scholarly journals COVID-19 Vaccines Cost-Effectiveness Analysis: A Scenario for Iran

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 37
Author(s):  
Atefeh Vaezi ◽  
Alipasha Meysamie
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effectiveness Analysis ◽  
Incremental Cost Effectiveness Ratio ◽  
Decision Making Process ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Critical Measure ◽  
Disability Adjusted Life ◽  
Disability Adjusted Life Year

COVID-19 vaccines are supposed to be critical measure for ending the pandemic. Governments had to decide on the type of vaccine to provide for their population. In this decision-making process, cost-effectiveness analysis is considered a helpful tool. This study is a cost-effectiveness analysis utilized to calculate the incremental cost per averted disability-adjusted life year (DALY) by vaccination compared to no vaccination for different COVID-19 vaccines. The incremental cost-effectiveness ratio (ICER) for a vaccination with COVID-19 vaccines was estimated at 6.2 to 121.2 USD to avert one DALY and 566.8 to 10,957.7 USD per one death. The lowest and highest ICERs belong to Ad26.COV2.S and CoronaVac, respectively. Considering the scenario of Iran, vaccines that are recommended include ad26.cov2.s, chadox1-S, rAd26-S + rAd5-S, and BNT162b2 in the order of recommendation.

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).

PD44 Multi-Comparator Incremental Cost-Effectiveness Ratio: A New Framework For Cost-Effectiveness Analysis

2018 ◽  
Vol 34 (S1) ◽  
pp. 144-145
Author(s):  
Stefano Lucherini ◽  
Robert Hughes ◽  
Paul Okhuoya
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
New Technology ◽  
Standard Of Care ◽  
Cost Effectiveness Analysis ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Second Best ◽  
Effectiveness Analysis ◽  
The Impact

Introduction:Current practice in cost-effectiveness analysis (CEA) involves the estimation of the incremental cost-effectiveness ratio (ICER) between a new intervention and one alternative comparator reflecting the standard of care. As this focuses on pairwise comparisons, rather than considering the whole range of available alternatives at any given time, this method fails to capture the full impact of bringing the new intervention to market.Methods:A multi-comparator ICER (MC-ICER) evaluating the impact of the new technology on patients treated with all comparators used in clinical practice, rather than a theoretical ‘second-best’ alternative only, was estimated. This can be achieved by weighting the incremental costs and benefits for each comparator by its change in market share to generate an MC-ICER. This is shown using a stylized example with three comparators.Results:The traditional ICER against the second-best alternative was USD 200,000 per QALY, while the estimated multi-comparator ICER is USD 133,548 per QALY, corresponding to a 33 percent decrease. This reflects the fact that patients who switch to the new intervention are not only those who had been previously treated with one particular comparator, as is assumed in a traditional CEA. The difference between the traditional ICER and the MC-ICER depends on how the new intervention impacts on the uptake of each comparator.Conclusions:Results show that, when comparator selection was made excluding dominated and extendedly-dominated alternatives, the MC-ICER, produced using the method described above, is lower than the traditional ICER comparing the new intervention to the second-best comparator. This captures the fact that patients may switch to the new intervention not only from the second-best comparator, but from the whole range of alternative treatments. Such patient movements determine the real impact, or opportunity cost, of the new intervention on the healthcare system and, therefore, should be captured in CEA alongside traditional one-way ICERs.

scholarly journals Atrial Fibrillation Screen, Management, and Guideline‐Recommended Therapy in the Rural Primary Care Setting: A Cross‐Sectional Study and Cost‐Effectiveness Analysis of eHealth Tools to Support All Stages of Screening

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Jessica Orchard ◽  
Jialin Li ◽  
Ben Freedman ◽  
Ruth Webster ◽  
Glenn Salkeld ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Oral Anticoagulant ◽  
Population Based ◽  
Incremental Cost Effectiveness Ratio ◽  
Anticoagulant Treatment ◽  
Cost Effectiveness Ratio ◽  
Oral Anticoagulant Treatment ◽  
Effectiveness Analysis

BACKGROUND Internationally, most atrial fibrillation (AF) management guidelines recommend opportunistic screening for AF in people ≥65 years of age and oral anticoagulant treatment for those at high stroke risk (CHA₂DS₂‐VA≥2). However, gaps remain in screening and treatment. METHODS AND RESULTS General practitioners/nurses at practices in rural Australia (n=8) screened eligible patients (≥65 years of age without AF) using a smartphone ECG during practice visits. eHealth tools included electronic prompts, guideline‐based electronic decision support, and regular data reports. Clinical audit tools extracted de‐identified data. Results were compared with an earlier study in metropolitan practices (n=8) and nonrandomized control practices (n=69). Cost‐effectiveness analysis compared population‐based screening with no screening and included screening, treatment, and hospitalization costs for stroke and serious bleeding events. Patients (n=3103, 34%) were screened (mean age, 75.1±6.8 years; 47% men) and 36 (1.2%) new AF cases were confirmed (mean age, 77.0 years; 64% men; mean CHA₂DS₂‐VA, 3.2). Oral anticoagulant treatment rates for patients with CHA₂DS₂‐VA≥2 were 82% (screen detected) versus 74% (preexisting AF)( P =NS), similar to metropolitan and nonrandomized control practices. The incremental cost‐effectiveness ratio for population‐based screening was AU$16 578 per quality‐adjusted life year gained and AU$84 383 per stroke prevented compared with no screening. National implementation would prevent 147 strokes per year. Increasing the proportion screened to 75% would prevent 177 additional strokes per year. CONCLUSIONS An AF screening program in rural practices, supported by eHealth tools, screened 34% of eligible patients and was cost‐effective. Oral anticoagulant treatment rates were relatively high at baseline, trending upward during the study. Increasing the proportion screened would prevent many more strokes with minimal incremental cost‐effectiveness ratio change. eHealth tools, including data reports, may be a valuable addition to future programs. REGISTRATION URL: https://www.anzctr.org.au . Unique identifier: ACTRN12618000004268.

scholarly journals ANALISIS EFEKTIVITAS BIAYA (COST EFFECTIVENESS ANALYSIS) PENGOBATAN INFEKSI SALURAN KEMIH MENGGUNAKAN ANTIBIOTIK SEFTRIAKSON DAN SEFOTAKSIM DI RS PARU ARIO WIRAWAN SALATIGA

2019 ◽  
Vol 1 (1) ◽  
pp. 20-26
Author(s):  
Kusumaning Wardhani ◽  
Ening Listyanti ◽  
Niken Dyahariesti ◽  
Richa Yuswantina
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis

Infeksi Saluran Kemih (ISK) adalah keadaan dimana kuman bertumbuh dan berkembangbiak di dalam traktus urinarius dengan jumlah yang bermakna. ISK diobati dengan antibiotik yang menjadi salah satu kategori biaya yang signifikan dalam anggaran farmasi di rumah sakit. Antibiotik golongan Sefalosporin digunakan sebagai drug of choise dan dicari lebih cost-effective. Untuk menentukan terapi yang lebih cost-effective antara penggunaan Setriakson dan Sefotaksim pada pasien ISK di rawat inap di RS Paru Ario Wirawan Salatiga. Penelitian ini menggunakan metode penelitian deskriptif dengan pengambilan data secara retrospektif.Dianalisis dengan metode CEA dengan parameter Average Cost Effectiveness Ratio (ACER) dan Incremental Cost Effectiviness Ratio (ICER) dilihat dari outcome lama rawat inap. Sampel pada penelitian ini sebanyak 39 pasien diantaranya 22 pasien menggunakan Seftriakson dan 17 pasien menggunakan Sefotaksim. Hasil penelitian menunjukkan, nilai ACER kelas I Sefotaksim sebesar Rp. 454.353. Nilai ACER kelas II Sefotaksim sebesar Rp. 212.283 dan nilai ICER sebesar -Rp. 134.987/hari. Nilai ACER kelas III Seftriakson sebesar Rp. 268.366. Biaya antibiotik yang paling cost-effective pada kelas I adalah Sefotaksim, paling cost-effective pada kelas II adalah Sefotaksim, paling cost-effective pada kelas III adalah Seftriakson.

scholarly journals Cost-effectiveness of a mobile phone-based support intervention to increase uptake of post-abortion family planning in Cambodia (Preprint)

2019 ◽  
Author(s):  
Jeremy Hill ◽  
Jourdan McGinn ◽  
John Cairns ◽  
Caroline Free ◽  
Chris Smith
Keyword(s):  
Cost Effectiveness ◽  
Family Planning ◽  
Incremental Cost ◽  
Mobile Phone ◽  
Mobile Technology ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Disability Adjusted Life ◽  
Post Abortion ◽  
The Cost

BACKGROUND Despite progress over the last decade, there is a continuing unmet need for contraception in Cambodia. Interventions delivered by mobile phone could help increase uptake and continuation of contraception, particularly amongst hard-to-reach populations, by providing interactive, personalised support inexpensively wherever the person is located and whenever needed. OBJECTIVE The objective of this study was to evaluate the cost-effectiveness of mobile phone-based support added to standard post-abortion family planning care in Cambodia, based on results of the MObile Technology for Improved Family Planning (MOTIF) trial. METHODS A model was created to estimate the costs and effects of the intervention versus standard care. We adopted a societal perspective when estimating costs, including direct and indirect costs for users. The incremental cost-effectiveness ratio was calculated for the base case, as well as a deterministic and probabilistic sensitivity analysis, which we compared against a range of likely cost-effectiveness thresholds. RESULTS The incremental cost of mobile phone-based support was estimated to be an additional $8,160.49 per 1000 clients, leading to an estimated 518 couple-years of protection gained per 1,000 clients and 99 disability adjusted life years averted. The Incremental Cost-Effectiveness Ratio (ICER) was $15.75 per additional Couple Year of Protection (CYP) and $82.57 per Disability Adjusted Life Year (DALY) averted. The model was most sensitive to personnel and mobile service costs. Assuming a range of cost-effectiveness thresholds of $58 to $176 for Cambodia, the probability of the intervention being cost-effective ranged from 11% to 95%. CONCLUSIONS This study demonstrates that the cost-effectiveness of the intervention delivered by mobile phone studied in the MOTIF trial lies within the estimated range of cost-effectiveness thresholds for Cambodia. When assessing value in interventions to improve the uptake and adherence to family planning services, the use of interactive mobile phone messaging and counselling for women who have had an abortion should be considered as an option to policy makers. CLINICALTRIAL This study is a cost-effectiveness analysis of the intervention evaluated in the Mobile Technology for Improved Family Planning (MOTIF) trial: ClinicalTrials.gov NCT01823861.

Cost-effectiveness analysis of neoadjuvant chemotherapy with intensive dose of epirubicin and different cycles in patients with locally advanced breast cancer: 4 FE100C versus 6 FE100C.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11565-e11565
Author(s):  
Nicolas Ramirez ◽  
Jorge Eduardo Herrera ◽  
Jose Fortino Chavez ◽  
Horacio Astudillo
Keyword(s):  
Breast Cancer ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
The Cost

e11565 Background: There are different combinations of neoadjuvant chemotherapy (NCT) to treat locally advanced breast cancer (LABC); treatment with cytostatics drugs make it a costly concern, by establishing economic differences in the consumption of healthcare resources. To compare the cost-effectiveness of two NCT strategies (4FE100C vs. 6FE100C). Methods: It was made a cost-effectiveness analysis (CEA) of two treatment schemes (4FE100C vs. 6FE100C) in patients with clinical stage III breast cancer, each cohort included 48 patients. Effectiveness parameter: pathologic complete response (pCR). Differential cost: incremental cost-effectiveness ratio (ICER) using a Markov’s model. Results are expressed in terms of incremental cost per extra unit of effectiveness. Costs were expressed in Mexican (MXN) pesos ($) as of 2005; these were calculated under the perspective of public healthcare system (SSP, for its acronym in Spanish) denominated IMSS, with a 3 to 4 years analytical horizon. In order to determine the robustness of the results, a sensitivity analysis was carried out by modifying only the medical direct costs with a 3% discount rate. Results: The use of 6FE100C offered greater effectiveness compared against 4FE100C; the medical direct cost of only the cytostatic drugs for NCT with 6 FE100C and 4 E100C generated a cost per case of $30,467.00 MXN (€ 2,343.61) and $18,004.00 MXN (€ 1,384.92), respectively. The greatest unit price was given by epirubicin. The CEA demonstrated that the cost-effectiveness (C/E) was greater with 6 FE100C and the incremental cost-effectiveness ratio (ICER) showed that it was necessary to pay $11,765,925.42 MXN (€ 905,071.20) because it tells us how much it is paid additionally for every extra unit of effectiveness (pCR) which assumes 6 FE100C in front of 4 FE100C. The sensitivity analysis performed shows the robustness of the results. Conclusions: The6 FE100C scheme is the chemotherapeutic strategy with better cost-effectiveness ratio and is the most efficient in the short run for treating LABC.

Incremental Cost-Effectiveness Analysis

1999 ◽  
Vol 52 (6) ◽  
pp. 517-522 ◽  
Author(s):  
Scott B. Cantor ◽  
Theodore G. Ganiats
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis
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