Max Lelie, Riet Parmentier, Eva de Jaegere, Steven Simoens, Lieven Annemans, Koen Putman
{"title":"A cost-effectiveness estimation of the Attempted Suicide Short Intervention Programme (ASSIP).","authors":"Max Lelie, Riet Parmentier, Eva de Jaegere, Steven Simoens, Lieven Annemans, Koen Putman","doi":"10.1080/14737167.2025.2497877","DOIUrl":"10.1080/14737167.2025.2497877","url":null,"abstract":"<p><strong>Objective: </strong>Patients who have previously attempted suicide are at a substantially increased risk of a repeated attempt. We have conducted a cost-utility analysis of the Attempted Suicide Short Intervention Programme (ASSIP) and compared it with treatment as usual in a Flemish population.</p><p><strong>Methods: </strong>A closed-cohort Markov-model was used to simulate suicide over a time-horizon of 20 years in a cohort of prior suicide attempt patients. This model is used to estimate Incremental Cost Effectiveness Ratios (ICERs) from societal and healthcare perspectives. A separate 'tipping-point' scenario was included, where the treatment effectiveness regresses over time.</p><p><strong>Results: </strong>ASSIP is shown to be a dominant strategy from the societal perspective and cost-effective from a healthcare perspective: the ICER after 10 years is € 1,133 and after 20 years € 304. In the tipping-point scenario, an regression of up to 82,7% after the intervention remains cost-effective, assuming an ICER threshold of € 44000 per QALY.</p><p><strong>Conclusion: </strong>Our study found that ASSIP is cost-effective in the Flemish region, saving both healthcare costs and societal expenses over time. Implementing ASSIP could provide significant economic and health benefits within 10 years, making it a valuable investment for improving mental health care.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"897-904"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faizur Rehman, Muhammad Wasay Shahid, Mehran Riaz, Malik Muhammad Umair, Farah Azhar, Muhammad Amer, Ali Ahmed
{"title":"Willingness to pay for a quality-adjusted life year (QALY) in Pakistan: implications for health policy.","authors":"Faizur Rehman, Muhammad Wasay Shahid, Mehran Riaz, Malik Muhammad Umair, Farah Azhar, Muhammad Amer, Ali Ahmed","doi":"10.1080/14737167.2025.2504945","DOIUrl":"10.1080/14737167.2025.2504945","url":null,"abstract":"<p><strong>Objectives: </strong>Allocating healthcare resources in developing countries like Pakistan is constrained by economic limitations and uneven distribution. Therefore, in this study, we aimed to investigate the Willingness to Pay (WTP) for one additional Quality-Adjusted Life Year (QALY) among the general population in Pakistan to establish contextually relevant thresholds for health technology assessment (HTA).</p><p><strong>Methods: </strong>We conducted a cross-sectional survey using the convenient sampling technique to estimate the WTP for one additional QALY among the general population of Pakistan. The contingent valuation method (CVM) using the payment card technique was used to assess its monetary value.</p><p><strong>Results: </strong>A total of 600 participants participated in the survey and resulted in 1200 WTP responses for further analysis. The mean WTP/QALY was 114,006.4 Pakistani rupee (PKR) (United States Dollar 410.11), equivalent to 0.29 times Pakistan's GDP per capita. The WTP/QALY for the quality-of-life improvement scenario was lower than the life-extension scenario. The two-part regression model showed that higher education and income were positively associated with WTP value.</p><p><strong>Conclusion: </strong>This study provides empirical evidence of the monetary value of one additional QALY from a sample of the Pakistani population. These findings highlight country-specific cost-effectiveness benchmarks, and incorporating WTP insights into the healthcare policy for better resource allocation, affordability, and long-term sustainability of the interventions.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"967-975"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mickaël Hiligsmann, Carolyn Gotay, Jayashri Sankaranarayanan, Carlo Lazzaro, Tamas Agh, Lieke Maas, John Yfantopoulos, Rob McMinn
{"title":"Expert review of pharmacoeconomics and outcomes research: high impact articles from 2024.","authors":"Mickaël Hiligsmann, Carolyn Gotay, Jayashri Sankaranarayanan, Carlo Lazzaro, Tamas Agh, Lieke Maas, John Yfantopoulos, Rob McMinn","doi":"10.1080/14737167.2025.2496217","DOIUrl":"10.1080/14737167.2025.2496217","url":null,"abstract":"","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"833-835"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bram Wouterse, João Vasco Santos, Mickaël Hiligsmann
{"title":"Future directions for the economics of prevention.","authors":"Bram Wouterse, João Vasco Santos, Mickaël Hiligsmann","doi":"10.1080/14737167.2025.2498665","DOIUrl":"10.1080/14737167.2025.2498665","url":null,"abstract":"","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"841-844"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Ferrara, Andrea Zovi, Roberto Langella, Angela Panico, Manlio Scognamiglio, Ugo Trama, Eduardo Nava, Maurizio Capuozzo, Ferdinando Primiano, Giuseppe Russo
{"title":"Consumption and expenditure of drugs used for the treatment of hypercholesterolemia: a governance analysis.","authors":"Francesco Ferrara, Andrea Zovi, Roberto Langella, Angela Panico, Manlio Scognamiglio, Ugo Trama, Eduardo Nava, Maurizio Capuozzo, Ferdinando Primiano, Giuseppe Russo","doi":"10.1080/14737167.2025.2493728","DOIUrl":"10.1080/14737167.2025.2493728","url":null,"abstract":"<p><strong>Background: </strong>Elevated cholesterol levels are a significant contributor to cardiovascular disease risk. While statins have long been the cornerstone for lowering LDL cholesterol, their associated side effects have prompted the exploration of alternative treatments, including ezetimibe, bempedoic acid, PCSK9 inhibitors and inclisiran.f.</p><p><strong>Research design and methods: </strong>This research seeks to analyze the usage patterns and financial implications during 2023 and 2024. The goal is to assess the economic impact of emerging therapies in hypercholesterolemia.</p><p><strong>Results: </strong>Findings indicate a decline in the exclusive use of traditional statins and a rise in the adoption of newer and combination therapies. Statin monotherapy usage decreased markedly from 42% in 2023 to 30% in 2024. Combination treatments, such as statins paired with ezetimibe, remained steady at 17% across both time frames. The utilization of novel treatments, notably PCSK9 inhibitors, increased from 33% to 40% between the two periods, whereas bempedoic acid, whether used alone or with ezetimibe, stayed below 2%.</p><p><strong>Conclusion: </strong>The landscape of hypercholesterolemia treatment has expanded with several new therapeutic options. Bempedoic acid may mitigate adverse effects and enhance treatment efficacy, potentially delaying the need for costlier injectable medications like evolocumab, alirocumab, and inclisiran.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"927-932"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaclyn M Beca, Stephanie Gosselin, Don Husereau, Eon Ting
{"title":"Challenges with integrating early-stage cancer trial endpoints into economic models: review of health technology recommendations for adjuvant or neoadjuvant therapies in Canada.","authors":"Jaclyn M Beca, Stephanie Gosselin, Don Husereau, Eon Ting","doi":"10.1080/14737167.2025.2525224","DOIUrl":"https://doi.org/10.1080/14737167.2025.2525224","url":null,"abstract":"<p><strong>Objectives: </strong>Adjuvant and neoadjuvant therapies for early-stage cancers demonstrate early clinical benefit in delaying disease recurrence. Health technology assessments require economic evaluations modeling lifetime disease trajectories. We examined modeling approaches used in Canadian health technology reviews to understand relevant challenges and identify opportunities for methodological improvements.</p><p><strong>Methods: </strong>From CADTH reimbursement recommendations for adjuvant/neo-adjuvant treatment of solid tumors, we collected outcomes and details of submitted clinical and economic evidence. We classified issues raised during economic review related to data maturity, surrogacy, treatment pathways, and assumptions surrounding extrapolation, duration of benefit and cure.</p><p><strong>Results: </strong>Reviews from Jul/2015-Mar/2023 were identified. Reimbursement was recommended in 14/18 (78%) reviews. All assessments described OS as immature. Most (9/10, 90%) reviews with interim comparative OS data recommended reimbursement, while several (3/8, 38%) without OS data were not recommended. CADTH revisions changed implications for cost-effectiveness ($50,000/QALY threshold) in 10/18 (56%) reviews. Duration of benefit assumptions were inconsistent among both submitters and reviewers. Cure-time was consistently revised to ≥5 years from initiation.</p><p><strong>Conclusions: </strong>Despite surrogate endpoints and immature survival data, positive reimbursement recommendations were common. CADTH re-analyses frequently had modest impacts on cost-effectiveness. Further guidance is needed to capture benefits and assess uncertainties with more consistency for early-stage cancers.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Franciso Álvarez García, Federico Martinón-Torres, Valentí Pineda, Alejandra López-Ibáñez de Aldecoa, Paulina Gálvez, An Ta, Johnna Perdrizet
{"title":"Cost-effectiveness analysis of 20-valent anti-pneumococcal vaccination in the Spanish pediatric population.","authors":"Franciso Álvarez García, Federico Martinón-Torres, Valentí Pineda, Alejandra López-Ibáñez de Aldecoa, Paulina Gálvez, An Ta, Johnna Perdrizet","doi":"10.1080/14737167.2025.2521445","DOIUrl":"10.1080/14737167.2025.2521445","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the cost-effectiveness of implementing different pneumococcal conjugate vaccines (PCV) - 20-valent (PCV20; 3 + 1), 13-valent (PCV13; 2 + 1), and 15-valent (PCV15; 2 + 1) - into the Spanish pediatric national immunization program (NIP) for pneumococcal disease prevention.</p><p><strong>Methods: </strong>A Markov model adopting a Spanish National Healthcare System perspective and annual cycles estimated the health and cost impact of PCV20, PCV13, and PCV15 over 10 years among children. Epidemiological, cost, and utility inputs were derived from published literature and official databases; vaccine efficacy inputs were based on PCV13 clinical effectiveness and 7-valent PCV efficacy and impact studies. Sensitivity analyses evaluated model robustness.</p><p><strong>Results: </strong>PCV20 implementation was predicted to reduce the pneumococcal disease burden, preventing > 1,000,000 pneumococcal disease cases and > 150 deaths, versus both comparators. The adoption of PCV20 was estimated to result in cost-savings of approximately €1 billion versus PCV13 and PCV15. PCV20 demonstrated dominance over both alternatives, with 100% of 1,000 probabilistic sensitivity analysis iterations indicating PCV20 dominance.</p><p><strong>Conclusion: </strong>Incorporating PCV20 3 + 1 into the Spanish pediatric NIP was predicted to be more effective at a lower cost than PCV13 2 + 1 and PCV15 2 + 1 due to its broader serotype coverage and enhanced protection against pneumococcal disease.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding the upper bound of survival for conducting and critically appraising economic evaluations of low-risk cancers.","authors":"Xuanqian Xie, Ishita Joshi, Myra Wang, Chunmei Li","doi":"10.1080/14737167.2025.2522326","DOIUrl":"10.1080/14737167.2025.2522326","url":null,"abstract":"<p><strong>Background: </strong>In most developed countries, overall survival rates for low-risk cancers (e.g. localized prostate and thyroid cancer) are comparable to those of the general population. The general population's survival rate may serve as an upper bound for survival in people with these cancers.</p><p><strong>Methods: </strong>By applying this concept, we demonstrated limitations of using Markov models for low-risk cancers and proposed an alternative modeling approach.</p><p><strong>Results: </strong>Markov disease progression models typically depict a gradual progression from early to advanced cancer stages and an increasing risk of cancer-specific mortality over time. However, data showed that the risk of death from cancer was often the greatest within the first few years following diagnosis. We therefore proposed an alternative modeling approach. This method involves calculating the average quality-adjusted life-years (QALYs) from the integrals of the survival curve, multiplied by the corresponding health utility curve. Alternatively, QALYs may be estimated by averaging survival and utility within each time interval and summing these estimates across intervals. We also applied these concepts to the critical appraisal of published economic evaluations.</p><p><strong>Conclusions: </strong>Understanding the upper bound of survival for low-risk cancers enables health economists to more accurately conduct cost-effectiveness analyses and assess the credibility of published economic evaluations. [Figure: see text].</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruihong Yao, Yao Yao, Xue Teng, Yao Jin, Shangwei Guan, Mei Dong, Tong Liu
{"title":"Cost-effectiveness analysis of adagrasib with or without cetuximab in the treatment of colorectal cancer patients with mutated KRAS G12C.","authors":"Ruihong Yao, Yao Yao, Xue Teng, Yao Jin, Shangwei Guan, Mei Dong, Tong Liu","doi":"10.1080/14737167.2025.2521439","DOIUrl":"10.1080/14737167.2025.2521439","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the cost-effectiveness of adagrasib plus cetuximab in contrast to adagrasib monotherapy in treating colorectal cancer (CRC) patients with mutated KRAS<sup>G12C</sup> from the perspective of healthcare payers in the USA.</p><p><strong>Methods: </strong>An economic evaluation utilizing a 3-state partitioned survival model assessed the cost-effectiveness of adagrasib plus cetuximab versus adagrasib monotherapy. The Kaplan-Meier curves for overall survival (OS) and progression-free survival (PFS) from a clinical trial were digitally extracted, and the Log-Logistic model was employed at the end of the trial to extrapolate the long-term survivals.</p><p><strong>Results: </strong>The estimated cost for adagrasib plus cetuximab treatment was higher than that of adagrasib monotherapy (290,645.434 USD vs 188,837.346 USD). The estimated utility was decreased compared to that of adagrasib monotherapy treatment (1.094 QALYs vs 1.359 QALYs). The ICER was calculated at -384,674.32 USD/QALY, suggesting the adagrasib plus cetuximab therapy did not demonstrate an economic advantage over adagrasib monotherapy for CRC patients with mutated KRAS<sup>G12C</sup>.</p><p><strong>Conclusion: </strong>Adagrasib plus cetuximab was not cost-effective compared to adagrasib monotherapy as a late-line treatment for advanced or metastatic CRC patients with mutated KRAS<sup>G12C</sup> in the USA.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological approaches in the economic evaluation of prognostic and predictive companion diagnostics: a systematic scoping review.","authors":"Tuukka Hakkarainen, Haavisto Ira, Leskelä Riikka-Leena","doi":"10.1080/14737167.2025.2519744","DOIUrl":"10.1080/14737167.2025.2519744","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic scoping review aimed to identify and analyze current methodological approaches used in model-based economic evaluations (EEs) of prognostic and predictive companion diagnostics (pCDx), highlighting methodological gaps and challenges.</p><p><strong>Methods: </strong>Systematic searches were conducted in PubMed and Scopus (January 2009-March 2023). Included studies were model-based EEs, methodological papers, or reviews specifically addressing prognostic or predictive CDx. Data extraction followed the modified CHEERS checklist. Results were synthesized narratively across six methodological domains. No formal risk of bias assessment was done per scoping review conventions.</p><p><strong>Results: </strong>Eighty-eight studies were included, of which 60 were model-based EEs. Most studies utilized Markov cohort models (37%) or decision tree-Markov hybrids (30%). Quality-adjusted life-years (QALYs) were the main outcome (88%). Only 15% of studies derived clinical utility from randomized controlled trials, and fewer than half explicitly modeled diagnostic accuracy. Methodological limitations included inconsistent modeling of real-world test-treatment pathways, insufficient consideration of pretest probabilities, diagnostic thresholds, and inadequate uncertainty analyses.</p><p><strong>Conclusions: </strong>This review identified variability and methodological gaps in economic evaluations of pCDx. Standardizing evaluation methods, integrating real-world evidence, and systematically considering the diagnostic accuracy and uncertainty could improve the robustness of pCDx evaluations. Limitations of this study included overrepresentation of breast cancer studies.</p><p><strong>Registration: </strong>OSF Registries (22 February 2023) DOI 10.17605/OSF.IO/GVFMQ.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}