European Journal of Health Economics最新文献

{"title":"Health state utilities associated with X-linked retinitis pigmentosa (XLRP).","authors":"Louis S Matza, Nan Li, Katie D Stewart, Mahmoud Hashim, Tom Denee, Feng Pan, Qiaoyi Zhang, Jennifer Lee, Michel Michaelides, Hendrik P N Scholl","doi":"10.1007/s10198-025-01761-y","DOIUrl":"10.1007/s10198-025-01761-y","url":null,"abstract":"<p><strong>Background: </strong>X-linked retinitis pigmentosa (XLRP) is a rare, inherited retinal disease characterized by impairment in visual field and visual acuity with continuous progression leading to blindness. Gene therapies for XLRP are under investigation, and health state utilities are needed for use in cost-utility analyses examining the value of these treatments.</p><p><strong>Objective: </strong>This study aimed to estimate utilities associated with XLRP severity.</p><p><strong>Methods: </strong>Eleven health state vignettes depicting combinations of impairment in visual field and visual acuity associated with XLRP were developed based on literature review and input from clinicians, patients, and a caregiver. Vignettes included text describing visual acuity impairment, visual field impairment, night blindness, impact on quality of life, and two images representing the combination of visual field and visual acuity impairment for each health state. Health states were valued in time trade-off interviews with general population respondents in the UK.</p><p><strong>Results: </strong>A total of 245 participants completed interviews (51.0% female; mean age = 41.4 years; Newcastle, n = 80; London, n = 85; Edinburgh, n = 80). In a ranking task, participants preferred health states with less severe visual impairment, and this preference was reflected in the utilities. Mean (standard deviation) utilities ranged from 0.900 (0.121) for the health state with no visual acuity impairment and mild visual field impairment to 0.271 (0.478) for the health state describing blindness.</p><p><strong>Conclusion: </strong>Results highlight the substantial impact of visual impairment on health state preference and quality of life. The health state utilities estimated in this study may be appropriate for use in cost-effectiveness models evaluating treatments for XLRP.</p><p><strong>Jel classification codes: </strong>I1; I12; I19.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1263-1273"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651880","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":"Translating the EORTC CAT core and the QLQ-C30 to the EQ-5D-5L in patients with metastatic breast cancer: A comparison of direct and indirect mapping algorithms.","authors":"Pimrapat Gebert, Anna Maria Hage, Felix Fischer, Christoph Paul Klapproth, Ulrike Grittner, Maria Margarete Karsten","doi":"10.1007/s10198-025-01824-0","DOIUrl":"https://doi.org/10.1007/s10198-025-01824-0","url":null,"abstract":"<p><strong>Background: </strong>To enable the use of different non-preference-based patient-reported outcome measures to derive utility values for health economic evaluations in oncological trials, this study developed direct and indirect mapping algorithms for estimating the EQ-5D-5L utility index via the German value set from the EORTC CAT Core and the QLQ-C30 in metastatic breast cancer patients.</p><p><strong>Methods: </strong>We included 1,839 observations from 878 patients with metastatic breast cancer from the PRO B study. We compared direct mapping algorithms, including adjusted limited dependent variable mixture models (ALDVMM), Tobit regression, ordinal least squares regression, and adjusted beta regression, while indirect mapping employed a generalized ordered logit model. Visualization was used to assess model performance across the entire distribution, while quantitative evaluation was performed using mean absolute error (MAE), root mean squared error (RMSE), and mean prediction bias.</p><p><strong>Results: </strong>Among the direct algorithms, adjusted beta regression demonstrated the best performance. It had the lowest MAE of 0.07-0.08 and RMSE of 0.11-0.13, a mean prediction bias of -0.004, close to zero. The indirect mapping model also performed well, with a mean prediction bias of 0.04 and MAE of 0.07, showing performance comparable to the preferred direct mapping algorithm for both the EORTC CAT Core and the QLQ-C30.</p><p><strong>Conclusions: </strong>This study developed and validated robust direct and indirect algorithms for estimating the EQ-5D-5L utility index from the EORTC CAT Core and the QLQ-C30 based on the German tariff. In particular, using this indirect mapping algorithm, the EORTC CAT Core and QLQ-C30 can be translated into quality-adjusted life-years, facilitating health economic evaluations across different country tariffs.</p><p><strong>Trial registration: </strong>DRKS (German Clinical Trials Register) DRKS00024015. Registered on 15 February 2021, https//drks.de/search/de/trial/DRKS00024015.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978038","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 costs associated with gender dysphoria in children, adolescents and young adults in germany: A prevalence-based analysis using statutory health insurance data.","authors":"Sophie Gottschalk, Claudia Konnopka, Katja Nettermann, Alicia Başoğlu, Ursula Marschall, Dirk Horenkamp-Sonntag, Angela Rölver, André Karch, Georg Romer, Hans-Helmut König","doi":"10.1007/s10198-025-01832-0","DOIUrl":"https://doi.org/10.1007/s10198-025-01832-0","url":null,"abstract":"<p><strong>Background: </strong>In the past decade, there has been an increase in individuals presenting to healthcare services with gender dysphoria (GD), the psychological distress that may arise when an individual's birth-assigned sex does not align with his/her experienced gender. The current study aimed to analyze resource use and costs associated with prevalent GD in individuals aged 4 to 30 years.</p><p><strong>Methods: </strong>The analysis was a prevalence-based cost study using data of the two largest German health insurance funds (BARMER and TK) from 2018, 2019, and 2020. Individuals with prevalent GD were identified based on ICD-10 diagnosis codes related to gender dysphoria. These were compared to a control group balanced for (1) age, birth-assigned sex, degree of urbanization, and (2) additionally for psychiatric diagnoses using entropy balancing. Outcomes of interest were total and sector-specific annual costs (outpatient, inpatient, medications) and health-related resource use (hospital days, defined daily doses of medications). Groups were compared stratified by age groups, birth-assigned sex, and for a subgroup of individuals with GD receiving hormonal therapy.</p><p><strong>Results: </strong>Individuals with prevalent GD aged 4-30 years had higher average resource use and costs compared to controls, with little variation between years (e.g. difference in 2019 +€4,843 [95% confidence interval €4,306; €5,380], balanced for age, birth-assigned sex, degree of urbanization). The group difference was observed across age groups and healthcare sectors, with the largest differences found in somatic and psychiatric inpatient hospitalizations, and with psychiatric costs accounting for 50% of the total cost difference. Comparing individuals with GD receiving hormonal therapy with controls, the difference in total costs was similar, but the contribution of psychiatric costs was less pronounced (29%). The cost difference decreased considerably in all subgroups and sectors when psychiatric diagnoses were additionally balanced for.</p><p><strong>Conclusions: </strong>Individuals with GD aged 4-30 years had higher annual resource use and costs than controls. Future studies analyzing resource use and costs over multiple years and examining the temporal association between GD and psychiatric disorders would allow a more accurate estimate of the costs directly attributable to GD.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977953","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":"Comparing EQ-5D-5L and SF-6Dv2 utilities with QLU-C10D utilities in hematologic cancer patients.","authors":"Tiantian Zhang, Aixue Zhang, Jing Li, Fangyu Li, Peng Liu, Pei Wang","doi":"10.1007/s10198-025-01815-1","DOIUrl":"https://doi.org/10.1007/s10198-025-01815-1","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the measurement properties between EQ-5D-5L/SF-6Dv2 and QLU-C10D utilities, and to assess the implications of their adoption in QALY estimation in hematologic cancer patients.</p><p><strong>Method: </strong>Longitudinal data of Chinese lymphoma and myeloma patients were adopted. Utility scores of the three instruments were calculated based on a variety of country-specific value sets. Their measurement properties including convergent validity, known-group validity, sensitivity, and responsiveness were compared. With-in group change in utilities derived from the instruments were also generated and compared.</p><p><strong>Results: </strong>A total of 200 lymphoma and 139 myeloma patients were enrolled at baseline; and 78 and 89 of them were followed up, respectively. The three kinds of utilities showed similar convergent validity; but all had restricted known-group validity. All of them could identify meaningful changes in clinical status; while whether QLU-C10D utilities was more responsive and yielded larger utility change were closely related to the value sets adopted.</p><p><strong>Conclusion: </strong>It appears that the advantages of QLU-C10D over EQ-5D-5L/SF-6Dv2 were not so obvious, and it may not necessarily produce more QALY gains as well. The choice of utility value set played an important role in the two aspects.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805299","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":"Hesitancy and compulsory vaccination: are non-mandatory vaccines the victims? A study on Italian regions.","authors":"Luisa Loiacono, Riccardo Puglisi, Leonzio Rizzo, Riccardo Secomandi","doi":"10.1007/s10198-025-01805-3","DOIUrl":"https://doi.org/10.1007/s10198-025-01805-3","url":null,"abstract":"<p><p>Vaccination campaigns are estimated to prevent up to 3 million deaths worldwide annually, with their success relying on sufficient immunization coverage and adherence to programs. Recent health crises and measures like the EU Digital Covid-19 Certificate have renewed interest in the effectiveness of strategies such as recommendations, mandates, and sanctions. We analyze data on vaccinations for children aged 0-2 from Italian regions during the pre-pandemic period, 2013 to 2019. This includes both recommended and mandatory vaccines, as well as the introduction of a 2017 law mandating certain vaccinations. Our analysis shows the law increased vaccination rates for newly mandatory vaccines by up to 6%. Regional differences emerged, particularly in high-hesitancy areas where citizens tended to prioritize mandatory vaccines over recommended ones. In these regions, while coverage for mandatory vaccines improved significantly, recommended vaccines saw relatively lower attention, highlighting the need for policies that support comprehensive vaccination efforts.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796085","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":"PROM-based monitoring and alerts reduce post-surgery healthcare utilization of patients undergoing joint replacement: A secondary analysis of the PROMoting Quality RCT.","authors":"David Ehlig, Lukas Schöner, Alexander Geissler, Laura Wittich, Reinhard Busse, Justus Vogel","doi":"10.1007/s10198-025-01810-6","DOIUrl":"https://doi.org/10.1007/s10198-025-01810-6","url":null,"abstract":"<p><strong>Objectives: </strong>Healthcare systems increasingly face shortages of medical professionals, and simultaneously experience a rise in demand for healthcare services. In this study, we investigated whether a digital PROM-based monitoring and alert system for hip and knee replacement patients post-surgery can support in decreasing healthcare expenditures and utilization.</p><p><strong>Methods: </strong>We used data from the randomized controlled trial PROMoting Quality, focusing on 546 hip and 492 knee replacement patients from nine German hospitals between October 2019 and December 2020 with available claims data. Patients were equally randomized into two groups: one receiving a PROM-based intervention at 1, 3, and 6 months post-surgery, the other receiving standard care. We compared 1-year post-surgery healthcare utilization using mixed-effects regression models. We further extrapolated the intervention effects to the German healthcare system.</p><p><strong>Findings: </strong>Results showed post-surgery health expenditure reductions of 7.9% (-318.08, p = 0.015) for hip and 7.3% (-386.72, p = 0.053) for knee replacements. Significant decreases were observed in outpatient care contacts (-1.51, p = 0.005), physiotherapy sessions (-1.65, p = 0.037), and number of prescriptions (-2.14, p = 0.042) for hip replacements. For knee replacement patients, significant determinants of the cost differences were fewer prescriptions (-3.40, p = 0.013) and medical aids (-0.81, p = 0.041).</p><p><strong>Conclusion: </strong>Our findings suggest that digital health interventions can reduce utilization and save scarce healthcare resources. It can be hypothesized that the \"being taken care of\" effect reduced the need for reassurance of the recovery progress, leading to fewer GP visits and decreased utilization of other healthcare services.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796086","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":"Economic evaluation of advanced practice physiotherapy models of care for upper extremity musculoskeletal disorders In Denmark: a registry-based cohort study.","authors":"Simon Lafrance, Cecilie Rud Budtz, Martin Byskov Kinnerup, François Desmeules, Jason Robert Guertin, Merete Nørgaard Madsen, David Høyrup Christiansen","doi":"10.1007/s10198-025-01817-z","DOIUrl":"https://doi.org/10.1007/s10198-025-01817-z","url":null,"abstract":"<p><strong>Background: </strong>Advanced practice physiotherapy (APP) models of care, which provide greater autonomy and responsibility to physiotherapists, have emerged as promising solutions to increase healthcare access while providing cost-effective care for MSK disorders. A formal health economic evaluation of these models has yet to be undertaken in Denmark.</p><p><strong>Objectives: </strong>To perform a registry-based economic evaluation of APP care versus standard care models for managing upper extremity MSK disorders in four Danish orthopedic clinics in the societal perspective.</p><p><strong>Methods: </strong>Data related to sociodemographic, diagnoses, healthcare resource use, medication, costs, and sickness benefits within a two-year period after the initial consultation were extracted from Danish databases. Total healthcare costs including primary care (medical and rehabilitation), medication and hospital costs were calculated as well as productivity loss. Costs were converted to Euros 2022. Propensity score weighting was used to adjust for confounders.</p><p><strong>Results: </strong>A total of 13,517 patients were included in the main analysis. Healthcare cost distribution differed between the two models with higher rehabilitation (mean difference [MD]: €18; 95% CI: 8 to 28) but lower medication (MD: -€50; 95% CI: -58 to -43) costs with the APP model of care. However, there was no significant difference in total healthcare costs (MD: €86; 95% CI: -305 to 476) nor in productivity loss (MD: €197; 95% CI: -1678 to 2072) between the two models.</p><p><strong>Conclusion: </strong>APP care results in similar total healthcare costs and productivity loss when compared to standard care for adults with upper extremity MSK disorders.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785960","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":"Economic and human burden attributable to antimicrobial resistance in Spain: a holistic macro-estimation of costs.","authors":"Sabela Siaba, Bruno Casal","doi":"10.1007/s10198-024-01746-3","DOIUrl":"10.1007/s10198-024-01746-3","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) represents a major threat to medical practice, complicating infection management, and increasing mortality and healthcare costs. Macro estimations of this health issue remain underexplored because data are currently limited to hospital systems. This study aims to estimate the economic and human burden of AMR in Spain at a macro level. An economic model was constructed based on prevalence rates, premature deaths and published literature to assess costs. Methodology was based on several techniques depending on the type of cost to be estimated: hospital inpatient care costs (based on extra hospital days); outpatient care costs (employing reimbursement rates from regional health services); productivity losses due to premature deaths (using the Human Capital Approach) and morbidity (based on days absent from work). Using data from EARS-NET, ESAC-NET and GBD, a total of 30 bacteria-drug resistance combinations were analysed. The results showed that 77,870 infections, 6,199 premature deaths, and 426,495 extra hospital days were attributable to AMR in Spain, mostly due to Gram-negative bacteria. AMR was also responsible for 3,112 years of working life lost. The costs reached EUR 338.6 million (0.03% of GDP), costing each Spaniard EUR 7.15 per year. Direct costs accounted for 72% of total costs, while indirect costs represented 28%. To date, this is the first study that evaluates the cost of AMR across such a wide range of bacteria and infection sites. These estimates are useful for approximating the problem and for planning containment and action strategies.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"893-926"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873226","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 expenditures and economic growth: evidence via panel local projections.","authors":"William Ginn","doi":"10.1007/s10198-024-01750-7","DOIUrl":"10.1007/s10198-024-01750-7","url":null,"abstract":"<p><p>This study investigates the elasticity of healthcare expenditures (HCE) with respect to income growth using a balanced panel of 177 economies from 2001 to 2020. Applying a panel local projections (LP) model, we examine both global and heterogeneous effects across income groups, as defined by the World Bank income classification. The model is further extended to estimate the relationship between income and HCE during changing economic conditions. Accordingly, we find that the elasticity weakens during non-expansionary periods, while high-income countries exhibit a minimal contemporaneous response. In contrast, low-income countries exhibit a heightened contemporaneous response to income fluctuations during non-expansionary phases, revealing a hidden vulnerability to economic growth.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"877-892"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856616","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":"Age, morbidity, and time to death: End-of-life expenditures on health care for the young-old population.","authors":"Irene Torrini, Claudio Lucifora, Antonio Giampiero Russo","doi":"10.1007/s10198-025-01757-8","DOIUrl":"10.1007/s10198-025-01757-8","url":null,"abstract":"<p><p>In this paper, we analyze resource allocation and explore the life-cycle evolution of health care expenditures (HCE) by investigating the effect of age, morbidity and time to death (TTD) on HCE for the young-old population. Using a rich 10-year population-level panel, we estimate a fixed-effects model to analyze HCE patterns for different health care services and by primary disease. Our main findings indicate that the effect of age on total HCE is lower when morbidity is controlled for while it increases when we also condition on TTD. This indicates that, compared to those incurred at older ages, earlier deaths are associated with higher HCE. At younger ages, increased expenditures are also observed as the severity of the health condition deteriorates. We also show that expenses for out-of-hospital services mainly drive the evolution of total HCE by age, while inpatient expenses are primarily determined by morbidity and TTD. In the end-of-life period, hospital costs continue to rise, whereas expenses incurred for all other services fall sharply in the year of death. We prove that expenses for long-lasting conditions start to increase long before death, while those for acute conditions grow exponentially only in the last two years of life. Our work contributes to informing cost-containment policies through a better understanding of HCE evolution during the life cycle and in the last years of life.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1079-1099"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392530","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}