ClinicoEconomics and Outcomes Research最新文献

{"title":"Semaglutide 2.4 mg for Obese Patients with MASH: A Cost-Effectiveness Analysis from the Italian NHS Perspective.","authors":"Enrico Torre, Sergio Di Matteo, Chiara Martinotti, Giacomo Matteo Bruno, Alessandro Cabrino, Emma Lucia Fogliati, Andrea Giusti, Marco Barbieri, Luigi Carlo Bottaro, Giorgio Lorenzo Colombo","doi":"10.2147/CEOR.S585328","DOIUrl":"https://doi.org/10.2147/CEOR.S585328","url":null,"abstract":"<p><strong>Background and objectives: </strong>Metabolic dysfunction-associated liver disease (MASLD) and its progression to steatohepatitis (MASH) are highly prevalent among obese patients, contributing substantially to healthcare costs. Semaglutide, a GLP-1 receptor agonist, has shown metabolic and hepatic benefits in this population. This study assessed the cost-effectiveness of Wegovy^® (semaglutide 2.4 mg) versus no pharmacological treatment in obese patients with MASH ≤F3 without diabetes, from the perspective of the Italian National Health Service (NHS).</p><p><strong>Materials and methods: </strong>A cost-effectiveness analysis (CEA) was conducted using a Markov model developed in Microsoft Excel^®, adopting the Italian NHS perspective over a 10-year horizon. In line with study perspective, the model included healthcare resource use and direct costs associated with the management of obesity with MASH (≤F3) and related complications (major obesity related complications and liver disease evolution). Since semaglutide 2.4 mg is not yet reimbursed in Italy, cost assumptions were applied. The target population was estimated from epidemiological data, and utility values were derived from international literature, reflecting the relationship between weight loss and improved quality of life. Costs and outcomes were discounted at 3% annually. Model robustness was tested through one-way deterministic sensitivity analyses (OWSAs).</p><p><strong>Results: </strong>The base case estimated 782,920 obese adults in Italy with MASH ≤F3 without diabetes. The analysis yielded an incremental cost-effectiveness ratio (ICER) of €22,691 per QALY gained over 10 years, below the accepted Italian willingness-to-pay thresholds. OWSAs confirmed the robustness of results.</p><p><strong>Conclusion: </strong>Semaglutide 2.4 mg is a cost-effective and sustainable option for treating obese patients with MASH ≤F3 in Italy, a subgroup at high risk of progressing to advanced liver disease. By improving both fibrosis and body weight, semaglutide may play a key role in reducing the long-term clinical and economic burden of MASLD.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"585328"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Lifetime Costs of Severe Visual Impairment Due to Retinitis Pigmentosa.","authors":"Dejan Milentijevic, Christine Ferro, Sara Rosenblum, Gabriela Dieguez","doi":"10.2147/CEOR.S571305","DOIUrl":"https://doi.org/10.2147/CEOR.S571305","url":null,"abstract":"<p><strong>Introduction: </strong>Retinitis pigmentosa (RP) is a rare genetic eye disease characterized by progressive retinal degeneration, leading to blindness. RP-associated blindness and subsequent disability can generate substantial societal costs that far outweigh direct healthcare costs; however, prior studies have primarily focused on medical costs without quantifying lifetime indirect costs associated with RP-related disability. This study used actuarial models to examine lifetime excess costs resulting from RP-related disability. Results may advance the understanding of potential lifetime benefits of gene therapy for the treatment of RP.</p><p><strong>Methods: </strong>We used actuarial techniques to model three archetype patients with RP who become disabled at ages 50, 35, and 18, respectively, and quantified the costs associated with healthcare, social security and disability benefits, lost income, transportation, and supportive services. These costs were compared with scenarios without disability, assuming employment until retirement age.</p><p><strong>Results: </strong>Aggregate lifetime costs incurred by patients, payers, government, and employer programs vary by age and employment status at disability onset. We estimated the present value of lifetime costs following disability for a patient with RP at $1,741,141, $2,586,819, and $3,072,550 when disabled at ages 50, 35, and 18, respectively. These estimates represent lifetime excess costs, defined as the difference between lifetime costs with and without RP-related disability, of $1,222,496 (236%), $1,948,063 (305%), and $2,303,667 (300%), respectively. Lost income opportunity and costs incurred from employer and government sponsored disability benefits were the largest contributors to excess costs.</p><p><strong>Conclusion: </strong>This actuarial approach to assessing the burden of RP-related disability shows how costs, both direct and indirect, accrue over a lifetime following blindness. Projected lifetime disability costs are expected to far exceed all-cause healthcare costs, imposing an escalating burden on society. Gene therapies have the potential to prevent blindness, preserve income, and reduce disability-related costs, thereby reducing the societal cost burden associated with RP-related disability.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"571305"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Impact and Economic Burden of Uncoded Hyponatremia in Elderly - A Cost-of-Illness Study.","authors":"Wolfram Weinrebe, Felice Burn, Murat Karaman, Thomas Holler, Atesch Ateschrang, Alexander Kutz, Philipp Schuetz","doi":"10.2147/CEOR.S581335","DOIUrl":"https://doi.org/10.2147/CEOR.S581335","url":null,"abstract":"<p><strong>Purpose: </strong>Hyponatremia remains one of the most prevalent electrolyte disorders among geriatric inpatients but is frequently under-recognized in clinical coding. This <i>cost-of-illness (COI)</i> study aimed to (1) estimate the corrected prevalence of uncoded hyponatremia (ucHn) by integrating laboratory and administrative data, and (2) quantify its incremental social and economic burden on elderly patients.</p><p><strong>Patients and methods: </strong>A retrospective <i>COI</i> analysis covered 72,730 inpatient cases ≥70 years (2016-2024) in a Swiss hospital network. Hyponatremia was classified as coded (cHn; ICD-10 E87.1) or uncoded (ucHn; Na <135 mmol/L). Incremental costs were estimated via generalized linear models and probabilistic sensitivity analysis.</p><p><strong>Results: </strong>Among 13,657 patients with hyponatremia (18.7%), only 2,070 (2.8%) were coded. Prevalences were as follows: coded 2.8%, hidden15.9%, true prevalence 18.7%. ucHn was more prevalent in men (p<0.0001), presented with more mild cases (83.1/34.9%, p<0.0001), more incident cases (14.3/4.7%, p<0.0001), lower chronic hyponatremia (20.8/39.6% p<0.0001), significantly more frequent heart failure and lung cancer (p<0.0001), had higher asset cost (2,463 vs 1,654, p<0.0001), lower contribution margin 1 and 2 (p<0.0001) and a markedly higher 30-day mortality (46% vs 7%, p<0.0001). Mean length of stay (LOS) was 9.9 days vs 7.4 days (p<0.0001). ucHn generated incremental costs of CHF per case with a total systemic burden (2016-2024) amounted to ≈ 355 to 473 MCHF. Losses of autonomy, mobility, cognitive control and life years underline the impressive social impact for nearly every ucHn case.</p><p><strong>Conclusion: </strong>For the first time, the detected ucHn is evaluated. It presents a substantial social and economic burden with a previously unquantified excess mortality associated with uncoded hyponatremia. ucHn is widely underestimated in administrative hospital data. This COI study supports policy measures to improve documentation and awareness of hyponatremia in elderly patients with the aim of reducing its social impact.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"581335"},"PeriodicalIF":2.2,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discounting Practices in Cost-Effectiveness Analyses in Dentistry: A Systematic Review of Studies Published After 2020.","authors":"Ramona Maruster, Michael M Bornstein, Pedram Sendi","doi":"10.2147/CEOR.S600837","DOIUrl":"https://doi.org/10.2147/CEOR.S600837","url":null,"abstract":"<p><strong>Background: </strong>Economic evaluations guide resource allocation decisions in dentistry, where preventive interventions often involve upfront costs and long-term benefits. Discounting can strongly influence results, yet inconsistencies in rate selection and justification persist. Despite growing recognition that discount rate selection substantially influences cost-effectiveness conclusions, no systematic review has focused specifically on discounting practices in dental economic evaluations published under the CHEERS 2022 framework. We therefore reviewed discounting practices in cost-effectiveness analyses (CEAs) of dental interventions published after January 1, 2020.</p><p><strong>Methods: </strong>We systematically searched eight databases (MEDLINE via PubMed, Web of Science, EconLit, Embase, PROSPERO, Central, Scopus, CEA Registry) for full economic evaluations of dental interventions published after January 1, 2020, with time horizons >1 year. Inclusion was limited to Latin alphabet publications and empirical studies. Backward/forward citation tracking supplemented the search. Reporting quality was appraised using CHEERS 2022. Extracted data included discount rates, justifications, perspectives, model types, and intervention categories.</p><p><strong>Results: </strong>From 2581 records, 83 studies were included. Discount rates ranged from 1.5% to 9%; 3% was most common (41%). Thirteen percent omitted discounting, and 27% provided no justification; when justified, 60% cited government guidelines. Perspectives were predominantly healthcare sector (44%), with societal only 8%. Preventive interventions accounted for 47%. Average CHEERS 2022 compliance was 80.4%.</p><p><strong>Conclusion: </strong>Discounting practices in recent dental CEAs remain inconsistent, potentially biasing against preventive strategies. Greater adherence to reporting standards and context-specific guideline updates are needed.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"600837"},"PeriodicalIF":2.2,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Resource Utilization and the Direct Medical Cost of Fibromyalgia Patients in a Tertiary Hospital in Saudi Arabia.","authors":"Shiekha S AlAujan, Saja H AlMazrou, Haya A AlNahedh, Lama A AlFalih, Abdulhadi M AlQahtani","doi":"10.2147/CEOR.S578039","DOIUrl":"https://doi.org/10.2147/CEOR.S578039","url":null,"abstract":"<p><strong>Purpose: </strong>Fibromyalgia (FM) is a chronic disorder characterized by widespread pain and multiple comorbidities and imposes a substantial economic burden on healthcare systems worldwide. Although extensively studied in Western countries, the economic impact of FM in Saudi Arabia remains unexplored. This study aimed to estimate healthcare resource utilization and the associated direct medical costs related to FM in a tertiary hospital in Saudi Arabia.</p><p><strong>Patients and methods: </strong>A retrospective study was conducted using a bottom-up approach to assess the cost of illness associated with FM from a healthcare perspective. Analyzed data were extracted from February 2021 to February 2022 from the medical records of adult patients with FM who visited a tertiary healthcare hospital. Unit costs for each healthcare resource used in 2022 Saudi riyals (SAR) were obtained from the hospital's billing system. The primary cost items were converted to US dollars (USD).</p><p><strong>Results: </strong>Data were extracted from 128 patients. They were predominantly female (93%) with a mean age of 47.1 years. Most patients were either overweight (43.4%) or obese (41.6%), and 56.3% had three or more comorbidities. Rheumatology was the most frequently accessed specialty (52.3%). Antidepressants were the most prescribed medications (77.3%). The average annual direct medical cost per patient was SAR 9,601.2 (USD 2,560.3), with healthcare team specialist visits and diagnostic procedures constituting 50.7% and 45.6% of the total costs, respectively. Laboratory tests imposed the highest financial burden (mean cost per patient: SAR 3,268.5 ; USD 871.6), whereas medications contributed only 3.7% of the total costs.</p><p><strong>Conclusion: </strong>FM places a substantial burden on the Saudi healthcare system. Although the annual cost falls within the average global range, healthcare team visits followed by diagnostic procedures are the main drivers of FM costs. These findings provide essential knowledge for healthcare planning and resource allocation by policymakers aiming to reduce the costs associated with FM in Saudi Arabia.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"578039"},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Health Technology Assessment (HTA) of Olpasiran and Pelacarsen for Secondary Prevention of Coronary Heart Disease (CHD).","authors":"Elena Filipova, Ivona Danova, Iana Simova, Toni Vekov","doi":"10.2147/CEOR.S583568","DOIUrl":"https://doi.org/10.2147/CEOR.S583568","url":null,"abstract":"<p><strong>Purpose: </strong>In recent studies elevated lipoprotein(a) (Lp(a)) levels have been identified as an independent and causal risk factor for atherosclerosis and coronary heart disease. This study aims to perform a comparative early health technology assessment (HTA) of olpasiran and pelacarsen for secondary prevention of coronary heart disease (CHD) in patients with atherosclerotic cardiovascular disease, familial hypercholesterolemia, and elevated Lp(a).</p><p><strong>Patients and methods: </strong>We developed a Markov state transition model to simulate the progression of a cohort of 597 patients with history of coronary heart disease (CHD) as myocardial infarction, coronary artery disease or peripheral artery disease, familial hypercholesterolaemia in the treatment arms of OCEAN(a)-Outcomes trial (NCT05581303) [16] and Lp(a) HORIZON trial (NCT04023552). Baseline risks of CHD, costs and utilities were obtained from published sources. Clinical trial data were used to derive reductions in lipoprotein(a). Mendelian randomization study data were used to estimate clinical benefits. Annual discounting was 3.5%.</p><p><strong>Results: </strong>The treating strategy comprising olpasiran 150 mg every 3 months in addition to standard of care saved 3.29 QALYs, compared with standard of-care alone. With 3.5% annual discounting, there were 0.23 QALYs saved. The treating strategy comprising pelacarsen 80 mg every month in addition to standard of care saved 8.63 QALYs, compared with standard of-care alone (undiscounted). With 3.5% annual discounting, there were 0.58 QALYs saved.</p><p><strong>Conclusion: </strong>We found that olpasiran was highly cost-effective at the annual price of 10,424.78 BGN, compared with standard-of-care alone. Pelacarsen was highly cost-effective at the annual price of 6105.99 BGN. The threshold applied is that of gross domestic product (GDP) per capita as indicated by the National Council on prices and reimbursement of medicinal products in Bulgaria.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"583568"},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Treatment Patterns in Patients with Atopic Dermatitis Initiating Ruxolitinib Cream: A 12-Month Follow-Up Analysis of a US Payer Claims Database.","authors":"Jinan Liu, Karishma Desai, Hung-Yuan P Chen, Chia-Chen Teng, Daniel Sturm, Grace E Stockbower, Vincent J Willey","doi":"10.2147/CEOR.S569871","DOIUrl":"10.2147/CEOR.S569871","url":null,"abstract":"<p><strong>Purpose: </strong>This study describes a cohort of US commercially insured and Medicare Advantage patients with atopic dermatitis (AD) using ruxolitinib cream therapy and characterizes their treatment patterns before ruxolitinib cream initiation and during a 12-month follow-up.</p><p><strong>Patients and methods: </strong>This retrospective, observational cohort study analyzed longitudinal administrative claims and social drivers of health data for patients diagnosed with AD and treated with ruxolitinib cream. Patient characteristics, treatment patterns, and healthcare resource utilization were described for the 6 months before and 12 months after ruxolitinib cream initiation.</p><p><strong>Results: </strong>The overall population (N=556) had a mean (SD) age of 40.3 (17.3) years and was 60.8% female, with 71.9% of patients being in the upper 2 socioeconomic status index score quartiles. Baseline predominant treatment patterns (overall cohort) included no treatment (26.6%), topical corticosteroids (53.4%), biologics (22.5%), systemic corticosteroids (20.9%), topical calcineurin inhibitors (14.9%), and topical phosphodiesterase-4 inhibitors (6.7%). Post-index treatment patterns showed a decreasing trend in corticosteroid use, with topical corticosteroid use dropping from 31.3% in months 1-6 to 26.6% in months 7-12, and systemic corticosteroid use stabilizing after an initial decrease (16.0% to 16.6%). However, the mean cumulative prednisone-equivalent dose among patients using systemic corticosteroids decreased overall by 28.9%, from 402.1 mg at baseline to 362.3 mg during months 1-6 and to 285.7 mg during months 7-12 of follow-up. Among the biologic-naïve cohort (n=431), 90.0% remained biologic-free during follow-up, and among the biologic-experienced cohort (n=125), 14.4% discontinued biologics during follow-up. The percentage of patients with healthcare encounters for AD decreased from 85.3% at baseline to 70.0% during follow-up.</p><p><strong>Conclusion: </strong>The reduced use of other AD treatments, including corticosteroids, and the high proportion of patients remaining biologic-free during the 12-month follow-up support the durability of the effectiveness of ruxolitinib as a therapeutic option for adults and adolescents with AD.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"569871"},"PeriodicalIF":2.2,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Bivalent Prefusion F Vaccine for Prevention of Respiratory Syncytial Virus Among Older Adults in Italy.","authors":"Sergio Di Matteo, Paolo Bonanni, Sara Boccalini, Roberto Di Virgilio, Emma Lucia Fogliati, Giorgio Lorenzo Colombo","doi":"10.2147/CEOR.S584975","DOIUrl":"https://doi.org/10.2147/CEOR.S584975","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) represents a significant health threat for older adults and individuals with comorbidities. RSV infection is often underdiagnosed, limiting the understanding of its clinical and economic burden. The approval of the bivalent RSV prefusion F vaccine offers a new preventive strategy. This study evaluated its cost-effectiveness to optimize resource allocation in Italy.</p><p><strong>Materials and methods: </strong>A Markov cohort model was developed to assess the cost-effectiveness of vaccinating adults with a single dose of RSVpreF vaccine versus no vaccination, from the perspective of the Italian National Health Service (NHS). Two vaccination scenarios were analyzed: a base-case scenario assuming implementation of the vaccination strategy in the general population aged 75-99 years, and an alternative scenario focusing on adults aged 60-74 years with comorbidities. A vaccination coverage rate of 52.5% was assumed, according to the rate recorded among individuals over 65 years during the 2024/2025 season. Model outcomes included RSV cases, hospitalizations, deaths, direct medical costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). To test the robustness of the results, deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were conducted.</p><p><strong>Results: </strong>In base-case scenario, the analysis indicated that vaccination with RSVpreF vaccine could have prevented 314,486 RSV cases and 7163 deaths, resulting in gains of 41,638 LYs and 30,317 QALYs. The ICER was €10,662 per LY gained and €14,644 (range: €9021 to €21,740) per QALY gained. In the alternative scenario the model estimated the prevention of 221,600 RSV cases and 2567 deaths, resulting in gains of 28,429 LYs and 20,395 QALYs. The ICER was €11,211 per LY gained and €15,628 (range: €9597 to €21,965) per QALY gained. Both scenarios proved to be cost-effective.</p><p><strong>Conclusion: </strong>Vaccinating with RSVpreF vaccine has shown substantial clinical and economic benefits. These findings support the inclusion of RSV vaccination in national immunization programs for older populations.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"584975"},"PeriodicalIF":2.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Burden of COVID-19 Hospitalization in Almaty, Kazakhstan.","authors":"Anuar Akhmetzhan, Akmaral Abikulova, Maksat Mamyrkul, Aigul Medeulova, Nargiz Batryrkhankyzy Nassyrova, Kamilla Faizullina","doi":"10.2147/CEOR.S569792","DOIUrl":"https://doi.org/10.2147/CEOR.S569792","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has caused substantial health and economic impacts worldwide. However, evidence on the economic burden of COVID-19 hospitalizations in Central Asia remains limited. This study aims to estimate the economic burden of COVID-19 hospitalizations in the Almaty metropolitan area from both healthcare system and societal perspectives between 2020 and 2022.</p><p><strong>Methods: </strong>Administrative hospital data were used to analyze all COVID-19 hospitalizations in Almaty during 2020-2022. Direct medical costs were estimated from the healthcare system perspective using standardized reimbursement tariffs from Kazakhstan's Mandatory Social Health Insurance system. Indirect costs were estimated from a societal perspective using the human capital approach to quantify productivity losses due to hospitalization, recovery, and premature mortality. Sensitivity analyzes the effects of variations in wage levels, discount rates, and medical costs.</p><p><strong>Results: </strong>Older adults (≥65 years) experienced the highest burden of severe outcomes, accounting for the largest share of ICU admissions and deaths. The number of hospitalized patients increased sharply in 2021, accompanied by longer hospital stays and higher healthcare resource utilization. The total economic burden peaked in 2021 at $258.0 million, driven by increased hospitalizations, ICU utilization, and productivity losses associated with hospitalization, recovery, and premature mortality. Sensitivity analysis showed that overall cost estimates were robust to variations in discount rates, while wage assumptions moderately influenced indirect cost estimates.</p><p><strong>Conclusion: </strong>COVID-19 hospitalizations impose a substantial economic burden on both the healthcare system and society in Almaty, particularly during the 2021 pandemic peak. Strengthening early public health interventions and improving real-time health data systems may help optimize resource allocation and enhance preparedness for future health crises.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"569792"},"PeriodicalIF":2.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13079554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cost Analysis of Adverse Event Management of Systemic Therapies for Metastatic Colorectal Cancer on Patients with at Least Two Previous Lines of Treatment in Spain.","authors":"Ana Fernández, Beatriz González Astorga, Nuria Rodríguez, María José Safont, Paula Castro Albarrán, María Mareque, Itziar Oyagüez","doi":"10.2147/CEOR.S586388","DOIUrl":"https://doi.org/10.2147/CEOR.S586388","url":null,"abstract":"<p><strong>Objective: </strong>First, to estimate the cost associated with the management of grade ≥3 adverse events (AEs) experienced by patients with metastatic colorectal cancer (mCRC) who had received late-line therapies (3L+) in Spain. Second, based on the tolerability profiles, the total AEs cost per therapy was estimated.</p><p><strong>Methods: </strong>A cost-analysis was developed to estimate the economic impact associated with the patient management throughout the course of related-AEs of currently available 3L+ therapies for mCRC in Spain (regorafenib, fruquintinib, trifluridine/tipiracil (T/T) and T/T + bevacizumab). The National Health System (NHS) perspective was selected, thus only direct healthcare resources were considered (pharmaceutical treatments, specialist visits, hospital admissions and procedures). For each AE, a total management cost was calculated by multiplying resource consumption by its unitary cost. Finally, for each alternative, the total AEs cost was estimated multiplying the AEs incidence rate by its management cost. Unit costs (€, 2025) were obtained from national databases. AEs incidence rates were obtained from pivotal clinical trials. Anchored comparisons were calculated using a difference-in-differences (DID) approach with best-supportive care as a common reference.</p><p><strong>Results: </strong>Total cost associated with AEs grade ≥3 occurring in patients with mCRC receiving 3L+ ranged from €300.19/patient for the management of hypertension to €3335.11/patient for increased bilirubin. Adjusting AEs for reported incidences, the total cost was €284.54 for fruquintinib (FRESCO), €301.82 for fruquintinib (FRESCO-2), €749.91 for T/T + bevacizumab (SUNLIGHT), €750.56 for T/T (SUNLIGHT), €1383.57 for T/T (RECOURSE) and €1158.57 for regorafenib (CORRECT). Fruquintinib in the anchored comparison based on FRESCO and FRESCO-2 shows: a cost reduction of €398.70 and €360.98 compared to regorafenib (CORRECT), and a cost reduction of €491.55 and €453.83 compared to T/T (RECOURSE).</p><p><strong>Conclusion: </strong>The results of this analysis showed that fruquintinib was associated with lower management costs of AEs in patients with mCRC treated in late-line in Spain.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"586388"},"PeriodicalIF":2.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}