Cost Effectiveness and Resource Allocation最新文献

{"title":"Handling uncertainty in cost-effectiveness analysis in dental medicine: a systematic review with a focus on affordability and risk-aversion.","authors":"Pedram Sendi, Mojdeh Walterscheidt, Michael M Bornstein","doi":"10.1186/s12962-025-00641-9","DOIUrl":"https://doi.org/10.1186/s12962-025-00641-9","url":null,"abstract":"<p><strong>Background: </strong>The number of published cost-effectiveness analyses in dental medicine has substantially increased in recent years. A key methodological issue in these analyses is how to address uncertainty in costs and effects, which also impacts uncertainty around the expected cost-effectiveness ratio. The cost-effectiveness acceptability curve has become the standard method to summarize uncertainty in probabilistic cost-effectiveness analyses. However, it does not inform decision-makers about budget impact or account for the fact that they are often risk-averse. The cost-effectiveness affordability curve and the cost-effectiveness risk-aversion curve have been proposed to address these limitations. In this systematic review, we assess how uncertainty has been handled in cost-effectiveness analyses in dental medicine, with a particular focus on affordability and risk-aversion.</p><p><strong>Methods: </strong>We conducted a systematic literature search across electronic databases (MEDLINE, Web of Science, Cochrane Library, EconLit, Embase) on April 18, 2025, and performed manual searches of selected references. Articles published after January 1, 2021, were included. From each study, we extracted information on the first author, year of publication, country, intervention evaluated, study design (model-based, trial-based, or combined), use of deterministic and/or probabilistic sensitivity analysis, and whether budget impact and risk-aversion were considered.</p><p><strong>Results: </strong>From a total of 57 published cost-effectiveness analyses, 49 (85%) used a deterministic sensitivity analysis and 37 (65%) used a probabilistic sensitivity analysis. Budget impact analysis was performed in five studies (9%), and only one study formally applied both the cost-effectiveness affordability curve and the cost-effectiveness risk-aversion curve.</p><p><strong>Conclusion: </strong>The use of methods to address uncertainty related to budget constraints and risk-aversion remains limited in dental medicine. As decision-makers often operate within budget constraints and health is considered the most valuable good, incorporating methods that address affordability and risk-aversion could enhance the relevance and impact of cost-effectiveness analyses in dental care.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"32"},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare professionals' perceptions of electronic prescription systems in outpatient services: a qualitative study at UNS hospital.","authors":"Joko Sudarsono, Satibi Satibi, Lutfan Lazuardi, Anna Wahyuni Widayanti","doi":"10.1186/s12962-025-00639-3","DOIUrl":"https://doi.org/10.1186/s12962-025-00639-3","url":null,"abstract":"<p><strong>Background: </strong>The outpatient prescription service at UNS Hospital has traditionally relied on paper-based prescriptions. The outpatient prescription service at UNS Hospital is transitioning from paper-based to electronic prescription systems (EPSs). While existing literature highlights EPS benefits, gaps remain in understanding healthcare professionals' subjective experiences during implementation. This qualitative study explores doctors' and pharmacists' perceptions regarding the motivations, benefits, challenges, readiness, and system development suggestions for EPS implementation in outpatient services at UNS Hospital.</p><p><strong>Methods: </strong>In-depth interviews were conducted with six doctors and four pharmacists between January and April 2024. The study participants were prescription doctors and pharmacists at UNS Hospital. The data were analyzed using thematic analysis techniques. Thematic analysis was used to identify the themes that emerged from the interviews.</p><p><strong>Results: </strong>Five themes emerged: (1) Motivations centered on reducing medication errors and enhancing operational efficiency; (2) Benefits included improved communication, cost control, and streamlined workflows; (3) Readiness revealed pharmacists' enthusiasm versus doctors' cautious adaptation. (4) System suggestions emphasized real-time drug stock integration and advanced search features. (5)Electronic Prescription System Features included Information on adverse drug reaction.</p><p><strong>Conclusion: </strong>While healthcare professionals perceive EPS as beneficial for safety and efficiency, addressing challenges like user training and system interoperability is critical for successful adoption. Implementing participant-driven suggestions, such as real-time inventory alerts, could optimize EPS effectiveness. These insights provide actionable strategies for hospitals transitioning to digital prescribing systems.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"31"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of family physician program and health transformation plan on utilization and cost of health services.","authors":"Zeynab Safarpoor, Farhad Lotfi, Mohsen Bayati, Hossein Moordzade, Zahra Goudarzi, Khosro Keshavarz","doi":"10.1186/s12962-025-00637-5","DOIUrl":"10.1186/s12962-025-00637-5","url":null,"abstract":"<p><strong>Introduction: </strong>Health system reforms are essential. In Iran, some of the most significant changes include the implementation of the Family Physician Program (FPP) and the Health Transformation Plan (HTP). The aim of this study was to assess the impact of these programs on the cost and use of services.</p><p><strong>Methods: </strong>This quasi-experiment targeted insured individuals under the Iranian Health Insurance Organization in Fars province from 2010 to 2021. ANOVA, T-tests, and interrupted time-series analysis were used to investigate the impacts of FPP and HTP on service utilization and cost changes before and after the introduction of these programs.</p><p><strong>Results: </strong>FPP decreased specialist visits, drug utilization, and drug expenditure in the short run. But eventually, it resulted in more general practitioner (GP) consultations, laboratory services, and imaging, hospitalization, and drug spending. The HTP first resulted in more GP consultations, laboratory services, drug use, and hospitalization but less use of imaging services and more total service spending. Eventually, the HTP resulted in more GP consultations, fewer GP prescriptions, and less laboratory test and imaging service spending.</p><p><strong>Conclusion: </strong>FPP was successful in achieving some initial goals, such as decreasing expenditure and service usage through a referral system. It was finally unsuccessful in the long run due to the dissolution of this system and lack of proper supervision. At the beginning, the HTP imposed significant costs to insurance providers; however, it ultimately led to a reduction in the cost for particular services over a prolonged interval.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"30"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab plus chemotherapy in advanced endometrial cancer: a cost-effectiveness analysis.","authors":"Xinqiang Zhao, Longjiang She, Xiaoning Liu, Zhenggang Bi","doi":"10.1186/s12962-025-00625-9","DOIUrl":"10.1186/s12962-025-00625-9","url":null,"abstract":"<p><strong>Objectives: </strong>Recently, NRG-GY018 clinical trial demonstrated that adding pembrolizumab to chemotherapy led to significantly longer progression-free survival than chemotherapy alone in the first-line treatment of advanced or recurrent endometrial cancer (a/rEC). This analysis aimed to estimate the cost-effectiveness of pembrolizumab plus paclitaxel plus carboplatin chemotherapy (PC) as the first-line treatment for a/rEC in the US and China.</p><p><strong>Methods: </strong>A Markov model based on the clinical data from NRG-GY018 trial was established to estimate the cost and efficacy of PC and paclitaxel plus carboplatin groups for a/rEC in mismatch repair-proficient (pMMR) and mismatch repair-deficient (dMMR) populations. Direct medical costs and utility values were collected from the government databases, local databases, and published literatures. The main outcomes were incremental cost-effectiveness ratios (ICERs), incremental monetary benefit (INMB), and incremental net-health benefit (INHB). The robustness of the model was assessed using one-way and probabilistic sensitivity analyses.</p><p><strong>Results: </strong>With the 5-year time horizon, treatment with PC gained an additional 0.87 QALYs (1.34 LYs) in pMMR and 4.17 QALYs (5.14 LYs) in the dMMR population. In the US, the ICERs of PC compared to chemotherapy were 404,575 $/QALY in pMMR and 124,406 $/QALY in dMMR patients, respectively. In China, the ICERs of PC compared to chemotherapy were 220,259 $/QALY and 70,207 $/QALY in pMMR and dMMR populations, respectively. The results of sensitivity analyses supported the robustness of our models.</p><p><strong>Conclusions: </strong>For patients with a/rEC, PC was cost-effective compared with chemotherapy in the first-line treatment for dMMR populations in the US. However, the combination of pembrolizumab with chemotherapy was not a cost-effective strategy for pMMR a/rEC in the US and a/rEC in China regardless of the MMR status, a price reduction process is required to reach the traditional cost-effectiveness threshold.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"29"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of epilepsy, 1990-2021: a systematic analysis for the Global Burden of Disease Study in 2021.","authors":"Tianqi Sun, Tianfu Yu, Pengcheng Liu","doi":"10.1186/s12962-025-00635-7","DOIUrl":"10.1186/s12962-025-00635-7","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic epilepsy is a serious neurological disorder that can lead to premature death and severe disability. We aimed to assess the global burden of idiopathic epilepsy, to provide a comprehensive understanding of the current dynamics and trends in idiopathic epilepsy, and to gain insight into its epidemiological attributes.</p><p><strong>Methods: </strong>This study assessed the global, regional, and national impact of idiopathic epilepsy through incidence and disability-adjusted life year (DALY) based on the Global Burden of Disease Study 2021 (GBD 2021). After statistically summarizing the global incidence rates and disability-adjusted life years (DALYs), we performed Estimating Average Percent Change (EAPC) correlation analyses and Joinpoint regression analyses to further derive global trends in idiopathic epilepsy incidence rates and DALYs. Furthermore, through decomposition analysis, we determined which factors significantly influence the change in incidence and DALYs and the extent of their contribution. In addition, this study quantified the disparities in the burden of idiopathic epilepsy across countries through cross-country social inequality analyses, and finally predicted the future burden of idiopathic epilepsy based on Bayesian Age-Period-Cohort Model (BAPC).</p><p><strong>Results: </strong>From 1990 to 2021, the incidence of idiopathic epilepsy increased generally, whereas DALY decreased. In terms of age and gender, the burden of idiopathic epilepsy is more severe in children and older age groups, with males bearing a higher burden than females. In terms of geographical distribution, the incidence was significantly higher in high Socio-Demographic Index (SDI) regions, while the burden of idiopathic epilepsy was heavier in low SDI areas. Decomposition analyses showed that the increase in incidence of idiopathic epilepsy and DALY in high SDI regions was mainly driven by epidemiological changes, whereas the increase in low SDI areas was more due to population growth. Cross-country social inequality analyses showed that despite improvements in the burden of idiopathic epilepsy, the burden and inequalities in low SDI countries remains significant. Projections indicated an increase in the incidence of idiopathic epilepsy globally, particularly in the 85 + age group, while global DALY was anticipated to continue declining.</p><p><strong>Conclusions: </strong>Although global health is improving in line with population growth and age structure, the burden of idiopathic epilepsy remains significant. This study provides an important basis for prevention and care strategies for idiopathic epilepsy in different regions. Future work should focus on integrating idiopathic epilepsy into public health priorities, promoting effective measures, and narrowing treatment gaps.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"28"},"PeriodicalIF":1.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review for cost-effectiveness analysis of laparoscopic Intra-peritoneal Onlay Mesh for ventral hernia repair in Indian settings.","authors":"Charu Guleria, Dinesh Kumar, Krushna Chandra Sahoo","doi":"10.1186/s12962-025-00638-4","DOIUrl":"10.1186/s12962-025-00638-4","url":null,"abstract":"<p><strong>Background: </strong>Health Technology Assessment in India (HTAIn) carries evidence-based decision making in improving health care. This study was done to assess cost-effectiveness of the laparoscopic IPOM technique compared to open VHR from health system perspective of India.</p><p><strong>Methods: </strong>A Meta-analysis of outcomes of both procedures was carried out whereas cost estimates were obtained from national health system costing database.</p><p><strong>Results: </strong>A meta-analysis of Randomized Control Trials (RCTs) showed similar risk in hernia recurrence rates between laparoscopic IPOM and open technique (RR: 1.28 95% C.I: 0.81, 2.04) but with significantly less risk for wound infections (RR: 0.31 95% C.I: 0.18, 0.54). Estimated cost from National Health System Costing Database (NHSCD) per VHR was high for laparoscopic IPOM (INR 58,872) compared to open hernioplasty (INR 36,166) with estimated Incremental Cost-Effective Ratio of INR 5,023 per wound infection averted.</p><p><strong>Conclusions: </strong>Laparoscopic IPOM was not clinically effective in hernia recurrence and less likely to be cost-effective.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"27"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of a new paradigm to simplify testing, monitoring and treatment of hepatitis C virus in the United States.","authors":"Douglas Dietrich, Nancy Reau, Aijaz Ahmed, Rob Blissett, Adam Igloi-Nagy, Alon Yehoshua","doi":"10.1186/s12962-025-00622-y","DOIUrl":"10.1186/s12962-025-00622-y","url":null,"abstract":"<p><p>The hepatitis C virus (HCV) testing and treatment pathway in the United States (US) includes a range of tests and appointments causing delays and loss to follow-up. We assessed the cost-effectiveness of simplifying the pathway using an economic model to estimate health outcomes, cost differences and incremental cost per quality-adjusted life year (QALY) and life year (LY) of the new paradigm compared to the other scenarios. The analysis compared three scenarios, one based on treatment guidelines, one based on real-world practice and a hypothetical scenario with a simplified pathway (\"new paradigm\"); these differed in testing and treatment process steps and times. The new paradigm resulted in cost reductions between $19,751 and $16,448, and excess QALYs between 0.42 and 0.70, suggesting that simplifying the US HCV patient pathway may be cost-effective and allows a quicker path to successful treatment and reduce the number of patients lost to follow-up.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"25"},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of myopia-control spectacles and contact lenses for children and adolescents in Wales.","authors":"Hayley Bennett, Andy Britton, David O'Sullivan, Francesca Lado","doi":"10.1186/s12962-025-00632-w","DOIUrl":"10.1186/s12962-025-00632-w","url":null,"abstract":"<p><strong>Background: </strong>Early intervention to slow childhood progression of myopia may improve quality of life and prevent future complications that burden individuals and healthcare systems. This study assessed the cost-effectiveness of myopia-control spectacles and contact lenses for the reduction of myopia progression among children and adolescents in Wales.</p><p><strong>Methods: </strong>A cost-utility analysis compared peripheral plus spectacle lenses (PPSL), multifocal soft contact lenses (MFSCL) and orthokeratology against single-vision correction. Efficacy and safety were informed by a Cochrane systemic review and meta-analyses. Quality-adjusted life years (QALYs) and costs incurred by NHS Wales were modelled over a lifetime horizon and discounted at 3.5%. Sensitivity analyses estimated uncertainty in incremental cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>PPSL was estimated to provide minimal benefit at a higher cost than single-vision correction. MFSCL gave a 0.28 QALY improvement at an additional cost of £4,040; corresponding to an ICER of £8,367 versus single-vision correction. Orthokeratology provided 0.5 QALYs at an additional cost of £3,732; corresponding to an ICER of £3,995 versus single-vision correction. In probabilistic sensitivity analysis, ICERs were below £20,000 in 71% and 90% of simulations for MFSCL and orthokeratology, respectively. Orthokeratology was the most cost-effective strategy in 76% of simulations. Cost-effectiveness was influenced by changes in progression rates, intervention costs and the utility of high myopia. However, orthokeratology remained the most cost-effective strategy throughout.</p><p><strong>Conclusions: </strong>MFSCL and orthokeratology may be cost-effective options to slow the progression of myopia at thresholds applied in the UK. Further research is needed to understand the long-term effects of myopia-control interventions and their impact on quality of life.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"26"},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cost-effectiveness analysis of two psychological treatments for controlled drinking in individuals alcohol use disorder.","authors":"Sergio Flores, Egill Jónsson-Bachmann, Stina Ingesson-Hammarberg, Anders Hammarberg, Camilla Nystrand, Filipa Sampaio","doi":"10.1186/s12962-025-00633-9","DOIUrl":"10.1186/s12962-025-00633-9","url":null,"abstract":"","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"24"},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of costs in implementing the HEARTS hypertension program in Nigerian primary care.","authors":"Emmanuel Ndenor Sambo, Muhammad Jami Husain, Soumava Basu, Malau Mangai Toma, Sunday Victor Eze, Kufor Osi, Nanlop Ogbureke, Okeoma Erojikwe, Bolanle Banigbe, Andrew E Moran, Deliana Kostova","doi":"10.1186/s12962-025-00626-8","DOIUrl":"10.1186/s12962-025-00626-8","url":null,"abstract":"<p><strong>Background: </strong>The Nigeria Hypertension Control Initiative (NHCI) program, launched in 2020, integrates hypertension care into primary healthcare using the HEARTS technical package, which includes screening, health counselling, and standardized hypertension treatment protocols. This package has been piloted through NHCI in Kano and Ogun States and in the Federal Capital Territory (FCT) Abuja, as part of the Hypertension Treatment in Nigeria (HTN) project.</p><p><strong>Objective: </strong>To assess the costs of scaling up the HEARTS hypertension control package and compare these costs with those of usual care.</p><p><strong>Methods: </strong>Data on the costs of implementing the HEARTS program were collected from 15 purposively sampled primary health facilities in Kano, Ogun, and FCT Abuja between February and April 2024. Costs included training, medicines, provider time, and administrative expenses. We used the HEARTS costing tool, an Excel-based instrument, to collect and analyze the annual costs from a health system perspective, using an activity-based approach.</p><p><strong>Results: </strong>The estimated annual cost of implementing HEARTS was USD 16 per adult primary care user (PCU), with variations across the three locations: USD 21 in Abuja, USD 11 in Kano, and USD 16 in Ogun. Average annual medication costs per patient treated under HEARTS also varied by location, amounting to USD 28 in Abuja, USD 27 in Ogun, and USD 16 in Kano. Under usual care, annual medication costs per patient were estimated at USD 32 in Kano and USD 16 in Ogun (data for Abuja were unavailable). Major cost drivers for the HEARTS package included provider time (49%) and medication (47%), compared to usual care, where medication alone accounted for 80% of costs. Implementing HEARTS requires a full-time equivalent of 0.45 doctors, 1.59 nurses, and 5.21 community health workers per 10,000 primary care users.</p><p><strong>Conclusions: </strong>In the Nigerian primary care setting, provider time costs and medication costs emerge as major considerations in scaling up hypertension services. Policy options could consider reducing follow-up visit frequency for well-controlled patients to decrease provider time costs. Additionally, medication costs may be reduced by prioritizing first-line treatments and volume-driven purchasing as program scale-up continues.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"23"},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}