Value in Health最新文献

{"title":"Meditation and Mindfulness Practices as Supporting Tools to Mental Health Interventions in the Philippines.","authors":"Dalmacito A Cordero","doi":"10.1016/j.jval.2025.06.022","DOIUrl":"10.1016/j.jval.2025.06.022","url":null,"abstract":"","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709000","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 Assessment of the Maturity of Cancer Survival Data Used in Economic Models for the National Institute for Health and Care Excellence's Single Technology Appraisals.","authors":"Jiyeon Kang, John Cairns, Nicholas R Latimer, Stephen Duffield, Richard Grieve","doi":"10.1016/j.jval.2025.07.010","DOIUrl":"10.1016/j.jval.2025.07.010","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the maturity of survival data used in cancer drug appraisals by the National Institute for Health and Care Excellence (NICE) and the implications for decision making.</p><p><strong>Methods: </strong>We assessed the maturity of survival data used in economic models within NICE single technology appraisals published between January 1, 2011 and December 31, 2023 (n = 301). We categorized these survival data according to whether they were \"highly immature\" (<20% of events), \"immature\" (20%-50%), or \"mature\" (>50%). We applied multinomial logistic regression analysis to assess the association of factors such as time period, the introduction of the Cancer Drugs Fund (CDF), cancer type, disease severity/stage, technology type, and trial design (single-arm or randomized controlled trial), with the maturity of the survival data. We then assessed the association of the maturity of the survival data with the subsequent recommendation of the NICE appraisal committee.</p><p><strong>Results: </strong>After adjusting for potential confounders, the percentage of appraisals with highly immature survival data increased from 25.1% (pre-CDF) to 40.4% (post-CDF) (P = .105). Appraisals that used single-arm trials or were for early-stage cancers were more likely to use highly immature survival data. Those technologies with highly immature data were more likely to receive CDF recommendations (30.4% vs 11.5%, P = .007).</p><p><strong>Conclusions: </strong>The trend toward more NICE single technology appraisals of cancer drugs relying on immature survival data are consistent with moves by regulatory agencies to encourage expedited approvals for innovative therapies. For Health Technology Assessment decision-making, it is essential to balance early drug access with the use of robust evidence.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708998","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":"Impact of Constrained Access to Primary Care on Health-Related Quality of Life.","authors":"Anna Wilding, Charlie Moss, Luke Munford, Matthew Sutton","doi":"10.1016/j.jval.2025.07.013","DOIUrl":"10.1016/j.jval.2025.07.013","url":null,"abstract":"<p><strong>Objectives: </strong>Timely access to healthcare has implications for health through early diagnosis and management of long-term conditions. However, when healthcare services are provided during traditional working hours, this limits workers' ability to attend appointments.</p><p><strong>Methods: </strong>We used repeated cross-sectional data from full-time employees participating in the National General Practice Patient Survey in England between 2013 and 2017 (N = 1 097 156). We estimated the health-related quality of life effects (measured by EQ-5D-5L) of an individual being unable to take time away from work to attend primary care appointments. We used an instrumental variable approach to overcome endogeneity concerns around health and employment.</p><p><strong>Results: </strong>Jobs constraining primary care access led to significantly lower EQ-5D-5L utility scores (local average treatment effect = -0.101) (95% CI -0.153 to -0.044), representing an 11.4 percentage point decrease at the mean. The effects were concentrated on physical health domains of the EQ-5D-5L rather than mental health, and the effect on pain/discomfort was the largest in magnitude. The negative effect on the EQ-5D-5L utility score was larger in magnitude for individuals with long-term conditions than those without.</p><p><strong>Conclusions: </strong>Improving access to primary care by reducing constraints on access during typical working hours could improve population health. Further investigation is needed of the effects of this access barrier for individuals with long-term conditions, and the cost-effectiveness of different policy approaches.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699651","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-Effectiveness of Long-Chain Omega-3 Supplementation for the Secondary Prevention of Cardiovascular Disease in the United States.","authors":"Aldo A Bernasconi, Kevin C Maki, Eric A Finkelstein","doi":"10.1016/j.jval.2025.07.005","DOIUrl":"10.1016/j.jval.2025.07.005","url":null,"abstract":"<p><strong>Objectives: </strong>A variety of eicosapentaenoic (EPA) and docosahexaenoic (DHA) omega-3 dietary supplements of varying dosage and pricing are available in the United States and commonly used for secondary cardiovascular prevention. Although these interventions' efficacy has been studied, their cost-effectiveness remains unknown. The goal of this article is to assess whether omega-3 dietary supplements are cost-effective for secondary cardiovascular prevention in adults in the United States. Our analysis explicitly incorporates a reported higher risk of atrial fibrillation associated with omega-3 supplementation.</p><p><strong>Methods: </strong>This economic evaluation used a Markov model over a 10-year horizon with health states defined by cardiovascular disease status. Effectiveness was measured by quality-adjusted life-years (QALYs) gained, and costs were calculated from a US healthcare system perspective, estimated in 2023 US dollars. Data were obtained from the published literature. Deterministic and probabilistic sensitivity analyses were conducted to estimate the influence of parameter uncertainties on the resulting cost-effectiveness ratios. Scenarios including low (300 mg/day), medium (1000 mg/day), and high (2500 mg/day) supplementation dosages of EPA and DHA omega-3s were considered. Average and incremental cost-effectiveness ratios (ICERs) in US$/QALY are presented.</p><p><strong>Results: </strong>At a willingness-to-pay threshold of $50 000/QALY, 1000 mg/day is the most cost-effective dose (ICER of $ 25 024). At a willingness-to-pay of $100 000, 2500 mg/day (ICER of $57 981) is the most cost-effective dose.</p><p><strong>Conclusions: </strong>These findings reveal that use of EPA and DHA omega-3 dietary supplements, in a wide range of dosages and prices, are cost-effective for secondary prevention of cardiovascular disease for US adults.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699649","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":"Are Generic Preference-Based Measures Valid for Use in Informal Carers? A Psychometric Investigation.","authors":"Jan Faller, Cathrine Mihalopoulos, Gang Chen, Nikki McCaffrey, Brendan Mulhern, Lidia Engel","doi":"10.1016/j.jval.2025.07.009","DOIUrl":"10.1016/j.jval.2025.07.009","url":null,"abstract":"<p><strong>Objectives: </strong>Using generic preference-based measures (GPBMs) to capture informal carer health-related quality-of-life outcomes provides consistency across economic evaluations and facilitates combining patient and carer quality-adjusted life-years. This study assesses the psychometric performance of the 5-level EQ-5D (EQ-5D-5L) and Assessment of Quality of Life 8-Dimension (AQoL-8D) and how they conceptually relate to carer-related measures among Australian informal carers.</p><p><strong>Methods: </strong>This was a secondary analysis of an online survey (n = 500 informal carers) containing carer-related measures (Adult Social Care Outcomes Toolkit for Carers [ASCOT-Carer], Care-Related Quality-of-Life [CarerQol], Carer Experience Scale [CES]) and GPBMs (EQ-5D-5L and AQoL-8D). Descriptive analysis, ceiling effects, convergent and known-group validity, and test-retest reliability were assessed. Exploratory factor analysis was conducted exploring the conceptual overlap between the GPBMs and carer-related measures.</p><p><strong>Results: </strong>Completion rates for the GPBMs were above 94%, with no ceiling effects. Test-retest reliability (only available for the EQ-5D-5L) revealed good agreement (intraclass correlation = 0.825), with moderate (usual activities, pain/discomfort, and anxiety/depression) to substantial (mobility and self-care) agreement on domains. Both GPBMs were moderately correlated with carer-specific measures and discriminated groups based on hours of care, tasks, number of care recipient diagnoses, number cared for, sharing a household, and duration of care. Exploratory factor analysis identified some overlap (predominantly health-related concepts) between carer-related measures and the GPBMs.</p><p><strong>Conclusions: </strong>The EQ-5D-5L and AQoL-8D are acceptable for use in informal carers, with the choice of instrument dependent on the constructs intended to be measured. The inclusion of both GPBMs and carer-related measures during outcome assessment may still be warranted to understand carer well-being and burden.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699647","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":"Comprehensive Access to Semaglutide: Clinical and Economic Implications for Medicare.","authors":"Victoria W Dayer, Iman Nourhussein, Adam Kasle, Ryan N Hansen, Angelo Navas, Sean D Sullivan","doi":"10.1016/j.jval.2025.07.007","DOIUrl":"10.1016/j.jval.2025.07.007","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to estimate comprehensive value of semaglutide in the Medicare population for current and future FDA-approved indications.</p><p><strong>Methods: </strong>We used data from government reports, published clinical studies, and real-world claims to model clinical outcomes and costs in patients with diabetes, overweight/obesity, and metabolic-associated steatohepatitis over a 10-year period (2026 to 2035). We estimated the financial impact to the Medicare program by comparing the impact of costs of averted clinical events and anticipated treatment costs under various treatment utilization and price assumptions with a scenario in which no patients were treated with semaglutide. We used estimates of the net price of semaglutide, an estimated negotiated price based on a 10% discount from net price starting in year 2, and accounted for patient out-of-pocket costs.</p><p><strong>Results: </strong>Over the 10-year period, we estimated that broad access to semaglutide would result in 38 950 cardiovascular events avoided, and 6180 deaths avoided due to reduction in cardiovascular events and improvement in chronic kidney disease or metabolic-associated steatohepatitis progression. The net financial impact to Medicare was estimated to be savings of $715 million over 10 years. Alternative scenarios yielded net savings ranging from $1.04 billion to $412 million. A scenario that accounted for loss of exclusivity of semaglutide and other treatments produced 10-year cost savings to Medicare of approximately $1.71 billion.</p><p><strong>Conclusions: </strong>Availability of semaglutide in Medicare for all FDA-approved indications would have a substantial impact on health outcomes at net savings of between $1.04 billion and $412 million over 10 years.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699648","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":"Measuring the First Mover Advantage in US Biosimilar Markets.","authors":"J Daniel McGeeney, Aylin Sertkaya, Samantha A McCormick, Andreas Lord, Ayesha Berlind, Sonal Parasrampuria, Michael L Lanthier, Trinidad Beleche, Nicholas C Holtkamp","doi":"10.1016/j.jval.2025.07.011","DOIUrl":"10.1016/j.jval.2025.07.011","url":null,"abstract":"<p><strong>Objectives: </strong>We project market share trends to estimate the median long-run, steady-state market share advantage of first movers in US biosimilar markets.</p><p><strong>Methods: </strong>We used the IQVIA National Sales Perspective data to calculate monthly active pharmaceutical ingredient unit sales in 6 US biosimilar markets (bevacizumab, filgrastim, infliximab, pegfilgrastim, rituximab, and trastuzumab) from the third quarter of 2015 through the fourth quarter of 2023. We fit trends to each product's share of the biosimilar market and projected long-run steady-state values using modified exponential decay functions for first movers and logistic growth functions for later entrants. We compared the median steady-state market share of the first mover to that of later entrants.</p><p><strong>Results: </strong>In 4 of 6 US biosimilar markets studied, we project the first-mover to earn more market share in the long run than all later entrants. First movers will earn a long-run steady-state market share that is between 8.9 and 12.0 percentage points higher than the second entrant, depending on the number of biosimilar competitors in the market. Considering the size of biologic markets, each percentage point potentially represents $5 million in annual sales.</p><p><strong>Conclusions: </strong>In 4 of 6 US markets analyzed, the first biosimilar entrant has a long-run steady-state advantage over all later entrants, which is in addition to the short-run benefit of higher prices. To date, several biosimilar developers have entered the US market before resolving all patent issues. The first mover's long-term advantage may be sizable in dollar terms, which could partially explain this behavior.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699652","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-Effectiveness of Interventions Addressing Loneliness Among Adults: A Systematic Literature Review.","authors":"Annette Bertolino, Johan Jarl, Ulf Gerdtham, Sanjib Saha","doi":"10.1016/j.jval.2025.07.006","DOIUrl":"10.1016/j.jval.2025.07.006","url":null,"abstract":"<p><strong>Objectives: </strong>Loneliness and social isolation are major public health concerns that contribute to numerous health consequences. Although many interventions effectively reduce loneliness and social isolation, their cost-effectiveness remain unclear. This study aimed to evaluate and consolidate evidence on the cost-effectiveness of interventions addressing loneliness or social isolation.</p><p><strong>Methods: </strong>We conducted a systematic literature review of studies published until March 2024. A narrative synthesis of the selected studies was conducted to assess whether interventions for adults >18 years old were cost-effective, and we identified and discussed probable factors affecting cost-effectiveness. We assessed the reporting quality of the selected studies using the Consolidated Health Economic Evaluation Reporting Standards 2022.</p><p><strong>Results: </strong>We included 16 studies covering 18 distinct interventions. Group-based interventions addressing loneliness and/or social isolation appeared generally more likely to be cost-effective compared with individual-based interventions, as were those explicitly targeting lonely individuals and with longer time horizons. Most studies included a societal perspective (8 studies, 10 interventions) and used quality-adjusted life-years (11 interventions). A total of 8 interventions were reported to be cost-effective. Overall, the reporting quality was judged satisfactory; however, none of the studies incorporated equity aspects, ie, distributional cost-effectiveness analysis.</p><p><strong>Conclusions: </strong>Group-based interventions appear generally cost-effective in reducing loneliness despite heterogeneities among studies. However, more research is required with homogenous methodology, for example, societal perspective and longer time horizon before routine implementation.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683243","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":"Rare Disease Policy in High-Income Countries: An Overview of Achievements, Challenges, and Solutions.","authors":"","doi":"10.1016/j.jval.2025.06.009","DOIUrl":"10.1016/j.jval.2025.06.009","url":null,"abstract":"","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668585","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":"Assessing the Health-Related Quality of Life of Children With Asthma or Eczema by a Proxy: Does Assessment Perspective Matter?","authors":"Jia Jia Lee, Rachel Lee-Yin Tan, Jian Yi Soh, Elizabeth Huiwen Tham, Anne Eng Neo Goh, Zai Ru Cheng, Nisha Suyien Chandran, Siyun Lucinda Tan, Michael Herdman, Nan Luo","doi":"10.1016/j.jval.2025.07.004","DOIUrl":"10.1016/j.jval.2025.07.004","url":null,"abstract":"<p><strong>Objectives: </strong>We compared the measurement properties of 2 proxy versions (proxy-proxy perspective, P1 and proxy-patient perspective, P2) of EQ-5D-Y-3L (Y-3L) and EQ-5D-Y-5L (Y-5L) for assessing the health-related quality of life (HRQoL) of pediatric patients with asthma or eczema.</p><p><strong>Methods: </strong>We recruited pediatric patients with asthma or eczema and their parents or legal guardians from 2 tertiary hospitals in Singapore. Patients completed Y-3L, Y-5L, and a disease-specific HRQoL questionnaire. Proxies completed either P1 or P2 version of Y-3L and Y-5L. Asthma control and eczema severity were assessed by clinicians. A subset of patient-proxy dyads was reassessed (follow-up duration: 101.3 ± 63.6 days). The known-groups validity, responsiveness to improvement, and patient-proxy agreement of both proxy versions were assessed using the Y-3L index score (3L-Index), Y-5L level sum score (5L-LSS), and EQ visual analog scale scores.</p><p><strong>Results: </strong>We surveyed 328 child-proxy dyads (P1: 154 dyads; P2: 174 dyads). P2 (47.1%-56.3%) exhibited lower ceiling effects than P1 (53.9%-60.4%). All P1-derived scores differed as expected between Global Initiative for Asthma- or Validated Investigator Global Assessment for Atopic Dermatitis-defined known groups but not all P2-derived scores differed as expected. P1/P2 standardized effect size based on improvement in P1/P2-generated scores was 0.48/0.21 for 3L-Index and 0.28/0.42 for 5L-LSS. Patient-proxy agreement was low for all proxy versions (Intraclass correlation coefficient, ICC: 0.22-0.42). Proxies reported better HRQoL than patients regardless of the version used.</p><p><strong>Conclusions: </strong>Neither proxy version of the 2 EQ-5D-Y questionnaires displayed a clear superiority, suggesting that assessment perspective may not affect proxy-reported HRQoL of children with asthma or eczema. Researchers and clinicians should select the proxy perspective based on the purpose of evaluation.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675829","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}