Expert Review of Pharmacoeconomics & Outcomes Research

OBJECTIVES: After patent expiration of original biological drugs, they can be marketed as biosimilars. In this study, we analyzed the bid approach of the Hungarian National Health Insurance Fund Administration (NHIFA) based on the results of two consecutive bids on colony stimulating factor (CSF). METHODS: The Hungarian NHIFA database was used to analyze the changes in the number of patients treated with CSF and reimbursement paid by NHIFA, 12 months preceding and following the bids...

BACKGROUD: Sunitinib and Pazopanib are two metastatic renal cell carcinoma (MRCC) treatment alternatives, however the health system in Chile does not consider coverage for any. The cost-effectiveness versus relevant comparator was assessed to support evidence-based decision making. METHODS: A four health states Markov model was built: first, second line treatments, BSC and death. Benefits were measured in QALYs and efficacy estimates were obtained from an indirect treatment comparison...

INTRODUCTION: Increased prevalence of stroke, and the subsequent increased economic burden on the healthcare system and society is a raising concern in India. Objectives of this study were to assess risk factors, cost of treatment and therapy outcomes in stroke patients. METHODS: This cross-sectional study was conducted in 130 patients of either sex at a government tertiary care hospital of India. Relevant information was collected from available records and through patient interview after permission from ethics committee...

Unlike the adult heart failure (HF) patient population, there is scarce of information on the overall burden of HF in the pediatric population across geographies and within different age groups. Areas covered: A systematic review aims to describe and quantify the economic, humanistic, and societal burden of pediatric (age <18 years) HF on patients and caregivers. Eighteen published studies over a period of 10-years (Jan 1st 2006- May 20th 2016) were identified through Embase, Medline, Cochrane Library and selected congresses...

OBJECTIVES: This study compared the cost and quality of life (QoL) of 407 advanced colorectal cancer patients, randomly assigned to receive LV5FU2 followed by FOLFOX6 (sequential strategy) or FOLFOX6 followed by FOLFIRI (combination strategy). METHODS: Costs were compared from the French health insurance perspective, until the end of the second line of treatment. Consumed resources, collected during the trial, included medicines, hospitalizations, examinations, and transportation...

Innovative drugs have been approved in ophthalmology. Thus, the number and importance of economic evaluation studies of ophthalmic drugs have been growing. This study aims to assess the methodological quality of pharmacoeconomic studies of ophthalmic drugs. Areas covered: A systematic search was conducted in Pubmed/Embase until November 2018 to identify full pharmacoeconomic studies evaluating ophthalmic drugs. The quality of studies was evaluated using the British Medical Journal (BMJ) checklist. Quality indicators were evaluated by the Fisher's exact test...

BACKGROUND: The aim of this study was to develop a spending predictor model to evaluate the direct costs associated with the management of ABSSSIs from the National health-care provider's perspective of Italy, Romania, and Spain. METHODOLOGY: A decision-analytic model was developed to evaluate the diagnostic and clinical pathways of hospitalized ABSSSI patients based on scientific guidelines and real-world data. A Standard of Care (SoC) scenario was compared with a dalbavancin scenario in which the patients could be discharged early...

In January 2018 the European Commission published a Proposal for a Regulation on Health Technology Assessment (HTA): 'Proposal for a Regulation on health technology assessment and amending Directive 2011/24/EU'. A number of stakeholders, including some Member States, welcomed this initiative as it was considered to improve collaboration, reduce duplication and improve efficiency; there were however a number of concerns including its legal basis, the establishment of a single managing authority, the preservation of national jurisdiction over HTA decision making and the voluntary/mandatory uptake of joint assessments by Member States...

Tick-borne encephalitis (TBE) reflects an increasing burden and can affect public health policy. Vaccination could be the most effective option to reduce the disease burden, this review can support national recommendations for TBE vaccination in Slovenia. Areas covered: This burden is relatively high in Slovenia and can be estimated by using an incidence-based disability-adjusted life years (DALYs) methodology. Notably, DALYs have been estimated for Slovenia in various studies. The present study summarizes the main differences and conclusions between two studies that dealt with the calculation of DALYs for TBE in Slovenia...

End-stage renal disease is associated with significant comorbidity and mortality. Among its implications, hyperphosphatemia constitutes a consistent and independent risk factor. The use of benchmark treatment, low-cost calcium-based binders declined due to a potential calcification effect on coronary arteries. Areas covered: Given the increasing prevalence of end-stage renal disease and the high cost of hyperphosphatemia's new primary modality, the non-calcium based phosphate binders, we set-off to systematically assess the economic evaluations of non-calcium containing phosphate binders, sevelamer and lanthanum...

BACKGROUND: Intensive Care Unit (ICU) medication costs contribute to a large portion of the total ICU costs. Evaluating ICU drug expenditures is essential for optimal resource use especially in countries with limited resources. Considering the dearth of data regarding ICU medication expenses in the Middle East, we sought to evaluate ICU medication charges at a large academic hospital in Jordan. METHODS: ICU drug charges were extracted from the hospital administration database at King Abdullah University Hospital for 2014-2015 fiscal years (FYs)...

OBJECTIVES: The economic crisis in Greece has triggered an extensive public debate about use of generic drugs (generics). Despite their cost-saving potential, generic market penetration remains very low. This raises questions on awareness of, perception on and preference for generics by healthcare professionals and patients. This is a descriptive study on the level of knowledge and attitudes towards generics of final year pharmacy school students in Greece. METHODS: An electronic questionnaire was distributed to 173 senior pharmacy school students in three Universities in Greece...

BACKGROUND: Antihypertensive drugs play a crucial role in reducing cardiovascular morbidity and mortality. Variability in prescribing patterns constitutes a major challenge for current healthcare systems. This study aimed to compare patterns of use of antihypertensives in general practice in two southern European populations. METHODS: Observational study. Data on antihypertensive drugs consumption in primary care setting (2016) were obtained from pharmacy refill records in Campania (Italy) and Aragon (Spain)...

Poor prescription drug adherence is common, jeopardizing the benefits of treatment and increasing the costs of health care in the United States. A frequently reported barrier to adherence is patient out-of-pocket (OOP) costs. Areas Covered: This systematic review examines interventions that address patient cost sharing to improve adherence to prescription drugs and reduce costs of care. Twenty-eight published studies were identified with twenty-two distinct interventions. The majority of papers were published in or after 2010, and nearly a third were published in or after 2015...

Real-world evidence (RWE) is increasingly being used in coverage, reimbursement and formulary decisions for medicines globally. Areas covered: The Middle East (ME) region is significantly behind in generating and using RWE in health policy decisions due to several factors that shaped the health sector over the past few decades. The trend, however, is changing due to several factors that are shaping the future of healthcare industry in the region. Among other factors, rising healthcare cost, changing population and disease demographics, increased focus on quality of healthcare, digitization of medical data, increased demand for local clinical and economic data, and overall greater influence of global trends in the healthcare industry...

Diabetic foot ulcer (DFU) prevalence is as high as 25% and 40-80% of DFUs become infected (DFI). About 20% of infected ulcers will spread to bone causing diabetic foot osteomyelitis (DFO). DFU costs Medicare $9-13 billion/year. The most expensive costs associated with DFU are inpatient costs and hospital admissions. DFO costs are driven mostly by surgical procedures. DFU patients have a 3-year cumulative mortality rate of 28% and rates approaching 50% in amputated patients. Areas Covered: This review will summarize the current health and economic burden of DFO covering management, epidemiology, and copious costs associated with DFO...

Atopic dermatitis (AD) is a common chronic, pruritic inflammatory skin disease. It is associated with a high personal burden of illness and economic consequences. Since AD can occur at any age, and many treatments and prevention options exist, a high diversity of health economic findings can be expected. Areas covered: A literature search was performed in January 2018 with the objective to report on previously published health economic analyses in AD. In total, 89 analyses were identified. Most analyses focused on the cost-of-illness (n = 34; 38%) followed by cost-utility and/or cost-effectiveness evaluations (n = 26; 29%) and cost analyses (n = 12; 13%) of treatments in AD...

OBJECTIVES: Our study explores whether, and how, different methodological choices are associated with different health technology assessment (HTA) outcomes. We focus on the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) in Germany and the National Institute for Health and Care Excellence (NICE) in England. Both agencies may be considered as exemplars for the application of the principles of evidence-based medicine and the logic of cost-effectiveness, respectively. METHODS: We extracted data from all publically available G-BA appraisals until April 2015, as well as all NICE single technology appraisals completed during this period...

OBJECTIVES: To compare the time trade-off (TTO) utility values of EQ-5D-5L health states elicited from different general populations in Asia. METHODS: We analyzed the TTO data from seven Asian EQ-5D-5L valuation studies in which utility values of 86 EQ-5D-5L health states were elicited from general population samples. An eight-parameter multiplicative regression model including five dimension parameters (mobility [MO], self-care, usual activities [UA], pain/discomfort, anxiety/depression) and three level parameters (level 2 [L2], level 3 [L3], and level 4 [L4]) was used to model the data from each of the populations...

INTRODUCTION: During the last years, a significant number economic evaluations of HPV vaccination has been published. Given that cost-effectiveness constitutes an essential part of decision-making with regards to the reimbursement of a health technology, the purpose of this study is to provide a supportive tool to decision-makers regarding the economic efficiency of the introduction of HPV vaccination to national immunization programs. Areas covered: The PubMed database was searched in order to identify cost-effectiveness studies for HPV vaccination...