PharmacoEconomics Open最新文献

{"title":"Cost Comparison of Repeat Placental Growth Factor-Based Testing in Women with Suspected Preterm Pre-eclampsia, Compared to Usual Care: The PARROT-2 Trial.","authors":"Alice Hurrell, Louise Webster, Jenie Sparkes, Cheryl Battersby, Katherine Clark, Kate E Duhig, Marcus Green, Paul T Seed, Zoe Vowles, Jenny Myers, Andrew H Shennan, Lucy C Chappell, Rachael M Hunter","doi":"10.1007/s41669-025-00629-4","DOIUrl":"10.1007/s41669-025-00629-4","url":null,"abstract":"<p><strong>Objectives: </strong>The aim was to evaluate health resource use and cost, and conduct a cost comparison of repeat placental growth factor (PlGF)-based testing for suspected pre-eclampsia, compared with usual care.</p><p><strong>Methods: </strong>This was a health economic evaluation in women participating in the PARROT-2 trial of repeat revealed PlGF-based testing, compared to usual care, for suspected preterm pre-eclampsia in 22 maternity units in England, Scotland, and Wales, (ISRCTN85912420, 25/11/2019). We conducted a cost comparison analysis, describing health resource use and associated cost per woman, infant, and mother-infant dyad according to randomised allocation to repeat revealed PlGF-based testing or usual care with repeat concealed testing. Additional analysis was stratified according to the initial PlGF-based test result (normal, abnormal, or very abnormal). A post-hoc, within-trial cost-effectiveness analysis was also conducted.</p><p><strong>Results: </strong>Between December 17, 2019, and September 30, 2022, 1253 participants were randomised. Costs per woman, infant, or mother-infant dyad were similar between the repeat revealed testing group and the group receiving usual care with repeat concealed testing. In the revealed group compared to the usual care group, there were significantly greater costs associated with neonatal admissions for special care (mean difference £1169 95% confidence interval 398-1939), but not neonatal intensive care or high-dependency care. Costs correlated with the initial PlGF-based test result, with the highest costs per mother-infant dyad in the group with a very abnormal initial test result (£38,284 [standard deviation {SD} 35,997]) and lowest costs in the group with a normal initial test result (£13,156 [SD 9568]). Repeat testing was unlikely to be cost-effective, and the cost-effectiveness acceptability curve demonstrated low probability for a range of decision thresholds.</p><p><strong>Conclusion: </strong>There is no evidence of an overall significant difference in cost associated with a policy of universal, routine repeat testing, compared to usual care, in women receiving an initial PlGF-based test for suspected pre-eclampsia.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"355-364"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912541","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":"Healthcare Cost Associated with an Acute Mental Healthcare Bundle in Pediatric Emergency Departments.","authors":"Lola Ibraimova, Amanda S Newton, Stephen B Freedman, Jennifer Thull-Freedman, Bruce Wright, Arto Ohinmaa, Dat T Tran","doi":"10.1007/s41669-025-00631-w","DOIUrl":"10.1007/s41669-025-00631-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate healthcare cost associated with a standardized mental healthcare bundle in two tertiary pediatric emergency departments (EDs) in Alberta, Canada.</p><p><strong>Methods: </strong>We linked data from the two EDs and administrative health databases. Patients < 18 years presenting with mental health concerns were enrolled during two periods: pre-implementation (standard care) and implementation (mental health bundle). Healthcare resource utilization (HCRU) and costs were compared over 12 months following the initial ED visit.</p><p><strong>Results: </strong>The study included 686 pre-implementation (mean age 12.6 years) and 692 implementation (mean age 13.0 years) patients with similar sex distribution (p = 0.65). Implementation patients had lower admission rates at the index ED visit (4.6% versus 9.8%; p < 0.001). During 1 year of follow-up, implementation patients had fewer hospitalizations (mean = 0.4 versus 0.5; p < 0.001), non-ED ambulatory care visits (mean = 2.7 versus 10.0; p < 0.001), and practitioner claims (mean = 34.3 versus 46.8; p = 0.001). Implementation patients had lower healthcare costs ($12,408 [95% CI $10,336-$14,479] versus $19,326 [95% CI $16,596-$22,056]; p < 0.001) attributable to lower hospitalization ($6845 [95% CI $5257-$8435] versus $9994 [95% CI $8205-$11,782]; p = 0.01), ambulatory care ($1711 [95% CI $1383-$2038] versus $4027 [95% CI $3326-$4727]; p < 0.001), and practitioner ($3851 [95% CI $3410-$4292] versus $5306 [95% CI $4676-$5935]; p < 0.001) expenses during the follow-up. After risk adjustments, care bundle was associated with a 40% [95% CI 26-52%] reduction in mental health-related healthcare costs (p < 0.001) and 37% (95% CI 23-49%) reduction in all-cause healthcare costs (p < 0.001).</p><p><strong>Conclusions: </strong>Integrating a standardized mental healthcare bundle in pediatric EDs was associated with less healthcare use and cost savings. These findings support its broader use to enhance mental healthcare delivery in emergency settings.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"265-274"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965620","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":"Use of Health State Utility Values in Cost-Utility Analyses of Selected Infectious Diseases in Aging Populations: A Systematic Review and Critical Appraisal.","authors":"Thi Hao Pham, Jovan Mihajlović, Ivan Loncar, Ba Khuong Cao, Florian Zeevat, Thanh An Pham, Abrham Wondimu, Kinga Meszaros, Jurjen van der Schans","doi":"10.1007/s41669-025-00621-y","DOIUrl":"10.1007/s41669-025-00621-y","url":null,"abstract":"<p><strong>Background: </strong>Health state utility values (HSUVs) are vital in cost-utility analyses (CUAs) that inform policymaking. However, suboptimal selection and application of HSUVs have been reported in areas such as cardiovascular disease and cancer. This study reviewed the methodological quality and appropriateness of HSUV in CUA use for interventions targeting infectious diseases in aging populations.</p><p><strong>Methods: </strong>A systematic search of the MEDLINE database was conducted to identify CUAs that evaluated interventions against six major infectious diseases from January 2000 to July 2025. Two reviewers independently screened the identified studies based on eligibility criteria. The two reviewers then assessed the included studies using a modified checklist that covered how HSUVs were selected, elicited, and applied. Findings are summarized by descriptive statistics across the entire period (January 2000 to July 2025) and three sub-periods (2000-2009, 2010-2019, and 2020 to July 2025).</p><p><strong>Results: </strong>Among the 146 included CUA studies, only 10 (7%) relied exclusively on original sources for HSUVs, while 78% used economic data, either alone or in combination with other secondary sources or assumptions. Most studies (78-91%) did not provide sufficient rationale or descriptions for the population or how HSUVs were elicited, and 42% failed to report all utility components. Complete comparability between the CUAs and reference data for the diagnosis, severity, and country was observed in only 51-60% of studies. Notably, fewer than half of CUAs reported HSUVs that were consistent with their cited sources, and 80% did not discuss the limitations associated with HSUV use. Most criteria showed limited improvements, and in some cases declines, between January 2000 and July 2025.</p><p><strong>Conclusion: </strong>CUAs of infectious diseases in aging populations are frequently associated with suboptimal practices in how HSUVs are selected, elicited, and applied. These shortcomings highlight the need for cautious interpretation of CUA data and for greater methodological transparency. Improving the quality of economic evaluations will require systematic approaches to how HSUVs are selected and elicited, with increased investment in primary data collection and the creation of accessible utility databases.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"229-247"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763617","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":"Societal Economic Burden of Antibiotic Resistance in Uganda: A Cost of Illness Study.","authors":"Elly Nuwamanya, Jonathan Mayito, Stephen Okoboi, Ronald Galiwango, Dathan Byonanebye, Suzan Nakasendwa, Flavia Dhikusooka, Janet Nabisere, Vivian Twemanye, Conrad Tumwine, Mackline Hope, Reuben Kiggundu, Ellon Twinomuhwezi, Lumbwe Chola, Joseph Babigumira, Thorkild Tylleskär, Francis Kakooza, Andrew Kambugu","doi":"10.1007/s41669-025-00625-8","DOIUrl":"10.1007/s41669-025-00625-8","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance (ABR), largely owing to inappropriate prescriptions and misuse of antibiotics, threatens the effectiveness of current and future antibiotic treatments, resulting in prolonged hospitalization and premature mortality. We estimated the economic burden of ABR in nine regional referral hospitals (RRHs) in Uganda.</p><p><strong>Methods: </strong>This prevalence-based cost-of-illness study was conducted from the societal perspective. We used a top-down micro-costing approach to identify and measure direct healthcare (capital and recurrent) costs in nine RRHs in Uganda. Patient costs, including informal care (absenteeism, foregone leisure, presenteeism, and out-of-pocket expenses), and lost productivity owing to ABR were estimated using clinical outcomes data and relevant literature. We used the human capital approach to estimate productivity losses due to ABR-related morbidity and premature mortality. A one-way sensitivity analysis was conducted to assess the impact of individual parameters on the economic burden estimates.</p><p><strong>Results: </strong>The annual societal cost of ABR in nine RRHs was estimated at US$1.43 million, representing 0.003% of Uganda's gross domestic product. Lost productivity costs accounted for 82% of the total, while informal care and direct healthcare costs represented 10% and 8%, respectively. Premature mortality associated with ABR accounted for 62% of the total cost of productivity loss; accommodation, food, and out-of-pocket costs represented 55% of the informal care costs; and recurrent costs accounted for 89% of direct healthcare costs. The overall annual societal, health system, and patient costs per ABR-patient were US$4983, US$423, and US$4560, respectively. ABR health system costs were 3% higher (US$61,293 versus US$59,646) among females than among males. Patient costs associated with ABR were higher among females than males, with informal care costs being 4% higher (US$70,657 versus US$67,886), and lost productivity costs 34% higher (US$622,510 versus US$410,354). Overall, societal total costs and per-patient costs of ABR were 29% (US$754,461 versus US$537,886) and 21% (US$5063 versus US$4014) higher in females than in males, respectively. The one-way sensitivity analysis revealed that the societal economic burden of ABR estimates were most influenced by uncertainties in construction cost per square meter of space utilized by ABR patients, reduced hospital capacity, and the discount rate.</p><p><strong>Conclusions: </strong>ABR poses a substantial societal burden that necessitates urgent and targeted gender-based interventions to prevent its escalation. These estimates may be used for future economic evaluation studies of ABR-mitigating interventions and to inform antimicrobial stewardship policies.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"305-316"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724911","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":"Assessing the Expected Costs of Continuous Remote Monitoring for Post-Discharge Home Use and the Readmission Reduction Required to Achieve Cost Neutrality.","authors":"Arendse Tange Larsen, Liza Sopina, Eske Kvanner Aasvang, Christian S Meyhoff, Søren Rud Kristensen, Jakob Kjellberg","doi":"10.1007/s41669-025-00632-9","DOIUrl":"10.1007/s41669-025-00632-9","url":null,"abstract":"<p><strong>Background/objective: </strong>Hospital-level care at home is gaining traction, but evidence on health economic implications remains limited. The aim of this study was to estimate expected costs of continuous remote monitoring of vital signs in the post-discharge setting, to assess the burden of readmissions among relevant patient groups, and to compare monitoring costs with the potential savings from reduced readmissions. The study was conducted from a restricted societal perspective within the Danish healthcare system.</p><p><strong>Methods: </strong>The costs of 3-day post-discharge home monitoring were estimated using a micro-costing approach based on the WARD-Home project. The analysis excluded healthcare costs incurred outside the hospital sector or beyond the 3-day period. Readmission rates, length of stay, and associated costs were analyzed using Danish registry data on patients potentially suitable for post-discharge monitoring but currently not receiving it.</p><p><strong>Results: </strong>Estimated per-patient costs of 3-day monitoring were EUR 159. Registry data showed an overall 3-day readmission rate of 1.7%, with average length of stay of 4.4 days, and costs of EUR 4674. Comparing average costs of readmissions within 3 days-corresponding to monitoring duration-with the monitoring costs indicated that if post-discharge monitoring reduces readmissions, cost-neutrality could be achieved if it prevents one readmission in every 29 patients monitored.</p><p><strong>Conclusions: </strong>Continuous remote monitoring offers a solution to post-discharge patients at risk of short-term deterioration and readmission. If one readmission is prevented per every 29 patients monitored, the approach has the potential to achieve cost-neutrality. Future studies are needed to validate these estimates and determine whether reductions in readmissions and actual cost savings can be achieved in practice.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"365-379"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146065868","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 NHS England's Type 2 Diabetes Path to Remission Pilot Scheme: Evidence From Real-World Data and Patient Simulation Modelling.","authors":"Adam Martin, Tayamika Zabula, Davide Tebaldi, Miaoqing Yang, Tamara Brown, Louisa Ells","doi":"10.1007/s41669-025-00622-x","DOIUrl":"10.1007/s41669-025-00622-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The 'Type 2 Diabetes Path to Remission' programme (T2DPR) of NHS England (NHSE) is a low-calorie diet intervention with behavioural support for adults with a recent type 2 diabetes mellitus (T2D) diagnosis and body mass index (BMI) &gt; 25 kg/m&lt;sup&gt;2&lt;/sup&gt; (&gt; 27 kg/m&lt;sup&gt;2&lt;/sup&gt; if White). The DiRECT trial, involving a similar intervention, showed the intervention cost per additional case of remission after 1 year exceeded £2000, and £20,000 after 5 years. However, it remains unclear whether this represents value for money for NHSE, whether comparable outcomes would be achieved in routine care settings or what the associated costs are from the service user perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to conduct an economic evaluation of the T2DPR pilot programme from the perspectives of NHSE and of service users, and the budget impact of a nationwide rollout of the programme to all eligible adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Real-world clinical data from T2DPR pilot programmes were linked to National Diabetes Audit (NDA) datasets (n = 838). A cost-utility analysis with a lifetime time horizon was conducted from the NHSE perspective using the UKPDS Outcomes Model v.2.2, which predicted quality-adjusted life years (QALYs) and healthcare costs based on data collected pre-referral and at 12 months. A counterfactual scenario without the intervention was modelled using pre-referral data only. Assumptions on weight regain and HbA1c trajectories beyond 24 months were tested in sensitivity analyses. National T2D incidence and obesity prevalence data informed estimates of eligible adults for nationwide rollout and projected budget impact. Questionnaire data on service user out-of-pocket expenses provided indicative financial costs from the user perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The T2DPR pilot is estimated to be cost effective at a £20,000 per quality-adjusted life-year threshold, provided weight and HbA1c levels remain lower than in a counterfactual scenario for at least 6-7 years (£19,759.80/QALY assuming 7 years). Given that an estimated 50,000 adults would be eligible annually if rolled out nationwide, a 10% uptake would cost NHSE approximately £6.1 million per year, while uptake of around one-third of eligible adults would exceed £20 million. Some service users reported additional out-of-pocket expenses, primarily from trying different product flavours and continued consumption of products beyond the duration specified in the scheme. These expenses are likely partially offset by savings on overall grocery expenses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A nationwide rollout of T2DPR would have significant implications for healthcare budgets and opportunity costs, given potentially high demand driven by the high incidence of T2D among eligible adults. Cost effectiveness depends on the weight and HbA1c regain experienced by service users after discharge. Future research should explore","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"289-304"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775226","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":"Impact of Inhibitor Development on the Cost Effectiveness of Prophylactic Treatment with Recombinant Factor VIII in Previously Untreated Patients with Severe Hemophilia A.","authors":"Li Yang, Jie Peng, Congling Gu, Zhenguo Wang, Genyong Zuo","doi":"10.1007/s41669-025-00623-w","DOIUrl":"10.1007/s41669-025-00623-w","url":null,"abstract":"<p><strong>Background/objectives: </strong>Inhibitor development against recombinant factor VIII (rFVIII) is a significant complication in the prophylactic treatment of severe hemophilia A. The economic impact of varying inhibitor risks among rFVIII products is unclear. We compare the cost effectiveness of two rFVIII products with different incidences of inhibitor development (antihemophilic factor [recombinant], plasma/albumin-free method [rAHF-PFM] vs BAY 81-8973) for prophylaxis in Chinese previously untreated patients (PUPs) with severe hemophilia A.</p><p><strong>Methods: </strong>From a Chinese healthcare system perspective, a Markov model simulated the lifetime outcomes (inhibitors, bleeding, complications) for PUPs with severe hemophilia A receiving lifetime prophylactic treatment with rAHF-PFM or BAY 81-8973 (incidence of inhibitor development: 30.3% vs 54.8%). Data were sourced from literature, clinical experts, and public sources. Cost effectiveness was assessed using base-case, one-way sensitivity, and probabilistic sensitivity analysis (PSA).</p><p><strong>Results: </strong>The base-case analysis indicated that rAHF-PFM extended survival by 0.055 years (17.965 vs 17.910) and increased quality-adjusted life years (QALYs) by 0.779 QALYs (9.290 vs 8.511), while saving Chinese Yuan (CNY) 4,578,403 (CNY 12,060,222 vs CNY 16,638,625) compared with BAY 81-8973 in PUPs with severe hemophilia A. Results were most sensitive to the annualized bleeding rate and utility of patients free of bleeding episodes. PSA with 5000 Monte Carlo simulations estimated a 97.5% probability that rAHF-PFM was the cost-effective option.</p><p><strong>Conclusions: </strong>Prophylactic treatment with rAHF-PFM is likely more cost effective than BAY 81-8973 for Chinese PUPs with severe hemophilia A. This finding is primarily driven by the lower incidence of inhibitor development and fewer bleeding episodes associated with rAHF-PFM in the model.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"317-329"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669429","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":"Budget Impact of the LungFlag™ Predictive Risk Model for Lung Cancer Screening.","authors":"Carolina Heuser, Michael K Gould, Eran Choman, Nicolò Olghi, Sarika Ogale, Milan Obradovic","doi":"10.1007/s41669-025-00627-6","DOIUrl":"10.1007/s41669-025-00627-6","url":null,"abstract":"<p><strong>Background/objective: </strong>Lung cancer screening has historically been associated with false-positive results that can lead to complications and increased costs. LungFlag is a machine-learning risk prediction model using individual-level data to identify people at high risk of developing non-small cell lung cancer (NSCLC), prompting healthcare professionals to consider appropriate actions such as recommended screening with low-dose computed tomography. This study evaluated the budget impact of using the LungFlag risk prediction model to identify candidates for lung cancer screening from a US payer perspective.</p><p><strong>Methods: </strong>This budget impact model estimated total annual costs with or without LungFlag for a hypothetical 1 million-member US commercial health plan. Incremental costs were evaluated over a 5-year period with a cycle length of 1 year; no discounting was applied. All costs were adjusted to 2021 US dollars. The population included screening-naïve individuals aged 50-80 years with a ≥20-pack-years smoking history who were either current smokers or former smokers who had quit smoking in the previous 15 years (US Preventive Services Task Force 2021 criteria). LungFlag performance was measured 9-12 months before clinical diagnosis. Sensitivity and scenario analyses explored the robustness of base-case assumptions.</p><p><strong>Results: </strong>The budget impact model showed that LungFlag was associated with a total cumulative cost savings of US$2.8 million over 5 years, largely attributable to reduced advanced NSCLC treatment costs (-$4.4 million) as more patients were identified with early stage I rather than stage III/IV disease. Using LungFlag, an estimated 17 additional NSCLC diagnoses were identified, 22 fewer NSCLC-related deaths occurred over 5 years, 50 more patients had stage I NSCLC at diagnosis, and 33 fewer patients had stage III or IV NSCLC at diagnosis.</p><p><strong>Conclusions: </strong>Using LungFlag to identify candidates for lung cancer screening was estimated to save US$2.8 million over 5 years from a US commercial health plan perspective, largely attributable to reduced costs of treating advanced NSCLC.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"331-339"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781963","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":"Retractions of Health Economic Evaluations: A Systematic Review.","authors":"Eric Julian Manalastas, Aditi Hombali, Juliette C Thompson, David Alexander Scott","doi":"10.1007/s41669-025-00624-9","DOIUrl":"10.1007/s41669-025-00624-9","url":null,"abstract":"<p><strong>Objectives: </strong>Retractions of scientific articles have increased over time, across different health fields, disease indications, and study designs. However, it is currently unknown whether, and to what extent, retractions have impacted the literature of health economic evaluations. This research aimed to identify retracted health economic evaluations, describe the characteristics of such studies, and analyse reasons for retraction.</p><p><strong>Methods: </strong>We conducted a systematic review of health economic evaluations published in peer-reviewed journals and subsequently retracted, identified using MEDLINE, Embase, and the Retraction Watch database from inception to May 2025. Retraction notices were examined and publication details, including reasons for retraction, were extracted.</p><p><strong>Results: </strong>We identified 17 retracted economic evaluations published from 2006 to 2024. Studies evaluated a range of interventions in a broad array of disease indications. Retracted economic evaluations were published in 17 unique journals, 11 of which were top-tier outlets. Errors were the most common reason for retraction (11/17 studies, 64%), including errors in inputs, analysis, and/or model structure. Evidence of misconduct (plagiarism, duplicate publication, and peer-review manipulation) was found in 4/17 studies (24%). Retractions were rapid, with 12/17 studies (71%) retracted within the same year. Mean citation count was 4.8; the highest was 33. Despite retraction, studies were included in subsequent evidence reviews (6/17 studies, 35%) and one was used to inform clinical practice recommendations (1/17 studies, 6%).</p><p><strong>Conclusion: </strong>Evidence for retractions of health economic evaluations was found, spanning a variety of disease indications, interventions, and journal sources, due to errors or scientific misconduct. In some cases, papers produced subsequent citations in the literature despite retraction.</p><p><strong>Trial registration: </strong>OSF https://osf.io/8c6jb/?view_only=0ed118b9830e45058e56fc333b93a62f .</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"215-227"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844123","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":"Potential Economic Value of Multi-cancer Early Detection Testing Under Differential Cost Trends for Cancer Screening and Management.","authors":"Anuraag R Kansal, Ali Tafazzoli, Weicheng Ye, Walter Morris, Denise Zou, Bruce Quinn, A Mark Fendrick","doi":"10.1007/s41669-025-00626-7","DOIUrl":"10.1007/s41669-025-00626-7","url":null,"abstract":"<p><strong>Objectives: </strong>Multi-cancer early detection (MCED) tests aim to reduce the clinical and economic burden of cancer by detecting cases at earlier, more treatable stages. Recent trends indicate that the costs of cancer management are escalating, while screening costs have remained relatively stable over the past decade. This study evaluated the impact of these differing cost trends on the cost-effectiveness and net cost of MCED testing in the United States (US).</p><p><strong>Methods: </strong>A hybrid state-transition and decision-tree model was adapted for a lifetime analysis from commercial insurance and Medicare perspectives. Base-case treatment costs were derived from a Surveillance, Epidemiology, and End Results (SEER)-Medicare database study, and MCED test prices were set at $949 or $712 (25% reduction). Historical annual growth rates ranging from - 5 to 10% were then applied to management and screening costs. Contour plots were used to depict the results from these cost growth scenarios. MCED test performance was informed based on results from a case-control study.</p><p><strong>Results: </strong>Across perspectives, the incremental cost-effectiveness ratio (ICER) of MCED was between $50,000 and $100,000/quality-adjusted life year (QALY) with no cost growth. In the commercial insurance perspective, MCED was found to gain QALYs and lower spending when the growth rate of cancer management costs exceeded 2-4% with no MCED cost growth. The ICER exceeded $150,000/QALY if the growth rate of MCED costs exceeded 4-6% with no cancer management cost growth. In Medicare, the same thresholds were reached with management growth rates of 7-8% and screening growth rates > 7%, respectively. Cost neutrality was achieved within 5-10 years when cancer management growth rates significantly exceeded MCED cost growth, but was not reached within 30 years if MCED cost growth rates exceed those of cancer management. Results were robust across conducted scenario and sensitivity analyses.</p><p><strong>Conclusions: </strong>Early detection with MCED may help mitigate rising cancer management costs, yielding improved cost-effectiveness and, in some scenarios, a path to cost neutrality.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"275-287"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820240","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}