European Journal of Health Economics最新文献

{"title":"Healthcare resource utilization and costs of letermovir for cytomegalovirus-prophylaxis after allogeneic hematopoietic cell transplantation in a real-world, multi-centre study in Germany.","authors":"Marie Engelhard, Sebastian M Wingen-Heimann, Annika Y Classen, Igor-Wolfgang Blau, Gesine Bug, Corinna Hebermehl, Sabrina Kraus, Olaf Penack, Andrés R Rettig, Timo Schmitt, Torsten Steinbrunn, Daniel Teschner, Maria J G T Vehreschild, Claudia Wehr, J Janne Vehreschild, Sina M Pütz","doi":"10.1007/s10198-025-01890-4","DOIUrl":"10.1007/s10198-025-01890-4","url":null,"abstract":"<p><strong>Objectives: </strong>Letermovir has demonstrated efficacy and tolerability as prophylaxis against clinically significant cytomegalovirus infection (csCMVi) in CMV-seropositive adult patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) compared to alternative antivirals. Despite these advantages, associated costs remain substantial. This study addresses the evidence gap by evaluating the health economic impact of CMV prophylaxis with letermovir in a real-world setting for alloHCT patients.</p><p><strong>Methods: </strong>This retrospective, multi-centre case-control study was conducted at six German tertiary care centres. A micro-costing approach evaluated hospitalisation and anti-CMV drug acquisition costs over a 48-week follow-up period post-alloHCT. The analysis included patients surviving at least 100 days following alloHCT, comparing individuals receiving letermovir prophylaxis (cases) with those who did not (controls) between January 2018 and April 2021.</p><p><strong>Results: </strong>The incidence of csCMVi was significantly higher in the control than in the letermovir group (56%, n = 98 vs. 34%, n = 63, p < 0.001). Median hospital length of stay was significantly longer in the control group (45 days, IQR 36-66) compared to the letermovir group (39 days, IQR 32-55; p < 0.001). Hospitalisation costs were comparable (p = 0.865), while anti-CMV drug acquisition and overall direct treatment costs were significantly higher in the letermovir group (€21,844, 95% CI 19,247 - 25,107 vs. €7,711, 95% CI 12,692 - 25,107, p < 0.001; 81,871, 95% CI 76,721 - 87,021 vs. 67,161, 95% CI 61,693 - 72,629, p < 0.001). Besides letermovir, cost drivers post-alloHCT were rehospitalisation and csCMVi.</p><p><strong>Conclusions: </strong>Our study demonstrated higher anti-CMV drug acquisition costs and overall direct treatment costs in patients receiving letermovir prophylaxis compared to controls. However, these higher costs are accompanied by significantly improved clinical outcomes.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1469-1478"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203888","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}

{"title":"Costs and use of antimigraine drugs in Italy: a ten-year analysis of national data.","authors":"Luigi Francesco Iannone, Marina Romozzi, Paolo Calabresi, Roberto De Icco, Raffaele Ornello, Cristina Tassorelli, Simona Sacco, Pierangelo Geppetti","doi":"10.1007/s10198-026-01977-6","DOIUrl":"https://doi.org/10.1007/s10198-026-01977-6","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a highly prevalent neurological disorder associated with substantial disability and economic burden. Considering the recent introduction of anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), expenditure analysis are needed to evaluate a rapidly evolving therapeutic field. Therefore, we analyzed national pharmaco-utilization trends of antimigraine drugs in Italy over the decade 2014-2023 using publicly available data from the \"Osservatorio Nazionale sull'Impiego dei Medicinali\" (OsMed) report of the Italian Medicines Agency (AIFA).</p><p><strong>Methods: </strong>All antimigraine drugs reimbursed by the National Health Service and classified under the antimigraine drug group were included. Indicators comprised defined daily doses (DDD) per 1,000 inhabitants per day, per-capita expenditure, cost per DDD, and user-level measures.</p><p><strong>Results: </strong>In 2023, 0.6% of the Italian population received antimigraine drugs, with a median age of 51 years and a marked female predominance. National expenditure reached €92 million, corresponding to €1.56 per capita and 0.4% of pharmaceutical spending, with consumption of 1.2 DDD/1,000 inhabitants per day. Triptans accounted for 65% of costs and 75% of use, remaining the dominant class. Anti-CGRP mAbs, introduced in 2019, rapidly expanded to represent 35% of expenditure in 2023, with the highest cost per DDD. Historical classes such as ergot alkaloids and other antimigraine agents declined to negligible levels. Over the decade, consumption increased modestly (compound annual growth rate + 3.1%) while expenditure rose more slowly (+ 1.5%), with costs escalation after the introduction of anti-CGRP mAbs. Of note, the overall expending for novel anti-CGRP drugs remains limited when considering the high prevalence of migraine.</p><p><strong>Conclusions: </strong>These findings highlight the evolving therapeutic scenario of migraine in Italy, the impact of innovation on budget, and the need for real-world studies integrating pharmaco-utilization, direct and indirect costs and clinical outcomes.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867721","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":"Repurposing biosimilars, rethinking costs: a framework for sustainable drug pricing for repurposed bevacizumab for intravitreal injections.","authors":"Evert A Manders, Vincent van Der Wel, Reinier Schlingemann, Carla E M Hollak, Saco J de Visser","doi":"10.1007/s10198-025-01891-3","DOIUrl":"10.1007/s10198-025-01891-3","url":null,"abstract":"<p><p>Bevacizumab, originally developed by Genentech under the brand name Avastin^® as an anti-cancer drug, has gained widespread off-label use in ophthalmology due to its similar mechanism of action to other anti-VEGF treatments and its significantly lower cost compared to available on label alternatives for ophthalmological indications. While off-label bevacizumab has been standard in clinical practice for over a decade, recently, a repurposed formulation (brand name: Lytenava^®, Outlook Therapeutics Ltd), developed specifically for vascular retinal conditions, received marketing approval from the European Medicines Agency. This raises questions about what the price for a repurposed formulation should reasonably be, reflecting the efforts to obtain regulatory approval. This paper examines potential cost-based-plus pricing for such a repurposed formulation of bevacizumab using a novel pricing framework across four scenarios. By evaluating the pricing structure through an analysis of critical cost components, including, among others, research and development expenditures, manufacturing costs, and cost-of-capital, the study proposes a price range of €73 to €177 per injection. The explicit breakdown of these cost components provides valuable insights into the economic structure of repurposed biosimilars like bevacizumab, emphasizing how a cost-based-plus pricing model can support more transparent and informed negotiations between pharmaceutical companies and healthcare payers. Ultimately, this approach contributes to the development of pricing strategies that balance affordability for healthcare systems with sustainable returns for manufacturers while fostering the broader development of repurposed treatments. The findings of this paper aim to advance the dialogue on equitable pricing for repurposed therapies.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1453-1467"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133051","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}

{"title":"Cost-effectiveness analysis of influenza vaccination with high-dose vaccine versus standard-dose quadrivalent vaccine in older adults in Spain.","authors":"Jose-Maria Abellan-Perpiñan, Esther Redondo Margüello, Ángel Gil de Miguel, Iván Sanz Muñoz, Ariadna Diaz-Aguiló, Paloma Palomo, Manel Farré, Daniel Callejo, Marco Pinel, Juan Luis López-Belmonte","doi":"10.1007/s10198-026-01894-8","DOIUrl":"10.1007/s10198-026-01894-8","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Influenza is a widespread acute respiratory illness which represents a significant public health challenge from both the National Health Service (NHS) and societal perspective, especially in the older adults. The aim of this study was to assess the cost-effectiveness of influenza vaccination with a high-dose quadrivalent vaccine (HD-QIV) versus a standard dose quadrivalent vaccine (SD-QIV) in the older adults in Spain.</p><p><strong>Methods: </strong>We assessed the public health and economic benefits of various alternatives using a decision-tree model. This model considered factors such as influenza cases, visits to general practitioners (GP), emergency department (ED) visits, hospitalizations due to cardiorespiratory events, and influenza-related mortality. To address uncertainties deriving from both epidemiological and economic sources, we conducted deterministic and probabilistic sensitivity analyses.</p><p><strong>Results: </strong>From a societal perspective, HD-QIV compared to SD-QIV prevented during an influenza season 54,039 influenza cases, 7,733 GP consultations, 1,585 ED visits, 30,772 episodes of hospitalization due to cardiorespiratory events over a single influenza season and 1,203 deaths when vaccinating adults ≥ 65 years old in Spain, resulting in 14,316 LYs and 12,545 QALYs gained over a lifetime horizon. The reduction in health outcomes outweighed the increase in vaccination costs, translating to a reduction in total costs with HD-QIV compared to SD-QIV. Therefore, vaccinating older adults in Spain with HD-QIV instead of SD-QIV was a dominant strategy when evaluating hospitalizations due to cardiorespiratory events. HD-QIV remained dominant from an NHS perspective. Sensitivity analyses confirmed the robustness of the model.</p><p><strong>Conclusions: </strong>This analysis showed that vaccinating older adults in Spain with HD-QIV instead of SD-QIV would reduce cases of influenza, GP and ED visits, hospitalizations, deaths, and associated costs, and thus it should be the strategy of choice in a situation of budgetary constraints from either a societal or an NHS perspective.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1497-1508"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349679","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}

{"title":"Cash-for-care and its impact on older adults' informal and formal long-term care use: evidence from continental European countries.","authors":"Viktoria Szenkurök","doi":"10.1007/s10198-026-01901-y","DOIUrl":"10.1007/s10198-026-01901-y","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1525-1538"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357478","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}

{"title":"Promoting healthy behaviour with financial incentives: three challenges and solutions for large scale implementation.","authors":"Stefan A Lipman, David R de Buisonjé, Koen van der Swaluw","doi":"10.1007/s10198-025-01893-1","DOIUrl":"10.1007/s10198-025-01893-1","url":null,"abstract":"<p><p>Financial incentives are a promising intervention to promote healthier behaviours and potentially reduce health inequalities. Despite robust evidence supporting their effectiveness in encouraging actions such as smoking cessation, increased physical activity, and improved diet, large-scale implementation of financial incentives in Europe remains limited. This perspective identifies three key challenges impeding their broader use: (1) difficulties in reaching the populations most in need, (2) short-lived behavioural effects after removal of the incentives, and (3) uncertainty about sustainable and equitable funding. Drawing on interdisciplinary evidence, we explore potential solutions such as tailored incentive design, strategies to prolong behavioural change (e.g. intermittent reinforcement or dynamic phase-outs), and the development of public or private funding models. We argue that while financial incentives should not replace structural health policy interventions, they can be a powerful complementary tool. A coordinated research agenda is needed to inform scalable and effective implementation.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1379-1386"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114939","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}

{"title":"Predicting EuroQol (EQ-5D-5 L) health state utilities from functional outcomes of sleep questionnaire (FOSQ-10) scores.","authors":"Andrea N Natsky, Ching Li Chai-Coetzer, Andrew Vakulin, Billingsley Kaambwa","doi":"10.1007/s10198-025-01885-1","DOIUrl":"10.1007/s10198-025-01885-1","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1387-1402"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094774","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}

{"title":"Complex intervention for MS patients in Germany - can it be cost-saving for the society?","authors":"Markus Krohn, Susan Raths, Steffen Fleßa","doi":"10.1007/s10198-026-01907-6","DOIUrl":"10.1007/s10198-026-01907-6","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1549-1561"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357526","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}

{"title":"Health sector corruption and access to healthcare in Africa.","authors":"Idrissa Ouedraogo, Windkouni Haoua Eugenie Maïga, Robert Gillanders, Doris Aja-Eke","doi":"10.1007/s10198-026-01896-6","DOIUrl":"10.1007/s10198-026-01896-6","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1509-1523"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437458","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":"Healthcare cost for non-hospital services and pharmaceuticals among breast cancer survivors: an event study.","authors":"Aarushi Dhingra, Brenda Gannon, Terence C Cheng, Luke Connelly, Gita Mishra","doi":"10.1007/s10198-025-01889-x","DOIUrl":"10.1007/s10198-025-01889-x","url":null,"abstract":"<p><p>Breast cancer survivors require continuing long-term care, which leads to substantial resource use and subsequently increased healthcare costs (HC), having an impact on both the individual and society. This paper aims to investigate the impact of a breast cancer diagnosis on monthly HC and out-of-pocket (OOP) costs among survivors. We apply an event study methodology using a two-part fixed-effect model. Data from the Australian Longitudinal Study of Women's Health (2002-2017) is utilised, which is linked to extensive high-frequency administrative records from the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme, the Australian Cancer Database and the National Death Index. The findings reveal that a diagnosis leads to a persistent and substantial increase in total HC and OOP costs, with the largest increases occurring in the first six months. The effects' duration and magnitude vary by the type of healthcare service and pharmaceuticals.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1403-1435"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094782","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}