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

How unprofessional behaviours between healthcare staff threaten patient care and safety.

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-30 DOI: 10.1080/14737167.2025.2460518

Justin Aunger, Jill Maben, Johanna I Westbrook

{"title":"How unprofessional behaviours between healthcare staff threaten patient care and safety.","authors":"Justin Aunger, Jill Maben, Johanna I Westbrook","doi":"10.1080/14737167.2025.2460518","DOIUrl":"10.1080/14737167.2025.2460518","url":null,"abstract":"Introduction: Unprofessional behaviors (UB) such as bullying and incivility among healthcare staff are a significant and pervasive issue, impacting staff wellbeing, and patient safety and experiences of care. Despite its prevalence, misconceptions persist regarding the impact of UB and the mechanisms through which it affects patients.Areas covered: We draw upon evidence including outcomes from an extensive realist review and empirical research, to demonstrate the impacts of UB on patient safety and experience, particularly focusing on how even mild forms of incivility can compromise care quality. Recent research demonstrates a correlation between UB among healthcare professionals and reduced performance, increased medical errors, compromised safety culture, and inequities in patient outcomes. Additionally, we highlight the disproportionate impact of UB on minoritised staff and its resulting effects on patient care, which has the potential to perpetuate healthcare inequities via reducing staff diversity.Expert opinion: Emerging evidence indicates that subtle UB such as incivility and undermining may be more damaging to patient outcomes than previously acknowledged. Addressing UB requires effective, tailored interventions, especially considering the disproportionate impact on diverse healthcare teams. Urgently combating UB is required to not only enhance patient safety but also to improve equity in care in healthcare systems worldwide.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058514","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 trastuzumab emtansine for second-line treatment of HER2+ advanced breast cancer in Singapore. 曲妥珠单抗emtansine在新加坡用于HER2+晚期乳腺癌二线治疗的成本-效果分析

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-22 DOI: 10.1080/14737167.2025.2456065

Wei Han Melvin Wong, Raymond Ng, Mohamed Ismail Abdul Aziz, Benjamin Shao-Kiat Ong, Kwong Ng

{"title":"Cost-effectiveness analysis of trastuzumab emtansine for second-line treatment of HER2+ advanced breast cancer in Singapore.","authors":"Wei Han Melvin Wong, Raymond Ng, Mohamed Ismail Abdul Aziz, Benjamin Shao-Kiat Ong, Kwong Ng","doi":"10.1080/14737167.2025.2456065","DOIUrl":"https://doi.org/10.1080/14737167.2025.2456065","url":null,"abstract":"Objective: To evaluate the cost-effectiveness of trastuzumab emtansine (T-DM1) compared to both lapatinib plus capecitabine (lapcap) and trastuzumab plus capecitabine (trascap) for treating human epidermal growth factor 2-positive advanced breast cancer patients, who have received prior treatment with trastuzumab and a taxane, in Singapore.Research design and methods: A three-state partitioned survival model was used to evaluate the cost-effectiveness from the local healthcare system perspective. Key effectiveness data, including progression-free survival and overall survival from the pivotal EMILIA trial, were used alongside local clinician inputs. Health state utilities (in quality-adjusted life years [QALYs]) were obtained from the literature and direct medical costs obtained from the public health institutions in Singapore. Scenario, one-way, and probabilistic sensitivity analyses were conducted to explore the impact of uncertainties on cost-effectiveness.Results: The base-case incremental cost-effectiveness ratios (ICERs) for T-DM1, compared to lapcap and trascap, were S$472,600 and S$495,200 per QALY gained, respectively. Sensitivity and scenario analyses showed high ICERs, with a 50% price reduction for T-DM1 resulting in an ICER above S$200,000.Conclusion: At current prices, T-DM1 is unlikely to be a cost-effective use of Singapore's limited healthcare budget. These findings can help inform policymakers, alongside other considerations, on funding decisions.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002914","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

Public value judgments about the criteria for reimbursement of medicines in South Korea. 韩国公众对药品报销标准的价值判断。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-08-06 DOI: 10.1080/14737167.2024.2388815

Kyung-Bok Son

{"title":"Public value judgments about the criteria for reimbursement of medicines in South Korea.","authors":"Kyung-Bok Son","doi":"10.1080/14737167.2024.2388815","DOIUrl":"10.1080/14737167.2024.2388815","url":null,"abstract":"Objectives: This study quantified the public value (PV) of the criteria and sub-criteria in the current drug reimbursement systems in South Korea and examined sociodemographic factors that associated with PV.Methods: The Analytic Hierarchy Process (AHP) was used to quantify the PVs of criteria and sub-criteria. We developed a questionnaire to generate pairwise comparison matrices among criteria and sub-criteria. From 27 March to 1 April 2023, we recruited 1,000 study participants using a quota sampling method stratified by age, sex, and region based on Korean census data.Results: The PVs for the criteria were highest for clinical usefulness (28.5%), followed by cost-effectiveness (27.1%), budget impact (24.3%), and reimbursement in other countries (20.1%). The sociodemographic characteristics of the participants had a significant impact on the PVs of the criteria. Willingness to pay additional premiums for national health insurance was negatively associated with PV for clinical usefulness and cost-effectiveness and positively associated with PV for reimbursement in other countries.Conclusions: The public prioritized clinical usefulness and cost-effectiveness as the main criteria. However, the PVs of the criteria were divergent and associated with sociodemographic factors. Divergent public interests require an evidence-informed deliberative process for reimbursement decisions.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"53-61"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874564","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 utility and impact of digital endpoints for improving breast cancer outcomes. 数字终点对改善乳腺癌预后的作用和影响。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-08-11 DOI: 10.1080/14737167.2024.2390056

Ismail Jatoi, Jonathan A L Gelfond

{"title":"The utility and impact of digital endpoints for improving breast cancer outcomes.","authors":"Ismail Jatoi, Jonathan A L Gelfond","doi":"10.1080/14737167.2024.2390056","DOIUrl":"10.1080/14737167.2024.2390056","url":null,"abstract":"Introduction: In breast cancer clinical trials utilizing digital endpoints, wearable sensors record participants' health information during activities of daily living. These sensors are worn on the wrist or finger, placed as a skin patch or headband, or embedded on clothing. Data collected from wearable sensors form the basis of a digital endpoint, useful for determining effects of novel treatments on health outcomes, particularly quality-of-life outcomes.Areas covered: References for this article were selected from a PubMed search spanning from 1 January 2017,to 1 July 2024, using the terms 'wearable sensors,' 'digital endpoints,' 'virtualtrials,' 'breast cancer.' Additional articles from the authors' personal collection of papers and reviewers suggestions were also used.Expert opinion: Digital endpoints must be validated as proper surrogate measures for healthcare outcomes, prior to their use in breast cancer trials. Wearable sensors may introduce biases, such as 'missing not-at-random bias,' and perhaps even exacerbate disparities in healthcare outcomes if patients not comfortable with their use are excluded from clinical trials, or if the accuracy of sensors varies between racial and ethnic groups. Therefore, before embarking on trials with digital endpoints, validation studies are required, and limitations and risks of such trials need to be addressed.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-5"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893291","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

Pharmacovigilance and outcomes: experience from Saudi Arabia narrative review. 药物警戒与结果：沙特阿拉伯的经验回顾。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-09-08 DOI: 10.1080/14737167.2024.2399258

Thamir M Alshammari

{"title":"Pharmacovigilance and outcomes: experience from Saudi Arabia narrative review.","authors":"Thamir M Alshammari","doi":"10.1080/14737167.2024.2399258","DOIUrl":"10.1080/14737167.2024.2399258","url":null,"abstract":"Introduction: Pharmacovigilance (PV) plays a central role as a quality benchmark for healthcare systems in any country. Adverse drug reactions (ADRs) contribute significantly to patient hospitalization and are major contributors to morbidity and mortality worldwide. Achieving improvements in health infrastructure and employing precise monitoring tools are essential components of drug safety. As reliance on drug therapy increases, patient exposure to potential risks rises, emphasizing the importance of minimizing ADRs.Area covered: A search for studies published from January 2010 to November 2023 was retrieved from PubMed, Medline, and Google Scholar databases. We developed the search strategies using the Mesh terms and keywords. Only English-language literature was included.Expert opinion: Twenty-nine studies met the inclusion criteria and utilized to evaluate the pharmacovigilance and its outcomes. The Saudi 2030 vision outlines an initiative to enhance patient care through a robust, safety- and quality-centered culture, fostering collaboration between drug manufacturers and regulatory authorities. This collaborative approach is expected to result in higher-quality care for the public. Moreover, a unified, simple, and advanced ADR reporting portal, in collaboration with stakeholders, is recommended to enhance the quality of ADR reporting. Also, commitment to training, updating courses, and incorporating PV practices into curricula demonstrates progress in Saudi PV System.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"7-15"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119276","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

An early economic analysis of medical cannabis for the treatment of chronic pain. 对医用大麻治疗慢性疼痛的早期经济分析。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1080/14737167.2024.2412248

Shanna Marrinan, Anne K Schlag, Michael Lynskey, Callie Seaman, Mike P Barnes, Mike Morgan-Giles, David Nutt

{"title":"An early economic analysis of medical cannabis for the treatment of chronic pain.","authors":"Shanna Marrinan, Anne K Schlag, Michael Lynskey, Callie Seaman, Mike P Barnes, Mike Morgan-Giles, David Nutt","doi":"10.1080/14737167.2024.2412248","DOIUrl":"10.1080/14737167.2024.2412248","url":null,"abstract":"Background: Cannabis-based medicinal products (CBMPs) are increasingly demonstrating effectiveness in treating a wide range of conditions, with a relatively high safety profile in clinical usage compared to other prescription pain medications and few contraindications. Consultation and other prescription-related costs are, at present, higher for CBMPs than for some other treatment options, leading to some concern around wider prescribing.Research design and methods: An early cost-effectiveness model was developed to estimate the impact of prescribing CBMPs alone and/or in addition to analgesics, physiotherapy, and cognitive behavioral therapy for chronic pain in the UK for 1 year.Results: Due to their comparative effectiveness, CBMPs were found to be cost saving. Various scenarios were model tested; in all scenarios where CBMPs decrease pain-level states, less resource use is required. Increased efficacy of 5% was conservatively assumed based on current Real-World Evidence. In this scenario, CBMPs were significantly more cost-effective, and as costs relating to the prescribing of these continue to fall, relative savings are predicted to increase.Conclusion: These findings highlight the substantial cost saving that CBMPs may represent for the treatment of chronic pain patients, and the benefits for healthcare providers as a treatment for this often hard-to-treat population.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"39-52"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461494","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

Survival analysis of famotidine administration routes in non-traumatic intracerebral hemorrhage patients: based on the MIMIC-IV database. 非创伤性脑出血患者法莫替丁给药途径的生存率分析：基于 MIMIC-IV 数据库。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-08-30 DOI: 10.1080/14737167.2024.2394113

Ling Chen, Yan Wang

{"title":"Survival analysis of famotidine administration routes in non-traumatic intracerebral hemorrhage patients: based on the MIMIC-IV database.","authors":"Ling Chen, Yan Wang","doi":"10.1080/14737167.2024.2394113","DOIUrl":"10.1080/14737167.2024.2394113","url":null,"abstract":"Objective: This study compared the survival outcomes of non-traumatic intracerebral hemorrhage (ICH) patients with different famotidine administration routes and explored related risk factors.Methods: Data from ICH patients between 2008-2019 were extracted from the MIMIC-IV database. Survival differences between patients with intravenous (IV) and non-intravenous (Non-IV) famotidine administration were analyzed using Cox analysis and Kaplan-Meier survival curves.Results: The study included 351 patients, with 109 in the IV group and 84 in the Non-IV group after PSM. Cox analysis revealed that survival was significantly associated with age (HR = 1.031, 95%CI:1.011-1.050, p = 0.002), chloride ions (HR = 1.061, 95%CI:1.027-1.096, p < 0.001), BUN (HR = 1.034, 95%CI:1.007-1.062, p = 0.012), ICP (HR = 1.059, 95%CI:1.027-1.092, p < 0.001), RDW (HR = 1.156, 95%CI:1.030-1.299, p = 0.014), mechanical ventilation (HR = 2.526, 95%CI:1.341-4.760, p = 0.004), antibiotic use (HR = 0.331, 95%CI:0.144-0.759, p = 0.009), and Non-IV route (HR = 0.518, 95%CI:0.283-0.948, p = 0.033). Kaplan-Meier curves showed a significantly higher 30-day survival rate in the Non-IV group (p = 0.011), particularly in patients with normal ICP (HR = 0.518, 95%CI:0.283-0.948, p = 0.033).Conclusion: Non-IV famotidine administration significantly improves 30-day survival of ICH patients, especially for those with normal ICP, compared to IV administration.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"113-121"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999674","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

Impact of adherence on the cost-effectiveness of apixaban and rivaroxaban in stroke prevention among patients with atrial fibrillation in the United States. 依从性对阿哌沙班和利伐沙班在美国心房颤动患者中预防中风的成本效益的影响。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-09-03 DOI: 10.1080/14737167.2024.2398487

Anjana Mohan, Haluk Damgacioglu, Ashish A Deshmukh, Hua Chen, Matthew Wanat, Ekere James Essien, Rutugandha Paranjpe, Bilqees Fatima, Susan Abughosh

{"title":"Impact of adherence on the cost-effectiveness of apixaban and rivaroxaban in stroke prevention among patients with atrial fibrillation in the United States.","authors":"Anjana Mohan, Haluk Damgacioglu, Ashish A Deshmukh, Hua Chen, Matthew Wanat, Ekere James Essien, Rutugandha Paranjpe, Bilqees Fatima, Susan Abughosh","doi":"10.1080/14737167.2024.2398487","DOIUrl":"10.1080/14737167.2024.2398487","url":null,"abstract":"Objective: Despite the beneficial effects of DOACs, suboptimal adherence is widely documented, and real-world adherence is lower than in clinical trials. The objective of this study is to compare the cost-effectiveness of apixaban versus rivaroxaban for stroke prevention by incorporating real-world adherence from the US payer's perspective.Methods: We developed a Markov model with three health states to evaluate the total costs and quality-adjusted life years (QALY) at a willingness to pay threshold of $100,000. The population was a hypothetical cohort of 65-year-old patients with moderate to high stroke risk. The transition probabilities of healthy adherent, nonadherent, and stroke were obtained from a Medicare Advantage Plan. The utilities and costs were obtained from prior clinical studies. Deterministic and probabilistic sensitivity analyses were conducted.Results: Apixaban was cost-effective than rivaroxaban at a willingness to pay threshold of $100,000. Apixaban yielded an additional 0.12 QALYs at a cost of $1904.39, resulting in an incremental cost-effectiveness ratio (ICER) of $16,279.25 per QALY gained. The Monte Carlo simulations indicated that apixaban was cost-effective at 89.67% of simulations. The ICER results were impacted by the medical costs among nonadherent patients.Conclusion: After incorporating adherence, apixaban 5 mg was a cost-effective alternative to rivaroxaban 20 mg for stroke prevention among elderly atrial fibrillation (AF) patients.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"63-70"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119262","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

Direct healthcare costs for people with cerebral palsy in the Brazilian unified health system between 2015 and 2019. 2015 年至 2019 年期间巴西统一医疗系统中罹患颅内压增高症患者的直接医疗费用。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-08-13 DOI: 10.1080/14737167.2024.2390043

Emilie Batista Freire, Henry Maia Peixoto, Kênnea Martins Almeida Ayupe, Everton Nunes da Silva, Rodrigo Luiz Carregaro, Aline Martins de Toledo

{"title":"Direct healthcare costs for people with cerebral palsy in the Brazilian unified health system between 2015 and 2019.","authors":"Emilie Batista Freire, Henry Maia Peixoto, Kênnea Martins Almeida Ayupe, Everton Nunes da Silva, Rodrigo Luiz Carregaro, Aline Martins de Toledo","doi":"10.1080/14737167.2024.2390043","DOIUrl":"10.1080/14737167.2024.2390043","url":null,"abstract":"Background: Estimate the costs of inpatient and outpatient care for people with Cerebral Palsy (CP) in Brazil.Research design and methods: Health records of people with CP in the Hospital and Outpatient Information Systems of Brazil between 2015 and 2019 were analyzed. Variables analyzed were gender, age, ICD, Intensive Care Unit (ICU) use, total cost, and ICU cost. Costs were adjusted for inflation and converted to dollars. Linear regression analysis was performed to investigate the association between social and clinical variables and direct costs.Results: A total direct cost of approximately $166 million to the National Health System was identified, with $7.08 million/year and $26.1 million/year of inpatient and outpatient costs, respectively. The healthcare was primarily for children up to 14 years of age. The ICD 'spastic quadriplegic CP' received the most attendance. Rehabilitation was responsible for 75% of the outpatient care, with physiotherapy standing out. Increased age, use of ICU, and the types of CP are related to increased cost.Conclusions: Healthcare for people with CP produced expressive costs for the Brazilian public health system, mainly with outpatient procedures and rehabilitation, with children being the most attended. Estimating these costs assist in better resource allocation for more effective healthcare provision.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"81-89"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906374","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 tofacitinib for the treatment of moderate to severe rheumatoid arthritis: a systematic review and meta-analysis. 托法替尼治疗中重度类风湿关节炎的成本效益分析：系统综述和荟萃分析。

IF 1.8 4区医学

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-01-01 Epub Date: 2024-08-11 DOI: 10.1080/14737167.2024.2390041

Behzad Fatemi, Neda Yaghoubi, Nikta Shobeiri, Razieh Ahmadi, Taraneh Mousavi, Fatemeh Soleymani, Soheila Rezaei

{"title":"Cost-effectiveness analysis of tofacitinib for the treatment of moderate to severe rheumatoid arthritis: a systematic review and meta-analysis.","authors":"Behzad Fatemi, Neda Yaghoubi, Nikta Shobeiri, Razieh Ahmadi, Taraneh Mousavi, Fatemeh Soleymani, Soheila Rezaei","doi":"10.1080/14737167.2024.2390041","DOIUrl":"10.1080/14737167.2024.2390041","url":null,"abstract":"Background: As rheumatoid arthritis (RA) is a chronic and progressive disease that requires lifelong therapeutic intervention, it represents a considerable economic burden on those affected. This study investigated whether tofacitinib is a cost-effective therapeutic alternative to other DMARDs for treating moderate-to-severe RA.Research design and methods: All economic evaluation studies of tofacitinib compared to other DMARDs were identified. Using random-effects meta-analysis, we pooled incremental net benefit (INB) in (purchasing power parity) adjusted US$ with 95% confidence intervals. The modified economic evaluation bias checklist and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) instrument for quality appraisal were used. The subgroup analysis was done based on the comparator regimen.Results: Of the selected 11 studies, the number of studies from high-, upper-middle- and lower-middle-income countries was 7, 3, and 1, respectively. The subgroup analysis showed that tofacitinib with an INB of 19,180 US$ [95% CI, -34520 to -3840; p-value = 0.01] was not statistically cost-effective compared with cDMARDs (p-value > 0.0001). Compared to other DMARDs, the estimated pooled INB of tofacitinib was US$ 7260 [95% CI, 3030 to 11,480; p-value < 0.001], but there was substantial heterogeneity among the included studies, and the observed publication bias.Conclusion: While tofacitinib shows potential as a cost-effective treatment, tailored economic evaluations are needed to account for the diverse and evolving contexts of RA treatment.Registration: PROSPERO: CRD42023405970.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"29-38"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893290","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