Value in health regional issues最新文献

{"title":"Valuation of the Alzheimer’s Disease 5 Dimensions Instrument: A Discrete Choice Experiment With Life Duration in Chile","authors":"Daniel A. Araya-Ríos MA ,&nbsp;Kim-Huong Nguyen PhD ,&nbsp;Tracy A. Comans PhD ,&nbsp;Dominic Trépel PhD","doi":"10.1016/j.vhri.2025.101148","DOIUrl":"10.1016/j.vhri.2025.101148","url":null,"abstract":"<div><h3>Objectives</h3><div>To estimate utility weights for the Alzheimer’s Disease 5 Dimensions (AD-5D) instrument in the Chilean population to obtain health utilities.</div></div><div><h3>Methods</h3><div>A panel sample of the Chilean population was recruited online to complete a discrete choice experiment with time duration. Weights were built based on region of residence, gender, age, and educational level. The experimental design comprised 20 blocks, each composed of 12 choice sets. In each choice set, participants compared 2 health states described by the 5 AD-5D dimensions and the life duration. A multinomial logit model was used to analyze the data, and preference parameters were anchored to the health utility scale to produce utility weights that can be used to estimate quality-adjusted life years.</div></div><div><h3>Results</h3><div>The study included 1895 participants who completed the discrete choice tasks. The weighted sample showed that the respondents were more educated than the general population of Chile. However, other characteristics were comparable. The Physical Health dimension had the greatest impact on utility, followed by Living Situation, Mood, Memory, and Ability to do things for fun. The health utility values ranged from 1 to −1.09, with 23% of health states having negative utilities.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this study provides the first AD-5D utility weights for the Chilean population to be used in trials, healthcare, and economic evaluations of dementia-related interventions. Because the AD-5D instrument is based on the Quality of Life Alzheimer’s Disease Instrument, the estimated health utility weights allow estimation of quality-adjusted life years whenever the Quality of Life Alzheimer’s Disease is available.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"50 ","pages":"Article 101148"},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296995","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 Analysis of Universal Screening for Subclinical Hypothyroidism in Pregnancy Based on the Czech Nation-Wide Pilot Screening Program in Light of Current Evidence","authors":"Jan Tužil PhD ,&nbsp;Jan Jiskra PhD, MUDr ,&nbsp;Marcela Koudelková MUDr ,&nbsp;Renata Chloupková Mgr ,&nbsp;Kateřina Hejcmanová Mgr ,&nbsp;Ondřej Májek PhD ,&nbsp;Klára Tužilová MUDr ,&nbsp;Jana Bartáková PhD","doi":"10.1016/j.vhri.2025.101145","DOIUrl":"10.1016/j.vhri.2025.101145","url":null,"abstract":"<div><h3>Objectives</h3><div>In 2023, the Czech Guideline by Endocrinology society introduced universal screening of thyrotropin (TSH) in the first trimester of pregnancy. We modeled the incremental cost-effectiveness ratio (ICER), budget impact (BI), and new endocrinology referrals (ER) for universal screening of (1) TSH for subclinical hypothyroidism compared with the current testing and (2) extension to anti-thyroid peroxidase antibodies (anti-TPO).</div></div><div><h3>Methods</h3><div>A decision tree was built assuming that levothyroxine reduces the risks of gestational hypertension, miscarriage, and preterm birth and anti-TPO test improves diagnosis of postpartum thyroiditis. Models were parametrized using the best available evidence, probabilities, and utilities from the national pilot screening program. ICER was compared with a willingness-to-pay threshold of 47 430 EUR per quality-adjusted life year (QALY).</div></div><div><h3>Results</h3><div>Expecting 100 000 pregnancies yearly, introduction of universal TSH screening will result in 32.9 (−40 to 91.7) maternal QALYs gained, 65 (45-90) miscarriages and 52 (30-77) preterm deliveries prevented, with an ICER of 20 035 EUR/QALY (2315/3000 simulations cost-effective), the BI of 659 756 (439 993-895 993) EUR, and 2290 (1883-2728) ER (randomized-controlled-trial-level evidence). The extension of the TSH screening with anti-TPO will bring additional 111 (−398 to 604) QALY gained, ICER of 15 703 EUR per QALY (1945/3000 simulations cost-effective), the BI of 1 746 486 (1 241 391-2 350540) EUR, and 6927 (6121-7765) ER (low-level evidence).</div></div><div><h3>Conclusions</h3><div>Universal screening of TSH and extension with anti-TPO appear to be cost-effective. The population benefits of TSH screening are modest, but the BI is low. The model for anti-TPO is based on weak evidence and generates important BI.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101145"},"PeriodicalIF":1.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279852","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 and Budget Impact Analysis of Immunotherapy for First-Line Treatment of Advanced Kidney Cancer in Latin America: Evidence From Uruguay","authors":"Victorio Cervera MD, MSc ,&nbsp;Fabricio Ruiz DDS","doi":"10.1016/j.vhri.2025.101139","DOIUrl":"10.1016/j.vhri.2025.101139","url":null,"abstract":"<div><h3>Objectives</h3><div>Immunotherapy (IO) has significantly improved survival rates and quality of life in comparison with tyrosine kinase inhibitors for patients with advanced renal cell carcinoma (aRCC). We estimated the economic impact of incorporating IO into the National High-Cost Drug Financing Agency list of reimbursed medications for treating intermediate- and poor-risk aRCC in Uruguay.</div></div><div><h3>Methods</h3><div>We performed a cost-effectiveness analysis comparing nivolumab plus ipilimumab (intervention) with pembrolizumab plus axitinib (comparator) in intermediate and poor-risk aRCC using a 3-state Markov model. We included deterministic and probabilistic sensitivity analyses. Additionally, we constructed a budget impact model with a 5-year time horizon across intermediate and poor-risk groups.</div></div><div><h3>Results</h3><div>In the cost-effectiveness analysis base case, nivolumab plus ipilimumab option generated a mean cost savings per treated patient of −$41,864 and a gain of 0.60 and 0.56 in LYs and QALYs, respectively, with an incremental cost-effectiveness ratio of −$74,266.0. After probabilistic sensitivity analysis, the treatment regimen of nivolumab plus ipilimumab showed a 0.88 probability of being dominant compared with pembrolizumab plus axitinib for the treatment of patients with advanced RCC intermediate-poor risk group. In the comparative budget impact model between IO regimens, the cumulative cost for the pembrolizumab plus axitinib option was $80,422 148.5, whereas for nivolumab plus ipilimumab, it was $58,742,374.8, with a decremental difference of $21,679,773.7 in favor of the latter regimen.</div></div><div><h3>Conclusions</h3><div>Nivolumab plus ipilimumab represents a cost-saving option for first-line aRCC treatment and a cost-effective regimen for patients with intermediate and poor-risk aRCC in Uruguay.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101139"},"PeriodicalIF":1.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230959","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":"Epidemiology and Economic Burden of Suicide Among Brazilian Workers: Trends, Occupational Disparities, and Gender Differences","authors":"Douglas Paschoal dos Santos MSc ,&nbsp;Alfredo Chaoubah PhD ,&nbsp;Helian Nunes de Oliveira PhD","doi":"10.1016/j.vhri.2025.101143","DOIUrl":"10.1016/j.vhri.2025.101143","url":null,"abstract":"<div><h3>Objectives</h3><div>Suicide among workers represents a significant public health concern with substantial economic implications. This study aimed to analyze temporal trends in suicide cases and estimate the indirect costs of premature mortality among Brazilian workers from 2008 to 2022.</div></div><div><h3>Methods</h3><div>We analyzed data from Brazil’s Mortality Information System for workers aged 18 to 65 years. Indirect costs were calculated using the Human Capital Approach, considering lost productivity until retirement age (65 years). Sociodemographic characteristics, occupational factors, and regional variations were examined.</div></div><div><h3>Results</h3><div>A total of 121 880 suicide cases were identified, showing a 68.35% increase from 2008 to 2022. Males represented 84.65% of cases. The accumulated indirect costs amounted to R$26.31 billion (US$5.04 billion). The estimated lifetime indirect cost was R$71 billion (US$13.6 billion) for men and R$14 billion (US$2.9 billion) for women. Rural workers (16.5%) and construction workers (7.07%) had the highest number of cases, whereas management and judicial system positions showed the highest per-case indirect costs. Cases peaked at age 30, with most deaths occurring at home (60.3%). The South region showed disproportionately high suicide rates relative to its population.</div></div><div><h3>Conclusions</h3><div>The significant increase in suicide cases and substantial indirect costs highlight the need for targeted prevention strategies, particularly for young adults entering the workforce and high-risk occupations. The findings emphasize the importance of workplace mental health interventions and occupation-specific prevention approaches, considering both the frequency of cases and their economic impact.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101143"},"PeriodicalIF":1.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221651","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 Expanding Human Papillomavirus Vaccination to Adult Women in Indonesia: A Markov Model Approach","authors":"Nur Rochmah Hidayati MPharm ,&nbsp;Dwi Endarti MSc, PhD ,&nbsp;Didik Setiawan PhD","doi":"10.1016/j.vhri.2025.101147","DOIUrl":"10.1016/j.vhri.2025.101147","url":null,"abstract":"<div><h3>Objectives</h3><div>Human papillomavirus (HPV) infection is not only associated with cervical cancer but also with anogenital cancers and head and neck cancers. Cancers related to HPV contribute not only to high rates of morbidity and mortality but also impose significant healthcare costs.</div></div><div><h3>Methods</h3><div>A population-based Markov model for HPV-related cancers in Indonesia was developed using Microsoft Excel. We hypothesized a cohort of 100,000 population of girls and 100,000 population of adult women starting from 11 years old and followed until 74 years old based on 2 strategies. HPV vaccination of girls (current situation) as a base case and HPV vaccination of girls and adult women as a new proposed intervention. One-way and probabilistic sensitivity analyses were carried out to address the uncertainty in this study.</div></div><div><h3>Results</h3><div>Including adult women in HPV vaccination for preventing HPV-related cancers results in an incremental cost-effectiveness ratio of IDR −747,610/quality-adjusted life years. This indicated that including adult women alongside girls in preventing HPV-related cancers through HPV vaccination is cost saving. HPV vaccination is capable of reducing the incidence of HPV-related cancers in both girls and women. The number of HPV-related cancer cases that can be prevented in the intervention group compared with the base case is 2274 new cases per 100,000 population.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that adding adult women to the existing vaccination program (HPV vaccination in girls) in Indonesia is a cost-saving strategy for preventing HPV-related cancers. We recommend the implementation of a vaccination program for adult women could be included as a requirement for marriage for prospective brides.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"50 ","pages":"Article 101147"},"PeriodicalIF":1.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221059","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":"Impact of Improved Low-Density Lipoprotein Cholesterol Control in Patients with Diabetes in Malaysia: A Model-Based Population Health and Economic Analysis","authors":"Chee Yoong Foo MBBS, PhD ,&nbsp;Ruth Sim PhD ,&nbsp;Siew-Pheng Chan MBBS ,&nbsp;Anis Syazwani Abd Raof MSc ,&nbsp;Nurain Mohd Noor MBBS, MMED ,&nbsp;Norlaila Mustafa MD, MMED ,&nbsp;Rohana Abdul Ghani MB BCh BAO, MMED ,&nbsp;WB Wan Mohamad MD ,&nbsp;Lee-Ling Lim MBBS, PhD ,&nbsp;Asrul Akmal Shafie PhD ,&nbsp;Zanariah Hussein MBBS","doi":"10.1016/j.vhri.2025.101140","DOIUrl":"10.1016/j.vhri.2025.101140","url":null,"abstract":"<div><h3>Objectives</h3><div>Diabetes affects 537 million adults globally, significantly affecting non-high-income countries. Hyperlipidemia, a common comorbidity of diabetes, increases the risk of cardiovascular diseases, with low-density lipoprotein cholesterol (LDL-C) playing a crucial role. This study examines the population health outcomes and economic impact of improving LDL-C control among the population with diabetes in Malaysia.</div></div><div><h3>Methods</h3><div>Using a model-based approach, we projected the annual health burden of atherosclerotic cardiovascular disease (ASCVD) and the associated economic costs in Malaysia. The focus was on adults with diabetes and uncontrolled LDL-C. We used the UK Prospective Diabetes Study Outcome Model 2 for risk calculation, incorporating local demographic, clinical, and cost data to estimate the impact over a 10-year horizon.</div></div><div><h3>Results</h3><div>Our projections indicate a substantial burden from uncontrolled LDL-C in adults with diabetes, with over 1.24 (95% CI 1.15-1.34) million cumulative ASCVD cases and approximately 577 800 (95% CI 533 604-623 533) deaths over 10 years. Implementing effective LDL-C control measures could potentially prevent over 333 000 (95% CI 306 197-359 373) ASCVD events, 172 000 (95% CI 156 554-184 416) deaths, and more than 1.1 (95% CI 977 789-1 174 597) million years of life lost. Economically, it could reduce direct healthcare costs by RM 7.6 (95% CI 6.7-8.4) billion (∼30% reduction) and yield productivity gains of RM 7.5 (95% CI 5.8-8.7) billion over the decade.</div></div><div><h3>Conclusions</h3><div>This study underscores the values and urgency of incorporating LDL-C control into national health policies and clinical practices to address this pressing health issue effectively.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101140"},"PeriodicalIF":1.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221652","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 From Biosimilars Use in the Italian National Health Service","authors":"Maria Lucia Marino PhD ,&nbsp;Benedetta Bellini MSc ,&nbsp;Agnese Cangini MSc ,&nbsp;Francesco Trotta PhD","doi":"10.1016/j.vhri.2025.101142","DOIUrl":"10.1016/j.vhri.2025.101142","url":null,"abstract":"<div><h3>Objectives</h3><div>There is a paucity of evidence around the true economic value of biosimilars, especially in the long term. The aim of this study was to estimate the biosimilars uptake, cost trends of off-patent biologics and savings generated through the use of biosimilars in the Italian National Health Service in the 2013 to 2022 period.</div></div><div><h3>Methods</h3><div>We identified all biologics (ie, reference products) and related biosimilars that were approved in Europe and marketed in Italy until December 2022. The savings were estimated by multiplying sales volume for biosimilars by the difference between the reference product and biosimilars cost in each year.</div></div><div><h3>Results</h3><div>A total of 12 off-patent biologic medicines were included in the analysis, and in 2022, the mean uptake was 80%. It showed a descending trend of reference product and biosimilar cost, although, by maintaining a relevant difference. Italian National Health Service saved a total of 3.09 billion euros through the use of biosimilars, increasing over the study time period from 37.7 million euros to 762.6 million euros, representing 5% of overall pharmaceutical spending of public health facilities in 2022. The loss of savings due to the use of on-patent active ingredients, belonging to the same anatomical therapeutic chemical, was 1 billion euros.</div></div><div><h3>Conclusions</h3><div>The study confirmed a high biosimilar uptake in Italy and a decreasing trend in the mean cost per defined daily dose in the 2013 to 2022 period. Biosimilars led to important savings; however, major savings are obtainable by increasing the biosimilar uptake and preferring off-patent biologicals to on-patent medicines belonging to the same IV-level anatomical therapeutic chemical, when appropriate.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101142"},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203469","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":"Disease and Economic Burden of COVID-19 in the Prevaccine Era in a Fragmented Health System: The Argentine Case","authors":"Ariel Bardach MD, PhD ,&nbsp;Jamile Ballivian MD, MPH ,&nbsp;Carolina Moreno BSc ,&nbsp;Emiliano Navarro BSc ,&nbsp;Rosario Luxardo MD ,&nbsp;Moe H. Kyaw PhD ,&nbsp;Julia Spinardi MD, MSc ,&nbsp;Carlos Fernando Mendoza PharmD, MSc, PhD ,&nbsp;Carolina M. Carballo MD ,&nbsp;Cecilia I. Loudet MD, MSc ,&nbsp;Natalia Espinola BSc, MSc","doi":"10.1016/j.vhri.2025.101137","DOIUrl":"10.1016/j.vhri.2025.101137","url":null,"abstract":"<div><h3>Objectives</h3><div>The impact of COVID-19 in Argentina’s health and economic outcomes before the implementation of the national vaccination plan has not been fully characterized. This study aimed to estimate the health and economic burden of COVID-19 in the adult population in Argentina.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study using a national COVID-19 surveillance data set to assess (1) clinical burden, including incidence rates, mortality rates, and patterns of hospitalization categorized by severity based on the World Health Organization criteria; (2) economic burden; and (3) years of life lost. The cost of illness analysis was used to estimate the cost per patient with COVID-19, expressed in 2023 US dollars ($). The analyzed period was from March 2020 to June 2021, before the introduction of the vaccination as a national strategic plan for COVID-19.</div></div><div><h3>Results</h3><div>During the study period, the incidence rate of COVID-19 among the adult population in Argentina was 11 490.2 cases per 100 000 persons. As in many other countries in the region, most cases were classified as mild (95%), followed by 4% severe cases (requiring hospitalization) and 1% critical cases (intensive care unit [ICU] admission). The age-standardized years of life lost per 100 000 persons increased steeply from 58.6 in the 20 to 29 age group to 576.1 in the 60 to 69 age group. The total cost associated with COVID-19 was $1370 million, ranging from $244 in mild cases to $791 in critical cases. Concerning the health sectors, a higher total cost is observed in the social security sector, accounting for nearly 51% of the total costs, mainly because it has the highest rate of health coverage.</div></div><div><h3>Conclusions</h3><div>Before the vaccines were widely used, COVID-19 significantly strained Argentina’s public health and economy. These discoveries can aid policy makers in making well-informed choices and distributing resources efficiently to enhance future national strategies concerning surveillance, prevention, treatment, and potential long-term impacts on community health.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101137"},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195315","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":"Erratum to ‘The quality of economic evaluations of interventions to improve women and child health in Latin America: A systematic review’","authors":"","doi":"10.1016/j.vhri.2025.101144","DOIUrl":"10.1016/j.vhri.2025.101144","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101144"},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189952","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":"Current Generics Utilization and Associated Savings in Saudi Arabia: Insights From a Private Claims Database.","authors":"Shabab AlGhamdi, Ibrahim Abdulrahman Aljuffali, Ahmed Hamdan Aljedai, Razan Aljaser, Mohammed Aljumah, Christiane Maskineh, Omar Aldibasi, Ghassan Sleilaty, Nada Ahmed Alagil","doi":"10.1016/j.vhri.2025.101138","DOIUrl":"https://doi.org/10.1016/j.vhri.2025.101138","url":null,"abstract":"<p><strong>Objectives: </strong>Generic substituting is a recognized policy fostering access to innovation while reducing healthcare expenditure. In the Kingdom of Saudi Arabia, the Council of Health Insurance (CHI) introduced a new policy, CHI circular N°289 (28 September 2022), incentivizing generic utilization. To date, there is no documentation on the uptake and outcome of this policy. This study aims to analyze the policy's impact on medication utilization and financial outcomes. The objectives are to assess the generic utilization trends and related cost savings, local versus imported brand usage, and the evolving landscape of pharmaceutical utilization.</p><p><strong>Methods: </strong>This is a 10-month retrospective observational study (September 2022-June 2023) using monthly aggregate data from the National Public Health Information Exchange System platform. Generic utilization rates, spending, and current and potential savings were estimated, and local generic uptake was assessed. Indirect comparisons were made with the Kingdom of Saudi Arabia's historical 2019 data.</p><p><strong>Results: </strong>Generic utilization rates increased from 70% to 76%, whereas generic spending rates increased from 38% to 44%. Local generics drove medication utilization rates (45%), outpacing imported generics (30%) and brand medications (25%). The observed trend, aligning with European and North American countries, exceeds 2019 figures. Over 10 months, current savings approximated 330 million Saudi Riyal, with potential savings of 228 million Saudi Riyal.</p><p><strong>Conclusions: </strong>CHI circular N°289 (28/09/2022) promoting generic medication use was widely adopted, a trend expected to continue.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101138"},"PeriodicalIF":1.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174933","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}