Journal of Health Economics and Outcomes Research最新文献

{"title":"Antiretroviral Treatment Switch Among Treatment-Experienced People with HIV.","authors":"Benjamin Chastek, Uche Mordi, Mary J Christoph, Lisa B Le, Travis Lim, Sunil Majethia, Cassidy Trom, Joshua Cohen","doi":"10.36469/001c.156180","DOIUrl":"https://doi.org/10.36469/001c.156180","url":null,"abstract":"<p><strong>Background: </strong>HIV requires lifelong continuous antiretroviral therapy (ART) to prevent morbidity and mortality and to reduce onward transmission. People with HIV (PWH) may switch ART regimens for various clinical and nonclinical reasons. Identifying patterns of ART switching can inform shared decision-making and optimize regimen selection among treatment-experienced PWH.</p><p><strong>Objectives: </strong>To describe and compare treatment switching among PWH by regimen in a large US claims database, including a subset of PWH enrolled in Medicare Advantage.</p><p><strong>Methods: </strong>A retrospective analysis of closed US medical and pharmacy claims data was conducted in treatment-experienced PWH with commercial insurance or Medicare Advantage with Part D coverage from the Optum Research Database. PWH who switched to an ART regimen of interest (bictegravir/emtricitabine/tenofovir alafenamide [B/F/TAF], dolutegravir/lamivudine, dolutegravir/abacavir/lamivudine, dolutegravir + emtricitabine/tenofovir alafenamide, dolutegravir + emtricitabine/tenofovir disoproxil fumarate, and cabotegravir + rilpivirine) between July 1, 2017, and November 30, 2023, were included. Baseline characteristics were balanced across regimens in the overall study population using inverse probability treatment weighting. Time to switch/add-on was estimated using Kaplan-Meier analyses. Adjusted hazard ratios for the entire follow-up period were calculated using multivariable Cox proportional hazards models. Outcomes were assessed in the overall population and in the subset enrolled in Medicare Advantage.</p><p><strong>Results: </strong>Overall, 14 826 treatment-experienced PWH were included in the study. The proportion of PWH without switch/add-on after the first 12 months of follow-up was greater for those who were taking B/F/TAF compared with those taking the other regimens of interest (all <i>P</i> < .001). The risk of switch/add-on was significantly lower for those who were taking B/F/TAF vs those taking the other regimens of interest (all <i>P</i> ≤ .001). Findings were similar for the subset of Medicare Advantage enrollees.</p><p><strong>Discussion: </strong>Due to more effective treatments, PWH have increased life expectancy, and a growing proportion are qualifying for Medicare coverage. This analysis showed that PWH taking B/F/TAF, both in the overall population and the Medicare Advantage subset, maintained their initial treatment regimen longer and had a reduced risk of treatment switch/add-on compared with the other regimens of interest.</p><p><strong>Conclusions: </strong>These findings suggest that B/F/TAF has a lower likelihood of treatment switch/add-on for treatment-experienced PWH than other current ART regimens.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"73-78"},"PeriodicalIF":2.3,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12940528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325736","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 Paradox of Life Extension with Traditional Cost-Effectiveness Analysis: A Case Study with Duchenne Muscular Dystrophy.","authors":"Lauren Sedita, Alexa Klimchak, Eleanor Perfetto, Katherine Gooch, Daniel C Malone","doi":"10.36469/001c.156118","DOIUrl":"https://doi.org/10.36469/001c.156118","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Traditional quality-adjusted life-year (QALY)-based cost-effectiveness analyses (CEAs) may inadvertently penalize treatments extending survival in populations with disabilities. Duchenne muscular dystrophy (DMD) is a rare, progressive disease diagnosed during childhood with significant morbidity, premature mortality, and considerable healthcare costs. The impact of delaying mortality on CEAs for DMD is unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the impact of delaying nonfatal progression and/or mortality using a QALY-based CEA for three hypothetical DMD treatments, assessing if treatment value increases by delaying morbidity and/or mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A previously published, five-state QALY-based cost-effectiveness model for analyzing treatments in an early ambulatory DMD population was replicated, validated, and adapted to include an early nonambulatory (ENA) population. Maximum annual treatment price was determined for three hypothetical treatments individually compared for each population with standard of care (SoC): (A) delays nonfatal progression and mortality; (B) delays nonfatal progression; or (C) delays mortality. A 10-year delay was assessed for all three. Willingness-to-pay (WTP) thresholds ranged from &lt;math&gt;&lt;mn&gt;50&lt;/mn&gt; &lt;mrow&gt;&lt;mo&gt; &lt;/mo&gt;&lt;/mrow&gt; &lt;mn&gt;000&lt;/mn&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt;&lt;/math&gt; 200 000/QALY.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In both populations, QALYs gained vs SoC were highest for the hypothetical treatment delaying both nonfatal progression and mortality. Maximum annual treatment price was highest for the hypothetical treatment delaying nonfatal progression only (both populations and all WTP thresholds). Delaying mortality alone consistently had a negative annual valuation (not cost-effective even at &lt;math&gt;&lt;mn&gt;0&lt;/mn&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mo&gt;)&lt;/mo&gt; &lt;mo&gt;,&lt;/mo&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;g&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;f&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt;&lt;/math&gt; -8685 to &lt;math&gt;&lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;2148&lt;/mn&gt; &lt;mo&gt;(&lt;/mo&gt; &lt;mi&gt;E&lt;/mi&gt; &lt;mi&gt;A&lt;/mi&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;a&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;mo&gt;)&lt;/mo&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt;&lt;/math&gt; -13 253 to $-3278 (ENA population). For all treatments, valuation for the ENA population was consistently lower.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;These model results illustrate that delaying both nonfatal progression and mortality is less valuable in a traditional CEA than delaying nonfatal progression alone, even when the additional survival is at the patient's best possible health and lowest costs. These results emphasize the significant shortcomings of QALY-based CEAs for assessing the value of potential life-extending treatments for progressive, disabling diseases, like DMD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These results suggest that within a traditional CEA, delaying mortality decreases a DMD treatment's value","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"56-62"},"PeriodicalIF":2.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271229","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 Trastuzumab-Emtansine as Adjuvant Therapy for HER2-Positive Early Breast Cancer with Residual Invasive Disease in Colombia.","authors":"Daniel Samacá-Samacá, Diego Ballén, Milton Lombana, Melissa Díaz-Puentes, Sergio Augusto Cáceres-Maldonado, Juliana Saavedra, Laura Prieto-Pinto","doi":"10.36469/001c.156056","DOIUrl":"https://doi.org/10.36469/001c.156056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with HER2-positive (HER2+) breast cancer (BC) who have residual invasive disease after neoadjuvant therapy remain at a significantly increased risk of recurrence. Updated results from the KATHERINE trial demonstrated the clinical benefit of trastuzumab-emtansine (T-DM1), showing a significant improvement in event-free survival. However, in budget-constrained settings, assessing the cost-effectiveness of TDM-1 is essential to guide sustainable adoption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the cost-effectiveness analysis of adjuvant T-DM1 compared with trastuzumab in HER2+ early BC patients and residual disease, following neoadjuvant treatment, from the Colombian Health System perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a Markov model with a lifetime horizon to evaluate the cost-effectiveness of T-DM1 using the updated results of the KATHERINE trial (8.4-year follow-up). The model comprises 6 health states: patients with residual invasive disease on adjuvant treatment, non-metastatic recurrence, remission after non-metastatic recurrence, metastatic disease (first-line [1LmBC] and subsequent lines [2LmBC]), and death. Direct medical costs were included. The primary outcome was quality-adjusted life-years, with both costs and effects discounted annually at a 5% rate. Model assumptions were based on current guidelines and validated by local experts. Sensitivity and scenario analysis were performed to confirm the reliability of the results. Prices are shown in 2024 US dollars (4071.35 Colombian pesos = US $1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Under a willingness-to-pay threshold of 86% of the 2024 gross domestic product per capita (US &lt;math&gt;&lt;mn&gt;6831&lt;/mn&gt; &lt;mo&gt;)&lt;/mo&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;T&lt;/mi&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mi&gt;D&lt;/mi&gt; &lt;mi&gt;M&lt;/mi&gt; &lt;mn&gt;1&lt;/mn&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;d&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&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;o&lt;/mi&gt; &lt;mi&gt;v&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&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;s&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;z&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;b&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;s&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;v&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;s&lt;/mi&gt; &lt;mi&gt;w&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;y&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;r&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;n&lt;/mi&gt; &lt;mi&gt;b&lt;/mi&gt; &lt;mi&gt;y&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;r&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;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&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;u&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;e&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;s&lt;/mi&gt; &lt;mo&gt;(&lt;/mo&gt; &lt;mo&gt;&gt;&lt;/mo&gt; &lt;mn&gt;50&lt;/mn&gt;&lt;/math&gt; -30 510) and 2LmBC (US $-6317). The probabilistic sensitivity analysis confirmed T-DM1 dominance in 81.2% of the 1000 Monte Carlo simulations, demonstrating consistency across settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;T-DM1 is a cost-effective and dominant strategy for","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"58-65"},"PeriodicalIF":2.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271172","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":"Trial Interviews to Explore Glycogen Storage Disease Type Ia Patient Experiences Following Gene Therapy.","authors":"Diane M Turner-Bowker, Jessica Butler, Shayna Egan, David A Weinstein, David F Rodriguez-Buritica, Ayesha Ahmad, María-Luz Couce, Rebecca Riba-Wolman, John J Mitchell, Christina Theodore-Oklota","doi":"10.36469/001c.155666","DOIUrl":"10.36469/001c.155666","url":null,"abstract":"<p><strong>Background: </strong>Glycogen storage disease type Ia (GSDIa) is a rare, inherited, autosomal recessive deficiency of glucose-6-phosphatase (G6Pase), an enzyme necessary in glycogenolysis and gluconeogenesis. To maintain normal blood glucose levels and ensure survival, individuals living with GSDIa must frequently consume complex carbohydrates (eg, uncooked cornstarch). Dietary management can result in chronic complications and significant patient burden. DTX401 (pariglasgene brecaparvovec) is an investigational adeno-associated virus serotype 8 vector (AAV8)-based gene therapy designed to restore endogenous glucose production.</p><p><strong>Objectives: </strong>Patient experience interviews were conducted as part of an open-label, phase 1/2 dose-escalation trial (NCT03517085) evaluating the safety and efficacy of DTX401 in adults ≥18 years with GSDIa.</p><p><strong>Methods: </strong>Telephone interviews were conducted at Weeks 24, 52, and 104, using a semistructured interview guide. Qualitative interview data were audio recorded, transcribed, coded, and analyzed.</p><p><strong>Results: </strong>Most (86%; n = 6/7) reported overall symptom improvement and reduced burden following DTX401 treatment. Three (43%) reported no negative outcomes following gene therapy; 4 (57%) mentioned at least one negative change attributed to instances of blood sugar instability, lifestyle, or diet adjustments. Satisfaction fluctuated across timepoints; however, most were somewhat satisfied/very satisfied with gene therapy at Weeks 24 (80%), 52 (86%), and 104 (86%). No participants reported being very dissatisfied.</p><p><strong>Discussion: </strong>Following DTX401 treatment, most participants reported substantial reduction in cornstarch intake and corresponding improvements in symptoms, physical function, diet management, emotional function, self-perception, social function, sleep quality, work performance, and overall health. Few negative changes were reported. While some results regarding met expectations were mixed, most indicated they would still want gene therapy even if they had to continue cornstarch and if they had continued diet restrictions, and most reported satisfaction with treatment. While the study had limitations, interview results suggest that DTX401 helps to address aspects of the condition and treatment that patients have identified as burdensome.</p><p><strong>Conclusions: </strong>Most interviewees in this open-label trial of investigational DTX401 described positive experiences, including substantial reduction in burden and improved health-related quality of life following treatment throughout the trial. To optimize patient outcomes and experience with gene therapy, guidance on and close monitoring of dietary changes during implementation should be provided.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"39-47"},"PeriodicalIF":2.3,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201905","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 Continuously Diffused Oxygen Therapy Compared with Negative-Pressure Wound Therapy.","authors":"Matthew Mercurio, Lawrence A Lavery, Animesh Agarwal, Alisha Oropallo","doi":"10.36469/001c.155760","DOIUrl":"10.36469/001c.155760","url":null,"abstract":"<p><strong>Background: </strong>Continuous diffusion of oxygen (CDO) to wounds has demonstrated better effectiveness in healing wounds than negative-pressure wound therapy (NPWT). However, there is limited evidence regarding the cost-effectiveness of CDO therapy and its comparison with NPWT.</p><p><strong>Objectives: </strong>The purpose of this analysis is to report on the cost-effectiveness of CDO and NPWT using published clinical results as well as real-world clinical outcomes and cost information. The objectives included analyzing the cost-effectiveness of CDO therapy across multiple wound types and anatomical locations, testing the data for robustness, and comparing the cost-effectiveness using results from controlled clinical studies for CDO and NPWT.</p><p><strong>Methods: </strong>A prospective patients database using real-world clinical results of 764 patients treated using CDO therapy in a broad range of clinical practices across a wide range of wound types and wound locations was analyzed. The clinical data were combined with real world billing data to draw statistically valid cost comparisons. Using 3 methodologies, the cost savings were demonstrated across 2 healthcare systems.</p><p><strong>Results: </strong>In the US, the average cost savings of CDO was US $14 238 vs NPWT to heal a wound. Kaplan-Meier analysis showed that CDO use in clinical practice had 79.2% full closure in 112 days compared with NPWT, which has 43.2% full closure in the same timeframe for similar wound sizes and severity.</p><p><strong>Discussion: </strong>There are two primary reasons for the significant cost savings. First, CDO therapy is much easier to apply and maintain than traditional NPWT, as CDO dressings can easily be changed by patients at home without the assistance of a nurse. The second reason is the substantially higher efficacy of CDO therapy.</p><p><strong>Conclusion: </strong>CDO is highly efficacious in clinical practice and cost-effective compared with NPWT and other therapies such as moist wound therapy and hyperbaric oxygen.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"30-38"},"PeriodicalIF":2.3,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201973","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: Cost-Effectiveness of an Absorbable Antibacterial Envelope for Infection Control in Cardiac Implantable Electronic Device Procedures in Spain.","authors":"Tomás Datino, Daniela Afonso, Elana Greaves, Simon Eggington, Julen Monje, María Álvarez Orozco, Claudia Wolff, Stuart Mealing, Arístides de Alarcón","doi":"10.36469/001c.156166","DOIUrl":"10.36469/001c.156166","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.36469/jheor.2026.154974.].</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"20-29"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149895","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 an Absorbable Antibacterial Envelope for Infection Control in Cardiac Implantable Electronic Device Procedures in Spain.","authors":"Tomás Datino, Daniela Afonso, Elana Greaves, Simon Eggington, Julen Monge, Maria Álvarez Orozco, Claudia Wolff, Stuart Mealing, Arístides de Alarcón","doi":"10.36469/001c.154974","DOIUrl":"10.36469/001c.154974","url":null,"abstract":"<p><strong>Background: </strong>Infections represent the most serious complication associated with cardiac implantable electronic devices (CIEDs). This can result in prolonged hospital stays, high morbidity and mortality, and a significant economic burden for healthcare systems.</p><p><strong>Objectives: </strong>This study aimed to evaluate the cost-effectiveness of the TYRX absorbable antibacterial envelope for CIED infection prevention from the Spanish Healthcare System perspective.</p><p><strong>Methods: </strong>A decision tree model with a lifetime horizon was developed to compare standard antibiotic prophylaxis with its combination with TYRX, regardless of infection risk. The model incorporated infection incidence, mortality, and utility values up to 36 months, derived from REINFORCE, AdaptResponse, and WRAP-IT studies. Unit costs (2025 euros) included prevention strategies and infection management. Lifetime costs and quality-adjusted life-years (QALYs) were assigned to survivors beyond 36 months. The incremental cost-effectiveness ratio (ICER) was reported by CIED and weighted by implant distribution (permanent pacemaker [PPM, 76.5%], implantable cardioverter-defibrillator [ICD, 15.2%], cardiac resynchronization therapy with defibrillator [CRT-D, 5.4%], and pacemaker [CRT-P, 2.9%]). A subgroup analysis was performed in high-risk patients (PADIT≥7), modifying infection rates based on PADIT risk stratification, along with sensitivity analyses. Model inputs were validated by an expert panel.</p><p><strong>Results: </strong>TYRX was the dominant strategy (more effective and less costly) for CRT-D and ICD recipients and cost-effective for those receiving PPM (€17 740/QALY) or CRT-P (€14 647/QALY), considering a willingness-to-pay threshold of €25 000/QALY. Across the spectrum of CIEDs, the ICER was €11 709/QALY. TYRX remained cost-effective in 77% of sensitivity analysis simulations. In high-risk patients, TYRX was dominant for all CIEDs.</p><p><strong>Discussion: </strong>This study is believed to be the first economic evaluation of TYRX in Spain and provides novel evidence in a broad, unselected population. Previous cost-effectiveness analyses conducted across different healthcare systems have consistently shown that TYRX is cost-effective in patients at elevated risk for device-related infections. Although the populations and healthcare settings differ, our findings are consistent with this body of evidence.</p><p><strong>Conclusions: </strong>TYRX represents a dominant strategy for infection prevention for CRT-D and ICD and is cost-effective for PPM and CRT-P, based on Spain's willingness to pay.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"10-19"},"PeriodicalIF":2.3,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12850660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086041","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":"Impact of Early Treatment with Pimavanserin on Healthcare Resource Utilization Among Newly Diagnosed Patients with Parkinson's Disease Psychosis: A Pre-Post Medicare Claims Database Analysis.","authors":"Nazia Rashid, Krithika Rajagopalan, Daksha Gopal, Lambros Chrones, Dilesh Doshi","doi":"10.36469/001c.154805","DOIUrl":"https://doi.org/10.36469/001c.154805","url":null,"abstract":"<p><strong>Background: </strong>Pimavanserin is currently the only atypical antipsychotic (AAP) approved by the US Food and Drug Administration for treating hallucinations and delusions in Parkinson's disease psychosis (PDP). Benefit and efficacy of pimavanserin have been demonstrated through clinical trials; however, understanding other real-world outcomes is needed.</p><p><strong>Objective: </strong>This study evaluated healthcare resource utilization (HCRU) patterns before and after pimavanserin initiation to assess benefit and effectiveness of pimavanserin that may be seen in the real-world setting but not in clinical trials.</p><p><strong>Methods: </strong>A retrospective pre-post analysis using 100% Medicare claims data (Parts A, B, and D), April 1, 2015-December 31, 2021, was conducted. The study included AAP treatment-naïve PDP patients who initiated continuous pimavanserin monotherapy (index date) within 6 months of their incident PDP diagnosis, April 1, 2016-December 31, 2020 (ie, patient identification period). Outcomes measured during the 6 months before and after pimavanserin initiation included all-cause and psychiatric-related HCRU; further categorized as inpatient, emergency room (ER), outpatient, and office visits. Significant differences in the percentage of patients with at least 1 all-cause and at least 1 psychiatric-related HCRU were evaluated using McNemar's tests at <i>P</i> < .05.</p><p><strong>Results: </strong>Of the 694 patients newly diagnosed with PDP who initiated pimavanserin within 6 months of PDP diagnosis, mean age was 76.9 (±6.8) years, 54.8% were male, and 78.3% had concomitant dementia. The percentage of patients with at least 1 all-cause HCRU was significantly higher during the 6 months pre-index vs post-index, with inpatient (26.1% vs 20.5%, <i>P</i> < .05), ER (51.3% vs 35.2%, <i>P</i> < .05), outpatient (83.0% vs 79.3%, <i>P</i> < .05), and office visits (97.4% vs 95.8%, <i>P</i> < .05). Similarly, the percentage of patients with at least 1 psychiatric-related HCRU was significantly higher 6 months pre-index vs post-index, with inpatient (7.8% vs 4.9%, <i>P</i> < .05), ER (9.7% vs 3.5%, <i>P</i> < .05), outpatient (23.6% vs 13.0%, <i>P</i> < .05), and office visits (68.7% vs 55.8%, <i>P</i> < .05).</p><p><strong>Conclusions: </strong>Newly diagnosed PDP patients initiating pimavanserin within 6 months demonstrated significant reductions in 6-month post-index all-cause and psychiatric-related HCRU. Further analysis examining the association between time of pimavanserin initiation and the magnitude of benefits are warranted.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"13 1","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052389","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":"Comparison of Prostate-Specific Antigen Response in Black Patients with Metastatic Castration-Sensitive Prostate Cancer Initiated on Apalutamide vs Abiraterone Acetate.","authors":"Gordon Brown, Sabree Burbage, Ibrahim Khilfeh, Carmine Rossi, Shawn Du, Frederic Kinkead, Lilian Diaz, Dominic Pilon, Benjamin Lowentritt","doi":"10.36469/001c.151273","DOIUrl":"10.36469/001c.151273","url":null,"abstract":"<p><strong>Background: </strong>Improved clinical outcomes have been observed in patients with metastatic castration-sensitive prostate cancer (mCSPC) who experience deep prostate-specific antigen (PSA) responses after treatment with androgen receptor pathway inhibitors (ARPIs).</p><p><strong>Objective: </strong>This retrospective longitudinal study aimed to compare real-world PSA90 response (≥90% reduction from pretreatment levels) in Black patients with mCSPC treated with apalutamide vs abiraterone acetate.</p><p><strong>Methods: </strong>Electronic medical record (EMR) data from Precision Point Specialty Analytics were linked to claims data from the Komodo Research Database. Black adult patients with mCSPC who initiated apalutamide or abiraterone acetate on or after 9/17/2019 were included. Inverse probability of treatment weighting was used to balance patient characteristics between treatment cohorts. PSA90 was evaluated during the on-treatment period, defined as the time from index date to the earliest of treatment discontinuation, initiation of a new ARPI or radiopharmaceutical, or end of insurance claims activity or clinical activity. Weighted Kaplan-Meier curves and hazard ratios (HRs) were used to compare PSA90 responses between treatment cohorts.</p><p><strong>Results: </strong>This study included 363 patients, of which 236 initiated apalutamide and 127 initiated abiraterone acetate. At 6 months following treatment initiation, a greater proportion of patients treated with apalutamide (65.4%) vs abiraterone acetate (49.0%) achieved a PSA90 response. Patients who initiated apalutamide vs abiraterone acetate were 66% more likely to achieve a PSA90 response within 6 months of treatment initiation (HR, 1.66; 95% confidence interval, 1.18-2.35; <i>P</i> = .004). The median time-to-PSA90 response was approximately 6 months earlier for patients treated with apalutamide (3.3 months) compared with abiraterone acetate (9.1 months).</p><p><strong>Discussion: </strong>This study leveraged robust information from combined insurance claims and routinely collected EMR data to evaluate PSA90, a clinically relevant biomarker of treatment response, among Black patients with mCSPC. These results are among the first in this understudied patient population and suggest that a deeper and earlier PSA response achieved with apalutamide relative to abiraterone acetate can extend to Black patients in a real-world US clinical setting.</p><p><strong>Conclusion: </strong>Black patients treated with apalutamide experienced significantly higher PSA90 response rates than those treated with abiraterone acetate, suggesting possible clinical benefits from early treatment response in this population.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 2","pages":"270-278"},"PeriodicalIF":2.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889343","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 Burden of Respiratory Syncytial Virus Infection in Colombia: A Nationwide Cost-of-Illness Study.","authors":"Giancarlo Buitrago, Paula González-Caicedo, Juan M Reyes-Sanchez, Claudia Burgos, Jair Arciniegas, Jorge La Rotta, Omar Escobar, Andreina Alamo","doi":"10.36469/001c.151678","DOIUrl":"10.36469/001c.151678","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Respiratory syncytial virus (RSV) is one of the leading causes of acute respiratory infections and severe cases can lead to hospitalization or death. The epidemiology and health resource utilization of RSV infection in Colombia is not well understood. Given the recent availability of new RSV preventatives, this study estimated the economic burden of RSV in Colombia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cost-of-illness study employed a retrospective cohort design and bottom-up costing approach to estimate direct healthcare costs associated with RSV-related acute respiratory infections across pediatric and adult populations. Administrative data from sentinel surveillance centers belonging to the National Epidemiological Surveillance System of the Colombian National Institute of Health, the database for the study of the Capitation Payment Unit database, and the Integrated Social Protection Information System were utilized to estimate RSV incidence, mortality, and healthcare costs. Costs were expressed in US dollars.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 264 744 RSV-related healthcare consultations were identified in 2019. The highest incidence was among infants under 1 year (61.8 per 1000), while general mortality was highest in adults 75 years and older (46.6 per 100,000), followed by infants (42.4 per 100 000). Total direct healthcare costs were estimated at &lt;math&gt;&lt;mn&gt;682.87&lt;/mn&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;l&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;mo&gt;(&lt;/mo&gt; &lt;mn&gt;95&lt;/mn&gt;&lt;/math&gt; 281.39 million- &lt;math&gt;&lt;mn&gt;1084.35&lt;/mn&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;l&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;mo&gt;)&lt;/mo&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;w&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;h&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;a&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;e&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;mi&gt;h&lt;/mi&gt; &lt;mi&gt;a&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;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;b&lt;/mi&gt; &lt;mi&gt;u&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;b&lt;/mi&gt; &lt;mi&gt;y&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;v&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mn&gt;15&lt;/mn&gt; &lt;mi&gt;y&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;s&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;o&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mo&gt;.&lt;/mo&gt; &lt;mi&gt;A&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;o&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;f&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;s&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mn&gt;1&lt;/mn&gt; &lt;mi&gt;y&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mo&gt;,&lt;/mo&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;e&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;v&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;c&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;r&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;u&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mo&gt;(&lt;/mo&gt; &lt;mi&gt;I&lt;/mi&gt; &lt;mi&gt;C&lt;/mi&gt; &lt;mi&gt;U&lt;/mi&gt; &lt;mo&gt;)&lt;/mo&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;i&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;s&lt;/mi&gt; &lt;mi&gt;h&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;d&lt;/mi&gt; &lt;mi&gt;t&lt;/mi&gt; &lt;mi&gt;h&lt;","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 2","pages":"262-269"},"PeriodicalIF":2.3,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809909","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}