Value in health regional issues最新文献

{"title":"Service Utilization Patterns and Direct Medical Costs of Hospitalization in Patients With Renal Failure Before and After Initiating Home Peritoneal Dialysis","authors":"Marisol Torres-Toledano ScM ,&nbsp;Víctor Granados-García ScD ,&nbsp;Laura Cortés-Sanabria ScD ,&nbsp;Alfonso Martín Cueto-Manzano PharmD ,&nbsp;Yvonne N. Flores PhD ,&nbsp;Jorge Salmerón ScD","doi":"10.1016/j.vhri.2023.12.004","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.004","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to determine the hospital service utilization patterns and direct healthcare hospital costs before and during peritoneal dialysis (PD) at home.</p></div><div><h3>Methods</h3><p>A retrospective cohort study of patients with kidney failure (KF) was conducted at a Mexican Social Security Institute hospital for the year 2014. Cost categories included inpatient emergency room stays, inpatient services at internal medicine or surgery, and hospital PD. The study groups were (1) patients with KF before initiating home PD, (2) patients with less than 1 year of home PD (incident), and (3) patients with more than 1 year of home PD (prevalent). Costs were actualized to international dollars (Int$) 2023.</p></div><div><h3>Results</h3><p>We found that 53% of patients with KF used home PD services, 42% had not received any type of PD, and 5% had hospital dialysis while waiting for home PD. The estimated costs adjusting for age and sex were Int$5339 (95% CI 4680-9746) for patients without home PD, Int$17 556 (95% CI 15 314-19 789) for incident patients, and Int$7872 (95% CI 5994-9749) for prevalent patients; with significantly different averages for the 3 groups (<em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Although the use of services and cost is highest at the time of initiating PD, over time, using home PD leads to a significant reduction in use of hospital services, which translates into institutional cost savings. Our findings, especially considering the high rates of KF in Mexico, suggest a pressing need for interventions that can reduce healthcare costs at the beginning of renal replacement therapy.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 114-122"},"PeriodicalIF":2.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699484","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":"The Short-Term Cost-Effectiveness of a Fixed-Ratio Combination of Insulin Degludec and Aspart: A Cost of Control Analysis in Australia and India","authors":"Jack Garcia Uranga Romano MSc ,&nbsp;Samuel Joseph Paul Malkin MSc ,&nbsp;Barnaby Hunt MSc","doi":"10.1016/j.vhri.2023.12.007","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.007","url":null,"abstract":"<div><h3>Objectives</h3><p>The real-world ARISE study demonstrated initiation of fixed-ratio combination insulin degludec and aspart (IDegAsp) led to improvements in people achieving key glycemic control targets compared with prior therapies in Australia and India. This study evaluated the short-term cost-effectiveness of IDegAsp in these countries, in terms of the cost per patient achieving these targets.</p></div><div><h3>Methods</h3><p>A model was developed to evaluate the cost of control (treatment costs divided by the proportion of patients achieving each target) of IDegAsp versus prior therapies received in ARISE for 2 endpoints: glycated hemoglobin (HbA1c) &lt;7.0%, and HbA1c less than a predefined individual treatment target. Costs, expressed from a healthcare payer perspective, were captured in 2022 Australian dollars (AUD) and 2022 Indian rupees (INR).</p></div><div><h3>Results</h3><p>The number of patients needed to treat to bring one to endpoints of HbA1c &lt;7.0% and less than an individualized target with IDegAsp was 51% and 87% lower, respectively, than with prior therapies in Australia, and 52% and 66% lower, respectively, versus prior therapies in India. Cost of control was AUD 2449 higher and AUD 64 863 lower with IDegAsp versus prior therapies for endpoints of HbA1c &lt;7.0% and less than an individualized target, respectively, in Australia and INR 211 142 and INR 537 490 lower with IDegAsp compared with prior therapies in India.</p></div><div><h3>Conclusions</h3><p>IDegAsp was estimated to be cost-effective versus prior therapies when considering an individualized HbA1c target in Australia, and when considering an individualized HbA1c target and HbA1c &lt;7.0% in India.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 108-113"},"PeriodicalIF":2.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000037/pdfft?md5=f8266d7c483af8b55f41e71ce159f7b9&pid=1-s2.0-S2212109924000037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694019","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":"A Step Toward the Development of the First National Multi-Criteria Decision Analysis Framework to Support Healthcare Decision Making in Saudi Arabia","authors":"Ahmed Al-Jedai MBA ,&nbsp;Hajer Almudaiheem PharmD ,&nbsp;Yazeed Alruthia PhD ,&nbsp;Abdullah Althemery PhD ,&nbsp;Hana Alabdulkarim PharmD ,&nbsp;Rita Ojeil MSc ,&nbsp;Ali Alrumaih PharmD ,&nbsp;Suliman AlGhannam MD ,&nbsp;AbdulAali AlMutairi PhD ,&nbsp;Zuhair Hasnan MD","doi":"10.1016/j.vhri.2023.12.005","DOIUrl":"10.1016/j.vhri.2023.12.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the feasibility of implementing multi-criteria decision analysis (MCDA) and to select the criteria for preparing a national MCDA framework for health technology assessment of orphan drugs in the Kingdom of Saudi Arabia (KSA).</p></div><div><h3>Methods</h3><p>The study was conducted in 3 phases. In phase I, a targeted literature review was performed to gather relevant information on the implementation of MCDA in healthcare decision making. Phase II was a cross-sectional survey, conducted to obtain insights from different stakeholders and key opinion leaders on specific topics from the KSA perspective. Phase III included a round-table discussion involving experts to validate the results obtained in the phase II survey and further elaborate on specific requirements that may be critical for developing the first national MCDA framework in the KSA.</p></div><div><h3>Results</h3><p>All the key opinion leaders involved in the study acknowledged the importance of implementing MCDA in the KSA. The Ministry of Health was assigned the responsibility of chairing the MCDA decision process. The experts selected the quantitative, qualitative, and economic criteria to be considered for the MCDA framework. The stakeholders decided to initiate a pilot phase using the deliberative MCDA methodology for the assessment of orphan drugs based on the selected criteria for a period of 1 year and then reevaluate the need to adapt the pragmatic MCDA model.</p></div><div><h3>Conclusion</h3><p>This article describes the novel initiative that examined the feasibility and process required for the development of the first MCDA framework in the KSA to support healthcare decision making.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 100-107"},"PeriodicalIF":2.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000013/pdfft?md5=9d066ce5a51135997270f99f78adc5c3&pid=1-s2.0-S2212109924000013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672789","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":"Impact of Lung Cancer on Health-Related Quality of Life, Financial Toxicity, and Household Economics in Patients From the Public and the Private Healthcare Sector in Argentina","authors":"Federico Augustovski PhD ,&nbsp;Florencia Tsou MD ,&nbsp;Lucas González MSc ,&nbsp;Claudio Martín MD ,&nbsp;Silvina Vigo MD ,&nbsp;Carolina Gabay MD ,&nbsp;Andrea Alcaraz MSc ,&nbsp;Fernando Argento MSc","doi":"10.1016/j.vhri.2023.12.001","DOIUrl":"10.1016/j.vhri.2023.12.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Non–small cell lung cancer (NSCLC) is Argentina’s first cause of cancer death. Most patients have an advanced stage at diagnosis, with poor expected survival. This study aimed to characterize the health-related quality of life (HRQOL) and economic impact of patients treated in the private healthcare sector and compare it with that of the public sector.</p></div><div><h3>Methods</h3><p>We undertook an observational cross-sectional study that extended a previous study to a referral private center in Argentina. Outcomes included the EuroQol EQ-5D-3L (to assess HRQOL), Comprehensive Score for Financial Toxicity (financial toxicity instrument), Work Productivity and Activity Impairment – General Health (to assess productivity loss), and out-of-pocket expenses in adults diagnosed of NSCLC.</p></div><div><h3>Results</h3><p>We included 30 consecutive patients from a private healthcare center (July 2021 to March 2022), totaling 131 patients (n = 101 from previous public study). The whole sample had low quality of life and relevant economic impact. Patients in the private healthcare sector showed lower disease severity and higher educational level and household income. In addition, private healthcare system patients showed higher utility (0.77 vs 0.73; <em>P</em> &lt; .05) and lower impairment of daily activities (41% vs 59%; <em>P</em><span> = .01). Private health system patients also showed lower financial toxicity as measured by the Comprehensive Score for Financial Toxicity score (23.9 vs 20.14; </span><em>P</em> &lt; .05) but showed no differences when financial toxicity was assessed as a dichotomic variable.</p></div><div><h3>Conclusions</h3><p>Although patients with NSCLC treated in a private healthcare center in Argentina showed a relevant HRQOL and economic impact, this impact was smaller than the one observed in publicly funded hospitals.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 94-99"},"PeriodicalIF":2.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643010","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":"Quality of Life of Patients With Cancer at the Beni Mellal Oncology Center","authors":"Mohamed Aboufaras PhD ,&nbsp;Karima Selmaoui PhD ,&nbsp;Nadia Ouzennou PhD","doi":"10.1016/j.vhri.2023.12.002","DOIUrl":"10.1016/j.vhri.2023.12.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Cancer and its treatments<span> significantly impact individuals’ lives and quality of life<span> (QOL). Research on QOL examines these effects, encompassing physical, psychological, and social aspects. Understanding QOL factors is vital for both patients and clinicians. The evaluation of QOL of patients with cancer and its associated predictive factors has not been previously investigated within the Beni Mellal-Khenifra region of Morocco. Our primary aim was to assess the QOL experienced by patients while simultaneously identifying the determinants and predictors influencing it.</span></span></p></div><div><h3>Methods</h3><p><span><span>Patients were enrolled in a cross-sectional study conducted at the Beni Mellal Oncology Center. Each participant was required to fill out the Moroccan Arabic version of the European Organization for Research and </span>Treatment of Cancer QLQ-C30 questionnaire, along with a supplemental questionnaire gathering sociodemographic information. A </span>linear regression analysis was executed to ascertain predictors of the Global Health Status (GHS) and 5 functional scales. The statistical analysis was carried out using Statistical Package for Social Science (SPSS) v25 software.</p></div><div><h3>Results</h3><p>Our study included 369 patients, with an average age of 52.89. The mean score on the QLQC30 GHS Scale was 64.97. Notably, this score exhibited positive correlations with emotional, social, and role functioning scales, while demonstrating negative correlations with prostate and lung cancers, as well as the presence of pain. Furthermore, the presence of fatigue exhibited associations with all functioning scales, except for social functioning.</p></div><div><h3>Conclusions</h3><p>Patients exhibited a favorable GHS. However, it is noteworthy that prostate cancer, lung cancer, the presence of pain, and diminished emotional, social, and role functioning emerged as independent factors significantly associated with poorer GHS.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 86-93"},"PeriodicalIF":2.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563884","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":"Portuguese Global Medicines Access Index 2021—An Indicator to Measure Access to Hospital Medicines","authors":"Sofia Oliveira-Martins PhD ,&nbsp;Miguel Costa Lopes MPharm ,&nbsp;Alexandra Cardoso dos Santos MA, MBA ,&nbsp;Ana Margarida Advinha PhD","doi":"10.1016/j.vhri.2023.11.011","DOIUrl":"10.1016/j.vhri.2023.11.011","url":null,"abstract":"<div><h3>Objectives</h3><p>Access to innovative and effective medication is a citizen’s right. The main objectives of this study were to build an indicator to measure access to medicines within hospitals, the Global Medicines Access Index, and to identify the main existing barriers.</p></div><div><h3>Methods</h3><p>Cross-sectional study carried out in Portuguese National Health Service hospitals. A consensus methodology (expert panel of 7 members) was used to define which dimensions should be included in the index and the weighting that each should take. The panel identified 6 dimensions: access to innovative medicines, proximity distribution, shortages, access to medicines before financing decision, value-based healthcare, and access to medication depending on cost/funding. Data were collected through an electronic questionnaire (September 2021).</p></div><div><h3>Results</h3><p>The response rate was 61.2%. Most hospitals used medicines with and without marketing authorization before the funding decision. Monitoring and generating evidence of new therapies results is still insufficient. The identified barriers were the administrative burden as the major barrier in purchasing medicines, with a relevant impact on shortages of medicines. Most respondents (87%) had a proximity distribution program, mainly implemented in the pandemic context, and the price/funding model was only identified by 10% as a barrier to access. The 2021 Global Medicines Access Index was 66%. Shortages and value-based use of medicines were the dimensions that had more influence in lowering the index value.</p></div><div><h3>Conclusions</h3><p>The new formula used to obtain a unique and multidimensional index for access to hospital medicines seems to be more sensitive and objective and will be used to monitor access.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 80-85"},"PeriodicalIF":2.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543096","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":"The Drug Burden Index and Level of Frailty as Determinants of Healthcare Costs in a Cohort of Older Frail Adults in New Zealand","authors":"Shnece Duncan MCom ,&nbsp;Hans Ulrich Bergler MSc ,&nbsp;Andrea Menclova PhD ,&nbsp;John W. Pickering PhD ,&nbsp;Prasad S. Nishtala PhD ,&nbsp;Nagham Ailabouni PhD ,&nbsp;Sarah N. Hilmer PhD ,&nbsp;Dee Mangin MBChB ,&nbsp;Hamish Jamieson PhD","doi":"10.1016/j.vhri.2023.11.009","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.009","url":null,"abstract":"<div><h3>Objectives</h3><p>Frailty is common in older people and is associated with increased use of healthcare services and ongoing use of multiple medications. This study provides insights into the healthcare cost structure of a frail group of older adults in Aotearoa, New Zealand. Furthermore, we investigated the relationship between participants’ anticholinergic and sedative medication burden and their total healthcare costs to explore the viability of deprescribing interventions within this cohort.</p></div><div><h3>Methods</h3><p>Healthcare cost analysis was conducted using data collected during a randomized controlled trial within a frail, older cohort. The collected information included participant demographics, medications used, frailty, cost of service use of aged residential care and outpatient hospital services, hospital admissions, and dispensed medications.</p></div><div><h3>Results</h3><p>Data from 338 study participants recruited between 25 September 2018 and 30 October 2020 with a mean age of 80 years were analyzed. The total cost of healthcare per participant ranged from New Zealand $15 (US dollar $10) to New Zealand $270 681 (US dollar $175 943) over 6 months postrecruitment into the study. Four individuals accounted for 26% of this cohort’s total healthcare cost. We found frailty to be associated with increased healthcare costs, whereas the drug burden was only associated with increased pharmaceutical costs, not overall healthcare costs.</p></div><div><h3>Conclusions</h3><p>With no relationship found between a patient’s anticholinergic and sedative medication burden and their total healthcare costs, more research is required to understand how and where to unlock healthcare cost savings within frail, older populations.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 72-79"},"PeriodicalIF":2.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001383/pdfft?md5=9d42d9941cddc2639bddf749f8b4391a&pid=1-s2.0-S2212109923001383-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503662","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":"Association of Healthcare Fragmentation and the Survival of Patients with Colorectal Cancer in Colombia","authors":"Andrés Felipe Patiño-Benavidez MD ,&nbsp;Giancarlo Buitrago MD, MSc, PhD ,&nbsp;Nicolás Rozo-Agudelo MD ,&nbsp;Laura Estefanía Saldaña-Espinel MD ,&nbsp;Óscar Andrés Gamboa-Garay MD ,&nbsp;Javier Eslava-Schmalbach MD, MSc, PhD ,&nbsp;Carlos Bonilla-González MD ,&nbsp;Óscar Guevara-Cruz MD ,&nbsp;Rubén Ernesto Caycedo MD ,&nbsp;Edgar Germán Junca MD ,&nbsp;Ricardo Sánchez-Pedraza MD, MSc","doi":"10.1016/j.vhri.2023.12.003","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.003","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to identify the association between healthcare fragmentation and survival for patients with colorectal cancer in Colombia.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was performed using administrative databases, with an electronic algorithm to identify patients with colorectal cancer based on codes. The patients were enrolled between January 1, 2013, and December 31, 2016. The exposure variable was fragmentation, which was measured based on the number of different healthcare institutions that treated a patient during the first year after diagnosis. Matching was performed using propensity scores to control for confounding, and the hazard ratio for exposure to higher fragmentation was calculated for the matched sample.</p></div><div><h3>Results</h3><p>A total of 5036 patients with colorectal cancer were identified, 2525 (49.88%) of whom were women. The mean number of network healthcare institutions for the total sample was 5.71 (SD 1.98). The patients in the quartile with higher fragmentation had the highest mortality rate, 35.67 (95% CI 33.63-38.06) per 100 patients. The comparison of higher and lower quartiles of fragmentation resulted in an incidence rate ratio of 1.23 (95% CI 1.04-1.45; <em>P</em> = .02). Of the 5036 patients, 422 (8.38%) were classified as the exposed cohort (higher fragmentation). The total matched sample consisted of 844 subjects, and an HR of 1.26 (95%CI; 1.05-1.51) was estimated.</p></div><div><h3>Conclusions</h3><p>Exposure to more highly fragmented healthcare networks decreases overall 4-year survival for patients with colorectal cancer in Colombia.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 63-71"},"PeriodicalIF":2.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001425/pdfft?md5=0839f20a8e3133bcfbd75fb3e288a1fa&pid=1-s2.0-S2212109923001425-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139493687","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 Comparing QuantiFERON-TB Gold Plus Test and Tuberculin Skin Test for the Diagnosis of Latent Tuberculosis Infection in Immunocompetent Subjects in Colombia","authors":"Cristian E. Navarro MD, MSc ,&nbsp;John E. Betancur MSc","doi":"10.1016/j.vhri.2023.11.010","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.010","url":null,"abstract":"<div><h3>Objectives</h3><p><span>To determine the cost-effectiveness of the QuantiFERON-TB Gold Plus (QFT-Plus) test versus the tuberculin skin test in diagnosing </span>latent tuberculosis infection in immunocompetent subjects in the context of the Colombian healthcare system.</p></div><div><h3>Methods</h3><p>A hypothetical cohort of 2000 immunocompetent adults vaccinated with Bacillus Calmette-Guérin at birth<span> who are asymptomatic for tuberculosis disease was simulated and included in a decision tree over a horizon of &lt;1 year. The direct healthcare costs related to tests, antituberculosis treatment<span>, and medical care were considered, and diagnostic performance was used as a measure of effectiveness. The incremental cost-effectiveness ratio (ICER) was estimated, and univariate deterministic and probabilistic sensitivity analyses were carried out using 5000 simulations. The currency was the US dollar for the year 2022, with a cost-effectiveness threshold of $6666 USD (1 gross domestic product per capita for 2022).</span></span></p></div><div><h3>Results</h3><p>QFT-Plus was cost-effective with an ICER of $5687 USD for each correctly diagnosed case relative to a threshold of $6666 USD. In the deterministic analysis, QFT-Plus was cost-effective in half of the proposed scenarios. The variable that most affected the ICER was the prevalence of latent tuberculosis and test sensitivities. In the probabilistic analysis, QFT-Plus was cost-effective in 54.74% of the simulated scenarios, and tuberculin skin test was dominant in 13.84%.</p></div><div><h3>Conclusions</h3><p>The study provides evidence of the cost-effectiveness of QFT-Plus compared with the tuberculin skin test in diagnosing latent tuberculosis infection in immunocompetent adults in the Colombian context.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 54-62"},"PeriodicalIF":2.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139493688","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":"The Shortfalls of Mental Health Compartment Models: A Call to Improve Mental Health Investment Cases in Developing Countries","authors":"Cyprian M. Mostert PhD ,&nbsp;Andrew Aballa MSc ,&nbsp;Linda Khakali MSc ,&nbsp;Willie Njoroge MSc ,&nbsp;Jasmit Shah PhD ,&nbsp;Samim Hasham PhD ,&nbsp;Zul Merali PhD ,&nbsp;Lukoye Atwoli PhD","doi":"10.1016/j.vhri.2023.11.012","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.012","url":null,"abstract":"<div><h3>Objectives</h3><p>There are irregularities in investment cases generated by the Mental Health Compartment Model. We discuss these irregularities and highlight the costing techniques that may be introduced to improve mental health investment cases.</p></div><div><h3>Methods</h3><p>This analysis uses data from the World Bank, the World Health Organization Mental Health Compartment Model, the United Nations Development Program, the Kenya Ministry of Health, and Statistics from the Kenyan National Commission of Human Rights.</p></div><div><h3>Results</h3><p>We demonstrate that the Mental Health Compartment Model produces irrelevant outcomes that are not helpful for clinical settings. The model inflated the productivity gains generated from mental health investment. In some cases, the model underestimated the economic costs of mental health. Such limitation renders the investment cases poor in providing valuable intervention points from the perspectives of both the users and the providers.</p></div><div><h3>Conclusions</h3><p>There is a need for further calibration and validation of the investment case outcomes. The current estimated results cannot be used to guide service provision, research, and mental health programming comprehensively.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 48-53"},"PeriodicalIF":2.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139487163","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}