Value in health regional issues最新文献

{"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}

{"title":"The Reform Dynamics of State Management Practices in the Healthcare Sector of the Republic of Kazakhstan: A Global and Local Perspective","authors":"Talgat Zharlygassinov ,&nbsp;Rashid Ruzanov PhD ,&nbsp;Manshuk Dosmanbetova PhD","doi":"10.1016/j.vhri.2024.101047","DOIUrl":"10.1016/j.vhri.2024.101047","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the changes in public administration practices in this area in the Republic of Kazakhstan and to assess the general state of healthcare in the country.</div></div><div><h3>Methods</h3><div>The study used various methods, including analysis, historical research, deduction, and forecasting, to assess the current state and prospects for healthcare development in the Republic of Kazakhstan and some post-Soviet countries in Eastern Europe.</div></div><div><h3>Results</h3><div>The findings indicate that although these countries have lower qualitative and quantitative healthcare characteristics than more developed nations, they still outperform Kazakhstan. This suggests that Kazakhstan should take a more proactive approach toward developing its healthcare system and prioritizing the well-being of its citizens, their standard of living, and their ability to combat diseases, including financially.</div></div><div><h3>Conclusions</h3><div>The article contributes new insights into the healthcare systems of developing countries, including post-Soviet nations.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508902","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 Use of a Specialized Oral Nutritional Supplement in the Management of Chronic Wounds in Patients With and Without Diabetes Mellitus: Cost-Effectiveness Analysis","authors":"Adriano Antonio Mehl MD, MSc, PhD ,&nbsp;Victoria Marzagão Ribeiro Pagliosa BSc ,&nbsp;Débora Auad Tauil BSc ,&nbsp;Valéria Abrahão Schilling Rosenfeld MD","doi":"10.1016/j.vhri.2024.101049","DOIUrl":"10.1016/j.vhri.2024.101049","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the cost-effectiveness of the use of a specialized oral nutritional supplement (ONS) with proline, arginine, vitamins, and micronutrients to stimulate the healing of chronic wounds in patients with and without diabetes mellitus.</div></div><div><h3>Methods</h3><div>This is a quantitative study on cost-effectiveness. This model used a decision-tree model followed by a budget impact analysis from the Brazilian public healthcare system’s perspective. For this analysis, the population and data from a randomized trial of an oral specialized-ONS-containing supplement were considered. For budget impact analysis, an epidemiologic approach was used to estimate the eligible population. The eligible population comprised 3 different groups: patients with pressure ulcers, patients with vascular ulcers, and patients with diabetic feet. The budget impact analysis used the results of the cost-effectiveness analysis.</div></div><div><h3>Results</h3><div>The results demonstrate that the use of specialized ONS, when compared with control ONS, proved to be cost saving (cheaper and more effective), considering the presence of predictive scar factor. The aggregated budget impact analysis results shows that the total reduction of costs after 5 years is USD 332 628 437.00.</div></div><div><h3>Conclusions</h3><div>The use of a specialized ONS was cost-effective in the healing of chronic wounds, when compared with control. The budget impact analysis showed a significant decrease in costs in a 5-year time horizon for the management of pressure ulcers, vascular ulcers, and diabetic feet.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508903","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 High Cost of the Legal Route in Public Health: The Impact of the Judicialization of Medicines in the Municipal Unified Health System in Campinas.","authors":"Stefane Cristina Paixão Oliveira, Dyego Carlos Souza Anacleto de Araújo, Patricia Moriel, Marília Berlofa Visacri","doi":"10.1016/j.vhri.2024.101050","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101050","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the costs and factors associated with the judicialization of medicines for the municipal Unified Health System in Campinas, São Paulo, Brazil, from 2017 to 2021.</p><p><strong>Methods: </strong>This cross-sectional study used data provided by the Municipal Health Department of Campinas and the Court of Justice of the State of São Paulo.</p><p><strong>Results: </strong>The sample comprised 506 medicines (322 active substances) and 493 legal cases. Of the US$9.270 million disbursed, 67.3% were allocated to purchase medicines. On average, 28.8% of the pharmaceuticals were listed on the National List of Essential Medicines (Rename), of which 52.3% were listed in the specialized component. Expenditures on nonincorporated and oncological medicines accounted for 76% of the total value. Acquisition of brand-specific medicines was predominant (53.7%), of which 75.5% had therapeutic equivalents. ABC curve shows that only 28 active substances corresponded to 79.8% of the expenses incurred to serve 573 plaintiffs. Four factors, when present in legal actions, prevented the rational use of public resources: assumption of responsibilities of other federative entities, acquisition of medicines not incorporated in Rename and oncological drugs, trademark determination, and the requirement to supply the medicine for an indefinite period. Costs associated with these factors caused an increase in expenditure, even with a decrease in legal demands filed against the municipality.</p><p><strong>Conclusions: </strong>Judicialization of medicines in Campinas from 2017 to 2021 required an allocation of US$6.2 million, aimed at treating only 0.068% of the population. Associated factors include legal requirements and internal management challenges that have increased costs.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508904","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":"Corrigendum to 'Cost-effectiveness Analysis of Prostate Specific Antigen Screening among Chinese Men': [Value in Health Regional Issues Volume 21, May 2020, Pages 272-279].","authors":"Guoqiang Zhao, Yuchen Shao, Nan Zhang, Jialin Wang, Linlin Yuan, Xiaojie Sun, Lizheng Shi","doi":"10.1016/j.vhri.2024.101053","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101053","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475912","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":"Savings Through Telemedicine: Initial Data From a Hospital-at-Home Program","authors":"Chong Yau Ong MMed(FM) ,&nbsp;Angus Jun Jie Ng BSc ,&nbsp;Sarah Yu Juan Ang BSc ,&nbsp;Jean Mui Hua Lee MBBS","doi":"10.1016/j.vhri.2024.101046","DOIUrl":"10.1016/j.vhri.2024.101046","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to estimate travel-related time and cost savings from the use of telemedicine for an inpatient hospital-at-home program.</div></div><div><h3>Methods</h3><div>This was a retrospective study on the initial data obtained from a newly implemented hospital-at-home program from June 26, 2023, to March 31, 2024. Time cost savings were calculated based on difference between time spent on teleconsultation versus time needed to travel a round trip to patients’ homes to conduct physical consultation via home visit. Travel distances were calculated based on the distance of patient’s homes from the hospital.</div></div><div><h3>Results</h3><div>There were 505 teleconsultations (497 scheduled, 8 unscheduled) delivered throughout 132 enrollments. Total travel distance saved was 4022 km. Total time savings was 18 707 minutes or 13.0 days. Total trip cost savings were Singapore dollars 4618.70.</div></div><div><h3>Conclusions</h3><div>Despite being a newly introduced program, utilization of telemedicine in delivery of hospital-at-home showed time savings for the clinicians, cost savings from the distance needed to travel otherwise. Incorporation of telemedicine in hospital-at-home delivery demonstrated time and distance savings even at the pilot phase of program.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393643","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":"Custo-Efetividade de Diferentes Tratamentos Minimamente Invasivos Para Disfunção Temporomandibular de Origem Articular sob a Perspectiva do Sistema Público de Saúde Brasileiro","authors":"George A. Lemos PhD ,&nbsp;Pâmela L.P. da Silva PhD ,&nbsp;Eduarda C. Moretti PhD ,&nbsp;Antônio C. Pereira PhD","doi":"10.1016/j.vhri.2024.101014","DOIUrl":"10.1016/j.vhri.2024.101014","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the cost-effectiveness (CE) of minimally invasive interventions for pain associated with articular temporomandibular dysfunction from the Brazilian Public Health System (SUS) perspective.</div></div><div><h3>Methods</h3><div>This is a CE study with a 1-year time horizon. Effectiveness data were extracted from a network meta-analysis, and 2 treatments with moderate levels of evidence certainty were evaluated: arthrocentesis (ARTRO) plus intra-articular corticosteroid (CO) injection and ARTRO plus intra-articular injection of sodium hyaluronate (SH). For CE analysis, the costs of 2 types of SH (low and high molecular weight) and 4 COs (betamethasone [B], dexamethasone acetate [D], methylprednisolone sodium succinate [M], or triamcinolone hexacetonide [T]) were considered. Modeling was conducted using TreeAge Pro Healthcare software, with the construction of a decision tree representing a hypothetical cohort of adults with articular temporomandibular dysfunction. Deterministic and probabilistic sensitivity analyses were performed. In addition, an acceptability curve was developed.</div></div><div><h3>Results</h3><div>The total costs per joint for ARTRO plus low- and high-molecular-weight SH and ARTRO plus COs B, D, M, and T were, respectively, R$583.32, R$763.85, R$164.39, R$133.93, R$138.57, and R$159.86. ARTRO plus dexamethasone acetate was considered cost-effective, with lower cost and higher net monetary benefit than other technologies. In all sensitivity analysis scenarios, it remained cost-effective. It also showed greater acceptability.</div></div><div><h3>Conclusion</h3><div>ARTRO plus dexamethasone acetate was considered the cost-effective technology, exhibiting higher net monetary benefit and higher acceptability from the SUS perspective.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378348","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}