European Journal of Health Economics最新文献

{"title":"Total costs of different lines of treatment in diffuse large B-cell lymphoma in Denmark - a real-world data analysis.","authors":"Christian Graves Beck, Martin Lucas Jørgensen, Maya Friis Kjaergaard, Søren Ramme Bro, Tove Holm-Larsen","doi":"10.1007/s10198-025-01843-x","DOIUrl":"https://doi.org/10.1007/s10198-025-01843-x","url":null,"abstract":"<p><strong>Background: </strong>Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Cure rate is high after first-line treatment, however, prognosis for relapse/refractory patients remains poor. Multiple treatments to DLBCL have recently been approved, therefore it is important to understand the underlying total costs of the different treatment lines.</p><p><strong>Objective: </strong>To investigate the total healthcare costs per line of DLBCL treatment (first-line (1LoT), second-line (2LoT), third-line (3LoT), including best supportive care (BSC)), and to estimate patients' labour market attachment and sickness benefit level.</p><p><strong>Method: </strong>A nationwide real-world registry study covering the Danish DLBCL patients diagnosed 2012-2021 (August) from the National Lymphoma Registry (LYFO). Data were linked with other national registries to estimate the total costs per treatment line. Additionally, costs per line were adjusted to costs per-patient-per-month (PPPM).</p><p><strong>Results: </strong>4,159 DLBCL patients were included. Average progression-free time before progression to next LoT or being cured decreased from 2 years (1LoT) to half a year (3LoT + BSC). Average total healthcare costs per patient were estimated to €51,660 (1LoT), €59,094 (2LoT) and €35,808 (3LoT + BSC). Adjusting for progression-free time periods, costs per PPPM increased with later treatment lines. Patients' labour market attachment was in general low, and weeks of sickness benefit increased with later treatment lines.</p><p><strong>Conclusion: </strong>The study suggests that the total costs and weeks of sickness benefit increase with later treatment lines suggesting that more effective first-line treatment options not only have an importance for the patient prognosis but also may have an economic advantage for the healthcare sector and society.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility analysis of a web-based interactive patient education platform: evidence from a randomized clinical trial for end-stage renal disease patients.","authors":"Modou Diop, Lionel Perrier, Baptiste Haon, Lise Rochaix, Luc Behaghel, Jean-Claude K Dupont, Magali Morelle, Michelle Elias, Laure Esposito, Christophe Legendre, Hélène Longuet, Isabelle Durand-Zaleski, Evangéline Pillebout","doi":"10.1007/s10198-025-01828-w","DOIUrl":"https://doi.org/10.1007/s10198-025-01828-w","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic kidney disease and its most severe complication, end-stage renal disease (ESRD), represents an estimated financial burden of €4.4 billion in 2021 in France. Therapeutic patient education (TPE) improves ESRD management and health outcomes. This study explored whether providing access to an interactive web-based TPE platform with community features was cost-effective.</p><p><strong>Methods: </strong>A within-trial cost-utility analysis was carried out over an 18 months horizon, using data from the PIC-R (Plateforme Interactive Communautaire-dialyse et transplantation Rénale) trial. ESRD or post-transplant patients were randomized 1:1:1 to a control group with no specific TPE program (Control), an intervention group with online TPE (e-TPE) and an intervention group with online TPE coupled with community features such as a patient forum and a chatroom with both patients and health care professionals (e-TPE + chat). The outcome measure was the cost per quality-adjusted life-year (QALY) and per year of full capability (YFC). Both intention-to-treat (ITT) and per protocol (PP) analyses were conducted, and missing data were handled using multiple imputation and selection models. Sensitivity analyses were performed.</p><p><strong>Results: </strong>Among the 815 patients assessed for eligibility across 12 French centres, a total of 549 patients were included in the economic analysis: 186 in the Control group, 189 in the e-TPE group and 174 in the e-TPE + chat group. The e-TPE group demonstrated cost savings and slightly higher QALYs compared to the control group, making e-TPE dominant. Conversely, the e-TPE + chat intervention resulted in higher costs without substantial effectiveness gains, making it not cost-effective.</p><p><strong>Conclusions: </strong>e-TPE was deemed cost-effective for ESRD patients, while e-TPE + chat was not. Web-based platforms improve ESRD management when targeted to likely users.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we need a health technology assessment approach for non-inferiority specifically? A comment on: clinical equivalence and non-inferiority within health technology assessment by Taylor et al. (2025).","authors":"Beryl Primrose Gladstone, Werner Vach","doi":"10.1007/s10198-025-01840-0","DOIUrl":"https://doi.org/10.1007/s10198-025-01840-0","url":null,"abstract":"<p><p>Taylor and colleagues presented a very informative and comprehensive overview on the current practice of performing non-inferiority analysis in HTA. We would like to point out that HTA of potentially non-inferior technologies should be based on balancing potential advantages against potential deficits exactly as for potentially superior technologies.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does chronic disease coverage for outpatient care affect healthcare utilization and expenditures in China? Evidence from an administrative claim dataset.","authors":"Wen He, Yanyao Li","doi":"10.1007/s10198-025-01837-9","DOIUrl":"https://doi.org/10.1007/s10198-025-01837-9","url":null,"abstract":"<p><p>In developing countries, chronic patients face dual challenges: high healthcare expenditures coupled with inadequate utilization of outpatient services. Leveraging an administrative claim dataset and applying a two-way fixed effects approach, this study makes one of the first attempts to examine the impacts of chronic disease coverage, which extends additional insurance benefits for outpatient care, on healthcare utilization and expenditures among enrollees diagnosed with hypertension or diabetes in China. The empirical results reveal a dual effect of chronic disease coverage: (1) enrollees with hypertension or diabetes experienced a substantial reduction in outpatient cost-sharing rates, leading to a significant increase in both outpatient service utilization and associated expenditures; (2) concurrently, we observed decreases in general outpatient visits without this special coverage, inpatient utilization, and corresponding expenditures. Notably, the magnitude of expenditure reduction in these non-targeted services was outweighed by the increased spending on covered outpatient services, resulting in a net increase in total healthcare expenditures. Heterogeneity analysis further demonstrates that the impacts were more pronounced among older adults, those with more comprehensive insurance benefits and residents in areas with better-endowed medical facilities. This study offers empirically validated insights for enhancing chronic disease management within medical security systems and establishing age-friendly medical insurance schemes in China as well as other developing countries.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating QALYs in adults with cerebral palsy: mapping the San Martin scale to the EQ-5D-5L for economic evaluation.","authors":"Diana Marcela Nova Díaz, Aritz Adin, Eduardo Sánchez-Iriso","doi":"10.1007/s10198-025-01831-1","DOIUrl":"https://doi.org/10.1007/s10198-025-01831-1","url":null,"abstract":"<p><strong>Background: </strong>Responses on health-related quality of life measured by disease-specific instruments can be mapped onto the EQ-5D to estimate utility values for economic evaluation. San Martin´s Quality of Life Scale (St. MQoL-S) is a preferred measure to obtain health outcomes in adults with cerebral palsy. Nevertheless, it lacks a preference-based health utility score for estimating quality-adjusted life years (QALYs).</p><p><strong>Objective: </strong>To develop algorithms for mapping from the St. MQoL-S to allow future prediction of the EQ-5D-5L, in adults with cerebral palsy, when utility data have not been collected.</p><p><strong>Methods: </strong>Direct mapping models were developed using ordinary least squares, a generalized linear model, and Tobit regression analysis to estimate EQ-5D-5L utilities, with St. MQoL-S total and domain scores as explanatory variables, in a cross-sectional study of adults with cerebral palsy in Spain. Goodness-of-fit was assessed using mean absolute error (MAE) and root mean square error (RMSE). Repeated k-fold cross-validation was employed to select the optimal mapping model demonstrating superior predictive performance.</p><p><strong>Results: </strong>The best-performing model for predicting EQ-5D-5L utilities, includes the St. MQoL-S total scores, age, gender, and types of cerebral palsy as explanatory variables in a stepwise ordinary least squares regression, making it the most robust model for use as a mapping algorithm with external data.</p><p><strong>Conclusion: </strong>This is the first study to present mapping algorithms between the St. MQoL-S and EQ-5D-5L. The mapping functions preferred in this study seem adequate for estimating the utilities of the EQ-5D-5L for economic evaluation and to obtain QALYs in adults with cerebral palsy.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labor market entry prospects of people with visual impairments: evidence from administrative register data in the Netherlands.","authors":"Katharina Diehl, Eline Heppe, Melvin Vooren, Ilja Cornelisz, Chris van Klaveren","doi":"10.1007/s10198-025-01830-2","DOIUrl":"https://doi.org/10.1007/s10198-025-01830-2","url":null,"abstract":"<p><p>The UN's Convention on the Rights of Persons with Disabilities includes a right to equal work opportunities. People with visual impairments (VI) are targeted by this convention and experience low employment rates. The initial transition from education to labor is a predictor for later labor market participation. Exploiting administrative register data, we identified a graduated subpopulation with VI and matched them to a control group. This paper evaluates (1) group differences in various socio-economic outcomes following graduation, and (2) following initial employment. Following graduation there are fewer transitions into (self-)employment for people with VI and more transitions to disability insurance or social benefits, but similar patterns for unemployment insurance and further education. Scrutinizing subsequent dynamics for those that secured initial employment revealed a greater share of those with VI maintained employment as dominant source of income given there was a change in employment status. However, there are more dynamics recorded for individuals with VI, which may reflect difficulties retaining a job. This group remained overrepresented in disability insurance as well as social benefits. Differences with regards to self-employment, unemployment insurance, further education and the other no income status did not reach significance. In conclusion, this study did not find equal labor market prospects for declarants with VI. The finding that VI declarants face less favorable labor market prospects than their matched counterparts, despite having similar cognitive ability, underscores the need for policies that not only improve their labor market outcomes but also promote greater equality in opportunities to reach the UN convention's ideals.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is episodic future thinking effective in mitigating the influence of time preference in time trade-off?","authors":"Zhongyu Lang, Liying Zhang, Stefan A Lipman, Bradely Sugden, Kim Rand, Arthur E Attema","doi":"10.1007/s10198-025-01812-4","DOIUrl":"https://doi.org/10.1007/s10198-025-01812-4","url":null,"abstract":"<p><strong>Objectives: </strong>The composite time trade-off (cTTO) method has been found to be influenced by time preferences for future life years, which typically results in a downward bias on cTTO utilities without adjustment. Contrary to prior research that adjusted for this distortion ex-post, this study takes an ex-ante approach, using Episodic Future Thinking (EFT), to potentially prevent time preference distortion. We aim to investigate the effect of EFT on time preference and cTTO utilities compared to using alternative methods.</p><p><strong>Methods: </strong>A total of 150 participants from the UK general public were recruited for interviewer-led online interviews and randomly assigned to either the control or treatment group. In the control group, they were asked to recall recent memories using the Episodic Recent Thinking (ERT) protocol, serving as filler tasks; in the treatment group, they were asked to imagine life in the next 10 to 20 years, i.e. using an EFT protocol. Afterwards, respondents were asked to value seven EQ-5D-5L health states with cTTO tasks, followed by a nonparametric method to measure time preference.</p><p><strong>Results: </strong>We observed a similar pattern of time preference across the two groups, with the majority discounting positively. EFT did not significantly affect time preference. In addition, the difference between cTTO utilities mitigated by EFT and those adjusted using the ex-post approach for time preference is minimal.</p><p><strong>Conclusions: </strong>In conclusion, EFT does not seem to mitigate time preference for life years and has negligible effect on cTTO utilities, necessitating alternative strategies for reducing bias in health utilities.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Price determinants and pricing policies concerning potentially innovative health technologies: a scoping review.","authors":"Nicolas S H Xander, Tom Belleman, Maximilian Salcher-Konrad, Anne Hendrickx, Jeffrey Chen, Anne-Sophie Klein Gebbink, Peter Schneider, Kate Morgan, Oliver Groene, Isabelle Durand-Zaleski, Frederick W Thielen, Carin A Uyl-de Groot","doi":"10.1007/s10198-025-01834-y","DOIUrl":"https://doi.org/10.1007/s10198-025-01834-y","url":null,"abstract":"<p><strong>Background: </strong>Policymakers face challenges in developing pricing policies for potentially innovative healthcare technologies (pIHTs) that balance limited budgets, access, and incentives for innovation. This study aimed to map existing evidence and identify knowledge gaps regarding price determinants and pricing policies for pIHTs and their effect on access and sustainability.</p><p><strong>Methods: </strong>We conducted a scoping Review of scientific and grey literature in English published between 2014 and September 2023 with pre-specified inclusion and exclusion criteria to identify stakeholder-informed price determinants, pricing policies applied by European Economic Area (EEA) or Organisation for Economic Cooperation and Development (OECD) member states, and their access-related impacts. Literature databases and various stakeholder organisation websites were searched. Further records were included through snowballing and manual addition.</p><p><strong>Results: </strong>135 Records were included. Stakeholder views on price determinants were available from 15 records and predominantly involved value-based determinants. Pricing policies in EEA/OECD member states are heterogeneous and often feature a mix of policy interventions and implementation methods. External price referencing (EPR), while yielding short-term affordability improvements, is associated with price inequities and launch strategies impairing patient access. Policies combining pricing methods and considering a pIHT's value have more positive access-related impact but may face feasibility and implementation challenges. Two records mentioned medical device pricing; none featured environmental aspects.</p><p><strong>Conclusion: </strong>While EPR is commonly applied across Europe, value-informed pricing in connection with health technology assessment is more favoured regarding pIHT access in the literature. Knowledge gaps concern medical device pricing, stakeholder views on price determinants, and the implementation of environmental aspects in pIHT pricing.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tough versus soft regulations to promote generic medications in Italy.","authors":"Aarushi Dhingra, Gianluca Fiorentini, Ayman Fouda, Naomi Moy","doi":"10.1007/s10198-025-01826-y","DOIUrl":"https://doi.org/10.1007/s10198-025-01826-y","url":null,"abstract":"<p><p>This paper investigates the effects of regulations aiming to optimise the multi-agency relationships, with a focus on the prescription choice between generic versus branded medications. In 2012, Italian legislators introduced two laws targeting general practitioners prescription behaviour, a soft (recommendations) law followed by a hard (mandatory) law to promote generic medication. We implement a regression discontinuity in time framework and an event study to quarterly administrative data for individuals with chronic kidney disease linked to data from their general practitioners in Emilia-Romagna, Italy. The results indicate that the policies were effective, but had modest effects on increasing the prescription of generic medications. Hard laws seem to have played a key role in driving this change. Heterogeneity checks provide evidence that less competition among GPs and interaction with specialists increased generic medication prescriptions.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The health and long-term care costs in the last year of life in The Netherlands.","authors":"Christel E van Dijk, Tristan Langereis, Jan-Willem H Dik, Trynke Hoekstra, Bernard van den Berg","doi":"10.1007/s10198-025-01763-w","DOIUrl":"10.1007/s10198-025-01763-w","url":null,"abstract":"<p><p>Knowing the determinants of rising health and long-term care costs is crucial to support cost containment policies and to predict future expenditures. According to the \"red herring\" debate, not ageing per se, but proximity to death is the most important determinant of future expenditures. This study aims to update and expand the existing Dutch literature after two major reforms in health and long-term care. Insurance claims data from 2018-2019 of 13,738,193 insured individuals were included. Using negative binomial regression analyses, the association between deceased individuals and survivors on total health and long-term care costs was investigated, as well as per health care sector. Costs rose sharply in the two months prior to death. Regression models showed an association with total health and long-term care costs of 10.8 for deceased individuals compared with survivors (crude model) and 3.3 (adjusted model). Especially including age and chronic diseases decreased the association. The largest differences in costs between deceased individuals and survivors in the adjusted model were found for geriatric rehabilitation care and primary care stays (16.7), home nursing (10,6), and long-term care (9.3). Not just the costs of deceased individuals are important for health care costs, but also age, as measured by being in the highest age category, and chronic diseases. The costs of deceased individuals were heterogeneous across health care sectors.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1149-1162"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}