Value in health regional issues最新文献

{"title":"Cost-Effectiveness of Aerial Logistics for Immunization: A Model-Based Evaluation of Centralized Storage and Drone Delivery of Vaccines in Ghana Using Empirical Data.","authors":"Maria J Ospina-Fadul, Pedro Kremer, Scott E Stevens, Florence Haruna, Marion Okoh-Owusu, Godfred K Sarpong, Kingsley Osei-Kwakye, Billy Joshua, Osei Sakyi","doi":"10.1016/j.vhri.2024.101066","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101066","url":null,"abstract":"<p><strong>Objectives: </strong>In mid-2020, the Ghana Health Service introduced Zipline's aerial logistics (centralized storage and delivery by drones) in the Western North Region to enhance health supply chain resilience. This intervention led to improved vaccination coverage in high-utilization districts. This study assessed the cost-effectiveness of aerial logistics as an intervention to improve immunization coverage.</p><p><strong>Methods: </strong>An attack rate model, adjusted for vaccination coverage and vaccine efficacy, was used to estimate disease incidence among vaccinated and unvaccinated populations, focusing on 17 022 infants. Incremental cost-effectiveness ratios of US dollar per averted disability-adjusted life-year (DALY) were evaluated from societal and government perspectives, using real-world operations data. Probabilistic sensitivity analysis was performed using Monte Carlo simulations.</p><p><strong>Results: </strong>In 2021, aerial logistics averted 688 disease cases. Incremental cost-effectiveness ratios were $41 and $58 per averted DALY from the societal and government perspectives, respectively. The intervention was cost-saving when at least 20% of vaccines delivered by aerial logistics replaced those that would have been delivered by ground transportation, with potential government savings of up to $250 per averted DALY. Sensitivity analysis confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>Under conservative assumptions, aerial logistics was a highly cost-effective intervention to increase immunization coverage. The intervention was cost-saving even with low levels of replacement of traditional last mile delivery. These findings support expanding aerial logistics within the national immunization program and have significant implications for other low- and middle-income countries seeking cost-effective health supply chain solutions.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"101066"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Pain-A Global Problem Demanding Local Evidence and Guidelines.","authors":"Rafael Pinedo-Villanueva, Manuel A Espinoza","doi":"10.1016/j.vhri.2024.101069","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101069","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"101069"},"PeriodicalIF":1.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Real-World Evidence for Health Technology Assessment in Asia: Suggested Typology and Scoping Review.","authors":"Ryan R Nugraha, Arie Rahadi, Christian Suharlim","doi":"10.1016/j.vhri.2024.101068","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101068","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to provide the typology of real-world evidence (RWE) and challenges associated with improving the use of RWE in Asian countries.</p><p><strong>Methods: </strong>This article is divided into 2 subsections. First, a narrative review was conducted to classify RWE based on available real-world data. This method was also used to develop a typology of RWE, particularly considering the nature of the data, the potential evidence generated, and the integration methods into health technology assessment (HTA). Finally, a scoping review was undertaken to identify and filter studies focusing on the implementation of RWE in Asia.</p><p><strong>Results: </strong>The use of RWE is associated with many caveats, and therefore, its use in Asia is particularly limited. Based on the narrative review, RWE is divided into 3 broad categories: macro-, meso-, and micro-RWE; each represents a different quality of evidence and range of use as evidence for HTA. Although typology helps with consolidating RWE choices for supporting HTA decision making, challenges still persist in using it for HTA purposes. Institutional support, technical capacity, and infrastructure, including data-related issues, may hinder progress in improving the RWE ecosystem for HTA in Asia.</p><p><strong>Conclusions: </strong>RWE is a helpful tool that can assist in decision making, especially in reimbursement-related decisions. Although knowing facets of RWE helps in choosing appropriate evidence to assist in policy making, challenges associated with its implementation, especially in the Asian context, need to be anticipated.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"101068"},"PeriodicalIF":1.4,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Alzheimer's Disease and Its Costs to Healthcare System in a Large Population in Brazil.","authors":"Ana Carolina Vilarinho, Rhainer Guillermo Ferreira","doi":"10.1016/j.vhri.2024.101064","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101064","url":null,"abstract":"<p><strong>Objectives: </strong>In Brazil, cases of Alzheimer's disease (AD) are particularly prevalent in the southeastern region, including Minas Gerais, the largest state in the area. This study aimed to estimate the disease burden and healthcare costs from 2018 to 2022.</p><p><strong>Methods: </strong>Data on life expectancy, human development index, population size, and gross domestic product per capita were extracted to calculate disability-adjusted life-years (DALYs). Hospital admission data for AD were obtained from the Brazilian Unified Health System Department of Informatics (DATASUS) database, including the number of cases, deaths, age-specific data, and treatment costs. These variables, along with health, social, and environmental data, were processed to create risk factor layers, and the mean cost per DALY was calculated. Generalized estimating equation models were used to analyze the relationship between DALYs and various predictors, controlling for spatial autocorrelation. Maps were created to visualize the distribution of DALYs and cost per DALY.</p><p><strong>Results: </strong>There were 323 221 deaths from AD in Brazil, with cities averaging 3.61 deaths (range 1-73) and 5.43 hospitalizations (range 1-91) annually. The mean cost per city over these years was $9935.87 (range $44.22 to $787 307.93). In Minas Gerais, significant predictors of the estimated burden of AD include the percentage of the population aged 65 years and older, the human development index, and the prevalence of cardiovascular diseases. DALYs were higher than observed, indicating potential underreporting and insufficient resource allocation for AD treatment and prevention.</p><p><strong>Conclusions: </strong>These results emphasize the need for region-specific policies and strategies to address the AD burden effectively. Policy makers should use this information to improve planning and allocate resources appropriately for treatment and prevention.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"101064"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Potential Health and Economic Benefits of Optimized Low-Density Lipoprotein Cholesterol Management in Malaysia's Atherosclerotic Cardiovascular Disease Population: A Model-Based Analysis.","authors":"Chee Yoong Foo, Nurul Azwani Nadia Mansor, Thurston Erng, Mohd Sapawi Mohamed, Gurudevan Mahadevan, Glendon Lau, Asri Ranga, Tiong Kiam Ong","doi":"10.1016/j.vhri.2024.101059","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101059","url":null,"abstract":"<p><strong>Objectives: </strong>This study quantified the health and economic benefits of improving low-density lipoprotein cholesterol (LDL-C) control in Malaysian patients with established atherosclerotic cardiovascular disease (ASCVD). It aimed to inform policy discussions and healthcare planning for effective ASCVD management.</p><p><strong>Methods: </strong>A deterministic, prevalence-based model was used to project the annual health burden and direct medical costs associated with recurrent ASCVD events over a 10-year horizon. The target population included adults (≥30 years) with established ASCVD and uncontrolled LDL-C levels (>1.8 mmol/L). The model comprised 3 modules: population size projection, recurrent ASCVD risk calculation (by means of the Secondary Manifestations of ARTerial disease [SMART] risk model), and direct medical and productivity cost estimation. The current status quo and a scenario with a 50% improvement in mean LDL-C were compared.</p><p><strong>Results: </strong>We projected over 800 000 adults with established ASCVD in 2023, increasing to approximately 1.4 million by 2032. Under the status quo, about 55 000 recurrent ASCVD events were expected within 10 years, with significant direct medical costs and productivity losses. Improved LDL-C control could potentially reduce recurrent events by 7000 cases (13% reduction), prevent 2100 premature deaths, and save approximately 32 400 years of life. Economically, this could lead to a reduction of approximately 72 million MYR in direct medical costs and a gain of approximately 132.4 million MYR in productivity over a decade.</p><p><strong>Conclusions: </strong>Optimizing LDL-C control in high-risk patients with ASCVD presents a critical opportunity to reduce health and economic burdens in Malaysia.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101059"},"PeriodicalIF":1.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in a Slovak Representative Sample: A Validation Study of the Short Form-8 Scale.","authors":"Dana Purova, Jana Furstova, Natalia Kascakova, Alena Dobrotkova, Dagmar Sigmundova, Jozef Hasto, Peter Tavel","doi":"10.1016/j.vhri.2024.101058","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101058","url":null,"abstract":"<p><strong>Objectives: </strong>The Short Form-8 (SF-8) is a widely used 8-item tool for health-related quality of life assessment. This study aimed to evaluate the psychometric properties of the Slovak version of the SF-8 in a population sample.</p><p><strong>Methods: </strong>A cross-sectional survey on a Slovak representative sample (n = 1018; mean age 46.24 ± 16.56 years; 51.3% women) monitoring health and well-being was performed in 2019. Exploratory network analysis and confirmatory factor analysis were used to assess the construct validity of the scale. Reliability and sociodemographic differences were evaluated.</p><p><strong>Results: </strong>A 2-factor model had an adequate fit to the data [χ²(19) = 186.2, P < .001, comparative fit index = 0.998, Tucker-Lewis index = 0.997, root mean square error of approximation = 0.093, standardized root mean of residuals = 0.039], with high reliability (α = 0.93, ω = 0.95). The physical component score and mental component score (MCS) were negatively associated with the presence of chronic health conditions. Lower physical component score and MCS were associated with higher age (P < .001), and lower MCS were associated with female gender (P < .001).</p><p><strong>Conclusions: </strong>The Slovak version of the SF-8 represents a valuable tool for measuring health-related quality of life in the Slovak population in both practice and research.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101058"},"PeriodicalIF":1.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding What Matters: Stakeholder Views on Decision Criteria for Cancer Drug Selection in the Public Sector in Malaysia.","authors":"Haarathi Chandriah, Asrul Akmal Shafie, Muthukkumaran Thiagarajan","doi":"10.1016/j.vhri.2024.101052","DOIUrl":"10.1016/j.vhri.2024.101052","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine stakeholders' decision criteria preferences for formulary decisions of cancer drugs in the Ministry of Health. The secondary objective was to identify the outcome measures of interest for assessment of clinical benefits for cancer drugs.</p><p><strong>Methods: </strong>A survey questionnaire was administered online and as hard copy using purposive sampling to 32 healthcare facilities providing cancer services and the Formulary Management Branch in the Ministry of Health. Respondents reported whether a criterion \"will be considered\" and weighted its relative importance on a 5-point scale. The choice of safety and efficacy/effectiveness outcomes were ranked from 1 to 5, and the minimum value of benefit for the efficacy/effectiveness outcome ranked 1 was provided. Trade-offs between survival and quality of life were also explored. Inferential statistics were used to explore difference in responses.</p><p><strong>Results: </strong>A total of 316 healthcare professionals responded to the survey. The most important criteria for value assessment of cancer drug were safety and effectiveness. Other criteria deemed important were quality of evidence, disease severity, and patient-reported outcomes. There was no difference in the criteria preference and weights across the various respondent groups. Overall survival was the most preferred clinical benefit outcome. Overall, willingness to pay was higher for life-prolonging treatment than treatment that improved quality of life.</p><p><strong>Conclusions: </strong>This study revealed that a wide range of criteria beyond the traditional decision-making criteria of efficacy, safety, and cost-effectiveness are important for value assessment of cancer drugs for the purpose of formulary decisions.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101052"},"PeriodicalIF":1.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Screening for Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus: A Cost-Effectiveness Analysis in Singapore","authors":"Andrea Cremaschi PhD ,&nbsp;Willem van den Boom PhD ,&nbsp;Nicholas Beng Hui Ng MMed ,&nbsp;Beatrice Franzolini PhD ,&nbsp;Kelvin B. Tan PhD ,&nbsp;Jerry Kok Yen Chan PhD ,&nbsp;Kok Hian Tan MMed ,&nbsp;Yap-Seng Chong MD ,&nbsp;Johan G. Eriksson DMSc ,&nbsp;Maria De Iorio PhD","doi":"10.1016/j.vhri.2024.101048","DOIUrl":"10.1016/j.vhri.2024.101048","url":null,"abstract":"<div><h3>Objectives</h3><div>In Singapore, diabetes imposes a huge population health and economic burden. Despite that, there is paucity of evidence on the health economics of screening programs for type 2 diabetes, especially in the context of screening after gestational diabetes (GDM). The objective of this study is to assess cost-effectiveness of universal lifelong screening for type 2 diabetes after GDM, which is supported by current guidelines, compared with elective screening where 54% of mothers with GDM undertake one-off screening. Despite the recommendation for universal lifelong screening, only 54% comply with this in the first postpartum year.</div></div><div><h3>Methods</h3><div>We perform a cost-effectiveness analysis comparing 5 screening strategies, accounting for lifetime costs to the healthcare system and quality of life for Singapore women diagnosed with GDM. In particular, a hybrid decision model, based on a decision tree and Markov models, is implemented to estimate cost and quality-adjusted life-years (QALY). Probabilities, costs, and utilities are obtained from existing literature, governmental databases, the Growing Up in Singapore Towards Healthy Outcomes birth cohort study, and the National University Hospital.</div></div><div><h3>Results</h3><div>Compared with elective screening, universal annual screening reduces cost by SG$19.4 million while adding 3.8 thousand QALYs by each annual cohort of pregnant women. Furthermore, annual screening is cost-effective (lower cost and higher QALY) compared with triennial screening. Sensitivity analysis shows that the findings are robust to parameter specifications.</div></div><div><h3>Conclusions</h3><div>Universal annual screening of women with a history of GDM is cost-effective for reducing diabetes complications compared with strategies with less frequent screening in Singapore.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101048"},"PeriodicalIF":1.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin Chemotherapy Regimen in Comparison With Gemcitabine and Cisplatin Chemotherapy Regimen in the Treatment of Patients With Muscle Invasive Bladder Cancer in Iran.","authors":"Sadra Nadimi Parashkouhi, Iman Karimzadeh, Alireza Rezvani, Hadi Abbasian, Leila Zarei","doi":"10.1016/j.vhri.2024.101051","DOIUrl":"10.1016/j.vhri.2024.101051","url":null,"abstract":"<p><strong>Objectives: </strong>Bladder cancer incurs the highest lifetime treatment cost per patient among various cancers. Current guidelines endorse several cisplatin-based regimens as neoadjuvant chemotherapy. This cost-utility analysis aimed to compare 2 primary neoadjuvant chemotherapy regimens-dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) and gemcitabine and cisplatin (GC)-for patients with muscle-invasive bladder cancer, providing economic evidence to inform treatment guidelines in Iran.</p><p><strong>Methods: </strong>A Markov decision model was constructed, incorporating 4 states: after radical cystectomy without recurrence, no radical cystectomy, recurrence, and death over a lifetime horizon. Clinical outcomes were derived from the VESPER (French Genito-Urinary Tumor Group and French Association of Urology V05) phase 3 randomized controlled trial, whereas costs were obtained from local Iranian data. The main result involved determining an incremental cost-effectiveness ratio within the simulated population, with a willingness-to-pay threshold of 1656 USD (equivalent to Iran's gross domestic product per capita in 2023). Costs and benefits were discounted at 5.8% per annum, and probabilistic and univariate deterministic sensitivity analyses were conducted.</p><p><strong>Results: </strong>From the perspective of the Iranian healthcare payer, 6 cycles of dd-MVAC yielded 0.02 greater quality-adjusted life-years compared with 4 cycles of GC, resulting in a cost saving of 1 173 491 USD and an incremental cost-effectiveness ratio of -78 708 870. Consequently, dd-MVAC emerged as the dominant option over a lifetime horizon (23 years). The model proved most sensitive to variations in recurrence and toxicity probabilities during treatment.</p><p><strong>Conclusions: </strong>Based on this study's results, dd-MVAC represents a cost-saving treatment regimen per patient in the Iranian health system compared with GC, with superior utility.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101051"},"PeriodicalIF":1.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of the Recombinant Zoster Vaccine Among People Living with Human Immunodeficiency Virus in Japan [VHRI Volume 44, November 2024, 101025]","authors":"So Sato MD,&nbsp;Takaaki Konishi MD, PhD,&nbsp;Hiroyuki Ohbe MD, PhD,&nbsp;Hideo Yasunaga MD, PhD","doi":"10.1016/j.vhri.2024.101061","DOIUrl":"10.1016/j.vhri.2024.101061","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101061"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530669","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}