Value in health regional issues最新文献

{"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}

{"title":"Glycemic and Blood Pressure Control in Type 2 Diabetes Mellitus: Disability Costs Covered by Social Security, Evidence From Mexico","authors":"Ruth Pérez-Hernández PhD ,&nbsp;María Jesús Ríos-Blancas PhD ,&nbsp;Jesús Ramos-González MSPH ,&nbsp;Araceli Mercado-Lara MSc ,&nbsp;Silvia Magali Cuadra-Hernández PhD","doi":"10.1016/j.vhri.2024.101071","DOIUrl":"10.1016/j.vhri.2024.101071","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the difference in type 2 diabetes mellitus (T2DM) disability costs subsidized by the Mexican Social Security Institute for employees with normoglycemia and normotension (<em>n</em> = 547 488) from the 2016 to 2018 National Census of Workers with T2DM registered with the Mexican Social Security Institute.</div></div><div><h3>Methods</h3><div>We tested whether the control of these indicators reduced disability payments at work, the costs of subsidy distribution in different salary groups, and their associated diseases.</div></div><div><h3>Results</h3><div>Differences (<em>P</em> &lt; .001) emerged in disability leave costs for employees who did not control their blood pressure. Highest-earning employees had the highest costs compared with lower-earning workers. The most frequent subsidized diseases included gastric problems, lower-back disorders, and respiratory infections.</div></div><div><h3>Conclusions</h3><div>Based on data from all the insured employees with T2DM registered in the National Census, this study enjoyed strong internal validity, indicating that failure to control blood pressure levels correlated with higher costs. The highest costs resulted from noncomplicated diseases. Employees earning higher incomes accounted for the highest costs, suggesting the existence of unequal subsidy conditions.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101071"},"PeriodicalIF":1.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012483","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":"Rare Oncological Diseases and Their Large Slice in Demands to the Brazilian Government for Health Technologies Over 12 Years Since the Creation of CONITEC","authors":"Raíssa G. de Andrade BPharm ,&nbsp;Altacílio A. Nunes PhD ,&nbsp;Maurilio S. Cazarim PhD","doi":"10.1016/j.vhri.2024.101072","DOIUrl":"10.1016/j.vhri.2024.101072","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objetivo&lt;/h3&gt;&lt;div&gt;Descrever as características das demandas por tecnologias em saúde submetidas ao Governo Brasileiro.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Metodologia&lt;/h3&gt;&lt;div&gt;Foi realizada uma análise descritiva por levantamento dos relatórios produzidos pelo Comitê Nacional de Incorporação de Tecnologias em Saúde (CONITEC) desde sua criação no Brasil até 2023. Os dados extraídos foram tabulados em três domínios: identificação da demanda; perfil epidemiológico da doença; evidências clínicas e; avaliação econômica.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Resultados&lt;/h3&gt;&lt;div&gt;Foram incluídos 778 (95,7%) relatórios, dos quais 266 (34,2%) estavam relacionados às doenças raras e, destes, 86 (32,3%) destinavam-se à oncologia, dos quais 73,3% foram pedidos de incorporação de medicamentos, 51,0% de demanda externa, 48,2% relacionados à entidades públicas, e 58,7% tiveram como parecer final a recomendação. O impacto orçamentário incremental total e médio das tecnologias incorporadas foi de R$ 36.683.014.441,02 e R$ 1.111.606.498,20 e a razão de custo-efetividade incremental total e média foi de R$ 1.024.897,50/QALY e R$ 68.326,50/QALY, enquanto para as tecnologias não incorporadas foi de R$ 3.055.888.437,38; R$ 127.328.684,89; R$ 952.263,85/QALY e; R$ 52.903,54/QALY, respectivamente.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusão&lt;/h3&gt;&lt;div&gt;A área oncológica teve maior representatividade entre as demandas avaliadas, sendo que os cânceres raros representaram a maior parcela das tecnologias em saúde demandadas e, a decisão de incorporação foi majoritária. O impacto orçamentário incremental e razão de custo efetividade incremental foi maior para as tecnologias incorporadas, duas dentre elas ultrapassaram o limiar de custo-efetividade adotado pela CONITEC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To describe the characteristics of the demands for health technologies submitted to the Brazilian Government.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methodology&lt;/h3&gt;&lt;div&gt;A descriptive analysis was carried out by surveying the reports produced by the National Committee for the Incorporation of Health Technologies since its creation in Brazil until 2023. The extracted data were tabulated in 3 domains: identification of demand, epidemiological profile of the disease, and clinical evidence and economic assessment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 778 among 813 reports were included (95.7%), of which 266 (34.2%) were related to rare diseases. Of these, 86 (32.3%) were related to oncology, for 73.3% of which there were requests for the incorporation of medicines, 51.0% from external demand, 48.2% related to public entities, and 58.7% had the recommendation as a final opinion. The total and average incremental budgetary impact of the incorporated technologies was R$36 683 014 441.02 and R$1 111 606 498.20 and the total and average incremental cost-effectiveness ratio was R$1 024 897.50/QALY and R$68 326.50/QALY, whereas for nonincorporated technologies it was R$3 055 888 437.38; R$ 127 328 684.89; R$ 952 263.85/QALY and; R$","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"46 ","pages":"Article 101072"},"PeriodicalIF":1.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012489","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}