PharmacoEconomics Open最新文献

{"title":"Budget Impact of Prophylactic Letermovir to Prevent Cytomegalovirus Disease in High-Risk Adult Kidney Transplant Recipients.","authors":"Murvin Jootun, Irina Kolobova, Vladimir Turzhitsky, Lei Ai, Qinghua Li, Michael Wong, Abdel Hmissi, Andrew Beyer","doi":"10.1007/s41669-026-00679-2","DOIUrl":"https://doi.org/10.1007/s41669-026-00679-2","url":null,"abstract":"<p><strong>Background/objective: </strong>Cytomegalovirus (CMV) causes serious health problems in people with weakened immune systems, particularly those undergoing kidney transplantation. CMV can severely impact transplant outcomes through increased complications, graft loss, morbidity, and mortality. Valganciclovir (VGCV) is a commonly used prophylaxis after kidney transplantation for high-risk patients, but is known to induce leukopenia/neutropenia (LN). In the MK-8228-002 phase III trial, letermovir prophylaxis was non-inferior to VGCV for CMV prevention among high-risk adult kidney transplant recipients, but was also associated with significantly lower LN. This study aimed to evaluate the budget impact of introducing letermovir as a CMV prophylaxis drug for kidney transplant patients, with an increasing market share over 5 years compared with a market scenario with VGCV only, from a United States (US) payer perspective.</p><p><strong>Methods: </strong>A budget impact analysis was conducted from a US payer perspective, modeling a hypothetical health plan of 1,000,000 members, including 18 high-risk kidney transplant patients per year. The model compared a market scenario with VGCV only (without letermovir) versus a scenario in which letermovir is introduced into a healthcare plan with an increasing market share over 5 years. The model incorporated direct medical costs associated with prophylaxis drug acquisition and administration, LN events, and the downstream effects of LN events (e.g., CMV DNAemia, opportunistic infections, graft rejection/loss). Modeled outcomes included total budget impact and incremental cost per member per month (PMPM, 2025 USD). One-way sensitivity analysis (OWSA) was also conducted.</p><p><strong>Results: </strong>The annual total costs without letermovir were US$1,628,307 for each year and ranged from US$1,604,558 (year 1) to US$1,596,297 (year 5) in the scenario with letermovir. Incremental PMPM ranged from - US$0.0020 in year 1 to - US$0.0027 in year 5, indicating cost savings associated with letermovir in each year. The deterministic sensitivity analysis identified the rate of having LN events on VGCV as the most influential driver of the budget impact results, followed by the annual management cost of LN events and LN-associated events.</p><p><strong>Conclusion: </strong>This analysis provides evidence on the potential impact of introducing letermovir into the US market. While the acquisition cost of letermovir is higher than that of VGCV, there are estimated cost savings, primarily driven by the prevention of LN events and their associated downstream clinical consequences, suggesting that the savings from LN avoidance outweigh the incremental prophylaxis costs of introducing letermovir. However, the overall budget impact remains minimal and should be interpreted in the context of the evolving evidence base.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Threshold Price of Belantamab for Relapsed/Refractory Multiple Myeloma in China: A Cost-Effectiveness Analysis.","authors":"Xiaotong Zhang, Xiaoxuan Xing, Zhizhou Wang, Ke Wang, Yiming Hua, Lan Zhang, Xianzhe Dong","doi":"10.1007/s41669-026-00681-8","DOIUrl":"https://doi.org/10.1007/s41669-026-00681-8","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma is a life-threatening hematologic malignancy with a rising incidence and significant economic burden, driven largely by costly novel therapies. This study estimated the value-based price of belantamab, a novel agent for relapsed or refractory multiple myeloma, from the perspective of the Chinese healthcare system.</p><p><strong>Methods: </strong>A three-state partitioned survival model was constructed to compare belantamab plus bortezomib and dexamethasone (BVd) versus daratumumab plus bortezomib and dexamethasone (DVd) for the treatment of relapsed or refractory multiple myeloma over a lifetime horizon. Efficacy data were based on the DREAMM-7 trial (ClinicalTrials.gov identifier: NCT04246047). Cost inputs included the drug acquisition and administration, subsequent treatment, monitoring for post progression, disease evaluation and laboratory testing, and serious adverse events management. Health utilities were derived from published studies. Both costs and quality-adjusted life years (QALYs) were discounted at an annual rate of 4.5%. Probabilistic sensitivity analysis with 10,000 Monte Carlo simulations was conducted to estimate the threshold price of belantamab at a willingness-to-pay (WTP) threshold of twice China's 2025 GDP per capita (US$29,444 per QALY).</p><p><strong>Results: </strong>The BVd regimen yielded 6.15 QALYs compared with 4.51 QALYs for the DVd regimen. The probabilistic mean threshold price of belantamab was US$5.73/mg (95% CrI 2.16-8.89) at a WTP threshold of US$29,444/QALY.</p><p><strong>Conclusions: </strong>The threshold price of belantamab for BVd to be cost effective over DVd is US$5.73/mg at a WTP threshold of twice China's GDP per capita, indicating a need for a very substantial price reduction of approximately 98% from the US list price. This estimate provides evidence-based reference for future national price negotiation and reimbursement decisions in China.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Applied Researchers Engage with Methodological Tutorials: A Three-step Test Interview Study of an R Tutorial for Trial-Based Economic Evaluation.","authors":"Romain Jonathan Collet, Rosa Leek, G Ardine de Wit, Ângela Jornada Ben, Judith Ekkina Bosmans, Johanna Maria van Dongen","doi":"10.1007/s41669-026-00677-4","DOIUrl":"https://doi.org/10.1007/s41669-026-00677-4","url":null,"abstract":"<p><strong>Objectives: </strong>Methodological tutorials support the application of statistical methods in health technology assessment. Using an R tutorial for trial-based economic evaluation as a case study, we explored how applied researchers engaged with the tutorial and identified factors influencing its usability and perceived value.</p><p><strong>Methods: </strong>We conducted a three-step test interview study with applied researchers without experience with the tutorial (n = 17) and semi-structured interviews with applied researchers who had previously used it in their own work (n = 3). Participants worked through the tutorial whilst thinking aloud, followed by focussed and reflective interviews. Qualitative data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three themes were generated: (1) 'getting in and getting it to run', describing technical barriers; (2) 'understanding and making sense of what tutorials teach', reflecting challenges in applying methods and interpreting outputs; and (3) 'adapting and applying tutorials in practice', highlighting difficulties modifying code for real-world datasets. Barriers stemmed not only from methodological complexity but also from software setup, unclear terminology, limited coding skills and lack of support. Despite these, participants described tutorials in general as efficient learning tools when clearly structured, transparent and adaptable.</p><p><strong>Conclusions: </strong>We derived practical considerations that may help improve the accessibility, clarity and adaptability of future methodological tutorials. Methodological tutorials can support the learning and application of statistical methods, but their effective use depends on technical accessibility, user capability and access to support. These findings may inform future tutorial design and the development and validation of more structured guidance, such as a checklist for tutorial development.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Retractions of Health Economic Evaluations: A Systematic Review.","authors":"Eric Julian Manalastas, Aditi Hombali, Juliette C Thompson, David Alexander Scott","doi":"10.1007/s41669-026-00671-w","DOIUrl":"10.1007/s41669-026-00671-w","url":null,"abstract":"","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"941"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Targeted Review of Available Data Sources to Support Evidence-Informed Decisions: Implications for Health Technology Assessment in South Africa.","authors":"Evelyn Thsehla, Celeste Holden, Micheal Boachie, Susan Goldstein","doi":"10.1007/s41669-026-00666-7","DOIUrl":"10.1007/s41669-026-00666-7","url":null,"abstract":"<p><strong>Background: </strong>Universal health coverage (UHC) is central to the global health agenda. South Africa is in the process of developing a single financing system for UHC through a National Health Insurance (NHI). The NHI Act legislates the establishment of a health technology assessment (HTA) body to develop and, over time, add to an explicit package of health services funded by the NHI. This study aims to identify data that is publicly available for conducting HTA using the South African Values and Ethics for Universal Health Coverage (SAVE-UHC) framework.</p><p><strong>Methods: </strong>A targeted literature review was conducted to identify data sources for conducting HTA using the SAVE-UHC framework. The SAVE-UHC lists 12 domains that can be used to conduct HTA. We searched for published literature on PubMed using the following search terms: 'South Africa', 'healthcare', 'data sources', 'databases' and 'evidence' in the Title/Abstract fields. We also used our experience in the field to search for existing data from local and international organisations. We then mapped the data sources to the SAVE-UHC domains.</p><p><strong>Results: </strong>South Africa has some data to conduct HTA using the SAVE-UHC domains. Data for six of the domains (burden of disease, harms and benefits, cost effectiveness, budget impact, personal financial impact and equity) is available from local and international databases. Some data for the domain 'system factors and constraints' is available from the Office of Health Standards Compliance and the Human Resource Strategy for Health. Data on the five remaining domains (respect and dignity, solidarity and social cohesion, impact on personal relationships, impact on safety and security and ease of suffering) is limited.</p><p><strong>Conclusion: </strong>There are a number of data sources available to inform health technology assessment in South Africa. However, the data sources available only measure some of the value elements in the SAVE-UHC framework. Thus, South Africa needs to invest in healthcare data collection and management under the NHI to ensure healthcare decisions are made using relevant and recent evidence.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"781-799"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Methods for Extrapolating Costs and Effects in Economic Evaluations of Remote Monitoring.","authors":"Sabine Michelsen Raunbak, Jakob Juul Christensen, Ulla Møller Weinreich, Søren Paaske Johnsen, Flemming Witt Udsen","doi":"10.1007/s41669-026-00670-x","DOIUrl":"10.1007/s41669-026-00670-x","url":null,"abstract":"<p><strong>Introduction: </strong>Telehealth, including remote monitoring, has the potential to reduce healthcare resource use. However, economic evaluations often have insufficient methodological quality, including long-term investigation. The problem is that data are often unavailable for the entire time horizon of interest, but here different extrapolation methods can be applied.</p><p><strong>Objective: </strong>The objective of this study is to examine how long-term economic evaluations of telehealth interventions (remote monitoring) have been designed and conducted with a particular focus on extrapolation methods, and to identify the applied extrapolation methods.</p><p><strong>Methods: </strong>This scoping review was conducted according to guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The systematic search in Embase, PubMed, EconLit, Web of Science, NHS Economic Evaluation Database, and CINAHL, supplemented with a grey literature search in Google Scholar, identified economic evaluations, where minimum one alternative was telehealth, the time horizon exceeded 12 months, and extrapolation methods were applied. Last search date was 23 January 2025, and two reviewers screened the studies simultaneously. Data were extracted using a predefined data extraction sheet.</p><p><strong>Results: </strong>A total of 57 studies were included in this scoping review. Use of simpler extrapolation methods (Profiles and Constant values) was prevalent in 84% and 57% of the studies, respectively. These simple methods were used both in combination and alone. Even when trial-based data were available for a shorter time horizon, the simpler methods were used just as frequently as the more advanced methods. Only 32% of the studies included a sensitivity analysis for investigating the impact of the time horizon on the decision. Furthermore, transparency was missing in the reporting of applied extrapolation methods, and explicit investigation of uncertainty from the choice of extrapolation method is warranted.</p><p><strong>Conclusions: </strong>This scoping review finds that economic evaluations of telehealth interventions (remote monitoring) mainly rely on simpler extrapolation methods with limited justification, validation, and uncertainty analysis. Further investigation into the implications of use of different extrapolation methods is warranted, and guidelines on use of extrapolation methods are needed to ensure transparency.</p><p><strong>Registration: </strong>A protocol was published elsewhere.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"801-817"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cost-Effectiveness Analysis for Treatments of Patients with Early Stage Huntington's Disease in the USA.","authors":"Divya Patil, Julia F Slejko, Joseph M Savitt, T Joseph Mattingly Ii","doi":"10.1007/s41669-026-00668-5","DOIUrl":"10.1007/s41669-026-00668-5","url":null,"abstract":"<p><strong>Background/objective: </strong>Huntington's disease (HD) is a rare neurodegenerative condition caused by mutations in the huntingtin gene. Emerging therapies such as Tominersen and AMT-130 have potential to treat HD, highlighting the importance of evaluating their cost-effectiveness. This study evaluates the cost-effectiveness of Tominersen and AMT-130 versus standard of care (SoC) for early stage HD in the US.</p><p><strong>Methods: </strong>A Markov model with four health states (early, middle, late, and death) was developed to estimate lifetime costs and benefits from a modified societal perspective, with death as an absorbing state. The model used 1-year cycle length with half-cycle correction, and an annual discount rate of 3% was used for all future costs and utilities. Health benefits were measured in quality-adjusted life years (QALYs). All costs were adjusted to 2024 US dollars. As per the incremental cost-effectiveness ratio (ICER) value assessment framework, a willingness-to-pay threshold (WTP) of $500,000/QALY gained was considered given that HD is a rare disease. Scenario analysis assessed the impact of adding value of hope to the base-case utility values. Deterministic and probabilistic sensitivity analyses were conducted to capture uncertainty across all model parameters.</p><p><strong>Results: </strong>Compared with SoC, Tominersen increased costs by $2.11 million and QALYs by 0.93, resulting in an ICER of $2.28 million per QALY gained, whereas AMT-130 increased costs by $1.49 million and QALYs by 5.23, resulting in an ICER of $285,703 per QALY gained in the base case. Probabilistic analysis showed AMT-130 had 80% probability of being cost-effective at $350,000/QALY gained.</p><p><strong>Conclusions: </strong>From a modified US societal perspective, this analysis suggests that AMT-130 may be cost-effective relative to SoC, whereas Tominersen exceeds the WTP threshold of $500,000 per QALY gained. Further evidence on long-term effectiveness and durability is needed to inform policy and reimbursement decisions.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"909-918"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Impact of PromarkerD In Vitro Diagnostic Testing on the Management of Chronic Kidney Disease in Type 2 Diabetes: A Budget Impact Analysis.","authors":"Gareth C Fernandez, Isabella A Joubert, Kirsten E Peters, Lianzhi K Chen, Jacqueline S Gray, Pearl L Tan, Michael Shanik, Richard J Lipscombe","doi":"10.1007/s41669-026-00669-4","DOIUrl":"10.1007/s41669-026-00669-4","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the clinical and economic impact of integrating Promarker^®D, a validated biomarker-based blood test that predicts kidney function decline up to 4 years before clinical evidence of chronic kidney disease (CKD), into routine management of patients with type 2 diabetes (T2D) from a US healthcare payer perspective.</p><p><strong>Methods: </strong>A 10-year budget impact model simulated outcomes and costs of one million adults with T2D receiving standard of care (SoC) alone or SoC plus PromarkerD testing providing risk-stratified management. Model inputs were derived from published literature and included disease progression probabilities and healthcare costs associated with CKD, end-stage renal disease (ESRD), PromarkerD testing, and sodium-glucose cotransporter 2 inhibitor (SGLT2i) therapy. Costs were discounted at 3% annually. Scenario and one-way sensitivity analyses assessed parameter uncertainty. Results were translated to covered lives and national diagnosed T2D populations using epidemiologic prevalence estimates.</p><p><strong>Results: </strong>The model predicted that PromarkerD-guided early intervention delayed CKD progression, as reflected by reduced transition to advanced CKD stages over time, reduced ESRD incidence by ~6.4%, and reduced mortality by ~5.1% within 10 years. The PromarkerD-guided intervention generated net savings of US $1.2 billion (net present value) per million individuals over the study period. Annual savings began in year 4 (US $116 million), and cumulative savings became positive by year 6 (US $288 million). Results were most sensitive to assumptions regarding treatment benefit in moderate-risk individuals and baseline SGLT2i use but remained cost-offsetting across most scenarios.</p><p><strong>Conclusions: </strong>In this model-based analysis, PromarkerD-guided risk stratification enabled earlier intervention, was associated with delayed CKD progression, reduced ESRD incidence and mortality, and demonstrated long-term cost offsets from a US payer perspective. The magnitude of economic impact depends on the timely implementation of treatment in response to early risk identification in real-world practice.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"897-907"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Price of Absence: Productivity Costs and Sickness-Absence Episodes Attributable to Mental and Behavioral Disorders in the Brazilian Federal Workforce - A Nationwide Time-Series Study (2012-2024).","authors":"Douglas Paschoal Dos Santos, Alfredo Chaoubah, Helian Nunes de Oliveira, Quéren Hapuque de Carvalho, João Henrique Gonçalves Mazzeu","doi":"10.1007/s41669-026-00673-8","DOIUrl":"10.1007/s41669-026-00673-8","url":null,"abstract":"<p><strong>Background: </strong>Mental and behavioral disorders (MDs) represent a leading cause of sickness absence among Brazilian public servants, generating substantial social and economic burdens. Despite their impact, comprehensive nationwide assessments of productivity costs attributable to MDs over extended periods remain scarce.</p><p><strong>Objectives: </strong>The aim of this study was to estimate the productivity costs associated with MDs (ICD-10 Chapter V) among Brazilian federal civil servants from 2012 to 2024 compared with the four other most prevalent non-mental causes of absence.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal study using administrative data from SIAPE-SAÚDE (n = 471,507 workers/year average). Outcomes were classified according to ICD-10, focusing on MDs (F00-F99) and comparing them with the four other most prevalent non-mental causes. Productivity costs were estimated using the Human Capital Approach, calculating lost workdays (22 days per 30-day leave) multiplied by daily remuneration. Annual episode rates, average leave duration, and mean costs were stratified by region, education, gender, and age. All monetary values were adjusted to December 2024.</p><p><strong>Results: </strong>MDs accounted for 3.94 billion Brazilian Real (BRL) (38% of total costs among leading causes), representing 13.9 million days lost. Costs were concentrated in mood disorders (F30-F39: BRL 2.04 billion) and neurotic/stress-related disorders (F40-F48: BRL 1.49 billion). Episode rates increased from 42.3 to 83.8 per 1000 employees (2012-2019), declined in 2020 (39.4), then recovered to 85.8 in 2023. Women showed higher episode rates (particularly those aged ≤ 30 years: ≈ 160 per 1000), while men exhibited longer absences (44.7 vs 37.5 days) and higher per-case costs (BRL 11,720 vs BRL 8905). Marked increases occurred in autism spectrum disorders (+ 1673%) and attention-deficit/hyperkinetic disorder (ADHD) (+ 331%).</p><p><strong>Conclusions: </strong>MDs impose a substantial and persistent burden of productivity costs on the Brazilian federal public service, with rising sickness-leave episode rates over the period and pronounced gender, educational, and regional disparities, requiring targeted, equity-oriented occupational health policies.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"873-885"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Tezepelumab Versus Omalizumab in Patients with Severe Uncontrolled Allergic Asthma in Spain.","authors":"Elena Villamañan, Santiago Quirce, Covadonga Torres, Néstor Martínez, Carla Garí, Neus Vidal-Vilar, Carlos Almonacid","doi":"10.1007/s41669-026-00667-6","DOIUrl":"10.1007/s41669-026-00667-6","url":null,"abstract":"<p><strong>Background: </strong>Severe uncontrolled asthma (SUA) represents a complex and heterogeneous form of asthma that persists despite treatment. Allergic immunoglobulin E (IgE)-mediated SUA can be treated with tezepelumab or omalizumab.</p><p><strong>Objective: </strong>The aim was to estimate the cost-effectiveness of tezepelumab compared to omalizumab in the treatment of patients with allergic SUA, from the perspective of the Spanish National Health System (NHS).</p><p><strong>Methods: </strong>A Markov model was developed with a time horizon of 60 years, 28-day cycles, and five health states: controlled asthma; uncontrolled asthma; controlled asthma with exacerbation; uncontrolled asthma with exacerbation; and death. The efficacy parameters of the model were based on the NAVIGATOR and SOURCE clinical trials for tezepelumab and standard therapy, and on a network meta-analysis for omalizumab. Utilities and disutilities were extracted from NAVIGATOR and SOURCE and from the literature. The model considered direct costs (€, 2025): pharmacological, administration, exacerbations, disease management, and adverse events arising from oral corticosteroid use, obtained from Spanish data sources. Incremental costs per quality-adjusted life-year (QALY) gained were estimated for tezepelumab compared to the 106 omalizumab dosing profiles defined by weight and IgE. The results were contextualized to the Spanish setting using weight and IgE data obtained from the Primary Care Clinical Database and the literature. Deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were performed.</p><p><strong>Results: </strong>Tezepelumab was cost-effective compared with omalizumab (450 mg/4 weeks; incremental cost-effectiveness ratio €17,213.44/QALY), considering a willingness-to-pay threshold of €30,000/QALY, and was dominant (more effective and less costly) at higher doses. This represents 69.81% of the dosing profiles and 53.47% of the population with allergic SUA in Spain. The DSA confirmed that tezepelumab was cost-effective compared to omalizumab (450 mg) despite the variations in the parameters used. Tezepelumab was cost-effective or dominant in 80.00% of the PSA simulations.</p><p><strong>Conclusion: </strong>In this analysis, tezepelumab was a cost-effective option compared with omalizumab (≥ 450 mg/4 weeks) for the treatment of patients with allergic SUA aged 12 years and older from the perspective of the Spanish NHS.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"859-871"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}