PharmacoEconomics Open最新文献

{"title":"Economic Evaluation of Lecanemab for Early Symptomatic Alzheimer's Disease in South Korea.","authors":"Seungyeon Shin, Maryanne Kim, Song Hee Hong","doi":"10.1007/s41669-025-00593-z","DOIUrl":"10.1007/s41669-025-00593-z","url":null,"abstract":"<p><strong>Background/objectives: </strong>Alzheimer's disease (AD) exerts a considerable economic burden on South Korea's aging population. Lecanemab, an amyloid-targeting therapy, has demonstrated efficacy in mitigating cognitive decline in early-stage AD but remains non-reimbursed in South Korea due to concerns over its economic feasibility. This study aimed to examine the cost-effectiveness of lecanemab using nationwide claims data for cost estimation within the South Korean healthcare system. Considering the substantial societal burden of AD, we also evaluated the cost-effectiveness of lecanemab from a limited societal perspective.</p><p><strong>Methods: </strong>A Markov state transition cohort model was developed to compare costs and outcomes of lecanemab combined with standard of care (SoC) versus SoC alone. The model simulated five stages of AD progression: mild cognitive impairment, mild AD, moderate AD, severe AD, and death. Transition probabilities between health states were derived from data provided by the National Alzheimer's Coordinating Center. Formal medical costs and long-term care costs were obtained from the national claims database, while drug cost and other medical expenses were derived from previous studies. Additional cost components such as opportunity cost of caregiver time, out-of-pocket expenses, and time and travel costs for hospital visits were included in the limited societal perspective. Korean-specific utilities for patients and caregivers differentiated by states of AD progression and care settings were obtained from the published literature. Effectiveness was measured in quality-adjusted life years (QALYs) over a lifetime horizon. Scenario analyses were conducted by varying compositions of the cohort, age of onset, and drug pricing.</p><p><strong>Results: </strong>The incremental cost-effectiveness ratio (ICER) of lecanemab combined with SoC was 198,171,820 Korean Won (KRW)/QALY from the healthcare payer perspective and 181,185,820 KRW/QALY from the limited societal perspective, which significantly exceeded South Korea's willingness-to-pay (WTP) threshold of 30 million KRW/QALY. Sensitivity analyses revealed that the ICER was highly influenced by variations in treatment effect and discount rates. The result of scenario analyses suggested that targeting lecanemab to patients with mild AD or implementing price reductions could substantially improve its cost-effectiveness.</p><p><strong>Conclusions: </strong>Lecanemab's high cost poses a challenge to its inclusion in the National Health Insurance formulary under South Korea's current WTP thresholds. Strategic price adjustments and patient targeting are essential to enhance its economic viability. These findings provide valuable insights for policymakers and stakeholders in balancing treatment outcomes and resource allocation for AD management.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"793-804"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675469","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 Evaluation of Treatment With Trastuzumab Deruxtecan for HER2-Low Advanced or Metastatic Breast Cancer in Previously Treated Patients.","authors":"Silvia Fenix-Caballero, Pablo Caleffa-Menendez, Carmen Maria Dominguez-Santana, Emilio Jesus Alegre-Del-Rey, Antonio Olry de Labry Lima","doi":"10.1007/s41669-025-00592-0","DOIUrl":"10.1007/s41669-025-00592-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the efficiency and budgetary impact of trastuzumab deruxtecan (T-DXd) compared with standard therapy in previously treated HER2-low advanced or metastatic breast cancer, from the perspective of the Spanish National Health System.</p><p><strong>Methods: </strong>A partitioned survival model was developed using data from the DESTINY-BREAST04 trial. Health outcomes were measured in quality-adjusted life years (QALYs) for both the overall population and the hormone receptor-positive (RH+) subgroup. The analysis was conducted from the perspective of the Spanish National Health System over a 75-month time horizon. A univariate sensitivity analysis was performed to explore parameter uncertainty. Costs were derived from Spanish healthcare databases and expert input.</p><p><strong>Results: </strong>At 75 months, for the overall patient population, the total healthcare cost for patients treated with T-DXd was €201,328.27, compared with €64,654.80 with standard therapy. T-DXd provided 1.24 QALYs (2.24 life years), while standard therapy provided 1.03 QALYs (1.86 life years). The incremental cost-utility ratio (ICUR) for T-DXd compared with standard of care (SOC) was €648,710.32/QALY. For the hormone receptor-positive (RH+) subgroup, the total healthcare cost for patients treated with T-DXd was €204,262.69, compared with €71,596.21 with standard therapy. T-DXd provided 1.33 QALYs (2.46 life years), while standard therapy provided 1.08 QALYs (1.99 life years). The ICUR for T-DXd compared with SOC was €541,758.59/QALY. The estimated 5-year budget impact ranged from €72 million to €140 million for the overall population and €64 million to €124 million for the RH+ subgroup.</p><p><strong>Conclusions: </strong>Trastuzumab deruxtecan in HER2-low advanced or metastatic breast cancer shows limited cost effectiveness and represents a significant budgetary challenge for the Spanish National Health System, particularly in RH+ patients.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"827-836"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784957","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 Analyses of Adolescent- and Young-Adult-Focused HIV Interventions Incorporating HIV Transmission: a Scoping Review of Modeling Methods and Proposed Guidance.","authors":"Wanyi Chen, Simeng Li, Carol Mita, Sarah E Rutstein, Audrey Pettifor, John Giardina, Kenneth Freedberg, Kimberly A Powers, Andrea Ciaranello, Anne M Neilan","doi":"10.1007/s41669-025-00583-1","DOIUrl":"10.1007/s41669-025-00583-1","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults (AYA) are disproportionately affected by human immunodeficiency virus (HIV) globally, with high-burden population subgroups differing across regions. Cost-effectiveness modeling analyses of AYA-focused HIV interventions have provided vital information to policy makers by projecting long-term health and economic impacts of interventions' effects on reduced HIV transmission. To provide a broad overview of available modeling approaches and identify gaps in methods reporting, we evaluated modeling methodologies used in AYA-focused cost-effectiveness analyses incorporating HIV transmission.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Web of Science for peer-reviewed articles that were published January 2006 to August 2023 and described models that considered HIV transmission in estimating cost-effectiveness of AYA-focused HIV prevention interventions. We extracted selected study characteristics, transmission model properties, and methods to estimate long-term health and economic outcomes. We assessed study quality using published guidelines.</p><p><strong>Results: </strong>Among 42 studies, 38% included individuals assigned male or female sex at birth, 19% included females only, and 43% included males only; 24% focused on AYA only; 88% were set in Africa; and 7% were restricted to certain population subgroups. The most common population subgroups examined were women who have transactional sex (24%) and men who have sex with men (17%). Most (88%) studied primary prevention interventions for people at risk of HIV; 29% examined secondary prevention interventions including treatment and testing. Most (98%) assessed incremental cost-effectiveness ratios (ICERs) were defined as incremental cost per incremental life year (either quality-adjusted or disability-adjusted), or cost per infection averted, or both. Of 24 different transmission models identified with distinct structures, 59% were dynamic. Of 20 studies that translated averted infections into long-term health benefit, 55% used their transmission models directly through assigning health utilities to modeled states. A total of 30 studies converted averted infections into long-term cost savings, among which, 73% used their transmission models directly by assigning costs to modeled states. Fewer than half captured age-specific sexual and care-engagement behaviors. Important gaps in quality included incomplete reporting of model validation and calibration results.</p><p><strong>Conclusions: </strong>We identified heterogeneous modeling approaches in cost-effectiveness analyses of AYA-focused HIV interventions incorporating transmission. Reporting of key elements could be improved. We propose additional criteria that could clarify choices around modeling approaches and strengthen the reporting of model validation and calibration results.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"739-755"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187556","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":"Exploratory Cost-Effectiveness of a Novel Bioprosthetic Valve for Surgical Aortic Valve Replacement in Spain.","authors":"María Ascaso, Daniel Pérez, Lourdes Montero, Jens Deckert, Andrea White, Paloma González, Marta Mengual, Seila Lorenzo-Herrero, Carlos Crespo, Sergio Cánovas","doi":"10.1007/s41669-025-00582-2","DOIUrl":"10.1007/s41669-025-00582-2","url":null,"abstract":"<p><strong>Objectives: </strong>Limited information is available regarding the impact of valve choice for patients with aortic stenosis (AS) undergoing surgical aortic valve replacement (SAVR) in Spain. Herein, we aimed to explore the potential cost-effectiveness of a new bioprosthetic valve with RESILIA tissue versus mechanical alternatives from a Spanish healthcare perspective.</p><p><strong>Methods: </strong>Health outcomes, including quality-adjusted life years (QALYs), adverse events, and costs were estimated for two cohorts of patients with severe AS (aged ≥ 65 or 55-64 years) over a lifetime horizon employing a UK cost-effectiveness model adapted to Spanish clinical practice to compare a novel bioprosthesis versus mechanical alternatives. This model included a decision tree to describe short-term outcomes and a partitioned survival model to evaluate mortality and long-term outcomes. A panel of clinical experts validated the model methodology, including parameters and assumptions considered. Sensitivity analyses were performed to account for uncertainty.</p><p><strong>Results: </strong>The novel bioprosthetic valve led to cost savings for both cohorts (€6209/patient for age ≥ 65 years; €8289/patient for ages 55-64 years). These were mainly driven by a reduction in anticoagulation- and adverse event-associated resources, outweighing the costs derived from more reoperations estimated with the novel bioprosthetic valve. An observable increase in QALYs was detected in both age groups (0.0051 and 0.0191, respectively). Hence, the novel bioprosthetic valve is expected to be a dominant alternative for patients 55 years or older who are eligible for SAVR. It remained cost-effective in > 98% of sensitivity analyses.</p><p><strong>Conclusions: </strong>Our exploratory study indicates the novel RESILIA bioprosthetic valve as a potential alternative to mechanical valves for SAVR in patients 55 years or older can lead to budgetary cost savings and improved health outcomes in Spain.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"757-769"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192101","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":"Adjusting Health State Utility Values for Multiple Conditions: Real-World EQ-5D-3L Data Modeling in Brazil.","authors":"Milene Rangel da Costa, Bráulio Dos Santos Júnior, Marisa da Silva Santos","doi":"10.1007/s41669-025-00586-y","DOIUrl":"10.1007/s41669-025-00586-y","url":null,"abstract":"<p><strong>Background and objective: </strong>Decision analytical models are typically included in health economic evaluations to represent clinical pathways and enable the estimation of clinical and economic outcomes of health technologies. Clinical effects are frequently measured in terms of health-related quality of life and expressed as utility values. It is not rare that a health state in an analytical model simultaneously comprises more than one health condition. In this situation, the utility of each coexisting health condition could be combined using the additive, multiplicative, minimum, or adjusted decrement estimator (ADE) methods. However, there is no consensus about the best approach. This study aimed to compare different methods to estimate utility values for health states in which patients carry more than one health condition using data from the Brazilian population.</p><p><strong>Methods: </strong>Data were obtained from a multicentric cross-sectional evaluation study conducted in Brazil. Individuals completed the EQ-5D-3L questionnaire, a generic preference-based instrument that is used to obtain utility values, and were requested to disclose if they had any health conditions. Utilities were obtained according to the Brazilian value set. Four methods for adjusting joint utilities were tested: additive, multiplicative, minimum, and ADE. Observed and estimated utility values were compared for accuracy and bias.</p><p><strong>Results: </strong>A total of 5774 individuals were included in the analysis. The utility score (mean ± SE) was 0.8235 ± 0.1717. Lower utility scores were associated with an increased number of comorbidities, reaching 0.467 ± 0.192 for individuals with seven conditions. The minimum method produced accurate utility estimates for individuals with two simultaneous health conditions. For health states with more than two conditions, the multiplicative method presented more accurate estimates. Overall, fixing the baseline utility equal to the mean utility of healthy individuals produced less biased estimates compared with a baseline utility equal to 1.</p><p><strong>Conclusion: </strong>Depending on the utility data available and the number of concomitant conditions, different adjustment methods could be used that produce accurate estimates. For the adjustment of Brazilian utility values for health states with comorbidities, the minimum and multiplicative methods should be preferred if two or more than two conditions are present, respectively.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"785-791"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192100","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":"Real-World Analysis of Healthcare Utilization, Treatment Patterns, and Economic Burden in Medicare Beneficiaries with Parkinson's Disease: Implications by Levodopa Formulation and Disease Severity.","authors":"Renée J G Arnold, Winona Tse, Kimberly Martin, Renee Kuan","doi":"10.1007/s41669-025-00588-w","DOIUrl":"10.1007/s41669-025-00588-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate healthcare utilization, costs, and treatment patterns of Medicare beneficiaries with Parkinson's disease (PD) treated with different carbidopa-levodopa regimens.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using 100% fee-for-service Medicare research identifiable claims data from 2017 to 2019. The study population included 201,241 Medicare beneficiaries aged 65-90 years with PD who received at least one prescription for a carbidopa-levodopa-containing regimen. Treatment patterns, healthcare resource utilization, and costs were analyzed, stratified by medication regimen containing levodopa and levodopa equivalent daily dose (LEDD), the latter as a proxy for disease severity.</p><p><strong>Results: </strong>Immediate release (IR) carbidopa-levodopa was the most common initial prescription (83%). Extended release (ER) formulations had the highest mean daily dose (1140 mg, although the equivalent dose in a non-ER formulation is approximately 570 mg, in line with the other three primary regimens). Treatment persistence and cost generally increased with higher LEDD. Concomitant medication use, particularly dopamine agonists, also increased with higher LEDD. Total 3-year per patient healthcare costs were lower for patients prescribed controlled release (CR) carbidopa-levodopa (US $98,650); compared with US $116,394 for patients prescribed IR carbidopa-levodopa; US $123,650 for those prescribed CR + IR carbidopa-levodopa; and US $125,802 for ER carbidopa-levodopa. Costs tended to increase with higher LEDD, primarily driven by outpatient care and medications.</p><p><strong>Conclusions: </strong>This study provides comprehensive real-world evidence on carbidopa-levodopa use in Medicare beneficiaries with PD. Findings highlight the need for individualized treatment approaches, considering both symptom control and healthcare costs. Future research should focus on prospective studies to assess long-term outcomes and economic impact of different treatment strategies in PD, considering disease severity and quality of life.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"771-783"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310227","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 the CADScor System in Low-Risk Patients Presenting to the Emergency Department with Chest Pain.","authors":"Suzanne J Baron, Serge Korjian, C Michael Gibson, Matthew R Reynolds","doi":"10.1007/s41669-025-00590-2","DOIUrl":"10.1007/s41669-025-00590-2","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that up to 13% of patients presenting to the emergency department (ED) with low-risk chest pain receive further cardiac testing beyond an electrocardiogram and serial cardiac enzymes. The CADScor System is a US Food and Drug Administration (FDA)-cleared device that uses ultra-sensitive phonocardiography to evaluate the risk of significant coronary artery disease (CAD).</p><p><strong>Objective: </strong>To evaluate the relative cost-effectiveness of the CADScor system compared with other diagnostic modalities for the evaluation of low-risk chest pain in patients presenting to the ED in the USA.</p><p><strong>Methods: </strong>A two-part economic model, consisting of a decision analytic tree followed by a short-term Markov model, was developed to compare 1-year costs and outcomes (e.g., quality-adjusted life year [QALY], false-negatives, and related cardiac events) associated with the CADScor System as the first-line test versus other noninvasive cardiac tests from the perspective of the US healthcare system (TreeAge Pro). Model inputs were derived from literature, and costs for treatment strategies were calculated from average US reimbursements associated with Current Procedural Terminology and Medicare Severity Diagnosis Related Group codes. Values were reported in 2023 US dollars (USD). Parameter uncertainty was assessed through a series of deterministic and one-way sensitivity analyses.</p><p><strong>Results: </strong>Base case results demonstrated that a CADScor-First strategy was cost saving compared with other noninvasive cardiac tests without a substantial difference in adverse events. Economic results were consistent when coronary artery disease (CAD) prevalence rates were varied from 2 to 30% and across a variety of sensitivity analyses. The overall cost savings were estimated to be $7.3-15.3 million USD per 10,000 patients with low-risk chest pain.</p><p><strong>Conclusions: </strong>Use of a CADScor-First strategy in the evaluation of patients with low-risk chest pain presenting to the ED may result in substantial cost savings for the US healthcare system. More research is needed to understand the long-term costs and outcomes of this strategy.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"805-814"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476162","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 an Insertable Cardiac Arrhythmia Monitor after Non-ST-Elevation Myocardial Infarction in the UK.","authors":"Amy Dymond, E Barker, N Tsitiridis, A Schmetz, S Thompson Hilpert, C Jøns, S Behrens, P Søgaard, W Green","doi":"10.1007/s41669-025-00595-x","DOIUrl":"10.1007/s41669-025-00595-x","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients surviving a non-ST-elevation myocardial infarction (NSTEMI) have an elevated risk of future major adverse cardiovascular events (MACE), which can be mitigated through long-term cardiac arrhythmia monitoring. The present study evaluated the cost-effectiveness of continuous remote arrhythmia monitoring using an insertable cardiac monitor (ICM) combined with standard of care (SoC) compared with SoC alone.</p><p><strong>Methods: </strong>A cost-effectiveness analysis using a lifetime partitioned survival model was developed for high-risk NSTEMI patients from a UK National Health Service (NHS) perspective. Survival analysis was used to determine the transition of patients from the pre-MACE health state (where patients could experience arrhythmia, major bleeding, or systemic embolism) to the MACE health state (worsening heart failure, stroke, and acute coronary syndrome events). The survival analysis and arrhythmia diagnosis rates were informed by the BIO|GUARD-MI trial. The model captured direct costs associated with each MACE and implantation and removal of the ICM device and treatment costs following arrhythmia detection. The model captured the health implications for an ICM with SoC, compared with SoC alone, in terms of the total quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were undertaken to explore the impact of parameter uncertainty on the model results.</p><p><strong>Results: </strong>The use of ICMs plus SoC for daily remote cardiac arrhythmia monitoring is cost effective, when compared with SoC alone, in high-risk NSTEMI patients over a lifetime horizon, with an incremental cost-effectiveness ratio of £7766 per QALY gained. The ICM was associated with an additional 0.184 QALYs per patient for an additional cost of £1430. The ICM remained cost effective during the deterministic and probabilistic sensitivity analyses.</p><p><strong>Conclusion: </strong>The addition of an ICM to SoC in high-risk NSTEMI patients is cost effective from the perspective of the UK NHS and would, therefore, be a further option for the management of such patients in clinical practice.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"837-848"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708416","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":"Including Productivity as an Element to Reflect Value of the Treatment: A Systematic Review of Published Health Economic Evaluations.","authors":"Hiroaki Mamiya, Kittima Wattanakamolkul, Nan Li, David Bin-Chia Wu, Mariko Hirozane, Ataru Igarashi","doi":"10.1007/s41669-025-00589-9","DOIUrl":"10.1007/s41669-025-00589-9","url":null,"abstract":"<p><strong>Background: </strong>Productivity is utilised inconsistently in value assessment and poses methodological and conceptual challenges for estimation. This systematic literature review aims to understand how productivity gain/loss for patients and caregivers was measured in health economic evaluation, identify the preferred instruments to capture productivity gain/loss and assess their properties.</p><p><strong>Methods: </strong>A systematic literature review was conducted using PubMed, Ovid MEDLINE, Embase, Japan-specific (J-STAGE and Ichushi Web) and economic literature databases (Cost-Effectiveness Analysis (CEA) Registry, Paediatric Economic Database Evaluation (PEDE) and National Health Service Economic Evaluation Database (NHS EED)). Additional relevant data were identified using clinical trial registries and grey literature searches. Studies published between January 2021 and December 2023 which presented economic evaluations with outcomes relevant to productivity measures were included. Instruments were selected for practical relevance and frequent use in studies, while research-specific and single-study questionnaires were excluded.</p><p><strong>Results: </strong>Among 1431 published health economic evaluations with productivity in the assessment, 152 were included in this review. These studies were almost equally distributed over the 3-year period, with a slightly higher number in 2023 versus 2021 [54 (35.5%) versus 48 (31.6%)]. In total, 118/152 studies reported patient measures only, 14/152 reported caregiver measures only and 20/152 reported both patient and caregiver measures. Based on the inclusion criteria, 20 of the 88 identified instruments were further investigated in this review. The Work Productivity and Activity Impairment Questionnaire (WPAI) [23 (15.1%)], Institute for Medical Technology Assessment (iMTA) Productivity Cost Questionnaire (iPCQ) [23 (15.1%)] and Trimbos/iMTA Questionnaire for Costs associated with Psychiatric Illness​ (TIC-P) [(8 (5.3%)] were the most commonly used instruments. All three instruments were reported as valid and reliable. All three instruments reported absenteeism, presenteeism and overall work impairment. WPAI additionally included information on daily activity impairment. The human capital approach (n = 18) and the friction cost approach (n = 17) were utilised to assign monetary value to the lost productivity.</p><p><strong>Conclusions: </strong>This review identified a significant number of health economic evaluations between 2021 and 2023, which included productivity loss in the assessment. Various instruments were used to measure productivity loss in these studies, while a few instruments were commonly used across studies. To ensure consistent measurement of productivity, it is crucial to establish a standard tailored to a country or region, considering differences across countries or regions. Furthermore, necessary adaptations should be made on the basis of the specific health in","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"723-738"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476163","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":"Willingness to Pay for Improved Quality of Services from Informal Health Providers in Urban Slums in Nigeria.","authors":"Obinna Onwujekwe, Godwin Uche Ezema, Chukwudi Nwokolo, Chinyere Ojiugo Mbachu","doi":"10.1007/s41669-025-00597-9","DOIUrl":"https://doi.org/10.1007/s41669-025-00597-9","url":null,"abstract":"<p><strong>Introduction: </strong>The shortage of formal healthcare providers in urban slums has resulted in the widespread presence of untrained informal healthcare providers (IHPs), who often deliver low-quality services. Integrating these IHPs into the formal healthcare system through capacity-building initiatives could enhance the quality of services offered to clients. However, this may lead to an increase in healthcare costs, which would be passed on to the clients. This paper provides new evidence on the level of households' willingness to pay (WTP) for improved quality of services from IHPs that will be occasioned by linking IHPs to the formal health system.</p><p><strong>Methods: </strong>The levels of consumers' WTP for linking IHPs to the formal health system for improved quality of services was elicited using the contingent valuation method (CVM) in eight slums from two states in southeast Nigeria, namely Anambra and Enugu. A pre-tested interviewer-administered questionnaire was used to elicit WTP from 1025 randomly selected households from the slums. Data were analyzed using R and Stata software. Univariate, bivariate, and multivariate analyses were performed. Theoretical validity of WTP was analyzed using both multiple logistic and Tobit regression analyses at 95% confidence level.</p><p><strong>Findings: </strong>Findings showed that 64.5% of households were willing to make a one-off payment for linkages that will ensure improved quality of services from IHPs. The mean willingness-to-pay amount was Nigerian naira (₦)1353 (US $2.08), and 27.1% of the households were willing to pay ≥ ₦1353 ($2.08). Higher asset index and socioeconomic status were positively associated with willingness to pay for improved quality of health services. Each unit increase in asset index was associated with a 28% increase in the odds of willingness to pay (odds ratio (OR) 1.28; p < 0.001), while each unit increase in socioeconomic status score was associated with an 86% increase in the odds of willingness to pay (OR 1.86; p < 0.001). Compared with households that usually seek care from formal providers, those that usually seek care from informal providers (OR 0.4; p = 0.01) and those that usually seek care from both provider types (OR 0.34; p = 0.01) were significantly less likely to express willingness to pay for improved quality of health services.</p><p><strong>Conclusions: </strong>The level of WTP for linking IHPs with the formal health system is an indication that a considerable proportion of urban slum dwellers desire to have better quality of services and are willing to support interventions that can be used to actualize the linkages. Hence, such interventions would be acceptable to slum dwellers.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964046","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}