ClinicoEconomics and Outcomes Research最新文献

{"title":"The Economic Impact of Loss to Follow-Up in Eosinophilic Esophagitis: A Model-Based Analysis from the Perspective of Italian National Health Service.","authors":"Marzia Bonfanti, Martina Fardella, Marianna Morani, Salvatore Oliva, Edoardo Vincenzo Savarino, Roberta Giodice, Jean Pierre Saab, Ester Castagnaro, Andrea Tassone, Umberto Restelli","doi":"10.2147/CEOR.S551500","DOIUrl":"10.2147/CEOR.S551500","url":null,"abstract":"<p><strong>Purpose: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease requiring long-term management. Loss to follow-up (LTFU) is a significant issue, leading to increased complications and higher healthcare costs. One key factor contributing to LTFU is the lack of structured transition models for patients moving from pediatric to adult care. This study provides the first model-based economic evaluation of LTFU in EoE within the Italian National Healthcare Service (NHS) and aims to quantify the economic impact of LTFU as well as evaluate the potential cost reduction associated with implementing a structured transition model.</p><p><strong>Patients and methods: </strong>A health economic model was developed to assess the financial burden of LTFU in EoE from the perspective of the Italian NHS. The model incorporated epidemiological, clinical, and economic inputs, estimating, within a time-horizon of one year, the economic burden of LTFU and the cost differential between patients with continuous care and those experiencing a care gap (≥2 years). The analysis included costs related to emergency department (ED) visits, hospitalizations, pharmacological treatments, and outpatient services. All costs were reported in 2024 euros. Additionally, a simulation was conducted to evaluate the potential economic benefits of a structured transition model.</p><p><strong>Results: </strong>The total economic burden of LTFU in EoE was estimated at € 84.9 million, with an average cost per patient of € 15,468, nearly double the cost of patients receiving continuous care (€ 7,744). The primary cost drivers were hospitalizations (69%) and pharmacological treatments (30%). The introduction of a transition model reducing LTFU by 30% could result in a € 25.4 million cost reduction, primarily through decreased hospital admissions and optimized treatment strategies.</p><p><strong>Conclusion: </strong>LTFU in EoE is associated with a significant economic burden. Implementing a structured transition model could improve patient retention, enhance adherence to treatment, and generate important cost savings.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"551500"},"PeriodicalIF":2.2,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379119","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":"Impact of Delaying Disease Recurrence on Economic Burden in Patients with HER2+ Early-Stage Breast Cancer (eBC).","authors":"Nicole Princic, Eleanor Faherty, Meghan Moynihan, Caroline Henriques, Sandhya Mehta","doi":"10.2147/CEOR.S560281","DOIUrl":"https://doi.org/10.2147/CEOR.S560281","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess neoadjuvant (neo), post-neo, and adjuvant (adj) treatment (tx) patterns, recurrence rates, and the impact of recurrence timing on the cumulative cost burden among HER2+ early breast cancer (eBC) patients.</p><p><strong>Methods: </strong>Merative™ MarketScan^® Databases were used to identify adults newly diagnosed with eBC between 1/1/2017-9/30/2022 with ≥1 HER2 targeted treatment following BC date. Surgery within a year of the BC date delineated neo and post-neo/adj periods before and after the surgery date. Recurrence was reported during the post-surgery period and was defined as evidence of additional chemotherapy treatment, metastasis, or end-of-life care. Generalized linear model (GLM) (gamma distribution and log link) was used to assess the impact of disease recurrence on cumulative 3-year total all-cause costs during the post-surgery period.</p><p><strong>Results: </strong>A total of 3745 patients with HER2+ eBC were included in the study (mean age 53.7 yrs): 57.4% (n=2151) with adj tx only, 40.2% (n=1504) with neo and post-neo tx, 1.9% (n=70) with surgery only, and 0.5% (n=20) neo tx only. During follow-up (median duration post-surgery: 2 years), the rate of first recurrence was highest for surgery only (70.0%) and similar for adj only (16.0%) and neo and post-neo tx (14.3%) cohorts. GLM showed that the cumulative cost burden following surgery was higher among patients who experienced the first recurrence in <12 months vs no recurrence ($348,834 vs $265,279). Patients with chemo only as adj tx had a higher cumulative cost burden (Risk Ratio [RR] 1.28; p <0.001) than those with HER2 targeted treatment; and patients with neo tx had a lower cost burden (RR 0.85, p <0.001) compared with those with no neo tx.</p><p><strong>Conclusion: </strong>Delays in recurrence were associated with lower cumulative cost burden. Study findings highlight that the appropriate use of more effective HER2 targeted treatments that delay the time of first recurrence in neoadjuvant and adjuvant settings may improve patient outcomes and reduce the long-term healthcare burden associated with BC.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"560281"},"PeriodicalIF":2.2,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311345","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":"Characteristics and Utilization Patterns of Medicare Beneficiaries Initiating Long-Acting Injectable Antipsychotic Medications.","authors":"Michael Grabner, Yueh-Yi Chiang, Chia-Chen Teng, Susan dosReis, Katherine M Harris","doi":"10.2147/CEOR.S567370","DOIUrl":"https://doi.org/10.2147/CEOR.S567370","url":null,"abstract":"<p><strong>Purpose: </strong>US Medicare beneficiaries in fee-for-service (FFS) and Medicare Advantage (MA) plans may differ in sociodemographics, treatment patterns, and healthcare costs, but real-world evidence is limited. Our objective was to gain a holistic understanding of Medicare beneficiaries using long-acting injectable antipsychotic medications (LAI-AM) as a case study.</p><p><strong>Patients and methods: </strong>This observational study describes two distinct cohorts of new LAI-AM users enrolled in FFS or MA plans from July-2017 through December-2020. Data were extracted from the Centers for Medicare & Medicaid Services' Chronic Conditions Data Warehouse (for FFS) and the Carelon Research Healthcare Integrated Research Database^® (for MA). Setting the first LAI-AM claim as index date, we identified adult beneficiaries enrolled for ≥12-months before (baseline) and after (follow-up) the index date. We described LAI-AM users' sociodemographic and clinical characteristics, medication adherence (proportion of days covered [PDC]), and healthcare costs.</p><p><strong>Results: </strong>We identified 3180 FFS- and 525 MA-enrolled LAI-AM initiators. Compared to the MA cohort, the FFS cohort was younger (mean 49 vs 53 years), had more males (56% vs 45%), and had more living in the South and West. Many had a depressive mood disorder (70%) and/or substance use disorder (40%). The mean PDC was 0.52 (SD 0.34) for FFS and 0.46 (SD 0.34) for MA. Only 33% (FFS)/27% (MA) had a PDC≥0.8 (adherent). In both cohorts, total medical costs decreased and total pharmacy costs increased from baseline to follow-up.</p><p><strong>Conclusion: </strong>Differences in sociodemographic characteristics between FFS and MA plan LAI-AM initiators did not correspond with different patterns or costs of treatment.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"567370"},"PeriodicalIF":2.2,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285701","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 Evaluation of Combined Testing Strategies Using Erythrocyte Sedimentation Rate and C-Reactive Protein Tests.","authors":"Ben Yarnoff, Walter Morris, Hossein Zivaripiran, Megan McCutcheon, Thomas Koshy","doi":"10.2147/CEOR.S578961","DOIUrl":"https://doi.org/10.2147/CEOR.S578961","url":null,"abstract":"<p><strong>Objective: </strong>To conduct an economic analysis of the use of combined ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) testing strategies compared to CRP testing alone in U.S hospitals.</p><p><strong>Methods: </strong>A decision tree model was developed to evaluate the cost-effectiveness and cost-benefit of combined ESR and CRP testing compared to CRP alone. The model estimated the laboratory costs, number of misdiagnoses, and follow-up costs associated with misdiagnoses. Model inputs were sourced from published literature and clinical guidelines. Two combined testing strategies were evaluated: 1) result is positive only if both ESR and CRP results are positive (ESR + CRP) and 2) result is positive if either the ESR or CRP result is positive (ESR/CRP). Strategies were evaluated for five individual and three grouped conditions.</p><p><strong>Results: </strong>Results demonstrated that the ESR + CRP testing strategy is a cost-effective strategy for reducing misdiagnoses and is expected to result in a net cost reduction to the healthcare system when accounting for the reduction in follow-up costs associated with misdiagnoses. In contrast, the ESR/CRP strategy led to increased misdiagnoses when compared to CRP alone.</p><p><strong>Conclusion: </strong>Results indicate that adopting the ESR + CRP strategy would reduce misdiagnoses and overall costs to healthcare systems.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"578961"},"PeriodicalIF":2.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221600","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":"Budget Impact of Secukinumab in Psoriatic Arthritis Patients with Contraindication to TNF-Alpha Inhibitors.","authors":"Unchalee Permsuwan, Piyameth Dilokthornsakul, Ratree Sawangjit","doi":"10.2147/CEOR.S570011","DOIUrl":"https://doi.org/10.2147/CEOR.S570011","url":null,"abstract":"<p><strong>Background: </strong>Secukinumab, an IL-17A inhibitor, has been recommended for psoriatic arthritis (PsA) patients with contraindications to TNF-alpha inhibitors (TNFi). However, its budgetary implications in Thailand remain unclear.</p><p><strong>Objective: </strong>To estimate the 5-year budget impact of introducing secukinumab 150 mg for PsA patients contraindicated to TNFi therapy from the perspective of the Thai healthcare system.</p><p><strong>Methods: </strong>A budget impact analysis (BIA) was developed following the Thai HTA Guideline. Two treatment scenarios were compared: the current standard of care using csDMARDs and a new scenario incorporating secukinumab 150 mg (auto-injector). The model estimated eligible patients based on national demographics and clinical data. Costs included direct medical costs for medications, administration, monitoring, and complications. Net budget impact (NBI) was estimated. Deterministic sensitivity analyses were conducted to evaluate the impact of varying uptake rates and treatment durations.</p><p><strong>Results: </strong>Under the base-case scenario over five years, secukinumab use resulted in the NBI of 15.14 million THB (434,965 USD), with an average annual net budget impact of 3.03 million THB (86,993 USD). Drug acquisition accounted for 97.16% of the total budget impact. Sensitivity analyses revealed a higher financial burden with increased uptake or lifetime treatment but remained within a manageable range (up to 18.34 million THB or 526,849 USD).</p><p><strong>Conclusion: </strong>Introducing secukinumab for PsA patients contraindicated to TNFi is associated with a moderate increase in healthcare expenditure. These findings suggest that inclusion of secukinumab in the National List of Essential Medicines for this specific population may be feasible, conditional on successful price negotiation and/or managed entry arrangements to ensure budgetary sustainability and equitable access.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"570011"},"PeriodicalIF":2.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221679","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":"Socio-Economic Impacts of Childhood Sickle Cell Disease on Households in Lubumbashi: An Exploratory Mixed-Methods Study.","authors":"Criss Koba Mjumbe, Deborah Mazuya Fataki, Laetitia Ngongo Mwanvua, Noemie Kisimba Kapala, Virginie Mujinga Katumba, Edouard Mbaya Munianji, Jephte Moliba","doi":"10.2147/CEOR.S571343","DOIUrl":"10.2147/CEOR.S571343","url":null,"abstract":"<p><strong>Introduction: </strong>Sickle cell disease is a common genetic disorder in Africa, particularly In the Democratic Republic of Congo (DRC), sickle cell disease causes anemia, pain, and complications in young children. It places a heavy burden on families, both medically and economically, especially in the absence of support or health insurance. This study examines how this disease affects the daily lives of households in Lubumbashi.</p><p><strong>Methods: </strong>This mixed-methods study combined quantitative and qualitative approaches to explore the impact of sickle cell disease on households with children in Lubumbashi. It included 70 children aged 0 to 15 years and their families, with data collected from hospital records and in-depth semi-structured interviews. The data were analyzed using descriptive statistics for the quantitative component and thematic analysis for the qualitative component, thus integrating statistics and personal accounts for a comprehensive understanding of family life.</p><p><strong>Results: </strong>The study showed that children with sickle cell disease, mostly aged 0 to 5 years, experience frequent painful crises that disrupt their daily lives and those of their families. Treatment, often symptomatic and costly, leads to repeated hospitalizations, stress, and income loss for parents. The disease also affects children's schooling and social lives, with learning difficulties and frequent stigmatization. Limited access to hydroxyurea and regular follow-up care exacerbates the vulnerability of families. They express an urgent need for financial, psychological, and educational support, as well as improved access to treatments and healthcare facilities.</p><p><strong>Conclusion: </strong>Sickle cell disease profoundly disrupts the lives of children and their families, causing painful crises, hospitalizations, and academic and financial difficulties. Early screening, access to hydroxyurea, prophylaxis, and specialized clinics, combined with educational and psychosocial support, could improve their daily lives. Solidarity-based financing mechanisms or targeted subsidies are essential to alleviate the economic burden on families.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"571343"},"PeriodicalIF":2.2,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575777","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 Work-Related Low Back Pain in Indonesia Before and During the COVID-19 Era, 2019-2021: Analysis of Global Burden of Disease Estimates.","authors":"Abdul Kadir, Derren D C H Rampengan, Andrean V H Simanjuntak, Theresia Anggriani, Muhammad Dharma Nauval, Muhammad Ichsan Adnan, Surna Lastri, Muhammad Iqhrammullah","doi":"10.2147/CEOR.S575081","DOIUrl":"10.2147/CEOR.S575081","url":null,"abstract":"<p><strong>Introduction: </strong>Occupational ergonomic risk factors are a major contributor to musculoskeletal disorders and productivity loss, yet their welfare implications remain underexplored in low- and middle-income settings. This study aimed to quantify the health and economic burden of ergonomic risks across Indonesian provinces using the Value of Lost Welfare (VLW) framework.</p><p><strong>Methods: </strong>Disability-adjusted life years (DALYs) attributable to ergonomic risks were obtained from the Global Burden of Disease 2019-2021 estimates. VLW was calculated by multiplying DALYs with the Value of a Statistical Life Year (VSLY), derived from GDP per capita and adjusted for purchasing power parity. Both absolute VLW (International Dollar, Int$) and the VLW-to-GDP ratio were computed at national and provincial levels. Socioeconomic inequality was assessed using the slope index of inequality (SII) and relative index of inequality (RII).</p><p><strong>Results: </strong>National VLW increased from Int$ 44.6 billion in 2019 to Int$ 48.5 billion in 2021, with the largest contributions observed in East Java (Int$ 7.3 billion) and West Java (Int$ 6.1 billion), while smaller provinces such as Gorontalo and North Maluku contributed less than Int$ 200 million. Despite a steady rise in DALYs, the VLW-to-GDP ratio followed the economic cycle, increasing during the 2020 downturn (1.47%) and declining to 1.36% in 2021 as GDP rebounded. Socioeconomic inequality in the VLW-to-GDP ratio was statistically significant, with SII of -0.00165 (95% CI: -0.00255 to -0.00074) and RII of -0.118 (95% CI: -0.183 to -0.053).</p><p><strong>Discussion: </strong>Occupational ergonomics imposes a substantial and persistent health-economic burden in Indonesia, amounting to nearly Int$ 50 billion annually. The observed socioeconomic gradient indicates that lower-GDP provinces experience disproportionately greater welfare losses relative to their economic capacity, underscoring the need for sustained workplace interventions and targeted regional policies, particularly in lower-GDP regions.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"575081"},"PeriodicalIF":2.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515856","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":"Experiences of Healthcare Providers and Households Facing Healthcare Costs in Eastern Kasai/DR Congo: A Qualitative Analysis.","authors":"Barry Mutombo, Criss Koba Mjumbe, Alain Mpanya, Daniel Kazadi Cilumbayi, Pascal Lutumba","doi":"10.2147/CEOR.S573451","DOIUrl":"10.2147/CEOR.S573451","url":null,"abstract":"<p><strong>Introduction: </strong>Access to healthcare in the DRC remains limited, not only due to high costs and low health insurance coverage, but also because of out-of-pocket payments, which expose households to catastrophic health expenditure. This study aimed to analyze the perceptions and strategies of both healthcare providers and the population when faced with payment difficulties in Kasaï Oriental.</p><p><strong>Methodology: </strong>This is a qualitative study that was conducted from June to July 2024 through 13 focus groups and 9 semi-structured interviews. Participants included healthcare providers (doctors, nurses, midwives), small merchants and motorcycle taxi drivers in urban and rural areas. Thematic analysis was performed using ATLAS.ti 6 after transcription and translation of the interviews.</p><p><strong>Results: </strong>Healthcare providers highlight limited technical equipment, sometimes leading to transferring patients outside the province, increasing their cost of care, making medicine shortages more frequent and developing a dependence on vertical programmes. High costs force households to delay seeking care, go into debt, sell family assets, or resort to self-medication, traditional healers, and sometimes churches. This can even lead to the loss of patients, even those who were already in contact with the health system. Various solidarity mechanisms (instalment payments, community funds, rebates, assistance from benefactors) make it possible to partially overcome financial barriers. Nevertheless, the population perceives healthcare as generally unaffordable, sometimes leading to the escape from healthcare centres of patients unable to pay and even their abduction.</p><p><strong>Conclusion: </strong>Financial barriers remain a major obstacle to equitable access to healthcare. Strengthening public funding and promoting mutual health insurance schemes are essential for progress towards universal health coverage in Democratic Republic of Congo.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"573451"},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515827","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":"Comparative Cost Analysis of Ambulance Utilization: Advanced Life Support (ALS) vs Basic Life Support (BLS) at King Abdulaziz Medical City, Riyadh.","authors":"Abdullah Alabdali, Mohammed Alharkan","doi":"10.2147/CEOR.S570790","DOIUrl":"https://doi.org/10.2147/CEOR.S570790","url":null,"abstract":"<p><strong>Purpose: </strong>Unit-hour utilization (UHU) is the most common metric for evaluating the productivity of ambulances and crews for ambulance services. Calculating UHU is essential for maximizing profitability and evaluating the number of hours of ambulance utilization during a shift. This has not been examined previously at King Abdulaziz Medical City (KAMC). KAMC is a major tertiary-care medical center in Riyadh, Saudi Arabia, with dedicated ALS (Advanced Life Support) and BLS (Basic Life Support) ambulance units. This study aimed to determine the cost of operating the emergency calls (advanced life support [ALS]) unit and non-emergency calls (basic life support [BLS]) unit and compare the costs of emergency calls (ALS) and non-emergency calls (BLS). The study used a standardized institutional checklist that itemizes expenditures across logistics, equipment, maintenance, salary, pharmacy, and fuel cost components.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study. Institutional Review Board approval was obtained from King Abdullah International Medical Research Center. The study examined emergency and non-emergency calls for a period of 12 months. This study was based on a checklist assessing various expenditures to calculate the cost of ambulance utilization at KAMC in 2022.</p><p><strong>Results: </strong>The total average ambulance utilization cost per year for ALS was 4,806,245.7 SR, and the average ambulance utilization cost per hour was 548.65 SR; these costs were to operate the ALS crew for 24 hours, seven days a week. Conversely, the total average ambulance utilization cost per year for BLS was 3,934,156.92 SR, and the average ambulance utilization cost per hour was 449.10 SR. The main expenses concerned salaries and overhead costs for ALS and BLS.</p><p><strong>Conclusion: </strong>This study provides insights into the cost of ambulance utilization between ALS and BLS. The higher cost of ALS calls may be attributed to the higher level of training, equipment, and staffing required.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"570790"},"PeriodicalIF":2.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500175","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":"Pharmaceutical Manufacturing in China Innovation Performance: A Dynamic QCA Analysis Based on the WSR Perspective.","authors":"Wangwang Zhu, Shiqi Tao, Xiaoying Zhou, Rui Fu","doi":"10.2147/CEOR.S560908","DOIUrl":"https://doi.org/10.2147/CEOR.S560908","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the theoretical foundations and driving mechanisms of innovation performance in the Chinese pharmaceutical manufacturing industry, offering theoretical and practical insights for enhancing the industry's innovation capacity and global competitiveness.</p><p><strong>Patients and methods: </strong>Drawing upon the \"Wuli-Shili-Renli\" (WSR) systems methodology and a configurational perspective, this study employs dynamic Qualitative Comparative Analysis (QCA) to analyze Chinese provincial panel data spanning 2015-2021. The study explores the configurational effects of influencing factors across three dimensions-digital economy, environmental regulation, and social capital-on the innovation performance of the pharmaceutical manufacturing industry across 30 Chinese provinces and municipalities.</p><p><strong>Results: </strong>(1) The consistency scores for all antecedent conditions were below 0.9, indicating that no single factor constitutes a necessary condition for high innovation performance in the pharmaceutical manufacturing industry. (2) Three effective configurational paths driving high innovation performance were identified: the \"dual-driven\", \"multiple-dominant\", and \"balanced coordination\" paths. The overall solution consistency was 0.938, with an overall solution coverage of 0.511. (3) Temporally, configuration consistency exhibited a marked decline in 2017 and 2019, dropping below 0.9. (4) Spatially, the \"balanced coordination\" path achieved the highest provincial coverage, accounting for approximately 60%. Meanwhile, the \"multiple-dominant\" path revealed significant regional disparities, underscoring the need for most provinces to promote collaborative innovation within the industry.</p><p><strong>Conclusion: </strong>The integration of the \"Wuli-Shili-Renli\" (WSR) systems methodology with dynamic fuzzy-set Qualitative Comparative Analysis (fsQCA) transcends the limitations of single-paradigm research. This study offers two primary contributions. First, it provides a robust theoretical framework for analyzing high innovation performance in the Chinese pharmaceutical manufacturing industry, thereby enriching the international innovation management literature. Second, it serves as a cross-cultural exemplar, synthesizing Eastern systems thinking with Western empirical methods to advance the global discourse on pharmaceutical innovation. Furthermore, the findings offer actionable insights for policymakers and stakeholders to foster high-quality development and enhance the global competitiveness of the pharmaceutical industry.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"18 ","pages":"560908"},"PeriodicalIF":2.2,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610401","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}