  
Orthopaedic Care ◽  
Middle Income Countries ◽  
Cover System ◽  
The Uk ◽  
The Cost ◽  
Frugal Innovations

BackgroundMusculoskeletal disease is one of the leading clinical and economic burdens of the UK health system, and the resultant demand for orthopaedic care is only set to increase. One commonly used and one of the most expensive hardware in orthopaedic surgery is the surgical drill and saw. Given financial constraints, the National Health Service (NHS) needs an economic way to address this recurring cost. We share evidence of one frugal innovation with potential for contributing to the NHS’ efficiency saving target of £22 billion by 2020.MethodsExploratory case study methodology was used to develop insights and understanding of the innovations potential for application in the NHS. Following a global search for potential frugal innovations in surgery, the Arbutus Drill Cover System was identified as an innovation with potential to deliver significant cost savings for the NHS in the UK.ResultsThe Arbutus Drill Cover System is up to 94% cheaper than a standard surgical drill available in the UK. Clinical and laboratory tests show that performance, safety and usability are as good as current offerings in high-income countries and significantly better than hand drills typically used in low-and-middle-income countries. The innovation meets all regulatory requirements to be a medical device in the Europe and North America.ConclusionsThe innovation holds promise in reducing upfront and life span costs for core equipment used in orthopaedic surgery without loss of effectiveness or safety benchmarks. However, the innovation needs to navigate complicated and decentralised procurement processes and clinicians and healthcare leaders need to overcome cognitive bias.

scholarly journals Potential health and economic impacts of dexamethasone treatment for patients with COVID-19

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ricardo Águas ◽  
◽  
Adam Mahdi ◽  
Rima Shretta ◽  
Peter Horby ◽  
...  
Keyword(s):  
Full Potential ◽  
Potential Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Time Period ◽  
Life Years ◽  
Exposure Levels ◽  
The Uk ◽  
The Cost ◽  
The Impact

AbstractDexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals The Online Elicitation of Personal Utility Functions (OPUF) tool: a new method for valuing health states

2022 ◽  
Vol 7 ◽  
pp. 14
Author(s):  
Paul Schneider ◽  
Ben van Hout ◽  
Marike Heisen ◽  
John Brazier ◽  
Nancy Devlin
Keyword(s):  
Utility Functions ◽  
Health State ◽  
Group Level ◽  
Health States ◽  
Online Tool ◽  
Value Set ◽  
Individual Level ◽  
Personal Utility ◽  
Value Sets ◽  
The Individual

Introduction Standard valuation methods, such as TTO and DCE are inefficient. They require data from hundreds if not thousands of participants to generate value sets. Here, we present the Online elicitation of Personal Utility Functions (OPUF) tool; a new type of online survey for valuing EQ-5D-5L health states using more efficient, compositional elicitation methods, which even allow estimating value sets on the individual level. The aims of this study are to report on the development of the tool, and to test the feasibility of using it to obtain individual-level value sets for the EQ-5D-5L. Methods We applied an iterative design approach to adapt the PUF method, previously developed by Devlin et al., for use as a standalone online tool. Five rounds of qualitative interviews, and one quantitative pre-pilot were conducted to get feedback on the different tasks. After each round, the tool was refined and re-evaluated. The final version was piloted in a sample of 50 participants from the UK. A demo of the EQ-5D-5L OPUF survey is available at: https://eq5d5l.me Results On average, it took participants about seven minutes to complete the OPUF Tool. Based on the responses, we were able to construct a personal EQ-5D-5L value set for each of the 50 participants. These value sets predicted a participants' choices in a discrete choice experiment with an accuracy of 80%. Overall, the results revealed that health state preferences vary considerably on the individual-level. Nevertheless, we were able to estimate a group-level value set for all 50 participants with reasonable precision. Discussion We successfully piloted the OPUF Tool and showed that it can be used to derive a group-level as well as personal value sets for the EQ-5D-5L. Although the development of the online tool is still in an early stage, there are multiple potential avenues for further research.

The Cost of Procuring and Delivering COVID-19 Vaccines in Low- and Middle-Income Countries: A Model of Projected Resource Needs

2021 ◽  
Author(s):  
Mohamed Mustafa Diab ◽  
Armand Zimmerman ◽  
Siddharth Dixit ◽  
Wenhui Mao ◽  
Ipchita Bharali ◽  
...  
Keyword(s):  
Middle Income ◽  
Middle Income Countries ◽  
Resource Needs ◽  
The Cost ◽  
Low And Middle Income

Logistics Cost Dynamics in International Business: A Causal Approach

2020 ◽  
Vol 55 (4) ◽  
pp. 478-495
Author(s):  
Ashutosh Kar ◽  
Pratyay Ranjan Datta
Keyword(s):  
International Business ◽  
Vital Role ◽  
Logistics Cost ◽  
Middle Income ◽  
Jel Codes ◽  
Middle Income Countries ◽  
The Usa ◽  
Causal Approach ◽  
The Cost ◽  
The Impact

The cost of logistics plays a vital role in the pricing of goods in international trade. Besides, the recent imposition of additional tariff by even upper-middle income countries such as the USA, China etc., has led to an increase in the total landed cost of goods. However, a seller has no option but to adapt to changing tariff requirements and can articulate only the logistics cost to a certain extent. This aspect requires an understanding of the logistics cost dynamics in international business. Since a higher volume of goods moves by marine transportation, this study focusses on the same. In this article, authors have attempted to establish a statistically significant relationship between prices and other factors like fuel, number of vessels, freight, and weight value ratio. The paper introduces a logistics-coefficient to indicate the extent of integration of logistics activities to keep the total-landed-cost (TLC) unchanged. Finally, the author proposes the system dynamics model to study the impact of changes in any one or some or all these factors on the price of the product. This model will enable the global firm to decide the entry and exit in the market. JEL Codes: F23

scholarly journals Cost-effectiveness of interventions to reduce the risk of healthcare-acquired infections in middle-income countries: A systematic review

2019 ◽  
Vol 20 (6) ◽  
pp. 266-273
Author(s):  
Pushpa Udayangani Gamalathge ◽  
Sanjeewa Kularatna ◽  
Hannah E Carter ◽  
Sameera Senanayake ◽  
Nicholous Graves
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Developed Countries ◽  
Healthcare Systems ◽  
Quality Of Reporting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
The Cost

Background: Hospital-acquired infections (HAI) contribute to prolonged hospital stays and account for a substantial economic burden to healthcare systems. Middle-income countries (MICs) experience a greater burden of HAI than developed countries. Evidence on the cost-effectiveness of interventions to reduce HAI is required to inform decision-making in these settings. Aim: To synthesise the evidence on cost-effectiveness as related to HAI interventions in MICs and to assess the quality of this evidence. Methods: A systematic review of published literature on the cost-effectiveness of interventions to reduce the incidence of HAI in MICs between 2000 and 2018 was conducted. Results: Six studies met the pre-determined inclusion criteria. The studies were from three countries: Thailand; India; and Vietnam. The evidence suggests that interventions to reduce HAI are cost-effective and, in most cases, cost-saving to healthcare systems. The quality of the reporting varied across studies. Conclusions: The implementation of HAI prevention interventions appears to be a high value use of resources in MICs. There is a need for further cost-effectiveness analyses in a wider range of MICs in order to confirm these findings. Improved standardisation and quality of reporting is required.

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