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Cost-effectiveness of brentuximab vedotin compared with conventional chemotherapy for relapsed or refractory classic Hodgkin lymphoma in China. 在中国,布伦妥昔单抗韦多汀与传统化疗治疗复发或难治性典型霍奇金淋巴瘤的成本效益比较。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-06-06 DOI: 10.1186/s13561-024-00514-6
Shitong Xie, Yanan Sheng, Ling-Hsiang Chuang, Jing Wu
{"title":"Cost-effectiveness of brentuximab vedotin compared with conventional chemotherapy for relapsed or refractory classic Hodgkin lymphoma in China.","authors":"Shitong Xie, Yanan Sheng, Ling-Hsiang Chuang, Jing Wu","doi":"10.1186/s13561-024-00514-6","DOIUrl":"10.1186/s13561-024-00514-6","url":null,"abstract":"<p><strong>Background: </strong>Relapsed or refractory classic Hodgkin lymphoma (RRcHL) associates with poor prognosis and heavy disease burden to patients. This study evaluated the cost-effectiveness of brentuximab vedotin (BV) in comparison to conventional chemotherapy in patients with RRcHL, from a Chinese healthcare perspective.</p><p><strong>Methods: </strong>The lifetime cost and quality adjusted life years (QALYs) were estimated through a partitioned survival model with three health states (progression free, post progression, and death). Two cohorts for each BV arm and chemotherapy arm were built, representing patients with and without transplant after BV or chemotherapy, respectively. Clinical parameters were retrieved from BV trials and the literature. Resource utilization data were mainly collected from local expert surveys and cost parameters were reflecting local unit prices. Utility values were sourced from the literature. A discount rate of 5% was employed according to the Chinese guideline. A series of deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness and uncertainty associated with the model.</p><p><strong>Results: </strong>Results of the base case analysis showed that the incremental cost-effectiveness ratio (ICER) for BV versus chemotherapy was $2,867 (¥19,774). The main model driver was the superior progression-free and overall survival benefits of BV. The ICERs were relatively robust in a series of sensitivity analyses, all under a conventional decision threshold (1 time of Chinese per capita GDP). With this conventional threshold, the probability of BV being cost-effective was 100%.</p><p><strong>Conclusions: </strong>Brentuximab vedotin can be considered a cost-effective treatment versus conventional chemotherapy in treating relapsed or refractory classic Hodgkin lymphoma in China.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","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 endovascular treatment for acute ischemic stroke in China: evidence from Shandong Peninsula. 中国急性缺血性脑卒中血管内治疗的成本效益:来自山东半岛的证据。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-06-05 DOI: 10.1186/s13561-024-00513-7
Lu Han, Kuixu Lan, Dejian Kou, Zehua Meng, Jin Feng, Elizabeth Maitland, Stephen Nicholas, Jian Wang
{"title":"Cost-effectiveness of endovascular treatment for acute ischemic stroke in China: evidence from Shandong Peninsula.","authors":"Lu Han, Kuixu Lan, Dejian Kou, Zehua Meng, Jin Feng, Elizabeth Maitland, Stephen Nicholas, Jian Wang","doi":"10.1186/s13561-024-00513-7","DOIUrl":"10.1186/s13561-024-00513-7","url":null,"abstract":"<p><strong>Background: </strong>Recently, the endovascular treatment (EVT) of acute ischemic stroke has made significant progress in many aspects. Intravenous thrombolysis (IVT) is usually recommended before endovascular treatment in clinical practice, but the value of the practice is controversial. The latest meta-analysis evaluation was that the effect of EVT versus EVT plus IVT did not differ significantly. The cost-effectiveness analysis of EVT plus IVT needs further analysis. This study assesses the health benefits and economic impact of EVT plus IVT in Shandong Peninsula of China.</p><p><strong>Method: </strong>We followed a cross-section design using the Chinese-Shandong Peninsula public hospital database between 2013 and 2023. The real-world costs and health outcomes were collected through the Hospital Information System (HIS) and published references. We calculated incremental cost-effectiveness ratios (ICERs) from the perspective of Chinese healthcare using the complex decision model to compare the costs and effectiveness between EVT versus EVT + IVT. One-way and Monte Carlo probabilistic sensitivity analyses were performed to assess the robustness of the economic evaluation model.</p><p><strong>Results: </strong>EVT alone had a lower cost compared with EVT + IVT whether short-term or long-term. Until 99% dead of AIS patients, the ICER per additional QALY was RMB696399.30 over the willingness-to-pay (WTP) threshold of 3× gross domestic product (GDP) per capita in Shandong. The probabilistic sensitivity analysis of 3 months, 1 year and long-term horizons had a 97.90%, 97.43% and 96.89% probability of cost-effective treatment under the WTP threshold (1×GDP). The results of the one-way sensitivity analysis showed that direct treatment costs for EVT alone and EVT + IVT were all sensitive to ICER.</p><p><strong>Conclusions: </strong>EVT alone was more cost-effective treatment compared to EVT + IVT in the Northeast Coastal Area of China. The data of this study could be used as a reference in China, and the use of the evaluation in other regions should be carefully considered.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The healthcare costs of increased body mass index-evidence from The Trøndelag Health Study. 体重指数增加的医疗成本--来自特伦德拉格健康研究的证据。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-06-01 DOI: 10.1186/s13561-024-00512-8
Christina Hansen Edwards, Johan Håkon Bjørngaard, Jonas Minet Kinge, Gunnhild Åberge Vie, Vidar Halsteinli, Rønnaug Ødegård, Bård Kulseng, Gudrun Waaler Bjørnelv
{"title":"The healthcare costs of increased body mass index-evidence from The Trøndelag Health Study.","authors":"Christina Hansen Edwards, Johan Håkon Bjørngaard, Jonas Minet Kinge, Gunnhild Åberge Vie, Vidar Halsteinli, Rønnaug Ødegård, Bård Kulseng, Gudrun Waaler Bjørnelv","doi":"10.1186/s13561-024-00512-8","DOIUrl":"10.1186/s13561-024-00512-8","url":null,"abstract":"<p><strong>Background: </strong>Earlier studies have estimated the impact of increased body mass index (BMI) on healthcare costs. Various methods have been used to avoid potential biases and inconsistencies. Each of these methods measure different local effects and have different strengths and weaknesses.</p><p><strong>Methods: </strong>In the current study we estimate the impact of increased BMI on healthcare costs using nine common methods from the literature: multivariable regression analyses (ordinary least squares, generalized linear models, and two-part models), and instrumental variable models (using previously measured BMI, offspring BMI, and three different weighted genetic risk scores as instruments for BMI). We stratified by sex, investigated the implications of confounder adjustment, and modelled both linear and non-linear associations.</p><p><strong>Results: </strong>There was a positive effect of increased BMI in both males and females in each approach. The cost of elevated BMI was higher in models that, to a greater extent, account for endogenous relations.</p><p><strong>Conclusion: </strong>The study provides solid evidence that there is an association between BMI and healthcare costs, and demonstrates the importance of triangulation.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A microcosting approach for planning and implementing community-based mental health prevention program: what does it cost? 规划和实施社区心理健康预防计划的微观成本计算方法:成本是多少?
IF 2.7 3区 经济学
Health Economics Review Pub Date : 2024-05-21 DOI: 10.1186/s13561-024-00510-w
Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton
{"title":"A microcosting approach for planning and implementing community-based mental health prevention program: what does it cost?","authors":"Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton","doi":"10.1186/s13561-024-00510-w","DOIUrl":"10.1186/s13561-024-00510-w","url":null,"abstract":"<p><strong>Background: </strong>Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that are ethnically and linguistically diverse and provide an example for estimating the cost of a mental health prevention and promotion programs consisting of multiple evidence-based interventions.</p><p><strong>Methods: </strong>We used a semi-structured interview process to collect cost data through the first year of program planning, start-up and initial implementation from key staff. We calculated costs for each activity, grouped them by major project categories, and identified the cost drivers of each category. We further validated cost estimates through extensive literature review. The cost analysis was done from the provider's perspective, which included the implementing agency and its community partners. We delineated costs that were in-kind contributions to the program by other agency, and community partners. Sensitivity analyses were conducted to estimate uncertainty around parameters.</p><p><strong>Results: </strong>For the first year of the development and implementation of the program, (funded through program and in-kind) is estimated at $1,382,669 (2022 US$). The costs for the three main activity domains for this project are: project management $135,822, community engagement $364,216 and design and execution $756,934. Overall, the cost drivers for the first year of this intervention were: hiring and onboarding staff, in-person community building/learning sessions, communications and marketing, and intervention delivery.</p><p><strong>Conclusion: </strong>Implementation of community-based mental health promotion and prevention programs, when utilizing a participatory approach, requires a significant amount of upfront investment in program planning and development. A large proportion of this investment tends to be human capital input. Developing partnerships is a successful strategy for defraying costs.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic review of the economic evaluation model of assisted reproductive technology. 辅助生殖技术经济评估模型的系统回顾。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-05-20 DOI: 10.1186/s13561-024-00509-3
Yuxin Si, Tao Tan, Kexue Pu
{"title":"Systematic review of the economic evaluation model of assisted reproductive technology.","authors":"Yuxin Si, Tao Tan, Kexue Pu","doi":"10.1186/s13561-024-00509-3","DOIUrl":"10.1186/s13561-024-00509-3","url":null,"abstract":"<p><strong>Background: </strong>With the increasing demand for fertility services, it is urgent to select the most cost-effective assisted reproductive technology (ART) treatment plan and include it in medical insurance. Economic evaluation reports are an important reference for medical insurance negotiation. The aim of this study is to systematically evaluate the economic evaluation research of ART, analyze the existing shortcomings, and provide a reference for the economic evaluation of ART.</p><p><strong>Methods: </strong>PubMed, EMbase, Web of Science, Cochrane Library and ScienceDirect databases were searched for relevant articles on the economic evaluation of ART. These articles were screened, and their quality was evaluated based on the Comprehensive Health Economics Evaluation Report Standard (CHEERS 2022), and the data on the basic characteristics, model characteristics and other aspects of the included studies were summarized.</p><p><strong>Results: </strong>One hundred and two related articles were obtained in the preliminary search, but based on the inclusion criteria, 12 studies were used for the analysis, of which nine used the decision tree model. The model parameters were mainly derived from published literature and included retrospective clinical data of patients. Only two studies included direct non-medical and indirect costs in the cost measurement. Live birth rate was used as an outcome indicator in half of the studies.</p><p><strong>Conclusion: </strong>Suggesting the setting of the threshold range in the field of fertility should be actively discussed, and the monetary value of each live birth is assumed to be in a certain range when the WTP threshold for fertility is uncertain. The range of the parameter sources should be expanded. Direct non-medical and indirect costs should be included in the calculation of costs, and the analysis should be carried out from the perspective of the whole society. In the evaluation of clinical effect, the effectiveness and safety indexes should be selected for a comprehensive evaluation, thereby making the evaluation more comprehensive and reliable. At least subgroup analysis based on age stratification should be considered in the relevant economic evaluation.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting healthcare expenditure based on Adjusted Morbidity Groups to implement a needs-based capitation financing system. 根据调整后发病率组别预测医疗支出,以实施基于需求的按人头付费融资系统。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-05-08 DOI: 10.1186/s13561-024-00508-4
Jorge-Eduardo Martínez-Pérez, Juan-Antonio Quesada-Torres, Eduardo Martínez-Gabaldón
{"title":"Predicting healthcare expenditure based on Adjusted Morbidity Groups to implement a needs-based capitation financing system.","authors":"Jorge-Eduardo Martínez-Pérez, Juan-Antonio Quesada-Torres, Eduardo Martínez-Gabaldón","doi":"10.1186/s13561-024-00508-4","DOIUrl":"10.1186/s13561-024-00508-4","url":null,"abstract":"<p><strong>Background: </strong>Due to population aging, healthcare expenditure is projected to increase substantially in developed countries like Spain. However, prior research indicates that health status, not merely age, is a key driver of healthcare costs. This study analyzed data from over 1.25 million residents of Spain's Murcia region to develop a capitation-based healthcare financing model incorporating health status via Adjusted Morbidity Groups (AMGs). The goal was to simulate an equitable area-based healthcare budget allocation reflecting population needs.</p><p><strong>Methods: </strong>Using 2017 data on residents' age, sex, AMG designation, and individual healthcare costs, generalized linear models were built to predict healthcare expenditure based on health status indicators. Multiple link functions and distribution families were tested, with model selection guided by information criteria, residual analysis, and goodness-of-fit statistics. The selected model was used to estimate adjusted populations and simulate capitated budgets for the 9 healthcare districts in Murcia.</p><p><strong>Results: </strong>The gamma distribution with logarithmic link function provided the best model fit. Comparisons of predicted and actual average costs revealed underfunded and overfunded areas within Murcia. If implemented, the capitation model would decrease funding for most districts (up to 15.5%) while increasing it for two high-need areas, emphasizing allocation based on health status and standardized utilization rather than historical spending alone.</p><p><strong>Conclusions: </strong>AMG-based capitated budgeting could improve equity in healthcare financing across regions in Spain. By explicitly incorporating multimorbidity burden into allocation formulas, resources can be reallocated towards areas with poorer overall population health. Further policy analysis and adjustment is needed before full-scale implementation of such need-based global budgets.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England. 对英格兰接受胰岛素治疗的 2 型糖尿病患者进行持续葡萄糖监测的预算影响分析。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-05-06 DOI: 10.1186/s13561-024-00505-7
Murtada Alsaif, Ali Farhat, Zoe Blumer, Leela Barham
{"title":"Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England.","authors":"Murtada Alsaif, Ali Farhat, Zoe Blumer, Leela Barham","doi":"10.1186/s13561-024-00505-7","DOIUrl":"10.1186/s13561-024-00505-7","url":null,"abstract":"<p><strong>Introduction: </strong>In 2022, updated guidance from NICE expanded the options for self-monitoring of blood glucose for patients with type 2 diabetes (T2DM), to include continuous glucose monitoring (CGM). In this budget impact analysis, the cost impact of CGM was compared with traditional self-monitoring of blood glucose (SMBG) in adults with T2DM over 1 year from the commissioner perspective in England.</p><p><strong>Research design and methods: </strong>The NICE-eligible T2DM cohort was split into 4 subgroups to enable nuanced costing by insulin administration frequency: basal human insulin, premixed insulin, basal-bolus insulin and bolus insulin. The model's cost components comprised mild and severe hypoglycaemia (SH), diabetic ketoacidosis (DKA), consumables and healthcare resource utilisation in primary and secondary care.</p><p><strong>Results: </strong>The introduction of CGM is estimated to be cost additive by approximately £4.6 million in the basecase, driven by increased spending on the CGM device. Overall, healthcare activity was reduced by approximately 20,000 attendances, due to fewer SH and DKA episodes in the CGM arm. General Practitioner (GP) practice-based activity is expected to drop after the first year as patients requiring CGM training is reduced. The budget impact could be neutralised if the CGM sensor was discounted by 13.2% (£29.76 to £25.83).</p><p><strong>Conclusions: </strong>CGM may result in increased spending in the NICE-eligible T2DM cohort but is expected to reduce demand on secondary care services and GP time. These findings may be of interest to local decision-makers who wish to resolve the COVID-19 backlog with transformational investment in primary care to reduce secondary care activity.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does the introduction of an infliximab biosimilar always result in savings for hospitals? A descriptive study using real-world data 引进英夫利昔单抗生物仿制药是否总能为医院节省开支?使用真实世界数据的描述性研究
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-04-29 DOI: 10.1186/s13561-024-00507-5
Marko Krstic, Jean-Christophe Devaud, Farshid Sadeghipour, Joachim Marti
{"title":"Does the introduction of an infliximab biosimilar always result in savings for hospitals? A descriptive study using real-world data","authors":"Marko Krstic, Jean-Christophe Devaud, Farshid Sadeghipour, Joachim Marti","doi":"10.1186/s13561-024-00507-5","DOIUrl":"https://doi.org/10.1186/s13561-024-00507-5","url":null,"abstract":"Biosimilars are biologic drugs that have the potential to increase the efficiency of healthcare spending and curb drug-related cost increases. However, their introduction into hospital formularies through initiatives such as non-medical switching must be carefully orchestrated so as not to cause treatment discontinuation or result in increased health resource utilization, such as additional visits or laboratory tests, among others. This retrospective cohort study aims to assess the impact of the introduction of CT-P13 on the healthcare expenditures of patients who were treated with originator infliximab or CT-P13. Gastroenterology, immunoallergology and rheumatology patients treated between September 2017 and December 2020 at a university hospital in Western Switzerland were included and divided into seven cohorts, based on their treatment pathway (i.e., use and discontinuation of CT-P13 and/or originator infliximab). Costs in Swiss francs were obtained from the hospital's cost accounting department and length of stay was extracted from inpatient records. Comparisons of costs and length of stay between cohorts were calculated by bootstrapping. Sixty immunoallergology, 84 rheumatology and 114 gastroenterology patients were included. Inpatient and outpatient costs averaged (sd) CHF 1,611 (1,020) per hospital day and CHF 4,991 (6,931) per infusion, respectively. The mean (sd) length of stay was 20 (28) days. Although immunoallergology and rheumatology patients had higher average costs than gastroenterology patients, differences in costs and length of stay were not formally explained by treatment pathway. Differences in health resource utilization were marginal. The introduction of CT-P13 and the disruption of patient treatment management were not associated with differences in average outpatient and inpatient costs and length of stay, in contrast to the results reported in the rest of the literature. Future research should focus on the cost-effectiveness of non-medical switching policies and the potential benefits for patients.","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors influencing medical expenditures in patients with unresolved facial palsy and pharmacoeconomic analysis of upper eyelid lid loading with gold and platinum weights compared to tarsorrhaphy 影响未愈面瘫患者医疗支出的因素,以及上睑黄金和铂金砝码装载与跗关节成形术相比的药物经济学分析
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-04-27 DOI: 10.1186/s13561-024-00506-6
Izabela Nowak-Gospodarowicz, Marcin Gospodarowicz, Marek Rękas
{"title":"Factors influencing medical expenditures in patients with unresolved facial palsy and pharmacoeconomic analysis of upper eyelid lid loading with gold and platinum weights compared to tarsorrhaphy","authors":"Izabela Nowak-Gospodarowicz, Marcin Gospodarowicz, Marek Rękas","doi":"10.1186/s13561-024-00506-6","DOIUrl":"https://doi.org/10.1186/s13561-024-00506-6","url":null,"abstract":"There are no standards in diagnostic and therapeutic approaches to eye care in incomplete eyelid closure due to unresolved facial palsy (FP). Loading of the upper eyelid (UELL) with gold weights (GWs) or platinum chains (PCs) is a highly effective procedure for the correction of lagophthalmos. Despite this, the procedure is used infrequently in our country because of the relatively high price of the implant and the lack of reimbursement. The aim of this research was to assess the factors influencing medical expenditures in this group of patients and to analyze utility costs for the UELL procedure with the use of GW and PC compared to tarsorrhaphy. Material and methods The costs of 88 surgical procedures (40 GWs, 11 PCs and 37 tarsorrhaphies) and medical expenditures before and after surgery were calculated based on reporting of materials, staff salaries and the SF-36 questionnaire. Distribution quartiles of the cost per QALY measure (dependent variable) was assessed via an ordered logistic regression model with eight explanatory variables. Results The calculated total cost of the surgery was US$209 for tarsorrhaphy, US$758 for UELL with a GW and US$1,676 for UELL with a PC. Bootstrapped costs per QALY values (CUI) in 88% of cases were below the US$100,000 cutoff. Etiology and duration of facial palsy and presence of Bell’s phenomenon were factors that significantly influenced the CUI. Patient gender and age, history of previous eyelid surgery, and presence of corneal sensation were found to be not significant (p > 0.1). Calculated ICER for GW was US$1,241.74/1QALY and ICER for PC was US$13,181.05/1QALY compared to tarsorrhaphy. Conclusions Eye protection in patients with FP should be a crucial element of health policy. Findings suggest UELL procedure with a GW or a PC to be a cost-effective procedure with GW being the most cost-effective.","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140800736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Hierarchical Bayesian approach to small area estimation of health insurance coverage in Ethiopian administrative zones for better policies and programs 采用层次贝叶斯方法对埃塞俄比亚行政区的医疗保险覆盖率进行小范围估算,以制定更好的政策和计划
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-04-16 DOI: 10.1186/s13561-024-00498-3
Y. Shiferaw, S. A. Yilema, Yikeber Abebaw Moyehodie
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