Journal of Health Economics and Outcomes Research最新文献

{"title":"Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test.","authors":"Mallik Greene, Timo Pew, A Burak Ozbay, John B Kisiel, A Mark Fendrick, Paul Limburg","doi":"10.36469/001c.133939","DOIUrl":"https://doi.org/10.36469/001c.133939","url":null,"abstract":"<p><p><b>Background:</b> Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer-related deaths in the United States. Screening can prevent CRC by detecting advanced precancerous lesions. Adherence to screening is crucial in reducing CRC disease burden; however, there is limited research on the impact of digital outreach screening uptake and adherence. <b>Objective:</b> This study evaluated the impact of different digital outreach channels on patient adherence to CRC screening with a multi-target stool DNA (mt-sDNA) test in a real-world setting. Methods: Patients were individuals aged 45 to 85 years with a valid mt-sDNA test order from Exact Sciences Laboratories, LLC (Jan. 1, 2023-Sept. 23, 2023). All patients received letters and phone calls; some received short message service (SMS), email, or both. Adherence and time to test return were compared across digital outreach categories stratified by patient characteristics. Multivariable regression evaluated the association of digital outreach methods with adherence and time to test return. <b>Results:</b> Among 2 425 308 patients (43.5% between 50 and 64 years, 58.2% female), digital SMS only (62.7%) was the most common outreach method. Overall adherence was 70.1%, with highest adherence in the digital SMS-plus-email group (72.9%). Mean time to test return from shipment of mt-sDNA kit to receipt of valid test was 25.8 days. In adjusted analyses, patients receiving digital SMS plus email had the highest odds of test return (odds ratio, 1.75; 95% confidence interval [CI], 1.73-1.78; <i>P</i><.001) and had return times 8.7% shorter than the no-digital-outreach group (95% CI, 8.2-9.2; <i>P</i><.001). <b>Discussion:</b> Among nationally insured individuals within the recommended age range for CRC screening, overall adherence to the mt-sDNA test was in the 70s, with the highest rates in the digital (SMS and email) outreach group and the lowest in the no-digital-outreach group. <b>Conclusions:</b> These findings highlight the importance of multichannel navigation in facilitating completion of CRC screening with the mt-sDNA test.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"191-200"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of Population-Level Chronic Kidney Disease Interventions in the UK National Health Service.","authors":"George Agathangelou, Matthew Graham-Brown, Aisling C McMahon, George Xydopoulos, Larisa Gofman, Jacob Jaffe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Background:</b> Chronic kidney disease (CKD) affects 13% of the global population, is predicted to be the fifth leading cause of premature death by 2040, and is associated with increased risk of cardiovascular disease and acute cardiovascular events. With an aging population and rising diabetes rates, the prevalence of CKD is expected to escalate in the United Kingdom, leading to substantial healthcare costs. When patients reach end-stage kidney disease, interventions such as dialysis and transplantation are required. Dialysis is not only extremely costly but is also associated with a diminished quality of life and significantly elevated mortality. <b>Objectives:</b> This study assesses the cost-effectiveness of several population-level interventions designed to manage CKD, including its progression to end-stage kidney disease. <b>Methods:</b> A population-level Markov model was developed to evaluate the cost-effectiveness and population health impacts of 4 key interventions, individually and combined: (1) early/improved diagnosis, (2) enhanced CKD management, (3) increased use of SGLT-2 inhibitors, and (4) higher rates of pre-emptive live donor transplantation. The model incorporates both NHS direct costs and broader economic impacts, with a 10-year horizon and quarterly cycles. Two scenarios were analyzed: a base case (based on disease progression probabilities) and a constrained case (where growth in the number of patients receiving dialysis and transplantation is limited to historical rates observed in the UK National Health Service). <b>Results:</b> All interventions demonstrated cost-effectiveness, with the combined approach preventing 10 351 deaths and yielding 48 381 quality-adjusted life-years (QALYs) at a cost of £7675 per QALY in the base case scenario. In the constrained scenario, the combined interventions demonstrated cost-effectiveness, preventing 10 026 deaths and yielding 47 514 QALYs at a cost of £22 767 per QALY. <b>Conclusions:</b> The results demonstrate the cost-effectiveness of population level interventions for management of CKD, and the significant burden of dialysis, with avoidance of progression to dialysis a key driver of QALY gains and cost offsets.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"184-190"},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Resource Utilization and Costs Related to Falls and Fractures Among People With Type 2 Diabetes Receiving Basal Insulin: The FRAGILE Study.","authors":"Guillermo E Umpierrez, Elizabeth K Pogge, Xuan Li, Ronald Preblick, Jasvinder Gill, Naushira Pandya","doi":"10.36469/001c.133274","DOIUrl":"https://doi.org/10.36469/001c.133274","url":null,"abstract":"<p><p><b>Background:</b> The association between falls or fall-related fractures and hypoglycemia in people with type 2 diabetes is well established. Insulin treatment is associated with an increased risk of hypoglycemia, which is compounded in people of older age, but the risk is lower with longer-acting vs intermediate- or long-acting basal insulin analogs. <b>Objective:</b> To examine healthcare resource utilization and costs related to falls/fractures in people with type 2 diabetes treated with the longer-acting basal insulin Gla-300 (insulin glargine 300 U/mL) vs long-acting basal insulins (insulin glargine 100 U/mL or insulin detemir)/neutral protamine Hagedorn (NPH). <b>Methods:</b> This retrospective study of Optum's de-identified Clinformatics® Data Mart Database compared data for people aged 50 years or older with at least 1 prescription claim for basal insulin (excluding insulin degludec) between April 1, 2015, and April 30, 2021, who initiated Gla-300 insulin (basal insulin-naive) or transitioned to Gla-300 from a different basal insulin (basal insulin-switch). Cohorts were propensity score-matched. The primary outcome was fall/fracture-related hospitalization and emergency department visit events (per 100 person-years of follow-up [P100PYFU]). The association between fall/fracture events and hypoglycemia and costs were secondary outcomes. Outcomes were compared using 95% confidence intervals of rate and other ratios; no statistical inference was performed. <b>Results:</b> Fall/fracture-related hospitalization (2.88 vs 3.33 P100PYFU) and emergency department visit events (5.28 vs 5.95 P100PYFU) were numerically lower in people who initiated basal insulin with Gla-300 vs long-acting basal insulins/NPH, and in those who switched to Gla-300 vs long-acting basal insulins/NPH (2.54 vs 3.38 and 4.48 vs 5.21 P100PYFU, respectively). People with vs without hypoglycemia experienced more falls/fractures, regardless of whether initiating basal insulin or switching basal insulin treatment. Costs tended to be lower for people who switched to Gla-300; however, low event rates caused variability. <b>Conclusions:</b> The results of this study suggest that there is a positive correlation between fall/fracture events and hypoglycemia in people with type 2 diabetes and also, that fall/fracture-related healthcare resource utilization was numerically lower in people who initiated basal insulin with Gla-300 vs long-acting basal insulins/NPH, and in those who switched to Gla-300 vs long-acting basal insulins/NPH.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"171-183"},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Adult X-Linked Hypophosphatemia on Carers and Family Members: A Mixed-Methods Study.","authors":"Elina Matter, Claire Lawrence, Oliver Gardiner, Victoria Hayes, Gillian Logan, Ben Johnson, Andrew Lloyd","doi":"10.36469/001c.133860","DOIUrl":"https://doi.org/10.36469/001c.133860","url":null,"abstract":"<p><p><b>Introduction:</b> X-linked hypophosphatemia (XLH) is a rare, genetic disorder that severely impacts the health-related quality of life (HRQoL) of people living with the condition. This impact can also extend to carers and family members, described as a \"spillover effect.\" Measurement of spillover effects can lead to greater understanding of disease burden and potentially to more equitable decision-making regarding adoption of treatments by health technology assessment (HTA) bodies. This study aimed to explore spillover effects among carers and family members of adults with XLH. <b>Methods:</b> This cross-sectional, mixed-methods study included carers and family members of adults diagnosed with XLH in the United Kingdom. Quantitative data included a background questionnaire, the EQ-5D-5L, and the Work Productivity and Activity Impairment Questionnaire (WPAI). Qualitative data were gathered through semi-structured interviews. <b>Results:</b> Twenty carers or family members of adults with XLH completed the study. Four (20%) had an XLH diagnosis themselves. Mean (SD) EQ-5D utility was 0.66 (0.33) for the total sample, and 0.20 (0.31) and 0.77 (0.21) for participants with and without a personal diagnosis of XLH, respectively. The WPAI activity impairment was 42% and overall work impairment was 28%. Interviews revealed 6 areas of participants' lives impacted by XLH: emotional wellbeing, daily activities, work, finances, social lives and relationships, and physical impacts. <b>Conclusion:</b> Findings of this study indicate a substantial health-related quality-of-life and productivity burden for carers and family members of adults with XLH. The magnitude of this burden highlights the importance of incorporating such spillover effects in HTAs and broader rare disease policies.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"162-170"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoballoon Ablation With the POLARx FIT or the Arctic Front Advance Pro for Paroxysmal Atrial Fibrillation: A Health Economic Analysis.","authors":"Luigi Pannone, Steffen Uffenorde, Antonia Bosworth Smith, Domenico Giovanni Della Rocca, Pasquale Vergara, Ioannis Doundoulakis, Antonio Sorgente, Alvise Del Monte, Giacomo Talevi, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Ali Gharaviri, Mark La Meir, Pedro Brugada, Andrea Sarkozy, Gian Battista Chierchia, Carlo de Asmundis","doi":"10.36469/001c.133223","DOIUrl":"https://doi.org/10.36469/001c.133223","url":null,"abstract":"<p><p><b>Background:</b> Pulmonary vein isolation (PVI) is the main ablation strategy for the treatment of paroxysmal atrial fibrillation. Different technologies are available for PVI, including various cryoballoon catheters (CB-A). Compared with the Arctic Front Advance Pro™, the novel POLARx FIT™ CB-A might reduce costs for atrial fibrillation ablation. <b>Objective:</b> The aim of this study is to perform a health economic evaluation of two cryoballoon systems for PVI procedures. <b>Methods:</b> All patients undergoing their first PVI procedure with POLARx FIT™ CB-A or the Arctic Front Advance Pro™ CB-A were prospectively enrolled. The health economic analysis was performed on the index hospitalization and procedure. The primary safety endpoint included procedure-related adverse events within the index hospitalization. A decision tree model was built to estimate downstream costs. <b>Results:</b> A total of 80 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed, with 40 patients in each arm. Compared with the Arctic Front Advance Pro™ CB-A, POLARx FIT™ CB-A showed a lower procedure time, left-atrium dwell time, and fluoroscopy time. The complication rate was low (6.3%) and included 3 reversible phrenic nerve palsies in the POLARx FIT™ CB-A group vs 2 in the Arctic Front Advance Pro™ CB-A group. Compared with the Arctic Front Advance Pro, the POLARx FIT™ CB-A was associated with lower procedural costs (€2069.7 ± €165.2 vs €2239.5 ±  €366.0; <i>P</i> =.009). <b>Conclusion:</b> The POLARx FIT™ CB-A was associated with a shorter procedure time, translating into lower procedural costs, compared with the Arctic Front Advance Pro. Complications were rare and comparable between the two technologies.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"155-161"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the Fiscal Value of Children Conceived from Assisted Reproduction Technology in Australia Applying a Public Economic Perspective.","authors":"Mark Connolly, Nikos Kotsopoulos, Jinjing Li, Georgina Chambers","doi":"10.36469/001c.133796","DOIUrl":"https://doi.org/10.36469/001c.133796","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Public funding for assisted reproduction varies across countries, which can influence the numbers of infertile couples treated annually, and consequently the numbers of children born each year from this technology. As infertility is a medical condition treated within the healthcare system, it must compete against all other medical interventions for funding. This raises questions about how to evaluate a technology that gives rise to human life compared with other healthcare interventions that reduce morbidity and mortality. &lt;b&gt;Objective:&lt;/b&gt; To evaluate annual public spending on assisted reproduction technology (ART) in Australia to determine the likely fiscal impact for government over the projected lifetime of an ART-conceived birth cohort. &lt;b&gt;Methods:&lt;/b&gt; A public economic framework was used to evaluate the number of children born from ART procedures performed in Australia in 2021 based on projected future lifetime tax contributions and public benefits received. We leveraged data from the Survey of Income and Housing conducted by the Australian Bureau of Statistics and imputations from tax-transfer microsimulations over the lifetime of the cohort estimating cumulative net-taxes. Public spending per pupil for education and lifetime health costs (in Australian dollars) were included in the benefits estimates. &lt;b&gt;Results:&lt;/b&gt; We estimated lifetime gross taxes per individual of A &lt;math&gt;&lt;mn&gt;841&lt;/mn&gt; &lt;mrow&gt;&lt;mo&gt; &lt;/mo&gt;&lt;/mrow&gt; &lt;mn&gt;631&lt;/mn&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;f&lt;/mi&gt; &lt;mi&gt;A&lt;/mi&gt;&lt;/math&gt; 580 182 in direct taxation of earnings and A &lt;math&gt;&lt;mn&gt;261&lt;/mn&gt; &lt;mrow&gt;&lt;mo&gt; &lt;/mo&gt;&lt;/mrow&gt; &lt;mn&gt;448&lt;/mn&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;x&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mo&gt;.&lt;/mo&gt; &lt;mi&gt;A&lt;/mi&gt; &lt;mi&gt;f&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;f&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;f&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;v&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;A&lt;/mi&gt; &lt;mi&gt;R&lt;/mi&gt; &lt;mi&gt;T&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;A&lt;/mi&gt; &lt;mi&gt;R&lt;/mi&gt; &lt;mi&gt;T&lt;/mi&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;v&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;w&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;j&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;m","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"148-154"},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Article Correction: We Are on the Verge of Breakthrough Cures for Type 1 Diabetes, but Who Are the 2 Million Americans Who Have It?","authors":"Rebecca Smith, Samara Eisenberg, Aaron Turner-Phifer, Jacqueline LeGrand, Sarah Pincus, Yousra Omer, Fei Wang, Bruce Pyenson","doi":"10.36469/001c.134140","DOIUrl":"https://doi.org/10.36469/001c.134140","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.36469/jheor.2024.124604.].</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"138-147"},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Public Economic Burden of Migraine in Argentina.","authors":"Zrinka Orlović, Lucila Rey-Ares, María Florencia Viozzi, Rui Martins, Juliana Villarreal Ramírez, Santiago Veiga, Mark P Connolly","doi":"10.36469/001c.133639","DOIUrl":"https://doi.org/10.36469/001c.133639","url":null,"abstract":"<p><p><b>Background:</b> Migraine is a prevalent, underdiagnosed, highly debilitating neurological condition that affects individuals' quality of life and often negatively influences normal daily activities. <b>Objectives:</b> The study objective is to estimate the economic burden of migraine to the Argentine government by assessing the impact of the disease on tax revenue, absenteeism, and social support transfers. <b>Methods:</b> The analysis combines a cross-sectional model utilizing national demographic data and published migraine prevalence rates to estimate the annual burden for the entire migraine-affected cohort, and a longitudinal model assessing the average burden per individual from the age of 40, over a 20-year horizon. A fiscal framework based on generational accounting evaluated the impact of migraine on government finances. Sources of revenue such as direct and indirect taxes were weighted against elements of public expenditure (public sector absenteeism, healthcare expenses, and financial support) and compared with the general population. The effect of migraine on occupational outcomes was sourced from peer-reviewed publications, and costs were sourced from national databases. Results were reported as incremental fiscal consequences (2023 US dollars) and were discounted at 3% annually. <b>Results:</b> The fiscal burden of migraine in Argentina was estimated to be <math><mn>6505</mn> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>v</mi> <mi>i</mi> <mi>d</mi> <mi>u</mi> <mi>a</mi> <mi>l</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi></math> 1237 million across the entire migraine population. Annually, 29% of government costs were due to public sector absenteeism, 39% related to healthcare costs, 19% to foregone direct and indirect tax revenue, and 12% to foregone corporation taxes. Additional government transfers represented a minor contribution to the overall fiscal impact of migraine in Argentina. <b>Discussion:</b> The high rate of informal employment is likely to undermine disease burden estimates. Gender disparities were notable, with women bearing 76% of the burden, highlighting the need for gender-specific interventions. <b>Conclusions:</b> This study reveals a significant economic burden of migraine to the Argentinian government, primarily driven by absenteeism, healthcare costs, and foregone tax contributions. Targeted, gender-responsive healthcare and labor policies, especially for sectors with high informal employment, could help reduce these fiscal impacts.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"129-137"},"PeriodicalIF":2.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People and Families Affected by Glycogen Storage Disease Type Ia: An Analysis of Narrative Accounts Written by Individuals Living with GSDIa and Their Caregivers.","authors":"Eliza Kruger, Hayley M de Freitas, Iris Ferrecchia, Millie Gaydon, Andrew Lloyd","doi":"10.36469/001c.131811","DOIUrl":"10.36469/001c.131811","url":null,"abstract":"<p><p><b>Background:</b> Glycogen storage disease type Ia (GSDIa) is a rare inherited disorder that can lead to renal and hepatic complications, brain damage, and death. There is a lack of qualitative research describing the impact of GSDIa on individuals and their caregivers. <b>Objective:</b> This study was designed to describe the individual experiences of those affected by GSDIa through qualitative methods. <b>Methods:</b> Individuals with GSDIa and caregivers were recruited through two patient associations (US, UK). Participants were asked to write narratives about their experiences with GSDIa in their own words, with no set questions or topics. The resulting narrative accounts were analyzed thematically using a primarily inductive approach. Themes describing the impact of GSDIa on individuals and caregivers were identified. <b>Results:</b> Eight caregivers, three of whom had lost a child to GSDIa, and 11 individuals living with GSDIa provided written summaries of their experiences of life with the condition. Participants described symptoms, the burden of managing frequent cornstarch feeds, and the broader impacts of GSDIa. These included effects on daily activities, family, emotional and social functioning, romantic relationships, and educational/professional impacts. Participants also described challenges related to obtaining diagnosis and support, and the lack of GSDIa knowledge from healthcare professionals. <b>Discussion:</b> This study provided novel insights into the impact of GSDIa on individuals living with the condition and their caregivers. Participants reported a wide range of issues in their narratives and openly shared sensitive information about their experiences, which may not have been captured if they had taken part in a semi-structured interview format. <b>Conclusion:</b> The narrative method yielded a rich data set that provided details of the varied and individual experiences of GSDIa not captured by traditional quantitative methods or structured interviews. The narratives highlighted the unmet needs of both caregivers of and patients with GSDIa around cornstarch management, obstacles to proper treatment from healthcare professionals, and the absence of effective treatments. The open-ended narrative approach had advantages over standard qualitative methods to capture greater insight into individual experiences directly from participants in their own words.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"120-128"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of a Heart Failure Management System in the United States.","authors":"Antonia Bosworth Smith, Ubong Silas, Alex Veloz, Peter Mallow, Barbara Pisani, Diana Bonderman, Rhodri Saunders","doi":"10.36469/001c.130066","DOIUrl":"10.36469/001c.130066","url":null,"abstract":"<p><p><b>Background:</b> The disease burden of heart failure is mainly driven by high hospital readmission rates. Remote monitoring devices can be used to assess the status of patients after discharge and identify early signs of worsening symptoms. Initial studies indicated that Heart Failure Management System (HFMS), a novel monitoring device, can prevent hospital readmission. <b>Objective:</b> To determine the cost effectiveness of HFMS compared with standard of care (SOC) in the United States. <b>Methods:</b> A Markov model was developed to follow patients after their discharge from index hospitalization for heart failure. The costs and outcomes were estimated for 5 years. The patient cohort was initially in \"outpatient care,\" where they are at risk of an emergency room visit or hospital readmission. If hospitalized, patients returned to a second outpatient care health state. An \"escalation of care\" (eg, surgical intervention) may have removed patients from the intervention. The model took the payer perspective with costs in 2022 US dollars. The incremental cost-effectiveness ratio measured effectiveness through hospital readmissions. The willingness-to-pay threshold was set to the published cost of a heart failure rehospitalization ($10 737). Sensitivity and scenario analyses explored the robustness of the model to changes in inputs. <b>Results:</b> Compared with SOC, HFMS reduced the mean cost of care by <math><mn>6723</mn> <mo>(</mo></math> 155 122 vs $161 846) over the 5-year period. The mean number of hospital readmissions was reduced to 1.075 with HFMS from 1.201 with SOC (-0.126 events). The incremental cost-effectiveness ratio showed that HFMS was a dominant strategy compared with SOC, leading to reduced costs and hospital readmissions in 93.4% of the 1000 Monte Carlo simulations; 94.1% of the simulations fell below the willingness-topay threshold. Savings with HFMS emerged from the third month. <b>Discussion:</b> The results indicated the cost-effectiveness of HFMS compared with SOC. The sensitivity analyses supported this finding. Reducing costly hospital readmissions may help to alleviate the burden of heart failure. Longer-term data on HFMS are encouraged to confirm or contest the model outcomes. <b>Conclusions:</b> The use of HFMS is expected to save costs and reduce hospitalizations over a 5-year period compared with the current SOC.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"113-119"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}