Journal of Medical Economics最新文献

{"title":"Quantifying all-cause healthcare resource utilization and costs of children with mild-to-moderate long COVID in France.","authors":"Jingyan Yang, Cheikh Tamberou, Elise Arnee, Pierre-Alexandre Squara, Ayoub Boukhlal, Jennifer L Nguyen, Hannah R Volkman, Stephane Fievez, Marina Lepoutre-Bourguet, Haifa Ben Romdhane, Charlotte Renaudat, Pascal Crépey, Olivier Robineau","doi":"10.1080/13696998.2025.2525002","DOIUrl":"10.1080/13696998.2025.2525002","url":null,"abstract":"<p><strong>Background: </strong>Although children are known to be at risk of developing long COVID, its economic burden is poorly described. We aimed to assess the all-cause healthcare resource utilization (HCRU) and associated direct medical costs of children with mild-to-moderate long COVID in France.</p><p><strong>Methods: </strong>This retrospective cohort study utilized The Health Improvement Network (THIN) primary care electronic health records to identify children aged <18 years with confirmed/probable COVID-19 diagnoses during March 2020 to December 2022 who developed long COVID, identified per the World Health Organization as suggestive symptoms present ≥3 months following SARS-CoV-2 infection. Patient characteristics, all-cause HCRU and direct healthcare costs from a national health insurance perspective were summarized. HCRU and costs were stratified into healthcare encounters, medical procedures, retail pharmacy usage, testing, caregiver sick leave, medical transport, and medical device usage.</p><p><strong>Results: </strong>Of 27,537 children diagnosed with acute COVID-19, 3,888 (14.1%) developed long COVID; mean age was 8.9 years, 49.2% were female and, among those with comorbidity, 24.5% had a Charlson Comorbidity Index score ≥1. During a mean post-diagnosis follow-up of 12.6 months, 93.6% of children had general practitioner consultations, 93.5% had pharmacy usage, and 61.0% had medical procedures. First-year costs were highest at €823 per patient per year; 4.3% of children required caregiver-related work absenteeism. Compared to children who did not develop long COVID, a long COVID diagnosis was associated with an incremental cost increase of €98 per patient per year.</p><p><strong>Limitations: </strong>Our findings only represent a national payer perspective. The true societal burden of long COVID in children is likely underestimated since long COVID-related indirect costs are not fully captured and access to care varies.</p><p><strong>Conclusion: </strong>Children living with long COVID managed in the community pose a non-neglectable burden on French health insurance, reinforcing the importance of managing long COVID with a multidisciplinary approach and optimizing resource allocation.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1002-1013"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505985","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 newborn screening for spinal muscular atrophy in Japan.","authors":"Akira Hata, Akihito Uda, Satoru Tanaka, Diana Weidlich, Walter Toro, Laetitia Schmitt, Ataru Igarashi, Matthias Bischof","doi":"10.1080/13696998.2024.2439734","DOIUrl":"10.1080/13696998.2024.2439734","url":null,"abstract":"<p><strong>Aims: </strong>Spinal muscular atrophy (SMA) is a rare genetic disorder characterized by progressive muscle weakness, atrophy, respiratory failure, and in severe cases, infantile death. Early detection and treatment before symptom onset may substantially improve outcomes, allowing patients to achieve age-appropriate motor milestones and longer survival. We assessed the cost-utility of newborn screening (NBS) for SMA in Japan.</p><p><strong>Materials and methods: </strong>A cost-utility model (decision tree and Markov model) compared lifetime health effects and costs between \"NBS\" for SMA (presymptomatic treatment) or \"no NBS\" (treatment initiated at symptom onset). Model inputs were sourced from literature, local data, and expert opinion. Sensitivity and scenario analyses were conducted to assess model robustness and data validity.</p><p><strong>Results: </strong>Based on the 1:10,000 SMA incidence, it was estimated that 43 newborns/year would have SMA, and a total of 39 patients with SMA would initiate presymptomatic treatment after NBS. An estimated 736 quality-adjusted life-years were gained per annual birth cohort with NBS. NBS for SMA was dominant compared with no NBS (i.e. less costly and more effective), with ¥8,856,960,096 reduced total costs with NBS versus no NBS (base-case). Sensitivity and scenario analyses supported cost effectiveness of NBS for SMA versus no NBS. A greater percentage of patients was estimated to enjoy longer survival and be without permanent assisted ventilation with NBS versus no NBS.</p><p><strong>Limitations: </strong>Real-world observations may differ from single-arm clinical trial outcomes. It was assumed that patients with SMA identified via NBS were asymptomatic and would receive treatment prior to symptoms. Best supportive care was not considered, and Japan-specific variations in gene replacement therapy protocol were not fully reflected.</p><p><strong>Conclusion: </strong>NBS for SMA allows for early identification of patients with SMA and treatment initiation before symptom onset, improving health outcomes and reducing total costs than without NBS.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"44-53"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785717","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":"Optimizing scan times in clinical neuroimaging: the potential of synthetic MRI.","authors":"Alexander von Hessling, Felix Stahl, Frauke Kellner-Weldon","doi":"10.1080/13696998.2025.2496065","DOIUrl":"https://doi.org/10.1080/13696998.2025.2496065","url":null,"abstract":"<p><strong>Aim: </strong>Synthetic Magnetic Resonance Imaging (SI) generates images from parametric maps of tissue properties and derives contrast weightings from the same acquisition. We aimed to evaluate the potential for scan time reduction using SI in patients with neurological indications in a tertiary care cantonal hospital.</p><p><strong>Methods: </strong>We searched our hospital database for head imaging performed between March 2020 and August 2022. Sequences were categorized as either fully replaceable (Scenario A) or potentially replaceable (Scenario B) if replacement would lead to limitations, such as resolution or contrast. We calculated the time used and potentially saved if all replaceable sequences and their respective planning were replaced by a 3-dimensional (3D) SI sequence lasting 3 or 5 min.</p><p><strong>Results: </strong>We identified 4,320 head examinations. Total examination time for replaceable sequence imaging in Scenario A was 656 h 54 min (minimum: 506 h 26 min; maximum: 982 h 53 min) and 778 h 38 min (minimum: 602 h 34 min; maximum: 1,223 h 34 min) for Scenario A & B. If 3D SI had been used, the estimated time required would have been 216 h for a 3-minute 3D SI and 360 h for a 5-minute 3D SI. The application of SI would have yielded an estimated reduction of 440 h 54 min (minimum: 290 h 26 min; maximum: 766 h 53 min) for Scenario A, and 562 h 38 min (minimum: 386 h 34 min; maximum: 907 h 34 min) for Scenario A & B.</p><p><strong>Conclusion: </strong>Reducing scan time with 3D SI is feasible and depends on the scan time of 3D SI, the type and frequency of performed protocols, and its ability to meet high-quality requirements. The effectiveness is most pronounced when 3D SI can replace traditional weighted images while maintaining diagnostic standards.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"649-655"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999706","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 evaluation of PCV21 in vaccine-naïve adults aged 19-64 years with underlying medical conditions in the United States.","authors":"Zinan Yi, Elamin H Elbasha, Kwame Owusu-Edusei","doi":"10.1080/13696998.2025.2496070","DOIUrl":"https://doi.org/10.1080/13696998.2025.2496070","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to estimate the incremental health and economic outcomes associated with the use of PCV21 (Capvaxive) in vaccine-naive adults aged 19-64 years with underlying medical conditions in the United States (US).</p><p><strong>Methods: </strong>A static multi-cohort state-transition Markov model was utilized, drawing on data from published literature and publicly available databases and reports, comparing PCV21 (intervention) versus PCV20 or PCV15 + PPSV23 (comparator) from a societal perspective with a lifetime horizon. The target population consisted of vaccine-naive adults aged 19-64 years classified as at-risk (AR) or high-risk (HR). Key outcome measures included undiscounted clinical cases: invasive pneumococcal disease (IPD), inpatient and outpatient non-bacteremic pneumococcal pneumonia (NBPP), post-meningitis sequelae (PMS), deaths from IPD and inpatient NBPP, as well as discounted quality-adjusted life years (QALYs), and total costs (in 2023 USD), with the incremental cost-effectiveness ratios (ICERs) reported as $/QALY gained. Costs and QALYs were discounted at 3% per year. Deterministic and probabilistic sensitivity analyses were conducted.</p><p><strong>Results: </strong>The analysis indicated that the V116 strategy prevented a substantial number of cases and deaths compared to the PCV20 or PCV15 + PPSV23 strategies among vaccine-naive AR/HR adults aged 19-49 and 50-64 years. For instance, the use of PCV21 was projected to reduce IPD cases by 1,450 and 4,232, respectively, in the two age groups when compared with PCV20. The estimated ICERs for both age groups were found to be cost-saving when compared to both PCV20 and PCV15 + PPSV23. Deterministic and probabilistic sensitivity analyses confirmed the robustness of these findings, with over 95% of simulations yielding cost-saving results and all estimated ICERs remaining below $10,000/QALY gained.</p><p><strong>Conclusions: </strong>The findings suggest that the use of PCV21 (Capvaxive) in adults aged 19-64 years with underlying medical conditions in the US can prevent a significant number of pneumococcal disease cases and deaths while demonstrating favorable economic outcomes across various scenarios.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"665-673"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969908","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 prospective cohort study estimating total pre-surgical healthcare costs before and two-year total societal costs after resective brain surgery, and quality of life of patients with drug-resistant epilepsy undergoing surgery.","authors":"L Maas, C B C M Peeters, M Hiligsmann, S M J van Kuijk, S Tousseyn, J Kellenaers, G A P G van Mastrigt, M C G Vlooswijk, S Klinkenberg, L Wagner, J Nelissen, O E M G Schijns, H J M Majoie, K Rijkers","doi":"10.1080/13696998.2025.2473745","DOIUrl":"10.1080/13696998.2025.2473745","url":null,"abstract":"<p><strong>Background: </strong>In contrast to clinical effectiveness of resective epilepsy surgery (RES) for patients with drug-resistant epilepsy, societal costs of RES is still unclear. The aim of this study was to report on total societal costs up until two years after surgery and analyse the trend of post-surgical costs over time. Secondary objectives included assessing quality of life (QoL) changes and identifying determinants of post-surgical costs.</p><p><strong>Methods: </strong>Data were derived from the patients' entire medical history based on hospital files and accompanied by validated questionnaires before and 3-, 6-, 12-, and 24-months post-surgery to additionally include medical consumption outside of the hospital, productivity losses and gains, and QoL. To explore the trend of post-surgical costs over time and identify determinants of post-surgical costs, linear mixed effects and linear regression models were performed.</p><p><strong>Results: </strong>The study included 44 patients. Mean complete costs from diagnostics and treatment strategies in the period before referral for pre-surgical evaluation up until two years after RES were €121,856 (Interquartile range = €76,058-€137,027). Post-surgical costs significantly decreased 12 months (mean 3-month difference = €-6,675, <i>p</i> = 0.000) and 24 months (mean 3-month difference = €-7,690, <i>p</i> = 0.000) after surgery compared to 3 months before surgery. Higher post-surgical costs were associated with a clinically relevant increase in disease-specific QoL after RES (<i>p</i> = 0.000), previous ketogenic diet (<i>p</i> = 0.005), RES in the left hemisphere (<i>p</i> = 0.014), previous RES (<i>p</i> = 0.007), and higher diagnostics and treatment strategies costs before referral for pre-surgical evaluation (<i>p</i> = 0.021). For disease-specific and generic QoL, 20 (45%) patients reached a clinically relevant QoL increase two years after surgery compared to before RES.</p><p><strong>Conclusion: </strong>In conclusion, RES leads to significant reduction in costs 2 years post-surgery. History of RES and ketogenic diet, clinically relevant disease-specific QoL increase, surgery in the left hemisphere, and higher costs of diagnostics and treatment strategies before referral for pre-surgical evaluation were significant determinants for higher post-surgical costs after RES.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"364-376"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523706","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":"Noninvasive tests and diagnostic pathways to MASH diagnosis in the United States: a retrospective observational study.","authors":"Semiu O Gbadamosi, Kristin A Evans, Brenna L Brady, Anthony Hoovler","doi":"10.1080/13696998.2025.2468582","DOIUrl":"10.1080/13696998.2025.2468582","url":null,"abstract":"<p><strong>Aim: </strong>Although liver biopsy is considered the most reliable diagnostic tool for metabolic dysfunction-associated steatohepatitis (MASH), it is invasive and can be costly. Clinicians are increasingly relying on routine biomarkers and other noninvasive tests (NITs) for diagnosis. We examined real-world diagnostic pathways for patients newly diagnosed with MASH with a primary focus on NITs.</p><p><strong>Materials and methods: </strong>This retrospective, observational study analyzed healthcare claims data (Merative MarketScan Commercial and Medicare Databases) from patients in the United States newly diagnosed with MASH from October 1, 2016, to March 31, 2023. Patients ≥18 years old with ≥12 months of continuous enrollment with medical and pharmacy benefits prior to diagnosis were included. Diagnostic pathways leading up to MASH diagnosis, including NITs (blood-based and imaging-based tests) and liver biopsies were assessed. Prevalence of comorbid conditions, MASH-associated medication use, and the diagnosing physician specialty were also examined.</p><p><strong>Results: </strong>A total of 18,396 patients were included in the analysis. Routine laboratory tests (alanine aminotransferase [ALT], albumin, aspartate aminotransferase [AST], cholesterol, complete blood count, and hemoglobin A1c) were performed among ≥70% of patients prior to MASH diagnosis, including 89% of patients with a liver enzyme test (ALT and/or AST). More than 75% of patients had necessary laboratory tests to calculate AST to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores. The most common imaging performed was ultrasound (62%); liver biopsy was only performed in 10% of patients. There was a high prevalence of cardio metabolic risk factors such as hyperlipidemia (66%), hypertension (62%), obesity (58%), type 2 diabetes (40%), and cardiovascular disease (21%). Nearly half of the patients (49%) were diagnosed by a primary care physician.</p><p><strong>Limitations and conclusions: </strong>This study highlights real-world diagnostic pathways among patients newly diagnosed with MASH, supporting previous findings that liver biopsies are infrequently used in favor of noninvasive methods.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"314-322"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440972","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 strategic framework for synergizing managed entry agreement efforts to access pharmaceutical products in Saudi Arabia-results from a multi-stakeholder workshop.","authors":"Hussain Abdulrahman Al-Omar, Asma Abdulaziz Almuhsin, Lolwa Hamad Almudaiyan, Amal Hassan Al-Najjar, Laila Carolina Abu Esba, Hind Almodaimegh, Esraa S Altawil, Consuela Cheriece Yousef, Mansoor Ahmed Khan, Khalid AlYahya, Jehan Alamre, Fatma Maraiki, Jaime Espín, Rosanna Tarricone, Panos Kanavos","doi":"10.1080/13696998.2025.2506967","DOIUrl":"10.1080/13696998.2025.2506967","url":null,"abstract":"<p><strong>Background: </strong>Managed entry agreements (MEAs) between manufacturers and healthcare payers allow health systems to maximize patients' access to treatments while maintaining financial sustainability. However, to work efficiently, MEAs need to be integrated into a country's formal pricing, reimbursement, and market access processes. This study proposes a country-specific MEA framework for pharmaceutical products and sheds light on the key enablers of optimal implementation of MEAs in Saudi Arabia.</p><p><strong>Methods: </strong>This mixed-methods study was conducted through secondary data collection derived from systematic literature search followed by a half-day multi-stakeholder workshop hosted in Riyadh, Saudi Arabia including representatives from different governmental, quasi-governmental, and private sectors, all of whom had a job role related to pharmaceutical pricing, reimbursement, and market access. A predefined and validated set of questions was used to guide the workshop discussion with props and prompts to elicit more insights on MEAs design and framework from the participants. The workshop discussion and interactions were digitally recorded to enable verbatim transcription, followed by a thematic analysis.</p><p><strong>Results: </strong>Ten themes emerged from the workshop discussion with majority guided the framework design: (1) access to innovative medications; (2) stakeholder views about MEAs; (3) early dialogue; (4) prioritization of MEAs for pharmaceutical products; (5) the regulatory landscape; (6) designing a technical framework for MEAs; (7) innovative payment models; (8) health system governance; (9) challenges for successful implementation; and (10) stakeholder engagement.</p><p><strong>Conclusions: </strong>In Saudi Arabia, MEAs are perceived as strategic levers to enable health system to navigate the access paradox, particularly for innovative and high-cost therapies. Nevertheless, having in place a robust Saudi-specific framework and anchored regulations and policies is essential to ensure that MEAs enhance-rather than compromise-access, sustainability, and equity. As therapies grow more complex, Saudi Arabia must adopt agile, evidence-adaptive MEAs policy and structure to remain fit for purpose.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"753-765"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078212","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":"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 (<i>p</i> < 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":"260-267"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","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-of-illness of heart failure with preserved and reduced ejection fraction in the Philippines.","authors":"John Añonuevo, Camilo Oliver Aquino, Elaine Cunanan, Patrick James Encarnacion, Elmer Jasper Llanes, Diana Dalisay Orolfo, Chito Permejo, Dante Salvador, Mary Joy Taneo, Anthony Russell Villanueva, Helen Ong-Garcia, Precious Juzenda Montilla","doi":"10.1080/13696998.2025.2504269","DOIUrl":"10.1080/13696998.2025.2504269","url":null,"abstract":"<p><strong>Aim: </strong>Heart Failure (HF) poses a significant clinical and economic burden globally. Due to its progressive and chronic nature, HF requires both continuous medical management and acute care related to hospitalization. This study aimed to estimate the economic burden of HF in the Philippines, covering both outpatient care and inpatient management.</p><p><strong>Methods: </strong>The study utilized a bottom-up micro-costing approach to determine the economic burden of heart failure with mildly reduced ejection fraction (HFmrEF)/heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) across all NYHA classifications using a societal perspective. Price data were gathered from clinical experts, public and private hospitals, while quantity and probability assumptions were derived from published literature, subsequently validated through clinical expert consensus.</p><p><strong>Results: </strong>In 2022, an estimated 914,892 individuals were diagnosed with HF in the Philippines, based on a prevalence rate of 0.82%. This equates to a total economic burden of PHP 80.9B (USD 1.5B). Direct costs accounted for 90% of the total burden at PHP 72.8B (USD 1.3B). Hospital and medication expenses represented 61% of the total cost-of-illness, amounting to PHP 49.2B (USD 887.6 M).</p><p><strong>Conclusions: </strong>HF management poses a significant burden-of-disease for Filipinos. The annual societal costs of HF management potentially expose Filipinos to catastrophic health spending and impoverishment, especially in a system where a substantial portion of healthcare expenses are paid out-of-pocket. These findings highlight the urgent need to prioritize preventive public health interventions and enhance financial risk protection for HF patients.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"814-822"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086237","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 psoriasis treatment patterns and disease burden in Germany, with a focus on biologics and apremilast: data from a German statutory health insurance database.","authors":"Andreas Pinter, Marcus Schulte, Nils Kossack, Marc Pignot, Michael Schultze, Andrea Feldhus","doi":"10.1080/13696998.2025.2452054","DOIUrl":"10.1080/13696998.2025.2452054","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a chronic, systemic, inflammatory skin disease, with increasing prevalence; however, few studies have reported real-world prescription patterns and healthcare burden.</p><p><strong>Objectives: </strong>This retrospective, observational cohort study used statutory health insurance claims data (January 2014-December 2019) to estimate prevalence/incidence of moderate-to-severe psoriasis in Germany. Patient characteristics, treatment patterns/compliance, and healthcare resource utilization (HCRU)/costs were evaluated, focusing on apremilast and anti-interleukin (IL), and anti-tumor necrosis factor (TNF) biologics.</p><p><strong>Methods: </strong>The epidemiology population included adults with psoriasis; 1-year prevalence/incidence rates were extrapolated to the statutory health insurance population. The HCRU/costs population included adults with psoriasis and a first prescription for a drug of interest (index date). Baseline periods were 12 or 48 months before the index date, with 12‑month follow-up.</p><p><strong>Results: </strong>In 2019, the estimated psoriasis prevalence/incidence was 2,672.9 per 100,000 individuals/508.7 per 100,000 person-years. Of 2,809 patients in the HCRU/costs population, 3.6% (<i>n</i> = 101) received index drug apremilast, 10.2% (<i>n</i> = 287) anti-IL, 6.8% (<i>n</i> = 191) anti-TNF, and 79.4% (<i>n</i> = 2,230) traditional/other systemic therapy. Patients initiating apremilast were older and were more often biologic-naïve than those initiating anti-IL/TNF biologics. Twelve months after treatment initiation, drug adherence (medication possession rate >80%) and persistence (<60 days between prescriptions/no switch) were lower for apremilast <i>vs.</i> anti-IL and anti-TNF groups (24.8% <i>vs.</i> 59.6% and 53.9%; 36.6% <i>vs.</i> 66.9% and 57.6%, respectively). During a 12-month baseline period, psoriasis-related hospitalization was lower for apremilast <i>vs.</i> anti-IL and anti-TNF groups (4.95% <i>vs.</i> 15.68% and 14.14%) and higher during 12 months' follow-up (5.94% <i>vs.</i> 2.44% and 3.14%). Adjusted index drug costs during follow-up were €4,105, €3,498, and €13,777 higher for adalimumab, other anti-TNF and anti-IL biologics <i>vs.</i> apremilast, respectively, and the main driver for lower overall apremilast costs.</p><p><strong>Conclusion: </strong>Given variation in treatment adherence/persistence, HCRU, and costs between apremilast and biologics, these findings could be key considerations during treatment selection.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"207-220"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978947","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}