Value in health regional issues最新文献

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Evaluation of the Concept of Value-Based Healthcare Applied to an Integrated Palliative Care Program in Colombia 评估基于价值的医疗保健概念在哥伦比亚综合姑息关怀项目中的应用
IF 2
Value in health regional issues Pub Date : 2024-06-10 DOI: 10.1016/j.vhri.2024.101009
Gabriela Sarmiento MD , Johana Benavides MSc , Carlos A. Trujillo PhD , Nidya P. Velosa MD , Analhí Palomino MD , Luisa F. Rodríguez MD , Marcela A. Erazo MSc , Adriana J. Ávila Econ
{"title":"Evaluation of the Concept of Value-Based Healthcare Applied to an Integrated Palliative Care Program in Colombia","authors":"Gabriela Sarmiento MD ,&nbsp;Johana Benavides MSc ,&nbsp;Carlos A. Trujillo PhD ,&nbsp;Nidya P. Velosa MD ,&nbsp;Analhí Palomino MD ,&nbsp;Luisa F. Rodríguez MD ,&nbsp;Marcela A. Erazo MSc ,&nbsp;Adriana J. Ávila Econ","doi":"10.1016/j.vhri.2024.101009","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101009","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to evaluate the “Value-Based Healthcare” concept of an integrated palliative care (PC) program in Bogotá, Colombia, through the measurement of health outcomes and care costs in the last 3 months of life.</p></div><div><h3>Methods</h3><p>A multicenter, retrospective cohort study that included patients ≥18 years old who died in 2020 due to medical conditions amenable to PC. The measured health outcomes included pain, wellbeing, comfort, quality of life (QOL), and satisfaction. We analyzed the behavior of overall care costs during the last 3 months of the patients’ lives and controlled for the effect of exposure to the program, considering the disease type and insurance coverage, using a linear regression model, nearest-neighbor matching, and sensitivity analysis.</p></div><div><h3>Results</h3><p>Among patients exposed to the program, the mean pain score was 2.1/10 (± 1.3) and wellbeing was rated at 3.5/10 (± 1.0), comfort at 1.6/24 (± 1.3), QOL at 3.6/5.0 (± 0.17), and satisfaction at 9.3/100 (± 0.15). The positive changes in these scores were greater for patients who remained in the program for over 3 months. Cost reduction was demonstrated in the last 90 days of life, with statistically significant and chronologically progressive savings during the last 30 days of life exceeding 5 million pesos per patient (<em>P</em> &lt; .05).</p></div><div><h3>Conclusions</h3><p>This study demonstrated the success of PC in reducing pain, improving wellbeing and QOL, providing comfort, and ensuring high levels of satisfaction. Moreover, PC is an effective value-based healthcare strategy and can significantly enhance the efficiency of healthcare services by reducing end-of-life healthcare costs.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101009"},"PeriodicalIF":2.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297958","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}
引用次数: 0
Consensus-Based Recommendations for the Implementation of Health Technology Assessment in the United Arab Emirates 关于在阿拉伯联合酋长国实施卫生技术评估的基于共识的建议
IF 2
Value in health regional issues Pub Date : 2024-06-10 DOI: 10.1016/j.vhri.2024.101012
Khalid A. Alnaqbi MBBS, MSc , Amin Mohamed Elshamy PhD , Nicole Gebran PharmD , Sahar Fahmy PhD , Sara Aldallal MSc , Nada Korra PharmD , Ahmad Nader Fasseeh PhD , Zoltán Kaló PhD
{"title":"Consensus-Based Recommendations for the Implementation of Health Technology Assessment in the United Arab Emirates","authors":"Khalid A. Alnaqbi MBBS, MSc ,&nbsp;Amin Mohamed Elshamy PhD ,&nbsp;Nicole Gebran PharmD ,&nbsp;Sahar Fahmy PhD ,&nbsp;Sara Aldallal MSc ,&nbsp;Nada Korra PharmD ,&nbsp;Ahmad Nader Fasseeh PhD ,&nbsp;Zoltán Kaló PhD","doi":"10.1016/j.vhri.2024.101012","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101012","url":null,"abstract":"<div><h3>Objectives</h3><p>Healthcare research and development have accelerated at an unprecedented rate creating a challenge even for high-income countries to finance all new technologies. Health technology assessment (HTA) aims to maximize health gains out of available resources. Our study aimed to provide tailor-made recommendations for HTA implementation in the United Arab Emirates (UAE).</p></div><div><h3>Methods</h3><p>We conducted a policy survey to explore the gap between the current and preferred future environment of HTA implementation in the UAE. The survey was distributed in 2 workshops discussing the importance of HTA implementation, and results were further aggregated to yield a list of draft recommendations. Recommendations were then assessed for their feasibility in a round table discussion with experts in the field to generate actions for HTA implementation.</p></div><div><h3>Results</h3><p>Survey results and round table discussion indicated the need to leverage HTA for value-based decision making. Experts confirmed the unmet need for broader coverage of graduate and postgraduate HTA training with the aim of specific PhD programs in the UAE. Public funding for HTA appraisals and expanding the scope of HTA to nonpharmaceuticals was recommended. Furthermore, experts recommended that several HTA bodies should be coordinated centrally and highlighted the importance of having an explicit soft cost-effectiveness threshold for common technologies and a higher threshold for orphan drugs.</p></div><div><h3>Conclusions</h3><p>Although HTA in the UAE is still in its early stages, strong initiatives are being taken for its implementation. Our survey results served as a step in developing a detailed action plan for HTA implementation that will enhance the sustainability of the healthcare system.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101012"},"PeriodicalIF":2.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000451/pdfft?md5=edd4ad7c7632fe0e9000228ec749b451&pid=1-s2.0-S2212109924000451-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297833","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}
引用次数: 0
Patient Preferences for Out-of-Hospital Cardiac Arrest Care in South Africa: A Discrete Choice Experiment 南非患者对院外心脏骤停护理的偏好:离散选择实验
IF 2
Value in health regional issues Pub Date : 2024-06-09 DOI: 10.1016/j.vhri.2024.101006
Kalin Werner PhD , Willem Stassen PhD , Elzarie Theron MA , Lee A. Wallis PhD , Tracy K. Lin PhD
{"title":"Patient Preferences for Out-of-Hospital Cardiac Arrest Care in South Africa: A Discrete Choice Experiment","authors":"Kalin Werner PhD ,&nbsp;Willem Stassen PhD ,&nbsp;Elzarie Theron MA ,&nbsp;Lee A. Wallis PhD ,&nbsp;Tracy K. Lin PhD","doi":"10.1016/j.vhri.2024.101006","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101006","url":null,"abstract":"<div><h3>Objective</h3><p>This study examined the trade-offs low-resource setting community members were willing to make in regard to out-of-hospital cardiac arrest care using a discrete choice experiment survey.</p></div><div><h3>Methods</h3><p>We administered a discrete choice experiment survey to a sample of community members 18 years or older across South Africa between April and May 2022. Participants were presented with 18 paired choice tasks comprised of 5 attributes (distance to closest adequate facility, provider of care, response time, chances of survival, and transport cost) and a range of 3 to 5 levels. We used mixed logit models to evaluate respondents’ preferences for selected attributes.</p></div><div><h3>Results</h3><p>Analyses were based on 2228 responses and 40 104 choice tasks. Patients valued care with the shortest response time, delivered by the highest qualified individuals, which placed them within the shortest distance of an adequate facility, gave them the highest chance of survival, and costed the least. In addition, patients preferred care delivered by their family members over care delivered by the lay public. The highest mean willingness-to-pay for increased survival is 11 699 South African rand (ZAR), followed by distance to health facility (8108 ZAR), and response time (5678 ZAR), and the lowest for increasing specialization of provider (1287 ZAR).</p></div><div><h3>Conclusions</h3><p>In low-resource settings, it may align with patients’ preference to include targeted resuscitation training for family members of individuals with high-risk for cardiac arrest as a part of out-of-hospital cardiac arrest intervention strategies.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101006"},"PeriodicalIF":2.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000396/pdfft?md5=908de7dd839dad11e6a6c014a052c2f4&pid=1-s2.0-S2212109924000396-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294851","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}
引用次数: 0
Hospital Healthcare Resource Utilization and Associated Hospital Costs of Patients With Lupus Nephritis in China: A National Administrative Claim Database Study 中国狼疮性肾炎患者的医院医疗资源利用和相关住院费用:全国行政报销数据库研究
IF 2
Value in health regional issues Pub Date : 2024-06-08 DOI: 10.1016/j.vhri.2024.101001
Xin He PhD , Xiaochen Zhu MS , Zhiliu Tang PhD , Kerry Gairy MSc , Patricia Juliao Ph.D , Zongxi Wu BSc , Sheng Han PhD
{"title":"Hospital Healthcare Resource Utilization and Associated Hospital Costs of Patients With Lupus Nephritis in China: A National Administrative Claim Database Study","authors":"Xin He PhD ,&nbsp;Xiaochen Zhu MS ,&nbsp;Zhiliu Tang PhD ,&nbsp;Kerry Gairy MSc ,&nbsp;Patricia Juliao Ph.D ,&nbsp;Zongxi Wu BSc ,&nbsp;Sheng Han PhD","doi":"10.1016/j.vhri.2024.101001","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101001","url":null,"abstract":"<div><h3>Objectives</h3><p>Assess hospital healthcare resource utilization (HCRU) and associated hospital costs of patients with lupus nephritis (LN) in China and compare these outcomes with a systemic lupus erythematosus (SLE) cohort (SLE with/without LN) as well as exploring the effect of end-stage kidney disease (ESKD).</p></div><div><h3>Methods</h3><p>This retrospective administrative claims-based analysis identified patients with SLE and SLE with LN from China using diagnosis codes and keywords. Patients with LN were subcategorized by presence of ESKD. Outcomes included all-cause and disease-specific HCRU (defined as healthcare visits including inpatient and outpatient visits) and medical costs (in 2022 US dollars).</p></div><div><h3>Results</h3><p>In total, 3645 patients with SLE were included, of whom 404 (11%) had LN. Among those with LN, 142 (35%) had ESKD. Median (interquartile range) all-cause healthcare visits per patient per month (PPPM) was significantly greater for patients with LN (2.08 [4.01]) vs SLE (0.92 [1.64]; <em>P</em> &lt; .0001). Patients with LN and ESKD (3.00 [4.18]) had numerically more all-cause healthcare visits PPPM compared with LN patients without ESKD (1.50 [3.45]). Median all-cause costs PPPM were significantly greater among patients with LN ($287.46 [477.15]) vs SLE ($113.09 [267.39]; <em>P</em> &lt; .0001) and numerically higher for patients with LN and ESKD ($466.29 [958.90]) vs LN without ESKD ($223.50 [319.56]).</p></div><div><h3>Conclusions</h3><p>Chinese patients with LN had greater HCRU and hospital healthcare costs compared with the general SLE cohort. This burden was higher for those with ESKD. These data highlight the substantial HCRU among patients with LN in China, especially those with ESKD, suggesting the need for early diagnosis and timely management of LN to mitigate the economic burden.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101001"},"PeriodicalIF":2.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291991","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}
引用次数: 0
Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand 增加大肠癌诊断机会的成本效益:泰国分析
IF 2
Value in health regional issues Pub Date : 2024-06-07 DOI: 10.1016/j.vhri.2024.101010
Peeradon Wongseree MD , Zeynep Hasgul MSc , Mohammad S. Jalali PhD
{"title":"Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand","authors":"Peeradon Wongseree MD ,&nbsp;Zeynep Hasgul MSc ,&nbsp;Mohammad S. Jalali PhD","doi":"10.1016/j.vhri.2024.101010","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101010","url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of this study is to evaluate the cost-effectiveness of increasing access to colorectal cancer (CRC) diagnosis, considering resource limitations in Thailand.</p></div><div><h3>Methods</h3><p>We analyzed the cost-effectiveness of increasing access to fecal immunochemical test screening (strategy I), symptom evaluation (strategy II), and their combination through healthcare and societal perspectives using Colo-Sim, a simulation model of CRC care. We extended our analysis by adding a risk-stratification score (RS) to the strategies. We analyzed all strategies under the currently limited annual colonoscopy capacity and sufficient capacity. We estimated quality-adjusted life-years (QALYs) and costs over 2023 to 2047 and performed sensitivity analyses.</p></div><div><h3>Results</h3><p>Annual costs for CRC care will increase over 25 years in Thailand, resulting in a cumulative cost of 323B Thai baht (THB). Each strategy results in higher QALYs gained and additional costs. With the current colonoscopy capacity and willingness-to-pay threshold of 160 000 THB, strategy I with and without RS is not cost-effective. Strategy II + RS is the most cost-effective, resulting in 0.68 million QALYs gained with additional costs of 66B THB. Under sufficient colonoscopy capacity, all strategies are deemed cost-effective, with the combined approach (strategy I + II + RS) being the most favorable, achieving the highest QALYs (1.55 million) at an additional cost of 131 billion THB. This strategy also maintains the highest probability of being cost-effective at any willingness-to-pay threshold above 96 000 THB.</p></div><div><h3>Conclusions</h3><p>In Thailand, fecal immunochemical test screening, symptom evaluation, and RS use can achieve the highest QALYs; however, boosting colonoscopy capacity is essential for cost-effectiveness.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101010"},"PeriodicalIF":2.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141286193","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}
引用次数: 0
Simplified Chronic Hepatitis B Antiviral Initiation Criteria in Thailand: An Economic Evaluation 泰国简化慢性乙型肝炎抗病毒治疗启动标准:经济评估
IF 2
Value in health regional issues Pub Date : 2024-06-07 DOI: 10.1016/j.vhri.2024.101011
Piyameth Dilokthornsakul PharmD, PhD , Ratree Sawangjit PhD , Pisit Tangkijvanich MD , Maneerat Chayanupatkul MD , Unchalee Permsuwan PhD
{"title":"Simplified Chronic Hepatitis B Antiviral Initiation Criteria in Thailand: An Economic Evaluation","authors":"Piyameth Dilokthornsakul PharmD, PhD ,&nbsp;Ratree Sawangjit PhD ,&nbsp;Pisit Tangkijvanich MD ,&nbsp;Maneerat Chayanupatkul MD ,&nbsp;Unchalee Permsuwan PhD","doi":"10.1016/j.vhri.2024.101011","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101011","url":null,"abstract":"<div><h3>Objectives</h3><p>Criteria for antiviral treatment initiation in Thailand were complex and difficult to implement. This study determined the cost-effectiveness of 2 simplified antiviral treatment initiation criteria among patients with chronic hepatitis B in Thailand.</p></div><div><h3>Methods</h3><p>A hybrid model of the decision tree and Markov model was developed. Two simplified antiviral treatment initiation criteria were the expanded criteria, treating patients with hepatitis B surface antigen positive and viral load (hepatitis B virus deoxyribonucleic acid) &gt;2000 IU/mL or cirrhosis by tenofovir alafenamide (TAF), and the test-and-treat criteria, treating patients with hepatitis B surface antigen positive and viral load &gt;10 IU/mL or cirrhosis by TAF. PubMed was searched from its inception to July 2023 to identify input parameters. Best supportive care was chosen for patients who were ineligible for TAF. Incremental cost-effectiveness ratio per quality-adjusted life-year (QALY) was calculated.</p></div><div><h3>Results</h3><p>The expanded criteria and the test-and-treat could reduce the occurrence of patients progressing to hepatocellular carcinoma. In particular, both criteria could reduce 4846 new cases of hepatocellular carcinoma per 100 000 patients. The incremental cost-effectiveness ratios for the expanded criteria and the test-and-treat criteria were 24 838 Thai baht (THB)/QALY and 163 060 THB/QALY, respectively.</p></div><div><h3>Conclusions</h3><p>At the current willingness to pay of 160 000 THB/QALY, the expanded criteria were cost-effective, but the test-and-treat criteria were not cost-effective to be the simplified antiviral treatment initiation criteria for patients with chronic hepatitis B in Thailand.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101011"},"PeriodicalIF":2.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141286194","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}
引用次数: 0
Societal Preferences for Subsidizing Treatments Targeting Patients With Advanced Illness: A Discrete Choice Experiment 补贴晚期患者治疗的社会偏好:离散选择实验
IF 2
Value in health regional issues Pub Date : 2024-06-04 DOI: 10.1016/j.vhri.2024.101003
Drishti Baid BSocSci , Darius N. Lakdawalla PhD , Eric A. Finkelstein PhD
{"title":"Societal Preferences for Subsidizing Treatments Targeting Patients With Advanced Illness: A Discrete Choice Experiment","authors":"Drishti Baid BSocSci ,&nbsp;Darius N. Lakdawalla PhD ,&nbsp;Eric A. Finkelstein PhD","doi":"10.1016/j.vhri.2024.101003","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101003","url":null,"abstract":"<div><h3>Objectives</h3><p>Cost-effectiveness analyses are increasingly used to inform subvention decisions for moderately life extending treatments but apply several simplifying assumptions that may be inconsistent with public preferences. Contrary to standard assumptions, we hypothesize that societal willingness to allocate public funding toward these treatments is (1) diminishing for incremental improvements in survival and quality of life (QoL) and (2) greater for subvention policies that exclude the oldest old (&gt;80 years).</p></div><div><h3>Methods</h3><p>We tested these hypotheses using a web-based discrete choice experiment (<em>n</em> = 425) in Singapore. In each of 5 questions, respondents were shown 2 hypothetical treatments targeting patients with an expected prognosis of 2 months at very poor QoL and asked which treatment they wanted the government to subsidize, if any. Treatments were defined by 4 attributes: cost to the government, age of beneficiaries, expected gain in survival (2-12 months), and QoL (poor, fair, and good).</p></div><div><h3>Results</h3><p>Latent class models were used to analyze results. Results revealed 2 classes. In the majority class (69.7% of sample), respondents value incremental gains in survival and QoL at a diminishing rate. Their willingness to allocate public funding estimates (Singapore dollars 16 825-91 027 per patient per month) were much higher than traditional cost-effectiveness thresholds. In the second class, respondents were unwilling to subsidize treatments offering less than 2 months of life extension or poor QoL. Neither class preferred subvention policies that exclude the oldest old.</p></div><div><h3>Conclusions</h3><p>These findings suggest that the Singapore government should consider cost-effectiveness thresholds that rise with increases in life extension. Age-based restrictions should not be imposed.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101003"},"PeriodicalIF":2.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244999","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}
引用次数: 0
Long-Term Cost-Effectiveness of Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Adults With Type 1 Diabetes in Iran 伊朗 1 型糖尿病成人持续血糖监测与自我血糖监测的长期成本效益。
IF 2
Value in health regional issues Pub Date : 2024-05-30 DOI: 10.1016/j.vhri.2024.101002
Mohsen Choband Molaee PharmD , Zahra Gharib Naseri PharmD, PhD , Masoud Ali Karami PharmD, PhD
{"title":"Long-Term Cost-Effectiveness of Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Adults With Type 1 Diabetes in Iran","authors":"Mohsen Choband Molaee PharmD ,&nbsp;Zahra Gharib Naseri PharmD, PhD ,&nbsp;Masoud Ali Karami PharmD, PhD","doi":"10.1016/j.vhri.2024.101002","DOIUrl":"10.1016/j.vhri.2024.101002","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to determine long-term cost-effectiveness of continuous glucose monitoring (CGM) technology versus self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes (T1D) using multiple daily injections in Iran.</p></div><div><h3>Methods</h3><p>According to available data, the long-term costs and clinical outcomes of CGM and SMBG were estimated using the Sheffield Type 1 Diabetes Model, with a lifetime horizon from a payer’s perspective. The primary outcome was the cost per quality-adjusted life year (QALY) gained.</p></div><div><h3>Results</h3><p>The lifetime cost-effectiveness analysis demonstrated that on average, the use of CGM increased life expectancy by 1.32 years and QALYs by 1.63, compared with SMBG. The CGM group had an average discounted total cost of $40 093 US dollars, whereas the SMBG group had an average discounted total cost of $13 366. This resulted in an incremental cost-effectiveness ratio (ICER) of $16 386 per QALY gained, which is less than the threshold of 3 times the gross domestic product (GDP) per capita of Iran ($24 561).</p></div><div><h3>Conclusions</h3><p>Considering 3 times the GDP per capita as the threshold, CGM is likely to be cost-effective in Iran. However, for CGM to be very cost-effective (ie, have an ICER less than 1 times the GDP per capita) and presumably more accessible, the price of CGM should decrease to $40 per sensor, each with a lifespan of 14 days.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101002"},"PeriodicalIF":2.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184738","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}
引用次数: 0
Challenges and Reflections on Pandemic Disinformation: The Case of Hydroxychloroquine and the Implications for Global Public Health 大流行病虚假信息的挑战与思考:羟氯喹案例及其对全球公共卫生的影响
IF 2
Value in health regional issues Pub Date : 2024-05-24 DOI: 10.1016/j.vhri.2024.101005
Heslley Machado Silva PhD
{"title":"Challenges and Reflections on Pandemic Disinformation: The Case of Hydroxychloroquine and the Implications for Global Public Health","authors":"Heslley Machado Silva PhD","doi":"10.1016/j.vhri.2024.101005","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101005","url":null,"abstract":"<div><p>This text addresses the implications of misinformation during the COVID-19 pandemic, focusing on the use of hydroxychloroquine (HCQ) and other drugs based on a specific publication. The article titled “Deaths induced by compassionate use of hydroxychloroquine during the first COVID-19 wave: an estimate,” published in 2024 in the journal Biomedicine and Pharmacotherapy, reveals 17 000 deaths associated with the inappropriate use of HCQ in 6 countries, excluding Brazil and India. The dissemination of ineffective drugs, the persistence in recommending HCQ in Brazil, and the lack of an effective response from academia underscore the fragility of public health systems under pressure. Transparent communication between the scientific community and the public is vital, particularly considering studies, such as the one published in Nature Communications in 2021, which warns of the risks of chloroquine. The text highlights the influence of social media in spreading unverified information and emphasizes the need for criminal liability for those contributing to the spread of misinformation. It concludes by underlining the importance of learning from past mistakes to build a more resilient and informed future in the field of public health.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"43 ","pages":"Article 101005"},"PeriodicalIF":2.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089810","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}
引用次数: 0
The Process of Listing Prostheses and Medical Devices in Thailand’s Universal Health Coverage 将假肢和医疗器械列入泰国全民医保的过程
IF 2
Value in health regional issues Pub Date : 2024-05-22 DOI: 10.1016/j.vhri.2024.100990
Manthana Laichapis PharmD , Thanisa Thathong PharmD , Supisara Kanjanaphrut PharmD , Sirada Thansuwanwong PharmD , Yotsaya Kunlamas PharmD , Puree Anantachoti PhD , Bunchai Chongmelaxme PhD
{"title":"The Process of Listing Prostheses and Medical Devices in Thailand’s Universal Health Coverage","authors":"Manthana Laichapis PharmD ,&nbsp;Thanisa Thathong PharmD ,&nbsp;Supisara Kanjanaphrut PharmD ,&nbsp;Sirada Thansuwanwong PharmD ,&nbsp;Yotsaya Kunlamas PharmD ,&nbsp;Puree Anantachoti PhD ,&nbsp;Bunchai Chongmelaxme PhD","doi":"10.1016/j.vhri.2024.100990","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.100990","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to characterize the processes of listing prostheses and medical devices in all insurance schemes.</p></div><div><h3>Methods</h3><p>A literature review was performed, and in-depth interviews were conducted with the representatives of 6 insurance agencies. Civil Servant Medical Benefits Scheme (CSMBS), Social Security Scheme, Local Government Officer Scheme (LGOS), State Enterprise Scheme (SES), Universal Coverage Scheme (UCS), and Non-Thai Resident Scheme (NTRS).</p></div><div><h3>Results</h3><p>The outcomes of interest were structure details and the body of the working groups, listing processes, and key assessment criteria. Each insurance scheme’s process can be summarized in 5 steps: (1) receiving the proposed topics of health technologies, (2) screening, (3) selection, (4) consideration, and (5) approval and publicization. Notably, the organizational structures and working group compositions vary across schemes, leading to differences in process activities and assessment criteria. LGOS and SES are exceptions because they follow the application process of CSMBS. UCS demonstrates the most transparent process, providing specific working groups that are competent in undertaking each activity. The processes of listing prostheses and medical devices vary across health insurance in Thailand, leading to varying numbers of health technologies covered by insurance schemes.</p></div><div><h3>Conclusions</h3><p>This study characterizes prostheses and medical device listing processes in 6 Thai Universal Health Coverage insurance schemes (CSMBS, Social Security Scheme, UCS, LGOS, SES, and Non-Thai Resident Scheme). Variations in processes result in differing technology listings. It offers essential insights for healthcare professionals and policy makers.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100990"},"PeriodicalIF":2.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083347","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}
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