Expert Review of Pharmacoeconomics & Outcomes Research最新文献_第4页

Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine as second-line treatment for HER2-positive metastatic breast cancer. 曲妥珠单抗德鲁西替康与曲妥珠单抗恩坦辛作为her2阳性转移性乳腺癌二线治疗的成本-效用分析

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-17 DOI: 10.1080/14737167.2026.2718415

Gu Shilong, Guo Hao

{"title":"Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine as second-line treatment for HER2-positive metastatic breast cancer.","authors":"Gu Shilong, Guo Hao","doi":"10.1080/14737167.2026.2718415","DOIUrl":"https://doi.org/10.1080/14737167.2026.2718415","url":null,"abstract":"Background: This study evaluated the cost-effectiveness of trastuzumab deruxtecan (T-DXd) versus trastuzumab emtansine (T-DM1) as second-line treatment for HER2-positive metastatic breast cancer from the perspective of the Chinese healthcare system.Research design and methods: A partitioned survival model was developed based on the Asian subgroup of the DESTINY-Breast03 trial. The model adopted a 3-week cycle length and a lifetime horizon. Quality-adjusted life years (QALYs) were used as the primary outcome measure, and the incremental cost-effectiveness ratio (ICER) was calculated. Deterministic and probabilistic sensitivity analyses were performed to assess model robustness.Results: At a willingness-to-pay (WTP) threshold of RMB 298,995/QALY (three times China's per capita GDP in 2025), T-DXd provided an additional gain of 1.45 QALYs at an incremental cost of 499805 RMB, resulting in an ICER of RMB 343989.08/QALY (95% PI: 320688.31- 352510.34). Deterministic sensitivity analysis identified PFS utility value and T-DXd-related costs as key drivers of the ICER. The probabilistic sensitivity analysis showed that at a WTP threshold of approximately RMB 340,000/QALY, the probability of T-DXd being cost-effective was 50%.Conclusion: T-DXd does not demonstrate a cost-effectiveness advantage over T-DM1 at the current WTP threshold in China. However, given the ICER's proximity of the threshold, price reductions or regional economic variation may improve its cost-effectiveness.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758490","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}

引用次数: 0

From general-purpose models to purpose-built artificial intelligence systems for health economic modeling. 从通用模型到用于卫生经济建模的专用人工智能系统。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-17 DOI: 10.1080/14737167.2026.2717289

Attila Imre, Bertalan Nemeth, Ákos Józwiak, Balázs Nagy, László Balkányi, Ahmad Fasseeh, Zoltán Kaló, Antal Zemplényi

{"title":"From general-purpose models to purpose-built artificial intelligence systems for health economic modeling.","authors":"Attila Imre, Bertalan Nemeth, Ákos Józwiak, Balázs Nagy, László Balkányi, Ahmad Fasseeh, Zoltán Kaló, Antal Zemplényi","doi":"10.1080/14737167.2026.2717289","DOIUrl":"https://doi.org/10.1080/14737167.2026.2717289","url":null,"abstract":"Introduction: Health economic models (HEMs) provide a solid foundation for reimbursement policy decisions that shape patient access to new treatments and the allocation of scarce healthcare resources. Model development is labor-intensive and time-consuming, often requiring months of expert work. Recent advances in large language models (LLMs) prompted interest in whether artificial intelligence can support or partially automate this process, but the evidence base remains scattered and has not been mapped against the modeling workflow.Areas covered: This review examines current applications of LLMs to health economic modeling. Five proof-of-concept studies are included and mapped to an eight-stage workflow adapted from the ISPOR-SMDM Modeling Good Research Practices framework and discussed in terms of reproducibility, validation, adaptability, and technology readiness. Published work addressed model parameterization, model implementation, reporting and quality assessment, and local adaptation, while research question design, model conceptualization, uncertainty analysis, and model validation remained unaddressed.Expert commentary: The evidence supports cautious optimism. Near-term gains are augmenting human modelers on decomposed, verifiable sub-tasks rather than pursuing autonomous end-to-end modeling, which remains distant given current reliability levels and the iterative, collaborative nature of model development.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758915","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}

引用次数: 0

Cost-effectiveness analysis comparison of etelcalcetide, paricalcitol, and cinacalcet for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease. 依替卡尔肽、特泊卡尔醇和cinacalcet治疗慢性肾病患者继发性甲状旁腺功能亢进症的成本-效果分析比较

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-17 DOI: 10.1080/14737167.2026.2717287

Miao Liang, Sisi Liu, Xiaoxu Zhang, Lu Bai, Yaobin Fu

{"title":"Cost-effectiveness analysis comparison of etelcalcetide, paricalcitol, and cinacalcet for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease.","authors":"Miao Liang, Sisi Liu, Xiaoxu Zhang, Lu Bai, Yaobin Fu","doi":"10.1080/14737167.2026.2717287","DOIUrl":"https://doi.org/10.1080/14737167.2026.2717287","url":null,"abstract":"Background: Secondary hyperparathyroidism is a common complication in patients with chronic kidney disease (CKD), which can lead to cardiovascular diseases and the risk of fractures. Calcimimetics and active vitamin D analogs are the most frequently prescribed therapeutic drugs for treating this illness.Research design and methods: A decision-tree model was constructed from the perspective of the Chinese healthcare system, with a 1-year time horizon. The primary outcome was the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed.Results: Total annual costs were 20,771 yuan for cinacalcet, 34,350 yuan for paricalcitol, and 52,388 yuan for etelcalcetide. The ICER of etelcalcetide versus cinacalcet was 191,156.12 yuan per additional effective case, and 113,020.05 yuan versus paricalcitol. Cost-effectiveness acceptability curves indicated that cinacalcet was the optimal strategy when willingness-to-pay (WTP) was below 95,000 yuan per additional effective case; etelcalcetide became more cost-effective than paricalcitol when WTP exceeded 110,000 yuan per additional effective case, and became the optimal strategy among the three when WTP exceeded 190,000 yuan per additional effective case.Conclusion: The optimal pharmacological strategy for SHPT depends on the WTP threshold. Cinacalcet is preferred at lower WTP levels, while etelcalcetide offers superior cost-effectiveness at higher WTP.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758959","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}

引用次数: 0

The economic impact of opportunistic PSA screening: a real-world cost analysis from China amid evolving policy landscape. 机会性PSA筛查的经济影响：在不断变化的政策背景下，来自中国的现实世界成本分析。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-17 DOI: 10.1080/14737167.2026.2717281

Zhehan Lin, Wei Li, Pengcheng Hu, Chunlei Liu, Yizhen Wang, Shen Wang, Xiaopeng Lan

{"title":"The economic impact of opportunistic PSA screening: a real-world cost analysis from China amid evolving policy landscape.","authors":"Zhehan Lin, Wei Li, Pengcheng Hu, Chunlei Liu, Yizhen Wang, Shen Wang, Xiaopeng Lan","doi":"10.1080/14737167.2026.2717281","DOIUrl":"https://doi.org/10.1080/14737167.2026.2717281","url":null,"abstract":"Background: The clinical value of prostate-specific antigen (PSA) screening remains debated, and health economic evidence from real-world Chinese screening programs is lacking. This study aimed to determine whether PSA screening reduces prostate cancer treatment costs in China.Research design and methods: Using propensity score matching within a policy-driven community screening initiative in China, 61 screening-detected prostate cancer patients were matched with 61 symptom-detected controls. All patients were diagnosed and treated at the same central hospital. Total direct medical costs (including examination, hospitalization, surgery, chemotherapy, and radiotherapy) were compared between the two groups.Results: Screening-detected patients incurred significantly lower mean treatment costs than controls (107,609 CNY vs. 193,746 CNY; p = 0.0163), representing a 44% reduction.Conclusions: This first direct economic evidence from China suggests that PSA screening is associated with substantially reduced treatment costs, likely attributable to earlier diagnosis and less intensive treatment. These findings support the economic case for considering organized PSA screening as a preventive health measure in China. Further multicenter studies with longer follow-up are warranted to confirm these results.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764775","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}

引用次数: 0

Cost-effectiveness analysis of anlotinib plus penpulimab as first-line treatment for unresectable hepatocellular carcinoma. 安洛替尼联合彭普利单抗一线治疗不可切除肝癌的成本-效果分析。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-17 DOI: 10.1080/14737167.2026.2719622

Yu-Fan Huang, Jia-Jing Qin, Xiao-Qin Wu, Hui Liu, Susu Luo, Zhe-Qi Xu

{"title":"Cost-effectiveness analysis of anlotinib plus penpulimab as first-line treatment for unresectable hepatocellular carcinoma.","authors":"Yu-Fan Huang, Jia-Jing Qin, Xiao-Qin Wu, Hui Liu, Susu Luo, Zhe-Qi Xu","doi":"10.1080/14737167.2026.2719622","DOIUrl":"10.1080/14737167.2026.2719622","url":null,"abstract":"Background: The APOLLO trial showed anlotinib combined with penpulimab (AN-PE) was effective as first-line therapy for unresectable hepatocellular carcinoma (uHCC) versus sorafenib (SOR). Given high drug costs, this study evaluated the cost-effectiveness of AN-PE from the Chinese healthcare system perspective.Method: A partitioned survival model was built with TreeAge2022. Clinical data were derived from the APOLLO trial, drug costs from national procurement prices, and other parameters from literature. Outcomes included costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Model robustness was examined via one-way and probabilistic sensitivity analyses.Results: AN-PE gained 1.38 QALYs at $51,584.30, while SOR gained 1.16 QALYs at $12,414.88. The ICER was $174,830.60/QALY. Key drivers were progression-free survival(PFS) utility, penpulimab cost, progressive disease(PD) utility and anlotinib cost. At a willingness to pay (WTP) threshold of $40,365/QALY, AN-PE had 0% cost-effectiveness probability.Conclusion: AN-PE is unlikely to be cost-effective as first-line uHCC treatment in China.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759632","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}

引用次数: 0

First-line sugemalimab plus chemotherapy for metastatic non-small-cell lung cancer: an updated cost-effectiveness analysis based on 4-year survival data. 转移性非小细胞肺癌的一线sugemalimab +化疗：基于4年生存数据的最新成本-效果分析

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-16 DOI: 10.1080/14737167.2026.2717284

Zhengxiong Li, Jiaming Zhu, Kai Ma

{"title":"First-line sugemalimab plus chemotherapy for metastatic non-small-cell lung cancer: an updated cost-effectiveness analysis based on 4-year survival data.","authors":"Zhengxiong Li, Jiaming Zhu, Kai Ma","doi":"10.1080/14737167.2026.2717284","DOIUrl":"https://doi.org/10.1080/14737167.2026.2717284","url":null,"abstract":"Objective: Incorporating the 4‑year long‑term survival outcomes from the GEMSTONE‑302 trial, this study aimed to evaluate the cost‑effectiveness of sugemalimab plus chemotherapy versus chemotherapy alone as first‑line treatment for metastatic non‑small‑cell lung cancer (NSCLC) from the Chinese healthcare system perspective.Methods: A partitioned survival model was developed to simulate cost‑effectiveness outcomes over a 10‑year time horizon. Clinical data were sourced from the GEMSTONE‑302 trial, while costs and health utility values were derived from publicly available sources. The incremental cost‑effectiveness ratio (ICER) was estimated as the primary output. Sensitivity, scenario, and subgroup analyses were performed to assess the impact of uncertainty and heterogeneity on the model results.Results: The base-case ICER for sugemalimab plus chemotherapy versus chemotherapy alone was $84,769.34/QALY, exceeding the willingness-to-pay (WTP) threshold of two times China's 2024 per capita GDP ($26,889/QALY). Sensitivity and subgroup analyses confirmed the robustness of the base‑case results. Scenario analyses revealed that a price reduction or a patient assistance program (PAP) could bring the ICER below the WTP threshold.Conclusions: Sugemalimab plus chemotherapy may not be a cost-effective option as first-line treatment for metastatic NSCLC compared with chemotherapy, despite its clinical benefits. Implementing a PAP or reducing the price of sugemalimab could improve its cost-effectiveness.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759227","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}

引用次数: 0

Review and guidance for presenting cost-utility analysis with small QALY gains. 审核并指导以小质量收益呈现成本效用分析。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-16 DOI: 10.1080/14737167.2026.2715980

Xuanqian Xie, Olga Gajic-Veljanoski, Myra Wang, Hong Anh Tu, Chunmei Li

{"title":"Review and guidance for presenting cost-utility analysis with small QALY gains.","authors":"Xuanqian Xie, Olga Gajic-Veljanoski, Myra Wang, Hong Anh Tu, Chunmei Li","doi":"10.1080/14737167.2026.2715980","DOIUrl":"10.1080/14737167.2026.2715980","url":null,"abstract":"Background: The quality-adjusted life-year (QALY) is a preferred measure of effectiveness in health economic evaluations. Challenges arise when QALY gains are small, such as an unstable estimate of the incremental cost-effectiveness ratio due to a small, uncertain denominator.Methods: Health technology assessments (HTAs) published from 2016 to 2026 by a Canadian provincial HTA program (Ontario) were reviewed to examine the characteristics of cost-utility analyses (CUAs) that reported QALY gains ≤ 0.02 in their main analyses. Based on this evidence, preliminary guidance for presenting and interpreting CUAs with small QALY gains was developed.Results: Twenty-six CUAs from 15 HTAs were included. Six HTAs evaluated testing technologies and 9 evaluated non-pharmaceutical treatments. When interpreting CUA findings, we recommend the following: 1) present both the direction and magnitude of QALY changes, 2) assess consistency between QALY gains and clinical conclusions, 3) justify reasons for small QALY gains, 4) address the impact of uncertainty in technology costs, 5) use a larger number of iterations in probabilistic analysis to minimize randomization error, and 6) estimate QALY gains at the population level for screening technologies.Conclusions: Our preliminary guidance elucidates CUA results with small QALY gains and promotes greater standardization in health economic evaluation reporting.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683936","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}

引用次数: 0

Cost-effectiveness analysis of radiofrequency therapy versus surgery for the treatment of women with urinary incontinence: a long-term evaluation in Iran. 射频治疗与手术治疗女性尿失禁的成本-效果分析：伊朗的长期评估

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-16 DOI: 10.1080/14737167.2026.2717286

Leila Moazzemi Goudarzi, Soroush Dehghan, Lida Shams, Ali Darvishi, Rajabali Daroudi, Sudabeh DarvishBon

{"title":"Cost-effectiveness analysis of radiofrequency therapy versus surgery for the treatment of women with urinary incontinence: a long-term evaluation in Iran.","authors":"Leila Moazzemi Goudarzi, Soroush Dehghan, Lida Shams, Ali Darvishi, Rajabali Daroudi, Sudabeh DarvishBon","doi":"10.1080/14737167.2026.2717286","DOIUrl":"10.1080/14737167.2026.2717286","url":null,"abstract":"Background: Urinary incontinence (UI) imposes significant economic burdens on women. Evidence comparing the long-term cost-effectiveness of standard surgery versus minimally invasive radiofrequency (RF) therapy is scarce, particularly in resource-limited settings. We evaluated the cost-utility of surgery versus RF for UI from the Iranian health system perspective.Research design and methods: A lifetime Markov model compared costs (in purchasing power parity, PPP) and quality-adjusted life years (QALYs) of surgery and RF. We used local cost data and international clinical parameters. The incremental cost-effectiveness ratio (ICER) was evaluated against an $18,234 willingness-to-pay (WTP) threshold. Deterministic and probabilistic sensitivity analyses (PSA) assessed decision uncertainty.Results: In the base-case analysis, surgery yielded greater health benefits (10.93 QALYs) at a higher cost ($14,666.98 PPP) compared to RF (10.81 QALYs; $13,935.35 PPP). The ICER was $6,118.17 per QALY. However, PSA revealed considerable uncertainty: surgery had a 53% probability of being cost-effective compared to 47% for RF. Below a $13,000 WTP threshold, RF demonstrated a higher probability of being cost-effective.Conclusions: While surgery is the cost-effective strategy for long-term UI management in Iran at the current threshold, decision uncertainty is substantial. A flexible policy encouraging shared decision-making is recommended, as RF is preferable at lower WTP thresholds.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705942","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}

引用次数: 0

Determinants of out-of-pocket health expenditure: cross-country evidence across World Bank income groups. 自费医疗支出的决定因素：世界银行各收入群体的跨国证据。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-14 DOI: 10.1080/14737167.2026.2717294

Sameer Sofi, Effat Yasmin

{"title":"Determinants of out-of-pocket health expenditure: cross-country evidence across World Bank income groups.","authors":"Sameer Sofi, Effat Yasmin","doi":"10.1080/14737167.2026.2717294","DOIUrl":"10.1080/14737167.2026.2717294","url":null,"abstract":"Background: Out-of-pocket (OOP) health expenditure remains a major barrier to achieving Universal Health Coverage, yet limited evidence exists on whether its determinants differ systematically across World Bank income groups. This study examines the macroeconomic and health financing determinants of OOP health expenditure across 123 countries during 2000-2021.Research design and methods: Panel data from the World Bank and the World Health Organization were analyzed using the Instrumental Variables Two-Stage Least Squares (IV-2SLS) estimator to address endogeneity and unobserved heterogeneity. A dummy interaction approach captured income-specific effects across low-, middle-, and high-income economies.Results: The findings reveal substantial heterogeneity. Economic growth reduces OOP expenditure in low-income countries but increases it in middle- and high-income economies, reflecting a shift from essential healthcare utilization to discretionary healthcare consumption. Government health expenditure consistently lowers OOP expenditure, with stronger effects in higher-income countries, whereas private health expenditure shows mixed effects. Higher HIV prevalence significantly increases OOP expenditure, particularly in low-income countries.Conclusions: The determinants of OOP health expenditure differ markedly across income groups, indicating that uniform health financing policies may be ineffective. Income-sensitive strategies that strengthen public financing, promote inclusive economic growth, and improve financial protection are essential for reducing OOP expenditure and advancing UHC.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720179","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}

引用次数: 0

Cost-effectiveness analysis of liposomal irinotecan in combination with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) for the first-line treatment of adult patients with metastatic adenocarcinoma of the pancreas in Greece. 伊立替康脂体联合奥沙利铂、5-氟尿嘧啶和亚叶酸钙（NALIRIFOX）一线治疗成年胰腺转移性腺癌的成本-效果分析

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-08-14 DOI: 10.1080/14737167.2026.2718413

George Gourzoulidis, Vassiliki Chotzagiannoglou, Andriani Angelopoulou, Eleana Solakidou, Charalampos Tzanetakos

{"title":"Cost-effectiveness analysis of liposomal irinotecan in combination with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) for the first-line treatment of adult patients with metastatic adenocarcinoma of the pancreas in Greece.","authors":"George Gourzoulidis, Vassiliki Chotzagiannoglou, Andriani Angelopoulou, Eleana Solakidou, Charalampos Tzanetakos","doi":"10.1080/14737167.2026.2718413","DOIUrl":"10.1080/14737167.2026.2718413","url":null,"abstract":"Objective: To evaluate the cost-effectiveness of liposomal Irinotecan (Onivyde) in combination with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) compared to gemcitabine plus nab-paclitaxel (GemNabPac), for the first-line treatment (FLT) of adult patients with metastatic adenocarcinoma of the pancreas (mPDAC) in Greece.Methods: A partitioned survival model was adapted from a Greek payer perspective over a lifetime horizon. GemNabPac was selected as the comparator, representing the current standard of care in Greece. Clinical efficacy, safety, and utilities were derived from the NAPOLI-3 trial and published literature. Direct medical costs reflecting the year 2026 were included in the analysis. Model outcomes included quality-adjusted life years (QALYs), life years (LYs), total costs, and incremental cost-effectiveness ratios (ICERs).Results: The analysis showed that NALIRIFOX was associated with incremental gains of 0.14 QALYs and 0.16 LYs compared with GemNabPac, at an additional cost of €8,571. The resulting ICERs were €62,810 per QALY gained and €54,326 per LY gained.Conclusion: The present study indicates that NALIRIFOX provides clinically meaningful benefits and may represent a cost-effective option for patients with mPDAC in Greece, a population with very limited FLT options, under the assumptions and threshold used.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711903","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}

引用次数: 0