ClinicoEconomics and Outcomes Research最新文献

{"title":"The High Cost of Death After Acute Myocardial Infarctions: Results from a National US Hospital Database.","authors":"Peter J Mallow,&nbsp;Frederick Browne,&nbsp;Kamal Shemisa","doi":"10.2147/CEOR.S397220","DOIUrl":"https://doi.org/10.2147/CEOR.S397220","url":null,"abstract":"<p><strong>Introduction: </strong>This study described the differences in costs and length of stay (LOS) among patients with AMI who died versus survived using a large, nationally representative cohort of AMI patients.</p><p><strong>Methods: </strong>The 2019 HCUP NIS was used to analyze costs, and LOS among all patients with a principal diagnosis of AMI. A propensity-score matched analysis and multivariable regression were used to adjust for patient and hospital characteristics.</p><p><strong>Results: </strong>There were 4559 visits in each of the cohorts (total 9118). The adjusted mean hospital cost was $18,970 (95% CI $16,453 - $21,871) for those that survived and $23,173 (95% CI $20,167 - $26,626; p <0.001) for those that died. The LOS was 3.95 (95% CI 3.41-4.57) in survivors and 4.24 (95% CI 3.67-4.89; p <0.001) in those who died.</p><p><strong>Conclusion: </strong>Survivors of AMI incurred lower costs and length of stay than those who died. Higher costs were attributed to greater LOS and higher-level care. The results suggest that economic evaluations of cardiovascular interventions that do not include the cost of dying may underestimate the benefits of the intervention.</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/72/02/ceor-15-63.PMC9899015.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10673812","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":"Eleven-Year Trends in Lipid-Modifying Medicines Utilisation and Expenditure in a Low-Income Country: A Study from the Republic of Srpska, Bosnia and Herzegovina.","authors":"Dragan Kalinić,&nbsp;Ranko Škrbić,&nbsp;Duško Vulić,&nbsp;Svjetlana Stoisavljević-Šatara,&nbsp;Nataša Stojaković,&nbsp;Miloš P Stojiljković,&nbsp;Vanda Marković-Peković,&nbsp;Ana Golić Jelić,&nbsp;Nataša Pilipović-Broćeta,&nbsp;Nevena Divac","doi":"10.2147/CEOR.S410711","DOIUrl":"https://doi.org/10.2147/CEOR.S410711","url":null,"abstract":"<p><strong>Background: </strong>In last two decades, there have been substantial changes in the pattern of lipid-modifying medicines utilisation following the new treatment guidelines based on clinical trials. The main purpose of this study was to analyse the overall utilisation and expenditure of lipid-modifying medicines in the Republic of Srpska, Bosnia and Herzegovina during an 11-year follow-up period and to express its share in relation to the total cardiovascular medicines (C group) utilisation.</p><p><strong>Methods: </strong>In this retrospective, observational study, medicines utilisation data were analysed between 2010 and 2020 period using the ATC/DDD methodology and expressed as the number of DDD/1000 inhabitants/day (DDD/TID). The medicines expenditure analysis was used to estimate the annual expenditure of medicines in Euro based on DDD.</p><p><strong>Results: </strong>During the analysed period, the use of lipid-modifying medicines increased almost 3-times (12.82 DDD/TID in 2010 vs 34.32 DDD/TID in 2020), with a rise in expenditure from 1.24 million Euro to 2.15 million Euro in the same period. This was mainly driven by an increased use of statins with 163.07%, and among these, rosuvastatin increased more than 1500-fold, and atorvastatin with 106.95% increase. With the appearance of generics, simvastatin showed a constant decline, while the other lipid-modifying medicines in relation to the total utilisation had a neglecting increase.</p><p><strong>Conclusion: </strong>The use of lipid-modifying medicines in the Republic of Srpska has constantly increased and strongly corresponded to the adopted treatment guidelines and the positive medicines list of health insurance fund. The results and trends are comparable with other countries, but still the utilisation of lipid-lowering medicines represents the smallest share of total medicines use for the treatment of cardiovascular diseases, compared to high-income countries.</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/3c/6b/ceor-15-513.PMC10317530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10179310","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 Empagliflozin in Combination with Standard Care versus Standard Care Only in the Treatment of Heart Failure Patients in Finland.","authors":"Taru Hallinen,&nbsp;Santtu Kivelä,&nbsp;Erkki Soini,&nbsp;Veli-Pekka Harjola,&nbsp;Mari Pesonen","doi":"10.2147/CEOR.S391455","DOIUrl":"https://doi.org/10.2147/CEOR.S391455","url":null,"abstract":"<p><strong>Purpose: </strong>Sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin has recently been shown to improve the outcomes of heart failure (HF) patients regardless of patient's left ventricular ejection fraction by reducing the combined risk of cardiovascular death or hospitalization for worsening HF. The aim of this study was to assess the cost-effectiveness of adding empagliflozin to the standard care (SC) in comparison to SC only in the treatment of HF in Finland.</p><p><strong>Patients and methods: </strong>The assessment was performed in the cost-utility framework using two Markov cohort state-transition models, one for HF with reduced ejection fraction (HFrEF) and one for HF with preserved ejection fraction (HFpEF). The models have been primarily developed based on the EMPEROR-Reduced and EMPEROR-Preserved trials which informed the modelled patient characteristics, efficacy of treatments in terms of associated risks for heart failure hospitalizations, cardiovascular (CV) and non-CV death, treatment related adverse events (AE), and state- and event-specific health-related quality of life weights (EQ-5D). Direct health care costs were estimated from Finnish published references. Cost-effectiveness was assessed from health care payer perspective based on incremental cost-effectiveness ratio (ICER; cost per quality adjusted life-year [QALY] gained) and probability of cost-effectiveness (at willingness-to-pay [WTP] of 35,000 euros/QALY). The ICER was reported as the weighted (HFrEF, 43.5%; HFpEF, 56.5%) average result of the two models.</p><p><strong>Results: </strong>Empagliflozin + SC treatment increased the average quality-adjusted life-expectancy, and treatment costs of HF patients by 0.15 QALYs and 1,594 euros, respectively, when compared to SC. An additional QALY with empagliflozin was thus gained at a cost of 10,621 euros. The probability of empagliflozin + SC being cost-effective compared to placebo + SC was 77.6% and 83.5% with WTP of 35,000 and 100,000 euros/QALY, respectively.</p><p><strong>Conclusion: </strong>Empagliflozin is a cost-effective treatment for patients with HF in the Finnish health care setting.</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/98/0a/ceor-15-1.PMC9831000.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519067","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":"Evaluating the Clinical and Economic Outcomes Associated with Poor Glycemic Control in People with Type 1 Diabetes in the Netherlands.","authors":"Robert Gerald Jan Moes,&nbsp;Eline L Huisman,&nbsp;Samuel J P Malkin,&nbsp;Barnaby Hunt","doi":"10.2147/CEOR.S391626","DOIUrl":"https://doi.org/10.2147/CEOR.S391626","url":null,"abstract":"<p><strong>Introduction: </strong>Achieving and maintaining glycemic control is the cornerstone of type 1 diabetes management, with the aim of reducing the incidence of diabetes-related complications over the long term. However, many individuals fail to reach glycemic targets. The present study evaluated the clinical and economic burden associated with poor glycemic control in people with type 1 diabetes in the Netherlands, and the improvements in outcomes that can be achieved by improving treatment.</p><p><strong>Methods: </strong>Immediate glycemic control, defined as achieving a glycated hemoglobin (HbA1c) target of 7.0% at the start of the analysis, was compared with delays in achieving control of 1, 3 and 7 years, with outcomes projected using the IQVIA CORE Diabetes Model. Projections of life expectancy, quality-adjusted life expectancy, and direct and indirect costs (expressed in 2021 euros [EUR]) were made at a patient level and extrapolated to the population level.</p><p><strong>Results: </strong>Improving HbA1c from 8.0% to 7.0% and 9.0% to 7.0% resulted in gains of up to 0.66 and 1.37 quality-adjusted life years (QALYs) per patient over a lifetime, respectively. At a population level, achieving immediate glycemic control was associated with gains of 9438, 27,171 and 72,717 QALYs and cost savings of up to EUR 224 million, EUR 556 million and EUR 1.3 billion compared with remaining in poor control for 1, 3 and 7 years, respectively.</p><p><strong>Conclusion: </strong>The clinical and economic burden of poor glycemic control in people with type 1 diabetes in the Netherlands was projected to be substantial, but considerable gains in quality-adjusted life expectancy and cost savings could be achieved through early and effective treatment.</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/5c/33/ceor-15-87.PMC9910197.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10708102","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":"Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1.","authors":"Prina Donga,&nbsp;Bruno Emond,&nbsp;Carmine Rossi,&nbsp;Brahim K Bookhart,&nbsp;Johnnie Lee,&nbsp;Gabrielle Caron-Lapointe,&nbsp;Fangzhou Wei,&nbsp;Marie-Hélène Lafeuille","doi":"10.2147/CEOR.S413800","DOIUrl":"https://doi.org/10.2147/CEOR.S413800","url":null,"abstract":"<p><strong>Introduction: </strong>Integrase strand transfer inhibitor-based regimens (eg, containing dolutegravir [DTG]) are associated with weight/body mass index (BMI) increases among people living with HIV-1 (PLWH). Assessing antiretroviral therapy (ART)-related weight/BMI changes is challenging, as PLWH may experience return-to-health weight gain as a result of viral suppression. This retrospective, longitudinal real-world study compared weight/BMI outcomes among overweight/obese (BMI ≥25 kg/m²; thus excluding return-to-health weight/BMI changes), treatment-naïve PLWH who initiated darunavir (DRV)/cobicistat (c)/emtricitabine (FTC)/tenofovir alafenamide (TAF) or DTG + FTC/TAF.</p><p><strong>Methods: </strong>Treatment-naïve PLWH with BMI ≥25 kg/m² who initiated DRV/c/FTC/TAF or DTG + FTC/TAF (index date) had ≥12 months of baseline observation and ≥1 weight/BMI measurement in baseline and post-index periods in the Symphony Health IDV^® database (07/17/2017-12/31/2021) were included. Inverse probability of treatment weighting (IPTW) was used to balance differences in baseline characteristics between cohorts. On-treatment time-to-weight/BMI increases ≥5% were compared between cohorts using weighted adjusted Cox models.</p><p><strong>Results: </strong>Post-IPTW, 76 overweight/obese DRV/c/FTC/TAF-treated (mean age = 51.2 years, 30.7% female, 35.6% Black, mean baseline BMI = 33.2 kg/m²) and 88 overweight/obese DTG + FTC/TAF-treated PLWH (mean age = 51.5 years, 31.4% female, 31.4% Black, mean baseline BMI = 32.7 kg/m²) were included. The median [interquartile range] time from ART initiation to weight/BMI increase ≥5% was shorter for the DTG + FTC/TAF cohort (21.8 [9.9, 32.3] months) than the DRV/c/FTC/TAF cohort (median and interquartile times not reached; Kaplan-Meier rate at 21.8 months = 20.8%). Over the entire follow-up, overweight/obese PLWH initiating DTG + FTC/TAF had a more than twofold greater risk of experiencing weight/BMI increase ≥5% compared to those initiating DRV/c/FTC/TAF (hazard ratio [95% confidence interval]=2.43 [1.02; 7.04]; p = 0.036).</p><p><strong>Conclusion: </strong>Overweight/obese PLWH who initiated DTG + FTC/TAF had significantly greater risk of weight/BMI increase ≥5% compared to similar PLWH who initiated DRV/c/FTC/TAF and had shorter time-to-weight/BMI increase ≥5%, suggesting a need for additional monitoring to assess the risk of weight gain-related cardiometabolic disease.</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/dd/80/ceor-15-579.PMC10377594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9907232","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 Analysis of Chronic Kidney Disease Patients in Indonesia.","authors":"Endang Sunariyanti,&nbsp;Tri Murti Andayani,&nbsp;Dwi Endarti,&nbsp;Diah Ayu Puspandari","doi":"10.2147/CEOR.S388547","DOIUrl":"https://doi.org/10.2147/CEOR.S388547","url":null,"abstract":"<p><strong>Objective: </strong>The cost of treating chronic kidney disease requires large funds. Chronic kidney disease financing ranks 2nd in BPJS as the highest financing. All cost components in the treatment of chronic kidney disease are considered high, so adjustments and efficiency are needed. This study aims to perform a cost analysis in chronic kidney patients. In this article, we will discuss the cost components in treatment and see whether there are differences in the cost of treatment in each hospital.</p><p><strong>Methods: </strong>The study used a cross-sectional design with a hospital perspective and was conducted in 6 hospitals selected based on class in different regions: Sardjito Central General Hospital (class A), Yogyakarta Regional General Hospital (class B) and PKU Muhammadiyah Hospital (private class) represent hospitals in regional 1. Meanwhile, Makassar Central General Hospital (class A), Labuang Hospital Baji (class B) and Faisal Islamic Hospital (private class) represent hospitals in regional 3. The study lasted for 14 months from October 2019-December 2020. The total sample involved in this study was 582 samples. The cost components analyzed include hemodialysis costs, serious procedures and operations, services, radiology, laboratories, blood transfusions, drugs, medical devices, hospitalization and supplies.</p><p><strong>Results: </strong>Chronic kidney patient profile data, calculations and cost components are presented descriptively. The Mann-Whitney test was used to see whether there were differences in costs between hospitals in each region. The results showed that the total cost of treating chronic kidney disease was higher in class A hospitals compared to class B and private class hospitals.</p><p><strong>Conclusion: </strong>The highest cost component is the cost of hemodialysis, followed by severe procedures and services. The highest total cost of hemodialysis reached Rp. Rp.840,132,546, heavy action Rp. 423,156,000 and services Rp. 792,155,000. The results of statistical tests showed that there were differences in the cost of treating chronic kidney disease in hospitals in regional 1 and regional 3 (p < 0.05).</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/17/3b/ceor-15-621.PMC10393018.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9933772","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":"The Cost of Maternal Complications and Its Associated Factors Among Mothers Attending Public Hospitals in Harari Region and Dire Dawa City Administration, Eastern Ethiopia: An Institution-Based Cross-Sectional Study.","authors":"Samrawit Shawel,&nbsp;Behailu Hawulte Ayele,&nbsp;Yadeta Dessie,&nbsp;Abera Kenay Tura,&nbsp;Gimaye Dinsa,&nbsp;Abainash Tekola,&nbsp;Miheret Mandefro,&nbsp;Awoke Masrie,&nbsp;Aklilu Tamire,&nbsp;Obsan Kassa Tefasa","doi":"10.2147/CEOR.S416562","DOIUrl":"https://doi.org/10.2147/CEOR.S416562","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women face high costs for health-care services despite being advertised as free. These costs include non-medical expenses, lost productivity, difficulties caring for family members, and long-term financial impact from complications. Limited research has been done on the cost burden of maternal services and complications, despite numerous studies on maternal health service provision. This is notable considering the government's claim of providing free maternal health-care services.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in July (1-30) 2022 among 425 randomly selected mothers in Harari and Dire Dawa City, Eastern Ethiopia. Data were collected through structured questionnaires and medical record reviews. The collected data was entered into Epi-Data version 3.02 and analyzed using STATA version 14.0 after data cleaning. Descriptive statistics and linear regression analysis were used to examine the data, ensuring assumptions of linearity, independence, homoscedasticity, and normality were met. The correlation coefficient was used to assess the strength of the association.</p><p><strong>Results: </strong>The median cost of maternal complications was around 4250 ETB (81.3 USD; IQR = 2900-5833.3), factors that predicted cost were monthly family income of ≥3001 birr (β=1.13; 95% CI: 1.00, 1.26), distance from hospital (β=0.73; 95% CI = 0.64-0.83), being admitted for less than 4 days (β=0.60; 95% CI = 0.53-0.69), accompanied by relatives besides their husbands (β=1.93; 95% CI = 1.52-2.46), caesarian sections delivery (β=1.17; 95% CI = 1.04-1.31), and giving birth to a normal baby (β=0.86; 95% CI = 0.77-0.97).</p><p><strong>Conclusion: </strong>Maternal complications incur significant costs, with factors such as family income, travel time, hospital stay, caregiver presence, mode of delivery, and neonatal outcome predicting these costs. The Ethiopian health system should address the additional expenses faced by mothers with complications and their caregivers.</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/01/85/ceor-15-645.PMC10494998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295553","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 Systematic Review and Statistical Analysis of Factors Influencing the Cost-Effectiveness of Transcatheter Aortic Valve Implantation for Symptomatic Severe Aortic Stenosis.","authors":"Laura Heathcote,&nbsp;Tushar Srivastava,&nbsp;Archita Sarmah,&nbsp;Ben Kearns,&nbsp;Anthea Sutton,&nbsp;Pascal Candolfi","doi":"10.2147/CEOR.S392566","DOIUrl":"https://doi.org/10.2147/CEOR.S392566","url":null,"abstract":"<p><strong>Objective: </strong>Transcatheter aortic valve implantation (TAVI) is a disruptive technology recommended for patients with symptomatic severe aortic stenosis (sSAS). Despite being available for over 15 years in Europe, with an extensive volume of clinical and economic evaluations across all surgical risk groups, there is little evidence on the identification of the key drivers of TAVI's cost-effectiveness. This study sought to identify these factors and quantify their role.</p><p><strong>Methods: </strong>A systematic literature review was conducted to identify published economic evaluations of TAVI. This was supplemented by health technology assessment reports. The primary outcome was the likelihood of TAVI being found cost-effective. Secondary outcomes of TAVI being dominant, and the incremental health benefits of TAVI were also explored.</p><p><strong>Results: </strong>Forty-two studies, reporting 65 unique analyses, were identified. TAVI was found to be cost-effective and dominant in 74% and 20% of analyses, respectively. The latest generation balloon-expandable TAVI device (SAPIEN 3) was more likely to be found cost-effective, as was TAVI use in low-risk populations and when performed via transfemoral access route. There was heterogeneity in the approach taken to economic modelling, which may also influence estimates of cost-effectiveness. Analyses that found TAVI to be dominant always compared it to surgery and usually considered the latest generation balloon-expandable TAVI device. Largest health benefits were observed for the inoperable risk group.</p><p><strong>Conclusion: </strong>For patients with sSAS, TAVI is typically a cost-effective treatment option. There are important differences by device generation, risk group and access route. It is crucial to consider these differences when appraising the health economic evidence-base for TAVI.</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/2c/f9/ceor-15-459.PMC10277006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9722994","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":"Co-Design as Enabling Factor for Patient-Centred Healthcare: A Bibliometric Literature Review.","authors":"Sofia Silvola,&nbsp;Umberto Restelli,&nbsp;Marzia Bonfanti,&nbsp;Davide Croce","doi":"10.2147/CEOR.S403243","DOIUrl":"https://doi.org/10.2147/CEOR.S403243","url":null,"abstract":"<p><p>Service design and in particular co-design are approaches able to align with the need of healthcare contexts of value-based and patient-centered processing through a participatory design of services. The purpose of this study is to identify the characteristics of co-design and its applicability to the reengineering of healthcare services, as well as to detect the peculiarities of the application of this approach in different geographical contexts. The methodology applied for the review, Systematic Literature Network Analysis (SLNA), combines qualitative and quantitative perspectives. In detail, the analysis applied the paper citation networks and the co-word network analysis to detect the main research trends over time and to identify the most relevant publications. The results of the analysis highlight the backbone of literature on the application of co-design in healthcare as well as the advantages and the critical factors of the approach. Three main literature streams emerged concerning the integration of the approach at meso and micro level, the implementation of co-design at mega and macro level, and the impacts on non-clinical related outcomes. Moreover, the findings underline differences in co-design in terms of impacts and success factors in developed countries and economies in transition or developing countries. The analysis shows the potentially added value of the application of a participatory approach to the design and redesign of healthcare services both at different levels of the healthcare organization and in the contexts of developed countries and economies in transition or developing countries. The evidence also highlights potentialities and critical success factors of the application of co-design in healthcare services redesign.</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/16/57/ceor-15-333.PMC10200122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521481","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 Aripiprazole Tablets with Sensor versus Oral Atypical Antipsychotics for the Treatment of Schizophrenia Using a Patient-Level Microsimulation Modeling Approach.","authors":"Avijeet S Chopra,&nbsp;Dusica Hadzi Boskovic,&nbsp;Amit Kulkarni,&nbsp;Jeffrey M Cochran","doi":"10.2147/CEOR.S396806","DOIUrl":"https://doi.org/10.2147/CEOR.S396806","url":null,"abstract":"<p><strong>Objective: </strong>Strategies designed to track drug ingestion may improve medication adherence and clinical outcomes in adults with schizophrenia. This study aimed to estimate the cost-effectiveness of aripiprazole tablets with sensor (AS; Abilify MyCite^®) versus generic oral atypical antipsychotics (AAPs) in schizophrenia from the United States payer and societal perspectives over 12 months.</p><p><strong>Methods: </strong>An individual-level microsimulation was developed to generate individual trajectories using data from a phase 3b multicenter, open-label, mirror-image trial in adults with schizophrenia treated prospectively for 6 months with AS. The patient's clinical characteristics and outcomes were computed as a function of the Positive and Negative Syndrome Scale (PANSS) scores. Direct and indirect medical cost estimates were sourced from the literature; EuroQol 5-Dimensions (EQ-5D) utilities were derived using risk equations based on patient and clinical characteristics. Scenario analyses were also conducted to assess outcomes under the assumption of treatment durability over 12 months.</p><p><strong>Results: </strong>Over 12 months, AS showed a 12.2% improvement in PANSS score. AS had an incremental cost of $2168 and incremental cost savings of $22,343 from the payer and societal perspectives, respectively, with an incremental quality-adjusted life-year (QALY) gain of 0.0298 versus oral AAPs. Further, AS resulted in a 28.2% reduction in hospitalizations over 12 months. At a willingness-to-pay of $100,000 per QALY, the net monetary benefit over 12 months was $25,323 from the payer perspective. Under the assumption of the durability of the treatment effect of AS, the findings were similar to those of the base case analyses, though with greater cost savings and QALYs gained with AS. The results from the sensitivity analyses were consistent with those of the base case analysis.</p><p><strong>Conclusion: </strong>AS may be a cost-effective strategy, with lower costs and improved quality of life among patients with schizophrenia over 12 months, from the payer and societal perspectives.</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/bc/5c/ceor-15-375.PMC10218468.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9539775","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}