PharmacoEconomics Open最新文献

{"title":"Comparing Different Implementation Strategies for Collaborative Dementia Care Management in Terms of Patients' Characteristics, Unmet Needs, and the Impact on Quality of Life and Costs in Germany.","authors":"Moritz Platen, Wolfgang Hoffmann, Bernhard Michalowsky","doi":"10.1007/s41669-024-00548-w","DOIUrl":"10.1007/s41669-024-00548-w","url":null,"abstract":"<p><strong>Objective: </strong>To compare the implementation of collaborative dementia care management (cDCM) across two settings regarding patients' characteristics, unmet needs, and the impact on health-related quality of life (HRQoL) and costs.</p><p><strong>Methods: </strong>This analysis was based on data from the DCM:IMPact study, implementing cDCM in a physician network (n = 22 practices) and two day care centers (DCC) for community-dwelling persons with dementia over 6 months in Germany. Participants completed comprehensive assessments at baseline and 6 months after, soliciting sociodemographic and clinical characteristics, unmet needs, HRQoL and healthcare resource utilization. Patient characteristics and unmet needs were analyzed descriptively, and the impact of cDCM on costs and HRQoL was assessed using multivariable regression models.</p><p><strong>Results: </strong>At baseline, patients from the physician network (n = 46) exhibited more pronounced neuropsychiatric symptoms (NPI mean score 14 versus 10, p = 0.075), were more frequently diagnosed with dementia (76% versus 56%, p = 0.040), were less likely assigned a care level by the long-term care insurance (63% versus 91%, p ≤ 0.001) to access formal care services and had more unmet needs (12.8 versus 11.0, p ≤ 0.001), especially for social care services than DCC patients (n = 57). After 6 months, the adjusted means indicated that cDCM implemented in the physician network was more effective [EQ-5D-5L utility score; 0.061; 95% confidence interval (CI) - 0.032 to 0.153] and less costly (- 5950€; 95% CI - 8415€ to - 3485€) than cDCM implemented in DCC.</p><p><strong>Conclusions: </strong>Patients and the healthcare system may benefit more when cDCM is implemented in physician networks. However, patient characteristics indicated two samples with specific conditions and various unmet needs using different ways of accessing healthcare, demonstrating the need for cDCM in both settings, which must be considered when implementing cDCM to integrate the respective sectors efficiently.</p><p><strong>Trial registration: </strong>German Clinical Trials Register: DRKS00025074. Registered 16 April 2021-retrospectively registered.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"271-282"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824282","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 Burden of Haemophilia from a Societal Perspective: A Scoping Review.","authors":"Amr A El-Sayed, Nancy S Bolous","doi":"10.1007/s41669-024-00540-4","DOIUrl":"10.1007/s41669-024-00540-4","url":null,"abstract":"<p><strong>Introduction: </strong>Haemophilia is a rare genetic bleeding disorder that leads to musculoskeletal complications. The high cost of haemophilia treatment necessitates a thorough evaluation of its economic burden. However, due to the difficulty of estimating direct non-medical, indirect, and intangible costs, studies often underestimate the actual economic burden of haemophilia. This scoping review aims to summarise economic studies in haemophilia conducted from a societal perspective.</p><p><strong>Methods: </strong>A systematic search across eight scholarly databases, grey literature, and reference lists until the 5^th of July 2023 was conducted to identify relevant studies. The inclusion criteria encompassed full-text, English-language publications of economic analyses in congenital haemophilia from a societal perspective. Model-based studies and those adopting a payer perspective were excluded. Costs were adjusted to international dollars (I$) and US dollars (US$) in 2022 for comparability.</p><p><strong>Results: </strong>Out of 2993 potential sources identified, 25 studies met the inclusion criteria, covering 7226 persons with haemophilia across 22 countries. All studies reported direct medical costs, with four excluding the cost of haemostatic therapy. Fifteen studies reported direct formal non-medical costs, while eight reported direct informal non-medical costs. All but one study reported the indirect costs. The average annual costs of haemophilia varied widely based on treatment modality, disease severity, geographical location, and included cost categories. When including the cost of clotting factor replacement therapy (CFRT), the total cost for severe haemophilia without inhibitors ranged from 1566 I$ to 700,070 I$ per person per year (lowest value reported in India and highest in the United States). CFRT represented up to 99.9% of the total cost for those receiving prophylaxis and up to 95.1% for episodic treatment. Haemostatic therapies accounted for 82% of the total cost in patients with inhibitors.</p><p><strong>Conclusion: </strong>There is a significant heterogeneity in defining cost categories required for a comprehensive economic analysis from a societal perspective. While haemostatic therapies constitute a substantial portion of the overall cost, direct non-medical and indirect costs are crucial as they are often paid out-of-pocket and may impede access to treatment. It is essential for haematologists and economists to establish a standardised costing framework for future studies, particularly in the era of novel therapies.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"179-205"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638728","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":"Incorporating Resource Constraints in Health Economic Evaluations: Overview and Methodological Considerations.","authors":"Praveen Thokala, Henrique Duarte, Stuart Wright, Don Husereau, Isabelle Durand-Zaleski, Peter Lindgren, Roelien Postema, Gerardo Machnicki, Louis Garrison","doi":"10.1007/s41669-024-00537-z","DOIUrl":"10.1007/s41669-024-00537-z","url":null,"abstract":"<p><p>It is well known that healthcare resource constraints influence the capacity to deliver care, affecting both the costs and outcomes of medical interventions. If these constraints are not adequately accounted for in economic evaluations, there may be a lack of understanding regarding the full impact of implementing health technologies, leading to decisions being made with suboptimal information. This paper offers an overview of the types of healthcare resource constraints and their potential effects, and introduces a framework grounded in operations research and health economics principles, outlining the methodological considerations for incorporating resource constraints into economic evaluations. Drawing from a literature review and advisory group feedback, three categories of resource constraints were identified: single-use resource constraints, reusable resource constraints and patient throughput constraints. The proposed framework outlines a comprehensive set of steps necessary for effectively incorporating constraints into health economic evaluations and details specific approaches and methodological considerations for each stage to ensure a more accurate and realistic assessment of health interventions. This paper also aims to raise awareness among payers and decision-makers with regards to the limitations of technology evaluations in a resource-constrained health system. Specifically, it suggests that health technology assessment agencies ought to offer guidance on incorporating constraints into the submissions they receive. Moreover, it advocates for a more comprehensive economic evaluation in economic assessments to fully capture an intervention's value.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"161-178"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838640","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":"Correction: From Clinical to Non-clinical Outcomes in the Treatment of HIV: An Economic and Organizational Impact Assessment.","authors":"Lucrezia Ferrario, Barbara Menzaghi, Giuliano Rizzardini, Alessandro Roccia, Elisabetta Garagiola, Daniele Bellavia, Fabrizio Schettini, Emanuela Foglia","doi":"10.1007/s41669-025-00558-2","DOIUrl":"10.1007/s41669-025-00558-2","url":null,"abstract":"","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"327"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033968","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 Association between COVID-19 Status and Economic Costs in the Early Stages of the COVID-19 Pandemic: Evidence from a UK Symptom Surveillance Digital Survey.","authors":"Sung Wook Kim, Caterina Alacevich, Catia Nicodemo, Raphael Wittenberg, Simon de Lusignan, Stavros Petrou","doi":"10.1007/s41669-024-00544-0","DOIUrl":"10.1007/s41669-024-00544-0","url":null,"abstract":"<p><strong>Introduction: </strong>In the absence of a vaccination programme, the coronavirus disease 2019 (COVID-19) pandemic had substantial impacts on population health and wellbeing and health care services. We explored the association between COVID-19 status, sociodemographic, socioeconomic and clinical factors and economic costs during the second wave of the COVID-19 pandemic.</p><p><strong>Data: </strong>The study used patient-reported digital survey and symptom surveillance data collected between July and December 2020, in collaboration with a primary care computerised medical record system supplier, EMIS Health, in the UK. The study included 11,534 participants.</p><p><strong>Methods: </strong>Generalised linear models (GLM) and two-part regression models were used to estimate factors associated with economic costs (£sterling, 2022 prices) estimated from two perspectives: (i) a UK National Health Service (NHS) and personal social services (PSS) perspective and (ii) a societal perspective.</p><p><strong>Results: </strong>Experience of the onset of COVID-19 symptoms started more than 3 months ago was associated with significantly higher NHS and PSS costs (GLM: £319.8, two-part: £171.7) (p < 0.001) and societal costs (GLM: £776.9, two-part: £675.6) (p < 0.001) in both models. A positive test result within the previous 14 days was associated with significantly higher NHS and PSS costs (two-part: £389.1) (p < 0.05) and societal costs (GLM: £470.7, two-part: £439.2) (p < 0.01). Age between 31 and 55 years was associated with significantly higher societal costs than age between 16 and 30 years.</p><p><strong>Conclusion: </strong>This study identifies and quantifies factors associated with the economic costs incurred during the second wave of the COVID-19 pandemic in the UK. The results of our study can inform cross-country comparisons and other cost comparisons.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"231-245"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751371","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":"What Does Pharmaceutical 3D Printing Cost? A Framework and Case Study with Hydrocortisone for Adrenal Insufficiency.","authors":"Sejad Ayyoubi, Liesbeth Ruijgrok, Hugo van der Kuy, Renske Ten Ham, Frederick Thielen","doi":"10.1007/s41669-024-00551-1","DOIUrl":"10.1007/s41669-024-00551-1","url":null,"abstract":"<p><strong>Background: </strong>Pharmaceutical three-dimensional printing (3DP) technology offers an automated platform that can be utilized to manufacture personalized medicine, improving pharmacotherapy. Although 3D-printed products have entered clinical trials, no costing studies have been performed yet. Cost insights can aid researchers and industry in making informed decisions about the feasibility and scalability of 3DP.</p><p><strong>Objective: </strong>The aim of this research was therefore to develop a framework that can be utilized to estimate the manufacturing cost of one 3D tablet in a hospital pharmacy setting.</p><p><strong>Methods: </strong>To develop the costing framework, general manufacturing phases were identified, consisting of (i) pre-printing, (ii) printing, and (iii) post-printing. For each phase, cost categories were defined, including personnel, materials, equipment, facility, and quality assurance. The three phases combined with the categories formed the base of the costing framework. An earlier developed 3D-printed hydrocortisone formulation (M3DICORT) was used as a case study. Costs were expressed in 2022 euros (€). The framework was applied to M3DICORT in four scenarios: a base case scenario, worst-case scenario, best-case scenario, and a scaling scenario. In the scaling scenario, we assumed that 3D inks were mass produced.</p><p><strong>Results: </strong>Costs of manufacturing a single M3DICORT tablet were €1.97-3.11 (best-case-worst-case) and €1.58-2.26 for the scaling scenario.</p><p><strong>Conclusion: </strong>Manufacturing costs of 3D-printed pharmaceuticals were thus far unknown. The framework is translated into an open-access costing tool to facilitate adoption by other parties, and is also applicable for other pharmaceutical 3DP techniques.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"207-215"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910126","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":"Burden of Disease of Breast Cancer in Italy: A Real-World Data Analysis.","authors":"F S Mennini, A Marcellusi, P Sciattella, M Scortichini, Angela Ragonese, F Cattel, R D'Antona, L Del Mastro, S Gori, G Perrone, R Migliorini, M Trabucco Aurilio","doi":"10.1007/s41669-024-00543-1","DOIUrl":"10.1007/s41669-024-00543-1","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) constitutes a significant public health challenge in Italy, with a considerable impact on healthcare resources and societal costs. Despite advancements in diagnostics and therapies, the economic burden of BC remains substantial, necessitating a comprehensive evaluation to inform healthcare policy and resource allocation. The aim of this study is to estimate both direct health costs and social security costs related to BC.</p><p><strong>Methods: </strong>This study utilized real-world data from the Italian Health Information System (HIS) and Local Health Unit (LHU) Umbria 2 HIS databases spanning 2010-2019. Direct health costs, encompassing hospitalizations, outpatient visits, and drug prescriptions, were assessed alongside social security costs associated with BC-related work inability. Statistical analyses and probabilistic models were employed to estimate costs and evaluate trends over time.</p><p><strong>Results: </strong>The analysis revealed an annual cost of €273 million for hospital admissions related to BC in Italy, with metastatic BC (MBC) incurring the highest average annual cost per patient (€5018). When outpatient visits and drug consumption were incorporated, the mean annual cost per patient in LHU Umbria 2 rose to €11,380 for MBC. Social security costs, predominantly comprising disability benefits (DBs), totaled €579 million annually. Overall, the study estimated the total annual economic impact of BC in Italy to exceed €1 billion, with social costs representing 50.4% of the total burden.</p><p><strong>Conclusions: </strong>This comprehensive assessment underscores the substantial economic strain imposed by BC in Italy and highlights the need for early detection and intervention strategies to mitigate costs and enhance patient outcomes. These findings offer valuable insights into the economic landscape of BC, guiding policy decisions and resource allocation efforts aimed at optimizing BC management and alleviating its societal burden.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"283-290"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693334","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":"Costs of Illness for Huntington's Disease: A Systematic Review.","authors":"Divya Patil, Emily F Gorman, T Joseph Mattingly","doi":"10.1007/s41669-024-00531-5","DOIUrl":"10.1007/s41669-024-00531-5","url":null,"abstract":"<p><strong>Background: </strong>Huntington's disease (HD) is associated with significant financial burden for patients and payers. The objective was to identify and quantify costs of HD by stage of disease progression.</p><p><strong>Methods: </strong>A systematic search of Medline, Embase, Scopus, and Cochrane Library was used to identify types of costs that are frequently reported for individuals diagnosed with HD and to quantify those costs across early, middle, and late stages of HD. Full-text, original research articles were included if they reported costs specific to HD burden. To standardize stage-level costs, Shoulson Fahn and Barthel Index scores were combined to estimate the cost for early, middle-, and late-stage HD.</p><p><strong>Results: </strong>A total of 692 abstracts were identifie,d and following abstract screening, a total of 80 full-text articles were reviewed for inclusion. Only five studies were included for extraction and synthesis including three from the USA, one from the United Kingdom (UK), and one from Peru. Annual inpatient, outpatient, drug costs, and caregiving costs all increased substantially as disease progressed. Outpatient costs were approximately 2.5 times greater than inpatient costs for early and middle stages of HD. Among all the costs associated with HD, annual caregiver cost emerges as the most significant costs in the economic burden of HD, ranging from a minimum of $6041 for early stage to a maximum of $133,200 for late-stage HD. Significant variation was observed across studies, especially comparing costs observed in Peru with the USA and UK.</p><p><strong>Conclusion: </strong>Outpatient costs exceed inpatient costs, especially in early and middle stages, underscoring the importance of outpatient care. All costs seem to rise rapidly, in a nonlinear fashion, as patients advance to later stages. While only two studies reported caregiver burden, these costs were significanly higher in the most severe stage, where patients were completely dependent on a caregiver. This review highlights the complexity of cost assessment in HD and underscores the need for consistent methods and further research to guide effective policy actions.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"5-13"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471894","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":"Mortality, Clinical Complications, and Healthcare Resource Utilization Associated with Managing Transfusion-Dependent β-Thalassemia and Sickle Cell Disease with Recurrent Vaso-occlusive Crises in Italy.","authors":"Chuka Udeze, Melania Dovizio, Chiara Veronesi, Luca Degli Esposti, Nanxin Li, Thi Xuan Mai Patricia Dang, Gian Luca Forni","doi":"10.1007/s41669-024-00532-4","DOIUrl":"10.1007/s41669-024-00532-4","url":null,"abstract":"<p><strong>Objective: </strong>To examine the clinical burden and healthcare resource utilization (HCRU) among patients with transfusion-dependent β-thalassemia (TDT) and patients with sickle cell disease (SCD) with recurrent vaso-occlusive crises (VOCs) in Italy.</p><p><strong>Methods: </strong>Eligible patients were identified from an administrative claims database from 1 January 2010 and 1 February 2019. Patients with TDT had ≥ 1 iron chelation treatment, ≥ 8 red blood cell transfusions (RBCTs) during any 12-month period, and ≥ 12 months of available data pre- and post-index (i.e., first RBCT claim). Patients with SCD with recurrent VOCs had ≥ 2 VOCs/year in ≥ 2 consecutive years and ≥ 12 months of available data pre- and post-index (second VOC claim in the second of 2 consecutive years). Patients were propensity score matched to five controls by age, sex, geographic area, and index year. Clinical and HCRU outcomes were evaluated post-index.</p><p><strong>Results: </strong>In total, 214 patients with TDT and 111 patients with SCD with recurrent VOCs were matched to 1070 and 555 controls, respectively. Both patient groups had substantially higher mortality rates than controls (TDT: 4.8 versus 0.8 deaths per 100 person-years; SCD: 1.6 versus 0.4 deaths per 100 person-years). Clinical complications were prevalent in both patient groups. Compared with controls, both patient groups had significantly higher mean rates of all-cause hospitalizations (TDT: 1.4 versus 0.1; SCD: 2.0 versus 0.1) and outpatient services (TDT: 21.9 versus 1.6; SCD: 6.2 versus 1.0) per patient per year (all: p < 0.05).</p><p><strong>Conclusions: </strong>Management of TDT and SCD in Italy is associated with significant clinical and health system burden, highlighting the need for new treatments that eliminate RBCTs and VOCs.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"115-124"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522637","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-Utility and Budget Impact Analysis of Adding SGLT-2 Inhibitors to Standard Treatment in Type 2 Diabetes Patients with Heart Failure: Utilizing National Database Insights from Thailand.","authors":"Tanawan Kongmalai, Juthamas Prawjaeng, Phorntida Hadnorntun, Pattara Leelahavarong, Usa Chaikledkaew, Ammarin Thakkinstian, Varalak Srinonprasert","doi":"10.1007/s41669-024-00526-2","DOIUrl":"10.1007/s41669-024-00526-2","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) in type 2 diabetes (T2D) patients poses a significant clinical and financial burden. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have shown cardiovascular benefits in trials, they are not included in Thailand's National List of Essential Medicines (NLEM), and their value-for-money remains unassessed.</p><p><strong>Objective: </strong>This study aims to evaluate the cost-utility of adding SGLT2i to the standard treatment for T2D-HF patients in Thailand.</p><p><strong>Methods: </strong>A Markov model with 3-month cycles and a lifetime horizon was conducted from a societal perspective. Efficacy data came from a systematic review and meta-analysis. Transition probabilities and direct medical costs were derived from the National Health Security Office database, while direct non-medical costs and utility were collected through patient interviews at Siriraj hospital to reflect Thailand's context. The main outcomes were incremental costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). A sensitivity and budget impact analysis were also performed.</p><p><strong>Results: </strong>Canagliflozin led to the highest increase in QALYs, at 1.21 years, followed by dapagliflozin (0.54 years) and empagliflozin (0.06 years). Collectively, SGLT2i yielded an increase of 0.41 QALYs. Canagliflozin incurred the highest additional treatment cost at United States dollars (US$)5600, followed by dapagliflozin (US$3547) and empagliflozin (US$2694). The ICERs for canagliflozin, dapagliflozin, empagliflozin, and overall SGLT2i were US$4632, US$6430, US$48,952, and US$8480 per QALY gained, respectively. SGLT2i were not cost-effective compared with Thailand's willingness-to-pay threshold of US$4564 per QALY gained. However, threshold analysis indicates that the costs of canagliflozin, dapagliflozin, empagliflozin, and overall SGLT-2i should be reduced by 2.3%, 38.2%, 90.2%, and 55.6%, respectively, to be cost-effective. Budget impact analysis revealed that the total budget for treating T2D patients with HF over 5 years is US$15.6 million.</p><p><strong>Conclusions: </strong>Adding SGLT2i to standard treatment reduced HF hospitalization and mortality rates and improved QALYs in T2D-HF patients. Nevertheless, they would not be cost-effective at current prices in Thailand.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"69-81"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292818","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}