Value in Health最新文献

{"title":"The health economics of Alzheimer's disease and related dementias.","authors":"Thomas Rapp, Pei-Jung Lin","doi":"10.1016/j.jval.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.jval.2025.02.002","url":null,"abstract":"","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An acquired taste: latent class analysis to compare adolescent and adult preferences for EQ-5D-Y-3L health states.","authors":"Jonathan L Nazari, Juan M Ramos-Goñi, Ning Yan Gu, A Simon Pickard","doi":"10.1016/j.jval.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.020","url":null,"abstract":"<p><strong>Objectives: </strong>United States stakeholders advised including adolescents in the valuation study for the EQ-5D-Y-3L, a step towards greater acknowledgement of children in informing societal values. This study aimed to assess the relative contribution of adolescent and adult preferences to a model when combined.</p><p><strong>Methods: </strong>Discrete choice experiment (DCE) data were collected from an online sample of 1,529 adults and 714 adolescents (ages 11-17). Each respondent completed 15 DCE tasks which were analyzed using latent class models representing varying number of preference classes. Within the best-fitting model, the contribution of each class was determined by the 'scale-adjusted class share' (SACS), combining the class's proportion of respondents (class share) and the magnitude of coefficients (within-class scale). We estimated the contribution of adolescent and adult respondents to SACS for each class, with lower SACS representing less contribution to the combined model.</p><p><strong>Results: </strong>The best fitting model described 6 classes. Adults had higher contribution to all except one class, accounting for 78.7% of the total contribution. After adjusting for the unequal sample size of adolescent and adult respondents, adults contributed approximately 65.0% and adolescents contributed 35.0% of the weights towards a combined model.</p><p><strong>Conclusions: </strong>Adolescents showed diminished, disproportionate representation in a combined model, due in part to more indifferent, less informative preferences for EQ-5D-Y-3L health states compared to adults. Latent class analysis showcases one approach to estimate and weight contributions from intentionally sampled subgroups in a combined model.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qini curves for potential impact assessment of risk predictive models informing intervention policies.","authors":"Pierpaolo Palumbo","doi":"10.1016/j.jval.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.024","url":null,"abstract":"<p><strong>Objectives: </strong>Predictive models in medicine help make decisions about which individual to treat with a given therapeutic or preventive intervention. Before being tested in large field studies and recommended for clinical adoption, it is important to evaluate not only their statistical accuracy but also the impact they may have when used to inform health intervention policies. We aim to provide simple methods for the potential impact assessment of health intervention policies based on predictive models.</p><p><strong>Methods: </strong>We propose an analytic framework based on Qini curves wherein prediction-based policies are analyzed on two impact endpoints: i) the fraction of the population that would be selected for the intervention (coverage) and ii) the effect on the clinical outcomes of interest (disutility). The drivers of values are the disease prevalence, the predictive performance of the model, and the effectiveness of the intervention.</p><p><strong>Results: </strong>We present simple formulas for calculating coverage and disutility from either observational or randomized controlled data. We illustrate possible value measures arising from geometrical properties on the Qini plane: delta coverage and disutility, number needed to treat, and integrated difference between Qini curves. We show the applicability of the Qini analysis by providing examples about prevention of falls in older adults and prevention of secondary cardiovascular events with pioglitazone.</p><p><strong>Conclusions: </strong>Coverage and disutility capture key value components of prediction-based policies. The method can be used for comparing models or tuning risk thresholds for managing trade-offs between conflicting objectives (e.g., clinical benefits, side effects, and healthcare resources).</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of internet-based psychological interventions: a scoping review of methodological choices.","authors":"Amira J Hariz, Karine Chevreul, Laure Daval, Mathilde Husson, Corinne Alberti, Morgane Michel","doi":"10.1016/j.jval.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.023","url":null,"abstract":"<p><strong>Objectives: </strong>Internet-based psychological interventions hold promise for cost-effectiveness, yet their evaluation lacks standardisation, potentially leading to methodological discrepancies and inconclusive results. This study aims to conduct a scoping review of economic methods used when evaluating these interventions.</p><p><strong>Methods: </strong>Articles published between January 2015 and December 2020 were retrieved from PubMed, Embase, Cochrane Library, CINAHL, ECONLIT, and PsychINFO. Two reviewers independently screened titles, abstracts, and full texts of relevant publications, and extracted prespecified data. Outcomes related to intervention characteristics, comparators, perspective, time horizon, costs, benefits, economic endpoints, and uncertainty analysis methods were retrieved and synthetised narratively.</p><p><strong>Results: </strong>We identified 703 references and included 85. Seventy-four included a cost-utility analysis and 58 a cost-effectiveness analysis, with 47 carrying out both. The comparator was treatment as usual in 52 studies (61.2%) but varied widely across studies. A societal perspective was adopted in 60 studies, supplemented by a healthcare perspective in half. Time horizon was one year or less in 68 articles (80.0%). Intervention costs (71/85 studies) predominantly covered delivery costs (45/71 studies), while development and promotional costs were infrequently considered (respectively 14 and 5/71 studies). Interventions' reach, opportunity costs, user engagement and equity issues were rarely addressed. Key factors influencing cost-effectiveness included perspective, time horizon, costs included, and methods for handling missing data.</p><p><strong>Conclusions: </strong>Assessment of cost-effectiveness in internet-based psychological interventions shows variability, potentially affecting efficiency evidence. Conventional methods are often favoured overlooking digital tools' specificities. Tailored guidelines for such evaluations could be helpful for standardised and reliable evidence.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Savings and Improved Clinical Outcomes from a Mobile Health Cardiovascular Disease Self-Management Program.","authors":"Walter Roberts, Helena Lyson, Clint Speer, Elena Tovar, Edo Paz, Eyal Zimlichman","doi":"10.1016/j.jval.2025.01.025","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.025","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the impact of a mobile health (mHealth) cardiovascular disease (CVD) self-management program on medical spending, health care utilization, and clinical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort, pre-post observational analysis of medical claims data from February 2018 to September 2023. Participants enrolled in the mHealth CVD self-management program were compared to matched non-participants to assess changes in medical spending and utilization, employing a difference-in-differences (DiD) approach. Moderation analyses tested whether the effect of participation on medical costs differed according to participants' demographic and employer characteristics. Linear mixed models were also used to evaluate changes in participant blood pressure.</p><p><strong>Results: </strong>There were 7,112 participants and an equal number of matched non-participants from 14 employers included in the cost savings analysis. Participation in the mHealth CVD self-management program was associated with an annualized per member savings of $1,709 as compared to matched non-participants. While savings were consistent across participant sex and employer type, older participants experienced greater savings. Program participation was associated with fewer inpatient hospital days and increased primary care utilization following enrollment. Program participants experienced significant reductions in blood pressure, with the largest reductions seen among those with stage 2 hypertension at baseline.</p><p><strong>Conclusions: </strong>Participation in a mHealth CVD self-management program was associated with significant cost savings and clinical improvements across diverse populations, highlighting its effectiveness as a cost-efficient tool for managing CVD and improving health outcomes. Further research is needed to explore the long-term benefits and cost-effectiveness of mHealth programs to support broader adoption.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of interventions to reduce the environmental footprint of healthcare.","authors":"Anna-Veera Seppänen, Zeynep Or","doi":"10.1016/j.jval.2025.01.021","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.021","url":null,"abstract":"<p><strong>Background: </strong>The healthcare sector contributes significantly to global warming, yet strategies for reducing its impact are not well integrated into health policy. This scoping review aimed to identify the range of effective interventions that can reduce the environmental footprint of healthcare, and to provide an overview of their impact.</p><p><strong>Methods: </strong>We searched for peer-reviewed articles published in English, French or Swedish between 2010 and September 2024 in Medline and Web of Science, following the Joanna Briggs Institute guidelines and the PRISMA Extension for Scoping Reviews. Publications were selected by two researchers and a documentalist. Data from included studies were extracted and synthesized in tables and described in a narrative synthesis.</p><p><strong>Results: </strong>We identified seven systematic reviews and 44 original research articles. Most of the effective interventions targeted hospitals and varied from energy saving practices and reducing potent anaesthetic gases to changing care protocols and improving waste management. The measured impact of interventions was context-specific and depended on national energy sources. Only a few studies reported on the impact of structural and strategic changes in healthcare provision, across care settings.</p><p><strong>Conclusions: </strong>There is an urgent need for better understanding the costs and benefits of diffusing effective green interventions across care providers and developing more systemic approaches for optimising care provision and use, to achieve a meaningful impact.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical Methods for Analyzing EQ-5D in Randomized Clinical Trials - A Systematic Literature Review.","authors":"Jiajun Yan, Brittany Humphries, Ruinan Xie, Ziran Yin, Zhenyan Bo, Sha Diao, Jing Cai, Preston Tse, Meixuan Li, Eleanor Pullenayegum, Shun Fu Lee, Feng Xie","doi":"10.1016/j.jval.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jval.2025.02.001","url":null,"abstract":"<p><strong>Objective: </strong>We conducted a systematic literature review to summarize the application of statistical methods for analyzing treatment effect on EQ-5D in RCTs.</p><p><strong>Method: </strong>We searched two electronic databases (MEDLINE and EMBASE, from inception through 2021) and www.</p><p><strong>Clinicaltrial: </strong>gov. Eligible studies were RCTs that analyzed post-baseline EQ-5D data by treatment group. Information on trial characteristics, EQ-5D data characteristics and statistical methods were extracted. Descriptive statistics were used to summarize results by dimension response, EQ VAS, and EQ-5D utility.</p><p><strong>Results: </strong>A total of 2125 trials met the eligibility criteria. EQ-5D was commonly considered a secondary (n=1219, 57.4%) or exploratory (n=775, 36.5%) endpoint in RCTs. EQ-5D utilities were the most analyzed. Both utilities and EQ VAS were primarily analyzed in numerical format. The most common statistical models for analyzing utilities were linear fixed-effect model for single post-baseline (192/589, 32.6%) and linear mixed-effect model for multiple post-baselines (338/984, 34.3%). Of the 2054 studies that analyzed numerical EQ-5D, 221 (10.8%) examined model assumptions and 438 (21.3%) adjusted for the baseline score. Missing data were explicitly assessed in 661 trials, among which 347 (52.5% of 661) applied imputations, with the two most used imputation methods being multiple imputations (n=200, 57.6% of 347) and last observation carried forward (n=106, 30.5% of 347).</p><p><strong>Conclusion: </strong>This review found that health utilities are the most frequently analyzed EQ-5D data collected in clinical trials, followed by EQ VAS. Significant variation was observed in the selection of models, with most trials lacking adjustments for baseline data and appropriate methods for handling missing data.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Landscape of Open Source Health Economic Models: A Systematic Database Review and Analysis.","authors":"Raymond H Henderson, Chris Sampson, Xavier Glv Pouwels, Stephanie Harvard, Ron Handels, Talitha Feenstra, Ramesh Bhandari, Aryana Sepassi, Renée Arnold","doi":"10.1016/j.jval.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.019","url":null,"abstract":"<p><strong>Introduction: </strong>Health economic models are crucial for health technology assessment to evaluate the value of medical interventions. Open source models (OSMs), where source code and calculations are publicly accessible, enhance transparency, efficiency, credibility, and reproducibility. This study systematically reviewed databases to map the landscape of available OSMs in health economics.</p><p><strong>Methods: </strong>A systematic database review was conducted, informed by guidance from ISPOR's OSM Special Interest Group. Eleven databases and specific OSM repositories were searched using predefined terms. Identified models were screened and duplicates were removed.</p><p><strong>Results: </strong>The search yielded 8,664 hits, resulting in 182 unique OSMs. GitHub hosted the majority (74%), followed by Zenodo (11%). R was the predominant software platform (64%). Infectious disease was the most common application domain (29%). Markov models were the most frequent model type (49%). Licensing with Creative Commons was typical. Government and academic institutions were the primary sponsors, although many models lacked clear sponsorship.</p><p><strong>Discussion: </strong>This review identified a diverse array of OSMs primarily hosted on GitHub and developed using R. The models covered a wide range of medical fields, with a majority focus on infectious diseases. Licensing clarity and standardized reporting are essential to maximize OSM impact. Combining repository searches with a traditional literature search provides a comprehensive approach to identifying OSMs.</p><p><strong>Conclusion: </strong>This review highlighted the availability and diversity of OSMs in health economics, predominantly utilizing R and focusing on infectious disease, oncology, and neurology. Future work should enhance search capabilities, standardize model reporting, and leverage OSMs for health policy impacts.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newer GLP-1 RAs Are Associated With Improved Glycemic Control in US Adults With Type 2 Diabetes: a Population-Level Time Series Analysis.","authors":"Lei Lv, Yan Wang, Lin Xie, Josh Noone, Sara Alvarez, Yuehan Zhang, Yan Song, Daniel M Rotroff","doi":"10.1016/j.jval.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.jval.2025.01.018","url":null,"abstract":"<p><strong>Objectives: </strong>The population-level impact of newer glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatments on patients with type 2 diabetes remains unclear. Therefore, this study investigated the association of newer GLP-1 RAs with population-level diabetes-related outcomes in US adults with type 2 diabetes.</p><p><strong>Methods: </strong>This was a noninterventional, retrospective analysis of administrative insurance claims data obtained from Optum's de-identified Clinformatics® Data Mart Database between January 2004 and December 2022. Individual patient data were aggregated into monthly time series at the population level. Associations between the proportion of patients on newer GLP-1 RAs of interest (dulaglutide, once-weekly or oral semaglutide, and tirzepatide) and average hemoglobin A1c (HbA1c), HbA1c <7.0%, and HbA1c <8.0% were assessed using time series regressions. Time-based trends in population-level outcomes were assessed using interrupted time series analyses. All analyses were adjusted for potential confounders.</p><p><strong>Results: </strong>Time series regression analyses demonstrated that a higher proportion of patients taking newer GLP-1 RAs was associated with a lower average HbA1c and a higher proportion of patients with HbA1c <7.0% (after 5 months of treatment) and <8.0% (after 2 months of treatment). Results from the interrupted time series analyses demonstrated that population-level glycemic control has been improving since the first newer GLP-1 RA (dulaglutide) was approved. This trend has persisted, even following the COVID-19 emergency declaration.</p><p><strong>Conclusions: </strong>A higher percentage of patients receiving newer GLP-1 RAs was associated with significantly improved population-level glycemic control. The newer GLP-1 RA period displayed improved population-level glycemic control vs the older GLP-1 RA period.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Health Equity in Health Technology Assessment Processes: A Landscape Analysis of 13 Health Systems in Asia.","authors":"Chanthawat Patikorn, Chia Jie Tan, Jeong-Yeon Cho, Sarayuth Khuntha, Nguyen Thi Ha, Rini Noviyani, Mac Ardy J Gloria, Anton L V Avanceña, Sitaporn Youngkong, Kyoko Shimamoto, Nathorn Chaiyakunapruk","doi":"10.1016/j.jval.2025.01.012","DOIUrl":"10.1016/j.jval.2025.01.012","url":null,"abstract":"<p><strong>Objectives: </strong>This landscape analysis aimed to summarize the role of health equity in the health technology assessment (HTA) process (topic nomination, topic prioritization, assessment, appraisal, and decision making) in Asia.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted, followed by in-depth interviews with key informants. Content analysis was performed to summarize the role of health equity in HTA in 13 health systems in Asia, including Brunei Darussalam, Cambodia, China, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam.</p><p><strong>Results: </strong>Health equity was reported to be considered in most health systems' HTA processes, except for Cambodia and Myanmar, which do not have an established HTA process. Interviews revealed that health equity has been more frequently considered to address the unmet medical needs of specific diseases (eg, high disease burden or severity, rare diseases, cancer, and diseases affecting children and the elderly) in Brunei Darussalam, China, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, and Vietnam or inequities in socially disadvantaged groups (eg, socioeconomic status and geographical location) in Indonesia and the Philippines. Equity-informative economic evaluation was still in the early stages, with only 3 health systems reporting their use.</p><p><strong>Conclusions: </strong>Health equity is considered in the HTA process in most Asian health systems. However, quantitative evaluation of health equity impact is still in its infancy because few health systems have just begun to perform equity-informative economic evaluations.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}