Journal of Medical Economics最新文献

{"title":"2024 in review: high impact articles from the <i>Journal of Medical Economics</i>.","authors":"Ivo Abraham, Mike Gregg","doi":"10.1080/13696998.2025.2455859","DOIUrl":"https://doi.org/10.1080/13696998.2025.2455859","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"221-223"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052794","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":"Healthcare resource utilization and costs of using cariprazine as the first versus subsequent adjunctive therapy for major depressive disorder.","authors":"Prakash S Masand, Anita H Clayton, Mousam Parikh, François Laliberté, Guillaume Germain, Malena Mahendran, Cristina Martinez, Nadia Nabulsi","doi":"10.1080/13696998.2025.2457872","DOIUrl":"10.1080/13696998.2025.2457872","url":null,"abstract":"<p><strong>Aim: </strong>Inadequate response to antidepressant therapy (ADT) is common in major depressive disorder (MDD); atypical antipsychotic (AA) adjunctive therapy may be effective for these patients. This study aimed to compare healthcare resource utilization (HRU) and costs between patients initiating the AA cariprazine as their first adjunctive therapy vs those initiating cariprazine subsequently.</p><p><strong>Methods: </strong>The Merative MarketScan Commercial Database (January 1, 2015, to June 30, 2021) was used to identify US adults with MDD and ≥1 pharmacy claim for cariprazine adjunctive to ADT in 2018 or after. Rates of mental health (MH)‑related and all‑cause HRU per patient-year (PPY) and mean healthcare costs per-patient-per-year (PPPY) were assessed after patients first initiated adjunctive therapy. HRU and costs were compared between cohorts using rate ratios (RRs) and mean cost differences, respectively, estimated from multivariable regression models.</p><p><strong>Results: </strong>Of 838 patients receiving cariprazine, 44.7% initiated cariprazine as their first adjunctive therapy to ADT, and 55.3% initiated it subsequently. Those initiating cariprazine first had significantly lower rates of MH‑related hospitalizations (RR [95% confidence interval] = 0.55 [0.30, 0.90], <i>p</i> = .020) and outpatient (OP) visits (0.67 [0.57, 0.82], <i>p</i> < .001) PPY than those initiating cariprazine subsequently. Moreover, patients initiating cariprazine as their first adjunctive therapy had lower annual total MH‑related healthcare costs (mean cost difference [95% confidence interval] -$2,182 [-$4,206, -$69], <i>p</i> = .040), driven primarily by lower OP visit costs (-$1,511 [-$2,330, -$615], <i>p</i> < .001). Similar trends were observed for all-cause HRU and costs.</p><p><strong>Limitations: </strong>This was a retrospective analysis of secondary data with limited follow-up. Claims were a proxy for cariprazine use.</p><p><strong>Conclusions: </strong>Results from this real‑world study of commercially insured US adults suggest that initiating cariprazine as the first adjunctive therapy rather than a subsequent therapy could help mitigate the considerable economic burden of MDD for appropriate patients.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"235-244"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023832","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":"Willingness to pay for the effect of SARS-CoV-2 antivirals in preventing COVID-19 transmission to others in the Japanese population.","authors":"Ataru Igarashi, Kenji Kurazono, Naoya Itsumura, Tomomi Takeshima, Kosuke Iwasaki","doi":"10.1080/13696998.2025.2461897","DOIUrl":"https://doi.org/10.1080/13696998.2025.2461897","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the willingness to pay (WTP) of the Japanese population for the transmission prevention function of SARS-CoV-2 antiviral treatments and identify the attributes associated with higher WTP.</p><p><strong>Methods: </strong>A web-based survey (registration number: UMIN000054955) was conducted from May 17 to June 1, 2024, targeting a general population using a survey company panel. We aimed to obtain around 3,000 valid responses. Respondents were randomly divided into two groups: one assuming a COVID-19 infection (infection-assumed group) and the other without this assumption (non-infection-assumed group). WTP was assessed using an open-ended question format, asking how much they would be willing to pay out-of-pocket for a hypothetical antiviral drug that reduces the risk of transmitting COVID-19 to others by half. The survey also collected demographic information, COVID-19 related attributes, empathy levels using the Multidimensional Empathy Scale (MES), and health literacy using the Communicative and Critical Health Literacy scale. The mean WTP for COVID-19 treatment was calculated for all respondents and for the infection-assumed and non-infection-assumed groups. Subgroup analyses examined the effects of respondent attributes on WTP. A linear regression model with stepwise selection identified factors associated with WTP.</p><p><strong>Results: </strong>Responses were obtained from 3,657 individuals, with 3,131 valid responses analyzed. The mean WTP among all respondents was JPY 3,205 (USD 20.85) (standard error: JPY 84 [USD 0.55]). The infection-assumed group showed a 21% higher WTP than the non-infection-assumed group (p < 0.001). Subgroup analyses indicated that WTP varied based on attributes such as co-residing children, occupation, empathy levels, and health literacy. Higher WTP was significantly associated with being aged 65 years and older, higher household income, absence of co-residing children, being a company employee, executive, or public servant, fear of COVID-19 infection, higher other-oriented emotional reactivity (a factor of MES), and higher health literacy.</p><p><strong>Conclusion: </strong>We presented the WTP of the Japanese population for the transmission prevention function of COVID-19 treatments as an actual monetary value. Factors such as empathy, health literacy, and some attributes were significantly associated with WTP. These findings might help inform policymakers in developing health policies based on the universal health insurance system in Japan.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1-13"},"PeriodicalIF":2.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066129","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 semaglutide in people with obesity and cardiovascular disease without diabetes.","authors":"Phil McEwan, Martin Bøg, Mads Faurby, Volker Foos, Ildiko Lingvay, Christopher Lübker, Ryan Miller, Joshua C Toliver, Florian Yeates, A Michael Lincoff","doi":"10.1080/13696998.2025.2459529","DOIUrl":"https://doi.org/10.1080/13696998.2025.2459529","url":null,"abstract":"<p><p>AimsThe cardioprotective effects of semaglutide 2.4 mg reported in the SELECT cardiovascular (CV) outcomes trial (ClinicalTrials.gov NCT03574597) provide clinical benefit for subjects with overweight or obesity and established CV disease without type 2 diabetes (T2D). We assessed cost-effectiveness of semaglutide 2.4 mg in this population against the American College of Cardiology/American Heart Association value framework.Materials and methodsA cohort-level Markov-state cost-effectiveness model using trial-derived data with outcomes from a healthcare sector perspective measured over a lifetime horizon was developed. Treatment costs were based on US list prices; scenario analyses used literature-reported estimated rebates. Healthcare costs and benefits were discounted at 3.0%. A simulated cohort of 100,000 subjects was aligned to the SELECT trial population baseline characteristics and time-on-treatment. Subjects received either semaglutide 2.4 mg or placebo in addition to standard of care (SoC). Modelled outcomes included clinical events (CV events, progression to T2D, chronic kidney disease [CKD]) and health economic measures, including direct costs and quality-adjusted life years (QALYs).ResultsMean semaglutide 2.4 mg treatment duration was 2.79 years. Per 100,000 subjects, treatment avoided 2,791 non-fatal myocardial infarctions, 3,000 coronary revascularizations, 487 non-fatal strokes, and 115 CV deaths over the modeled lifetime horizon. Average per-subject lifetime treatment costs were $47,353; savings arose from avoided T2D ($14,431), CKD ($2,074), and CV events ($1,512). Semaglutide 2.4 mg was associated with increased lifetime costs ($29,767), additional QALYs gained (0.218) and an incremental cost-effectiveness ratio of $136,271/QALY at list price; a scenario using an empirically estimated 48% rebate predicted $32,219/QALY.LimitationsThe generalizability of observations from SELECT to a broader US population is unknown. Our model does not capture all outcomes nor costs that may be affected by weight loss. Modeling assumptions may present limitations.ConclusionsSemaglutide 2.4 mg use as in SELECT is cost-effective at list price, using a $150,000/QALY willingness-to-pay threshold.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066159","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":"https://doi.org/10.1080/13696998.2025.2459499","url":null,"abstract":"<p><p>Objective/AimIn 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).MethodsNational 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.ResultsThe 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).LimitationsCosts have been calculated based on national averages reported by CMS (Medicare perspective) and are estimates. Regional differences may be present.ConclusionsPatients 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":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-01-28","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}

{"title":"Assessing the economic impact and healthcare resource utilization of inpatient pneumococcal disease among adults: a French national claims database study.","authors":"M Doyinsola Bailey, Gaëlle Farge, Manon Breau Brunel, Salini Mohanty, Gem Roy, Gérard de Pouvourville, Benoit de Wazieres, Cécile Janssen, Solenne Tauty, Françoise Bugnard, Mélanie Goguillot, Stève Bénard, Kelly D Johnson","doi":"10.1080/13696998.2025.2458957","DOIUrl":"https://doi.org/10.1080/13696998.2025.2458957","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumococcal diseases (PD) caused by <i>Streptococcus pneumoniae</i> include invasive PD (IPD) and non-bacteremia pneumococcal pneumonia (NBPP). Current French vaccination guidelines FOCUS on patients with underlying medical conditions (UMC) who are at a higher risk of PD. This study describes the healthcare resource utilization (HCRU) and economic burden of inpatient PD in French adults, to inform vaccination guidelines, especially among vulnerable subpopulations at increased risk of PD.</p><p><strong>Methods: </strong>A retrospective study utilizing the French administrative healthcare database (SNDS) was conducted among adults with a inpatient PD episode between 2015 and 2018. HCRU and costs were described per inpatient PD episode, according to patient risk level, type of PD, and age group.</p><p><strong>Results: </strong>Between 2015 and 2018, 42,466 inpatient PD episodes were identified. Most of inpatient PD episodes (73.8%) occurred in patients with UMCs. The median (Q1-Q3) cost per inpatient PD episode seemed higher among medium-risk patients (€14,863 (€7,875 - €30,434)) than among low-risk (€11,034 (€5,803 - €23,098)) and high-risk patients (€13,258 (€7,143 - €26,815)). Cost per inpatient PD episode did not seem to increase steadily with age, however, ≥65 patients represented 59.5% of all inpatient PD episodes and 52.3% of the overall inpatient PD episodes cost (€548,224,569 out of €1,049,214,069).</p><p><strong>Limitations: </strong>Due to constraints of the SNDS dataset, results are limited to inpatient episodes of PD and may not be representative of all PD episodes in France.</p><p><strong>Conclusion: </strong>This large, retrospective study highlights a substantial economic burden associated with inpatient PD in France, especially among individuals with UMCs and those aged 65 years or over. These results emphasize the need to improve prevention strategies, especially among older patients, regardless of their risk level.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047008","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":"Decision model to evaluate the cost of clinical events associated with switching from Apixaban to Rivaroxaban among patients with non-valvular atrial fibrillation in the United States and Germany.","authors":"Rupesh Subash, Cecilia Duan, Anshul Shah, Dionne M Hines, Michelle Zhang, Thitima Kongnakorn, Elke Dworatzek, Agnes Kisser, Melissa Hagan","doi":"10.1080/13696998.2025.2450933","DOIUrl":"https://doi.org/10.1080/13696998.2025.2450933","url":null,"abstract":"<p><strong>Aims: </strong>Direct-acting oral anticoagulants (DOACs) have emerged as the preferred treatment for nonvalvular atrial fibrillation (NVAF). However, evidence concerning the economic outcomes of DOAC switching remains limited. This study aimed to assess the economic outcomes of DOAC switching in the US and Germany, two countries with a high AF prevalence and DOAC utilization.</p><p><strong>Methods: </strong>A decision model was developed to assess the incidence and cost of stroke/systemic embolism (SE) and major bleeding (MB) associated with switching from apixaban to rivaroxaban in patients with NVAF. The model compared two scenarios: continuers (patients continuing apixaban) and switchers (patients switching from apixaban to rivaroxaban). Model inputs on clinical event rates were sourced from a published real-world study, costs inputs were from a standard costing database and published literature. The analysis was conducted over a 1-year time horizon from US Medicare fee-for-service and German public healthcare payer perspectives.</p><p><strong>Results: </strong>Over one year, 47,036 patients among a hypothetical plan size of 1,000,000 US Medicare fee-for-service members and 1,019,079 patients among the German adult population size of 70,107,122 were estimated to be treated for NVAF with apixaban. Switching all patients from apixaban to rivaroxaban resulted in 1,498 and 32,447 additional clinical events (stroke/SE and MB) and deaths in the US and Germany, respectively, compared to continuing with apixaban. This led to a total incremental cost of $17.3 million and €153 million from Medicare fee-for-service and German public healthcare perspectives, respectively.</p><p><strong>Limitations: </strong>The incidence and hazard ratios of clinical events informing this analysis were based on a US commercial and Medicare Advantage population and may not be generalizable to other populations.</p><p><strong>Conclusions: </strong>Switching from apixaban to rivaroxaban was associated with increased clinical events, deaths, and higher medical care costs, potentially representing a less favorable strategy economically compared to continuing apixaban among patients with NVAF.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006875","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":"Evaluating the cost-utility of ferric derisomaltose versus ferric carboxymaltose in patients with inflammatory bowel disease and iron deficiency anaemia in Norway.","authors":"T E Detlie, L N Karlsen, E Jørgensen, N Nanu, R F Pollock","doi":"10.1080/13696998.2024.2444833","DOIUrl":"https://doi.org/10.1080/13696998.2024.2444833","url":null,"abstract":"<p><strong>Aims: </strong>Iron deficiency anemia (IDA) is among the most common extraintestinal sequelae of inflammatory bowel disease (IBD). Intravenous iron is often the preferred treatment in patients with active inflammation with or without active bleeding, iron malabsorption, or intolerance to oral iron. The aim of the present study was to evaluate the cost-utility of ferric derisomaltose (FDI) versus ferric carboyxymaltose (FCM) in patients with IBD and IDA in Norway.</p><p><strong>Materials and methods: </strong>A published patient-level simulation model was used to evaluate the cost-utility of FDI versus FCM in patients with IBD and IDA from a Norwegian national payer perspective. Iron need was modelled based on bivariate distributions of hemoglobin and bodyweight combined with simplified tables of iron need from the FDI and FCM summaries of product characteristics. Patient characteristics and disease-related quality of life data were obtained from the PHOSPHARE-IBD trial. Cost-utility was evaluated in Norwegian Kroner (NOK) over a five-year time horizon.</p><p><strong>Results: </strong>Patients required 1.64 fewer infusions of FDI than FCM over five years (5.62 versus 7.26), corresponding to 0.41 fewer infusions per treatment course. The reduction in the number of infusions resulted in cost savings of NOK 7,720 (NOK 35,830 with FDI versus NOK 43,550 with FCM). The need for phosphate testing in patients treated with FCM resulted in further cost savings with FDI (no costs with FDI versus NOK 4,470 with FCM). Total cost savings with FDI were therefore NOK 12,190. FDI also increased quality-adjusted life expectancy by 0.071 quality-adjusted life years (QALYs) driven by reduced incidence of hypophosphatemia and fewer interactions with the healthcare system.</p><p><strong>Conclusions: </strong>FDI resulted in cost savings and improved quality-adjusted life expectancy versus FCM in patients with IDA and IBD in Norway. FDI therefore represents the economically preferable iron formulation in Norwegian patients with IBD and IDA in whom it is indicated.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1-15"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864560","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":"Transcatheter aortic valve replacement and the value of increasing treatment for severe symptomatic aortic stenosis: a plain language summary.","authors":"J P Sevilla, Mark J Russo, Christin A Thompson, Xiayu Jiao, David E Bloom","doi":"10.1080/13696998.2024.2403926","DOIUrl":"https://doi.org/10.1080/13696998.2024.2403926","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"27 1","pages":"1036-1045"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467698","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 a lung cancer screening program in the netherlands: a simulation based on NELSON and NLST study outcomes.","authors":"Hilde Ten Berge,Bo Willems,Xuanqi Pan,Evgeni Dvortsin,Joachim Aerts,Maarten J Postma,Mathias Prokop,Michel M van den Heuvel","doi":"10.1080/13696998.2024.2404359","DOIUrl":"https://doi.org/10.1080/13696998.2024.2404359","url":null,"abstract":"BACKGROUNDIn the Netherlands, lung cancer is the leading cause of cancer-related death, accounting for more than 10,000 annual deaths. Lung cancer screening (LCS) studies using low-dose computed tomography (LDCT) have demonstrated that early detection reduces lung cancer mortality. However, no LCS program has been implemented yet in the Netherlands. A national LCS program has the potential to enhance the health outcomes for lung cancer patients in the Netherlands.OBJECTIVE AND METHODSThis study evaluates the cost-effectiveness of LCS compared to no-screening in the Netherlands, by simulating the screening outcomes based on data from NEderlands-Leuvens Longkanker Screenings ONderzoek (NELSON) and National Lung Screening Trial (NLST). We simulated annual screening up to 74 years of age, using inclusion criteria from the respective studies. A decision tree and Markov model was used to predict the incremental costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICERs) for the screening population. The analysis used a lifetime horizon and a societal perspective.RESULTSCompared to no-screening, LCS resulted in an ICER of €5,169 per QALY for the NELSON simulation, and an ICER of €17,119 per QALY for the NLST simulation. The screening costs were highly impactful for the cost-effectiveness. The most influential parameter was the CT scan cost. Cost reduction for CT from €201 to €101 per scan would reduce the ICER to €2,335 using NELSON criteria. Additionally, LCS could prevent 15,115 and 12,611 premature lung cancer deaths, accompanied by 1.66 and 1.31 QALYs gained per lung cancer case for the NELSON and NLST simulations, respectively.CONCLUSIONLCS was estimated to be cost-effective in the Netherlands for both simulations at a willingness-to-pay threshold of €20,000 per QALY. Using the NELSON criteria, less than €5,500 per QALY had to be spent. Lowering the cost per CT exam would lead to a further reduction of this amount.","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"26 1","pages":"1197-1211"},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268244","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}