Expert Review of Pharmacoeconomics & Outcomes Research最新文献_第6页

Comparative landscape of artificial intelligence-assisted systematic literature reviews. 人工智能辅助系统文献综述的比较景观。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-03 DOI: 10.1080/14737167.2026.2695957

Ákos Bernard Józwiak, László Balkányi, Judit Hagymásy

引用次数: 0

Universal school-based mental health promotion in Vietnam: a critical appraisal of a health-economic evaluation. 越南普遍以学校为基础的心理健康促进：对健康经济评价的批判性评价。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-03 DOI: 10.1080/14737167.2026.2691992

Afschin Gandjour

引用次数: 0

From model validation to policy resilience: stress testing healthcare systems with AI and cross-sectorial methodology. 从模型验证到政策弹性：使用人工智能和跨部门方法对医疗保健系统进行压力测试。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-16 DOI: 10.1080/14737167.2026.2690296

Freija van Lent, Lieke Maas

引用次数: 0

Impact of clinical pharmacist-led antimicrobial stewardship on prescribing optimization and economic outcomes in a Chinese county hospital: a retrospective cohort study. 临床药师主导的抗菌药物管理对处方优化和经济效益的影响：一项回顾性队列研究。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-19 DOI: 10.1080/14737167.2026.2691187

Gao-Yi Yi, Hong-Mei Diao, Qiang Zhou, Xiu-Qiong Liu, Yang-Sen He

{"title":"Impact of clinical pharmacist-led antimicrobial stewardship on prescribing optimization and economic outcomes in a Chinese county hospital: a retrospective cohort study.","authors":"Gao-Yi Yi, Hong-Mei Diao, Qiang Zhou, Xiu-Qiong Liu, Yang-Sen He","doi":"10.1080/14737167.2026.2691187","DOIUrl":"10.1080/14737167.2026.2691187","url":null,"abstract":"Background: Clinical pharmacist-led antimicrobial stewardship (AMS) programs have proven effective in tertiary care, yet rigorous pharmacoeconomic evidence from primary care remains limited. This study evaluates the cost-effectiveness of clinical pharmacist consultation in a Chinese county hospital setting.Research design and methods: This retrospective cohort study analyzed 200 hospitalized patients (March to December 2024). The intervention group (n = 100) received pharmacist-led AMS including pre-prescription review and therapeutic monitoring. The control group (n = 100) received standard care without pharmacist consultation. Primary outcomes were antimicrobial therapy costs and duration.Results: Pharmacist-led AMS reduced antimicrobial costs by 52% (mean difference: ¥290.43, 95% CI: -428.29 to -152.56; p < 0.001) and therapy duration by 23% (7.0 vs. 9.1 days; p < 0.001). Cost savings were most pronounced in patients without obvious infection focus (97% reduction). Clinical efficacy was comparable between groups despite higher baseline severity in the intervention group.Conclusions: Clinical pharmacist-led AMS achieves substantial cost containment and prescribing optimization in county-level hospitals without compromising clinical safety. These findings support expanding clinical pharmacy services as a cost-effective strategy for antimicrobial resistance containment in resource-limited settings.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"823-831"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263770","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

Economic burden of breast cancer in Cyprus from a societal perspective. 从社会角度看塞浦路斯乳腺癌的经济负担。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-23 DOI: 10.1080/14737167.2026.2691182

Yiola Marcou, Konstantinos Ferentinos, Evros Kitiris, Loukia Samata, Nikolas Koullouros

{"title":"Economic burden of breast cancer in Cyprus from a societal perspective.","authors":"Yiola Marcou, Konstantinos Ferentinos, Evros Kitiris, Loukia Samata, Nikolas Koullouros","doi":"10.1080/14737167.2026.2691182","DOIUrl":"10.1080/14737167.2026.2691182","url":null,"abstract":"Background: Breast cancer (BC) is the most common cancer among women globally, creating a substantial economic burden on healthcare systems, patients, and society. This study aimed to estimate the annual cost of managing early-stage (eBC) and metastatic breast cancer (mBC) in Cyprus.Research design and methods: A mixed-methods approach was used: (a) a prevalence-based cost-of-illness model estimated BC costs; (b) semi-structured interviews with physicians and patients validated epidemiological data, captured clinical practice, and assessed indirect costs such as productivity loss. Data sources included national statistics, clinical guidelines, published literature, and patient surveys.Results: The societal economic burden of BC in Cyprus was €180.9 million in 2024. Disease management accounted for 68.8% of costs, including genetic testing, hospitalization, surgery, radiation, and symptom management. Drug costs represented 11.3%, productivity loss 10.6%, and healthcare resource use (follow-up tests and imaging) 9.3%. Per-patient costs for mBC were nearly double those for eBC.Conclusion: BC imposes a significant economic burden on Cyprus, with mBC substantially increasing resource use and costs. These findings support early detection initiatives, value-driven mBC treatments, and provide a baseline for evaluating prevention and treatment strategies.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"777-782"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301548","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

REFLECTIVE-TIAB: cost-effective prompt optimization for large language model-based title and abstract screening in literature reviews. REFLECTIVE-TIAB：在文献综述中基于大语言模型的标题和摘要筛选的成本效益提示优化。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-22 DOI: 10.1080/14737167.2026.2691995

Ákos Józwiak, Attila Imre, Judit Hagymásy, Judit Tittmann, Ágnes Nagy, Sándor Kovács, Przemyslaw Kardas, Job Fm van Boven, Irene Mommers, Tamás Ágh

{"title":"REFLECTIVE-TIAB: cost-effective prompt optimization for large language model-based title and abstract screening in literature reviews.","authors":"Ákos Józwiak, Attila Imre, Judit Hagymásy, Judit Tittmann, Ágnes Nagy, Sándor Kovács, Przemyslaw Kardas, Job Fm van Boven, Irene Mommers, Tamás Ágh","doi":"10.1080/14737167.2026.2691995","DOIUrl":"10.1080/14737167.2026.2691995","url":null,"abstract":"Background: Title and abstract screening is a labor-intensive stage of systematic reviews. Large language models (LLMs) can automate this process, but performance depends heavily on prompt design and model selection, which is typically manual and time-consuming. Our objective was to evaluate whether automated, reflection-driven prompt optimization improves LLM performance during title and abstract screening.Research design and methods: REFLECTIVE-TIAB uses the GEPA reflective prompt optimizer to improve prompts under an asymmetric loss penalizing false negatives. Nine LLMs screened 8,520 de-duplicated records from a COPD exacerbation predictor search. A 100-abstract gold standard was constructed from inter-model disagreements and was expert-labeled. The prompt was optimized on Llama 3.3 70B via DSPy/GEPA and evaluated across all nine models.Results: Optimization improved recall across all LLMs (+3.7% to +37.1%). Gemini 3 Flash Preview achieved the highest performance (91% accuracy, F1 81.6%) while costing 25-fold less per abstract than GPT-5.2, which ranked among the lowest-performing models. A prompt optimized on a single open-source model is generalized to all nine without retraining. Total optimization cost was $6.36.Conclusions: REFLECTIVE-TIAB provides automated, model-transferable prompt optimization for literature screening at negligible cost. Model price did not predict screening performance. The framework could substantially reduce screening workload while preserving comprehensiveness.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"747-755"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270727","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

Pharmacoeconomics of high-cost therapies: real world challenges. 高成本疗法的药物经济学：现实世界的挑战。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-22 DOI: 10.1080/14737167.2026.2691186

Elvira Meni Maria Gkrinia, Andrej Belančić, Ivana Stević, Dinko Vitezić, Slobodan Janković

{"title":"Pharmacoeconomics of high-cost therapies: real world challenges.","authors":"Elvira Meni Maria Gkrinia, Andrej Belančić, Ivana Stević, Dinko Vitezić, Slobodan Janković","doi":"10.1080/14737167.2026.2691186","DOIUrl":"10.1080/14737167.2026.2691186","url":null,"abstract":"Introduction: The emergence of high-cost therapies, particularly in oncology, rare diseases, and advanced therapy medicinal products, has increased the need for robust pharmacoeconomic evaluations to support healthcare decision-making. These innovative interventions often promise substantial clinical benefits but also pose challenges due to limited long-term data, high upfront costs, and uncertain cost-effectiveness.Areas covered: This narrative review critically examines key pharmacoeconomic frameworks, e.g. cost-effectiveness analysis and cost-utility analysis, and highlights their limitations in assessing such novel therapies. The role of real-world evidence, advanced modeling techniques, and patient-reported outcomes is explored, alongside the ethical and policy considerations that arise in pricing, access, and reimbursement. Recent literature and case studies involving gene and cell therapies are reviewed, illustrating the complexity of determining value under uncertainty.Expert opinion: The paper advocates for a more flexible, transparent, and patient-centered approach to health technology assessment, integrating societal values and dynamic reassessment mechanisms. Such strategies are essential for achieving sustainable access to high-value therapies while maintaining health system efficiency and equity.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"723-738"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276713","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

Budget impact analysis of capivasertib as a second-line therapy for advanced breast cancer in the United States. capivasertib作为美国晚期乳腺癌二线治疗的预算影响分析

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-22 DOI: 10.1080/14737167.2026.2691183

Trang Nguyen, Shweta Mital

{"title":"Budget impact analysis of capivasertib as a second-line therapy for advanced breast cancer in the United States.","authors":"Trang Nguyen, Shweta Mital","doi":"10.1080/14737167.2026.2691183","DOIUrl":"10.1080/14737167.2026.2691183","url":null,"abstract":"Background: Capivasertib was the first AKT inhibitor approved by the US FDA as a second-line treatment for PIK3CA/AKT1/PTEN-altered, HR+/HER2- advanced breast cancer. However, capivasertib is costly. This study provides the first evidence on the financial impact for third-party payers to reimburse capivasertib.Research design and methods: We estimated the change in total costs from adding capivasertib to the treatment mix over 3 years. The size of the target population was estimated using data on incidence and prevalence for breast cancer, PIK3CA/AKT1/PTEN alterations, and risk of failure to first-line treatment. Costs associated with drug administration, disease management, and adverse events were captured. Costs were measured in 2023 US dollars.Results: In a 1-million-member population, 113, 114, and 115 individuals would be eligible for capivasertib treatment in years 1, 2, and 3, respectively. Adding capivasertib to the second-line setting would add $31,939,838 in net costs over 3 years. Specifically, drug costs would increase by $34,251,781 but would be offset by savings of $323,632 in adverse event costs and of $1,988,311 in follow-up costs. These net costs amount to $0.88 per-member-per-month.Conclusion: While introduction of capivasertib could reduce adverse event and follow-up costs, it may result in an overall increase in payers' budget.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"803-811"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263773","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

TENS in chronic pain management: a 11-year nationwide analysis using the French National Health Data System. 慢性疼痛管理中的TENS：使用法国国家健康数据系统的11年全国分析。

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-06-25 DOI: 10.1080/14737167.2026.2691988

Vincent Arcani, Anne Donnet, Sylvain Redon

{"title":"TENS in chronic pain management: a 11-year nationwide analysis using the French National Health Data System.","authors":"Vincent Arcani, Anne Donnet, Sylvain Redon","doi":"10.1080/14737167.2026.2691988","DOIUrl":"10.1080/14737167.2026.2691988","url":null,"abstract":"Background: Chronic pain affects one in five people globally, frequently leading to complex polypharmacy. Transcutaneous electrical nerve stimulation (TENS) offers a non-pharmacological alternative to mitigate drug-related problems (DRPs) and reduce medication burden. This study evaluates a decade of real-world TENS utilization trends in France.Research design and methods: We conducted a nationwide retrospective study (2014-2024) using the French National Health Data System (Open LPP). Metrics included rental and purchase volumes, associated expenditures, and the purchase-to-rental (P/R) ratio, utilized as a behavioral proxy for long-term therapeutic persistence.Results: TENS initiations (rentals) increased 1.5-fold (91,709 to 158,947), while purchases grew 2.4-fold (17,362 to 41,784). Significant feminization was observed across all cohorts (p < 0.05). The overall P/R ratio was 22.7%. Women showed higher persistence than men (23.3% vs. 21.3%, p < 0.001). The highest persistence occurred in the 40-59 age group (25.4%), whereas the lowest was among patients under 19 (15.2%).Conclusion: TENS utilization in France shows a strong upward trend. While long-term adoption has improved, persistence remains limited, particularly in younger populations. The P/R ratio serves as a critical marker of clinical adoption and access dynamics.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"769-775"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301546","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

Health impact and cost-effectiveness analysis of introducing a national immunization program with 21-valent versus 20-valent pneumococcal conjugate vaccines for adults ≥65 years of age in Denmark. 丹麦≥65岁成人接种21价和20价肺炎球菌结合疫苗的国家免疫规划对健康的影响和成本效益分析

IF 2.2 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2026-07-01 Epub Date: 2026-07-10 DOI: 10.1080/14737167.2026.2691191

Oluwaseun Sharomi, Rachel J Oidtman, John C Lang, Kevin M Bakker, Tufail Malik, Giulio Meleleo, Line Roesgaard Kantsø, Emilie Theisen Honore, Maja Holm Vinfeldt, Simone Ruth Flindhardt, Eleana Tsoumani

{"title":"Health impact and cost-effectiveness analysis of introducing a national immunization program with 21-valent versus 20-valent pneumococcal conjugate vaccines for adults ≥65 years of age in Denmark.","authors":"Oluwaseun Sharomi, Rachel J Oidtman, John C Lang, Kevin M Bakker, Tufail Malik, Giulio Meleleo, Line Roesgaard Kantsø, Emilie Theisen Honore, Maja Holm Vinfeldt, Simone Ruth Flindhardt, Eleana Tsoumani","doi":"10.1080/14737167.2026.2691191","DOIUrl":"10.1080/14737167.2026.2691191","url":null,"abstract":"Background: Streptococcus pneumoniae is a vaccine-preventable bacterium responsible for invasive pneumococcal disease (IPD). Adults ≥65 are most susceptible to IPD, and pneumococcal vaccines may reduce morbidity and mortality.Research design and methods: A deterministic dynamic transmission model evaluated the health impact and cost-effectiveness of a 21-valent pneumococcal conjugate vaccine (PCV; PCV21) national immunization program (NIP) compared with a 20-valent PCV (PCV20) NIP for adults ≥65 in Denmark from 2020 through 2120. Cumulative pneumococcal disease cases and deaths averted, quality-adjusted life years (QALYs), and societal healthcare costs are reported. An incremental cost-effectiveness ratio (ICER) was calculated comparing a PCV21 NIP to a PCV20 NIP.Results: Compared to a PCV20 NIP, a PCV21 NIP would avert an additional 29,309 non-bacteremic pneumococcal pneumonia (NBPP) cases, 9,625 hospitalizations (IPD and inpatient NBPP), 627 IPD cases, and 1,312 deaths over 100 years for the ≥65 age group. Further, 835.2 million Danish kroner of societal cost savings and 759 QALYs would be gained with a PCV21 NIP. The ICER value indicates that a PCV21 NIP would be a cost-saving dominant strategy for adults ≥65.Conclusions: Implementing a PCV21 NIP for adults ≥65 would be a cost-effective strategy to help reduce the burden of pneumococcal disease-related morbidity and mortality in Denmark.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"757-767"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410681","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