Malaisamy Muniyandi, Sahil Abdul Salam, Karikalan Nagarajan
{"title":"Patient-centered and technology-enabled strategies to improve tuberculosis treatment adherence.","authors":"Malaisamy Muniyandi, Sahil Abdul Salam, Karikalan Nagarajan","doi":"10.1080/14737167.2026.2691181","DOIUrl":"10.1080/14737167.2026.2691181","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) treatment adherence (how regular patients follow the prescribed medication) has a major role in TB control. In high‑burden countries such as India, poor adherence contributes to treatment failure, relapse, and the emergence of drug-resistant TB (DR-TB), despite substantial programmatic efforts to improve treatment outcomes.</p><p><strong>Areas covered: </strong>This review examines a broad range of TB treatment adherence strategies, including digital adherence technologies, behavioral and psychosocial interventions, directly observed therapy models, medication dispensing and monitoring tools, incentive‑based support programs, and emerging artificial intelligence and biometric approaches. Evidence from published literature were searched in PubMed and Google Scholar and synthesized.</p><p><strong>Expert opinion: </strong>This review highlights that digital adherence strategies could reduce cost, travel, and time by making adherence monitoring more efficient and less resource-intensive for both patient and providers. This could complement existing adherence strategies in the programme. Multicomponent strategies that combine real-time adherence monitoring, counseling, community engagement, and social support are likely to be most effective in sustaining adherence, preventing drug resistance, and advancing progress toward TB elimination.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"577-586"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263800","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":"Antimicrobial resistance as an economic externality: optimal control, Pigouvian taxation, and governance implications.","authors":"Aritra Jana, Debnarayan Khatua, Santi M Mandal","doi":"10.1080/14737167.2026.2659620","DOIUrl":"10.1080/14737167.2026.2659620","url":null,"abstract":"<p><strong>Background: </strong>The rise of antimicrobial resistance (AMR) is a major concern worldwide, with serious implications for health and the economy. Global burden estimates, coupled with mortality projections for 2019, indicate that antimicrobial-resistant infections will cause large-scale deaths and massive economic losses by 2050. AMR is not only about health; It is an economic externality created by misaligned incentives in health, agriculture, and trade.</p><p><strong>Methods: </strong>We present a dynamic endogenous model that captures the interplay among antibiotic use, resistance evolution, and social costs. Optimal fiscal interventions are identified and evaluated using simulation scenarios based on European data, with particular attention to the impact of diverting tax revenue to stewardship and diagnostics.</p><p><strong>Results: </strong>The models demonstrate that, under optimal social conditions, antibiotic use should be reduced by 8.6% relative to private use levels. The combination of around <math><mrow><mrow><mi>$</mi></mrow></mrow><mn>0.775</mn></math> per dose with the Pigouvian tax can be used as a diagnostic and stewardship investment to adjust incentives and build public health power.</p><p><strong>Conclusion: </strong>The study makes a distinct contribution by explicitly incorporating revenue recycling into a dynamic Pigouvian framework, thereby supporting the idea that self-governance benefits from AMR taxation. The solution is then coordinated toward long-term economic planning with intervention in biomedicine against AMR.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"639-650"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689092","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":"Timely access to new drugs in a single-payer system: policy analysis from South Korea's reimbursement framework.","authors":"Yoo Seung-Lai","doi":"10.1080/14737167.2025.2561020","DOIUrl":"10.1080/14737167.2025.2561020","url":null,"abstract":"<p><strong>Background: </strong>Timely access to innovative medicines remains a policy challenge in single-payer systems. South Korea has introduced mechanisms such as economic evaluation exemptions and risk-sharing agreements (RSAs) to improve access while maintaining expenditure controls. However, empirical evidence on their real-world impact remains limited.</p><p><strong>Research design and methods: </strong>A retrospective observational analysis was conducted using data on 85 new drugs assessed by the Health Insurance Review and Assessment Service (HIRA) between 2022 and 2024. Publicly available HTA datasets were categorized by evaluation outcome, pricing ratios, and projected budget impact. Statistical analyses included descriptive analysis, correlation testing, and multivariable linear regression.</p><p><strong>Results: </strong>Eighty-two percent of assessed drugs were reimbursed. A full recommendation from HIRA strongly predicted listing outcomes. Drugs with moderate budget impact (1.5-10 billion Korean Won) experienced shorter timelines. International price ratios - averaging 64% of the mean level across reference countries - were the only consistent predictors across settings.</p><p><strong>Conclusion: </strong>Evaluation outcomes, assessment complexity, and budget forecasts are key determinants of reimbursement in Korea. Refinement of HTA processes and adaptive use of RSAs may enhance access efficiency while preserving budgetary sustainability.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"603-612"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069411","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}
Regina Rendas-Baum, Jakob Bjorner, Victor Preckler, Taizo Matsuki, Yufan Ho, Daniel Molnar, Shinichi Noto, Ataru Igarashi
{"title":"Estimating respiratory syncytial virus health utility values for older adults and their caregivers in the Japanese population: a time trade-off study.","authors":"Regina Rendas-Baum, Jakob Bjorner, Victor Preckler, Taizo Matsuki, Yufan Ho, Daniel Molnar, Shinichi Noto, Ataru Igarashi","doi":"10.1080/14737167.2026.2671770","DOIUrl":"10.1080/14737167.2026.2671770","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a common virus affecting the respiratory system in all ages. The study's objective was to obtain RSV-related health utility values for older adults and their caregivers from the Japanese population.</p><p><strong>Research design and methods: </strong>A cross-sectional, observational study was conducted among Japanese adults (≥18 years) between April-June 2023 to quantify the burden of RSV. Participants completed an online survey with six vignettes describing RSV-related health states for patients and caregivers: severe lower respiratory tract infection (sLRTI), lower respiratory tract infection (LRTI), and upper respiratory tract infection (URTI). Using a time trade-off (TTO) approach, respondents indicated the number of days they would trade to avoid these health states. Quality-adjusted life-year (QALY) losses were then estimated.</p><p><strong>Results: </strong>Of 1,770 participants, 1,529 were excluded, leaving 241 for analysis (45 with caregiving experience). Median discounted TTO values were 73, 22, and 7 days for sLRTI, LRTI, and URTI, respectively, and 31, 16, and 3 days to avoid caregiving burden. QALY losses were 0.200, 0.060, and 0.018 for patients and 0.086, 0.043, and 0.008 for caregivers.</p><p><strong>Conclusions: </strong>Japanese individuals are willing to trade a significant number of days from the end of their life to avoid an RSV episode or its caregiver burden.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"683-691"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927473","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}
Fuad Fadhel Alotaibi, Abdulrahman A Alsuhibani, Siew Chin Ong, Yih Chew Poh, Marwan A Alrasheed, Ali Alhomaidan
{"title":"Analyzing the direct medical cost of schizophrenia in Hospital Pulau Pinang, Malaysia.","authors":"Fuad Fadhel Alotaibi, Abdulrahman A Alsuhibani, Siew Chin Ong, Yih Chew Poh, Marwan A Alrasheed, Ali Alhomaidan","doi":"10.1080/14737167.2026.2659625","DOIUrl":"10.1080/14737167.2026.2659625","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia (SCZ) is a major public health concern that places a significant economic burden on healthcare systems. This study assessed the direct medical costs of SCZ and examined cost drivers at Hospital Pulau Pinang (HPP), Malaysia.</p><p><strong>Objective: </strong>To estimate and compare direct medical costs for SCZ patients across various healthcare services, including medications, diagnostics, hospitalizations, and outpatient care.</p><p><strong>Methods: </strong>A retrospective, bottom-up costing analysis was conducted using medical records of all adult SCZ patients treated at HPP from 1 January 2019, to 27 April 2021. Data included demographic and clinical features, with costs categorized by service type.</p><p><strong>Results: </strong>Among 120 patients (20 inpatients), 54.2% were female with a mean age of 39.5 ± 10.3 years. The mean annual inpatient cost per patient was MYR 8,483.4, with hospitalization alone contributing 62%. Outpatient costs averaged MYR 2,222 ± 2,571.9.</p><p><strong>Conclusions: </strong>SCZ treatment imposes a high financial burden, particularly due to hospitalization. These findings provide essential cost estimates to support healthcare planning and policy-making in Malaysia.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"629-637"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867290","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}
Katlego Bjang, Madimetje Kutume, Nthabiseng Mongoai, Boitshepo Sebothoma, Rajesh Vagiri, Johanna C Meyer, Brian Godman, Letlhogonolo Makhele
{"title":"Cost and clinical analysis of community-acquired pneumonia within an antimicrobial stewardship-governed academic hospital in South Africa, and its implications.","authors":"Katlego Bjang, Madimetje Kutume, Nthabiseng Mongoai, Boitshepo Sebothoma, Rajesh Vagiri, Johanna C Meyer, Brian Godman, Letlhogonolo Makhele","doi":"10.1080/14737167.2026.2663891","DOIUrl":"10.1080/14737167.2026.2663891","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is a common respiratory infection treated with antibiotics. Patients needing antibiotics risk poor outcomes due to antimicrobial resistance (AMR). In LMIC, inappropriate prescribing is common due to a lack of sufficient diagnostics, leading to empiric prescribing. Antimicrobial stewardship programmes can improve prescribing practices.</p><p><strong>Research design and methods: </strong>A retrospective cohort study reviewing antibiotic prescription charts from May to September 2024 at an academic hospital in South Africa. A treatment pathway model was used to evaluate patients' clinical outcomes.</p><p><strong>Results: </strong>Severe pneumonia was observed in 59.3% of patients, compared with 40.7% with uncomplicated pneumonia, with the majority of severe cases occurring in patients aged 51-75 years (37.5%). The cost of treatment per patient was higher for severe pneumonia (R1,328.12) versus uncomplicated cases (R1,157.40), with labor costs the largest cost component (58%). Severe cases contributed 63% (R63, 749.10) of total treatment costs, while uncomplicated cases accounted for 37% (R38,195.50). The treatment pathway model analysis indicated that hospitalisation rates decreased from 85% on Review Day 3 to 58% on Review Day 7 for severe cases.</p><p><strong>Conclusion: </strong>Higher treatment costs and longer hospital stays were associated with severe pneumonia, underscoring the need for early, appropriate intervention.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"651-665"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728737","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}
Martina Tomassini, Ilaria Ruotolo, Alessandro Ugolini, Giovanni Sellitto, Giovanni Galeoto
{"title":"Outcome measures for fear of movement in individuals with musculoskeletal disorders: a systematic review with meta- analysis.","authors":"Martina Tomassini, Ilaria Ruotolo, Alessandro Ugolini, Giovanni Sellitto, Giovanni Galeoto","doi":"10.1080/14737167.2026.2691177","DOIUrl":"10.1080/14737167.2026.2691177","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of movement is a significant psychological factor in musculoskeletal disorders and can negatively affect clinical outcomes. Several assessment tools are currently available to measure fear of movement. This systematic review aimed to analyze and compare the psychometric properties of the main scales used in populations with musculoskeletal disorders.</p><p><strong>Methods: </strong>A systematic literature review was conducted according to PRISMA guidelines. Studies were identified through MEDLINE (via PubMed), CINAHL (via EBSCO), Web of Science, and Scopus. Methodological quality was assessed using the COSMIN checklist. A meta-analysis was performed on studies reporting internal consistency.</p><p><strong>Results: </strong>99 studies were included, identifying a total of 29 assessment tools. Most instruments demonstrated good reliability and validity. However, substantial heterogeneity in methodological quality was observed, together with limited reporting of measurement error and responsiveness across studies.</p><p><strong>Conclusions: </strong>Numerous tools are available for assessing fear of movement, with some scales showing high levels of reliability and validity across different clinical and linguistic contexts. These findings provide useful guidance for selecting appropriate instruments for clinical practice and research, supporting improved assessment and management of fear of movement in patients with musculoskeletal pain.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero identifier is CRD420251009756.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"587-601"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263756","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":"Estimated cost-effectiveness of adjuvant nivolumab for resected stage IIB-IIC melanoma in the United States.","authors":"Islam Eljilany, Vakaramoko Diaby","doi":"10.1080/14737167.2026.2665725","DOIUrl":"10.1080/14737167.2026.2665725","url":null,"abstract":"<p><strong>Background: </strong>The CheckMate 76K trial analysis showed that the use of nivolumab as adjuvant therapy in the treatment of patients with resected stage IIB-IIC melanoma reduced recurrence-free survival (RFS). This study aimed to estimate the cost-effectiveness of nivolumab as adjuvant therapy in these patients from the United States (U.S.) payer perspective.</p><p><strong>Research design and methods: </strong>A cohort-based Markov model with monthly cycles was developed to simulate RFS over a Five-year base-case horizon. Health states included recurrence-free without adverse events, recurrence-free with adverse events, and disease recurrence (absorbing). Transition probabilities were derived from parametric survival models fitted to reconstructed individual patient-level RFS data. Sensitivity and scenario analyses were applied.</p><p><strong>Results: </strong>Over five years, nivolumab increased costs by USD 182,783 and yielded 0.444 additional quality-adjusted life-years (QALYs), resulting in an incremental cost-effectiveness ratio (ICER) of USD 411,958 per QALY. Nivolumab was not cost-effective at conventional U.S. willingness-to-pay thresholds in the base case. Sensitivity analyses confirmed robustness, while scenarios assuming greater durability of benefit improved cost-effectiveness but generally remained above thresholds.</p><p><strong>Conclusions: </strong>Within a conservative recurrence-focused framework, adjuvant nivolumab improves health outcomes but is unlikely to be cost-effective at current prices over a short-term horizon. Reassessment will be essential as longer-term evidence emerges.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"667-681"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766857","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}
Nikhil Jain, Isha Lohumi, Vanessa Ravel, Ben Wijnen, Jason J Madan, Silvia Maa Evers
{"title":"Development of a resource use measurement (RUM) instrument to estimate the economic burden of suicide in India.","authors":"Nikhil Jain, Isha Lohumi, Vanessa Ravel, Ben Wijnen, Jason J Madan, Silvia Maa Evers","doi":"10.1080/14737167.2026.2691178","DOIUrl":"10.1080/14737167.2026.2691178","url":null,"abstract":"<p><strong>Background: </strong>Suicide related events lead to the mobilization of a diverse array of resources affecting multiple sectors across society. These resources include healthcare service utilization, out-of-pocket expenditures, productivity losses of patients and caregivers, and resources borne by education, law enforcement, and the criminal justice system. These dimensions are particularly pertinent in Low and Middle-Income Countries (LMICs), where help-seeking and care provision pathways are complex, diverse and fragmented.</p><p><strong>Methods: </strong>A previous systematic literature review and consequent focused search for existing RUM instruments for mental health informed the development of the initial draft of the instrument. The face and content validity of the instrument were assessed through an online expert consultation using cognitive interviewing techniques.</p><p><strong>Results: </strong>A modular RUM instrument was developed to capture all resources from a societal perspective. Validation with diverse experts led to the validation of comprehensibility, directionality, memory recall, prioritization, feasibility, and structural aspects of the instrument. The iterative processes ensure cultural suitability, appropriateness, and user-friendly design.</p><p><strong>Conclusion: </strong>This study marks a methodological advancement in the development of a comprehensive and adaptable RUM instrument for use across LMICs. The instrument would aid in the generation of robust economic evidence to inform suicide prevention policies and advocacy efforts.</p><p><strong>Clinical trial registration: </strong>https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTIzNjIy&Enc=&userName=.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"693-702"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257929","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}