Value in health regional issues最新文献

{"title":"Revision of Malawi’s Health Benefits Package: A Critical Analysis of Policy Formulation and Implementation","authors":"Emilia Connolly DO, MPH ,&nbsp;Sakshi Mohan MS ,&nbsp;Pakwanja Twea BA ,&nbsp;Thulasoni Msuku MS ,&nbsp;Andreas Kees MS ,&nbsp;Lalit Sharma BA ,&nbsp;Stephanie Heung BA ,&nbsp;Dominic Nkhoma PhD ,&nbsp;Gerald Manthalu PhD","doi":"10.1016/j.vhri.2023.10.007","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.10.007","url":null,"abstract":"<div><h3>Objectives</h3><p>Health benefits packages (HBPs), which define specific health services that can be offered for free or at a reduced cost to fit within public revenues, have been recommended for over 30 years to maximize population health in resource-limited settings. However, there remain gaps in defining and operationalizing HBPs. We propose a combination of design and prioritization methods along with practical strategies to improve the implementation of future iterations of the HBP in Malawi.</p></div><div><h3>Methods</h3><p>For HBP development for Malawi’s Third Health Sector Strategic Plan, we combined cost-effectiveness analysis with a quantitative, consultative multicriteria decision analysis. Throughout the process of development, we documented challenges and opportunities to improve HBP design and application.</p></div><div><h3>Results</h3><p>The primary and secondary HBP included 115 interventions. However, the definition of an HBP is just one step toward focusing limited resources, with functional operationalization as the most critical component. Full implementation of previous HBPs has been limited by challenges in aid coordination with the misalignment of nonfungible vertical donor funding for the HBP without accounting for the complexity and interconnectedness of the health system. Opportunities for improved application include creation of a complementary minimum health service package to guide overall resource inputs through an integrative approach.</p></div><div><h3>Conclusions</h3><p>We believe that expanded participatory HBP methods that consider value, equity, and social considerations, along with a shift to providing integrated health service packages at all levels of care, will improve the efficiency of using scarce resources along the journey to universal health coverage.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001206/pdfft?md5=841d8919d6713cdd5c482d5313f5bfb0&pid=1-s2.0-S2212109923001206-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138472441","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":"Demands for Intersectoral Actions to Meet Health Challenges in East and Southern Africa and Methods for Their Evaluation","authors":"Francesco Ramponi PhD ,&nbsp;Aloysius Ssennyonjo MSc ,&nbsp;Stephen Banda MSc ,&nbsp;Tom Aliti PhD ,&nbsp;Dominic Nkhoma PhD ,&nbsp;Oliver Kaonga PhD ,&nbsp;Susan Griffin PhD ,&nbsp;Paul Revill MSc ,&nbsp;Edward Kataika MA ,&nbsp;Juliet Nabyonga-Orem PhD","doi":"10.1016/j.vhri.2023.09.001","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.09.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Focusing on the East, Central, and Southern African region, this study examines both regional and country-level initiatives aimed at promoting multisectoral collaboration to improve population health and the methods for their economic evaluation.</p></div><div><h3>Methods</h3><p>We explored the interventions that necessitate cooperation among policymakers from diverse sectors and the mechanisms that facilitate effective collaboration and coordination across these sectors. To gain insights into the demand for multisectoral collaboration in the East, Central, and Southern African region, we presented 3 country briefs, highlighting policy areas and initiatives that have successfully incorporated health-promoting actions from outside the health sector in Zimbabwe, Uganda, and Malawi. Additionally, we showcased initiatives undertaken by the Ministry of Health in each country to foster coordination with national and international stakeholders, along with existing coordination mechanisms established for intersectoral collaboration. Drawing on these examples, we identified the primary challenges in the economic evaluation of multisectoral programs aimed at improving health in the region.</p></div><div><h3>Results</h3><p>We illustrated how decision making in reality differs from the traditional single-sector and single-decision-maker perspective commonly used in cost-effectiveness analyses. To ensure economic evaluations can inform decision making in diverse settings and facilitate regional collaboration, we highlighted 3 fundamental principles: identifying policy objectives, defining the perspective of the analysis, and considering opportunity costs. We emphasized the importance of adopting a flexible and context-specific approach to economic evaluation.</p></div><div><h3>Conclusions</h3><p>Through this work, we contribute to bridging the gap between theory and practice in the context of intersectoral activities aimed at improving health outcomes.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923000870/pdfft?md5=ebc240833e7b3e50a02a2c2a55eaf084&pid=1-s2.0-S2212109923000870-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138437814","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":"Breast Cancer Screening in Georgia: Choosing the Most Optimal and Cost-Effective Strategy","authors":"Abyan Irzaldy MD, MSc ,&nbsp;Rema Gvamichava MD, PhD ,&nbsp;Tina Beruchashvili PhD ,&nbsp;Lela Sturua MD, PhD ,&nbsp;Nicolien T. van Ravesteyn PhD ,&nbsp;Harry J. de Koning MD, PhD ,&nbsp;Eveline A.M. Heijnsdijk PhD","doi":"10.1016/j.vhri.2023.09.002","DOIUrl":"10.1016/j.vhri.2023.09.002","url":null,"abstract":"<div><h3>Objectives</h3><p>To define the optimal and cost-effective breast cancer screening strategy for Georgia.</p></div><div><h3>Methods</h3><p>We used the Microsimulation Screening Analysis-Breast (MISCAN-Breast) model that has been adapted to the Georgian situation to evaluate 736 mammography screening strategies varied by interval (biennial and triennial), starting ages (40-60 years), stopping ages (64-84 years), and screening modality (with and without clinical breast examination [CBE]). Quality-adjusted life-years (QALYs) and additional cost (healthcare perspective) compared with no screening per 1000 women were calculated with 3% discount. Major uncertainties (eg, costs) are addressed as sensitivity analyses.</p></div><div><h3>Results</h3><p>Strategies using a combination of mammography and CBE yielded in substantially higher costs with minimal differences in outcomes compared with mammography-only strategies. The current screening strategy, biennial mammography screening from the age of 40 until 70 years with CBE, is close to the frontier line but requires high additional cost given the QALY gains (€16 218/QALY), well above the willingness-to-pay threshold of €12 720. The optimal strategy in Georgia would be triennial mammography-only screening from age 45 to 66 years with an incremental cost-effectiveness ratio of €12 507.</p></div><div><h3>Conclusions</h3><p>Biennial screening strategies are resource-intensive strategies and may not be feasible for Georgia. By switching to triennial mammography-only strategy from the age of 45 until 66 years, it is possible to offer screening to more eligible women while still gaining substantial screening benefits. This is to address capacity issues which is a common barrier for many Eastern European countries.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923000882/pdfft?md5=c5fd1da873e11da76e8d0ecf55fc1e23&pid=1-s2.0-S2212109923000882-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Model of Nirmatrelvir/Ritonavir in Brazil: Analysis of a Vaccinated Population","authors":"Ricardo R.A. Fernandes PhD ,&nbsp;Bruno M. Barros MSc ,&nbsp;Milene R. da Costa PhD ,&nbsp;Carlos A.S. Magliano PhD ,&nbsp;Bernardo R. Tura PhD ,&nbsp;Quenia Cristina D. Morais MSc ,&nbsp;Marisa Santos PhD","doi":"10.1016/j.vhri.2023.09.005","DOIUrl":"10.1016/j.vhri.2023.09.005","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study is to conduct a cost-utility analysis of the use of the antiviral nirmatrelvir/ritonavir, applied to a vaccinated Brazilian population against COVID-19, from the perspective of the Brazilian Public Health System (SUS).</p></div><div><h3>Methods</h3><p>A microsimulation model was created with individual-level data and daily cycles, with a 1-year time horizon, to compare the current scenario of standard care with a scenario in which nirmatrelvir/ritonavir is offered to the population. Adults of any age group that received ≥2 doses of the COVID-19 vaccine formed the investigated population. Direct medical costs of the outpatients and inpatients admitted to the ward or intensive care unit were included. The effectiveness of the model was measured in quality-adjusted life-years (QALYs).</p></div><div><h3>Results</h3><p>In all simulations, the use of nirmatrelvir/ritonavir resulted in incremental costs per patient of US dollar (USD)245.86 and incremental effectiveness of 0.009 QALY, over a year. The incremental cost-utility ratio was USD27 220.70/QALY. The relative risk of the vaccinated population was the factor that affected the outcome most, according to the univariate sensitivity analysis. The probabilistic sensitivity analysis resulted in 100% of the simulations being more costly and effective, but that only 4% of them were below the established cost-effectiveness threshold of USD24 000.00/QALY. In the scenario considering only the population over 60 years old and immunosuppressed (of any age), the incremental cost-utility ratio was USD7589.37/QALY.</p></div><div><h3>Conclusions</h3><p>The use of nirmatrelvir/ritonavir in the treatment of COVID-19 in a vaccinated population was cost-effective only for immunosuppressed individuals and people over 60 years of age.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300180","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":"Evolving Trends and Economic Burden of Benzodiazepine Use: Insights From a 10-Year Predictive Model","authors":"Andro Koren ,&nbsp;Luciana Koren ,&nbsp;Robert Marcec MD ,&nbsp;Darko Marcinko MD, PhD ,&nbsp;Robert Likic MD, PhD","doi":"10.1016/j.vhri.2023.10.005","DOIUrl":"10.1016/j.vhri.2023.10.005","url":null,"abstract":"<div><h3>Objectives</h3><p><span>Benzodiazepines (BZDs) are widely prescribed in Croatia to treat anxiety, insomnia, </span>mood disorders<span>, and epileptic seizures<span>. Long-term BZD use is associated with memory loss, Alzheimer’s disease, dependence, addiction, falls in elderly populations, and increased traffic accident risk.</span></span></p></div><div><h3>Methods</h3><p>Drug<span><span> consumption data were obtained from the Agency for Medicinal Products and Medical Devices of Croatia website. </span>Autoregressive integrated moving average models<span>, constructed using R programming language, forecasted diazepam, alprazolam, and overall BZD utilization and financial costs at a national level over 10 years.</span></span></p></div><div><h3>Results</h3><p>BZD consumption increased by up to 18.6% between 2012 and 2020. During the same period, diazepam utilization rose by 29.1%, and alprazolam consumption increased by 19.4%. Our model predicts that, by 2032, BZD, diazepam, and alprazolam utilization will increase substantially. The total projected financial expenditure for BZDs in 2032 is estimated at 14.22 million euros, with diazepam and alprazolam expenditures at 7.39 and 4.12 million euros, respectively. These increases will result in significant growth in healthcare spending and a rise in adverse effects related to long-term use.</p></div><div><h3>Conclusions</h3><p>National healthcare decision makers<span> should consider implementing regulatory and legislative measures to quantify, specify, and limit monthly BZD use for each patient. This would help control the negative side effects of prolonged BZD use while continuing to provide treatment for patients who genuinely need it.</span></p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177390","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":"Economical Evaluation of Prostate Cancer Treatment Using Intensity-Modulated Radiation Therapy, 3-Dimensional Conformal Radiation Therapy and Radical Prostatectomy: A Systematic Review","authors":"Amin Adel PhD ,&nbsp;Aziz Rezapour PhD ,&nbsp;Ali Aboutorabi PhD ,&nbsp;Ali Taghizadeh Kermani MD ,&nbsp;Hamidreza Ghorbani MD","doi":"10.1016/j.vhri.2023.08.009","DOIUrl":"10.1016/j.vhri.2023.08.009","url":null,"abstract":"<div><h3>Objectives</h3><p>Prostate cancer is a common form of cancer among men worldwide. The objective of this study was to conduct a systematic review of the economic evaluations of prostate cancer treatment strategies.</p></div><div><h3>Methods</h3><p>This systematic review was conducted using multiple electronic databases up to May 2021. English-language economic evaluation studies that compared intensity-modulated radiation therapy (IMRT), 3-dimensional conformal radiation therapy (3DCRT), and radical prostatectomy (RP) were included. The studies were evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. The search yielded 1151 potentially relevant publications, which were screened based on the title and abstract. After the removal of duplicates, 55 studies remained, and 9 studies were screened in full text. Finally, textual data were analyzed manually using by-content analysis method.</p></div><div><h3>Results</h3><p>All studies were cost-effective and evaluated quality-adjusted life year as the efficacy indicator. The studies were conducted from either payers' or health systems' perspectives, and the time horizon varied from 5 to 20 years. We included only full economic evaluation studies. The use of IMRT in comparison with 3DCRT was evaluated in 6 studies, based on which IMRT increased health and reduced side effects of treatment. According to incremental cost-effectiveness ratio (ICER) results, IMRT was more cost-effective than 3DCRT. Three studies evaluated the use of RP in comparison with radiotherapy. Based on these studies, radiotherapy was more effective than RP.</p></div><div><h3>Conclusion</h3><p>IMRT was found to be more cost-effective than 3DCRT in all 6 studies compared with the threshold. Radiotherapy was found to be more effective than RP. However, long-term clinical trial studies are needed to confirm these findings and to provide more definitive conclusions.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923000869/pdfft?md5=4788ffe13298419572b3eb6fb46848f9&pid=1-s2.0-S2212109923000869-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048056","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":"Choosing the Best Instrument for Measuring Health Spillover Effect in Caregivers of Patients With Multiple Sclerosis","authors":"Hoda Faraji PharmD, PhD ,&nbsp;Fatemeh Soleymani PharmD, MPH, PhD ,&nbsp;Mehdi Yaseri PhD ,&nbsp;Mohammad Ali Sahraian MD ,&nbsp;Akbar Abdollahiasl PharmD, PhD ,&nbsp;Azin Meftah MSc ,&nbsp;Shekoufeh Nikfar PharmD, MPH, PhD","doi":"10.1016/j.vhri.2023.08.008","DOIUrl":"10.1016/j.vhri.2023.08.008","url":null,"abstract":"<div><h3>Objectives</h3><p>To measure the health spillover effect in caregivers of patients with multiple sclerosis (MS), we aimed to select the best instrument from 2 common health-related quality of life (QoL) instruments, the 3-level EQ-5D (EQ-5D-3L) and the Health Utilities Index Mark 3 (HUI-3), by assessing them.</p></div><div><h3>Methods</h3><p>Using consecutive sampling, 452 primary caregivers of patients with MS were asked to fill out a Care-related QoL instrument (CarerQol-7D), EQ-5D-3L, HUI-3, and the Center for Epidemiologic Studies Depression Scale between October 2019 and May 2020. Convergent and clinical validity were assessed to measure spillover effect in caregivers of patients with MS.</p></div><div><h3>Results</h3><p>A strong correlation of health-utility scores between EQ-5D-3L and HUI-3 (r = 0.914, <em>P</em> &lt; .01) was observed. The 95% limit of agreement (LoA) for CarerQol-7D and HUI-3 (−10.6 to 8.2) was narrower than the LoA for CarerQol-7D and EQ-5D-3L (−15.1 to 17.1). Both EQ-5D-3L and HUI-3 proved clinical validity for the QoL of caregivers. The CarerQoL-7D score was significantly lower in female (<em>P</em> &lt; .001), single (<em>P</em> &lt; .014), lower-educated (<em>P</em> &lt; .001), parent’s relatives (<em>P</em> &lt; .001), and unemployed (<em>P</em> &lt; .001) caregivers.</p></div><div><h3>Conclusions</h3><p>We found that both, EQ-5D-3L and HUI-3, were appropriate for measuring caregivers’ QoL, although HUI-3 was a better choice because of its narrower LoA. Our findings suggest researchers should use HUI-3 to measure the quality-adjusted life-year of caregivers to aggregate with the QoL of patients in the denominator of an economic evaluation equation, such as the cost-effective ratio.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923000857/pdfft?md5=4e518426307c655ce768e65ace4adb53&pid=1-s2.0-S2212109923000857-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs of Receiving Developmental Services for Children With Global Developmental Delay at Siriraj Hospital in Bangkok, Thailand","authors":"Krittaporn Sinpho MD ,&nbsp;Pat Rojmahamongkol MD","doi":"10.1016/j.vhri.2023.09.004","DOIUrl":"10.1016/j.vhri.2023.09.004","url":null,"abstract":"<div><h3>Objectives</h3><p>To identify the cost from the societal, caregiver, and hospital perspectives for receiving developmental services for children with global developmental delay (GDD) at Siriraj Hospital.</p></div><div><h3>Methods</h3><p>This descriptive study collected data from children under 5 years old with GDD from November, 2021 to October, 2022. The hospital’s perspective cost and caregivers’ direct medical costs were obtained from the Siriraj database. Caregivers were interviewed about their expenses for direct nonmedical and indirect costs. Caregivers and hospital perspective costs were summed to total societal perspective.</p></div><div><h3>Results</h3><p>Of the 100 caregivers<strong>,</strong> most (39%) of their children had Universal Coverage; however, 22% of the caregivers decided not to use any healthcare coverage. The median annual cost of the societal perspective was 209.81 (range 14.51-2134.08) US dollar (USD)/child. Median annual caregiver’s perspective, direct medical, direct nonmedical and indirect costs were 119.82 (range 9.20-2068.91), 0 (range 0-231.89), 68.96 (range 2.87-2068.91), and 0 (range 0-1293.07) USD/child, respectively. The mean proportion of the expenses of each child among direct medical, direct nonmedical, and indirect costs was 11:71:18. The median annual hospital perspective cost was 71.38 (range 5.17-807.13) USD/child.</p></div><div><h3>Conclusion</h3><p>The annual societal economic burden for each Thai child with GDD was 209.81 USD. The direct nonmedical cost, especially transportation, was the largest proportion of the total cost from the caregiver’s perspective. Effective referral system, proper specialist allocation throughout the country, and developing of the service system are crucial for the alleviation of this burden.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048057","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":"Automated Peritoneal Dialysis With Remote Patient Monitoring: Clinical Effects and Economic Consequences for Poland","authors":"Joanna Augustyńska MSc ,&nbsp;Monika Lichodziejewska-Niemierko MD, PhD ,&nbsp;Beata Naumnik MD, PhD ,&nbsp;Michał Seweryn PhD ,&nbsp;Agnieszka Leszczyńska MSc ,&nbsp;Ryszard Gellert MD, PhD ,&nbsp;Bengt Lindholm MD, PhD ,&nbsp;Jacek Lange MD ,&nbsp;Justyna Kopel MSc","doi":"10.1016/j.vhri.2023.09.011","DOIUrl":"10.1016/j.vhri.2023.09.011","url":null,"abstract":"<div><h3>Objectives</h3><p>Remote patient monitoring<span><span> (RPM) of patients treated with automated peritoneal dialysis (APD) at home allows clinicians to supervise and adjust the dialysis process remotely. This study aimed to review recent scientific studies on the use of RPM </span>in patients treated with APD and based on extracted relevant data assess possible clinical implications and potential economic value of introducing such a system into practice in Poland.</span></p></div><div><h3>Methods</h3><p>A systematic literature review was performed in the MEDLINE, EMBASE, and Cochrane databases. The model of clinical effects and costs associated with APD was built as a cost-effectiveness analysis with a 10-year time horizon from the Polish National Health Fund perspective. Cost-effectiveness analysis compared 2 strategies: APD with RPM versus APD without RPM.</p></div><div><h3>Results</h3><p>Thirteen publications assessing the clinical value of RPM among patients with APD were found. The statistical significance of APD with RPM compared with APD without RPM was identified for the main clinical outcomes: frequency and length of hospitalizations, APD technique failure, and death. An incremental cost-effectiveness ratio was equal to €27 387 per quality-adjusted life-year. The obtained incremental cost-effectiveness ratio is below the willingness-to-pay threshold for the use of medical technologies in Poland (€36 510 per quality-adjusted life-year), which means that APD with RPM was a cost-effective technology.</p></div><div><h3>Conclusions</h3><p>RPM in patients starting APD is a clinical option that is worth considering in Polish practice because it has the potential to decrease the frequency of APD technique failure and shorten the length of hospitalization.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399374","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":"Adapting Economic Evaluation Methods to Shifting Global Health Priorities: Assessing the Value of Health System Inputs","authors":"Finn McGuire PhD ,&nbsp;Sakshi Mohan MSc ,&nbsp;Simon Walker PhD ,&nbsp;Juliet Nabyonga-Orem PhD ,&nbsp;Freddie Ssengooba PhD ,&nbsp;Edward Kataika PhD ,&nbsp;Paul Revill PhD","doi":"10.1016/j.vhri.2023.08.005","DOIUrl":"10.1016/j.vhri.2023.08.005","url":null,"abstract":"<div><h3>Objectives</h3><p>We highlight the importance of undertaking value assessments for health system inputs if allocative efficiency is to be achieve with health sector resources, with a focus on low- and middle-income countries. However, methodological challenges complicated the application of current economic evaluation techniques to health system input investments.</p></div><div><h3>Methods</h3><p>We undertake a review of the literature to examine how assessments of investments in health system inputs have been considered to date, highlighting several studies that have suggested ways to address the methodological issues. Additionally, we surveyed how empirical economic evaluations of health system inputs have approached these issues. Finally, we highlight the steps required to move toward a comprehensive standardized framework for undertaking economic evaluations to make value assessments for investments in health systems.</p></div><div><h3>Results</h3><p>Although the methodological challenges have been illustrated, a comprehensive framework for value assessments of health system inputs, guiding the evidence required, does not exist. The applied literature of economic evaluations of health system inputs has largely ignored the issues, likely resulting in inaccurate assessments of cost-effectiveness.</p></div><div><h3>Conclusions</h3><p>A majority of health sector budgets are spent on health system inputs, facilitating the provision of healthcare interventions. Although economic evaluation methods are a key component in priority setting for healthcare interventions, such methods are less commonly applied to decision making for investments in health system inputs. Given the growing agenda for investments in health systems, a framework will be increasingly required to guide governments and development partners in prioritizing investments in scarce health sector budgets.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923000821/pdfft?md5=a672303c84fb984f68c54fdd71858f5f&pid=1-s2.0-S2212109923000821-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399370","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}