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Cost-effectiveness research

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435 papers 25 to 100 followers Cost-effectiveness, cost-utility, value of information, willingness to pay, technology assessment, economic evaluation
By Jamie Jarmul Md / PhD student at UNC - Chapel Hill, PhD in Health Policy and Management
Jean-Eric Tarride, F Russell Quinn, Gord Blackhouse, Roopinder K Sandhu, Natasha Burke, David J Gladstone, Noah M Ivers, Lisa Dolovich, Andrea Thornton, Juliet Nakamya, Chinthanie Ramasundarahettige, Paul A Frydrych, Sam Henein, Ken Ng, Valerie Congdon, Richard V Birtwhistle, Richard Ward, Jeffrey S Healey
We present an economic evaluation of a recently completed cohort study in which 2054 seniors were screened for atrial fibrillation (AF) in 22 Canadian family practices. Using a Markov model, trial and literature data were used to project long-term outcomes and costs associated with 4 AF screening strategies for individuals aged 65 years or older: no screening, screen with 30-second radial manual pulse check (pulse check), screen with a blood pressure machine with AF detection (BP-AF), and screen with a single-lead electrocardiogram (SL-ECG)...
November 2018: Canadian Journal of Cardiology
Ellen H Morrow, Jennwood Chen, Ravi Patel, Brandon Bellows, Raminder Nirula, Robert Glasgow, Richard E Nelson
OBJECTIVE: To evaluate the decision of watchful waiting (WW) versus elective laparoscopic hernia repair (ELHR) for minimally symptomatic paraesophageal hernias (PEH) with respect to cost-effectiveness. BACKGROUND: The current recommendation for minimally symptomatic PEHs is watchful waiting. This standard is based on a decision analysis from 2002 that compared the two strategies on quality-adjusted life-years (QALYs). Since that time, the safety of ELHR has improved...
July 24, 2018: American Journal of Surgery
Anita W Asgar, Michele Pighi, Xavi Millan, Razi Khan, Jean-Francois Dorval, Reda Ibrahim, Lorenzo Azzalini, Raoul Bonan
BACKGROUND: Vascular complications are an important complication of transcatheter aortic valve implantation and are associated with increased morbidity and mortality as well as cost. The Solopath device is an expandable vascular access system that has previously been shown to be associated with lower rates of vascular complications. This study sought to evaluate the impact of the use of this system on vascular complications and costs in a decision model analysis. METHODS: A cost-consequence analysis was undertaken utilizing event rate data from the PARTNER trials and a published retrospective analysis of the Solopath device...
September 7, 2018: Journal of Medical Economics
Marita Zimmermann, Elizabeth Brouwer, Jeffrey A Tice, Matt Seidner, Anne M Loos, Shanshan Liu, Richard H Chapman, Varun Kumar, Josh J Carlson
BACKGROUND: Several disease-modifying therapies (DMTs) treat relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS). Few comprehensive cost-effectiveness analyses exist in this area, particularly from a payer perspective, despite rapidly increasing prices of DMTs. OBJECTIVE: We aimed to systematically compare cost effectiveness of all relevant DMTs for first-line treatment of RRMS, second-line treatment of RRMS, and first-line treatment of PPMS...
August 23, 2018: CNS Drugs
Maeve K Hopkins, Chad A Grotegut, Geeta K Swamy, Evan R Myers, Laura J Havrilesky
OBJECTIVE:  To assess the costs, complication rates, and harm-benefit tradeoffs of induction of labor (IOL) compared to scheduled cesarean delivery (CD) in women with class III obesity. STUDY DESIGN:  We conducted a cost analysis of IOL versus scheduled CD in nulliparous morbidly obese women. Primary outcomes were surgical site infection (SSI), chorioamnionitis, venous thromboembolism, blood transfusion, and readmission. Model outcomes were mean cost of each strategy, cost per complication avoided, and complication tradeoffs...
March 2019: American Journal of Perinatology
Miriam P van der Meulen, Iris Lansdorp-Vogelaar, S Lucas Goede, Ernst J Kuipers, Evelien Dekker, Jaap Stoker, Marjolein van Ballegooijen
Purpose To compare the cost-effectiveness of computed tomographic (CT) colonography and colonoscopy screening by using data on unit costs and participation rates from a randomized controlled screening trial in a dedicated screening setting. Materials and Methods Observed participation rates and screening costs from the Colonoscopy or Colonography for Screening, or COCOS, trial were used in a microsimulation model to estimate costs and quality-adjusted life-years (QALYs) gained with colonoscopy and CT colonography screening...
June 2018: Radiology
Louis P Garrison, Mark V Pauly, Richard J Willke, Peter J Neumann
The second section of our Special Task Force builds on the discussion of value and perspective in the previous article of the report by 1) defining a health economics approach to the concept of value in health care systems; 2) discussing the relationship of value to perspective and decision context, that is, how recently proposed value frameworks vary by the types of decisions being made and by the stakeholders involved; 3) describing the patient perspective on value because the patient is a key stakeholder, but one also wearing the hat of a health insurance purchaser; and 4) discussing how value is relevant in the market-based US system of mixed private and public insurance, and differs from its use in single-payer systems...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Darius N Lakdawalla, Jalpa A Doshi, Louis P Garrison, Charles E Phelps, Anirban Basu, Patricia M Danzon
The third section of our Special Task Force report identifies and defines a series of elements that warrant consideration in value assessments of medical technologies. We aim to broaden the view of what constitutes value in health care and to spur new research on incorporating additional elements of value into cost-effectiveness analysis (CEA). Twelve potential elements of value are considered. Four of them-quality-adjusted life-years, net costs, productivity, and adherence-improving factors-are conventionally included or considered in value assessments...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Patricia M Danzon, Michael F Drummond, Adrian Towse, Mark V Pauly
The fourth section of our Special Task Force report focuses on a health plan or payer's technology adoption or reimbursement decision, given the array of technologies, on the basis of their different values and costs. We discuss the role of budgets, thresholds, opportunity costs, and affordability in making decisions. First, we discuss the use of budgets and thresholds in private and public health plans, their interdependence, and connection to opportunity cost. Essentially, each payer should adopt a decision rule about what is good value for money given their budget; consistent use of a cost-per-quality-adjusted life-year threshold will ensure the maximum health gain for the budget...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Charles E Phelps, Darius N Lakdawalla, Anirban Basu, Michael F Drummond, Adrian Towse, Patricia M Danzon
The fifth section of our Special Task Force report identifies and discusses two aggregation issues: 1) aggregation of cost and benefit information across individuals to a population level for benefit plan decision making and 2) combining multiple elements of value into a single value metric for individuals. First, we argue that additional elements could be included in measures of value, but such elements have not generally been included in measures of quality-adjusted life-years. For example, we describe a recently developed extended cost-effectiveness analysis (ECEA) that provides a good example of how to use a broader concept of utility...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Richard J Willke, Peter J Neumann, Louis P Garrison, Scott D Ramsey
The sixth section of our Special Task Force (STF) report reviews and comments on recent US-oriented value assessment frameworks, specifically those published by the American College of Cardiology/American Heart Association, the Institute for Clinical and Economic Research, the American Society of Clinical Oncology, the National Comprehensive Cancer Network, and the Memorial Sloan Kettering Cancer Center. We review published commentaries that address the validity, reliability, and conceptual underpinnings of these frameworks...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Louis P Garrison, Peter J Neumann, Richard J Willke, Anirban Basu, Patricia M Danzon, Jalpa A Doshi, Michael F Drummond, Darius N Lakdawalla, Mark V Pauly, Charles E Phelps, Scott D Ramsey, Adrian Towse, Milton C Weinstein
This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Brian Solow, Edmund J Pezalla
No abstract text is available yet for this article.
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Margaret Heslin, Oluwagbemisola Babalola, Fowzia Ibrahim, Dominic Stringer, David Scott, Anita Patel
BACKGROUND: Estimating individual-level medication costs in an economic evaluation can involve extensive data collection and handling. Implications of detailed versus general approaches are unclear. OBJECTIVES: To compare costing approaches in a trial-based economic evaluation. METHODS: We applied four costing approaches to prescribed medication data from the Tumour necrosis factor inhibitors Against Combination Intensive Therapy randomized controlled trial...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Hendrik Koffijberg, Saskia Knies, Mart P Janssen
BACKGROUND: When proven effective, decision making regarding reimbursement of new health technology typically involves ethical, social, legal, and health economic aspects and constraints. Nevertheless, when applying standard value of information (VOI) analysis, the value of collecting additional evidence is typically estimated assuming that only cost-effectiveness outcomes guide such decisions. OBJECTIVES: To illustrate how decision makers' constraints can be incorporated into VOI analyses and how these may influence VOI outcomes...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Sabrina Storgaard Sørensen, Morten Berg Jensen, Kjeld Møller Pedersen, Lars Ehlers
OBJECTIVES: To examine the heterogeneity in cost-effectiveness analyses of patient-tailored complex interventions. METHODS: Latent class analysis (LCA) was performed on data from a randomized controlled trial evaluating a patient-tailored case management strategy for patients suffering from chronic obstructive pulmonary disease (COPD). LCA was conducted on detailed process variables representing service variation in the intervention group. Features of the identified latent classes were compared for consistency with baseline demographic, clinical, and economic characteristics for each class...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
E Losina, I M Usiskin, S R Smith, J K Sullivan, K C Smith, D J Hunter, S P Messier, A D Paltiel, J N Katz
OBJECTIVE: The cost-effectiveness of the recently-introduced generic celecoxib in knee OA has not been examined. METHOD: We used the Osteoarthritis Policy (OAPol) Model, a validated computer simulation of knee OA, to evaluate long-term clinical outcomes, costs, and cost-effectiveness of generic celecoxib in persons with knee OA. We examined eight treatment strategies consisting of generic celecoxib, over-the-counter (OTC) naproxen, or prescription naproxen, with or without prescription or OTC proton-pump-inhibitors (PPIs) to reduce gastrointestinal (GI) toxicity...
May 2018: Osteoarthritis and Cartilage
Anna Fernández, Juan M Mendive, Sonia Conejo-Cerón, Patricia Moreno-Peral, Michael King, Irwin Nazareth, Carlos Martín-Pérez, Carmen Fernández-Alonso, Antonina Rodríguez-Bayón, Jose Maria Aiarzaguena, Carmen Montón-Franco, Antoni Serrano-Blanco, Inmaculada Ibañez-Casas, Emiliano Rodríguez-Sánchez, Luis Salvador-Carulla, Paola Bully Garay, María Isabel Ballesta-Rodríguez, Pilar LaFuente, María Del Mar Muñoz-García, Pilar Mínguez-Gonzalo, Luz Araujo, Diego Palao, María Cruz Gómez, Fernando Zubiaga, Desirée Navas-Campaña, Jose Manuel Aranda-Regules, Alberto Rodriguez-Morejón, Juan de Dios Luna, Juan Ángel Bellón
BACKGROUND: Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care...
February 23, 2018: BMC Medicine
Elizabeth A Handorf, Daniel F Heitjan, Justin E Bekelman, Nandita Mitra
The analysis of observational data to determine the cost-effectiveness of medical treatments is complicated by the need to account for skewness, censoring, and the effects of measured and unmeasured confounders. We quantify cost-effectiveness as the Net Monetary Benefit (NMB), a linear combination of the treatment effects on cost and effectiveness that denominates utility in monetary terms. We propose a parametric estimation approach that describes cost with a Gamma generalized linear model and survival time (the canonical effectiveness variable) with a Weibull accelerated failure time model...
February 22, 2018: Statistical Methods in Medical Research
David A Turner, Rebekah Fong Soe Khioe, Lee Shepstone, Elizabeth Lenaghan, Cyrus Cooper, Neil Gittoes, Nicholas C Harvey, Richard Holland, Amanda Howe, Eugene McCloskey, Terence W O'Neill, David Torgerson, Richard Fordham
The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reduction in the incidence of all osteoporosis-related fractures. To make decisions about whether to implement any screening program, we should also consider whether the program is likely to be a good use of health care resources, ie, is it cost-effective? The cost per gained quality adjusted life year of screening for fracture risk has not previously been demonstrated in an economic evaluation alongside a clinical trial...
May 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
2018-02-24 12:37:51
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