Journal of Medical Economics最新文献

{"title":"All-cause healthcare resource utilization and costs among community-managed adults with long-COVID in France, 2020-2023.","authors":"Jingyan Yang, Cheikh Tamberou, Elise Arnee, Pierre-Alexandre Squara, Ayoub Boukhlal, Jennifer L Nguyen, Hannah R Volkman, Stéphane Fiévez, Marina Lepoutre-Bourguet, Jinma Ren, Haifa Ben Romdhane, Pascal Crépey, Olivier Robineau","doi":"10.1080/13696998.2025.2485626","DOIUrl":"10.1080/13696998.2025.2485626","url":null,"abstract":"<p><strong>Background: </strong>The clinical and economic burden of long COVID is poorly understood. We aim to assess all-cause healthcare resource utilization (HCRU) and costs in the primary care setting among adults with long COVID in France.</p><p><strong>Methods: </strong>A retrospective cohort study using the electronic healthcare records (EHRs) of confirmed and/or probable COVID-19 patients from The Health Improvement Network (THIN) data between March 2020 and December 2022 was conducted. Long COVID was identified per World Health Organization (WHO) definition as suggestive symptoms present ≥3 months following acute SARS-CoV-2 infection. Patients' characteristics, HCRU, direct healthcare and indirect costs (National Health Insurance-based prices) were summarized. Costs between patients with previous SARS-CoV-2 infection who developed long COVID, patients with previous SARS-CoV-2 infection who did not develop long COVID (COVID only), and contemporaneous controls without SARS-CoV-2 infection were compared (Non-COVID).</p><p><strong>Results: </strong>Long COVID developed among 30,122 (11.6%) adults; mean (SD) age was 50 (17) years, 63.6% were female and 27.5% had a Charlson Comorbidity Index score >2. During the post-infection follow-up (mean = 13 months), 97.3% of patients had general practitioner consultations (GP) and 62.4% had nursing care. Costs were highest during the first post-diagnosis year with per patient per year costs of €2,443 (total cost of €52 million), including costs for GP (€208) and specialist (€170) consultations, outpatient procedures (€413), retail pharmacy use (€595), biological testing (€147), and medical device usage (€172). Patients with long COVID had additional costs of €163 and €176 when compared to patients in the COVID only and Non-COVID cohorts, respectively.</p><p><strong>Limitations: </strong>Since the THIN database is generated from GP EHRs, there is the possibility of measurement/documentation errors and missing values which could compromise the validity and accuracy of certain results.</p><p><strong>Conclusion: </strong>Long COVID was associated with non-negligible HCRU, direct and indirect costs to the French healthcare system. These findings reinforce the importance of optimizing long-term resource allocation for patients infected with SARS-CoV-2.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"535-543"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753156","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 economic impact of the 21-valent pneumococcal conjugate vaccine (V116) for adults in Japan: a delta price approach.","authors":"Peter P Mueller, Atsushi Tajima, Kelsie Cassell, Taizo Matsuki, Nicole Cossrow, Zinan Yi, Kelly D Johnson, Kwame Owusu-Edusei","doi":"10.1080/13696998.2024.2445429","DOIUrl":"10.1080/13696998.2024.2445429","url":null,"abstract":"<p><strong>Introduction: </strong>This study analyzed the health and economic impact of the 21-valent pneumococcal conjugate vaccine (V116) and the 20-valent pneumococcal conjugate vaccine (PCV20), as well as their relative cost-effectiveness, in Japanese adults aged 65 years using a delta pricing approach.</p><p><strong>Methods: </strong>A Markov model was employed to simulate the movement of the Japanese population among four health states: healthy, pneumococcal disease (consisting of invasive pneumococcal disease [IPD] with or without meningitis and non-bacteremic pneumococcal pneumonia [NBPP]), post-meningitis sequelae, and death. The model was populated with publicly available demographic and epidemiologic data, stratified by risk level. Pneumococcal serotype distribution and vaccine effectiveness, as well as direct and indirect treatment costs and health-related utilities, were derived from published sources. The model used a lifetime horizon and 2% discounting of costs and life-years. Costs were adjusted to 2023 values in Japanese yen (¥). Outcomes were cases and deaths, life-years and quality-adjusted life-years (QALYs), vaccination and treatment costs, and incremental cost-effectiveness ratios. The range over which V116 was cost-saving and cost-effective was determined.</p><p><strong>Results: </strong>Compared to PCV20, V116 averted an additional 28 cases of IPD, 918 cases of NBPP, 5 deaths from IPD, and 51 deaths from NBPP over the lifetime of a single age 65 cohort. Life-years and QALYs gained were 1,019 and 642, respectively, relative to PCV20; V116 saved ¥733 million in direct medical costs and ¥557 million in indirect costs, compared to PCV20. V116 was found to be cost-saving at price premiums up to ¥1,322 (payer perspective) or ¥2,327 (societal perspective) and remained below a willingness-to-pay threshold of ¥5 million/QALY for premiums up to ¥7,113 (payer perspective) or ¥8,117 (societal perspective).</p><p><strong>Conclusions: </strong>V116 is projected to provide more population health benefits in Japan than PCV20, and to be cost-effective at a variety of price premiums.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"136-145"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Budget impact of introducing glofitamab for treatment of relapsed or refractory diffuse large B-cell lymphoma after two or more lines of systemic therapy in the United States.","authors":"Zahra Mahmoudjafari, Jia Li, Eric Bercaw, Hélène Parisé, Katalin Bognar, Si-Tien Wang, Anthony Masaquel","doi":"10.1080/13696998.2025.2486839","DOIUrl":"10.1080/13696998.2025.2486839","url":null,"abstract":"<p><strong>Background: </strong>Glofitamab is a T-cell engaging bispecific monoclonal antibody that was granted accelerated approval from the United States Food and Drug Administration for adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified or large B-cell lymphoma arising from follicular lymphoma, after ≥2 lines of systemic therapy (3L+).</p><p><strong>Methods: </strong>A budget impact model was developed for a hypothetical blended commercial/Medicare health plan with 1,000,000 members. Comparators were axicabtagene ciloleucel (Axi-cel), lisocabtagene maraleucel (Liso-cel), tisagenlecleucel (Tisa-cel), loncastuximab tesirine, polatuzumab vedotin + bendamustine + rituximab, rituximab + gemcitabine + oxaliplatin, tafasitamab + lenalidomide, and epcoritamab (Epcor). Total costs included those for drugs, wastage, administration, grade ≥3 adverse reactions, and all-grade cytokine release syndrome) and routine care. Market shares were based on internal projections and expert opinions. Total and per-member per-month (PMPM) net budget impacts over 3 years were calculated.</p><p><strong>Results: </strong>Approximately nine patients were projected to be eligible for 3L + DLBCL treatment in a health plan of 1,000,000 members. The introduction of glofitamab as a treatment option resulted in estimated total and PMPM cost savings of $728,697 and -$0.0202, respectively, over 3 years. Costs were reduced across all cost categories but particularly in drug costs. Among the newer therapies, total 3-year cost per treated patient was lowest for glofitamab: $226,658 versus Tisa-cel = $564,113; Axi-cel = $540,002; Liso-cel = $516,272; and Epcor = $335,293. Across all sensitivity analyses, the inclusion of glofitamab had minimal PMPM budget impact, ranging from -$0.0256 to -$0.0108.</p><p><strong>Conclusions: </strong>With the lowest 3-year total cost per treated patient among the newer therapies, glofitamab being an available option in the 3L + DLBCL market is estimated to save a hypothetical 1,000,000-member health plan $728,697 in cumulative total costs and $0.0202 in PMPM costs over 3 years.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"595-604"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753159","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 multiple criteria qualitative value-based pricing framework \"MARIE\" for new clinical status.","authors":"Akina Takami, Naotaka Sakashita, Tatsuhiro Uenishi, Ayako Shoji, Ataru Igarashi","doi":"10.1080/13696998.2025.2492478","DOIUrl":"https://doi.org/10.1080/13696998.2025.2492478","url":null,"abstract":"<p><strong>Background: </strong>Adjustment of drug prices after the change of their clinical status in the current drug pricing system in Japan functions as an appropriate allocation mechanism for drug expenditures under the universal health insurance system. However, the failure to incorporate a drug's value when determining its price decreases pharmaceutical companies' motivation to develop and launch novel drugs in Japan.</p><p><strong>Methods: </strong>In this study, we applied the value-based pricing framework MARIE to drugs with new clinical status. We estimated drug prices at the time of approval for the initial indication and new clinical status, with a total of 32 drugs by using MARIE. To estimate maximum number of patients for the new clinical status, we referred to the market expansion rate and calculated it backwards.</p><p><strong>Results: </strong>As a result, the median change of MARIE-estimated price under new clinical status against those under initial indication was -50.24% (range, -80.36% to 16.39%). For the initial indication, the median ratio of the drug price estimated with MARIE to the initial list price was 122.12% (range, 15.57% to 2237.38%); the median ratio of actual to estimated drug price were similar to those in our previous study (125.65%).</p><p><strong>Conclusions: </strong>We proposed the versatile, practical, convenient, multiple criteria, qualitative VBP framework MARIE for the new clinical status. Under the MARIE system, price would only be changed when the \"box\" (category of the maximum number of patients) in the conversion table of the maximum number of the patients changes as the environment changes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"606-614"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011369","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":"Axicabtagene ciloleucel compared to standard of care in Canadian patients with relapsed or refractory large B-cell lymphoma: a cost-effectiveness analysis of the ZUMA-7 trial.","authors":"John Kuruvilla, Laurie H Sehn, Sydney Whitney, Anik R Patel, Heather Cameron, Geoffrey G J Reid","doi":"10.1080/13696998.2025.2498853","DOIUrl":"https://doi.org/10.1080/13696998.2025.2498853","url":null,"abstract":"<p><strong>Aims and background: </strong>In the pivotal ZUMA-7 trial, second-line (2L) treatment with axicabtagene ciloleucel (axi-cel) had superior clinical outcomes compared to standard of care (SOC; salvage chemoimmunotherapy followed by high-dose therapy and autologous stem cell transplant in responders) in patients with large B-cell lymphoma (LBCL) who were refractory or relapsed (r/r) within 12 months of completion of frontline therapy. The aim of this analysis was to evaluate the cost-effectiveness of axi-cel compared to SOC for 2L LBCL in Canada.</p><p><strong>Methods: </strong>A 3-health state partitioned-survival model was used to estimate the cost-effectiveness of axi-cel vs. SOC from a Canadian healthcare system perspective. Clinical outcomes were informed by ZUMA-7. The model calculated expected quality-adjusted life years (QALYs), total costs, and the incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>Over a lifetime horizon, the model estimated a total of 9.48 and 7.25 QALYs, and total costs of $569,168 and $337,906 for axi-cel and SOC, respectively, resulting in an ICER of $103,810/QALY. When adjusting for the substantial proportion of patients in the SOC arm who received cellular therapy as subsequent treatment, the ICER was reduced to $78,555/QALY.</p><p><strong>Conclusions: </strong>Treatment with axi-cel in 2L is a cost-effective option that addresses an important unmet clinical need for Canadian patients with r/r LBCL.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"688-695"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996281","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":"Addendum.","authors":"","doi":"10.1080/13696998.2025.2524268","DOIUrl":"https://doi.org/10.1080/13696998.2025.2524268","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"986"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/13696998.2025.2477381","DOIUrl":"https://doi.org/10.1080/13696998.2025.2477381","url":null,"abstract":"","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":"28 1","pages":"363"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624974","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 bispecific antibody faricimab for treatment of neovascular age-related macular degeneration and diabetic macular edema in Japan.","authors":"Yasuo Yanagi, Jun Tsujimura, Shinya Ohno, Kentaro Higashi, Naotaka Sakashita, Ayako Shoji, Ataru Igarashi","doi":"10.1080/13696998.2025.2478755","DOIUrl":"10.1080/13696998.2025.2478755","url":null,"abstract":"<p><strong>Objective: </strong>To assess the cost-effectiveness of faricimab <i>vs.</i> other anti-vascular endothelial growth factor (anti-VEGF) drugs for treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) in Japan, while considering societal burden associated with treatment.</p><p><strong>Methods: </strong>A Markov model for cost-effectiveness analysis of anti-VEGF treatment in patients with nAMD and DME was applied based on cost and utility value data from Japan. Faricimab administered through a treat-and-extend (T&E) regimen was compared with ranibizumab administered pro re nata (PRN) and T&E, aflibercept T&E, brolucizumab T&E, and best supportive care (BSC). Further to treatment costs (public payer perspective), the societal burden (societal perspective), including costs of travel, informal care, and productivity, was assessed.</p><p><strong>Results: </strong>In treatment of nAMD, lifetime quality-adjusted life years (QALYs) gained were highest with faricimab (faricimab T&E: 6.92, ranibizumab PRN: 6.88, ranibizumab T&E: 6.91, aflibercept T&E: 6.89, brolucizumab T&E: 6.89, BSC: 5.99). From the public payer perspective, the lifetime total cost for faricimab T&E was lower than those for ranibizumab (PRN, T&E) and brolucizumab (T&E), comparable to aflibercept T&E, and higher than BSC (incremental costs: 158,385 and 6,475,511 JPY, respectively). As a result, faricimab was cost-effective or dominant in the treatment of nAMD, excluding BSC. From the societal perspective, faricimab was dominant against all comparators in nAMD. In treatment of DME, QALYs gained were highest with faricimab (faricimab T&E: 8.51, ranibizumab PRN: 8.17, aflibercept PRN: 8.36, ranibizumab T&E: 8.13, BSC: 5.16). From both the public payer and societal perspectives, faricimab was dominant against all comparators in DME.</p><p><strong>Conclusions: </strong>When societal burdens were considered, faricimab was dominant in both nAMD and DME against all comparators, suggesting that the extended dosing interval associated with faricimab treatment may alleviate societal burdens and consequently improve patient outcomes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"448-459"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615680","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":"Use of external data to inform overall survival extrapolation in NICE technology appraisals for oncology drugs.","authors":"Audrey Petitjean, Huiyu Shang, Ash Bullement, Nicholas Latimer","doi":"10.1080/13696998.2025.2506968","DOIUrl":"10.1080/13696998.2025.2506968","url":null,"abstract":"<p><strong>Aim: </strong>To assess use of external evidence for overall survival (OS) estimation in oncology single-technology appraisals (STAs) by the National Institute for Health and Care Excellence (NICE).</p><p><strong>Methods: </strong>STAs for oncology drugs appraised by NICE between January 2021 and March 2023 were identified. For each eligible STA, OS extrapolation methods used, the rationale for using external data, the source and type of data, and information on acceptance by the evidence review group (ERG) and the appraisal committee were extracted.</p><p><strong>Results: </strong>Initially, 215 STAs were identified, of which 82 were eligible for the study. Of these, 32 STAs used external data for OS extrapolation, including trial data (44%), real-world data (47%), clinical opinion (25%), meta-analysis (1%) and previous STA (1%). External data were used more frequently in state-transition models for post-event transitions and cure assumptions, and in partitioned-survival models to replace pivotal trial OS, inform long-term survival estimates or to estimate OS based on surrogacy analysis. Sensitivity analyses on use of external data was explored in 16 (50%) of the STAs. The committee accepted use of external data in half of the analysed STAs, acknowledging uncertainty in OS extrapolation.</p><p><strong>Limitations: </strong>The analysis was limited to the STAs published between 2021 and 2023 and publicly available materials on the NICE website.</p><p><strong>Conclusion: </strong>This study provides an overview of external data used to estimate OS in oncology STAs conducted by NICE in recent years. External data, including trial data, real-world data and clinical opinions, were incorporated into recent oncology STAs at various modelling stages. ERGs and appraisal committees were generally accepting of the use of external data. However, it is crucial to conduct a sensitivity analysis and provide a justification for the methods and data source selection.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"803-813"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101977","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 enzalutamide with androgen-deprivation therapy (ADT) versus ADT alone for the treatment of high-risk biochemically recurrent non-metastatic castration-sensitive prostate cancer in Canada.","authors":"Armen Aprikian, Fred Saad, Ewa Wywial, Thomas McLean, Karissa Johnston, Yuxin Li, Andrew Chilelli","doi":"10.1080/13696998.2025.2503660","DOIUrl":"10.1080/13696998.2025.2503660","url":null,"abstract":"<p><strong>Aim: </strong>The EMBARK (NCT02319837) trial demonstrated that enzalutamide with androgen-deprivation therapy (ADT; enzalutamide combination) or without ADT (enzalutamide monotherapy) significantly improved metastasis-free survival compared with ADT alone in high-risk biochemically recurrent (BCR) non-metastatic castration-sensitive prostate cancer (nmCSPC; also known as non-metastatic hormone-sensitive prostate cancer [nmHSPC]). No new safety signals were observed during the trial. The findings of EMBARK led to Health Canada's approval of enzalutamide for this patient population. The aim of this analysis was to assess the cost-effectiveness of enzalutamide combination versus ADT alone in patients with high-risk BCR nmCSPC from the Canadian payer's perspective.</p><p><strong>Material and methods: </strong>A semi-Markov model was created to represent the treatment and disease progression of patients with high-risk BCR nmCSPC over a 30-year horizon. Costs and outcomes were discounted at 1.5% annually. Treatment effects for high-risk BCR nmCSPC were informed by data from the EMBARK trial. Life-years (LYs), quality-adjusted life-years (QALYs), lifetime costs and incremental cost-effectiveness ratio (ICER) were estimated for enzalutamide combination and ADT alone. A one-way sensitivity analysis (OWSA) and scenario analyses were conducted to assess the robustness of results.</p><p><strong>Results: </strong>In the base-case deterministic analysis over the modeled time horizon, enzalutamide combination accumulated 11.85 LYs and 8.96 QALYs versus 8.75 LYs and 6.24 QALYs for ADT alone. The total cost for enzalutamide combination was Canadian dollars (CAD) 166,199, compared with CAD 95,146 for ADT alone. When combining cost and clinical outcome data, enzalutamide combination was associated with an ICER of CAD 26,129 per QALY gained. The OWSA and scenario analysis results were consistent with the base-case results.</p><p><strong>Conclusion: </strong>The study findings suggest that enzalutamide combination was associated with an ICER of CAD 26,129 per QALY gained, which is within the standard Canadian thresholds for willingness-to-pay (i.e. <CAD 50,000 per QALY gained), making enzalutamide combination a preferred treatment option for patients with high-risk BCR nmCSPC in Canada.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"766-777"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110959","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}