ClinicoEconomics and Outcomes Research最新文献

{"title":"The Relative Value of Anti-Obesity Medications Compared to Similar Therapies.","authors":"Nina Kim,&nbsp;Joaquin Estrada,&nbsp;Isabella Chow,&nbsp;Aleksandrina Ruseva,&nbsp;Abhilasha Ramasamy,&nbsp;Chakkarin Burudpakdee,&nbsp;Christopher M Blanchette","doi":"10.2147/CEOR.S392276","DOIUrl":"https://doi.org/10.2147/CEOR.S392276","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate a need for improved health insurance coverage for anti-obesity medications (AOMs) by comparing clinical and economic benefits of obesity treatments to covered medications for selected therapeutic areas.</p><p><strong>Methods: </strong>Using a grey literature search, we identified and prioritized therapeutic areas and treatment analogues for comparison to obesity. A targeted literature review identified clinical and economic outcomes research across the therapeutic area analogues. Associated comorbidities, clinical evidence, indirect costs (ie, absenteeism and productivity loss), and direct medical costs were evaluated to determine the relative value of treating obesity.</p><p><strong>Results: </strong>Four therapeutic areas/treatment analogues were selected for comparison to obesity: smoking cessation (varenicline), daytime sleepiness (modafinil), migraines (erenumab), and fibromyalgia (pregabalin). Obesity was associated with 17 comorbidities, more than migraine (9), smoking (8), daytime sleepiness (5), and fibromyalgia (2). Economic burden was greatest for obesity, followed by smoking, with yearly indirect and direct medical costs totaling $676 and $345 billion, respectively. AOMs resulted in cost savings of $2586 in direct medical costs per patient per year (PPPY), greater than that for varenicline at $930 PPPY, modafinil at $1045 PPPY, and erenumab at $468 PPPY; pregabalin utilization increased costs by $924 PPPY. AOMs were covered by 10-16% of United States health insurance plans, compared to 45-59% for the four comparators.</p><p><strong>Conclusion: </strong>Compared to four therapeutic analogues, obesity represented the highest economic burden and was associated with more comorbidities. AOMs provide greater cost savings compared to selected analogues. However, AOMs have limited formulary coverage. Improved coverage of AOMs may increase access to these treatments and may help address the clinical and economic burden associated with obesity and its comorbidities.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/0e/ceor-15-51.PMC9886521.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643413","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 Analysis of Single-Inhaler Fluticasone Furoate/Umeclidinium/Vilanterol in Patients with Asthma in the Dubai Academic Healthcare Corporation.","authors":"Mohamed Hamouda,&nbsp;Mohamed Farghaly,&nbsp;Sara Al Dallal","doi":"10.2147/CEOR.S407025","DOIUrl":"https://doi.org/10.2147/CEOR.S407025","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma is a common, chronic respiratory disorder associated with substantial societal and economic burden globally, despite the availability of different treatment modalities. GSK has developed a once-daily single-inhaler triple therapy (SITT), comprised of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI); a combination of inhaled corticosteroid, long-acting muscarinic antagonist, and long-acting β₂-agonist for patients with uncontrolled asthma. A budget impact analysis was conducted to determine the financial impact of introducing FF/UMEC/VI SITT from the perspective of the Dubai Academic Healthcare Corporation (DAHC).</p><p><strong>Methods: </strong>A budget impact model was constructed using an epidemiology-based approach and used to estimate the expected 5-year budget impact of including FF/UMEC/VI for the treatment of eligible patients within the DAHC in the United Arab Emirates (UAE). The model included both pharmacy and efficacy-related costs. The perspective of the DAHC healthcare payer was adopted, thus only direct payer costs were included in the analysis. A one-way sensitivity analysis was conducted to test the robustness of the model structure, assumptions, and input parameters.</p><p><strong>Results: </strong>The total budget impact was estimated to save 1 million United States Dollars (USD) over 5 years, with budget impacts of 0.08 million USD in Year 1; 0.14 million USD in Year 2; 0.22 million USD in Year 3; 0.28 million USD in Year 4; and 0.33 million USD in Year 5. The overall budget impact per patient was estimated to save 12.2 USD over 5 years. In one-way sensitivity analyses, the budget impact was most sensitive to changes in the market uptake of FF/UMEC/VI.</p><p><strong>Conclusion: </strong>Healthcare payers may consider FF/UMEC/VI in the management of uncontrolled asthma which would save costs and reduce healthcare resource use in the UAE.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/60/ceor-15-549.PMC10351593.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827722","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":"COVID-19's Effects on Macroeconomic Indicators in Ethiopia: Systematic Review of Articles.","authors":"Tesfaye Denano","doi":"10.2147/CEOR.S416625","DOIUrl":"https://doi.org/10.2147/CEOR.S416625","url":null,"abstract":"<p><strong>Introduction: </strong>In the midst of the COVID-19 crisis, it might be difficult to provide the most vulnerable people with access to essential services. The main objective of this article is to lay the foundation for future solutions by collecting the results of previous published articles.</p><p><strong>Methods: </strong>This study used a systematic and integrated method that began by searching relevant literature in professional and generally published journal databases from March 2019- December 2021.</p><p><strong>Results: </strong>According to the results of the review, COVID-19 has had a significant effect on real and forecasted key macroeconomic variables such as economic growth, unemployment, inflation, poverty levels, and fiscal and monetary policy. In addition, this review reflects the sectorial effect of COVID-19 on health, factor productivity, domestic trade, exports, tourism, international aviation, remittances, the education sector, foreign direct investment, and the Ethiopian economy.</p><p><strong>Conclusion: </strong>While appropriate social distance and personal protective equipment strategies exist in all types of markets across the country, the government should take precautions against the recurrence of Covid-19 by disseminating credible information. Finally, fiscal optimization should be seen as a broader intervention in the economy as a whole.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/64/ceor-15-573.PMC10364812.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866034","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 Icosapent Ethyl (IPE) for the Reduction of the Risk of Ischemic Cardiovascular Events in Canada.","authors":"Jean Lachaine,&nbsp;Jean-Nicolas Charron,&nbsp;Jean C Gregoire,&nbsp;Robert A Hegele,&nbsp;Lawrence A Leiter","doi":"10.2147/CEOR.S377935","DOIUrl":"https://doi.org/10.2147/CEOR.S377935","url":null,"abstract":"<p><strong>Background: </strong>Despite the use of statins, many patients with cardiovascular disease (CVD) have persistent residual risk. In a large Phase III trial (REDUCE-IT), icosapent ethyl (IPE) was shown to reduce the first occurrence of the primary composite endpoint of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina.</p><p><strong>Methods: </strong>We conducted a cost-utility analysis comparing IPE to placebo in statin-treated patients with elevated triglycerides, from a publicly funded, Canadian healthcare payer perspective, using a time-dependent Markov transition model over a 20-year time horizon. We obtained efficacy and safety data from REDUCE-IT, and costs and utilities from provincial formularies and databases, manufacturer sources, and Canadian literature sources.</p><p><strong>Results: </strong>In the probabilistic base-case analysis, IPE was associated with an incremental cost of $12,523 and an estimated 0.29 more quality-adjusted life years (QALYs), corresponding to an incremental cost-effectiveness ratio (ICER) of $42,797/QALY gained. At a willingness-to-pay of $50,000 and $100,000/QALY gained, there is a probability of 70.4% and 98.8%, respectively, that IPE is a cost-effective strategy over placebo. The deterministic model yielded similar results. In the deterministic sensitivity analyses, the ICER varied between $31,823-$70,427/QALY gained. Scenario analyses revealed that extending the timeframe of the model to a lifetime horizon resulted in an ICER of $32,925/QALY gained.</p><p><strong>Conclusion: </strong>IPE represents an important new treatment for the reduction of ischemic CV events in statin-treated patients with elevated triglycerides. Based on the clinical trial evidence, we found that IPE could be a cost-effective strategy for treating these patients in Canada.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/37/ceor-15-295.PMC10124620.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725809","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":"Assessing the Health Economic Outcomes from Commercially Insured Relapsing Multiple Sclerosis Patients Who Switched from Other Disease-Modifying Therapies to Teriflunomide, in the United States.","authors":"Lita Araujo,&nbsp;Srikanth Kyatham,&nbsp;Kristen G Bzdek,&nbsp;Keiko Higuchi,&nbsp;Nupur Greene","doi":"10.2147/CEOR.S401687","DOIUrl":"https://doi.org/10.2147/CEOR.S401687","url":null,"abstract":"<p><strong>Objective: </strong>Assess patient characteristics, healthcare resource utilization (HCRU), and relapses in patients with multiple sclerosis (MS) who switched to teriflunomide from other disease-modifying therapies (DMTs).</p><p><strong>Methods: </strong>Retrospective study of US Merative™ MarketScan^® claims database (Jan 1, 2012-July 31, 2020,) including HIPAA-compliant, deidentified data. Patients ≥18 years with MS diagnosis (based on ICD-9/ICD-10 codes), receiving ≥1 DMT prior to teriflunomide and ≥12 months continuous enrollment pre and post index (date of teriflunomide initiation). Outcomes included inpatient and emergency room claims coinciding with MS diagnosis, MS-related healthcare costs, and annualized relapse rates (ARRs) (indirectly assessed using hospitalization/outpatient claims and steroid use coinciding with MS diagnosis).</p><p><strong>Results: </strong>The analyzed cohort (N=2016) was primarily female (79%); age (mean ± standard deviation) 51.4 ± 9.3 years; MS duration 4.7±2.8 years (at index). The majority (89.2%) were treated with one DMT before switching to teriflunomide. Use of outpatient services (event rate/100 person-years) increased post vs pre index; however, MRI visits significantly reduced over the same period (both <i>P</i><0.0001). Costs for MS-specific outpatient visits decreased by $371 per patient per year (PPPY) after switching to teriflunomide. Despite an increase in use post index (0.024 to 0.033 rate/100 person-years; <i>P</i><0.0001), costs for MS-specific laboratory services reduced (pre-index: $271 vs $248 PPPY post-index; <i>P</i>=0.02). Fewer patients had relapses after switching (pre-index: n=417 [20.7%]; post-index: n=333 [16.5%]). ARR was significantly lower after switching (pre-index: 0.269 vs post-index: 0.205; <i>P</i>=0.000).</p><p><strong>Conclusion: </strong>Switching to teriflunomide from existing DMTs in patients with relapsing MS resulted in a reduction in outpatient HCRU in this analysis of US claims data. The real-world effectiveness of teriflunomide was generally consistent with efficacy reported in clinical trials, showing a reduction in relapse following a switch to teriflunomide.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/59/ceor-15-361.PMC10208242.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9579256","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":"Teachers' Willingness to Pay for Social Health Insurance and Its Determinant Factors at Harar Region, Ethiopia, 2021.","authors":"Sintayehu Girma,&nbsp;Gizachew Abebe,&nbsp;Aklilu Tamire,&nbsp;Hamdi Fekredin,&nbsp;Bedasa Taye","doi":"10.2147/CEOR.S397766","DOIUrl":"https://doi.org/10.2147/CEOR.S397766","url":null,"abstract":"<p><strong>Background: </strong>Most developing nations lag behind in maintaining their populations' health. These nations are characterized by under-financing, low health cost protection mechanisms for the poor, and lack of risk pooling and cost sharing methods. To tackle this challenge, Ethiopia proposed social health insurance in 2010 even though its implementation was delayed. Hence, the purpose of this study was to assess teachers' willingness to pay for the newly proposed social health insurance and its associated factors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted and a stratified sampling technique was used to select government and private schools. After data were collected using a semi-structured self-administered questionnaire, binary and multivariate logistic regressions were done to examine determinants of willingness to pay for social health insurance.</p><p><strong>Results: </strong>Among participants who faced illness six months prior to the study, 85.7% reported that they paid \"out of their pocket\". About 59.2% and 54% of the teachers had a positive attitude and good knowledge toward health insurance schemes respectively. Of the total study respondents, 89.5% were willing to pay for the suggested insurance scheme. Forty eight percent of participants agreed to pay greater than or equal to 4% of their monthly salary. Willingness to pay was more likely among those who taught in secondary schools, had a positive attitude and good knowledge.</p><p><strong>Conclusion: </strong>Nearly three fourths of the teachers showed willingness to pay for social health insurance. Participants with good knowledge, a positive attitude and from primary schools were more likely to be willing to pay for social health insurance. Equipping all public facilities' employees with necessary knowledge of social health insurance is essential to reduce catastrophic health care costs. Future researchers need to consider qualitative studies to support these findings.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/06/ceor-15-181.PMC10010142.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9123737","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 Implementing Key Performance Indicators on Catheter-Associated Urinary Tract Infection (CAUTI) Rates Among Adult ICU Patients in Saudi Arabia.","authors":"Nouf Alhabdan,&nbsp;Asma Alyaemni,&nbsp;Mohammed M Aljuaid,&nbsp;Ali Baydoun,&nbsp;Samer Hamidi","doi":"10.2147/CEOR.S396160","DOIUrl":"https://doi.org/10.2147/CEOR.S396160","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of catheter-associated urinary tract infections (CAUTIs) in hospitals characterizes one of the most significant problems in healthcare. This study aims to assess whether the implementation of impact of key performance indicators (KPIs) checklist reduces the number of CAUTI in adults present in intensive care unit (ICU) with indwelling catheters.</p><p><strong>Methods: </strong>This is a retrospective analytical study conducted in a tertiary hospital in Riyadh, Saudi Arabia, from June 2020 to June 2021. One hundred and thirty-four patients with CAUTIs met the criteria and were included in the study. Socio-demographic data was collected to enable informed analysis based on personal information (age, gender, marital status, monthly income, level of education, and department) and medical history (duration of catheterization, types of organisms, history of chronic illness, and duration of hospitalization). The research also used a prevention of CAUTI checklist containing 26 items. The outcome measures were 1) the rate of CAUTIs measured pre- and post-implementing performance measurement indicators (KPI) of CAUTIs prevention practice and 2) the prevention of catheter-associated urinary tract infection in three areas: general information recording, insertion practices, and maintenance practices.</p><p><strong>Results: </strong>The study found that there was compliance with the prevention of CAUTIs in terms of recording the general patient's information (72%), insertion practices (52%), and maintenance practices (50%). However, most safety practices, including poor hygiene and safety standards, patient handling, and audited protocol programs, were not strictly followed, resulting in increased risk factors for CAUTIs.</p><p><strong>Conclusion: </strong>Compliance with the prevention of CAUTIs in terms of recording the general patient's information, insertion practices, and maintenance practices lies within the range of 50-75%, and the recommended practices are usually followed. A targeted education on CAUTI-prevention practices curtailing the most aggravating risk factors and adopting a safety culture driven by a patient handling and audited protocol program should be explored to reduce hospital CAUTIs.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/a8/ceor-15-41.PMC9869901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9178552","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 Cost Burden of BCG-Treated Non-Muscle Invasive Bladder Cancer Patients in Germany: A Retrospective Claims Analysis.","authors":"Nadia Quignot,&nbsp;Heng Jiang,&nbsp;Indraraj Umesh Doobaree,&nbsp;Jan Lehmann,&nbsp;Ola Ghatnekar","doi":"10.2147/CEOR.S398180","DOIUrl":"https://doi.org/10.2147/CEOR.S398180","url":null,"abstract":"<p><strong>Background: </strong>Intermediate and high-risk non-muscle-invasive bladder cancer (NMIBC) is typically managed with transurethral resection of the bladder tumour (TURBT) followed by intravesical Bacillus Calmette-Guérin (BCG) immunotherapy; however, NMIBC patients can become refractory or unresponsive to BCG treatment, and/or progress to muscle-invasive bladder cancer (MIBC). Healthcare resource utilization (HCRU) and costs in these patient populations are high.</p><p><strong>Methods: </strong>A retrospective longitudinal cohort design of adult (≥18 years) patients with bladder cancer and BCG treatment (01/01/2012-31/12/2017) was conducted using data from a representative subset of the German statutory health insurance database. During the follow-up period after last BCG, patients were categorized into subgroups of <i>No further NMIBC treatment, Continuous treatment for NMIBC</i>, or <i>MIBC evidence</i>; HCRU and costs were tabulated for each subgroup and for the entire cohort.</p><p><strong>Results: </strong>A total of 1049 patients met the study inclusion criteria (mean age, 70.9 years; 84.8% male). Across the different subgroups, patients showing <i>MIBC evidence</i> had more than two times higher hospitalization rates compared to the other subgroups. Overall, the entire BCG-treated cohort's total direct medical cost including hospitalizations, outpatient care and drugs was €33.9 million and €9250 per patient-year. Cost for patients with <i>MIBC evidence</i> was much higher, at €17,983 per patient-year, than patients with <i>No further NMIBC treatment</i> (€6617) and patients with <i>Continuous treatment for NMIBC</i> (€7786). Across the subgroups, hospitalization was the largest driver of cost and contributed the most to cost for those with <i>MIBC evidence</i>.</p><p><strong>Conclusion: </strong>The overall cost burden of this BCG-treated cohort of 1049 patients is high (€38 million whereof 4.1 million are indirect costs) over a mean follow-up of 3.9 years; economic burden is especially substantial for patients who fail BCG treatment and those who progress.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/03/ceor-15-227.PMC10075214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9267198","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 Associated with the Treatment with a Cardiovascular Polypill in Secondary Prevention in Spain: Cost-Effectiveness Results of the NEPTUNO Study.","authors":"Alberto Cordero,&nbsp;Regina Dalmau González-Gallarza,&nbsp;Lluis Masana,&nbsp;Valentín Fuster,&nbsp;Jose Mª Castellano,&nbsp;José Emilio Ruiz Olivar,&nbsp;Ilonka Zsolt,&nbsp;Antoni Sicras-Mainar,&nbsp;Jose Ramón González Juanatey","doi":"10.2147/CEOR.S396290","DOIUrl":"https://doi.org/10.2147/CEOR.S396290","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to estimate health-care resources utilization, costs and cost-effectiveness associated with the treatment with CNIC-Polypill as secondary prevention of atherosclerotic cardiovascular disease (ASCVD) compared to other treatments, in clinical practice in Spain.</p><p><strong>Patients and methods: </strong>An observational, retrospective study was performed using medical records (economic results [healthcare perspective], NEPTUNO-study; BIG-PAC-database) of patients who initiated secondary prevention between 2015 and 2018. Patients were followed up to 2 years (maximum). Four cohorts were balanced with a propensity-score-matching (PSM): 1) CNIC-Polypill (aspirin+atorvastatin+ramipril), 2) Monocomponents (same separate drugs), 3) Equipotent (equipotent drugs) and 4) Other therapies ([OT], other cardiovascular drugs). Incidence of cardiovascular events, health-care resources utilization and healthcare and non-healthcare costs (2020 Euros) were compared. Incremental cost-effectiveness ratios per cardiovascular event avoided were estimated.</p><p><strong>Results: </strong>After PSM, 1614 patients were recruited in each study cohort. The accumulated incidence of cardiovascular events during the 24-month follow-up was lower in the CNIC-Polypill cohort vs the other cohorts (19.8% vs Monocomponents: 23.3%, Equipotent: 25.5% and OT: 26.8%; p<0.01). During the follow-up period, the CNIC-Polypill cohort also reduced the health-care resources utilization per patient compared to the other cohorts, particularly primary care visits (16.6 vs Monocomponents: 18.7, Equipotent: 18.9 and OT: 21.0; p<0.001) and hospitalization days (2.3 vs Monocomponents: 3.4, Equipotent: 3.7 and OT: 4.0; p<0.001). The treatment cost in the CNIC-Polypill cohort was lower than that in the other cohorts (€4668 vs Monocomponents: €5587; Equipotent: €5682 and OT: €6016; p<0.001) (Difference: -€919, -€1014 and -€1348, respectively). Due to the reduction of cardiovascular events and costs, the CNIC-Polypill is a dominant alternative compared to the other treatments.</p><p><strong>Conclusion: </strong>CNIC-Polypill reduces recurrent major cardiovascular events and costs, being a cost-saving strategy as secondary prevention of ASCVD.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/05/ceor-15-559.PMC10363366.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861409","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":"Work Loss and Direct and Indirect Costs Associated with Parkinson's Disease.","authors":"Michelle Jerry,&nbsp;Steve Arcona,&nbsp;Donna McMorrow,&nbsp;Hana Schwartz,&nbsp;Nicole Princic,&nbsp;Rahul Sasane","doi":"10.2147/CEOR.S398509","DOIUrl":"https://doi.org/10.2147/CEOR.S398509","url":null,"abstract":"<p><strong>Purpose: </strong>To examine work loss and indirect costs during the three-year periods prior to and following initial diagnosis of Parkinson's disease (PD) in patients and in spouses of PD patients, as well as direct costs of healthcare.</p><p><strong>Patients and methods: </strong>This is a retrospective, observational cohort study using the MarketScan Commercial and Health and Productivity Management databases.</p><p><strong>Results: </strong>A total of 286 employed PD patients and 153 employed spouses met all diagnostic and enrollment criteria for short-term disability (STD) analysis (PD Patient cohort and Caregiving Spouse cohort). The proportion of PD patients having a STD claim increased from roughly 5% and plateaued at around 12-14% starting in the year prior to first diagnosis of PD. The mean number of days lost from work due to STD per year increased from 1.4 days in the 3rd year prior to diagnosis to 8.6 days in the 3rd year after diagnosis (corresponding to an increase in indirect costs from $174 to $1104). STD use for spouses of patients with PD was lowest in the year after their spouses were diagnosed and then rose dramatically in the 2nd and 3rd years after the spouse's diagnosis. Total all-cause direct health-care costs increased during the years leading up to PD diagnosis and were highest in the years following diagnosis, with PD-related costs contributing ~20-30% of the total.</p><p><strong>Conclusion: </strong>PD has both a significant direct and indirect financial burden on patients and their spouses when analyzed for 3 years before and after diagnosis.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/11/ceor-15-309.PMC10150754.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9416247","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}