Value in health regional issues最新文献

{"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}

{"title":"Breast Cancer Screening Using Clinical Breast Examination: A Cost-Effectiveness Analysis for South Africa","authors":"Sithabiso D. Masuku MSc ,&nbsp;Olena Mandrik PhD ,&nbsp;Noreen D. Mdege PhD ,&nbsp;Gauravi Mishra MD ,&nbsp;Richard Muwonge PhD ,&nbsp;Gesine Meyer-Rath PhD ,&nbsp;Naomi Lince-Deroche PhD ,&nbsp;Alan Brennan PhD","doi":"10.1016/j.vhri.2025.101127","DOIUrl":"10.1016/j.vhri.2025.101127","url":null,"abstract":"<div><h3>Objectives</h3><div>The World Health Organization emphasizes screening and early diagnosis to reduce advanced cancer incidence and mortality. In low-to-middle-income countries, breast cancer (BC) survival rates are low because of late detection. South Africa’s policy recommends twice-yearly clinical breast examinations (CBEs) for asymptomatic women aged 40 to 69. We assessed the impact of scaling up CBE screening on mortality and cost-effectiveness.</div></div><div><h3>Methods</h3><div>Using trial data on downstaging, we compared the current baseline (5% coverage) with scenario 1 (25% coverage by year 5 [ie, 5% increase annually]) and scenario 2 (75% coverage by year 5, [ie, 17.5% increase annually]). A cohort model tracked women from screening to diagnosis, estimating downstaging’s impact on BC cases over their lifetime. Costs from the healthcare payer’s perspective are presented in 2022 US dollars.</div></div><div><h3>Results</h3><div>Five-year screen detection rates were 2.39 and 2.08 per 1000 women screened for scenarios 1 and 2, respectively. Scenario 1 reduced BC mortality by 0.7% and scenario 2 by 2.3%. Compared with no screening, the current baseline screening program averts 1645 disability-adjusted life years (DALYs) at $20 341/DALY averted. Scenario 1 averted 3823 DALYs with economic efficiency improving to $17 776/DALY averted, whereas scenario 2 averted 12 165 DALYs at $19 552/DALY averted.</div></div><div><h3>Conclusions</h3><div>CBE scale-up effectively saves life years but is not cost-effective under the country’s opportunity cost-derived threshold of $3015/DALY averted. However, decisions on the best screening policy are not solely based on cost-effectiveness. They involve careful consideration of budgetary constraints and competing healthcare priorities. Scale-up should consider system capacity, minimum care standards and cost-effective early detection strategies.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101127"},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154510","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":"Evaluating the Cost-Effectiveness of Pharmacological Therapy in Alzheimer Disease in Brazil","authors":"Price Udo Price PhD ,&nbsp;Robert Heggie PhD ,&nbsp;Julio Cesar Moriguti PhD ,&nbsp;Leonardo Regis Leira Pereira PhD","doi":"10.1016/j.vhri.2025.101130","DOIUrl":"10.1016/j.vhri.2025.101130","url":null,"abstract":"<div><h3>Objectives</h3><div>Alzheimer disease (AD) is a worsening neurodegenerative disorder and the leading cause of dementia, accounting for 60% to 70% of cases. It contributes significantly to disability, caregiver reliance, and is the eighth leading cause of death. AD is one of the most expensive diseases to treat, creating an economic burden for the healthcare system and families of patients. Dementia care costs in Brazil are projected to reach $49.2 billion by 2030, $63.5 billion by 2040, and $77.3 billion by 2050. This study evaluated the cost-effectiveness of acetylcholinesterase inhibitors (standard of care [SoC]) in slowing disease progression compared with no pharmacological therapy (best supportive care [BSC]), lecanemab, and donanemab in mild AD patients.</div></div><div><h3>Methods</h3><div>We developed a decision-analytic model to simulate AD progression, using cost and health utility data specific to Brazil, supplemented with data from the literature when necessary. The model covers a 20-year horizon from both the Brazilian national healthcare system and societal perspectives. Costs and quality-adjusted life years (QALYs) were discounted at 3.5% per year to reflect their present value. Costs in local currencies were converted to US dollars (US$) and inflation-adjusted to 2024 values.</div></div><div><h3>Results</h3><div>In the base-case analysis from the healthcare perspective, SoC was more clinically effective than BSC with a cost per QALY of $5211. For lecanemab versus SoC, the cost per QALY gained was $2 098 225, whereas donanemab versus lecanemab was $1 460 400.</div></div><div><h3>Conclusions</h3><div>The SoC is a cost-effective pharmacological intervention for AD, offering the lowest cost per QALY gains over a 20-year period.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101130"},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154511","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 20-Valent Pneumococcal Conjugate Vaccine in Adults Aged ≥18 Years in Singapore","authors":"Jingwen Zhang PhD ,&nbsp;Jeffrey Vietri PhD ,&nbsp;Ahuva Averin MPP ,&nbsp;Dhwani Hariharan PhD ,&nbsp;Mark Atwood MS ,&nbsp;Liping Huang MD","doi":"10.1016/j.vhri.2025.101136","DOIUrl":"10.1016/j.vhri.2025.101136","url":null,"abstract":"<div><h3>Objectives</h3><div>The Singapore Ministry of Health recommends vaccination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) in adults aged 18 to 64 years with chronic medical conditions (“at risk”), 13-valent pneumococcal conjugate vaccine (PCV13) followed by PPSV23 (PCV13 → PPSV23) with PPSV23 revaccination in adults aged 18 to 64 years with immunocompromising conditions (“high risk”), and PCV13 → PPSV23 in all adults aged ≥65 years. We conducted a cost-effectiveness analysis of the newly licensed 20-valent PCV (PCV20) versus current recommendations.</div></div><div><h3>Methods</h3><div>Risks and costs of invasive pneumococcal disease, all-cause nonbacteremic pneumonia, and the expected impact of vaccination were projected over a lifetime modeling horizon using a probabilistic cohort model. Model inputs were based on local data, as available. Cost per quality-adjusted life year (QALY) gained with PCV20 (vs current recommendations) was assessed overall and among subgroups of the target population from a healthcare system perspective (discounting, 3%/year). Sensitivity analyses were also conducted.</div></div><div><h3>Results</h3><div>PCV20 was estimated to reduce invasive pneumococcal disease cases by 41, nonbacteremic pneumonia cases by 4335, and deaths by 196 among the model population (<em>N</em> = 1.6M). Net costs (vaccination + medical) and QALYs increased by S$0.3 million and 2693, respectively, yielding a cost/QALY of S$105 for PCV20. PCV20 was dominant among high-risk adults aged 18 to 64 years and all adults 65 to 99 years; among at-risk adults aged 18 to 64 years, cost/QALY for PCV20 was S$2081. PCV20 remained cost saving or highly cost-effective in sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Cost-effectiveness analysis suggests use of PCV20—in lieu of current Singapore Ministry of Health recommendations for adult pneumococcal vaccination—would represent a cost-effective use of scarce healthcare resources.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101136"},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116911","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 an Enhanced Patient Care Intervention for Improving Viral Suppression Among Kenyan Adults Living With HIV","authors":"Jenna Fritz MPH ,&nbsp;Juddy Wachira PhD ,&nbsp;Marta Wilson-Barthes MSPH ,&nbsp;Catherine Kafu PhD ,&nbsp;Diana Chemtai BS ,&nbsp;Becky Genberg PhD ,&nbsp;Omar Galárraga PhD","doi":"10.1016/j.vhri.2025.101129","DOIUrl":"10.1016/j.vhri.2025.101129","url":null,"abstract":"<div><h3>Objectives</h3><div>Patient-centered interventions can improve care engagement and treatment adherence for people living with HIV (PLWH). Yet, evidence on their cost-effectiveness remains sparse, hindering their prioritization over alternative models. This study estimated the cost-effectiveness of a patient-centered intervention for improving viral suppression among PLWH in western Kenya.</div></div><div><h3>Methods</h3><div>We analyzed the cost-effectiveness of an enhanced patient-centered (EPC) intervention via a randomized pilot trial among 328 PLWH in 2 rural clinics. The EPC arm included clinician-patient continuity, treatment dialogue, and flexible scheduling. The provider-patient communication (PPC) arm provided training on motivational interviewing. The standard of care arm provided patient-specific interventions to promote viral suppression. Costs were aggregated across the 2 clinics and measured from a societal perspective, including patient time, transportation, and medication. The incremental cost per disability-adjusted life year averted was calculated based on patient virologic failure risk, HIV transmissions averted, and life expectancy. Key parameters were varied by ±25% to examine uncertainty in incremental cost-effectiveness ratios.</div></div><div><h3>Results</h3><div>Compared with standard HIV care, both the EPC intervention and PPC training alone were more cost-effective at various willingness-to-pay thresholds. Providing PPC training alone was the dominant strategy (more effective and less costly) compared with the EPC intervention at $97.72 per HIV infection averted and $4.44 per disability-adjusted life year averted. Both interventions were cost savings when factoring in lifetime HIV treatment cost averted.</div></div><div><h3>Conclusions</h3><div>Patient-centered care models may be highly cost-effective for improving treatment outcomes among PLWH. These encouraging results warrant further testing in fully powered clinical trials.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101129"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105620","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 ‘Cost-Utility Analysis and Efficiency Frontier of Drugs Available in Brazil for the Treatment of Relapsing-Remitting Multiple Sclerosis’","authors":"","doi":"10.1016/j.vhri.2025.101141","DOIUrl":"10.1016/j.vhri.2025.101141","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101141"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090384","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":"Author Reply: Savings Through Telemedicine: Initial Data From a Hospital-at-Home Program","authors":"Angus Jun Jie Ng BSc ,&nbsp;Chong Yau Ong MMed","doi":"10.1016/j.vhri.2025.101134","DOIUrl":"10.1016/j.vhri.2025.101134","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101134"},"PeriodicalIF":1.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071806","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}