scholarly journals Cost-effectiveness study of the MitraClip system for mitral regurgitation treatment in inoperable patients

2021 ◽  
pp. 28-35
Author(s):  
E. G. Fedina ◽  
K. A. Perova ◽  
T. S. Teptsova ◽  
D. S. Shchurov
Keyword(s):  
Cost Effectiveness ◽  
Mitral Regurgitation ◽  
Medical Therapy ◽  
Time Horizon ◽  
Impact Analysis ◽  
Budget Impact ◽  
Management Practice ◽  
Optimal Medical Therapy ◽  
Current Management ◽  
Mitraclip System

The study aims to estimate the MitraClip system’s cost-effectiveness compared with optimal medical therapy in adult patients with inoperable mitral regurgitation and assess its impact on the budget of the Russian Federation health system.Materials and methods. The cost-effectiveness analysis of the MitraClip system was carried out using the Markov model. The time horizon was three & five years. The budget impact analysis (BIA) model compared the costs of treating patients distributed across different management practices. Standard management practice included only optimal medical therapy. Expected management practice included different patient allocation between the MitraClip system and optimal medical therapy. The time horizon for the budget impact analysis was five years. Results. The incremental cost-effectiveness ratio (ICER) per additional quality-adjusted life-year (QALY) gained of the MitraClip system in comparison with optimal medical therapy was 6,271,657 rubles in three years and 3,451,342 rubles in five years. Based on the BIA results of the MitraClip system, its use would lead to an increase in costs by 12.6 billion rubles (+6.09%, minimal scenario), by 37.8 billion rubles (+18.28%, optimal scenario) or by 63 billion rubles (+30.47%, maximum scenario).Conclusion. As a result of the analysis performed, it was found that economic efficiency is noted with an increasing time horizon of up to five years. The obtained ICER values are comparable with the average values obtained in other foreign cost-effectiveness studies. The use of this technology will lead to an increase in direct medical costs by 6.09% over five years compared to the current management practice. In more comprehensive MitraClip system implementation (maximum scenario), direct medical costs will increase by 30.47% compared to the current management practice.

scholarly journals Pharmacoeconomic aspects of the therapy for moderate and severe psoriatic arthritis

2021 ◽  
Vol 14 (2) ◽  
pp. 116-123
Author(s):  
A. V. Rudakova ◽  
D. G. Tolkacheva ◽  
V. D. Sokolova
Keyword(s):  
Cost Effectiveness ◽  
Healthcare System ◽  
Time Horizon ◽  
Impact Analysis ◽  
Budget Impact ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Effectiveness Analysis ◽  
The Russian Federation ◽  
The Cost

Objective: to perform cost-effectiveness analysis of the treatment for adult patients with psoriatic arthritis (PsA) with a Russian interleukin- 17А inhibitor netakimab in comparison with other biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) and to evaluate the influence of the inclusion of netakimab in the therapy for PsA on the budget of the Russian healthcare system.Material and methods. The evaluation of cost-effectiveness was performed from the position of the Russian healthcare system for patients with moderate and severe PsA. The evaluation was performed based on the results of the network meta-analysis of the randomized clinical studies. The criterion of clinical effectiveness included the changes in the condition of the joints by the criteria of the American College of Rheumatology (ACR20, ACR50, and ACR70) and changes in skin symptoms by the index of the prevalence and severity of psoriasis (PASI 75 and PASI 90) with a recalculation into quality-adjusted life-year (QALY). The time horizon of the cost-effectiveness analysis was 2 years. The calculation was based on the registered prices and VAT. If there was an original drug and a biosimilar registered on the pharmaceutical market, the calculation was based on the median of the registered prices. The budget impact analysis of the influence of netakimab inclusion in the therapy for patients with PsA was performed considering the structure of the prescription of bDMARDs and tsDMARDs that was determined in the pharmaco-epidemiological study conducted in the Russian Federation in 2020. The analysis was performed for patients that received medication by the scheme of reimbursement. The time horizon of the study was 3 years old.Results. In the base-case analysis, the cost-effectiveness ratio for netakimab was 1.210 mln rub/QALY (by 66.2–88.5% lower than in cases when comparison drugs were used). The budget impact analysis showed that the inclusion of netakimab in the therapy for PsA could reduce the costs by 376.60 mln rub (21.1%). Considering budget saving, the number of additional patients that can be treated will increase by 26.7% within 3 years.Conclusion. Netakimab is characterized by higher cost-effectiveness in comparison with other bDMARDs (adalimumab, golimumab, guselkumab, ixekizumab, infliximab, secukinumab, ustekinumab, certolizumab pegol, etanercept) and tsDMARDs (apremilast, tofacitinib) prescribed in the Russian Federation for patients with PsA. The inclusion of netakimab in the therapy for PsA will reduce the financial burden on the healthcare system.

scholarly journals PIN150 Economic VALUE of Treatment and Vaccine Technologies to Address the COVID-19 Pandemic: A Cost-Effectiveness and Budget IMPACT Analysis

2020 ◽  
Vol 23 ◽  
pp. S568
Author(s):  
W. Padula ◽  
S. Malaviya ◽  
N. Reid ◽  
F. Chingcuanco ◽  
J. Ballreich ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Impact Analysis ◽  
Budget Impact ◽  
Economic Value ◽  
Budget Impact Analysis

scholarly journals CCT: continuous care trial - a randomized controlled trial of the provision of continuous care during labor by maternity care assistants in the Netherlands

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Adrie Lettink ◽  
Karina Chaibekava ◽  
Luc Smits ◽  
Josje Langenveld ◽  
Rafli van de Laar ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cost Effectiveness ◽  
Epidural Analgesia ◽  
Maternity Care ◽  
Primary Outcome ◽  
Impact Analysis ◽  
Budget Impact ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Continuous Care

Abstract Background In 2009, the Steering Committee for Pregnancy and Childbirth in the Netherlands recommended the implementation of continuous care during labor in order to improve perinatal outcomes. However, in current care, routine maternity caregivers are unable to provide this type of care, resulting in an implementation rate of less than 30%. Maternity care assistants (MCAs), who already play a nursing role in low risk births in the second stage of labor and in homecare during the postnatal period, might be able to fill this gap. In this study, we aim to explore the (cost) effectiveness of adding MCAs to routine first- and second-line maternity care, with the idea that these MCAs would offer continuous care to women during labor. Methods A randomized controlled trial (RCT) will be performed comparing continuous care (CC) with care-as-usual (CAU). All women intending to have a vaginal birth, who have an understanding of the Dutch language and are > 18 years of age, will be eligible for inclusion. The intervention consists of the provision of continuous care by a trained MCA from the moment the supervising maternity caregiver establishes that labor has started. The primary outcome will be use of epidural analgesia (EA). Our secondary outcomes will be referrals from primary care to secondary care, caesarean delivery, instrumental delivery, adverse outcomes associated with epidural (fever, augmentation of labor, prolonged labor, postpartum hemorrhage, duration of postpartum stay in hospital for mother and/or newborn), women’s satisfaction with the birth experience, cost-effectiveness, and a budget impact analysis. Cost effectiveness will be calculated by QALY per prevented EA based on the utility index from the EQ-5D and the usage of healthcare services. A standardized sensitivity analysis will be carried out to quantify the outcome in addition to a budget impact analysis. In order to show a reduction from 25 to 17% in the primary outcome (alpha 0.05 and bèta 0.20), taking into account an extra 10% sample size for multi-level analysis and an attrition rate of 10%, 2 × 496 women will be needed (n = 992). Discussion We expect that adding MCAs to the routine maternity care team will result in a decrease in the use of epidural analgesia and subsequent costs without a reduction in patient satisfaction. It will therefore be a cost-effective intervention. Trial registration Trial Registration: Netherlands Trial Register, NL8065. Registered 3 October 2019 - Retrospectively registered.

scholarly journals Cost-effectiveness and budget impact analysis of infliximab and its biosimilar in patients with refractory moderate-to-severe Crohn’s disease using real world evidence in Thailand

2020 ◽  
Vol 23 (11) ◽  
pp. 1302-1310
Author(s):  
Pochamana Phisalprapa ◽  
Chayanis Kositamongkol ◽  
Julajak Limsrivilai ◽  
Satimai Aniwan ◽  
Phunchai Charatcharoenwitthaya ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Cost Effectiveness ◽  
Crohn's Disease ◽  
Real World ◽  
Impact Analysis ◽  
Budget Impact ◽  
Budget Impact Analysis ◽  
Real World Evidence

scholarly journals PCV48 COMMUNITY-BASED CARE FOR THE SPECIALIZED MANAGEMENT OF HEART FAILURE: A COST-EFFECTIVENESS AND BUDGET IMPACT ANALYSIS

2010 ◽  
Vol 13 (3) ◽  
pp. A158
Author(s):  
H Wijeysundera ◽  
M Machado ◽  
X Wang ◽  
G van der Velde ◽  
W Witteman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Impact Analysis ◽  
Budget Impact ◽  
Budget Impact Analysis ◽  
Community Based
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