Análise de custo-utilidade da terapia antimicrobiana parenteral ambulatorial, baseada em hospital-dia, pela perspectiva do Sistema Único de Saúde Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) of hospital-based infusion center in the Brazilian national health system

Abstract Background Several multi-attribute utility instruments (MAUIs) are available from which utilities can be derived for use in cost-utility analysis (CUA). This study provides a review of recommendations from national health technology assessment (HTA) agencies regarding the choice of MAUIs. Methods A list was compiled of HTA agencies that provide or refer to published official pharmacoeconomic (PE) guidelines for pricing, reimbursement or market access. The guidelines were reviewed for recommendations on the indirect calculation of utilities and categorized as: a preference for a specific MAUI; providing no MAUI preference, but providing examples of suitable MAUIs and/or recommending the use of national value sets; and recommending CUA, but not providing examples of MAUIs. Results Thirty-four PE guidelines were included for review. MAUIs named for use in CUA: EQ-5D (n = 29 guidelines), the SF-6D (n = 11), HUI (n = 10), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). EQ-5D was a preferred MAUI in 15 guidelines. Alongside the EQ-5D, the HUI was a preferred MAUI in one guideline, with DALY disability weights mentioned in another. Fourteen guidelines expressed no preference for a specific MAUI, but provided examples: EQ-5D (n = 14), SF-6D (n = 11), HUI (n = 9), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). Of those that did not specify a particular MAUI, 12 preferred calculating utilities using national preference weights. Conclusions The EQ-5D, HUI, and SF-6D were the three MAUIs most frequently mentioned in guidelines. The most commonly cited MAUI (in 85% of PE guidelines) was EQ-5D, either as a preferred MAUI or as an example of a suitable MAUI for use in CUA in HTA.

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Cost Utility of Target Therapies Compared to Dacarbazine for First-Line Treatment of Advanced Non-Surgical and Metastatic Melanoma in the Brazilian National Health System

Value in Health Regional Issues ◽

10.1016/j.vhri.2019.04.001 ◽

2019 ◽

Vol 20 ◽

pp. 103-109

Author(s):

Renata Leborato Guerra ◽

Flávia de Miranda Corrêa ◽

Ricardo Ribeiro Alves Fernandes ◽

Ivan Ricardo Zimmerman

Keyword(s):

Health System ◽

Metastatic Melanoma ◽

National Health ◽

National Health System ◽

Cost Utility ◽

Line Treatment ◽

First Line ◽

Target Therapies ◽

First Line Treatment

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Cost Effectiveness of Paliperidone Palmitate in National Health Service (NHS) Wales: A Cost Utility Analysis Based on the National Institute for Health and Care Excellence (NICE) Core Model for the Management of Schizophrenia

Value in Health ◽

10.1016/j.jval.2013.08.1414 ◽

2013 ◽

Vol 16 (7) ◽

pp. A549

Author(s):

J. Lee ◽

Y. Jiang ◽

A. Gauthier ◽

S. Curtis ◽

P. Musingarimi ◽

...

Keyword(s):

Cost Effectiveness ◽

National Health Service ◽

Health Service ◽

National Health ◽

Cost Utility ◽

Cost Utility Analysis ◽

Core Model ◽

Paliperidone Palmitate ◽

Utility Analysis

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Cost–utility analysis of remote versus conventional monitoring of pacemakers in the Arctic Circle

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.572 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Lopez-Villegas ◽

D Catalan-Matamoros ◽

S Peiro ◽

K T Lappegard ◽

R Lopez-Liria

Keyword(s):

Remote Monitoring ◽

National Health System ◽

Cost Utility ◽

Cost Utility Analysis ◽

The Arctic ◽

Utility Analysis ◽

System Perspective ◽

Life Years ◽

Monitoring Group

Abstract Introduction Several studies have demonstrated that remote monitoring (RM) of pacemakers is safe, effective and cost-saving. The aim of this study was to perform an economic assessment and check whether RM offers a cost-utility alternative to conventional monitoring in hospital (CM). Methods This is a controlled, randomized, non-masked clinical trial. Fifty patients with pacemaker were assigned to receive either RM (n = 25) or CM (n = 25). Data were collected during the 12 months. A cost-utility analysis was performed in order to assess whether RM of pacemakers is cost-effective compared to CM in hospital in terms of costs per gained quality-adjusted life years (QALY). The analysis was performed from the perspectives of the Norwegian Healthcare System (NHS) and patients. Results Overall, total costs from the NHS perspective were higher in the RM group (€2,079.84 vs. €271.97; p = 0.147). The costs related to the patients perspective were higher in the RM than those in the CM group (€223.99 vs. €158.42, respectively; P = 0.429). Patients included in the CM obtained 0.04 QALYs less than those in the RM group over 12 months and the total costs per QALY comprised €1,784.10 (P = 0.175) per user with a pacemaker implant. The total number of pacemaker transmissions per patient year comprised 86.46% of minors in the CM group. Conclusions The follow-up costs were similar between both groups. Cost-utility analysis showed broad confidence intervals with ICERs ranging from potential savings to high costs for an additional QALY, with most ICERs lower than the usual NHS thresholds for coverage decisions. Key messages Total costs from the National Health System perspective were higher in the remote monitoring group, although there were not significant differences between both groups of follow-up. The costs related to the patient perspective were higher in the remote monitoring than those in the conventional monitoring group, without significant differences.

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Cost-utility analysis of panitumumab use compared with cetuximab and bevacizumab for the first-line therapy of wild-type RAS metastatic colorectal cancer in the Peruvian health system.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15171 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15171-e15171

Author(s):

Valderrama Milton ◽

Moises Apolaya-Segura ◽

Paola Catherine Montenegro

Keyword(s):

Colorectal Cancer ◽

Health System ◽

Metastatic Colorectal Cancer ◽

Cost Utility ◽

Cost Utility Analysis ◽

Wild Type ◽

Utility Analysis ◽

First Line ◽

First Line Therapy ◽

Line Therapy

e15171 Background: To estimate the cost-utility of Panitumumab compared to Cetuximab (Erbitux®) and Bevacizumab (Avastin®) for the first-line therapy of metastatic colorectal cancer in the Peruvian health system Methods: A cost-utility analysis was performed using a Markov's model based in epidemiological parameters, metastatic colorectal cancer (mCRC) associated costs, and the efficacy of therapy using specific monoclonal antibodies against wild-type RAS mCRC. The costs of biological agents were estimated from the payers' viewpoint, using a 3.5% discount rate. The model includes the transition between five health states (mCRC, surgery, remission, progression, and death), and each cycle lasts for one month in a 3-year temporal horizon Results: The results of the model indicate that Bevacizumab and Panitumumab were cost–effective compared with Cetuximab. Therapy using Bevacizumab for a three-year period cost PEN 178,950.96 less than Panitumumab, but generated 0.91 less QALYs. The incremental cost-effectiveness ratio (ICER) showed that Cetuximab had extended dominance when compared to Panitumumab and Bevacizumab. This means that Panitumumab is more expensive, but it leads to a greater clinical benefit. Conclusions: Using the best published data available, these results suggest that the clinical effectiveness of Panitumumab and Bevacizumab translates into a favorable cost-utility ratio; and it particularly generates savings. The use of Panitumumab is associated to a longer survival, more QALYs gained and more months in remission.

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