Journal of Health Economics and Outcomes Research最新文献

{"title":"Adult T-cell Leukemia/Lymphoma in Japan: Real-World Treatment Patterns, Healthcare Resource Utilization, and Costs.","authors":"Charles Dharmani, Zahid Islam, Pingping Qu, Zoe Jiang, Jingjian Wang, Li Li, Yijing Tao, Lin Song","doi":"10.36469/001c.162558","DOIUrl":"10.36469/001c.162558","url":null,"abstract":"<p><strong>Background: </strong>Adult T-cell leukemia/lymphoma (ATL) is a rare and aggressive type of peripheral T-cell malignancy caused by the human T-lymphotropic virus type 1 (HTLV-1). Approximately 5 to 10 million people are infected with HTLV-1 worldwide, with high prevalence in Japan. This observational study analyzed patient characteristics, treatment patterns, healthcare resource utilization (HRU), and costs of ATL in Japan.</p><p><strong>Methods: </strong>A retrospective analysis of ATL patients from the Medical Data Vision database, Sept. 1, 2012-Aug. 31, 2022, was conducted.</p><p><strong>Results: </strong>Among 1572 ATL patients, 384 received systemic therapy. The mean age at diagnosis was 66.4 years, with 63.7% being ≥65 years; 55.2% patients were females. Excluding cancer, 61% of patients had a Charlson Comorbidity Index score of 0. The most frequently observed comorbidities were congestive heart failure (15.8%), diabetes (14.8%), and peptic ulcer disease (14.6%). Among the treated patients, 37.5% received 1 line of therapy, 26% received 2 lines of therapy, and 36.5% received ≥3 lines. Mogamulizumab was most frequently utilized (60.4%), as monotherapy or in combination regimens. The most common combination regimen in all lines of therapy were cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), utilized in 46.6% of patients. Additionally, use of combinations such as VCAP-AMP-VECP, which include vincristine, cyclophosphamide, doxorubicin, and prednisone; adriamycin, manimustine, and prednisone; and vindesine, etoposide, carboplatin, and prednisone, was observed in 33.3% of patients. Initial treatment was discontinued in 74.7% patients; only 3.4% received stem cell transplants. Most (96%) patients were hospitalized, 29.7% had emergency room visits, and 79.4% averaged 1.8 outpatient visits monthly. The mean all-cause healthcare cost per patient per month was $29 538 (¥4 647 300), mainly due to outpatient visits and hospitalizations.</p><p><strong>Conclusion: </strong>Although real-world studies based on MDV database have certain limitations, the findings of this study provide deeper understanding of the real-world patient characteristics, treatment patterns, HRU, and costs of ATL patients in Japan. The results indicate that patients often encounter high treatment costs and frequent hospitalizations, demonstrating the necessity for advanced regimens and highlighting the unmet need for more effective therapies in ATL patients that may reduce HRU and economic burden in this patient population.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 2","pages":"35-45"},"PeriodicalIF":2.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678877","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":"Real-World Economic Outcomes of Patients with Localized Prostate Cancer Treated with External Beam Radiation Therapy or Radical Prostatectomy.","authors":"Lawrence Karsh, Shawn Du, Jinghua He, Neal Shore, Kruti Joshi","doi":"10.36469/001c.163569","DOIUrl":"10.36469/001c.163569","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;External beam radiation therapy (EBRT) and radical prostatectomy (RP) are definitive options for patients with localized or locally advanced prostate cancer (LPC). Limited evidence exists on the post-treatment economic burden in these patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This real-world analysis investigated healthcare costs among Medicare beneficiaries with LPC who received EBRT or RP as initial definitive treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective, longitudinal cohort study using Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Included were Medicare Fee-For-Service beneficiaries newly diagnosed with LPC at the age of ≥65 years during 2012-2019 and received either EBRT or RP as an initial definitive therapy. After the initial therapy, all-cause and prostate cancer-related costs were summarized and stratified by the earliest observed definitive therapy (RP vs EBRT) and the National Comprehensive Cancer Network risk classification (low/intermediate-risk [LIR-LPC] vs high-risk [HR-LPC]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 17 066 LPC patients treated with EBRT, 60% (N =10 321) had LIR-LPC and 40% (N = 6745) had HR-LPC. During the follow-up, the mean per-person-per-year all-cause cost was &lt;math&gt;&lt;mn&gt;9837&lt;/mn&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;H&lt;/mi&gt; &lt;mi&gt;R&lt;/mi&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;P&lt;/mi&gt; &lt;mi&gt;C&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;o&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;h&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;I&lt;/mi&gt; &lt;mi&gt;R&lt;/mi&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;P&lt;/mi&gt; &lt;mi&gt;C&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mo&gt;(&lt;/mo&gt;&lt;/math&gt; 34 441 vs $24 604; &lt;i&gt;P&lt;/i&gt; &lt; .0001). Of the 9479 patients treated with RP, 43% (N = 4120) had LIR-LPC and 57% (N = 5359) had HR-LPC. The mean per-person-per-year all-cause cost during follow-up was &lt;math&gt;&lt;mn&gt;6829&lt;/mn&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;H&lt;/mi&gt; &lt;mi&gt;R&lt;/mi&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;P&lt;/mi&gt; &lt;mi&gt;C&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;o&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;h&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;I&lt;/mi&gt; &lt;mi&gt;R&lt;/mi&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;P&lt;/mi&gt; &lt;mi&gt;C&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mo&gt;(&lt;/mo&gt;&lt;/math&gt; 23 820 vs $16 991; &lt;i&gt;P&lt;/i&gt; &lt; .0001). Across all cohorts, the largest all-cause healthcare cost category was outpatient, followed by inpatient and prescription drug.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This real-world study on healthcare costs in patients with LPC treated with EBRT or RP showed HR-LPC is associated with significant incremental economic burden relative to LIR-LPC. The findings highlight the current unmet need for more cost-effective treatment strategies for HR-LPC.&lt;","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 2","pages":"27-34"},"PeriodicalIF":2.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653634","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 Impact of SARS-CoV-2 Infection on Health-Related Quality of Life Among Persons Aged 8 Years and Older, August 2020-July 2022.","authors":"Sheroi Johnson, Huong Q Nguyen, Melissa S Stockwell, Christina A Porucznik, Ruth A Karron, Fatimah S Dawood, Lisa A Posser, Alisha P Sarakki, Joseph B Stanford, Marissa Hetrich, Elizabeth Schappell, Maria D Knoll, Vic Veguilla, Alexandra Mellis, Jazmin Duque, Zuha Jeddy, Jamison Pike, Melissa A Rolfes","doi":"10.36469/001c.163131","DOIUrl":"10.36469/001c.163131","url":null,"abstract":"<p><p><b>Background:</b> Severe COVID-19 results in substantial economic burden and impacts quality of life. Assessing how mild COVID-19 impacts health utilities during acute infection and long term is important to estimate the full economic impact of SARS-CoV-2 infection. <b>Methods:</b> We analyzed EQ-5D-3L survey data from SARS-CoV-2 infected adults (aged ≥16 years) and children (aged 8-15 years) from 3 community and household cohorts in the United States (2020-2022). EQ-5D-3L scores were analyzed at 3 time points after symptom onset or first positive SARS-CoV-2 test result and converted to health utilities on a scale of 0-1 (1 = perfect health). Among adults, regression models were used to compare differences in health utility by demographic/clinical characteristics. <b>Results:</b> Among 575 participants with SARS-CoV-2 infections and EQ-5D-3L surveys, mean utilities were nearly 1 throughout the observation period. During days 0-14 after symptom onset, vaccinated participants had higher health utilities (beta, 0.57; 95% CI: 0.07, 1.07). Seeking medical care and having gastrointestinal symptoms (vs none), were associated with lower health utilities (beta, -0.96; 95% CI: -1.60, -0.31; and beta, -0.76; 95% CI: -1.30, -0.21, respectively). During days 15-30 after onset, unemployment was associated with lower health utility (beta, -0.64; 95% CI: -1.15, -0.14). During days 31-90 after onset, underlying conditions were associated with lower health utilities (beta, -0.32; 95% CI: -0.54, -0.09). Results for children were similar to those for adults. <b>Conclusion:</b> Mild COVID-19 may have minimal overall impact on quality of life; however, health utilities differed by vaccination status, presence of gastrointestinal symptoms, employment status, and presence of underlying conditions. Vaccination may play an important role in minimizing illness impact from SARS-CoV-2 infection.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 2","pages":"16-26"},"PeriodicalIF":2.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630745","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":"Understanding Ehlers-Danlos Syndrome: A Claims-Based Analysis of Healthcare Cost Patterns.","authors":"Samson A Oyediran, Youngran Kim, Zhanna Novikov, Trudy M Krause","doi":"10.36469/001c.145941","DOIUrl":"10.36469/001c.145941","url":null,"abstract":"<p><p><b>Background:</b> Ehlers-Danlos Syndrome (EDS) is a rare connective tissue disorder associated with substantial clinical complexity and healthcare utilization. Despite increasing recognition of EDS, little is known about its economic burden in the United States. <b>Objective:</b> To assess the all-cause healthcare costs for individuals with newly diagnosed EDS during the pre-diagnosis year and the first 2 years post-diagnosis. <b>Methods:</b> A retrospective cohort study was conducted using the Merative™ MarketScan® Commercial Claims and Encounters Database (2016-2022). Newly diagnosed patients were identified using ICD-10-CM codes, with the first observed diagnosis defined as the index date. Continuous enrollment for 12 months pre-index and 24 months post-index was required. Costs represented gross payments to providers, adjusted to 2022 US dollars. Outcomes included inpatient, outpatient, and pharmacy expenditures, with outpatient services further stratified. Two-part models were estimated: a logistic regression for the probability of incurring costs and a GLM gamma model with log link for cost intensity among users. <b>Results:</b> The study included 4765 patients (mean age, 28.8 years; 78% female). Total annual costs rose from <math><mn>19</mn> <mrow><mo> </mo></mrow> <mn>733</mn> <mi>p</mi> <mi>r</mi> <mi>e</mi> <mo>-</mo> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>e</mi> <mi>x</mi> <mi>t</mi> <mi>o</mi></math> 28 922 in the first year post-diagnosis, then declined to $21 804 in the second year, though remaining above baseline. Outpatient and pharmacy services were the largest contributors, while inpatient admissions, though less frequent, were resource intensive when they occurred. Two-part models showed that the likelihood of incurring any cost was significantly higher in Year 1 (β = 4.15, P < .001) but not in Year 2 (β = -0.03, P = .845). Among cost users, expenditures remained elevated in both Year 1 (β = 0.41, P < .001) and Year 2 (β = 0.13, P < .001). Female sex and higher Charlson Comorbidity Index scores were associated with significantly greater costs. Costs peaked immediately after diagnosis, driven by outpatient and pharmacy use, and remained elevated in Year 2. Patient characteristics, particularly comorbidities, strongly influenced expenditures. <b>Conclusions:</b> Healthcare costs for patients with EDS peaked during the first year following diagnosis and remained elevated in the second year relative to pre-diagnosis levels. These findings highlight the substantial and persistent economic impact of EDS on the healthcare system.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 2","pages":"8-15"},"PeriodicalIF":2.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578695","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":"Identifying Minimum Threshold Level of Trial Crossover Rates Yielding Nonsignificant Overall Survival Benefit Associated with Cancer Treatments: A Systematic Literature Review of HTA Submissions.","authors":"Anandaroop Dasgupta, Ankita Kaushik, Barinder Singh, Sumeet Attri, Billy Amzal, Oleg Gluz","doi":"10.36469/001c.163160","DOIUrl":"10.36469/001c.163160","url":null,"abstract":"<p><strong>Background: </strong>Crossover distortion in oncology trials occurs when control-arm patients switch to agent(s) in the experimental arm, potentially attenuating treatment effects in intention-to-treat (ITT) overall survival (OS) analyses. This complicates health technology assessment (HTA) decision-making by masking true treatment benefits. Understanding crossover thresholds compromising ITT OS statistical significance is critical for interpreting trial outcomes.</p><p><strong>Objective: </strong>We aimed to identify minimum threshold beyond which crossover rates are associated with loss of ITT OS statistical significance in advanced/metastatic breast, colorectal, gastrointestinal stromal, lung, prostate, and renal cancers.</p><p><strong>Methods: </strong>A systematic literature review of HTA reports (2013-2024) from NICE-UK, CDA-Canada, HAS-France, G-BA/IQWiG-Germany, PBAC-Australia, AIFA-Italy, AEMPS-Spain, and ICER-US was conducted. Searches were augmented with information from clinical practice guidelines and product labels from regulatory agencies. Submissions reporting crossover rates, with/without crossover-mitigation strategies applied, were analyzed to quantify the relationship between crossover rates and ITT OS statistical significance.</p><p><strong>Results: </strong>Fifty unique trials from 114 submissions reported crossover rates (NICE = 25, HAS = 19, CDA = 15, PBAC = 13, G-BA/IQWiG = 32, AEMPS = 9, ICER = 1), with crossover-mitigation strategies applied in 26 trials. A hypothesis-generating minimum benchmark of crossover rate (the ratio of control-arm participants switching to agent(s) in the experimental arm) ~42.7% was identified above which ITT OS lost statistical significance. Trials with high crossover rates (42.7%-88%) showed nonsignificant OS improvements, whereas lower rates (<42.5%) demonstrated significant OS benefits. Higher crossover rates were observed in trials with built-in vs natural crossover (52.9% vs 8.1%). In first-line setting, crossover rates >42.5% typically diluted OS benefit. In later-line and refractory diseases, OS significance often persisted beyond 42.7% threshold due to limited confounding by post-progression treatment options and faster death event accrual.</p><p><strong>Conclusion: </strong>Crossover impact varied by tumor type, treatment line, crossover type, and trial maturity. Crossover >42.7% generally compromised ITT OS significance; however, OS maturity attained in the trial or sustained efficacy of the intervention beyond progression may preserve statistical significance despite high crossover. A crossover rate exceeding 42.7% was associated with nonsignificant ITT OS outcomes in most trials, particularly in first-line settings. OS benefits may persist in later-line settings with fewer post-progression treatment alternatives. This evidence supports contextual interpretation of crossover-affected OS during HTA decision-making.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 2","pages":"1-7"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421617","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 of Semaglutide 2.4 mg for Obesity Disease Management in Japan: A Lifetime Economic Modeling Study Incorporating Retreatment Scenarios.","authors":"Yuta Kamada, Shogo Wada, Hiroyuki Matsuda, Yawen Dai","doi":"10.36469/001c.162614","DOIUrl":"10.36469/001c.162614","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a chronic disease associated with substantial morbidity and healthcare costs. In Japan, the Optimal Use Promotion Guidelines (OUG) impose restrictions on patient eligibility for semaglutide 2.4 mg and limit treatment duration. This study evaluated the cost-effectiveness of semaglutide 2.4 mg in Japan under retreatment assumptions informed by OUG requirements.</p><p><strong>Methods: </strong>A Markov cohort model (Core Obesity Model) was used to evaluate lifetime clinical and economic outcomes from a Japanese public payer perspective. The Core Obesity Model assesses the associations between risk factors and the incidence of obesity-related complications. People with obesity disease and either a BMI ≥35 kg/m2 with at least 1 obesity-related comorbidity (hypertension, dyslipidemia, or type 2 diabetes), or a BMI ≥27 kg/m² with at least 2 obesity-related health disorders, were included. The intervention was semaglutide 2.4 mg plus diet and exercise vs diet and exercise alone. We modeled retreatment scenarios (0, 1, or 2 retreatments) with a fixed 1-year off-treatment period after each regimen. Complication costs were sourced from Japanese studies. The primary outcome was the incremental cost-effectiveness ratio (ICER) in Japanese yen per quality adjusted life year (QALY), discounted at 2%.</p><p><strong>Results: </strong>In the base case, semaglutide 2.4 mg reduced the incidence of obesity-related complications, such as type 2 diabetes (T2D), cardiovascular events, obstructive sleep apnea, and gout. The ICER was ¥5 300 580/QALY for patients with obesity disease without T2D, and ¥7 077 984/QALY for patients with obesity disease with T2D. Retreatment significantly improved QALY gains compared with limited or no retreatment, reflecting longer maintenance of treatment benefit.</p><p><strong>Conclusions: </strong>Accounting for OUG consistent retreatment in Japan improved the cost-effectiveness of semaglutide 2.4 mg and provided a more realistic representation of long-term obesity management than single course assumptions. Analyses that omit retreatment may underestimate its long-term value in Japanese clinical practice. Results were broadly robust, although uncertainty remains around retreatment efficacy and long-term discontinuation. Semaglutide 2.4 mg represents a clinically and economically valuable intervention for obesity disease in Japan. These findings emphasize the need for long‑term, clinically realistic assessments when evaluating obesity treatments in Japan.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"288-296"},"PeriodicalIF":2.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375925","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 Annual vs Biennial Fecal Immunochemical Testing for Colorectal Cancer Screening in Japan: A Microsimulation Analysis.","authors":"Taichi Mori, Nobuyuki Shimohata, Rei Goto","doi":"10.36469/001c.162580","DOIUrl":"10.36469/001c.162580","url":null,"abstract":"<p><strong>Background: </strong>The optimal screening interval for fecal immunochemical testing (FIT) in Japan remains uncertain.</p><p><strong>Objective: </strong>This study aimed to evaluate the cost-effectiveness of biennial FIT screening compared with annual FIT screening to inform future national guidelines.</p><p><strong>Methods: </strong>We developed a microsimulation model of a cohort of 100 000 average-risk Japanese individuals aged 40 years and older followed over a 60-year horizon from a healthcare payer perspective. Two screening methods were compared: the current annual FIT and biennial FIT. Effectiveness was measured in quality-adjusted life-years (QALYs), and costs were measured in 2024 Japanese yen.</p><p><strong>Results: </strong>Annual FIT screening was dominant, resulting in lower total costs (¥408 058 vs. ¥451 407) and higher QALYs (26.483 vs 26.440) compared with biennial screening. Probabilistic sensitivity analysis indicated that annual screening was cost-effective in 92.7% of iterations at a WTP threshold of ¥5 million per QALY.</p><p><strong>Conclusions: </strong>The analysis indicated that annual FIT screening was dominant over biennial screening, because of its lower costs and higher QALY yield. These findings were supported by probabilistic sensitivity analysis. Although annual FIT screening is generally superior to biennial screening in Japan and provides greater health benefits at lower costs, future policies should aim to address endoscopic capacity constraints to ensure program sustainability.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"272-279"},"PeriodicalIF":2.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345411","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":"Unlocking the Value of Patient Self-Monitoring Technologies: A Multi-Country Framework to Calibrate Payer and HTA Coverage and Reimbursement Considerations with Innovation.","authors":"James K Karichu, Shafie Kamaruddin, Pinar Bilir, Paco Cerletti, Susan N Chang, Sumudu Dehipawala, Conor Maher, Abbie Malyon, Matthew O'Hara","doi":"10.36469/001c.163078","DOIUrl":"10.36469/001c.163078","url":null,"abstract":"<p><strong>Background: </strong>Patient self-monitoring (PSM) is emerging as an innovative modality for chronic disease management. While PSM technologies are established in therapeutic areas including diabetes and cardiovascular diseases, current payer and health technology assessments (HTA) do not adequately evaluate the unique facets of their value.</p><p><strong>Objectives: </strong>This study developed a multi-country, stakeholder-informed framework that considers the value drivers of PSM technologies, mapping these to payer and HTA evaluation criteria to guide evidence generation and reimbursement decision making.</p><p><strong>Methods: </strong>A sequential mixed methodology study of an artificial intelligence-enabled targeted literature review using Nested Knowledge® and qualitative primary research with 10 payer and healthcare practitioner respondents in the United States, United Kingdom, and Germany was used to inform development of the framework.</p><p><strong>Results: </strong>The framework comprises three interconnected core components: value drivers, evaluation criteria, and evidence generation considerations. The value drivers component consists of four themes: clinical, economic, humanistic, and societal. Primary research respondents weighted the respective emphasis of decision making as 60% clinical, 20% economic, 10% humanistic, and 10% societal value. Key value drivers included treatment efficacy/clinical utility, diagnostic efficacy, and healthcare resource utilization. Evaluation criteria indicate the coverage/reimbursement requirements of key payer and HTA organizations. Evidence generation considerations comprise potential study types and evidence generation activities.</p><p><strong>Conclusions: </strong>This framework provides a conceptual foundation for stakeholders including payers, HTA bodies, physicians, and developers to align upon evidence requirements for PSM technologies. It can support streamlined strategic evidence generation and consistent evaluation to improve patient access to innovative chronic disease self-monitoring technologies.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"248-254"},"PeriodicalIF":2.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295361","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":"Projected Reduction of Diabetes- and Obesity-Related Complication Risks Following the 12-Week Weight-Loss Phase of the RESET Study.","authors":"Bjoern Schwander, Kirk W Kerr, Ricardo Rueda, Maria Camprubi-Robles, Nicky Northway, Carl Lumsden, Louise Taylor, Suela Sulo","doi":"10.36469/001c.162856","DOIUrl":"10.36469/001c.162856","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2D) and obesity increase individuals' risk of microvascular and macrovascular complications, which may increase healthcare costs. The RESET program combined low-calorie diet using diabetes-specific nutritional formula and a digital lifestyle behavior change program to target sustainable weight loss and improved diabetes management.</p><p><strong>Objective: </strong>To quantify projected changes in diabetes-related complication risks following the 12-week weight-loss phase of the RESET program and to relate these modeled risk reductions to program costs.</p><p><strong>Methods: </strong>Data from 157 adults with type 2 diabetes (mean age, 56 years; diabetes duration, 2.2 years; baseline body mass index (BMI), 35 kg/m²; HbA1c, 7.5%) completing the RESET weight-loss phase were analyzed. Observed mean changes in HbA1c, BMI, and systolic blood pressure were applied to the UK Prospective Diabetes Study Outcomes Model 2 (UKPDS-OM2) to estimate projected relative risk reductions in microvascular and macrovascular complications over a 3-month horizon. Program costs were derived using a microcosting approach from the healthcare payer perspective, and parameter uncertainty was evaluated through 20 000 Monte Carlo simulations.</p><p><strong>Results: </strong>Participants achieved mean reductions of 1.0% in HbA1c, 11.0 kg in body weight, and 4.5 mmHg in systolic blood pressure. The model projected an overall relative reduction in total complication risk of 15.4% (95% confidence interval [CI], 9.1-21.4), corresponding to an absolute reduction of 1.9 projected events per 1000 participants over 3 months, comprising a -13.2% mean reduction in macrovascular and -23.8% in microvascular complication risks. Mean program cost was £1236 per participant (95% CI, £1001-£1492), corresponding to an incremental cost of £84 per 1% relative risk reduction.</p><p><strong>Conclusions: </strong>Short-term, intensive weight loss achieved clinically meaningful improvements in HbA1c and body weight that were associated with favorable reductions in projected microvascular and macrovascular complications at modest cost. Absolute event reductions over 3 months were modest, and sustaining these improvements is essential to realize long-term clinical and economic benefit.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"255-263"},"PeriodicalIF":2.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295367","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":"Real-World Completion of Multitarget Stool DNA Testing Among Texas Medicare Beneficiaries: Associations With Payer Type, Digital Outreach, and Social Vulnerability.","authors":"Timothy Ritter, Shrey Gohil, Betthany Thomas, Travelle Ellis, Gustavus Aranda, Sushovan Guha, Mallik Greene","doi":"10.36469/001c.162887","DOIUrl":"10.36469/001c.162887","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is a leading cause of cancer-related morbidity and mortality in the United States; however, a substantial proportion of eligible adults do not complete screening.</p><p><strong>Objectives: </strong>To evaluate real-world completion of multitarget stool DNA (mt-sDNA) testing for colorectal cancer screening among Medicare beneficiaries in Texas and to identify beneficiary-, provider-, and outreach-related factors associated with test completion.</p><p><strong>Methods: </strong>This retrospective cohort study included Texas beneficiaries aged 65 to 85 years with traditional Medicare or Medicare Advantage coverage who received an mt-sDNA kit between October 2014 and December 2024. Completion was defined as return of a valid test kit within 1 year of shipment. Multivariable logistic regression was used to identify factors associated with completion. Kaplan-Meier and Cox proportional hazards models were used to evaluate time to kit return.</p><p><strong>Results: </strong>Among 710 515 beneficiaries, 538 377 (75.8%) completed mt-sDNA testing within 1 year. Completion was higher among beneficiaries with traditional Medicare vs Medicare Advantage (81.7% vs 71.7%). In adjusted analyses, gastroenterologist ordering (odds ratio [OR], 2.66; 95% confidence interval [CI], 2.53-2.79), full digital outreach (OR, 1.73; 95% CI, 1.69-1.77), and prior mt-sDNA use (OR, 1.61; 95% CI, 1.59-1.64) were associated with higher odds of completion. Higher neighborhood income and lower social vulnerability were also associated with higher completion rates. Time-to-event analyses were consistent, with faster completion observed among patients receiving digital outreach, with prior mt-sDNA use, and those with gastroenterologist-ordered tests.</p><p><strong>Discussion: </strong>These findings suggest that both patient context and modifiable care delivery factors influence screening completion and may inform the design of more effective and equitable CRC screening programs.</p><p><strong>Conclusions: </strong>In this large real-world Medicare cohort, mt-sDNA completion was high overall but varied by payer type, provider specialty, outreach modality, and socioeconomic vulnerability.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"241-247"},"PeriodicalIF":2.5,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277558","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}