scholarly journals Clinical and economic aspects of the use of OneTouch glucose meters for the screening of diabetes mellitus

2021 ◽  
pp. 73-81
Author(s):  
A. E. Cheberda ◽  
D. Yu. Belousov
Keyword(s):  
Blood Glucose ◽  
Russian Federation ◽  
Cost Minimization ◽  
Research Effort ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Cost Minimization Analysis ◽  
Screening Cost ◽  
Current Research Effort

Diabetes is increasingly widespread in the Russian Federation. It is a severe chronic disease that both independently reduces quality of life and causes exacerbation of other pathologies. This makes evaluation of quality of diabetes management and understanding of clinical and economic properties of various technologies used to screen blood glucose levels, including portable blood glucose meters. Previously there already were clinical-economic evaluations of blood glucose meters within context of Russian Federation but they have not included modern high-precision equipment, thus ensuring attractiveness of current research effort into HTA of modern blood glucose meters that accounts for real life hospital practice. Goal. To assess the clinic-economic properties of modern blood glucose portable measurement systems of OneTouch family and the real-world practics of their use in Russian healthcare facilities. Methodology. The research was performed from the perspective of the Russian healthcare system. Target population was represented by a virtual cohort of 100 patients. Only direct costs were accounted for, specifically all costs caused by consumables involved in operating multifunctional laboratory complexes and all consumables involved in operating portable glucose meters. Employee salaries were also included (accounting for number of personnel involved in different procedures as based on a real clinical practice survey performed as part of this research). Since it is known that modern, standard-compliant portable glucose meters have an accuracy that is more than sufficient for routine screening, cost minimization analysis was used for assessment of economic effects when comparing different approaches to organizing glucose level screening. Research results. The survey during this research effort has indicated that not all medical facilities utilize “tandem usage” of multifunction laboratory complexes and portable glucose meters, however, such “tandem use” is the most widespread approach to organizing blood glucose screening. Cost minimization analysis has demonstrated that “tandem usage” is also the most economically attractive approach and results in cost savings for the medical facility. Conclusions. Current research effort which included cost analysis and cost minimization analysis has demonstrated that “tandem usage” approach which involves combined use of both multifunction laboratory complexes and portable glucose meter systems has substantial economic advantage (over 60 % for analysis with 5 year time horizon). Multiple sensitivity analyses have confirmed robustness of this result. This research further establishes the importance of communicating advantages of modern portable glucose meters to healthcare organizers since this technology is not only clinically rational but also economically optimal.

Pharmacoeconomic features of the use of drugs used in the treatment of allergic rhinitis

2021 ◽  
pp. 9-16
Author(s):  
Afanasyeva T.G. ◽  
Lavrova N.N. ◽  
Tumentseva V.R.
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Generic Drugs ◽  
Cost Minimization ◽  
Nasal Congestion ◽  
World Health ◽  
Cost Minimization Analysis ◽  
Wide Range

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.

scholarly journals Systematic Review and Quality Evaluation of Pharmacoeconomic Studies on Traditional Chinese Medicines

2021 ◽  
Vol 9 ◽  
Author(s):  
Nan Yang ◽  
Huihui Zhang ◽  
Taoyi Deng ◽  
Jeff Jianfei Guo ◽  
Ming Hu
Keyword(s):  
Sample Size ◽  
Study Design ◽  
Design Research ◽  
Cost Minimization ◽  
Pharmacoeconomic Evaluation ◽  
Cost Utility ◽  
Quality Score ◽  
Future Research ◽  
Economic Evaluations

Objectives: This study was aimed to find and appraise the available published pharmacoeconomic research on Traditional Chinese Medicine (TCM), to identify related issues and make suggestions for improvement in future research.Methods: After developing a search strategy and establishing inclusion and exclusion criteria, pharmacoeconomic studies on TCM were sourced from seven Chinese and English databases from inception to April 2020. Basic information about the studies and key pharmacoeconomic items of each study were extracted. The quality of each study was evaluated by using the British Medical Journal economic submissions checklist for authors and peer reviewers, focusing on factors such as study design, research time horizon, sample size, perspective, and evaluation methods.Results: A total of 431 published pharmacoeconomic articles with 434 studies on topics including cost-effectiveness, cost-benefit, cost-minimization, cost-utility, or combination analyses were identified and included in this review. Of these, 424 were published in Chinese and 7 in English. These studies conducted economic evaluations of 264 Chinese patent medicines and 70 types of TCM prescriptions for 143 diseases, including those of the central nervous, cardiovascular, respiratory, gynecologyical, and other systems. The studied TCMs included blood-activating agents (such as Xuesaitong tablet, Fufant Danshen tablet, and Danhong Injection), blood circulation promoting agents (such as Shuxuetong injection, Rupixiao tablet, and Fufang Danshen injection), and other therapeutic agents. The overall quality score of the studies was 0.62 (range 0.38 to 0.85). The mean quality score of studies in English was 0.72, which was higher than that of studies in Chinese with 0.62.Conclusions: The quality of pharmacoeconomic studies on TCM was relatively, generally low. Major concerns included study design, inappropriate pharmacoeconomic evaluation, insufficient sample size, or non-scientific assessment. Enhanced methodological training and cooperation, the development of a targeted pharmacoeconomic evaluation guideline, and proposal of a reasonable health outcome index are warranted to improve quality of future studies.

Cost Analysis Comparing Computed Tomographic Pulmonary Angiography (CTPA) and Ventilation-Perfusion (V/Q) Scanning for the Diagnosis of Pulmonary Embolism

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 567-567
Author(s):  
Alastair Dorreen ◽  
Chris Skedgel ◽  
Marc A. Rodger ◽  
Susan R. Kahn ◽  
Michael J. Kovacs ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cost Effectiveness ◽  
Cost Analysis ◽  
Incremental Cost ◽  
Cost Minimization ◽  
Imaging Modality ◽  
Sensitivity Analyses ◽  
Pulmonary Emboli ◽  
Cost Minimization Analysis ◽  
The Cost

Abstract Abstract 567 Background: Accurate diagnosis of a pulmonary embolism remains problematic due to the nonspecific findings of the clinical presentation and the limitations of radiographic imaging. Computed tomography pulmonary angiography (CTPA) has surpassed ventilation-perfusion (V/Q) scanning as the primary imaging modality in the investigation of patients with suspected pulmonary emboli due to its superior diagnostic accuracy. Data from a large randomized controlled trial has indicated that while strategies using both CTPA and V/Q are equally safe at excluding the diagnosis, CTPA detects significantly more pulmonary emboli (1). The purpose of this study was to perform a cost analysis comparing CTPA and V/Q scanning for the investigation of patients with suspected pulmonary emboli based upon this large trial. Methods: A cost analysis was performed using a decision-analysis model. The costs and outcomes of CTPA and V/Q scanning in detecting or ruling out pulmonary embolism over a 90 day analysis horizon were incorporated into a decision tree where the probabilities for each outcome were taken from (1) and a systematic literature review. The decision tree incorporated the thromboembolic and major bleeding complications associated with the diagnosis and treatment of pulmonary embolism in 100,000 patients. Outcomes in the model were measured in terms of quality-adjusted life years (QALYs). The economic model took a direct-payer perspective, considering direct costs to the health care system and patients. All costs were based on 2009 Canadian dollars. The primary economic evaluation was conducted within a deterministic cost-effectiveness analysis framework in terms of incremental cost per QALY. If the clinical benefits were found to be statistically insignificant the primary evaluation would be collapsed to a cost-minimization analysis and a secondary analysis would be performed to using probabilistic methods to estimate the expected incremental costs and outcomes based upon probability distributions around mean point estimates. Sensitivity analyses around key parameters were also performed. Results: The primary deterministic analysis collapsed to a cost-minimization analysis on the grounds that no statistically differences in the proportion of false negative results or mortality were observed in the randomized trial comparing CTPA with VQ scanning for the diagnosis of pulmonary embolism (1). The cost minimization analysis demonstrated a strategy using V/Q scanning as the primary imaging modality was less costly. CTPA was associated with an incremental cost of $11.3 million per 100,000 patients compared to V/Q scanning. CTPA was associated with an additional 3760 additional diagnoses of pulmonary embolism and 111 major bleeding episodes compared to V/Q scanning. The secondary probabilistic cost-effectiveness analysis revealed that CTPA was associated with an incremental cost of $4.8 million per 100,000-person cohort and 3134 QALYs gained relative to V/Q scanning for a cost-effectiveness of $1543 per QALY gained. Furthermore, the cost-effectiveness acceptability curve demonstrated CTPA had an 89% likelihood of being cost-effective relative to the threshold of $50,000 per QALY gained. Sensitivity analyses demonstrated cost-effectiveness ratio was most impacted by varying prevalence of pulmonary embolism and the relative and absolute differences in the proportions of fatal pulmonary embolism from falsely negative scans between the two tests. Conclusions: The results of the cost-minimization analysis imply that V/Q scanning is a less costly alternative to CTPA resulting from less pulmonary emboli diagnosed while maintaining similar 3-month rate of thromboembolic complications relative to CTPA. Secondary analysis, however, concluded that diagnostic algorithms incorporating CTPA may be cost-effective under defined circumstances. (1) Anderson et al. JAMA 2007; 298:2743-2753 Disclosures: No relevant conflicts of interest to declare.

scholarly journals A Model-Based Cost-Minimization Analysis as a Decision Tool in Obstetric Care in Helgeland, Northern Norway

2016 ◽  
Vol 9 (1) ◽  
pp. 191
Author(s):  
Halvard Angelsen ◽  
Jan Norum ◽  
Villy Angelsen ◽  
Fred A. Mürer ◽  
Randi Erlandsen
Keyword(s):  
Quality Of Care ◽  
Maternity Care ◽  
Cost Minimization ◽  
Cost Savings ◽  
Obstetric Care ◽  
Birth Registry ◽  
Cost Minimization Analysis ◽  
Model Based ◽  
Hospital Trust

BACKGROUND: Quality of care is of utmost importance in maternity care. Today, we base the choice of institution on risk factors. Recently, a Norwegian national plan introduced new guidelines concerning quality and staffing. Consequently, the hospital trusts had to increase the number of obstetricians and midwives and handle raised costs. One way to meet such challenges is to reduce the number of delivery units.OBJECTIVES: We aimed to clarify the costs and benefits of two alternative strategies in obstetric care in Helgeland hospital trust using a model-based cost-minimization analysis (CMA).METHODS: The consequences, in terms of cost/savings and mothers´ time of travelling, by closing two midwife-administered maternity units (MAMUs) and keeping the two departments of obstetrics (DOGs) running was analyzed. We implemented data from the Helgeland hospital trust and the Medical Birth Registry of Norway (MBRN) and the selected period was 2010-2012. The comparator was today’s organization. Costs were converted into Euros at the rate of € 1 = NOK 9.527.RESULTS: The model concluded the closing of two MAMUs created an annual net saving of € 584,346. The mothers´ mean time of travelling increased by 11 minutes and by 91 minutes for those directly affected by the closure. The organizational changes were concluded safe and of low risk with regard to quality of care. A sensitivity analysis revealed the number of midwives dismissed being the most important variable. CONCLUSION: A model-based CMA may be a supportive tool when evaluating maternity care.

Quality of health economic evaluations submitted to the Italian Medicines Agency: current state and future actions

2020 ◽  
Vol 36 (6) ◽  
pp. 560-568
Author(s):  
Angelica Carletto ◽  
Matteo Zanuzzi ◽  
Annalisa Sammarco ◽  
Pierluigi Russo
Keyword(s):  
Health Economic ◽  
Good Practice ◽  
Assessment Process ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Relevant Alternatives ◽  
Current State ◽  
Decision Analytic Modelling ◽  
Life Years

ObjectivesThe purpose of this study was to evaluate the current state of health economic evaluations (HEEs) submitted by pharmaceutical companies to the Italian Medicines Agency (AIFA) as part of their pricing and reimbursement (P&R) dossiers, and to explore potential future actions in order to enhance their quality.MethodsAll company dossiers submitted from October 2016 to December 2018 were reviewed to select those containing pharmacoeconomic studies. The general characteristics of HEEs were described and their quality assessed based on a checklist adapted from Philips et al. (Review of guidelines for good practice in decision-analytic modelling in health technology assessment. Health Technol Assess. 2004;8: 1–158).ResultsOf the 299 dossiers submitted to AIFA, 105 included one or more pharmacoeconomic studies, of which fifty-three were cost-effectiveness analyses. Overall, the compliance of the HEEs with the quality checklist was highly variable: some studies reached high methodological standards whereas others had serious flaws (mean 59.22 percent, range 19.35–90.32 percent). The main weaknesses were the unjustified exclusion of relevant alternatives, poor description and justification of model data and assumptions, and insufficient exploration of uncertainty and study validity. Non-homogeneity across studies was found in study perspectives, discount rates, methods for costing, estimating quality-adjusted life-years and conducting sensitivity analyses.ConclusionsBased on the results of this study, the recommended actions for increasing the quality of HEEs within reimbursement submissions in Italy are twofold: first, to set methodological standards for conducting and reporting HEEs; second, to strengthen the internal assessment process, also through the acquisition of companies' models and re-evaluation of results. These actions will hopefully provide greater contribution to the evidence-based P&R decision making.

scholarly journals Assessment of the Methodological Quality of Economic Evaluations: Main Mistakes

2019 ◽  
pp. 8-17
Author(s):  
Georgii Khachatryan ◽  
Oxana Ivakhnenko ◽  
Maria Sura ◽  
Maria Avxentyeva
Keyword(s):  
Russian Federation ◽  
Methodological Quality ◽  
Healthcare Quality ◽  
Economic Evaluations ◽  
Expensive Drug ◽  
Drug List ◽  
The Russian Federation ◽  
The Government ◽  
And Control

Results of the assessment of methodological quality of economic evaluations (EE), submitted to justify the inclusion/exclusion of drugs in the lists of drugs for medical use (list of vital and essential drugs, additional medication supply list and expensive drug list), are given in the article. The study was conducted in 2018 in the FSBI “Center for healthcare quality assessment and control” of the Ministry of Health of the Russian Federation. Assessment was performed based on 12 criteria in accordance with the requirements to the methodological quality of economic evaluations, described in the draft Order of the Government of the Russian Federation, No. 871, and then were approved in the Order of the Government of the Russian Federation, No. 871, state on 20.11.2018. The distribution of EE based on the number of criteria they did not meet, and also the frequency of made mistakes for each criterion are presented. Main reasons for EE not meeting the requirements to methodological quality, prescribed by the Order of the Government of the Russian Federation, No. 871, are analyzed.

Economic evaluations of leukemia: A review of the literature

2007 ◽  
Vol 23 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Frida Kasteng ◽  
Patrik Sobocki ◽  
Christer Svedman ◽  
Jonas Lundkvist
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Myeloid Leukemia ◽  
Cost Minimization ◽  
Treatment Strategies ◽  
Indirect Costs ◽  
Lymphocytic Leukemia ◽  
Economic Evaluations ◽  
New Treatment

Objectives:Leukemia, together with lymphoma and multiple myeloma, are hematological malignancies, malignancies of the blood-forming organs. There are four major types of leukemia: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). There is a growing amount of literature of the health economic aspects of leukemia. However, no comprehensive review is yet performed on the health economic evidence for the disease. Hence, our aim was to review and analyze the existing literature on economic evaluations of the different types of leukemia.Methods:A systematic literature search used electronic databases to identify published cost analyses and economic evaluations of leukemia treatments. After reviewing all identified studies, sixty studies were considered relevant for the purpose of the review.Results:The identified studies were published after 1990, with a few exceptions. Many of the identified economic evaluations in leukemia, particularly for ALL and AML, may be defined as cost-minimization analyses, where only the costs of different treatment strategies are compared. In CML, a new treatment, imatinib, was introduced in 2001 and several cost-effectiveness analyses have since then been conducted comparing imatinib with previous first line treatments.Conclusions:This review indicates that there is a shortage of cost-effectiveness information in leukemia. The introduction of new therapies will stress the need for new economic evaluations in this group of diseases. More information about the total costs, that is, including indirect costs, and quality of life effects would be valuable in future evaluations in leukemia.

VALUE AND PERFORMANCE OF ACCOUNTABLE CARE ORGANIZATIONS: A COST-MINIMIZATION ANALYSIS

2018 ◽  
Vol 34 (4) ◽  
pp. 388-392
Author(s):  
Sonal Parasrampuria ◽  
Allison H. Oakes ◽  
Shannon S. Wu ◽  
Megha A. Parikh ◽  
William V. Padula
Keyword(s):  
Cost Minimization ◽  
Cost Savings ◽  
Quality Data ◽  
Quality Level ◽  
Care Organization ◽  
Coordination Of Care ◽  
Accountable Care ◽  
Cost Minimization Analysis

Objectives:Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs.Methods:We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings.Results:Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386).Conclusions:Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.

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.

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