Journal of Medical Economics最新文献

{"title":"Investing in enhanced HIV prevention among young men who have sex with men in Brazil: insights from fiscal health modeling.","authors":"George Bray, Natalya Danchenko, Simon Brassel, Matthew Napier, Frederick McElwee, Hania El Banhawi, Nadine Mardini, Straus Tanaka, Sarah-Jane Anderson, Ian Jacob, Lotte Steuten","doi":"10.1080/13696998.2026.2709235","DOIUrl":"https://doi.org/10.1080/13696998.2026.2709235","url":null,"abstract":"<p><strong>Background and aims: </strong>HIV diagnoses have increased in Brazil from 2020 to 2023, with 54% of new diagnoses in 2023 occurring among men who have sex with men. This increase suggests a substantial need for HIV prevention, including pre-exposure prophylaxis (PrEP). We developed a fiscal health model to assess the financial impact of enhancing HIV prevention in Brazil.</p><p><strong>Methods: </strong>The fiscal health model used a multicohort Markov structure covering 15 annual cohorts of men who have sex with men aged 15-29 years, linking individual health states (<i>off PrEP</i>, <i>on PrEP</i>, diagnosed with HIV) to 4 fiscal states that individuals could occupy across their modeled lifetime (formally employed, informally employed, unemployed, retired). The model compared the status quo (current provision of HIV prevention, i.e. daily oral PrEP) with enhanced prevention (availability of long-acting PrEP and outreach programs to increase PrEP uptake and adherence). Outcomes are presented as an average fiscal benefit-cost ratio across all age cohorts' lifetimes (discounted at 5%). Scenario analyses were conducted over the cohorts' total lifetime (including retirement phase) and preretirement lifetime using either conservative or alternative estimates (differing viral suppression and employment reduction estimates).</p><p><strong>Results: </strong>In all scenarios, enhancing HIV prevention compared with status quo averts >70,000 HIV diagnoses among the modeled population of 526,046 young men who have sex with men. Enhancing HIV prevention generates a return on investment of 5% and 17% over the cohorts' total lifetimes and preretirement lifetimes, representing returns of R$0.5 billion (∼US$100 million) and R$1.7 billion (∼US$340 million), respectively. With alternative estimates, enhancing HIV prevention generates a return of 20% and 33% over the total lifetimes and preretirement lifetimes, respectively.</p><p><strong>Conclusions: </strong>Enhancing HIV prevention shows a positive return on investment. Decision-makers should consider long-term perspectives, ensuring opportunities to improve population health and contribute to a stronger economy are realized.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"2091-2106"},"PeriodicalIF":3.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664083","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":"Partial economic evaluations of combination vaccines: extended findings from a systematic literature review.","authors":"Manuela Di Fusco, Shailja Vaghela, Ceu Mateus, Katharina Janke","doi":"10.1080/13696998.2026.2701593","DOIUrl":"https://doi.org/10.1080/13696998.2026.2701593","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1955-1963"},"PeriodicalIF":3.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520449","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":"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":"Correction.","authors":"","doi":"10.1080/13696998.2026.2663737","DOIUrl":"https://doi.org/10.1080/13696998.2026.2663737","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1303"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773121","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":"10.1080/13696998.2026.2668135","DOIUrl":"10.1080/13696998.2026.2668135","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1420"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816468","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 incidence of opioid use disorder among people with acute and chronic pain managed with prescription opioids in the United States: economic and societal burden.","authors":"Andrew J Schoenfeld, Sushanth Jeyakumar, Jessica Morlando Geiger, Nicole Princic, Meghan Moynihan, Helen Varker, Liuhua Shi, Ann M Menzie","doi":"10.1080/13696998.2026.2655086","DOIUrl":"10.1080/13696998.2026.2655086","url":null,"abstract":"<p><strong>Aims: </strong>This retrospective, longitudinal, observational study evaluated the incidence of opioid use disorder (OUD) among patients newly initiating opioids to manage acute and chronic pain in the United States. Additionally, healthcare resource utilization (HCRU) and associated costs were analyzed.</p><p><strong>Materials and methods: </strong>Adult patients newly treated with prescription opioids were identified within the MarketScan administrative claims databases (2016-2018). Patients were classified as experiencing acute or chronic pain based on total prescription pain medication use within one year of the initial opioid prescription. Subgroups of patients with or without OUD were identified using diagnosis codes.</p><p><strong>Results: </strong>The 1-, 2-, and 3-year incidence rates of OUD were 0.21%, 0.32%, and 0.43%, respectively, among acute pain patients and 1.11%, 1.52%, and 1.92% among chronic pain patients. Unadjusted all-cause HCRU were substantially higher among patients with OUD compared to those without OUD over the 12-month period following OUD diagnosis. The associated unadjusted total all-cause healthcare costs were 3.1-times and 2.0-times higher for those with OUD compared to those without OUD in the acute and chronic pain cohorts, respectively. The total all-cause healthcare costs for patients with OUD remained significantly higher, even after adjusting for baseline characteristics. When extrapolated nationally, estimated costs for patients managing acute or chronic pain and newly diagnosed with OUD were $3.3 billion (B) and $5.9B, respectively, totaling $9.2B.</p><p><strong>Limitations: </strong>Pain medication use was identified using claims for filled prescriptions; patients' actual medication usage and use of over-the-counter medications cannot be ascertained. OUD diagnosis was based on specific ICD-10-CM diagnosis codes, potentially underestimating the true incidence and economic impact.</p><p><strong>Conclusions: </strong>Newly diagnosed OUD following prescription opioid use for managing acute and chronic pain imposes a substantial economic burden within the first year following OUD diagnosis. Increased use of effective non-opioid analgesics may help reduce the incidence and economic burden of OUD.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1355-1371"},"PeriodicalIF":3.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839018","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 comparison of intravenous immunoglobulin and subcutaneous efgartigimod in patients with chronic inflammatory demyelinating polyneuropathy.","authors":"Suraj A Muley, Irene Gucciardi, Vivek Kaisare, Christoph Wissmann, Sarah Bandy, Wei-Shi Yeh, Leslie Myers","doi":"10.1080/13696998.2026.2732441","DOIUrl":"https://doi.org/10.1080/13696998.2026.2732441","url":null,"abstract":"<p><strong>Aims: </strong>To compare the total treatment costs and cost per responder of IVIG and a newer therapy for adults with chronic inflammatory demyelinating polyneuropathy from a U.S. payer perspective.</p><p><strong>Methods: </strong>A cost per responder analysis compared Vyvgart hytrulo with Panzyga administered at standard (1 g/kg) and higher (2 g/kg) maintenance doses over 6- and 12-month time horizons. Efficacy, safety data, and responder definitions were sourced from the ADHERE trial for Vyvgart hytrulo, and the ProCID trial for Panzyga. Total treatment costs included drug acquisition, administration, and costs by responder status reported in 2026 USD. Twelve-month Panzyga response rates incorporated published evidence and clinical guideline assumptions for responders, non-responders, and those with inadequate initial response requiring dose escalation. Deterministic scenario analyses evaluated reduced Panzyga effectiveness and hypothetical Vyvgart Hytrulo average sales price (ASP) discounts. Threshold analyses identified the efficacy reduction and ASP discount required to change the model conclusions. Probabilistic sensitivity analysis evaluated parameter uncertainty in the clinical response estimates.</p><p><strong>Results: </strong>At 6 months, total treatment costs for Panzyga 1 g/kg, Panzyga 2 g/kg, and Vyvgart hytrulo were $124,812, $217,366, and $464,681, respectively. At 12 months, costs were $190,026, $402,301, and $698,583, respectively. Six-month responder rates were 80%, 92%, and 53% for Panzyga 1 g/kg, Panzyga 2 g/kg, and Vyvgart hytrulo, respectively; corresponding 12-month rates were 74%, 85%, and 48%. Cost-per-responder was consistently lower for Panzyga versus Vyvgart hytrulo at both time horizons. At 12 months, cost per responder was $256,792 for Panzyga 1 g/kg, $473,295 for Panzyga 2 g/kg, and $1,455,382 for Vyvgart hytrulo.</p><p><strong>Limitations: </strong>While no head-to-head clinical trial data were available, differences in trial design and responder definitions between studies may affect comparability.</p><p><strong>Conclusions: </strong>Under the assumptions of this model, Panzyga-based treatment pathways were associated with lower modeled total treatment costs and lower estimated cost per responder than Vyvgart hytrulo at both 6 and 12 months.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"2375-2385"},"PeriodicalIF":3.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012427","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":"What to expect in 2026-2027: important health economics and outcomes research topics.","authors":"Ivo Abraham, Mickael Hiligsmann, Kenneth K C Lee, Giorgio L Colombo, Leslie Citrome, Mike Gregg","doi":"10.1080/13696998.2026.2692757","DOIUrl":"10.1080/13696998.2026.2692757","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"2010-2019"},"PeriodicalIF":3.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794212","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 multitarget stool DNA testing for colorectal cancer screening in Chinese primary healthcare settings: a modelling study.","authors":"Hang Su, Jingyi Li, Xinyi Zhang, Zhihui Xiu, Tongtong Ge, Ning Tang, Xue Du, Ruijingfang Jiang, Sha Li, Jing Zhang, Ting Wei, Lizheng Xu, Shida Zhu, Lei Si, Maoyi Tian","doi":"10.1080/13696998.2026.2688701","DOIUrl":"10.1080/13696998.2026.2688701","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the cost-effectiveness of a one-time mt-sDNA-based colorectal cancer screening program compared with no screening, using real-world data from a government-led population-based screening program in Harbin Municipality of China.</p><p><strong>Methods: </strong>This modelling study was based on a real-world mt-sDNA CRC screening program in Chinese primary healthcare settings. The program targeted residents aged 45-64 years without a prior history of CRC. A decision analytic model was developed from the healthcare system perspective to compare mt-sDNA screening with a hypothetical no-screening scenario. Costs included mt-sDNA testing, diagnostic colonoscopy after positive results, adenoma resection, and colorectal cancer treatment by disease stage. Effectiveness was measured in quality-adjusted life-years (QALYs). The primary outcome was the incremental cost-effectiveness ratio (ICER), assessed against a willingness-to-pay threshold of CNY 166,744 per QALY gained. Costs and QALYs were discounted at 5% annually over a lifetime horizon. One-way deterministic sensitivity analysis and probabilistic sensitivity analysis with 10,000 simulations were conducted.</p><p><strong>Results: </strong>Among 749,517 participants, 79,169 had positive mt-sDNA results and 17,364 completed diagnostic colonoscopy, corresponding to a colonoscopy adherence rate of 21.93%. In the base-case analysis, mt-sDNA screening incurred CNY 264 higher lifetime costs and yielded an additional 0.006 QALYs per person versus no screening. The mt-sDNA screening was cost-effective with an ICER of CNY 43,627 per QALY gained. The cost-effectiveness results were particularly sensitive to colonoscopy adherence (ranging from CNY 94,907 to 10,037 per QALY as adherence varied from 10% to 100%) and to the unit cost of the mt-sDNA test (ranging from CNY 22,113 to 65,140 per QALY with <i>a</i> ± 50% variation in cost). All ICERs remained below the cost-effectiveness threshold.</p><p><strong>Conclusions: </strong>The mt-sDNA screening is cost-effective compared to no screening. These findings provide economic evidence to support the large-scale adoption of mt-sDNA-based screening in China.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"29 1","pages":"1800-1814"},"PeriodicalIF":3.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308318","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":"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":3.1,"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}