Value in health regional issues最新文献_第7页

Tiered Pricing and Alternative Mechanisms for Equitative Access to Vaccines in Latin America: A Narrative Review of the Literature 拉丁美洲疫苗平等获取的分级定价和替代机制：文献综述

IF 2

Value in health regional issues Pub Date : 2024-04-27 DOI: 10.1016/j.vhri.2024.01.003

Adriana Arango-Luque DMD, MSE , Daniela Yucumá MD, MPH , Camilo E. Castañeda MD (Neurologist) , Jaime Espin LLB, MHE, PhD in Economics , Francisco Becerra-Posada MD, MPH, DrPH

{"title":"Tiered Pricing and Alternative Mechanisms for Equitative Access to Vaccines in Latin America: A Narrative Review of the Literature","authors":"Adriana Arango-Luque DMD, MSE , Daniela Yucumá MD, MPH , Camilo E. Castañeda MD (Neurologist) , Jaime Espin LLB, MHE, PhD in Economics , Francisco Becerra-Posada MD, MPH, DrPH","doi":"10.1016/j.vhri.2024.01.003","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.01.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To review and describe alternative strategies for the supply of vaccines in Latin America.</p></div><div><h3>Methods</h3><p>We conducted a narrative review to explore and describe alternatives for equitable vaccine access in Latin America. We searched and considered the main access strategies reported in the literature through PubMed, Science Direct, and Google Scholar. Additionally, we reviewed the web sites of key stakeholders. The search was conducted using the following keywords: (“access” or “availability” or “acquisition” or “affordability” or “tiered pricing”) and (“vaccine”). Subsequently, documents that met the inclusion criteria were selected. Finally, findings were grouped by means of a thematic analysis and an interpretative synthesis.</p></div><div><h3>Results</h3><p>Twenty-four publications were included. We identified 5 main topics: current supply strategies, challenges for the acquisition of vaccines, vaccine prices equity, alternative supply strategies, and the advantages and impact of a tiered pricing strategy.</p></div><div><h3>Conclusions</h3><p>Our review suggests that tiered pricing can be an tool for accelerating the process of introducing vaccines in low-income countries at affordable prices and for countries that do not adhere to the current procurement mechanisms or are not eligible for Vaccine Alliance because giving countries prices for vaccines that reflect their ability to pay can result in better programmatic and financial planning for the purchase of these vaccines, and in return, vaccine manufacturers can gain access to wider markets However, this model has not been z improve access to vaccines that are aimed only at developing countries, mainly because the market in these countries is not profitable for producers.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100981"},"PeriodicalIF":2.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electronic Decision-Making Tool for Smoking Cessation (Pare de Fumar Conosco) Versus Standard of Care: A Cost-Effectiveness Analysis 戒烟电子决策工具 (Pare de Fumar Conosco) 与标准护理的对比：成本效益分析

IF 2

Value in health regional issues Pub Date : 2024-04-26 DOI: 10.1016/j.vhri.2024.01.002

Roberta S. Teixeira PhD , Arise G.S. Galil PhD , Ana Paula Cupertino PhD , Francisco Cartujano-Barrera MD , Fernando A.B. Colugnati PhD

{"title":"Electronic Decision-Making Tool for Smoking Cessation (Pare de Fumar Conosco) Versus Standard of Care: A Cost-Effectiveness Analysis","authors":"Roberta S. Teixeira PhD , Arise G.S. Galil PhD , Ana Paula Cupertino PhD , Francisco Cartujano-Barrera MD , Fernando A.B. Colugnati PhD","doi":"10.1016/j.vhri.2024.01.002","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.01.002","url":null,"abstract":"<div><h3>Objectives</h3><p>The study aimed to evaluate the cost-effectiveness of the <em>Pare de Fumar Conosco</em> software compared with the standard of care adopted in Brazil for the treatment of smoking cessation.</p></div><div><h3>Methods</h3><p>In the cohort of smokers with multiple chronic conditions, we developed an decision tree model for the benefit measures of smoking cessation. We adopted the perspectives of the Brazilian Unified Health System and the service provider. Resources and costs were measured by primary and secondary sources and effectiveness by a randomized clinical trial. The incremental cost-effectiveness ratio (ICER) was calculated, followed by deterministic and probabilistic sensitivity analyses and deterministic and probabilistic sensitivity analyses. No willingness to pay threshold was adopted.</p></div><div><h3>Results</h3><p>The software had a lower cost and greater effectiveness than its comparator. The ICER was dominant in all of the benefits examined (−R$2 585 178.29 to −R$325 001.20). The cost of the standard of care followed by that of the electronic tool affected the ICER of the benefit measures. In all probabilistic analyses, the software was superior to the standard of care (53.6%-82.5%).</p></div><div><h3>Conclusion</h3><p>The <em>Pare de Fumar Conosco</em> software is a technology that results in cost savings in treating smoking cessation.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100980"},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000074/pdfft?md5=c7fcc99e4e5465c7e9b666a4fedccb81&pid=1-s2.0-S2212109924000074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-Effectiveness of Technologies for the Treatment of Spinal Muscular Atrophy: A Systematic Review of Economic Studies 脊髓肌肉萎缩症治疗技术的成本效益：经济研究系统回顾

IF 2

Value in health regional issues Pub Date : 2024-04-26 DOI: 10.1016/j.vhri.2024.02.002

André Motta-Santos PhD , Kenya Noronha PhD , Carla Reis MSc , Daniela Freitas PhD , Lélia Carvalho MSc , Mônica Andrade PhD

{"title":"Cost-Effectiveness of Technologies for the Treatment of Spinal Muscular Atrophy: A Systematic Review of Economic Studies","authors":"André Motta-Santos PhD , Kenya Noronha PhD , Carla Reis MSc , Daniela Freitas PhD , Lélia Carvalho MSc , Mônica Andrade PhD","doi":"10.1016/j.vhri.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.02.002","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aims to systematically collect data on cost-effectiveness analyses that assess technologies to treat type I and II spinal muscular atrophy and evaluate their recommendations.</p></div><div><h3>Methods</h3><p>A structured electronic search was conducted in 4 databases. Additionally, a complementary manual search was conducted. Complete economic studies that evaluated nusinersen, risdiplam, onasemnogene abeparvovec (OA), and the best support therapy (BST) from the health system’s perspective were selected. The incremental cost-effectiveness ratios were compared with various thresholds for the analysis. The review was registered a priori in PROSPERO (CRD42022365391).</p></div><div><h3>Results</h3><p>Twenty studies were included in the analyses. They were all published between 2017 and 2022 and represent the recommendations in 8 countries. Most studies adopted 5, 6, or 10-state Markov models. Some authors took part in multiple studies. Four technologies were evaluated: BST (N = 14), nusinersen (N = 19), risdiplam (N = 5), and OA (N = 9). OA, risdiplam, and nusinersen were considered inefficient compared with the BST. Risdiplam and OA were generally regarded as cost-effective when compared with nusinersen. Because nusinersen is not a cost-effective drug, no recommendation can be derived from this result. Risdiplam and OA were compared in 2 studies that presented opposite results.</p></div><div><h3>Conclusions</h3><p>Nusinersen, risdiplam, and OA are being adopted worldwide as a treatment for spinal muscular atrophy. Despite that, the pharmacoeconomic analyses show that the technologies are not cost-effective compared with the BST. The lack of controlled studies for risdiplam and OA hamper any conclusions about their face-to-face comparison.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100985"},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Microcost Analysis of the Use of Personal Protective Equipment During and Before the COVID-19 Pandemic From a Hospital Perspective 从医院角度对 COVID-19 大流行期间和之前个人防护设备使用情况的微观成本分析

IF 2

Value in health regional issues Pub Date : 2024-04-25 DOI: 10.1016/j.vhri.2024.01.005

Mariana Andrades Fiorini Monteiro Novo MS , Lukas Fernando De Oliveira Silva MD , Daniela Fernanda dos Santos Alves PhD , Patrick Alexander Wachholz MD, PhD , Vania dos Santos Nunes-Nogueira MD, PhD

{"title":"A Microcost Analysis of the Use of Personal Protective Equipment During and Before the COVID-19 Pandemic From a Hospital Perspective","authors":"Mariana Andrades Fiorini Monteiro Novo MS , Lukas Fernando De Oliveira Silva MD , Daniela Fernanda dos Santos Alves PhD , Patrick Alexander Wachholz MD, PhD , Vania dos Santos Nunes-Nogueira MD, PhD","doi":"10.1016/j.vhri.2024.01.005","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.01.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To calculate the direct cost of personal protective equipment (PPE) used during the COVID-19 pandemic from the perspective of a Brazilian tertiary public hospital.</p></div><div><h3>Methods</h3><p>We evaluated the cost of PPE during the pandemic to the cost before (2021 vs 2019, respectively) using the microcosting method. Cost estimates were converted into US dollars in 2023, taking inflation into account and using purchasing power parity conversion rates. Our expenses included gloves, disposable gowns, head coverings, masks, N95 respirators, and eye protection. The number of PPE used was determined by the hospital’s usual protocol, the total number of hospitalized patients, and the number of days of hospitalization. We used the following variables for uncertainty analysis: PPE adherence, an interquartile range of median length of hospitalization, and variance in the cost of each PPE.</p></div><div><h3>Results</h3><p>In 2021, 26 618 individuals were hospitalized compared with 31 948 in 2019. The median length of stay was 6 and 4 days, respectively. The total and per-patient direct cost of PPE were projected to be 2 939 935.47 US dollar (USD) and 110.45 USD, respectively, during the pandemic, and 1 570 124.08 USD and 49.15 USD, respectively, before the pandemic. The individual cost of PPE was the most influential cost variable.</p></div><div><h3>Conclusions</h3><p>According to the hospital’s perspective, the total estimated direct cost of PPE during the COVID-19 pandemic was nearly twice as high as the previous year. This difference might be explained by the 3-fold increase in PPE in the treatment of patients with COVID-19 compared with patients without isolation precautions.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100984"},"PeriodicalIF":2.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effectiveness Analysis of Pharmacological Treatment for Adult Kidney Transplant Recipients in Colombia 哥伦比亚成年肾移植受者药物治疗的成本效益分析

IF 2

Value in health regional issues Pub Date : 2024-04-25 DOI: 10.1016/j.vhri.2024.02.001

Daysi Sanmartin MSc , Camilo Tamayo MSc , Luis Esteban Orozco MSc , Angélica Ordóñez MSc , Juliana Huertas BSc , Diego Ávila MSc , Johanna Echeverry MSc , Mónica Caicedo MSc , Paola García NEP

{"title":"Cost-effectiveness Analysis of Pharmacological Treatment for Adult Kidney Transplant Recipients in Colombia","authors":"Daysi Sanmartin MSc , Camilo Tamayo MSc , Luis Esteban Orozco MSc , Angélica Ordóñez MSc , Juliana Huertas BSc , Diego Ávila MSc , Johanna Echeverry MSc , Mónica Caicedo MSc , Paola García NEP","doi":"10.1016/j.vhri.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.02.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate cost-effective pharmacological treatment in adult kidney transplant recipients from the perspective of the Colombian health system.</p></div><div><h3>Methods</h3><p>A decision tree model for the induction phase and a Markov model for the maintenance phase were built. A review of the clinical literature was conducted to extract probabilities, and the life-years were used as the outcome. Costs were calculated using the administrative databases. The evaluating treatment schemes are organized by groups of evidence with direct comparisons.</p></div><div><h3>Results</h3><p>In the induction phase, anti-thymocyte immunoglobulin+ methylprednisolone is dominant, more effective, and less expensive, compared with basiliximab+methylprednisolone. In the maintenance phase, azathioprine (AZA) is dominant in contrast to mycophenolate mofetil (MFM) both with cyclosporine (CIC)+ corticosteroids (CE); CIC is dominant relative to sirolimus (SIR) and tacrolimus (TAC) (both with MFM+CE or AZA+CE), and TAC is dominant compared with SIR (in addition with MFM+CE or mycophenolate sodium [MFS]+CE); MFM is dominant in relation to MFS and everolimus, and SIR is more effective MFM but it does not exceed the threshold (in sum with TAC+CE); MFS and MFM are dominant relative to everolimus, and SIR is more effective than MFM, but it does not exceed the threshold (in addiction with CIC+CE); MFM is dominant in relation to TAC (in sum with SIR+CE), and CIC+AZA+CE is dominant in relation to TAC+MFM+CE.</p></div><div><h3>Conclusions</h3><p>The base-case results for all evidence groups are consistent with the different sensitivity analyses.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100983"},"PeriodicalIF":2.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effectiveness Analysis of Triptorelin, Goserelin, and Leuprolide in the Treatment of Patients with Metastatic Prostate Cancer: A Societal Perspective 治疗转移性前列腺癌患者的曲普瑞林、戈舍瑞林和亮丙瑞林的成本效益分析：社会视角

IF 2

Value in health regional issues Pub Date : 2024-04-24 DOI: 10.1016/j.vhri.2024.01.004

Mehdi Rezaee MSc , Iman Karimzadeh Pharm D, PhD , Amir Hashemi-Meshkini PhD , Shahryar Zeighami MD , Mohammad Bazyar Pharm D , Farhad Lotfi PhD , Khosro Keshavarz PhD

{"title":"Cost-effectiveness Analysis of Triptorelin, Goserelin, and Leuprolide in the Treatment of Patients with Metastatic Prostate Cancer: A Societal Perspective","authors":"Mehdi Rezaee MSc , Iman Karimzadeh Pharm D, PhD , Amir Hashemi-Meshkini PhD , Shahryar Zeighami MD , Mohammad Bazyar Pharm D , Farhad Lotfi PhD , Khosro Keshavarz PhD","doi":"10.1016/j.vhri.2024.01.004","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.01.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Metastatic prostate cancer is the most common malignant cancer and the second leading cause of death due to various types of cancer among men after lung cancer. This study aimed to analyze the cost-effectiveness of triptorelin, goserelin, and leuprolide in the treatment of the patients with metastatic prostate cancer from the societal perspective in Iran in 2020.</p></div><div><h3>Methods</h3><p>This is a cost-effectiveness study in which a 20-year Markov transition modeling was applied. In this study, local cost and quality-of-life data of each health state were gathered from cohort of patients. The TreeAge pro 2020 and Microsoft Excel 2016 software were used to simulate cost-effectiveness of each treatment in the long term. The one-way and probabilistic sensitivity analyses were also performed to measure robustness of the model outputs.</p></div><div><h3>Results</h3><p>The findings indicated that the mean costs and utility gained over a 20-year horizon for goserelin, triptorelin, and leuprolide treatments were $ 13 539.13 and 6.365 quality-adjusted life-years (QALY), $ 18 124.75 and 6.658 QALY, and $ 26 006.92 and 6.856 QALY, respectively. Goserelin was considered as a superior treatment option, given the estimated incremental cost-effectiveness ratio. The one-way and probabilistic sensitivity analyses confirmed the robustness of the study outcomes.</p></div><div><h3>Conclusions</h3><p>According to the results of the present study, goserelin was the most effective and cost-effective strategy versus 2 other options. It could be recommended to policy makers of the Iran healthcare system to prioritize it in clinical guidelines and reimbursement policies.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Article 100982"},"PeriodicalIF":2.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peripherally Inserted Central Catheter Versus Centrally Inserted Central Catheter for In-Hospital Infusion Therapy: A Cost-Effectiveness Analysis 用于院内输液治疗的外周置入中心导管与中心置入中心导管：成本效益分析

IF 2

Value in health regional issues Pub Date : 2024-02-23 DOI: 10.1016/j.vhri.2023.12.006

Simone de Souza Fantin RN, MSc, ScD , Marina Scherer dos Santos RN , Eduarda Bordini Ferro RN , Vania Naomi Hirakata MSc , André Ferreira de Azeredo da Silva MD, PhD , Eneida Rejane Rabelo-Silva RN, MSc, ScD

{"title":"Peripherally Inserted Central Catheter Versus Centrally Inserted Central Catheter for In-Hospital Infusion Therapy: A Cost-Effectiveness Analysis","authors":"Simone de Souza Fantin RN, MSc, ScD , Marina Scherer dos Santos RN , Eduarda Bordini Ferro RN , Vania Naomi Hirakata MSc , André Ferreira de Azeredo da Silva MD, PhD , Eneida Rejane Rabelo-Silva RN, MSc, ScD","doi":"10.1016/j.vhri.2023.12.006","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.006","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the comparative effectiveness and cost-effectiveness of peripherally inserted central catheters (PICCs) compared with centrally inserted central catheters (CICCs).</p></div><div><h3>Methods</h3><p>Prospective cohort study was followed by an economic analysis over a 30-day time horizon. Propensity score matching was used to select hospitalized adults with similar indications for PICC or CICC. The composite outcome was device removal or replacement because of complications before the end of treatment. The economic evaluation was based on a decision tree model for cost-effectiveness analysis, with calculation of the incremental cost-effectiveness ratio (ICER) per catheter removal avoided. All costs are presented in Brazilian reais (BRL) (1 BRL = 0.1870 US dollar).</p></div><div><h3>Results</h3><p>A total of 217 patients were followed in each group; 172 (79.3%) of those receiving a PICC and 135 (62.2%) of those receiving a CICC had no device-related complication, respectively. When comparing the events leading to device removal, the risk of composite endpoint was significantly higher in the CICC group (hazard ratio 0.20; 95% CI 0.11-0.35). The cost of PICC placement was BRL 1290.98 versus BRL 467.16 for a CICC. In the base case, the ICER for placing a PICC instead of a CICC was BRL 3349.91 per removal or replacement avoided. On univariate sensitivity analyses, the model proved to be robust within an ICER range of 2500.00 to 4800.00 BRL.</p></div><div><h3>Conclusions</h3><p>PICC placement was associated with a lower risk of complications than CICC placement. Although the cost of a PICC is higher, its use avoided complications and need for catheter replacement before the end of treatment.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 123-130"},"PeriodicalIF":2.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining the Impact of the Current Reimbursement Regulation on Patient Access to Innovative Medical Devices in Taiwan: Insights From 8 Years’ Reimbursement Data 研究台湾现行报销规定对患者获得创新医疗设备的影响：八年报销数据的启示

IF 2

Value in health regional issues Pub Date : 2024-02-12 DOI: 10.1016/j.vhri.2023.12.009

Jhao-Yang Peng MBA , Sang-Soo Lee PhD , Chun-Ru Lin MD , Haine Lee MPharm , Yong-Chen Chen PhD

{"title":"Examining the Impact of the Current Reimbursement Regulation on Patient Access to Innovative Medical Devices in Taiwan: Insights From 8 Years’ Reimbursement Data","authors":"Jhao-Yang Peng MBA , Sang-Soo Lee PhD , Chun-Ru Lin MD , Haine Lee MPharm , Yong-Chen Chen PhD","doi":"10.1016/j.vhri.2023.12.009","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.009","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to assess the impact of the reimbursement regulation of medical devices (Regulation), introduced by the National Health Insurance Administration (NHIA) in 2013, on patients’ access to innovative medical devices in Taiwan.</p></div><div><h3>Methods</h3><p>Analysis of the amount of time needed from application for NHIA reimbursement for new medical devices to receiving the decision from NHIA was done using the nonreimbursement product list featured on the NHIA website. Additionally, Welch analysis of variance was used to compare the amount of time it took from application to NHIA with reimbursement decisions made by the NHIA for different nonreimbursement code categories. Further, related Pharmaceutical Benefit Reimbursement Scheme meeting minutes were analyzed to obtain more detailed information concerning medical devices’ reimbursement or not.</p></div><div><h3>Results</h3><p>From December 2012 to June 2021, the overall reimbursement percentage was 56.7%, and the average amount of time between application and reimbursement was 856.7 ± 474.7 days. The mandatory reimbursement rate was about 45%. NHIA reimbursement decisions as special medical devices also take a longer amount of time, because the applicants need to agree to the decision (<em>P</em> < .05). The NHIA decision-making process for nonreimbursement medical devices requires a significantly longer amount of time than for general materials (eg, suture, etc) decisions.</p></div><div><h3>Conclusions</h3><p>Although the Regulation resolves payment issues, it also increases the amount of time to reach reimbursement decisions, thus hindering patient access to innovative medical devices. The study suggests that the review process needs to be simplified concerning reimbursement notification, using local real-world data to support reimbursement decisions.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Pages 18-25"},"PeriodicalIF":2.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139727104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye 土耳其种植体支持单冠和牙齿支持固定牙科修复体的成本效益分析》（Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye.

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Value in health regional issues Pub Date : 2024-02-09 DOI: 10.1016/j.vhri.2024.01.001

Lütfiye Tekpınar PhD , Vahit Yiğit PhD

{"title":"Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye","authors":"Lütfiye Tekpınar PhD , Vahit Yiğit PhD","doi":"10.1016/j.vhri.2024.01.001","DOIUrl":"10.1016/j.vhri.2024.01.001","url":null,"abstract":"<div><h3>Objectives</h3><p>The most cost-effective option for replacing lost teeth is not evident because there is a dearth of evidence-based information on implant-supported single crowns versus tooth-supported fixed dental prostheses. This study conducted the analysis of cost-effectiveness of implant-supported single crown and tooth-supported fixed dental prostheses from a social perspective in Türkiye.</p></div><div><h3>Methods</h3><p>Costs were calculated in the analysis from a social perspective for 2021. Costs and quality-adjusted prosthesis year (QAPY) values were computed over a 20-year period in the study using the Markov model. The computed values were discounted by 5%. The results are presented as the incremental cost-effectiveness ratio. To assess the impact of uncertainty on cost-effectiveness analyses, a tornado diagram and Monte Carlo simulations were created.</p></div><div><h3>Results</h3><p>Throughout the 20-year time horizon, tooth-supported fixed dental prostheses cost $985.58 cumulatively, whereas implant-supported single crown cost $2161.64 (US $1 = 9.22 ₺ as of 15 October 2021). The calculated incremental cost-effectiveness ratio is 1.333 per QAPY. Compared with the implant-supported single crown tooth-supported fixed dental prostheses, it offers a QAPY of 0.882 over a 20-year period, while costing an additional $1176.06.</p></div><div><h3>Conclusions</h3><p>These results suggest that the implant-supported single crown provided higher QAPY value but was costlier. When the research’s findings are compared with the literature, it becomes clear that Türkiye has lower dental care expenses than most other nations.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Pages 11-17"},"PeriodicalIF":2.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estimating the SF-6Dv1 Value Set for a Population-Based Sample in Lebanon 估算黎巴嫩人口样本的 SF-6Dv1 值集。

IF 2

Value in health regional issues Pub Date : 2024-02-09 DOI: 10.1016/j.vhri.2023.12.008

Samer A. Kharroubi PhD , Clara Mukuria PhD , Dalia Dawoud PhD , Donna Rowen PhD

{"title":"Estimating the SF-6Dv1 Value Set for a Population-Based Sample in Lebanon","authors":"Samer A. Kharroubi PhD , Clara Mukuria PhD , Dalia Dawoud PhD , Donna Rowen PhD","doi":"10.1016/j.vhri.2023.12.008","DOIUrl":"10.1016/j.vhri.2023.12.008","url":null,"abstract":"<div><h3>Objectives</h3><p>The SF-6Dv1 is a preference-based measure derived from the SF-36 for use in quality-adjusted life-year estimation for cost-utility analysis. Country-specific value sets for SF-6Dv1 are needed to reflect societal preferences but none are available for Lebanon and other Arabic countries. This study aimed to generate a value set for SF-6Dv1 for Lebanon and to compare results with the UK set.</p></div><div><h3>Methods</h3><p>A sample of 249 health states defined by the SF-6Dv1 were valued by a representative sample of 577 members of the Lebanon general population, using standard gamble. Several multivariate regression models at mean and individual level were fitted to estimate utilities for all SF-6Dv1 states with selection of best fitting models based on predictive ability, consistency, and model fit. The best fitting models were compared with those fitted in the UK study.</p></div><div><h3>Results</h3><p>Data from 553 eligible respondents providing 3308 valuations were used for the analysis. Lebanese values were consistently higher than UK values, indicating differences in preferences, and there were no negative values. The random effects model using only main effects was the best performing model. There were inconsistencies in 2 dimensions, thereby consistent models were estimated with values ranging from 0.367 to 1. The results are consistent with the UK results.</p></div><div><h3>Conclusions</h3><p>This study provides the first population-based value set for SF-6Dv1 health states for Lebanon, making it possible to generate quality-adjusted life-years for cost-utility analysis studies. The potential for applications of a standardized utility measure is enormous both in Lebanon and all Arab countries.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Pages 1-10"},"PeriodicalIF":2.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0