Value in health regional issues最新文献

{"title":"Healthcare Costs of Myocardial Infarction in Denmark: A Nation-Wide Registry-Based Cohort Study","authors":"Kristoffer Jarlov Jensen PhD ,&nbsp;Jedidiah I. Morton PhD ,&nbsp;Marius Mølsted Flege MD ,&nbsp;Janne Petersen PhD ,&nbsp;Zanfina Ademi PhD","doi":"10.1016/j.vhri.2025.101125","DOIUrl":"10.1016/j.vhri.2025.101125","url":null,"abstract":"<div><h3>Objectives</h3><div>Myocardial infarction (MI) is highly detrimental and healthcare intensive with a high incidence globally. This study aimed to estimate the individual healthcare costs of MI in Denmark from a public health provider perspective.</div></div><div><h3>Methods</h3><div>In this nation-wide registry-based cohort study, individuals with incident MI between 2012 and 2016 were propensity score-matched 1:3 with non-MI controls. Excess costs were calculated as costs of patients with MI minus average costs of matched controls, accounting for all individual-level hospital contacts and treatment, primary care, and reimbursed prescription medicine, analyzed as acute or long-term costs in 6-month intervals during 4 years before and 4 years after the MI event. For acute costs and the first 6 months, data were available to extend the cohort period to include index year 2019.</div></div><div><h3>Results</h3><div>In total, 34 310 individuals with a first-time MI were matched to non-MI controls. The mean total acute healthcare cost of first-time MI was €11 462 (95% confidence interval: 11 313-11 612), and cost was €5966 (5788-6145) during the first 6 months, decreasing to €1696 (1565-1827) during the next 6 months. Females with MI incurred 26% lower acute costs and 20% lower excess costs during the first 6 months than males did but higher excess costs than males past 1 year. Costs were highest in people aged 60 to 79 and gradually decreased over the later study years.</div></div><div><h3>Conclusions</h3><div>We found that MI is associated with significant acute and long-term health care costs. With constant or slightly decreasing healthcare expenses on a background of a general decline in MI incidence rates, the total healthcare spendings on MI may decline in the years ahead.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101125"},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906456","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":"Admissions and Deaths Due to Heart Failure and Acute Myocardial Infarction in the State of Minas Gerais: Analysis of Time Series","authors":"Priscila R. Cintra ,&nbsp;Ryan R.O. de Paula ,&nbsp;Luiz O.O. Pala PhD ,&nbsp;Thelma Sáfadi PhD ,&nbsp;Luciano J. Pereira PhD","doi":"10.1016/j.vhri.2025.101123","DOIUrl":"10.1016/j.vhri.2025.101123","url":null,"abstract":"<div><h3>Objectives</h3><div>Cardiovascular diseases (CVDs) are responsible for nearly one-third of the deaths in Brazil. Time-series studies help evaluate the effectiveness of prevention strategies and assist in health planning. Therefore, the aim of this study was to conduct a retrospective temporal analysis, considering sex and comorbidities, of hospitalizations and deaths due to acute myocardial infarction (AMI) and heart failure (HF) among adults over 20 years of age in Minas Gerais from 2016 to 2022.</div></div><div><h3>Methods</h3><div>The data were obtained from the Hospital Information System of the Unified Health System. Seasonal Autoregressive Integrated Moving Average with Exogenous variables models were created to evaluate seasonal components and/or interventions in the time series of deaths.</div></div><div><h3>Results</h3><div>We recorded a total of 90 670 hospitalizations due to AMI, with a case fatality rate of 0.085, and 178 477 hospitalizations due to HF, with a case fatality rate of 0.100. Men predominantly experienced AMI, whereas women predominantly experienced HF. We found that winter periods correlated with an increase in hospitalizations due to AMI and HF. We observed that hospitalizations due to respiratory diseases were associated with a higher risk of CVD. During the pandemic, we observed a reduction in hospitalizations due to CVDs. In September 2020, we observed a significant increase in male deaths due to AMI. Among women, we found an inverse relationship between hospitalizations for AIDS and deaths from HF. Hospitalizations due to HF decreased over time, whereas those for AMI increased.</div></div><div><h3>Conclusions</h3><div>Respiratory diseases were associated with an increased risk of CVD. Winter periods showed an increase in hospitalizations for AMI and HF.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"49 ","pages":"Article 101123"},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906041","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":"Health-Related Quality of Life in Children With Sickle Cell Anemia in Malaria-Endemic Regions: The Impact of Disease States and Malaria Prevention Strategies","authors":"Carol Kamya MPH ,&nbsp;Richard Idro MD, PhD ,&nbsp;Perez Ochanda MA ,&nbsp;Dennis Kalibbala MSc ,&nbsp;Thandile Nkosi-Gondwe PhD ,&nbsp;Pamela R. Akun MA ,&nbsp;Kamija S. Phiri PhD ,&nbsp;Feiko O ter Kuile PhD ,&nbsp;Oddvar Kaarboe PhD ,&nbsp;Bjarne Robberstad PhD","doi":"10.1016/j.vhri.2025.101120","DOIUrl":"10.1016/j.vhri.2025.101120","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the health-related quality of life (HRQoL) of children with sickle cell anemia (SCA) in Uganda and Malawi during steady disease states and sick attacks and to examine the impact of malaria chemoprevention with weekly dihydroartemisinin-piperaquine compared to monthly sulfadoxine-pyrimethamine.</div></div><div><h3>Methods</h3><div>This cohort study was nested within a clinical trial comparing weekly dihydroartemisinin-piperaquine with the standard of care (monthly sulfadoxine-pyrimethamine) among children with SCA. HRQoL was assessed using EQ-5D tools during steady states and sick attacks. Ordinary least squares regression identified factors associated with HRQoL.</div></div><div><h3>Results</h3><div>A total of 633 children with SCA were enrolled (mean age 8.1 years, standard deviation [SD] 3.7). HRQoL was higher during steady states but deteriorated during sick attacks, with the most problems reported in pain and discomfort. Older children (ages 12-16: mean difference [MD] = 0.09, <em>P</em> &lt; .0001) experienced higher HRQoL during steady states but lower HRQoL during sick attacks. Hospitalization negatively affected HRQoL; children hospitalized 1 to 3 times (MD = −0.27, <em>P</em> = .01) or ≥4 times (MD = −0.24, <em>P</em> = .02) had substantially lower HRQoL. There were no HRQoL differences between treatment arms.</div></div><div><h3>Conclusions</h3><div>The HRQoL of children with SCA was relatively high during steady states but declined substantially during sick attacks, especially because of severe pain and discomfort. HRQoL is influenced by a child’s age and frequency of hospitalization. Results provide information for calculation of quality-adjusted life years for future economic evaluation.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101120"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902081","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 Angiotensin Receptor Neprilysin Inhibitor Compared With Angiotensin-Converting Enzyme Inhibitor Among Patients With Heart Failure With Reduced Ejection Fraction in Malaysia","authors":"Wai Chee Kuan BPharm ,&nbsp;Zanfina Ademi PhD ,&nbsp;Sit Wai Lee MMedSc ,&nbsp;Siew Chin Ong PhD ,&nbsp;Kok Han Chee MBBS ,&nbsp;Sazzli Kasim MBChB ,&nbsp;Raja Ezman Raja Shariff MBChB ,&nbsp;Azmee Mohd Ghazi MBChB ,&nbsp;Muhamad Ali S.K. Abdul Kader MD ,&nbsp;Ka Keat Lim PhD ,&nbsp;Siddesh Shetty MD ,&nbsp;Julia Fox-Rushby PhD ,&nbsp;Juman Dujaili PhD ,&nbsp;Kenneth Kwing-Chin Lee PhD ,&nbsp;Siew Li Teoh PhD","doi":"10.1016/j.vhri.2025.101118","DOIUrl":"10.1016/j.vhri.2025.101118","url":null,"abstract":"<div><h3>Objectives</h3><div>This study compared the costs and effectiveness of angiotensin receptor neprilysin inhibitor (ARNI) with angiotensin-converting enzyme inhibitor (ACEI) for the heart failure with reduced ejection fraction population from the Malaysian Ministry of Health’s perspective.</div></div><div><h3>Methods</h3><div>A 3-state Markov model, with a monthly cycle, was constructed to estimate the lifetime healthcare costs, quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) of ARNI and ACEI. The monthly baseline risks for all-cause mortality and heart failure (HF) hospitalization were estimated from the PARADIGM-HF trial and age-adjusted to the Malaysian population. The treatment effects were obtained from the PARADIGM-HF trial. All-cause mortality risks from hospitalization, utility values, and costs were derived from local studies. All costs were adjusted to 2023. The ICER was compared with Malaysian Ringgit (RM) 55 426 per QALY (one gross domestic product per capita).</div></div><div><h3>Results</h3><div>Despite ARNI being more expensive compared with ACEI, it gained more QALYs, resulting in an ICER of RM46 498 per QALY. One-way sensitivity analyses found that the key model drivers were the relative treatment effects on cardiovascular mortality, duration of treatment effects, and time horizon. Probabilistic sensitivity analysis estimated that ARNI is 66% cost-effective at the cost-effectiveness threshold of RM55 426 per QALY. Subgroup analysis showed that ICER increased with age. Scenario analysis demonstrated that initiation of ARNI alongside sodium-glucose cotransporter-2 inhibitor (SGLT-2i) produces more favorable ICER and ARNI without SGLT-2i.</div></div><div><h3>Conclusions</h3><div>At the cost-effectiveness threshold of RM55 426 per QALY, ARNI is cost-effective compared with ACEI for the heart failure with reduced ejection fraction population. Expanding patient access to ARNI is likely to improve health outcomes cost-effectively.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101118"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902080","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 Analyses of Herpes Zoster Vaccines in Patients With Human Immunodeficiency Virus in Thailand","authors":"Nattanichcha Kulthanachairojana PhD ,&nbsp;Jatapat Hemapanpairoa PharmD ,&nbsp;Chanyanoot Santhaveesook PharmD ,&nbsp;Papassara Piboonsatsanasakul PharmD ,&nbsp;Arisa Fueymee PharmD","doi":"10.1016/j.vhri.2025.101119","DOIUrl":"10.1016/j.vhri.2025.101119","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to perform cost-utility and budget impact analyses of zoster vaccine live (ZVL) and recombinant zoster vaccine (RZV) compared with no vaccination in patients infected with human immunodeficiency virus (HIV) in Thailand.</div></div><div><h3>Methods</h3><div>A Markov model was used to estimate costs and outcomes as a quality-adjusted life year from a societal perspective. Costs and outcomes were discounted at 3% per year. Parameters for herpes zoster prevalence and complications were estimated from previous studies. The target population included patients with HIV infection aged ≥18 years with a CD4 count ≥ 200 cells/mm³. Direct medical and nonmedical costs were included in the analysis. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the results. A 5-year budget impact analysis of the vaccination program was performed.</div></div><div><h3>Results</h3><div>The incremental cost-effectiveness ratios of ZVL and RZV compared with no vaccination for patients with HIV infection were $2908.70 and $4391.36 per quality-adjusted life year gain, respectively. ZVL was more likely to be cost-effective. Threshold analysis revealed that RZV could be cost-effective if the cost per dose of RZV was reduced by 0.86%. An additional budget of $15 276 033 for ZVL and $43 338 761 for RZV was estimated to be needed over 5 years.</div></div><div><h3>Conclusions</h3><div>ZVL is cost-effective at the Thai willingness-to-pay threshold for patients with HIV infection aged ≥18 years with a CD4 count ≥ 200 cells/mm³. RZV needs a 0.86% price reduction to be cost-effective. These findings may be useful in evidence-based policymaking.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101119"},"PeriodicalIF":1.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894996","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":"Reviewer Acknowledgment","authors":"","doi":"10.1016/j.vhri.2025.101102","DOIUrl":"10.1016/j.vhri.2025.101102","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101102"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886751","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 Inclisiran for the Treatment of Primary Hypercholesterolemia or Mixed Dyslipidemia in Singapore","authors":"Yan Ling Lim MPH ,&nbsp;Ru-San Tan MBBS ,&nbsp;Kian Keong Poh MB, BChir ,&nbsp;Xiao Jun Wang PhD","doi":"10.1016/j.vhri.2024.101067","DOIUrl":"10.1016/j.vhri.2024.101067","url":null,"abstract":"<div><h3>Objectives</h3><div>This analysis evaluated the cost-effectiveness of inclisiran plus standard of care (SoC; comprising statins, ezetimibe, and fenofibrate) in primary hypercholesterolemia or mixed dyslipidemia from a Singapore healthcare system perspective. Inclisiran + SoC was separately compared with SoC, alirocumab + SoC, and evolocumab + SoC.</div></div><div><h3>Methods</h3><div>A lifetime Markov model in the United Kingdom (UK) was adapted to the Singapore setting. The modeled population (comprising 4 separate subpopulations: “primary prevention heterozygous familial hypercholesterolemia [HeFH],” “secondary prevention HeFH,” “atherosclerotic cardiovascular disease [ASCVD],” “primary prevention with elevated risk”) and efficacy of inclisiran were informed by the ORION-9, ORION-10, and ORION-11 trials. Comparative efficacies of inclisiran versus comparators were informed by a network meta-analysis. Baseline cardiovascular event risks were obtained from a large UK real-world data set and the Netherlands, and UK-based utilities were applied. Baseline population characteristics, distribution of patients in the ASCVD subpopulation, and costs were sourced from local clinicians and published literature. A willingness-to-pay threshold of S$45 000/quality-adjusted life-year (QALY) was selected.</div></div><div><h3>Results</h3><div>Across all subpopulations, inclisiran + SoC resulted in higher QALYs and total costs than SoC (incremental cost-effectiveness ratios, S$35 658-163 896/QALY) and dominated evolocumab + SoC and alirocumab + SoC. At the selected threshold, inclisiran + SoC is cost-effective among patients with ASCVD and secondary prevention HeFH. The deterministic sensitivity analysis found that the model was most sensitive to inclisiran’s acquisition cost and efficacy and rate ratios translating reductions in low-density lipoprotein cholesterol levels to the risk of cardiovascular death.</div></div><div><h3>Conclusions</h3><div>Compared with SoC, evolocumab + SoC, and alirocumab + SoC, inclisiran + SoC is cost-effective in patients with primary hypercholesterolemia or mixed dyslipidemia in Singapore at the selected threshold.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101067"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012493","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":"Diagnosing Burkitt Lymphoma in Sub-Saharan Africa by Sequencing of Circulating Tumor DNA: A Comparative Microcosting Study","authors":"Liz Morrell PhD ,&nbsp;Malale Tungu PhD ,&nbsp;Caroline Achola MMed ,&nbsp;Ismail Legason MSc ,&nbsp;Erick Magorosa MSc ,&nbsp;Priscus Mapendo PGDip ,&nbsp;Leah Mnango MMed ,&nbsp;Alex Mremi PhD ,&nbsp;Heavenlight Christopher MSc ,&nbsp;Emmanuel Josephat MSc ,&nbsp;Adam Burns PhD ,&nbsp;Helene Dreau MSc ,&nbsp;Mihaela Leonte BSc ,&nbsp;Lulu Chirande MMed ,&nbsp;Salama Mahawi MD ,&nbsp;Elifuraha Mkwizu MMed ,&nbsp;Hadija Mwamtemi PhD ,&nbsp;Godlove Sandi MD ,&nbsp;Claire El Mouden PhD ,&nbsp;Anna Schuh PhD ,&nbsp;Sarah Wordsworth","doi":"10.1016/j.vhri.2025.101113","DOIUrl":"10.1016/j.vhri.2025.101113","url":null,"abstract":"<div><h3>Objectives</h3><div>Determining the cost of diagnosis of Burkitt lymphoma by DNA sequencing from a blood sample, compared with current histopathology. Estimating future sequencing costs at increased scale and exploring the effect of positivity rate on per-case cost.</div></div><div><h3>Methods</h3><div>We conducted a microcosting of both diagnostics. Resource use information was derived from standard operating procedures and interviews with staff. Unit cost data were from salary scales, purchase records, and publicly available prices. Costs were collected during 2021 and 2022, in the currency of purchase, and converted to common year (2024) and currency (US dollar [$]), with a discount rate of 5%. For increased scale, we assumed simple scaling up of current sample preparation and higher-capacity sequencing machines running at least once a week to maintain turnaround times.</div></div><div><h3>Results</h3><div>We estimated a cost of $185.01 per patient for histopathology, with the main cost drivers being staining ($87.20, largely immunohistochemistry consumables, including $34.52 for antibodies) and the biopsy procedure ($72.29). The cost of the sequencing-based diagnostic was $710.15 at current throughput, with the largest contribution from the sequencing step because of the cost of sequencing reagents ($175.48 per sample). Costs are sensitive to throughput, reagent costs, and efficiency of utilization of equipment. At the current prevalence, cost per positive case is 2-fold higher at a positivity rate of 25% compared with 75%.</div></div><div><h3>Conclusions</h3><div>With the current technology and throughput, sequencing is likely to increase the cost of diagnosis compared with current pathology. Costs will reduce with increased scale, which requires establishing local reagent supply and maintenance capability.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101113"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807358","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":"Public Preferences for Reducing Health Inequality in Japan: A National Survey.","authors":"Kyoko Shimamoto, Tim Doran, Richard Cookson","doi":"10.1016/j.vhri.2025.101111","DOIUrl":"https://doi.org/10.1016/j.vhri.2025.101111","url":null,"abstract":"<p><strong>Objectives: </strong>Making health programs more equitable sometimes reduces their health benefit per unit of cost. Policy makers therefore need to understand public preferences for reducing health inequalities; however, this evidence has been restricted to Europe, with no estimates available in Asia. Thus, this study aimed to gauge health inequality aversion in Japan in comparison with the UK populations.</p><p><strong>Methods: </strong>National online survey of Japanese adults (aged 18-69), using a Japanese version of a UK benefit trade-off questionnaire, involving pairwise policy choices with different levels of health benefit and inequality. Attitudes toward reducing health inequality were classified using the same approach as the original UK study. Regression analyses were conducted to explore heterogeneity by age, gender, income, education, and geographic region.</p><p><strong>Results: </strong>On average, respondents in the analytic sample (n = 473) weighed health gains to the poorest fifth of people approximately 6 times more highly than health gains to the richest fifth; 76.9% had positive health inequality aversion. Health inequality aversion was higher in the poorest fifth of respondents and in the northern region of Japan, but otherwise was not closely correlated with other characteristics. There was a higher proportion of invalid responses in Japan (67.9%) than the United Kingdom (47.0%).</p><p><strong>Conclusions: </strong>Most people in Japan appear willing to forgo gains in total population health to reduce health inequality, such as in the United Kingdom. However, more research is needed to understand the high rate of inconsistent responses to the online version of this questionnaire, which was even higher in Japan than in the United Kingdom.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101111"},"PeriodicalIF":1.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781346","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 Mammography-Based Breast Cancer Screening in Indonesia","authors":"Ajeng V. Icanervilia PhD ,&nbsp;Keris Poelhekken MSc ,&nbsp;Jarir At Thobari PhD ,&nbsp;Lina Choridah PhD ,&nbsp;Susanna H. Hutajulu PhD ,&nbsp;Geertruida H. de Bock PhD ,&nbsp;Maarten J. Postma PhD ,&nbsp;Marcel J.W. Greuter PhD ,&nbsp;Antoinette D.I. van Asselt PhD","doi":"10.1016/j.vhri.2025.101112","DOIUrl":"10.1016/j.vhri.2025.101112","url":null,"abstract":"<div><h3>Objectives</h3><div>The Indonesian government has not implemented mammography as national screening program. Therefore, we evaluated the cost-effectiveness of mammography-based breast cancer screening strategy in Indonesia from a societal perspective.</div></div><div><h3>Methods</h3><div>The Simulation Model on radiation Risk and breast cancer Screening was used to examine various breast cancer screening scenarios, including different screening age (40-65 vs 35-65 years), frequency (every 2, 3, 4, or 5 years), and participation rate (50%, 70%, and 100%). The model’s input parameters were independently derived from published population statistics and systematic literature.</div></div><div><h3>Results</h3><div>Our findings indicate that, across all scenarios, mammography screening was cost-effective compared with no screening under the following conditions: (1) screening women aged 40 to 65 every 4 years at 50% participation rate, (2) screening women aged 40 to 65 every 4 years at 70% participation rate, (3) screening women aged 40 to 65 every 3 years at 70% participation rate, and (4) screening women aged 40 to 65 every 2 years at 100% participation rate. The incremental cost-effectiveness ratios these scenarios compared with the next best alternative were $4758 per life year gained (US dollars/LYG), $5263/LYG, $5436/LYG, and $7569/LYG, respectively, all of which were less than 3 times Indonesia’s gross domestic product per capita.</div></div><div><h3>Conclusions</h3><div>We recommend implementing mammography screening as a national program in Indonesia. The cost-effectiveness of screening strategies depends on factors such as participation rates, screening age, frequency, and the government’s willingness-to-pay threshold. We recognize Indonesia’s competing health priorities and limited resources. Acknowledging these priorities will help policymakers in making informed decisions about resource allocation.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101112"},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761153","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}