The cost-effectiveness and cost-utility of statin drug for the treatment of patients with cardiovascular disease, a systematic review

IntroductionThe combination of biomarkers and drugs is the subject of growing interest both from regulators, physicians and companies. This study protocol of a systematic review is aimed to describe available literature evidences about the cost-effectiveness, cost-utility or net-monetary benefit of the use of biomarkers in solid tumour as tools for customising immunotherapy to identify what further research needs.Methods and analysisA systematic review of the literature will be carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. PubMed and Embase will be queried from June 2010 to June 2021. The PICOS model will be applied: target population (P) will be patients with solid tumours treated with immune checkpoint inhibitors (ICIs); the interventions (I) will be test of the immune checkpoint predictive biomarkers; the comparator (C) will be any other targeted or non-targeted therapy; outcomes (O) evaluated will be health economic and clinical implications assessed in terms of incremental cost-effectiveness ratio, net health benefit, net monetary benefit, life years gained, quality of life, etc; study (S) considered will be economic evaluations reporting cost-effectiveness analysis, cost-utility analysis, net-monetary benefit. The quality of the evidence will be graded according to Grading of Recommendations Assessment, Development and Evaluation.Ethics and disseminationThis systematic review will assess the cost-effectiveness implications of using biomarkers in the immunotherapy with ICIs, which may help to understand whether this approach is widespread in real clinical practice. This research is exempt from ethics approval because the work is carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal.PROSPERO registration numberCRD42020201549.

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The cost-effectiveness of oral health interventions: A systematic review of cost-utility analyses

Community Dentistry And Oral Epidemiology ◽

10.1111/cdoe.12336 ◽

2017 ◽

Vol 46 (2) ◽

pp. 118-124 ◽

Cited By ~ 17

Author(s):

Ruvini M. Hettiarachchi ◽

Sanjeewa Kularatna ◽

Martin J. Downes ◽

Joshua Byrnes ◽

Jeroen Kroon ◽

...

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Oral Health ◽

Cost Utility ◽

Health Interventions ◽

The Cost

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A Systematic Review of the Cost-Effectiveness of Recombinant Factor VIIa (rFVIIa) and Activated Prothrombin Complex Concentrate (aPCC) in the Treatment of Mild to Moderate Bleeding Episodes for Haemophilia Patients with Inhibitors

Blood ◽

10.1182/blood.v112.11.4678.4678 ◽

2008 ◽

Vol 112 (11) ◽

pp. 4678-4678

Author(s):

Chris Knight ◽

Anne Møller Danø ◽

Tessa Kennedy-Martin

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Factor Viia ◽

Cost Effective ◽

Primary Treatment ◽

Cost Utility ◽

Economic Consequences ◽

Modelling Framework ◽

The Cost

Abstract Objectives: Although haemophilia patients with inhibitors are rare, the clinical, humanistic and economic consequences associated with this disorder are considerable. The primary treatment for such patients is either rFVIIa or aPCC. The aim of this study was to identify, review and evaluate the quality of the published literature on the relative cost-effectiveness of rFVIIa and aPCC in treating haemophilia patients with inhibitors. Methods: The review concentrates on the model type, the model design, model assumptions, and results. Results: The results of this study suggest that rFVIIa may be the cost-effective alternative to treatment with aPCC due to the superior efficacy of rFVIIa and hence the avoidance of subsequent lines of treatment. In 7 of the 9 studies, rFVIIa had the lower average treatment cost. The adapted modelling framework is similar in all the economic models reviewed, suggesting clinical acceptability of the approach used. The estimates of efficacy varied between the models, especially for aPCC. The efficacy for aPCC derived from retrospective studies was lower than reported in the literature. Sensitivity analysis had been undertaken in the majority of the economic analyses and the results were found to be robust to realistic parameter variations. Only one of the studies was a cost-utility study, showing the lack of measuring health status within this area. The results showed the large impact appropriate treatment can have on the quality of life for haemophilia patients with inhibitors. Conclusions: Ideally, there should be a systematic approach to identifying the relevant data and the lack of data from relevant randomized head-to-head trials is a contributing factor to the variation in efficacy rates and average dosages assumed. However, this systematic review has shown that despite differences in the estimates of efficacy, average dosage required, and unit costs the overall results are robust and appear to favour rFVIIa as the cost-effectiveness treatment for haemophilia patients with inhibitors.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031356 ◽

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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Considering the societal perspective in economic evaluations: a systematic review in the case of depression

Health Economics Review ◽

10.1186/s13561-020-00288-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Juliane Andrea Duevel ◽

Lena Hasemann ◽

Luz María Peña-Longobardo ◽

Beatriz Rodríguez-Sánchez ◽

Isaac Aranda-Reneo ◽

...

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Societal Perspective ◽

Depressive Disorders ◽

Cost Utility ◽

Healthcare Payer ◽

Economic Evaluations ◽

Screening Process ◽

Societal Costs ◽

The Cost

Abstract Background Depressive disorders are associated with a high burden of disease. However, due to the burden posed by the disease on not only the sufferers, but also on their relatives, there is an ongoing debate about which costs to include and, hence, which perspective should be applied. Therefore, the aim of this paper was to examine whether the change between healthcare payer and societal perspective leads to different conclusions of cost-utility analyses in the case of depression. Methods A systematic literature search was conducted to identify economic evaluations of interventions in depression, launched on Medline and the Cost-Effectiveness Registry of the Tufts University using a ten-year time horizon (2008–2018). In a two-stepped screening process, cost-utility studies were selected by means of specified inclusion and exclusion criteria. Subsequently, relevant findings was extracted and, if not fully stated, calculated by the authors of this work. Results Overall, 53 articles with 92 complete economic evaluations, reporting costs from healthcare payer/provider and societal perspective, were identified. More precisely, 22 estimations (24%) changed their results regarding the cost-effectiveness quadrant when the societal perspective was included. Furthermore, 5% of the ICURs resulted in cost-effectiveness regarding the chosen threshold (2% of them became dominant) when societal costs were included. However, another four estimations (4%) showed the opposite result: these interventions were no longer cost-effective after the inclusion of societal costs. Conclusions Summarising the disparities in results and applied methods, the results show that societal costs might alter the conclusions in cost-utility analyses. Hence, the relevance of the perspectives chosen should be taken into account when carrying out an economic evaluation. This systematic review demonstrates that the results of economic evaluations can be affected by different methods available for estimating non-healthcare costs.

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The Cost-Effectiveness of Empagliflozin Versus Liraglutide Treatment in People with Type 2 Diabetes and Established Cardiovascular Disease

Diabetes Therapy ◽

10.1007/s13300-021-01040-y ◽

2021 ◽

Author(s):

Lars Holger Ehlers ◽

Mark Lamotte ◽

Sofia Monteiro ◽

Susanne Sandgaard ◽

Pia Holmgaard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Cost Effectiveness ◽

The Cost

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Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

BMC Geriatrics ◽

10.1186/s12877-021-02287-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mireia Massot Mesquida ◽

Frans Folkvord ◽

Gemma Seda ◽

Francisco Lupiáñez-Villanueva ◽

Pere Torán Monserrat

Keyword(s):

Cost Effectiveness ◽

Psychotropic Drugs ◽

Medication Review ◽

Standard Care ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis ◽

Current Standard ◽

Dementia Patients ◽

The Cost

Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool. Methods The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months. Results The tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). Conclusions The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.

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Systematic review of cost-effectiveness analysis of behavior change communication apps: Assessment of key methods

Digital Health ◽

10.1177/20552076211000559 ◽

2021 ◽

Vol 7 ◽

pp. 205520762110005

Author(s):

Cynthia Afedi Hazel ◽

Sheana Bull ◽

Elizabeth Greenwell ◽

Maya Bunik ◽

Jini Puma ◽

...

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Behavior Change ◽

Quantitative Measure ◽

Cost Effectiveness Analysis ◽

Behavior Change Communication ◽

Change Communication ◽

Effectiveness Analysis ◽

Life Years ◽

The Cost

Objective Evidence backing the effectiveness of mobile health technology is growing, and behavior change communication applications (apps) are fast becoming a useful platform for behavioral health programs. However, data to support the cost-effectiveness of these interventions are limited. Suggestions for overcoming the low output of economic data include addressing the methodological challenges for conducting cost-effectiveness analysis of behavior change app programs. This study is a systematic review of cost-effectiveness analyses of behavior change communication apps and a documentation of the reported challenges for investigating their cost-effectiveness. Materials and methods Four academic databases: Medline (Ovid), CINAHL, EMBASE and Google Scholar, were searched. Eligibility criteria included original articles that use a cost-effectiveness evaluation method, published between 2008 and 2018, and in the English language. Results Out of the 60 potentially eligible studies, 6 used cost-effectiveness analysis method and met the inclusion criteria. Conclusion The evidence to support the cost-effectiveness of behavior change communication apps is insufficient, with all studies reporting significant study challenges for estimating program costs and outcomes. The main challenges included limited or lack of cost data, inappropriate cost measures, difficulty with identifying and quantifying app effectiveness, representing app effects as Quality-adjusted Life Years, and aggregating cost and effects into a single quantitative measure like Incremental Cost Effectiveness Ratio. These challenges highlight the need for comprehensive economic evaluation methods that balance app data quality issues with practical concerns. This would likely improve the usefulness of cost-effectiveness data for decisions on adoption, implementation, scalability, sustainability, and the benefits of broader healthcare investments.

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