Journals Applied Health Economics and H...

Applied Health Economics and Health Policy
Johannes Wendl, Andreas Simon, Martin Kistler, Jana Hapfelmeier, Antonius Schneider, Alexander Hapfelmeier
BACKGROUND AND OBJECTIVE: Despite the importance of medication adherence for chronically ill patients and the vast literature on its relationship to costs, this field suffers from methodological limitations. These are caused, amongst others, by the lack of generalizability of data sources, varying definitions of adherence, costs, and model specification. We aim to address this with different modeling approaches and to contribute evidence on the research question. METHODS: We extracted large cohorts of nine chronic diseases (n = 6747-402,898) from German claims data of stationary health insurances between 2012 and 2015 (t0-t3)...
March 18, 2023: Applied Health Economics and Health Policy
Waranya Rattanavipapong, Chittawan Poonsiri, Wanrudee Isaranuwatchai, Sopon Iamsirithaworn, Jutarat Apakupakul, Chaninan Sonthichai, Rungrueng Kitphati, Yot Teerawattananon
BACKGROUND AND AIMS: The introduction of Coronavirus disease 2019 (COVID-19) vaccines urged all Thais to seek prevention of serious illness and death from COVID-19. However, immunocompromised individuals might not be able to achieve an efficient immune response from these vaccines. This study aimed to evaluate the cost-effectiveness and budget impact of introducing Evusheld (tixagevimab plus cilgavimab) for three patient groups-organ transplant, autoimmune disease, and dialysis patients, from the Thai government perspective...
March 16, 2023: Applied Health Economics and Health Policy
Christopher H Henshall, Dávid Dankó, Leela Barham, Jaime Espín, Jorge Felix, Mary Harney, Peter Indra, Jorge Mestre-Ferrandiz, Gérard de Pouvourville, Federico Spandonaro, Luka Vončina, Nils Wilking
OBJECTIVES: Combinations of on-patent therapies (CTs) are increasingly common in oncology. They cause challenges for funding and affordability, and hence patient access, especially when constituent therapies are owned by different manufacturers. The aim of our study was to develop policy proposals for the assessment, pricing, and funding of CTs and identify which might be relevant in different European countries. METHODS: Following a review of available literature, seven hypothetical policy proposals were developed and subsequently assessed through 19 semi-structured interviews with health policy, pricing, technology assessment and legal experts in seven European countries to identify those most likely to gain traction...
March 10, 2023: Applied Health Economics and Health Policy
N K Gibbs, C Angus, S Dixon, C D H Parry, P S Meier
BACKGROUND: Health economic models aim to provide decision makers with information that is contextually relevant, understandable and credible. This requires ongoing engagement throughout the research project between the modeller and end-users. OBJECTIVES: We aim to reflect on how a public health economic model of minimum unit pricing of alcohol in South Africa benefited from, and was shaped by, stakeholders. We outline how engagement activities were used during the development, validation and communication phases of the research with input gathered at each stage to inform future priorities...
March 9, 2023: Applied Health Economics and Health Policy
Arthi Vasantharoopan, Victoria Simms, Yuyen Chan, Lorna Guinness, Hendramoorthy Maheswaran
BACKGROUND AND OBJECTIVE: Economic evaluations, a decision-support tool for policy makers, will be crucial in planning and tailoring HIV prevention and treatment strategies especially in the wake of stalled and decreasing funding for the global HIV response. As HIV testing and treatment coverage increase, case identification becomes increasingly difficult and costly. Determining which subset of the population these strategies should be targeted to becomes of vital importance as well. Generating quality economic evidence begins with the validity of the modelling approach and the model structure employed...
February 28, 2023: Applied Health Economics and Health Policy
Holly L Cranmer, Gemma E Shields, Ash Bullement
BACKGROUND: A common challenge in health technology assessments (HTAs) of cancer treatments is how subsequent therapy use within the trial follow-up may influence cost-effectiveness model outcomes. Although overall survival (OS) is often a key driver of model results, there are no guidelines to advise how to adjust for this potential confounding, with different approaches available dependent on the model structure. OBJECTIVE: We compared a partitioned survival analysis (PartSA) with a semi-Markov multi-state model (MSM) structure, with and without attempts to adjust for the impact of subsequent therapies on OS using a case study describing outcomes for people with relapsed/refractory multiple myeloma...
February 27, 2023: Applied Health Economics and Health Policy
Kevin Outterson, John H Rex
No abstract text is available yet for this article.
February 11, 2023: Applied Health Economics and Health Policy
Diogo L L Leao, Henricus-Paul Cremers, Dennis van Veghel, Milena Pavlova, Wim Groot
INTRODUCTION: Value-based healthcare has potential for cost control and quality improvement. To assess this, we review the evidence on the impact of value-based payment (VBP) models in the context of networks of care (NOC) and transmural care. METHODS: We used the PRISMA guidelines for this systematic literature review. We searched eight databases in July 2021. Subsequently, we conducted title and abstract and full-text screenings, and extracted information in an extraction matrix...
February 1, 2023: Applied Health Economics and Health Policy
Carlos Rojas-Roque, Alfredo Palacios
BACKGROUND: Little is known about the quality, quantity and disease areas analysed by health economic research that inform healthcare decision-making in Central America. This study aimed to review the existing health economic evaluations (HEEs) and budget impact analyses (BIAs) evidence in Central America based on scope and reporting quality. METHODS: HEEs and BIAs published from 2000 to April 2021 were searched in five electronic databases: PubMed, Embase, LILACS (Latin American and Caribbean Health Science Literature), EconLIT and OVID Global Health...
January 31, 2023: Applied Health Economics and Health Policy
Meghan McGee, Kellia Chiu, Rahim Moineddin, Abhimanyu Sud
BACKGROUND: Buprenorphine-naloxone is an essential part of the response to opioid poisoning rates in North America. Manipulating market exclusivity is a strategy manufacturers use to increase profitability, as evidenced by Suboxone in the USA. OBJECTIVE: To investigate excess costs of buprenorphine-naloxone due to unmerited market exclusivity (no legal patent or data protection) in Canada. METHODS: Using controlled interrupted time-series, this study examined changes in the cost of buprenorphine-naloxone before and after the first generics were listed on public formularies...
January 18, 2023: Applied Health Economics and Health Policy
Colm Leonard, Nick Crabb, David Glover, Sophie Cooper, Jacoline Bouvy, Milena Wobbe, Mark Perkins
The silent pandemic of antimicrobial resistance (AMR) is a global issue needing prompt attention. A comprehensive one-health approach across human and animal health, agriculture and the environment is needed to solve this, addressing overuse of antibacterials, and of course, optimising measures for preventing and controlling infection. We also need a robust pipeline of new antibacterials. However, the current pipeline is inadequate and several companies with new antibacterials have gone bankrupt due to low sales, leading to a 'broken market'...
January 17, 2023: Applied Health Economics and Health Policy
Yawen Jiang, Shan Jiang, Limin Li, Si Shi, Mincai Li, Lei Si
OBJECTIVE: This study evaluated the cost effectiveness of denosumab versus alendronate for secondary prevention of osteoporotic fractures among post-menopausal women in China. METHODS: A validated individual-level simulation model of osteoporotic fractures in the Chinese setting was adapted. Allowing both treatment discontinuation and waning effects, the analysis aimed to evaluate the incremental cost-effectiveness ratio of denosumab compared to alendronate by simulating a cohort of previously fractured individuals over the residual lifetime from the healthcare system perspective...
January 10, 2023: Applied Health Economics and Health Policy
Irina Pokhilenko, Luca M M Janssen, Aggie T G Paulus, Ruben M W A Drost, William Hollingworth, Joanna C Thorn, Sian Noble, Judit Simon, Claudia Fischer, Susanne Mayer, Luis Salvador-Carulla, Alexander Konnopka, Leona Hakkaart van Roijen, Valentin Brodszky, A-La Park, Silvia M A A Evers
BACKGROUND: Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials...
January 9, 2023: Applied Health Economics and Health Policy
Pooyeh Graili
BACKGROUND AND OBJECTIVE: Before listing by drug plans, new drugs that receive regulatory bodies' approval are assessed by the Health Technology Assessment agencies, including the Canadian Agency for Drugs and Technologies in Health (CADTH). Considering the impact of CADTH recommendations on payers' listing decisions, the growing number of high-cost drugs, and conditional listings, conditional recommendations have increasingly been of interest to the users of CADTH recommendations. This study aims to review the conditional reimbursement recommendations issued by CADTH and explores the reasons for those recommendations...
January 7, 2023: Applied Health Economics and Health Policy
Chris Schilling, Michelle Tew, Samantha Bunzli, Cade Shadbolt, L Stefan Lohmander, Zsolt J Balogh, Francesco Paolucci, Peter F Choong, Michelle M Dowsey, Philip Clarke
BACKGROUND AND OBJECTIVE: Waste in clinical trials remains rife. We developed an economic model to predict the cost of trials based on input costs, duration, power, number of sites, recruitment eligibility and consenting rates. METHODS: We parameterised the model for three proxy placebo-controlled surgical trials using data from a systematic review, a bespoke cost survey, and from the literature. We used the model to compare target and actual trial performance for (i) a trial that was completed on time but with more sites, (ii) a trial that completed after a time extension, and (iii) an incomplete trial...
December 28, 2022: Applied Health Economics and Health Policy
Rahab Mbau, Anita Musiega, Lizah Nyawira, Benjamin Tsofa, Andrew Mulwa, Sassy Molyneux, Isabel Maina, Julie Jemutai, Charles Normand, Kara Hanson, Edwine Barasa
BACKGROUND: Efficiency refers the use of resources in ways that optimise desired outcomes. Health system efficiency is a priority concern for policy makers globally as countries aim to achieve universal health coverage, and face the additional challenge of an aging population. Efficiency analysis in the health sector has typically focused on the efficiency of healthcare facilities (hospitals, primary healthcare facilities), with few studies focusing on system level (national or sub-national) efficiency...
December 28, 2022: Applied Health Economics and Health Policy
Esther A Boudewijns, Thomas M Otten, Mariam Gobianidze, Bram L Ramaekers, Onno C P van Schayck, Manuela A Joore
OBJECTIVES: The headroom analysis is an early economic evaluation that quantifies the highest price at which an intervention may still be cost effective. Currently, there is no comprehensive review on how it is applied. This study investigated the application of the headroom analysis, specifically (1) how the headroom analysis is framed (2) the analytical approach and sources of evidence used, and (3) how expert judgement is used and reported. METHODS: A systematic search was conducted in PubMed, Embase, Web of Science, EconLit, and Google Scholar on 28 April 2022...
December 28, 2022: Applied Health Economics and Health Policy
Iyn-Hyang Lee, Karen Bloor, Eun-Young Bae
OBJECTIVES: This study aimed to compare appraisal decisions about anticancer drugs between the health technology assessment (HTA) agencies in Korea and England, and investigate whether the decisions and supporting evidence are comparable. METHODS: This study identified 49 anticancer drugs listed by the Korean Ministry of Health and Welfare between January 2014 and December 2019. Of those, 46 anticancer drugs for 58 indications were included for analysis. Official appraisal documents from both countries for 58 drug-indication pairs were compared and assessed in terms of clinical and economic evidence...
December 20, 2022: Applied Health Economics and Health Policy
Patricia G Synnott, Dominic Voehler, Daniel E Enright, Stacey Kowal, Daniel A Ollendorf
BACKGROUND: Efforts to understand how treatments affect patients and society have broadened the criteria that health technology assessment (HTA) organizations apply to value assessments. We examined whether HTA agencies in eight countries consider treatment novelty in methods and deliberations. METHODS: We defined a novel pharmaceutical product to be one that offers a new approach to treatment (e.g., new mechanism of action), addresses an unmet need (e.g., targets a rare condition without effective treatments), or has a broader impact beyond what is typically measured in an HTA...
December 19, 2022: Applied Health Economics and Health Policy
Richard M Wood, Alison L Harper, Zehra Onen-Dumlu, Paul G Forte, Martin Pitt, Christos Vasilakis
BACKGROUND: It is a stated ambition of many healthcare systems to eliminate delayed transfers of care (DTOCs) between acute and step-down community services. OBJECTIVE: This study aims to demonstrate how, counter to intuition, pursual of such a policy is likely to be uneconomical, as it would require large amounts of community capacity to accommodate even the rarest of demand peaks, leaving much capacity unused for much of the time. METHODS: Some standard results from queueing theory-a mathematical discipline for considering the dynamics of queues and queueing systems-are used to provide a model of patient flow from the acute to community setting...
December 18, 2022: Applied Health Economics and Health Policy
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