Journal of Medical Economics最新文献

{"title":"Cost-minimisation analysis of anti-VEGF therapies in neovascular age-related macular degeneration and diabetic macular oedema in Switzerland.","authors":"Aude Ambresin, S W Quist, M Boer, S Maamari, D Barthelmes","doi":"10.1080/13696998.2025.2536420","DOIUrl":"10.1080/13696998.2025.2536420","url":null,"abstract":"<p><strong>Objective: </strong>This study compares the direct healthcare costs of anti-VEGF therapies, including treat-and-extend (T&E) and other durable regimens, for unilateral neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO) in Switzerland.</p><p><strong>Methods: </strong>An adapted cost-minimisation model estimated healthcare costs over two years for aflibercept 2 mg, aflibercept 8 mg, faricimab, ranibizumab, and ranibizumab biosimilars using clinical trial injection frequencies. Break-even analyses identified the medication prices and injection frequencies required for higher-cost therapies to achieve cost parity with the least expensive options. A one-way sensitivity analysis (OWSA) assessed key drivers of cost outcomes.</p><p><strong>Results: </strong>Aflibercept 8 mg was estimated to be associated with the lowest treatment costs for both indications (CHF 11,814 for nAMD; CHF 11,242 for DMO). Faricimab (CHF 13,737) and aflibercept 2 mg (CHF 15,243) followed in nAMD and DMO. Ranibizumab and its biosimilars incurred the highest costs: for nAMD, biosimilars ranged from CHF 16,243 to CHF 17,497 and the reference product reached CHF 18,424; for DMO, biosimilars ranged from CHF 18,187 to CHF 19,596, with the reference product at CHF 20,637. Break-even analyses for nAMD showed that prices would need to drop by -22% (faricimab, CHF 644) to -64% (ranibizumab reference, CHF 218) relative to aflibercept 8 mg. For DMO, reductions ranged from -42% (aflibercept 2 mg, CHF 493) to -81% (ranibizumab reference, CHF 114). The OWSA highlighted medication price and injection frequency as primary cost drivers.</p><p><strong>Conclusions: </strong>This study estimated that the potentially minimized injection frequency of aflibercept 8 mg in a clinical trial regimen may result in the lowest treatment costs for nAMD and DMO, followed by faricimab and aflibercept 2 mg, respectively.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1198-1213"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682731","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":"Budget impact model of acellular tissue engineered vessel for the repair of extremity arterial trauma when autologous vein is not feasible.","authors":"Fulton F Velez, Ravi R Rajani, Daniel C Malone, Lucille A Sun, Lisa Bloudek, Kai Carter, Mary Panaccio, Laura E Niklason","doi":"10.1080/13696998.2025.2469460","DOIUrl":"10.1080/13696998.2025.2469460","url":null,"abstract":"<p><strong>Aims: </strong>To predict the budget impact of Symvess (Symvess is a trademark of Humacyte Global, Inc.) (acellular tissue engineered vessel-tyod [ATEV]) for extremity arterial trauma repair when autologous vein repair is not feasible.</p><p><strong>Materials and methods: </strong>The 3-year budget impact of adding ATEV as a repair option alongside autologous vein, prosthetic graft, and \"non-autologous other\" grafts was evaluated from the perspectives of a Level I trauma center and third-party commercial payers. Conduit-specific complication rates were obtained from two clinical studies for ATEV and from the published literature and analysis of the PROOVIT registry for other conduits. Costs were compared pre- and post-ATEV availability. Conduit-related costs and complications included conduit infections, amputations, vein harvest site infection, surgical re-interventions, rehabilitation after amputation, and 12-month post-discharge costs. Impact on operating room (OR) time and readmissions was evaluated. A sensitivity analysis was conducted to evaluate parameter uncertainty.</p><p><strong>Results: </strong>With introduction of ATEV, there was a 29.8% reduction in amputations and a 29.5% reduction in graft infections over 3 years. From a Level I trauma center perspective, seven patients were expected to receive an ATEV over 3 years, with cumulative cost savings of $80,650 (2.3% decrease). OR time would decrease by 8.6 h, and readmission-related costs would be reduced by 16.7% with ATEV availability. From the third-party commercial payer perspective, 35 patients were expected to receive ATEV, with a budget impact showing a savings of -$0.08 per member per month after 3 years. For trauma centers, sensitivity analysis showed that cost drivers were amputation risk associated with \"non-autologous other\" graft types and market share of autologous vein (short ischemia time).</p><p><strong>Limitations: </strong>Uncertainty surrounding model parameters.</p><p><strong>Conclusions: </strong>ATEV was projected to be cost-saving over 3 years for both trauma centers and third-party payers due to reductions in the costs related to amputations and conduit infections.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"323-334"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449303","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":"Continuity of care for patients with chronic lymphocytic leukemia: an analysis of real-world data.","authors":"Sameh Gabella, Manoj Khanal, Yongmei Chen, Naleen Raj Bhandari, Katherine B Winfree, Sarang Abhyankar, Lisa M Hess","doi":"10.1080/13696998.2025.2554514","DOIUrl":"10.1080/13696998.2025.2554514","url":null,"abstract":"<p><strong>Aims: </strong>This study hypothesized that greater continuity of care (CoC) would be associated with lower all-cause healthcare resource utilization and improved overall survival (OS) among patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) among patients who received covalent Bruton tyrosine kinase inhibitor (cBTKi)-based therapy.</p><p><strong>Methods: </strong>Optum's de-identified Clinformatics^® Data Mart Database was used for this retrospective study. Patient-level CoC measured by continuity of hematologist/oncologist provider care was evaluated using published measures; the Herfindahl-Hirschman Index (HHI) was the primary measure (range 0 = no continuity to 1.0 = complete continuity). Outcomes included all-cause emergency room (ER) visits, inpatient hospitalizations, and OS. Multivariable regression models (logistic, negative binomial, and Cox proportional hazards), adjusted for baseline covariates, were conducted to evaluate the relationship of CoC with outcomes.</p><p><strong>Results: </strong>In total, 5,990 patients were included in the analysis; median follow-up was 31.8 months. Median HHI was 0.7210 (interquartile range = 0.4749, 1.0000). With higher CoC, there were lower odds of having an ER visit (HHI odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.87-0.91; <i>p</i> < 0.0001), lower number of ER visits (HHI rate ratio [RR] = 0.93; 95%CI 0.92-0.94; <i>p</i> < 0.0001), lower odds of inpatient hospitalization (HHI OR = 0.85; 95%CI: 0.84-0.87; <i>p</i> < 0.0001), and lower number of hospitalizations (HHI RR = 0.89; 95%CI: 0.88-0.90; <i>p</i> < 0.0001). There was no significant difference in OS (HHI hazard ratio = 0.99 (95%CI: 0.97-1.01) <i>p</i> = 0.18.</p><p><strong>Limitations: </strong>Causality cannot be inferred in this retrospective study.</p><p><strong>Conclusions: </strong>Greater CoC was significantly associated with reduced ER visits and reduced hospitalization, among patients diagnosed with CLL who received cBTKi therapy. While interpretation may be limited in the retrospective design, sensitivity and post-hoc analyses support this relationship. The findings from this study suggest the importance of maintaining a consistent oncologist/hematologist for the patient with CLL to reduce these healthcare events; however, causality cannot be inferred from this study.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1500-1511"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957334","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 drivers and delays in recovery following rotator cuff repair: insights from a national claims database.","authors":"Stephan Pill, Samantha J Beckley, Maha Karim, Shaun K Stinton, Thomas P Branch","doi":"10.1080/13696998.2025.2563465","DOIUrl":"10.1080/13696998.2025.2563465","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to establish a real-world benchmark of recovery following rotator cuff repair (RCR) using healthcare claims data. Secondary objectives included determining the effect of comorbidities and complications such as joint contracture, additional procedures, and rehospitalizations on the recovery timeline and costs.</p><p><strong>Materials and methods: </strong>Healthcare claims data from the IBM MarketScan Commercial Claims and Encounters Database (2015-2018) were reviewed to determine costs and recovery time after RCR. Costs and recovery duration (index surgery to last therapy claim) were calculated. Subgroup analyses assessed the effects of comorbidities (diabetes, obesity, peripheral vascular disease, cardiovascular disease) and postoperative events (revision, motion restoring surgery (MRS), complication-related surgery, and nonoperative hospitalization) on outcomes. Perioperative complications including joint fibrosis/contracture, infection, and pulmonary embolus were also reported. Descriptive statistics including medians with interquartile ranges (IQR) were reported.</p><p><strong>Results: </strong>In the 14,947 patients included in analysis, median index surgery cost was $11,454 (IQR = $8,169-$17,204). Median recovery was 153 days (IQR = 79-683). Development of postoperative shoulder contracture or adhesive capsulitis added a median of 162 recovery days and nearly doubled costs. Patients requiring surgery for a complication had 3.5-fold longer recoveries and 5-fold higher costs than those without complications. MRS increased recovery time and costs nearly 3-fold, and patients undergoing MRS were 7 times more likely to require arthroplasty. Comorbidities extended recovery by 30-90 days, modestly increased costs, and were associated with a 2-3 times higher frequency of pulmonary embolism.</p><p><strong>Limitations: </strong>Claims data may be affected by coding inconsistencies, lack of clinical detail, and inability to capture medication costs or outcomes beyond the last therapy claim.</p><p><strong>Conclusions: </strong>This study defined a benchmark for recovery after RCR and found that complications including contracture and motion restoring surgery substantially increased recovery time and costs. These benchmarks can guide earlier identification of patients at risk for delayed recovery and help in evaluating strategies to reduce economic burden and improve outcomes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1709-1720"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131019","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}