European Journal of Health Economics最新文献

{"title":"Pricing of innovative medicines and advanced therapies worldwide: an scoping review.","authors":"Roberto Lúcio Muniz, Vanessa Souza Pinto, Francisco de Assis Acúrcio, Augusto Afonso Guerra, Juliana Alvares-Teodoro","doi":"10.1007/s10198-026-01962-z","DOIUrl":"https://doi.org/10.1007/s10198-026-01962-z","url":null,"abstract":"<p><p>Pricing policies may contribute to improving patient access to medicines. Innovative Medicines and Advanced Therapies represent promising treatment options; however, their high costs and limited clinical evidence pose both clinical and financial risks. In many cases, prices do not reflect the actual benefit or degree of innovation, highlighting the need to better understand and refine pricing approaches. The objective of this scoping review is to assess the application of pricing policies for these products worldwide. The methodology followed the JBI Manual for Evidence Synthesis and the PRISMA Extension for Scoping Reviews guidelines. Publications describing pricing policies applied to the definition of prices for Innovative Medicines and Advanced Therapies were included. A comprehensive literature search was conducted. Study selection was performed in two stages by independent reviewers, who also carried out data extraction. Fifty-five publications describing pricing policies for these products across different countries were included. A wide range of policies and methodologies for price determination were identified. The review assessed value-based pricing, external reference pricing, tendering and/or negotiation, internal reference pricing, cost-plus approaches, and initiatives promoting price transparency. Pricing policies play an essential role in regulating the costs of Innovative Medicines and Advanced Therapies. Although such policies may facilitate access to these technologies, challenges such as lack of transparency and heterogeneous methodologies remain. It is crucial that policymakers establish fair and transparent pricing frameworks that balance access, incentives for innovation, and the sustainability of health systems.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551175","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":"Correction: Validation of EQ-HWB-9 among Chinese college students based on a nationwide survey.","authors":"Pei Wang, Yingtong Gu, Xing Chen, Xichen Tong, Yijia Feng, Luying Zhang","doi":"10.1007/s10198-026-01967-8","DOIUrl":"https://doi.org/10.1007/s10198-026-01967-8","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537612","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":"Closing the first wave of drug innovativeness in italy: final evidence from 2017 to 2025.","authors":"Giorgio Casilli, Carlotta Galeone, Marika De Nigris, Armando A Genazzani, Patrizia Popoli, Andrea Marcellusi, Dario Lidonnici, Claudio Jommi","doi":"10.1007/s10198-026-01956-x","DOIUrl":"https://doi.org/10.1007/s10198-026-01956-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study provides a comprehensive overview of the Italian framework for the appraisal of drug innovativeness, covering all 294 appraisals conducted by AIFA between 2017 and June 2025. It aims to describe the evolution and application of the 2017 criteria, explore the determinants of innovativeness recognition, and discuss the implications of the 2025 revision for value assessment and market access.</p><p><strong>Methods: </strong>All AIFA innovativeness reports available up to June 2025 were systematically reviewed and coded across the three appraisal domains - therapeutic need, added therapeutic value, and quality of evidence - together with contextual and regulatory variables (orphan designation, study design, EMA approval type, accelerated assessment, and PRIME designation). Descriptive and multinomial regression analysis were performed to identify predictors of appraisal outcomes and to explore associations with European and national timelines.</p><p><strong>Results: </strong>Among 294 appraisals, 27% were fully innovative, 29% conditionally innovative, and 44% non-innovative. ATV and quality of evidence were the strongest determinants, while therapeutic need played a secondary role. Orphan designation, pediatric/mixed populations, and the availability of RCT-based evidence increased the likelihood of a positive outcome. Medicines with EMA accelerated assessment were more often granted full innovativeness but did not achieve shorter national reimbursement timelines (median 432 days). Fully innovative medicines followed shorter EMA pathways (median 330 vs. 448 days), though not necessarily implying faster national access.</p><p><strong>Conclusions: </strong>AIFA's framework proved internal coherence, with ATV as the main driver. The 2025 criteria may enhance methodological rigor but reduce flexibility, requiring continuous monitoring to ensure timely and equitable access.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537617","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":"Real-world patterns of healthcare use, costs, and survival in diffuse large B-cell lymphoma: a nationwide Swedish register study.","authors":"Eva Herweijer, Kaisa Miikkulainen, Oskar Eklund, Brett Doble, Christoffer Holmberg, Viktor Hedlöf Kanje, Robyn Thorén, Christina Victoria Jones, Magnus Björkholm","doi":"10.1007/s10198-026-01964-x","DOIUrl":"10.1007/s10198-026-01964-x","url":null,"abstract":"<p><strong>Objectives: </strong>To describe healthcare resource utilization (HCRU), direct costs, and survival of DLBCL patients in Sweden.</p><p><strong>Methods: </strong>This retrospective cohort study followed adult patients with DLBCL from 2015 to 2023 using Swedish national registers. Time in specialty care was calculated as days per-person-year (PPY). Nordic diagnosis-related-group weights were used to estimate costs.</p><p><strong>Results: </strong>7,503 patients were diagnosed with DLBCL. Median age was 73.0 years; 56.9% male and 55.0% had ≥ 1 comorbidity. On average, patients spent 17.6 days (4.8% annually) PPY in care, with average costs of €15,417 PPY. HCRU was highest in the first and second year with 41.7 days (11.4%) and 12.6 days (3.5%) in care, respectively. Average time in care declined from 13.7 days (3.8%) in 2015 to 11.9 days (3.3%) in 2019, then stabilized. Overall survival was 76.5% (95%CI: 75.5-77.4) and 68.9% (95%CI: 67.9-70.0) at 1 and 2 years from diagnosis.</p><p><strong>Conclusions: </strong>DLBCL patients spent considerable time in specialist care, especially in the first two years post-diagnosis. Care use and costs remained stable over the period. This study provides the first population-level estimates of HCRU and direct costs for DLBCL in Sweden, offering valuable context for current management and future integration of evolving treatment strategies.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431470","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":"Unlocking herpes zoster vaccination value in Finland: return on investment and actuarial model.","authors":"Eleftherios Zarkadoulas, Hanna Raunio, Vivi Mauno, Maarten Postma, Nikolaos Kotsopoulos","doi":"10.1007/s10198-026-01949-w","DOIUrl":"10.1007/s10198-026-01949-w","url":null,"abstract":"<p><strong>Background: </strong>Herpes zoster (HZ) is common in Finland, leading to long-term postherpetic neuralgia (PHN) especially with ageing. HZ reduces productivity, placing an economic burden on society. An integrated actuarial and macroeconomic model assessed the return on investment of recombinant zoster vaccine (RZV) in Finland for adults ≥ 50 years versus no vaccination.</p><p><strong>Methods: </strong>A validated economic model determined HZ cases and complications avoided, health gains (quality-adjusted life-years, QALYs), and healthcare cost-savings. Actuarial techniques projected population trends incorporating employment factors. Lost productivity averted through vaccination provided fiscal revenue for the government, and increased gross domestic product (GDP) for society. QALY gains were monetised using 1-3xGDP per QALY. RZV was administered for 20 years, with lifetime impact assessment.</p><p><strong>Results: </strong>RZV vaccination of around 790,000 50year-olds was estimated to save 3,779 QALYs and €52 million (M) in healthcare costs. Averted productivity losses generated €152 M in fiscal revenue and €367 M in GDP, while vaccination costs were €236 M. From the fiscal perspective, 90% of vaccination costs were offset by fiscal and healthcare cost savings (without considering QALY gains). From the societal perspective, for every €1 invested in vaccination, €2.60-4.10 was saved (depending on QALY value). The benefit-cost ratio (BCR) remained positive across sensitivity analyses. The highest BCRs were achieved when vaccinating adults aged 50 years; or 65 years when excluding productivity benefits.</p><p><strong>Conclusion: </strong>RZV vaccination in working-age adults yielded economic benefits in Finland, generating €2.60-4.10 for society per €1 invested in vaccination, and with fiscal benefits offsetting 90% of vaccination costs.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431457","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-effectiveness of community versus hospital-based mental healthcare for severe mental illness in South-East Europe: economic evaluation of five randomised trials.","authors":"Ben Wijnen, Filip Smit, Ana Ivičević Uhernik, Ana Žegrec, Jovo Dedovic, Roumyana Dinolova, Raluca Nica, Aleksander Tomcuk, Robert Velickovski, Michel Wensing, Laura Shields-Zeeman, Ionela Petrea","doi":"10.1007/s10198-026-01960-1","DOIUrl":"https://doi.org/10.1007/s10198-026-01960-1","url":null,"abstract":"<p><strong>Introduction: </strong>The RECOVER-E project supported the shift away from mental health care provided in institutional settings (treatment as usual, TAU) towards community-based mental healthcare by introducing multidisciplinary community mental health teams (CMHT) for people with schizophrenia, bipolar disorder, and severe depression across five sites in Bulgaria, Croatia, Montenegro, North Macedonia, and Romania. This paper presents the cost-effectiveness of CMHT compared to TAU.</p><p><strong>Methods: </strong>Data from all five RECOVER-E trials (N = 931) was used to compute healthcare costs and societal costs which included additional patient and family costs, and costs stemming from productivity losses. Outcomes were incremental cost-effectiveness ratio's (ICER) for gaining a QALY and gaining a treatment responder (based on WHODAS 2.0).</p><p><strong>Results: </strong>Compared to TAU, CMHT had small incremental effects favouring CMHT (QALY: M = 0·023, SD = 0·013; Response: M = 0·093, SD = 0·034). The incremental costs were higher in CMHT than in TAU as seen from both the societal and healthcare perspective (societal costs: M=€1,892, SD=€950; healthcare costs: M = 1,125, SD=€720). The ICER for gaining a QALY was €82,261 and €48,913 as seen from the societal and healthcare perspective, respectively. These ICERs were well above the willingness to pay threshold of €20,000 for gaining a QALY. A similar picture arose with treatment response as outcome.</p><p><strong>Conclusion: </strong>Overall CMHT appeared to be more effective but also more costly, with the additional cost outweighing the benefits across countries, except in Bulgaria, which may highlight that cost-effectiveness is likely to be context dependent. Therefore, a recommendation for scaling up or sustaining CMHT must also depend on arguments other than health-economic alone, such as medical ethical, equity and human rights considerations.</p><p><strong>Trial registration: </strong>Bulgaria: NCT03922425, Croatia: NCT03862209, Macedonia: NCT03892473, Montenegro: NCT03837340, Romania NCT03884933.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377904","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 the magnitude and scope of disability-related direct costs: a systematised review.","authors":"Lena Morgon Banks, Zachary Morris, Sara Rotenberg, Daniel Mont, Monica Pinilla-Roncancio, Ludovico Carraro, Alex Cote, Mercoledi Nasiir, Jill Hanass-Hancock, Stephen McGarity, Pamela Smith, Sophie Mitra","doi":"10.1007/s10198-025-01851-x","DOIUrl":"10.1007/s10198-025-01851-x","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"969-985"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566080","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":"Healthcare costs of foodborne diseases in the United States: an analysis using electronic health records.","authors":"Xuerui Yang, James A Barkley, Barbara B Kowalcyk, Robert L Scharff","doi":"10.1007/s10198-025-01853-9","DOIUrl":"10.1007/s10198-025-01853-9","url":null,"abstract":"<p><p>This study used electronic health records from The Ohio State University Healthcare System to estimate hospital costs (payrolls, supplies, utilities) for foodborne diseases (FBD) across a range of clinical diagnoses. We considered the relationship between FBD and comorbidities since comorbidities may increase the risk of FBD or FBD sequelae. Our regression analysis advances prior work by estimating incremental FBD costs while adjusting for chronic conditions, comorbidities, and other confounders (e.g., demographics, payor and patient types) using large-scale EHR data, filling a critical gap in FBD cost estimation. We analyzed 8,147,264 encounter episodes from 2017 to 2021, totaling 697,732 patient years, with 930 being FBD-associated. Poisson regression yielded baseline annual FBD hospital costs of $8,258 per patient (cost-to-charge adjusted). When adjusting and comparing different types of comorbidities, the Clogg Z-test showed that cost estimates without comorbidity controls were $3,735 higher than baseline costs per patient-year (p = 0.098). However, there was little difference between the baseline and the estimates that took comorbidities into account. Instead of using foodborne pathogen-specific codes, costs were marginally lower by $1,492 (p = 0.058) when using gastroenteritis codes (such as infectious diarrhea). In contrast, gastrointestinal symptom codes such as diarrhea and others were associated with $3,440 (p < 0.001) higher costs than codes specific to foodborne pathogens. We discussed the implications of FBD cost variations through sensitivity analyses of comorbidity adjustments and diagnostic coding in methodology, and how these variations mimic liability assessments in the consumer and food industry.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1027-1046"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642561","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 of focused ultrasound compared to radiotherapy for Dutch patients with uncomplicated non-spinal bone metastases.","authors":"Julia Simões Corrêa Galendi, Ingrid Nijholt, Renée Hovenier, Jorik Slotman, Erik Phernambucq, Stephanie Stock, Clemens Bos, Manon Braat, Helena Verkooijen, Martijn Boomsma, Dirk Müller","doi":"10.1007/s10198-025-01861-9","DOIUrl":"10.1007/s10198-025-01861-9","url":null,"abstract":"<p><strong>Introduction: </strong>Non-randomized clinical trial has shown that Magnetic Resonance guided High-intensity focused ultrasound (MR-HIFU) leads to faster pain relief compared to the current standard of care External Beam Radiotherapy (EBRT).</p><p><strong>Objective: </strong>To evaluate the cost-utility of 'early MR-HIFU' (with optional EBRT afterwards) or 'delayed MR-HIFU' (i.e., MR-HIFU after failed EBRT) versus EBRT (with optional re-irradiation with EBRT) from the societal perspective in the Netherlands METHODS: A lifelong patient-level simulation model was developed. After a treatment with either MR-HIFU or EBRT, a patient could have: (i) complete pain relief, (ii) partial pain relief, (iii) persistent pain and (iv) death. We also accounted for the event of a pathological fracture. Model outputs were costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER). The net monetary benefit was calculated considering the willingness-to-pay threshold of €80,000 per QALY gained, adjusted by the Dutch disease severity index. Deterministic and probabilistic sensitivity analyses were conducted.</p><p><strong>Results: </strong>The strategy 'delayed MR-HIFU' costs €706 more than EBRT, whilst 'early MR-HIFU' costs €1,875 more than EBRT.'Early MR-HIFU' adds 0,15 more QALYs than EBRT, resulting in an ICER of €12.755 per QALY and an incremental net monetary benefit of €8,631. At a threshold of 80,000€ per QALY there is a 77% probability that 'early MR-HIFU' is the most cost-effective option.</p><p><strong>Conclusion: </strong>Although there are still uncertainties relating to implementation of MR-HIFU in patient care, our modelling study shows that offering MR-HIFU as an early treatment would be the most cost-effective option in the Netherlands.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1061-1072"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679402","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":"Patient and medical choice across public and private health providers: the case of birth timing manipulation in Brazil.","authors":"Paula Spinola, Rudi Rocha","doi":"10.1007/s10198-025-01835-x","DOIUrl":"10.1007/s10198-025-01835-x","url":null,"abstract":"<p><p>In this paper we assess the extent to which patient and physician preferences determine birth timing manipulation in public and private hospitals, among white and black mothers, using data from approximately 37 million births in Brazil. Our findings show that manipulation is markedly salient in the private sector and among white women. While the timing of births in the public sector is also influenced by specific incentives, their impact is less pronounced and more evenly distributed across racial groups. The analysis provides a comprehensive and integrated assessment of how treatment decisions respond to different individual incentives, for different population groups, and within distinct institutional settings, thus allowing for comparison of magnitude of estimates across health systems and populations.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1117-1148"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851410","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}