Journal of Medical Economics最新文献

{"title":"Cost per event avoided: adopt or avoid?","authors":"P Petrou, Olga Pitsillidou, Constantinos Petrou, Maarten J Postma","doi":"10.1080/13696998.2026.2638716","DOIUrl":"https://doi.org/10.1080/13696998.2026.2638716","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"885-888"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468227","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, public health impact, and budget impact of receipt of Pfizer-BioNTech COVID-19 vaccine, LP.8.1-adapted, 2025/2026 formula among adults aged 18 years and older at high risk for severe outcomes from COVID-19 in the United States.","authors":"Alon Yehoshua, Manuela Di Fusco, Abby E Rudolph, Elizabeth Thoburn, Santiago M C Lopez, Josie Dodd, Benjamin Yarnoff","doi":"10.1080/13696998.2026.2644761","DOIUrl":"https://doi.org/10.1080/13696998.2026.2644761","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the cost-effectiveness, public health impact, and budget impact of receiving the LP.8.1-adapted Pfizer-BioNTech COVID-19 Vaccine among United States adults aged ≥ 18 years.</p><p><strong>Methods: </strong>A previously published economic model was adapted to compare receiving the LP.8.1-adapted Pfizer-BioNTech COVID-19 Vaccine (2025/2026 formula) versus not in adults aged 18-64 years at high risk of severe COVID-19 and all adults aged ≥ 65 years. Age-specific epidemiological inputs were derived from public health surveillance data. Clinical, cost, and vaccine effectiveness parameters were informed by published literature. The budget impact analysis was based on a hypothetical 1-million-member plan and used a payer perspective.</p><p><strong>Results: </strong>Without vaccination, the model projected 41.5 million new symptomatic cases, 43,681 deaths, 338,252 hospitalizations, $80 billion in total costs, and 1.99 million QALYs lost among adults aged ≥18 years, with the greatest health burden observed among adults aged ≥65 years (73% of hospitalizations and 83% of deaths) and the greatest economic burden in adults aged 18 to 64 years at high risk of severe outcomes (62% of total costs). Compared to no vaccination, vaccination with the LP.8.1-adapted Pfizer-BioNTech COVID-19 vaccine (2025/2026 formula) in the populations aged 18 to 64 years and ≥18 years, respectively was projected to prevent 212,096 and 620,333 cases, 137 and 1,867 deaths, and 1,501 and 12,677 hospitalizations, resulting in incremental costs of $1.1 billion and $567 million, 2,411 and 15,430 LYs gained, 70,493 and 181,137 QALYs gained, ICERs of $16,238 and $3,137 from the societal perspective and $34,022 and $8,059 from the payer perspective. In the budget impact analysis from the payer perspective, vaccination was estimated to result in a modest budget increase.</p><p><strong>Conclusions: </strong>Vaccinating adults at high risk of severe COVID-19 with the LP.8.1-adapted Pfizer BioNTech COVID-19 Vaccine is projected to be a cost-saving measure from the societal perspective that could reduce the public health and economic burden of COVID-19.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1027-1045"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529749","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":"Model-based evaluation of colorectal cancer screening effectiveness: three rounds of multitarget stool DNA testing versus one colonoscopy.","authors":"Michael Dore, Derek W Ebner, Vahab Vahdat, Chris Estes, A Burak Ozbay, Victoria Foster, Paul J Limburg","doi":"10.1080/13696998.2026.2645491","DOIUrl":"https://doi.org/10.1080/13696998.2026.2645491","url":null,"abstract":"<p><strong>Background: </strong>Several colorectal cancer (CRC) screening modalities are guideline-recommended in the United States but differ in screening interval and real-world adherence. Accordingly, single-round test performance may not reflect cumulative effectiveness over time. This study compared the 10-year longitudinal outcomes of two CRC screening strategies-triennial next-generation multitarget stool DNA testing (ng mt-sDNA) and decennial screening colonoscopy.</p><p><strong>Methods: </strong>The validated, microsimulation-based Colorectal Cancer and Adenoma Incidence and Mortality (CRC-AIM) model was used to estimate 10-year cumulative outcomes for two guideline-recommended screening strategies: triennial ng mt-sDNA and decennial colonoscopy. Model inputs included test performance and real-world adherence. Outcomes included CRC and precancerous lesions detected, CRC mortality reductions, and life-years gained (LYG). Sensitivity analyses examined the effects of varying screening adherence and follow-up colonoscopy adherence.</p><p><strong>Results: </strong>Over 10 years per 1,000 individuals offered screening, ng mt-sDNA detected 13% more precancerous lesions and 11% more CRC cases than colonoscopy, with a greater proportion of CRCs identified through screening rather than symptomatic detection. ng mt-sDNA achieved greater CRC mortality reduction (33% vs 20%) and 62% more life-years gained, with consistent findings across sensitivity analyses.</p><p><strong>Conclusions: </strong>With real-world adherence, screening with triennial ng mt-sDNA demonstrates superior cumulative effectiveness compared with decennial colonoscopy, driven by higher adherence and favorable longitudinal performance. These findings support expanded use of noninvasive stool-based screening to reduce CRC mortality and alleviate colonoscopy capacity constraints. Broader adoption of ng mt-sDNA may enhance population-level CRC prevention by increasing participation and improving early detection.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"986-993"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512610","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":"Clinical burden and healthcare resource utilization after allogeneic hematopoietic stem cell transplant for sickle cell disease or β-thalassemia.","authors":"Duncan Brown, Nanxin Li, Jiahe Li, Suzan Imren, Kristin A Evans, Michelle Jerry","doi":"10.1080/13696998.2026.2660597","DOIUrl":"https://doi.org/10.1080/13696998.2026.2660597","url":null,"abstract":"<p><strong>Introduction: </strong>Allogeneic hematopoietic stem cell transplant (allo-HSCT) is a potentially curative treatment for patients with sickle cell disease (SCD) with recurrent vaso-occlusive crises (VOCs) or β-thalassemia. Real-world data on post-allo HSCT outcomes are limited among these patients.</p><p><strong>Methods: </strong>Patients with SCD with recurrent VOCs or β-thalassemia with allo-HSCT were identified in the Merative MarketScan Research Databases. Clinical outcomes, allo-HSCT complications, and healthcare resource utilization were summarized after allo-HSCT.</p><p><strong>Results: </strong>Eighty-one patients with SCD with recurrent VOCs and 33 with β-thalassemia were included. About one-third of patients with SCD experienced a VOC and one-quarter of patients with β-thalassemia required a red blood cell transfusion, in the year after the first 100 days following allo-HSCT. Approximately 40.7% of patients with SCD and 42.4% of patients with β-thalassemia developed acute graft-versus-host disease (GvHD), while 32.1% and 27.3% developed chronic GvHD, respectively. Patients with SCD had a mean of 74.1 (59.6) outpatient visits per patient per year and patients with β-thalassemia had a mean (SD) of 76.1 (61.3).</p><p><strong>Limitations: </strong>Due to the lack of International Classification of Diseases, 10th Revision (ICD-10) codes to distinguish between different types of allo-HSCT, this study was unable to assess outcomes of patients with haploidentical hematopoietic stem cell transplantation (haplo-HSCT), which is a type of allo-HSCT.</p><p><strong>Conclusion: </strong>Many patients with SCD with recurrent VOCs or β-thalassemia endure potentially life-threatening transplant-related complications and require substantial healthcare utilization following allo-HSCT. These findings suggest limitations of allo-HSCT and underscore the need for alternative curative treatment options.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1405-1419"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773869","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 analysis of capivasertib plus fulvestrant in the <i>PIK3CA/AKT1/PTEN</i>-altered subgroup with HR+/HER2- advanced breast cancer: a United States payer perspective.","authors":"Xi Liang, Daniel C Malone, Chia Jie Tan","doi":"10.1080/13696998.2026.2656072","DOIUrl":"https://doi.org/10.1080/13696998.2026.2656072","url":null,"abstract":"<p><strong>Aims: </strong>Capivasertib plus fulvestrant has emerged as a promising targeted therapy for HR+/HER2- advanced breast cancer (ABC). This study evaluated the cost-effectiveness of capivasertib plus fulvestrant vs. fulvestrant monotherapy in <i>PI3K/AKT/PTEN</i> pathway-altered patients with HR+/HER2- ABC from a U.S. payer's perspective.</p><p><strong>Materials and methods: </strong>A partitioned survival model with three health states (progression-free, progressive disease, and death) was developed over a 5-year time horizon. Progression-free survival (PFS) and overall survival (OS) data were derived from the CAPItello-291 trial (NCT04305496). Utility, disutility, and direct medical costs were obtained from published literature and the Centers for Medicare and Medicaid Services. Capivasertib cost was based on wholesale acquisition cost. Costs were presented in 2025 U.S. dollars. Both costs and outcomes were discounted by 3%. Incremental cost-effectiveness ratios (ICERs) based on quality-adjusted life-year (QALY) gained and equal value of life years gained (evLYG) were compared using a willingness-to-pay (WTP) threshold of $150,000. Sensitivity analyses, scenario analyses (10-year horizon and phase II trial data) and threshold analysis were conducted.</p><p><strong>Results: </strong>Capivasertib plus fulvestrant yielded more QALYs (1.89 vs. 1.29) and life years (3.31 vs. 2.49) but higher costs ($539,625 vs. $158,679) than fulvestrant alone, resulting in ICERs of $636,455/QALY gained and $459,358/evLYG over a 5-year time horizon. The cost of capivasertib ($28,332/4 weeks) had the greatest impact and would need to be reduced to $5,598/4 weeks to achieve cost-effectiveness.</p><p><strong>Limitations: </strong>Extrapolation of survival data reflects limited long-term trial data and increases uncertainty surrounding model parameters. Efficacy based on clinical trials may differ from real-world effectiveness.</p><p><strong>Conclusions: </strong>Despite clinical benefits, capivasertib plus fulvestrant was not cost effective at current price from a U.S. payer's perspective. The cost of capivasertib per 4 weeks would be required to decrease by ∼80% from $28,332 to $5,598 (about $87 per 200 mg) to meet the WTP threshold of $150,000.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1213-1229"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729332","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":"2025 in review: high-impact articles from the <i>Journal of Medical Economics</i>.","authors":"Ivo Abraham, Mike Gregg","doi":"10.1080/13696998.2026.2665047","DOIUrl":"https://doi.org/10.1080/13696998.2026.2665047","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1423-1430"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864193","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":"10.1080/13696998.2026.2618439","DOIUrl":"https://doi.org/10.1080/13696998.2026.2618439","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"249"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010909","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":"Incorporating underreporting of epidemiological burden in COVID-19 models: a targeted literature review.","authors":"Ishveen Chopra, Jingyan Yang, Alon Yehoshua, Carlos Fernando Mendoza, Manuela Di Fusco","doi":"10.1080/13696998.2026.2613591","DOIUrl":"https://doi.org/10.1080/13696998.2026.2613591","url":null,"abstract":"<p><strong>Background: </strong>Underreporting of infections, hospitalizations, and deaths can pose challenges to accurately estimating the true burden of COVID-19. Consequently, health burden assessments and economic evaluations may underestimate the public health impact of interventions such as vaccination.</p><p><strong>Methods: </strong>This targeted literature review summarized economic evaluations of COVID-19 that reported having adjusted for underreporting of epidemiological burden. Searches were performed in PubMed through 08/31/2025 with no geographic restrictions. Key study characteristics extracted: country, time period, population, parameters adjusted for underreporting, and the adjustment multipliers used. A high-level quality assessment of evidence was conducted, building on Drummond checklist and CHEERS. Given the qualitative nature of the question and the expected heterogeneity in study designs, the results were summarized qualitatively.</p><p><strong>Results: </strong>A total of 20 studies met the inclusion criteria. Of these, 14 (70%) reported numerical adjustment factors, and the remaining 30% did not report a numerical factor. The studies covered diverse geographic regions and time frames, with adjustments applied to parameters such as infections, hospitalizations, and mortality. The study quality was moderate to high. The multipliers used ranged widely across studies: 1 to 5 for mortality, 1 to 5 for hospitalizations, and 1 to 10 for infections, where a value higher than 1.0 reflects an adjustment factor for underreporting. The methodologies used to estimate underreporting varied, including comparisons to excess mortality data, Monte Carlo simulations, and validation against external datasets.</p><p><strong>Limitations: </strong>Most studies used pandemic time horizons.</p><p><strong>Conclusions: </strong>This review identified 14 modelling studies reporting numerical adjustment factors. The studies used diverse approaches and adjustment factors, reflecting variability in data availability and estimation methods. Recognizing and standardizing these adjustments is crucial for improving the accuracy and comparability of health economic analyses that inform policy decisions. Further research could refine underreporting estimates and assess their impact on economic model outcomes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"193-212"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018588","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 of vasopressin in the treatment of septic shock: insights from a European societal perspective.","authors":"Evelyn Walter, Federico Ghinelli, Isabelle Goyer, Marc Leone, Romain Pirracchio","doi":"10.1080/13696998.2026.2622854","DOIUrl":"https://doi.org/10.1080/13696998.2026.2622854","url":null,"abstract":"<p><strong>Background: </strong>Septic shock is a life-threatening condition associated with high morbidity, mortality, and healthcare costs. Vasopressin (VA) is recommended as a second-line vasopressor in septic shock, but its cost-effectiveness-especially regarding the timing of administration-remains unclear in European settings.</p><p><strong>Methods: </strong>A hybrid decision-analytic model combining a short-term decision tree and a long-term Markov model was developed to evaluate the cost-effectiveness of VA in adult patients with septic shock. The analysis was conducted from both a healthcare payer and societal perspective. Clinical efficacy inputs were derived from high-quality meta-analyses and systematic reviews. The model incorporated health-states such as end-stage renal-disease (ESRD) with need for renal replacement therapy (RRT), atrial fibrillation (AF), and mortality over a lifetime horizon. Two comparisons were analyzed: VA versus No VA, and early (within 3-12 h of shock onset) versus late VA administration. Outcomes included incremental cost-effectiveness ratio (ICER), life-years (LYs), quality-adjusted life-years (QALYs), and direct and indirect cost estimates.</p><p><strong>Results: </strong>Adding VA was a dominant strategy, improving clinical outcomes while reducing lifetime costs by 10,570 €per patient and yielding 0.09 additional QALYs. VA therapy reduced RRT dependence by 2.5% and increased AF-free survival by 6.2%. Early VA administration was even more cost-effective, providing 0.55 additional QALYs, 0.77 extra LYs, and 4,746 €in additional savings compared to late administration.</p><p><strong>Conclusion: </strong>Second-line VA is a cost-effective intervention for septic shock, notably when initiated early. These findings support guideline recommendations for early vasopressor use and emphasize the clinical and economic value of timely VA therapy.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"319-333"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119174","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":"Health and productivity benefits of anti-PD-(L)1 agents for early-stage cancer treatment in Hungary.","authors":"Daniel Ladino, Karl Patterson, Máté Várnai, Éva Balogh, Vivek Khurana, Raquel Aguiar-Ibáñez","doi":"10.1080/13696998.2026.2626240","DOIUrl":"https://doi.org/10.1080/13696998.2026.2626240","url":null,"abstract":"<p><strong>Aim: </strong>Anti-PD-(L)1 agents, inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1), are established therapies that improve cancer management as well as the disease and societal burden of specific metastatic and early-stage cancers. The aim of the study was to determine the impact of adopting anti-PD-(L)1 agents for the treatment of all eligible patients with early-stage cancers versus reserving anti-PD-(L)1 agents for patients with metastatic disease alone in Hungary.</p><p><strong>Methods: </strong>This study evaluated two scenarios, one where anti-PD-(L)1 agents were used to treat all eligible early-stage disease case<i>s</i> (ESD scenario) of melanoma (stage IIB-C and III), renal cell carcinoma (RCC), and triple-negative breast cancer (TNBC) versus a reference scenario where anti-PD-(L)1 agents were only used to treat metastatic disease cases in Hungary (2024-2033). A Markov-modeling approach estimated the health outcomes and productivity losses from each scenario from a societal perspective. Outcomes included recurrence-/event-/disease-free life-years, total life-years, quality-adjusted life-years (QALYs), productive years (patients and caregivers), recurrences/events, active treatments for metastatic disease, and deaths. The cumulative health and productivity impact of ESD treatment with anti-PD-(L)1 agents in Hungary was the difference in health and productivity outcomes between the ESD and reference scenarios for the time horizon of the model.</p><p><strong>Results: </strong>ESD treatment with anti-PD-(L)1 agents was estimated to increase recurrence-/event-/disease-free life-years (+13.8%), total life-years (+3.7%), and QALYs (+4.7%), as well as productive work years for patients (+39.6%) and caregivers (+27.6%). Concurrently, there would be fewer recurrences/events (-31.0%), active treatments for metastatic disease (-34.0%), post-recurrence deaths (-30.3%), and total deaths (-23.1%).</p><p><strong>Conclusion: </strong>Investing in anti-PD-(L)1 agents for early-stage disease may not only increase the life expectancy and QALYs for patients in Hungary but also increase productive work years for both patients and caregivers in Hungary. In addition, it may also help to reduce metastatic disease treatments and cancer-related deaths.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"379-392"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213448","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}