Applied Health Economics and Health Policy最新文献

{"title":"When Does Health Technology Assessment Need Deliberation? Evidence, Algorithms and the Limits of Consultation.","authors":"Ahmet Küçükuncular, Anthony J Culyer","doi":"10.1007/s40258-026-01071-1","DOIUrl":"https://doi.org/10.1007/s40258-026-01071-1","url":null,"abstract":"<p><p>Health technology assessment (HTA) increasingly depends on formal methods such as cost-effectiveness analysis, QALYs, thresholds, structured evidence reviews and decision criteria. These tools are indispensable, but they do not remove the need for judgement. Decisions about health technologies often involve heterogeneous evidence, uncertainty, contested values, institutional constraints, professional responsibilities and consequences for both identifiable patients and anonymous others whose care may be displaced. In this article, we ask when deliberation is likely to be needed in HTA, and what distinguishes it from algorithmic reasoning, consultation and commenting. We argue that deliberation should not be defended simply because it is democratic, inclusive or procedurally attractive. Its value is conditional. Deliberation becomes useful where evidence does not combine itself, where values shape what counts as relevant evidence, and where recommendations must be justified in ways that can withstand disagreement. We distinguish context-free scientific evidence, context-sensitive scientific evidence, and colloquial evidence, and show why their interpretation cannot be reduced to evidence accumulation or modelled calculation. We then identify the circumstances in which deliberation is most likely to add value: (1) when evidence is heterogeneous, incomplete, contested or context dependent, (2) when values, outcomes, equity or fairness are disputed, (3) when implementation is uncertain, and (4) when professional ownership, public credibility or political trust matter. We argue that HTA does not need deliberation everywhere, but where judgement must be exercised, exposed and justified.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of the Literature on Child and/or Adolescent Health Microsimulation Models.","authors":"Claire de Oliveira, Yingkun Justin Wen, Michael Endale Mengesha, Filipa Sampaio","doi":"10.1007/s40258-026-01066-y","DOIUrl":"https://doi.org/10.1007/s40258-026-01066-y","url":null,"abstract":"<p><strong>Background: </strong>Microsimulation models can be used for diverse purposes such as forecasting and undertaking economic evaluations. A review of the literature of existing child and/or adolescent microsimulation models has yet to be undertaken. The aim of this scoping review was to retrieve, synthesise and critically appraise the literature of child and/or adolescent health microsimulation models.</p><p><strong>Methods: </strong>A scoping review was conducted using PubMed, Embase, CINAHL, PsyclNFO, EconLit and Scopus. Additional searches (snowballing, Google searches, searches of specific journals and websites) were also undertaken to complement database searches. Relevant data on microsimulation models were extracted, and the quality of models was assessed using the Quality Assessment Reporting for Microsimulation Models checklist. Evidence was synthesised by scope of model, type of model and health outcome examined.</p><p><strong>Results: </strong>Forty-eight relevant microsimulation models were found. Most (n = 33) were developed specifically for children and/or adolescents, but there were a few (n = 15) broader models that examined these populations. Many microsimulation models were developed for the USA (n = 14); several were focused on select health conditions, such as obesity/overweight, cancer and human immunodeficiency virus (HIV). Just over half (n = 27) of the models found were classified as medium quality models, while the remaining ones were deemed high quality (n = 21). Nonetheless, several models lacked validation and, to a lesser extent, uncertainty analyses and generalisability.</p><p><strong>Conclusions: </strong>There are a substantial number of child and/or adolescent health microsimulation models. However, future research should focus on developing models on other prevalent child/adolescent health conditions (e.g. allergies, ADHD) and for low- and middle-income settings.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Minimisation and Cost-Benefit Analysis of Reusable Menstrual Pads Compared to Disposable Pads in a Low-Resource Nigerian Setting.","authors":"Amina Suleiman Rajah, Umar Lawal Bello, Ahmed Suberu, Muhammad Kamaluddeen Sani, Muazu Hassan Muazu, Shukurat M Bello, Japhet Jonah Haruna","doi":"10.1007/s40258-026-01069-9","DOIUrl":"https://doi.org/10.1007/s40258-026-01069-9","url":null,"abstract":"<p><strong>Background: </strong>Menstrual hygiene management poses significant economic and environmental challenges, with disposable products contributing to period poverty and plastic waste. Robust economic evaluations comparing reusable menstrual pads to disposable alternatives are lacking, particularly in low-income settings.</p><p><strong>Aim: </strong>This study assessed the costs, cost-minimisation outcomes, and cost-benefit implications of reusable menstrual pads compared with disposable pads and examined socio-economic factors associated with perceived economic value and willingness to adopt reusable pads.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted among 426 women and girls in Kano, Nigeria. A cost-minimisation analysis from the user perspective compared the cost per menstrual cycle managed, assuming equivalent menstrual-cycle coverage for reusable and disposable pads. A cost-benefit analysis incorporated monetised environmental externalities related to avoided menstrual waste. Costs were reported in 2025 Nigerian Naira and United States dollars using an exchange rate of ₦1650 = US$1. Sensitivity analyses assessed uncertainty in key cost and waste-management parameters.</p><p><strong>Results: </strong>Reusable menstrual pads were more cost-saving compared with disposable pads under the base-case assumptions. Disposable pads cost ₦1425 per cycle, while reusable pads cost ₦413 per cycle. Over 5 years, total undiscounted costs were ₦85,500 for disposable pads and ₦24,780 for reusable pads, yielding net savings of ₦60,720 per user. Including avoided waste-management costs, the net social benefit of switching to reusable pads was ₦63,609 over 5 years. The mean Likert score for the statement that reusable pads are more economical in the long run was 4.26 (SD 0.78), while the mean Likert score for the statement that upfront cost is a major barrier was 4.29 (SD 0.76). Perceived economic value was significantly associated with income (p = 0.003) and education (p < 0.001).</p><p><strong>Conclusion: </strong>Reusable menstrual pads may offer substantial cost savings and additional societal benefits through reduced menstrual waste in low-resource contexts. Programmes promoting reusable pads should address the upfront purchase cost through subsidies, financing models, or targeted distribution.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pricing Combination Therapies: A Systematic Review of Value Attribution, Cost-Sharing Mechanisms and Policy Frameworks.","authors":"Marta Trapero-Bertran, Carlos Martin-Saborido, Jorge Mestre-Ferrandiz, Nuria Amarilla, Lluís Segú","doi":"10.1007/s40258-026-01065-z","DOIUrl":"https://doi.org/10.1007/s40258-026-01065-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Combination therapies are increasingly central to modern pharmacotherapy, particularly in oncology and other high-burden diseases. However, pharmaceutical pricing and reimbursement systems remain largely designed for single-product-single-indication interventions. When multiple patented medicines are used together, especially when owned by different manufacturers, conventional pricing frameworks may struggle to align prices with the value of the combination while preserving incentives for innovation and timely patient access.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify, describe, and critically assess the methods, models, and policy frameworks proposed in the literature to establish prices for combination therapies, with particular attention to value attribution mechanisms, cost-sharing arrangements between manufacturers, and budget impact considerations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature review was conducted in accordance with PRISMA guidelines and a pre-registered Open Science Framework protocol. Searches were performed in MEDLINE, Scopus, Web of Science, EconLit, CRD databases, and grey literature sources for publications up to July 2025. Eligible studies analysed pricing approaches, economic models, reimbursement mechanisms, or policy frameworks relevant to combination therapies, including more recent multi-indication pricing literature. Given the heterogeneity of the literature, findings were synthesized using a structured narrative and thematic approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-nine studies met the inclusion criteria. The literature was dominated by conceptual and policy analyses, with relatively few empirical or implementation-oriented studies. Value attribution emerged as the central methodological challenge in pricing combination therapies. Several complementary approaches were proposed to operationalise value attribution, including adaptations of indication- or pathway-based pricing, manufacturer cost-sharing arrangements, managed entry agreements, and outcome-based reimbursement mechanisms. Empirical evidence suggests that health systems continue to rely primarily on pragmatic and often partial solutions rather than fully specified pricing frameworks. A complementary review of the multi-indication pricing literature indicates that, although the two fields address different pricing problems, they share important methodological and institutional lessons that can inform the development of pricing frameworks for combination therapies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The literature provides a growing repertoire of conceptual approaches for pricing combination therapies but limited empirical evidence on implementation. Pricing frameworks should place value attribution at their core while combining complementary policy mechanisms adapted to national pricing and reimbursement systems. Lessons from multi-indication pricing provide a valuable foundation but require additio","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Job Stress, Burnout and Healthcare Utilization: Evidence from a Systematic Literature Review and Implications for Future Research.","authors":"Sabela Siaba, Berta Rivera, Luis Currais","doi":"10.1007/s40258-026-01067-x","DOIUrl":"https://doi.org/10.1007/s40258-026-01067-x","url":null,"abstract":"<p><strong>Background: </strong>Job stress has become an increasing public health concern worldwide, affecting a substantial proportion of the workforce and contributing to significant morbidity. Although extensive evidence has documented its adverse health effects, much less is known about how occupational stress translates into healthcare utilization, which is essential for assessing its economic burden on healthcare systems and informing public policy.</p><p><strong>Objective: </strong>To our knowledge, this study provides the first systematic review of empirical evidence linking job stress and burnout to healthcare utilization.</p><p><strong>Methods: </strong>Following PRISMA guidelines, 533 articles published between January 1990 and February 2026 were identified in MEDLINE, Web of Science and SciELO databases and screened. After applying the eligibility criteria, based on peer-reviewed articles published in English or Spanish examining healthcare utilization among employed individuals exposed to job stress or burnout, 18 studies were included, highlighting the limited empirical evidence currently available.</p><p><strong>Results: </strong>All studies were conducted in high-income countries; 72% used cross-sectional designs, and job stress was most frequently measured using Karasek's demand-control model (56%). The findings suggest a consistent positive association between occupational stress and healthcare utilization, particularly medication use. Sixteen studies examined medication use, most reporting statistically significant associations with increased consumption of psychotropic drugs. In contrast, only two studies analyzed other forms of healthcare utilization, such as inpatient care or primary care consultations.</p><p><strong>Conclusion: </strong>Overall, the evidence suggests that adverse psychosocial working conditions may contribute to increased demand for healthcare resources, although important gaps remain regarding the broader healthcare consequences. This study proposes a research agenda to better assess and quantify its healthcare burden. Understanding this relationship is essential for designing workplace policies aimed at reducing occupational stress and improving the efficiency and sustainability of healthcare systems.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Maternal RSVpreF Vaccination Compared with Newborn Nirsevimab RSV Prophylaxis or No RSV Prophylaxis in Switzerland.","authors":"Jamie Bainbridge, Stuart Mealing, Charlotte Graham, Mathias Jenal, Nicolas von Dombrowski, Amy Dymond","doi":"10.1007/s40258-026-01063-1","DOIUrl":"10.1007/s40258-026-01063-1","url":null,"abstract":"<p><strong>Background: </strong>RSVpreF is a vaccine that immunises against respiratory syncytial virus (RSV), a seasonal respiratory virus, that can lead to lower respiratory tract infections. In Switzerland, RSVpreF is indicated for the passive protection of infants against RSV following maternal immunisation.</p><p><strong>Objective: </strong>The Swiss Federal Office of Public Health commissioned a health technology assessment (HTA) of RSVpreF for maternal vaccination, evaluating the clinical and cost effectiveness of the vaccine compared with nirsevimab (administered directly to newborns and infants) or no RSV prophylaxis. This study reports the cost-effectiveness model developed for the Swiss HTA.</p><p><strong>Methods: </strong>The model used a Markov model structure, a 1-year time horizon, a one-month cycle length, a Swiss healthcare payers' perspective, and a 3% discount rate for costs and health benefits. Health states included no RSV infection, RSV infection leading to hospitalisation, primary care visits or emergency department visits, post-RSV infection, and death. MATISSE informed RSVpreF efficacy, and MELODY and HARMONIE informed nirsevimab efficacy. Health outcomes were expressed as quality-adjusted life years (QALYs). Probabilistic and deterministic sensitivity analyses were undertaken to explore the impact of parameter uncertainty on the model results.</p><p><strong>Results: </strong>When compared with nirsevimab, RSVpreF reduces total costs (CHF -9,878,738) and QALYs (-18.4), with an incremental cost-effectiveness ratio (ICER) of 536,008 per QALY (N = 38,844). Compared with no RSV prophylaxis, RSVpreF increases total costs (CHF +470,441) and QALYs (+27.1), with an ICER of 17,377 per QALY (N = 38,844).</p><p><strong>Conclusions: </strong>RSVpreF is highly likely to be cost-effective versus both comparators at a range of plausible threshold values. The results of the model contributed to guidance updates in Switzerland, with RSVpreF now reimbursed by mandatory health insurance.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Interventions for Perinatal Anxiety and/or Depression: A Systematic Review of Global Evidence.","authors":"Ashwini Shivakumar Bidnurmath, Suganya Kumar, Filipa Sampaio","doi":"10.1007/s40258-026-01059-x","DOIUrl":"https://doi.org/10.1007/s40258-026-01059-x","url":null,"abstract":"<p><strong>Background and objective: </strong>Perinatal anxiety and depression are among the most common complications of pregnancy and childbirth. An up-to-date comprehensive synthesis of the available evidence on the cost-effectiveness interventions targeting these conditions across the perinatal period is lacking. The aim of this systematic review was to identify, synthesise and critically appraise the available evidence on the cost-effectiveness of interventions for perinatal anxiety and/or depression.</p><p><strong>Methods: </strong>Following the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), a systematic literature review was conducted using PubMed, PsycINFO, EconLit and Web of Science, including only full economic evaluations. The methodological quality of the included studies was assessed using the Drummond checklist, while the quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Evidence was synthesised, using a narrative approach.</p><p><strong>Results: </strong>Twenty-seven studies were included: 18 trials, eight models, and one cohort study. Eighteen interventions were cost effective, two were not cost effective, and seven reported unclear cost effectiveness. There was substantial economic evidence for interventions targeting perinatal depression compared with interventions targeting perinatal anxiety. Among the interventions for treating and preventing perinatal depression, cognitive behavioral therapy, interpersonal therapy, and primary care delivered through trained health visitors were either cost effective or cost-saving in multiple studies and can therefore be recommended. While most studies (n = 24) were of good quality, the reporting of uncertainty and valuations of costs and outcomes remained inconsistent. Furthermore, few studies adequately addressed distributional effects or included patient engagement. The economic evidence largely originated from high-income countries, with only three studies from Asia and one from Uganda.</p><p><strong>Conclusions: </strong>Economic evaluations of interventions for perinatal anxiety and/or depression were mostly of good quality, although most evidence originated from high-income countries. Anxiety disorders were underrepresented in the economic evaluation literature. Further studies should focus on assessing the economic value of these interventions in low- and middle-income settings, with greater attention to perinatal anxiety, which remains understudied.</p><p><strong>Clinical trial registration: </strong>Open Science Framework: https://doi.org/10.17605/OSF.IO/2K4PY .</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Adult Hepatitis A Vaccination Strategies in Korea Under an Aging Susceptibility Profile","authors":"Yuna Lim,&nbsp;Gerardo Chowell,&nbsp;Eunok Jung","doi":"10.1007/s40258-026-01056-0","DOIUrl":"10.1007/s40258-026-01056-0","url":null,"abstract":"<div><h3>Background</h3><p>Hepatitis A severity increases sharply with age, while Korea is experiencing a cohort shift in which low-seroprevalence adult cohorts are aging into older, higher-fatality age groups. This demographic and immunological transition creates an urgent policy question regarding how adult vaccination should be prioritized under resource constraints.</p><h3>Objective</h3><p>This study aimed to identify the most cost-effective adult hepatitis A vaccination strategy in Korea by comparing age-targeted vaccination scenarios that account for age-related mortality risk, socioeconomic disease burden, and realistic resource constraints.</p><h3>Methods</h3><p>We evaluated three adult vaccination scenarios targeting low-seroprevalence age groups: (<i>S</i>1) 20–39 years, (<i>S</i>2) 40–59 years with pre-vaccination antibody testing, and (<i>S</i>3) 20–59 years with antibody testing applied to those aged ≥ 40 years. Using an age-structured dynamic transmission model calibrated to Korean data, we derived dynamically feasible vaccination allocation trajectories under realistic capacity constraints using an optimal control framework and linked these trajectories to long-term transmission-model simulations. We conducted cost-effectiveness analyses based on disability-adjusted life years (DALYs) over a lifetime horizon from both healthcare system and societal perspectives and characterized uncertainty using probabilistic sensitivity analysis (PSA) and cost-effectiveness acceptability curves (CEACs). Robustness was examined using one-way sensitivity analyses.</p><h3>Results</h3><p>In the base case (4.5% annual discount rate), vaccination targeting adults aged 40–59 years (<i>S</i>2) consistently yielded the most favorable and robust cost-effectiveness profile under both perspectives, with the lowest incremental cost-effectiveness ratio (ICER). Vaccination of adults aged 20–59 years (<i>S</i>3) achieved the largest reduction in DALYs but required substantially higher incremental costs, resulting in a higher ICER than (<i>S</i>2). The smallest DALY reduction was produced by <i>S</i>1, which was the least efficient strategy. The PSA and CEACs confirmed that <i>S</i>2 remained the preferred option across most willingness-to-pay ranges.</p><h3>Conclusions</h3><p>Prioritizing adults aged 40–59 years offers the most balanced and robustly cost-effective strategy for hepatitis A vaccination in Korea, capturing substantial mortality reduction while limiting additional program costs. Broader adult vaccination may be justified when higher budgets or willingness-to-pay thresholds are acceptable, but prioritizing middle-aged adults provides the clearest value for money under epidemiological and economic conditions.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"24 5","pages":"869 - 882"},"PeriodicalIF":3.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19–Related Healthcare Utilization and Costs in a Large Insured US Population, 2021–2025","authors":"Xiaoyu Dong,&nbsp;Andrew J. Leidner,&nbsp;Jamison Pike,&nbsp;Bo-Hyun Cho,&nbsp;Megan Wallace,&nbsp;Fangjun Zhou","doi":"10.1007/s40258-026-01062-2","DOIUrl":"10.1007/s40258-026-01062-2","url":null,"abstract":"<div><h3>Background</h3><p>Comprehensive understanding of the economic impacts of COVID-19 over time remains limited, with recent estimates lacking both broad population coverage and detailed assessment of disease severity.</p><h3>Objective</h3><p>To provide updated estimates on healthcare utilization and costs associated with COVID-19 during both pandemic and post-pandemic periods using administrative claims data.</p><h3>Methods</h3><p>This retrospective observational study used administrative medical claims data in the USA from the Merative™ MarketScan^® databases to evaluate healthcare utilization and costs across various settings: outpatient, inpatient without intensive care unit (ICU) use, inpatient with ICU but without ventilation, and inpatient with both ICU and ventilation. The study population included enrollees with COVID-19–related medical encounters from July 2021 through June 2025. The period from July 2021 to June 2023 was classified as the pandemic period, and July 2023 to June 2025 as the post-pandemic period. Outcome measures included hospitalization and outpatient case rates, frequency of ICU admissions and ventilation utilization, mean hospital lengths of stay, and direct medical costs (reported in 2025 USD).</p><h3>Results</h3><p>From July 2021 to June 2025, approximately 64,000 COVID-19–related hospitalizations and 4.2 million outpatient cases were identified based on primary diagnoses. Hospitalization rates ranged from 3.0 to 1037.8 per 100,000 enrollee-years, and outpatient rates ranged from 10.4 to 122.1 per 1000 enrollee-years, peaking in early 2022 and declining thereafter with seasonal fluctuations. Hospitalization rates decreased across all age groups, although adults aged ≥ 65 years maintained the highest burden (312.6 per 100,000 enrollee-years in July 2024–June 2025). Mean length of stay and hospitalization costs declined across most adult groups, particularly for ICU-related cases. In the post-pandemic period, mean hospitalization costs ranged from $16,149 to $213,740 with a mean length of stay from 2.6 to 22.6 days. The mean outpatient costs ranged from $361 to $770 per case. Nationally, annual direct medical costs were estimated to be as high as $38.7 billion during the pandemic period and as high as $8.6 billion in 2024–2025, with adults aged ≥ 65 years accounting for approximately half of total expenditures.</p><h3>Conclusions</h3><p>COVID-19 continues to impose a substantial and persistent economic burden, even in the post-pandemic period, underscoring the importance of ongoing mitigation strategies and efficient healthcare resource planning.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"24 5","pages":"925 - 935"},"PeriodicalIF":3.1,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaborating for Affordable Patient Access to Medicines: Review of the First Decade of the Beneluxa Initiative in Pharmaceutical Policy.","authors":"Sabine Vogler, Verena Knoll, Anja Sonemann, Annemie Quanten, Roisin Adams, Tim de Jager, Marc Van de Casteele, Lonneke Timmers","doi":"10.1007/s40258-026-01057-z","DOIUrl":"https://doi.org/10.1007/s40258-026-01057-z","url":null,"abstract":"<p><p>Cross-country collaboration has been proposed as a policy solution to improve patient access to medicines. Since patient access to medicines at affordable costs has also become an issue for high-income countries, some European countries responded in 2015 by establishing the Beneluxa Initiative to work together in pharmaceutical policy. As of 2025, the Initiative comprised five countries (Austria, Belgium, Ireland, Luxembourg, and the Netherlands) and had ten years of experience in several joint collaborative activities, including horizon scanning, health technology assessment, reimbursement negotiations, and strategic exchange on policy developments. During its first decade, the Beneluxa Initiative conducted 15 joint health technology assessments and four joint negotiations. Insights gained through these collaborative processes have contributed to the refinement of methodological approaches and the exploration of new avenues, such as the establishment of the International Horizon Scanning Initiative with participation of additional countries. Although public attention often centres on joint negotiations, they represent only one dimension of the Initiative's work. The Beneluxa Initiative adopts a comprehensive product life-cycle approach, seeking to identify medicines with potentially high budget impact in early development stages, thereby allowing for timely preparation of collaborative assessments and negotiations. While differences in the legal and organisational national frameworks pose challenges and collaboration requires sufficient time resources, the Beneluxa experience demonstrated that collaboration in pharmaceutical policy across countries is possible and useful. Learnings can also be transferred to the global health policy community.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}