Journal of Medical Economics最新文献

{"title":"Cost-effectiveness of mepolizumab vs anti-interleukin-5/5r biologic therapies for the treatment of adults with severe asthma with an eosinophilic phenotype: a Chilean healthcare system perspective.","authors":"Felipe Moraes Dos Santos, Consuelo Rodríguez Martínez, Vanina Giovini, Manuel Antonio Espinoza, Carlos Balmaceda, Jose Romero","doi":"10.1080/13696998.2025.2520701","DOIUrl":"10.1080/13696998.2025.2520701","url":null,"abstract":"<p><strong>Aim: </strong>Asthma is a heterogeneous respiratory condition often classified into distinct phenotypes. Severe asthma, characterized by uncontrolled symptoms despite optimal treatment, imposes a significant burden on healthcare systems, particularly in low- and middle-income countries. This study evaluates the cost-effectiveness of mepolizumab compared with other interleukin (IL)-5 pathway inhibitors, benralizumab and reslizumab, in treating severe asthma with an eosinophilic phenotype in Chile.</p><p><strong>Materials and methods: </strong>A Markov cohort model was developed to compare mepolizumab (100 mg subcutaneously every four weeks) with benralizumab (30 mg subcutaneously every four weeks for the first three doses, every eight weeks subsequently) and reslizumab (3 mg/kg intravenously every four weeks), both as add-on therapies to standard care. Data from the Mepolizumab as Adjunctive Therapy in Patients with Severe Asthma (MENSA) clinical trial and a network meta-analysis were used. Utility values were extracted using the EuroQoL 5-Dimension questionnaire (EQ-5D-5L) questionnaire. Probabilistic and one-way sensitivity analyses assessed model robustness.</p><p><strong>Results: </strong>Mepolizumab demonstrated dominance with probability over 95% when compared with benralizumab and reslizumab. Cost savings ranged from 37,000 United States dollars (USD) to 104,000 USD, with an increase of 0.52 to 0.55 quality-adjusted life years. Mepolizumab was also associated with a lower incidence of exacerbations and asthma-related deaths. Sensitivity analyses confirmed the stability of the model outcomes across key parameters.</p><p><strong>Limitations: </strong>Limitations of the economic model are related to the lack of direct comparisons between mepolizumab and other biologics. Additionally, the absence of data on continuation criteria required estimating relative risks for the overall population.</p><p><strong>Conclusions: </strong>Mepolizumab offers greater efficacy and cost savings compared to benralizumab and reslizumab for eosinophilic asthma, providing essential insights for improving asthma management and informing healthcare policies in Chile.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"964-973"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world healthcare resource utilization of Alzheimer's disease in the early and advanced stages: a retrospective cohort study.","authors":"Elnara Fazio-Eynullayeva, Marianne Cunnington, Paul Mystkowski, Lei Lv, Abdalla Aly, Christopher W Yee, Raj Desai, Chia-Lun Liu, Mei Sheng Duh, Soeren Mattke","doi":"10.1080/13696998.2024.2442240","DOIUrl":"10.1080/13696998.2024.2442240","url":null,"abstract":"<p><strong>Aims: </strong>To compare all-cause and Alzheimer's disease (AD)-related healthcare resource utilization (HCRU) by cognitive stage.</p><p><strong>Methods and materials: </strong>This retrospective study analyzed insurance claims data linked to electronic health records (01/01/2015-12/31/2021). Patients with ≥1 cognitive assessment (Mini-Mental State Examination or Montreal Cognitive Assessment) and ≥1 medical or pharmacy claim for an AD diagnosis or AD medications were included. Inverse probability of treatment weighting (IPTW) was used to address potential confounding. All-cause and AD-related HCRU were summarized per patient per year (PPPY) and compared between early AD and advanced AD cohorts (defined according to cognitive scores) using generalized linear regression models; adjusted incidence rate ratios (IRRs), and 95% confidence intervals (CI) were reported.</p><p><strong>Results: </strong>A total of 193 patients were included (median age: 82 years; 63.2% female), 108 with early AD and 85 with advanced AD, with similar mean follow up. All-cause HCRU, on average, was similar between early AD and advanced AD cohorts (37.4 PPPY and 38.9 encounters PPPY, respectively). For AD-related HCRU, patients with early AD had fewer encounters PPPY, on average, than patients with advanced AD (1.26 and 3.88 encounters, respectively). Following IPTW adjustment, the advanced AD cohort had significantly higher overall AD-related HCRU (IRR: 3.64 [95% CI: 1.96-6.75], <i>p</i> < 0.001) and outpatient visits (IRR: 2.76 [95% CI: 1.68-4.54], <i>p</i> < 0.001) compared to the early AD cohort.</p><p><strong>Limitations: </strong>The relatively small sample size of patients with linked claims and cognitive score data limited the ability to assess contribution of all encounter types to HCRU trends, as well as generalizability to the broader AD population.</p><p><strong>Conclusions: </strong>Although all-cause HCRU was similar, patients with advanced AD incurred higher AD-related HCRU compared to patients living with early AD. Further research is needed to determine whether interventions earlier in disease progression can mitigate the AD-related healthcare burden for patients with advanced AD.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"81-88"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/13696998.2025.2477875","DOIUrl":"10.1080/13696998.2025.2477875","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"377"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US consumer and healthcare professional preferences for combination COVID-19 and influenza vaccines.","authors":"Christine Poulos, Philip O Buck, Parinaz Ghaswalla, Deborah Rudin, Cannon Kent, Darshan Mehta","doi":"10.1080/13696998.2025.2462412","DOIUrl":"10.1080/13696998.2025.2462412","url":null,"abstract":"<p><strong>Aims: </strong>To quantify preferences for an adult combination vaccine for influenza and COVID-19 (flu + COVID) compared with standalone influenza and COVID-19 vaccines.</p><p><strong>Materials and methods: </strong>This survey study used a series of direct-elicitation questions to assess preferences for a single-shot combination flu + COVID, standalone influenza, and standalone COVID-19 vaccines among US consumers (<i>N</i> = 601) and healthcare professionals (HCPs) (<i>N</i> = 299). Response frequencies described the proportion of each sample that would prefer a flu + COVID vaccine to standalone influenza and COVID-19 vaccines. A multivariate logit regression model explored how certain characteristics influenced the odds of selecting the flu + COVID vaccine over a standalone influenza vaccine.</p><p><strong>Results: </strong>Most consumers (398/601; 66.2%) and HCPs (250/298; 83.9%) preferred a flu + COVID vaccine to a standalone influenza vaccine. When not forced to choose between flu + COVID and standalone influenza vaccines, most consumers again selected the flu + COVID vaccine (62.3%); 14.7% would prefer separate standalone influenza and COVID-19 vaccines, 8.3% a standalone influenza vaccine only, 7.3% a COVID-19 vaccine only, and 7.4% neither vaccine. Consumers aged ≥50 years with a body mass index ≥40, those aged ≥65 years who previously received a COVID-19 vaccine, and those who had previously experienced severe impacts from influenza were more likely to choose a flu + COVID vaccine over a standalone influenza vaccine than were consumers without these characteristics. HCPs whose practice stocks high-dose influenza vaccines were more likely to choose the flu + COVID vaccine for patients aged ≥65 with no risk factors and patients aged 18-64 with ≥1 risk factor over the standalone influenza vaccine.</p><p><strong>Limitations: </strong>Results are subject to potential hypothetical, responder, selection, and information biases.</p><p><strong>Conclusions: </strong>Most US consumers and HCPs would likely prefer a single-shot combination flu + COVID vaccine compared with standalone influenza and COVID-19 vaccines. Given the low COVID-19 vaccination coverage rates in the US, the availability of a combination flu + COVID vaccine could help increase COVID-19 vaccine coverage.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"279-290"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness and cost-utility analysis of Haemate-P versus other von Willebrand disease treatments in Spain.","authors":"Juan E Megias-Vericat, Gines Escolar, Michele R Wilson, Pablo Mendez, Cheryl L McDade, Laura Vidal Barrientos, Radovan Tomic, Marco Panebianco, Stephan Linden, Songkai Yan","doi":"10.1080/13696998.2025.2474886","DOIUrl":"10.1080/13696998.2025.2474886","url":null,"abstract":"<p><strong>Objective: </strong>von Willebrand Disease (vWD) is the most common congenital bleeding disorder, with an estimated prevalence in Spain of 0.01%. The aim was to assess the cost-utility of Haemate-P compared with present alternatives in the treatment of vWD in Spain.</p><p><strong>Methods: </strong>A Markov model was developed in Microsoft Excel to estimate the cost-effectiveness of various treatments for vWD over a lifetime horizon. Transition probabilities among health states were based on age and number of bleeding events. Treatment strategies compared included Haemate-P, Fanhdi, and Wilate in long-term prophylaxis (LTP) or on-demand treatment (ODT). Costs and quality-of-life were measured based on patient age, treatment, and number of bleeding events incurred. Both costs and utilities were discounted at 3%. One-way and probabilistic sensitivity analyses were performed.</p><p><strong>Results: </strong>When comparing LTP regimens, Haemate-P was less costly and numerically more effective than both Fanhdi (incremental costs = -€1,313,845; incremental quality-adjusted life-years [QALY] = 0.13) and Wilate (incremental costs = -€2,233,940; incremental QALY = 0.29). For ODT, Haemate-P was assumed to have equal effectiveness as Fanhdi and Wilate but reduced the costs by €696,857 and €1,145,780, respectively. Haemate-P prophylaxis was more effective and less costly compared with Haemate-P on-demand in the base case (incremental costs = -€633,317; incremental QALY = 0.90). Results were generally robust to sensitivity analyses.</p><p><strong>Conclusions: </strong>In patients with severe vWD experiencing a high bleed rate, Haemate-P prophylaxis is a less costly and potentially more effective treatment strategy and Haemate-P is cost-saving among on-demand strategies.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"436-445"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The real-world impact of cariprazine on short- and long-term disability outcomes among commercially insured patients in the United States.","authors":"Prakash S Masand, Mousam Parikh, Jamie Ta, Enrico Zanardo, Dominique Lejeune, Cristina Martínez, François Laliberté, Nadia Nabulsi","doi":"10.1080/13696998.2025.2470014","DOIUrl":"10.1080/13696998.2025.2470014","url":null,"abstract":"<p><strong>Aim: </strong>To compare all-cause and mental health (MH)-related short-term and long-term disability leaves and associated costs among patients in the United States with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia spectrum disorders (SCZ) before versus after cariprazine initiation.</p><p><strong>Methods: </strong>Merative MarketScan Commercial and Health and Productivity Management (HPM) databases (January 2016 to December 2021) were utilized to identify adults diagnosed with BP, MDD, or SCZ with ≥2 pharmacy cariprazine claims (first claim = index), ≥3 months of cariprazine use (adjunctively for MDD), and continuous commercial insurance coverage and HPM eligibility during baseline (12 months pre-index) and ≥3 months post-index. Observation continued until cariprazine discontinuation, insurance or HPM eligibility end, 1 year post-index, or HPM data availability end. All-cause and MH-related disability claims, days, and costs were evaluated. Baseline versus post-index rates of disability claims (events) and days were compared using rate ratios (RR); costs were compared using mean cost differences. Comparisons were calculated from generalized estimating equation models. Analyses were replicated separately across indications.</p><p><strong>Results: </strong>There were 489 patients overall (BP = 238, MDD = 233, SCZ = 18; mean age = 43.3 years; 60.7% female; mean follow-up = 7.6 months). All-cause rates of disability events and days following cariprazine initiation were 29% (RR = 0.71 [95% CI = 0.57, 0.86]) and 28% (0.72 [0.53, 0.94]) lower than baseline, respectively (both <i>p</i> < .05). MH-related rates of disability events and days were 40% (0.60 [0.43, 0.80]) and 43% (0.57 [0.34, 0.84]) lower, respectively (both <i>p</i> < .01). All-cause disability costs were $2,917 lower and MH-related disability costs were $2,482 lower than baseline (40% and 51% decrease, respectively; both <i>p</i> < .01). Results were similar for indication-specific analyses.</p><p><strong>Limitations: </strong>Limited generalizability to patients who are unemployed, uninsured, or have public insurance.</p><p><strong>Conclusions: </strong>Rates of disability events, days, and mean costs were significantly lower after versus before cariprazine initiation. These results can help contextualize cariprazine's role in managing disability for these patients.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"335-345"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-efficiency and expanded access modeling of conversion to biosimilar bevacizumab in metastatic colorectal and non-squamous non-small cell lung cancer in Medicare.","authors":"Joshua A Roth, David Kratochvil, Stephanie Dorman, Mark Bernauer","doi":"10.1080/13696998.2025.2474884","DOIUrl":"10.1080/13696998.2025.2474884","url":null,"abstract":"<p><strong>Background: </strong>Biosimilars to originator bevacizumab (Avastin), such as bevacizumab-bvzr (Zirabev), can deliver substantial savings and/or expanded access to biologic therapy for patients with metastatic colorectal (mCRC) and non-squamous non-small cell lung cancer (mNSCLC). The objective of this study is to explore the cost-efficiency and budget-neutral expanded access of bevacizumab-bvzr in mCRC and mNSCLC in Medicare.</p><p><strong>Methods: </strong>We developed a Medicare payer perspective simulation model of patients treated for mCRC and mNSCLC to estimate cost-savings from converting bevacizumab (originator) to bevacizumab-bvzr or alternative biosimilars such as bevacizumab-awwb, -maly, and -abcd. The target patient population receiving annual first-line systemic therapy was calculated using Medicare enrollment data, SEER cancer incidence rates in patients age ≥65, and an assumption that 39.3% and 77.2% of new diagnoses receive systemic therapy for mCRC and mNSCLC respectively based on recent evidence. 76.0% of systemically treated mCRC patients and 11.4% of incident mNSCLC patients were expected to be treated with bevacizumab-based regimens based on recent evidence. Costs were derived from the 2024 Average Sales Price (ASP). Results include per-patient per-month (PPPM) cost savings (vs. originator), total monthly savings in the cohort, and number needed to convert (NNC) to biosimilar to fund the treatment of an additional 100 patients.</p><p><strong>Results: </strong>PPPM savings from conversion to bevacizumab-bvzr were $4,205 in mCRC and $8,410 in mNSCLC. In 100% conversion scenarios, full cohort monthly savings were $27,664,432 in mCRC (<i>n</i> = 6,579) and $32,319,323 in mNSCLC (<i>n</i> = 3,843), respectively. At 100% conversion, monthly savings from biosimilar conversion could fund up to 13,887 additional mCRC patient-months of treatment with bevacizumab-bvzr + FOLFOX, and up to 8,959 additional mNSCLC patient-months of treatment with bevacizumab-bvzr + paclitaxel + carboplatin. In mCRC and mNSCLC the biosimilar NNC from the originator was 47 and 43, respectively. The biosimilar NNC from other biosimilars ranged from 60-4,564 and 55-4,422 for mCRC and NSCLC, respectively.</p><p><strong>Conclusion: </strong>In the first cost-efficiency and expanded access study of biosimilar bevacizumab in mCRC and mNSCLC, we find that bevacizumab-bvzr-based regimens can result in substantial cost savings relative to originator-based first line treatment in Medicare. These cost savings could be reinvested to treat a substantial number of additional patients with mCRC or mNSCLC, or fund other costs of care in Medicare, on a budget-neutral basis.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"378-386"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A claims-based current clinical course of the post-treatment period after a unilateral elbow fracture.","authors":"Fernando Pena Molina, Maha Karim, Samantha J Beckley, Shaun K Stinton, Thomas P Branch","doi":"10.1080/13696998.2025.2517499","DOIUrl":"10.1080/13696998.2025.2517499","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this paper was to determine a claims-based timeline of unilateral elbow fracture recovery including the effect of comorbidities and post-treatment complications on recovery.</p><p><strong>Methods: </strong>This study utilized data from the IBM MarketScan database (2015-2018) to assess costs and recovery timelines after unilateral elbow fracture treatment. All costs are reported in U.S. dollars and reflect prices during the 2015-2018 period. Costs examined included: (i) index surgery/treatment, (ii) complication surgery, (iii) revision or salvage surgeries, (iv) non-operative hospitalization, (v) motion restoring surgery and (vi) additional elbow-related outpatient surgery. Costs of related physician visits, physical/occupational therapy and diagnostic radiology were also incorporated. The impact of comorbidities-diabetes, obesity, peripheral vascular disease, and cardiovascular disease-was evaluated. Additionally, data on re-hospitalizations, with or without further surgery, were analyzed to understand complications after the initial treatment. Perioperative complications including joint fibrosis/contracture, infection, and pulmonary embolus were also reported.</p><p><strong>Results: </strong>Index surgery/treatment median cost and length of post-treatment recovery (from index surgery/treatment to last physical/occupational therapy claim) was $4,494 ($872-$10,444) and 102.5 days (36-480 days), respectively. A total of 59% of patients completed their post-treatment period in 6 months with 41% of patients taking longer. Patients who required a complication surgery had median recovery times and costs that increased three- and seven-fold, respectively, in comparison to those without complication surgeries. Comorbidities added 66-113 days to recovery. Peripheral and cardio-vascular disease coincided with 1.7-3 times higher post-treatment costs.</p><p><strong>Conclusion: </strong>Comorbidities and complications following elbow fracture treatment lead to substantial increases in both costs and recovery durations. Understanding the typical recovery timeline after elbow fracture treatment, as well as the variations in outlier patients, can assist in optimizing recovery management and guiding appropriate interventions.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"934-943"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility analysis of difelikefalin for the treatment of moderate to severe Chronic Kidney Disease associated-Pruritus (CKD-aP) in adult patients receiving haemodialysis in Spain.","authors":"Emilio Sánchez-Alvarez, Jose-Luís Poveda, Rafael Sánchez-Villanueva, Isabel De La Paz Cañizares, Antonio Ramirez de Arellano, Olga Ruiz-Andrés","doi":"10.1080/13696998.2025.2501874","DOIUrl":"10.1080/13696998.2025.2501874","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic Kidney Disease-associated Pruritus (CKD-aP) is a disabling condition that affects around 60% of patients with end-stage kidney disease undergoing dialysis. Current off-label treatment options are neither effective nor appropriate for all dialysis patients, leaving a clear unmet need. This study aimed to evaluate the cost-effectiveness of difelikefalin - the only drug approved in Europe for the treatment of moderate to severe CKD-aP adult patients in haemodialysis - compared to the best supportive care (BSC) from the Spanish NHS perspective.</p><p><strong>Methods: </strong>A Markov model was developed with seven health states: five health states representing levels of pruritus intensity over time (No, Mild, Moderate, Severe and Very severe CKD-aP), kidney transplant and death as the absorbing state. The model included patients with moderate to severe CKD-aP at baseline, in line with difelikefalin approved indication and clinical trials. Local costs, utilities, mortality rates and kidney transplant probabilities were obtained from published literature. Costs and quality-adjusted life-years (QALYs) were discounted at a 3% annual rate with a lifetime horizon (36 years).</p><p><strong>Results: </strong>Difelikefalin was associated with an increased in QALYs (+0.49) and higher costs (+12,300€) compared to the BSC over a lifetime horizon. At a provisional cost estimate of 270.6€per 28-days for difelikefalin (based on a tentative list price for Spain), the incremental cost-utility ratio was 25,000€/QALY. The sensitivity analysis (DSA) confirmed the robustness of the results. The probabilistic sensitivity analysis (PSA), undertaken with 1000 iterations, indicated a 50% and 83% probability of difelikefalin being cost-effective at a willingness-to-pay (WTP) thresholds of 25,000 €/QALY and 30,000 €/QALY, respectively.</p><p><strong>Conclusions: </strong>Difelikefalin could be a cost-effective option compared to BSC for the management of CKD-aP in adult haemodialysis patients within the Spanish NHS setting. Considering the unmet needs, these results support the convenience of incorporating difelikefalin in routine clinical practice in Spain.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"835-847"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic impact associated with dronedarone use in patients with atrial fibrillation.","authors":"Zenobia Dotiwala, Julian Casciano, Gary Lebovics, Ron Preblick","doi":"10.1080/13696998.2025.2459499","DOIUrl":"10.1080/13696998.2025.2459499","url":null,"abstract":"<p><strong>Objective/aim: </strong>In 2009, dronedarone was approved by the United States Food and Drug Administration based on results from the ATHENA trial (NCT00174785), which showed significant reduction of cardiovascular (CV) hospitalization and death in patients with atrial fibrillation (AF) randomized to dronedarone versus placebo. In 2020, a retrospective study by Goehring et al. showed CV hospitalizations and deaths were lower in clinical practice following initiation of dronedarone compared to other antiarrhythmic drugs (AADs) in patients with AF and atrial flutter. However, the economic impact associated with dronedarone use has not been fully assessed. The objective of this study was to estimate the cost associated with CV outcomes reported by Goehring et al. (2020).</p><p><strong>Methods: </strong>National average Medicare payments in the Centers for Medicare and Medicaid Services (CMS) database (www.data.CMS.gov) were used to assign cost estimates to CV outcomes evaluated in Goehring et al. (2020) by diagnosis-related grouping. When costs were unavailable in the CMS database, a literature search was performed to identify publications reporting hospitalization costs.</p><p><strong>Results: </strong>The weighted average cost for CV hospitalization was calculated to be $20,508. When multiplied by the event rate reported in Goehring et al. (2020), cost per person year for CV hospitalization was 14% lower with dronedarone versus other AADs ($3,679 vs $4,272, respectively). For hospitalizations due to heart failure, cost was 31% lower with dronedarone compared with other AADs ($324 vs $472, respectively).</p><p><strong>Limitations: </strong>Costs have been calculated based on national averages reported by CMS (Medicare perspective) and are estimates. Regional differences may be present.</p><p><strong>Conclusions: </strong>Patients with AF taking dronedarone had lower costs associated with CV hospitalization compared with patients taking other AADs.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"245-250"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}