Value in health regional issues最新文献

{"title":"Cost-Effectiveness Analysis of Idursulfase for the Long-Term Treatment of Hunter Syndrome Using a Partitioned-Survival Model Approach in R","authors":"Khairu Hazwan Mustaffa MSc ,&nbsp;Asrul Akmal Shafie PhD ,&nbsp;Lock-Hock Ngu MBBS ,&nbsp;Rowani Mohd-Rawi MBBS","doi":"10.1016/j.vhri.2025.101089","DOIUrl":"10.1016/j.vhri.2025.101089","url":null,"abstract":"<div><h3>Objectives</h3><div>Hunter syndrome is among the costliest life-long genetic conditions associated with a substantial burden-of-illness and a significant impact on the health systems, families, and society. We estimated the cost-effectiveness of long-term enzyme replacement therapy with idursulfase versus the standard of care from a societal perspective using a streamlined modeling strategy in R.</div></div><div><h3>Methods</h3><div>A de novo 4-state partitioned survival model was developed to compare lifetime cost and outcomes of 2 care models operationalized in R. The disease progression was based on independent survival modeling of relevant Kaplan-Meier data. The healthcare and out-of-pocket costs were drawn from the local setting. The quality of life was measured using the EQ5D5L and the time trade-off valuation of health-state vignettes that match the states in the model. Probabilistic and deterministic sensitivity analyses were conducted to test the uncertainty around the model results.</div></div><div><h3>Results</h3><div>The lifetime incremental quality-adjusted life years were 4.1 years (95% CI, 2.37-5.68). Incremental costs were estimated to be $9.5 million (95% CI, 9.0 million-10.0 million), which primarily consists of drug costs (99%). The incremental costs per quality-adjusted life year were estimated to be approximately $2.4 million (95% CI, 1.7 million-3.8 million). Sensitivity analyses showed that the key drivers of incremental cost-effectiveness ratio were quality of life in the preprogression state and differential discounting approach, besides the acquisition cost of enzyme replacement therapy of idursulfase.</div></div><div><h3>Conclusions</h3><div>The incremental cost-effectiveness ratios were beyond any conventionally used cost-effectiveness threshold in all cases. At the current price, there is a significant discrepancy between the therapy’s funding decision and the cost-effectiveness assessment as a basis for guiding healthcare prioritization in Malaysia.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101089"},"PeriodicalIF":1.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437615","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":"Budget Impact Analysis of Intravitreal Injections Used to Treat Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema in the Dubai Healthcare System","authors":"Sara Al Dallal MSc ,&nbsp;Ahmed El Khashab ,&nbsp;Rao Prasan ,&nbsp;Amar Safar ,&nbsp;Mahmoud Wael MEc ,&nbsp;Fadwa Abdellatif MSc ,&nbsp;Ahmed Ibrahim","doi":"10.1016/j.vhri.2025.101083","DOIUrl":"10.1016/j.vhri.2025.101083","url":null,"abstract":"<div><h3>Objectives</h3><div>With the rising prevalence of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME), this study assesses the budget impact of current intravitreal injections (faricimab, brolucizumab, ranibizumab, and aflibercept) on Dubai’s private sector. The aim is to identify the most cost-effective intervention by evaluating utilization costs based on injection frequencies and direct acquisition expenses.</div></div><div><h3>Methods</h3><div>An Excel-based budget impact model, aligned with the current standard of care, incorporates direct medical costs only, acquisition prices of the 4 interventions, procedure costs, optical coherence tomography diagnosis and consultation visit costs, and average administration costs in Dubai’s healthcare system. Local experts’ opinions shape the clinical approach and costs. The model spans a 5-year horizon, considering a complete replacement or gradual increase in faricimab uptake. One-way sensitivity analysis ensures outcome robustness.</div></div><div><h3>Results</h3><div>The model, based on an estimated prevalence of 722 nAMD patients and 14 885 DME patients, projects faricimab’s growing market share yielding estimated total savings of 402 908 275 Arab Emirates Dirham over 5 years compared with current market shares. The savings stem from faricimab’s lower injection frequency and acquisition cost in managing DME and nAMD in Dubai’s healthcare system.</div></div><div><h3>Conclusions</h3><div>Increasing faricimab uptake promises substantial budget savings. Decision makers in Ophthalmology Care in the United Arab Emirates can efficiently allocate resources by endorsing faricimab as the primary treatment for nAMD and DME based on these findings.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101083"},"PeriodicalIF":1.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444422","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":"Comparing the Measurement Properties of the Preliminary Version of the EuroQol Health and Well-Being and EQ-5D-5L in Patients, Healthy General Public, and Caregivers","authors":"Guangjie Zhang MSc ,&nbsp;Zhihao Yang PhD ,&nbsp;Nan Luo PhD ,&nbsp;Jan Busschbach PhD","doi":"10.1016/j.vhri.2025.101081","DOIUrl":"10.1016/j.vhri.2025.101081","url":null,"abstract":"<div><h3>Objectives</h3><div>The EuroQol Health and Well-Being (EQ-HWB) is a new generic quality of life (QOL) questionnaire to capture broader aspects of health and well-being than EQ-5D-5L. This study examined the measurement properties of the preliminary EQ-HWB version in patients, healthy individuals, and healthy caregivers.</div></div><div><h3>Methods</h3><div>Respondents (1) with or without caregiver tasks, (2) with different diseases, or (3) in full health were recruited online. Ceiling effects, convergent and divergent validity, known disease, and caregiver group differences were explored, and an exploratory factor analysis was used.</div></div><div><h3>Results</h3><div>A total of 500 respondents were recruited, including 100 healthy individuals (excluding 40 healthy caregivers), 122 with chronic hepatitis B, 101 with HIV/AIDS, 107 with depression, and 90 with generalized anxiety disorder. The EQ-HWB activities dimension correlated most highly with the EQ-5D-5L mobility, self-care, and usual activities dimensions, whereas EQ-HWB physical sensation dimension was strongly related to the EQ-5D-5L pain/discomfort dimension. Additional EQ-HWB dimensions (self-identity, cognition, autonomy, feelings and emotions, and relationships) aligned most closely with the EQ-5D-5L anxiety/depression dimension. Both instruments differentiated disease burden across healthy individuals and patients and identified caregiving roles. The EQ-5D-5L revealed 3 factors in exploratory factor analysis, whereas the EQ-HWB included 2 additional factors (F1 cognition, F2 physical activity, F3 feelings and emotions, F4 positive items, and F5 physical sensation).</div></div><div><h3>Conclusions</h3><div>EQ-HWB is able to measure health-related QOL in healthy people, patients, and caregivers given that it shares the same conceptual structure with EQ-5D. EQ-HWB is more sensitive in patients with mental health conditions than the EQ-5D. These results support that EQ-HWB captures well-being alongside health-related QOL.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101081"},"PeriodicalIF":1.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419443","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-Effectiveness Analysis of Upadacitinib in Patients With Moderately to Severely Active Ulcerative Colitis in Greece","authors":"Charalampos Tzanetakos MSc ,&nbsp;Marina Psarra MSc ,&nbsp;Ilias Kotsis MSc ,&nbsp;George Gourzoulidis MSc","doi":"10.1016/j.vhri.2025.101091","DOIUrl":"10.1016/j.vhri.2025.101091","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the cost-effectiveness of upadacitinib in patients with moderately to severely active ulcerative colitis (UC), who have had an inadequate response, lost response, or were intolerant to either conventional therapy (bio-naïve) or a biologic agent (bio-exposed), in Greece.</div></div><div><h3>Methods</h3><div>A cost-effectiveness model, consisting of an 8-week decision tree model (induction period) and a long-term Markov state-transition model with a 4-week cycle length (maintenance period), was locally adapted from a public payer perspective over the patient’s lifetime. Upadacitinib was compared with other UC marketed biologics and small molecule agents in Greece. Clinical and utility data were retrieved from published literature. Direct costs pertaining to drug acquisition, administration, disease management, and adverse events were considered in the analysis. All cost inputs were indexed to 2023 euros. Model outcomes were patients’ quality-adjusted life-years (QALYs), total costs, and incremental cost-effectiveness ratios (ICERs).</div></div><div><h3>Results</h3><div>In the bio-naïve population, compared with adalimumab, golimumab, infliximab, ozanimod, tofacitinib, ustekinumab, and vedolizumab, upadacitinib was found to be more effective (QALY gains: 0.833, 0.670, 0.671, 0.783, 0.314, 0.577, and 0.522, respectively) and cost-effective (ICERs: €18 618, €21 682, €17 864, €15 637, €30 061, €12 776, and €16 263, respectively). In the bio-exposed population, compared with adalimumab, ozanimod, tofacitinib, ustekinumab, and vedolizumab, upadacitinib demonstrated again a more effective (QALY gains: 0.784, 0.697, 0.514, 0.723, and 0.719, respectively) and cost-effective profile (ICERs: €16 396, €13 661, €17 074, €10 975, and €13 881, respectively).</div></div><div><h3>Conclusions</h3><div>Upadacitinib was estimated to be the most effective and cost-effective treatment among all advanced treatments for moderately to severely active UC in Greece.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101091"},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419610","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-Effectiveness of Mineralocorticoid Receptor Antagonists in Ischemic and Nonischemic Heart Failure With Reduced Ejection Fraction: Perspective From a Universal Healthcare System","authors":"Cristiane Koeche BPharm, MSc ,&nbsp;Ana Claudia Cavalcante Nogueira MD, MSc ,&nbsp;Giselle Pinto da Silva Amaral MD ,&nbsp;Adriana J.B.A. Guimarães MD, PhD ,&nbsp;Yasmim Botelho Neiva ,&nbsp;Alexandre Magno Oliveira de Souza ,&nbsp;Marta Duran Fernandez MSc ,&nbsp;Luís Eduardo Rohde MD, PhD ,&nbsp;Andrei C. Sposito MD, PhD ,&nbsp;Luiz Sérgio F. de Carvalho MD, PhD","doi":"10.1016/j.vhri.2025.101084","DOIUrl":"10.1016/j.vhri.2025.101084","url":null,"abstract":"<div><h3>Objectives</h3><div>Mineralocorticoid receptor antagonists (MRAs) are cornerstones in the management of heart failure (HF) with reduced ejection fraction (HFrEF). New MRAs with improved safety profile, such as finerenone and eplerenone, were recently introduced. However, because of typical budget restrictions in middle-income countries, evaluating their cost-effectiveness is essential for optimizing treatment strategies.</div></div><div><h3>Methods</h3><div>We used a Bayesian network and Markov influence diagrams to estimate the incremental cost-effectiveness ratios (ICERs) in international dollars (Int$) per quality-adjusted life-year (QALY). Our model was fed by a systematic review and a network meta-analysis to compare MRAs effectiveness and used data from a cohort of 1066 Brazilian individuals with HFrEF (36% with ischemic and 64% with nonischemic disease).</div></div><div><h3>Results</h3><div>Over a 10-year time horizon, the treatment with spironolactone, eplerenone, and finerenone compared with no MRA utilization yielded discounted QALY per person of 0.072, 0.111, and 0.034, respectively. The ICERs were Int$7955, Int$6460, and Int$109 840 per QALY gained, respectively. Compared with spironolactone, eplerenone showed an ICER of Int$6178 per QALY gained. Assuming a willingness-to-pay threshold of 1 Brazilian per capita gross domestic product (Int$17 589) per QALY gained, the probabilistic sensitivity analyses suggest that spironolactone and eplerenone were cost-effective, respectively, in 87% and 92% of iterations. The 95% CIs were Int$2282 to Int$13 149 for spironolactone and Int$1795 to Int$12 351 for eplerenone per QALY gained. These findings were consistent across several scenarios including ischemic/nonischemic HF.</div></div><div><h3>Conclusions</h3><div>Eplerenone is likely the most cost-effective MRA in Brazil considering individuals with both ischemic and nonischemic HFrEF.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101084"},"PeriodicalIF":1.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394897","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":"Valuing an Index of Sanitation-Related Quality of Life in Urban Mozambique: A Discrete Choice Experiment","authors":"Patrick V. Katana MSc ,&nbsp;Neiva Banze MD ,&nbsp;Cremildo Manhiça BSc ,&nbsp;Catildo Cubai BSc ,&nbsp;Lucia Viera MD ,&nbsp;Edi Fulai MD ,&nbsp;Oliver Cumming MSc ,&nbsp;Edna Viegas PhD ,&nbsp;Igor Capitine PhD ,&nbsp;Ian Ross PhD","doi":"10.1016/j.vhri.2025.101087","DOIUrl":"10.1016/j.vhri.2025.101087","url":null,"abstract":"<div><h3>Objectives</h3><div>A total of 1.5 billion people live without basic sanitation. A 5-attribute index of sanitation-related quality of life (SanQoL-5) has been applied in 9 countries. SanQoL-5 attributes and their levels require weighting (valuation), with the resulting index ranging from 0 to 1. To date, SanQoL-5 valuation applied simple methods such as rank sum, not robust methods such as discrete choice experiment (DCE). We aimed to value SanQoL-5 using a DCE in urban Mozambique.</div></div><div><h3>Methods</h3><div>We enrolled 601 adults in the cities of Maputo and Dondo, sampling women and men equally. The DCE task was a choice of which was “better” among 2 combinations of SanQoL-5 attribute levels (always, sometimes, never). Each respondent completed 10 tasks and a dominance test. After fitting a mixed logit model, we rescaled coefficients to derive the index.</div></div><div><h3>Results</h3><div>The highest-valued attribute was disgust (“never feel disgusted while using the toilet”) at 0.25. The other attributes had similar values (ranging 0.18-0.19). People valued “sometimes” levels at approximately 60% of “never” levels. Therefore, moving from the middle level to the worst involves a larger decrement than moving from the best to the middle. Mean SanQoL-5 by toilet type followed a gradient with Sustainable Development Goal 6 categories: “open defecation” 0.30, “unimproved” 0.45, “limited” 0.60, and “at least basic” 0.70.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first DCE-based valuation of any index of sanitation-related quality of life, enabling SanQoL-5 to be used in economic evaluation. Identifying sanitation service transitions associated with the greatest quality of life gains could inform more efficient resource allocation.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101087"},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387548","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":"Effects of Reimbursement Add-On Policies on Trastuzumab and Bevacizumab Biosimilar Adoption in a Japanese Oncology Setting","authors":"Hiroaki Mamiya PhD, MPH ,&nbsp;Toshiki Fukasawa PhD ,&nbsp;Koji Kawakami MD, PhD","doi":"10.1016/j.vhri.2025.101090","DOIUrl":"10.1016/j.vhri.2025.101090","url":null,"abstract":"<div><h3>Objectives</h3><div>The Japanese government has introduced reimbursement incentive policies designed to promote biosimilar adoption for oncology biologics, including the provision of a financial incentive of ¥1500 (approximately $10) per prescription to physicians who prescribe biosimilars. This study aimed to evaluate the impact of Japan’s reimbursement policies on the uptake of oncology biosimilars, specifically trastuzumab and bevacizumab, in the outpatient setting.</div></div><div><h3>Methods</h3><div>We conducted an interrupted time series analysis using the health insurance claims database to assess the impact of the policy on biosimilar uptake, comparing trends before and after the policy intervention.</div></div><div><h3>Results</h3><div>The analysis incorporated 22 440 trastuzumab and 14 022 bevacizumab claims. For trastuzumab, interrupted time series analysis showed a significant slope change after policy implementation, with a slope change of 0.33% per month (95% CI 0.07-0.58). In contrast, bevacizumab did not exhibit significant changes in slope or level postintervention; however, its biosimilar uptake steadily increased over the entire study period.</div></div><div><h3>Conclusions</h3><div>This study suggests that reimbursement incentives have significantly enhanced the uptake of trastuzumab biosimilars in Japan, whereas bevacizumab has not exhibited a similar response. Given these findings, it is crucial for policy makers to design reimbursement strategies that are specifically tailored to the characteristics of each biosimilar to optimize their effectiveness.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101090"},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388306","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":"Life With Cystic Fibrosis: The Socioeconomic Impact on Patients and Their Caregivers","authors":"Tomas Mlcoch MSc ,&nbsp;Barbora Decker PhD ,&nbsp;Jan Tuzil PhD ,&nbsp;Barbora Turkova MSc ,&nbsp;Katerina Doleckova MSc ,&nbsp;Barbora Koznarova MSc ,&nbsp;Simona Zabranska MSc ,&nbsp;Tereza Blazkova MSc ,&nbsp;Helena Dolezal MSc ,&nbsp;Barbora Pilnackova MSc ,&nbsp;Tomas Dolezal PhD","doi":"10.1016/j.vhri.2025.101085","DOIUrl":"10.1016/j.vhri.2025.101085","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to provide the first evidence of the socioeconomic burden of cystic fibrosis (CF) in Czechia.</div></div><div><h3>Methods</h3><div>In a cross-sectional questionnaire-based primary data collection conducted from 2020 to 2021 among Czech patients with CF, we collected demographic, clinical, and healthcare resource use data, out-of-pocket and social transfer costs, and questionnaires: Cystic Fibrosis Questionnaire-Revised, Work Productivity and Activity Impairment, EQ-5D, and Zarit Burden Interview. Productivity loss/costs were assessed using the human capital approach with patient patient-assumed life expectancy of 45 years and caregiver retirement age of 64 years and discounted by 3%.</div></div><div><h3>Results</h3><div>A total of 257 patients completed the questionnaires (37% of the Czech CF population). The average age was 17 years; most were females (59%), and the average forced expiratory volume in 1 second was 81.4% (SD 25.4%). A total of 107 patients had caregivers with an average age of 39 years and a significant caregiver time burden (extra 4.6 hours/day). The average Zarit Burden Interview score (25.4) was comparable with advanced cancer, dementia, or Duchenne muscular dystrophy. The proportion of unemployed caregivers was 10× higher than the general population (31% vs 3.2%). Total out-of-pocket family costs related to CF were €278/month, mainly for medicines (€105), foods (€73), and transport (€59); 25% received a disability pension and 18% other social security benefits. The work impairment of employed patients and caregivers was 25% and 15%, respectively, mostly due to presenteeism. Total lifetime productivity costs extrapolated to all Czech patients with CF (n = 687) and their caregivers were €155 181 286 (€225 883/person).</div></div><div><h3>Conclusions</h3><div>The societal burden imposed on Czech patients with CF and their caregivers is significant. Caregivers seem to be affected by higher disease activity more than patients.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101085"},"PeriodicalIF":1.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377597","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-Effectiveness Analysis of Pharmacological Treatment With Insulin and Insulin Analogs for Type 1 and Type 2 Diabetes Mellitus in Colombia","authors":"Luis Esteban Orozco Ramirez MSc ,&nbsp;Diego Fernando Ávila Ibáñez MSc ,&nbsp;Christian Camilo Anzola Morales MSc ,&nbsp;Luz Karime Osorio Arango MSc ,&nbsp;Merideidy Plazas MSc ,&nbsp;Ivan Darío Escobar END","doi":"10.1016/j.vhri.2024.101073","DOIUrl":"10.1016/j.vhri.2024.101073","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to estimate the cost-effectiveness relationship of insulins and insulin analogs in diabetes mellitus type 1 (DM1) and 2 (DM2), from the perspective of the Colombian health system.</div></div><div><h3>Methods</h3><div>A short-term decision tree model (SM) was built, the outcome of which was severe/nocturnal hypoglycemia, and a long-term Markov model for quality-adjusted life-years. The probabilities were calculated through a literature review of effectiveness and safety. The costs are estimated from official databases. Deterministic and probabilistic sensitivity analyses were performed.</div></div><div><h3>Results</h3><div>For DM1, in prandial insulins, and for both models, the cost-effective interventions (CEIs) are aspartate and lispro. In basal insulins, the CEIs are NPH and glargine U-100 in both models. In the comparison of detemir and NPH, detemir generates lower nocturnal hypoglycemia and higher quality-adjusted life-years; however, in the long-term Markov model, the incremental cost-effectiveness ratio exceeds the threshold. For DM2, in the prandial insulin, and for both models, aspartate is a CEI and the glargine U-300 is also a CEI in the SM. In basal insulin, the CEIs are glargine U-100 and detemir (for nocturnal hypoglycemia) in both models and glargine U-300 is also a CEI in the SM. Finally, in the group of combinations, iGlarLixi is dominant over IDegLira.</div></div><div><h3>Conclusions</h3><div>The results favor the use of analog insulins over human insulins, the former reducing the possibility of acute events and chronic complications to a greater extent.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101073"},"PeriodicalIF":1.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143199114","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":"Utility Values of Health Status in Gastric Cancer: A Systematic Review","authors":"Cristian Gonzalez MA ,&nbsp;Manuel Espinoza PhD ,&nbsp;Matías Libuy MA ,&nbsp;Francisca Crispi MA ,&nbsp;Arnoldo Riquelme MD ,&nbsp;Fernando Alarid-Escudero PhD ,&nbsp;Gonzalo Latorre MD ,&nbsp;Margarita Pizarro MD ,&nbsp;Cristóbal Cuadrado PhD","doi":"10.1016/j.vhri.2024.101063","DOIUrl":"10.1016/j.vhri.2024.101063","url":null,"abstract":"<div><h3>Objectives</h3><div>Gastric cancer (GC) imposes a significant burden of disease globally. Multiple treatments are available but are associated with high costs and potentially detrimental effects on quality of life. The utility values of health status are measures of patient preference over quality of life, which are increasingly used for health and economic decision-making. Currently, there is little systematized information on the utility values for different stages of GC. This systematic review synthesizes and meta-analyses the literature on GC utilities.</div></div><div><h3>Methods</h3><div>A search was conducted in PubMed, Embase, MEDLINE, and Cochrane Library for studies reporting utility values calculated using direct and indirect methods. Information from the selected studies was extracted and appraised, and meta-analyses of utility values based on GC health states were performed.</div></div><div><h3>Results</h3><div>Twelve studies involving 4585 patients were included. Random-effects meta-analysis estimates showed a mean utility of 0.77 (95% CI 0.7–0.85) for stage I, 0.75 (95% CI 0.65–0.85) for stage II, 0.70 (95% CI 0.63–0.96) for stage III, and 0.64 (95% CI 0.56–0.32) for stage IV. All estimates showed considerable heterogeneity.</div></div><div><h3>Conclusions</h3><div>Our study provides an updated overview of the literature on utility values in GC and presents a discussion of the relevance of GC stages for its analysis. Decision-makers should consider patients’ preferences in the proposal of policies and clinical decisions.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101063"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075790","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}