Applied Health Economics and Health Policy最新文献

{"title":"The Economics of Antibiotic Resistance: A Systematic Review and Meta-analysis Based on Global Research.","authors":"Sabela Siaba, Bruno Casal, Iván López-Martínez","doi":"10.1007/s40258-025-01001-7","DOIUrl":"https://doi.org/10.1007/s40258-025-01001-7","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance (ABR) is a growing global health threat; reliable evidence on its impact is crucial for prioritising public health interventions.</p><p><strong>Objective: </strong>This study provides an updated, systematic review and meta-analysis to determine the true effect size of resistant infections on economic and clinical outcomes. It also evaluates methodologies used in ABR economic literature, offering recommendations for improving future research.</p><p><strong>Methods: </strong>Following PRISMA guidelines, 11,252 articles published between 2000 and 2022 were reviewed from several databases. Studies were included if they reported the economic costs of ABR in humans and compared resistant with susceptible infections. Meta-analyses were conducted using random intercept models; standardised mean difference (SMD) was used for length of stay, and odds ratio (OR) for mortality. The Mantel-Haenszel method was applied to obtain pooled estimates.</p><p><strong>Results: </strong>Results showed that 73% of the studies were conducted in high-income economies, the majority were performed at tertiary care settings (71%) and 67% employed only a hospital perspective. The available evidence indicated that the attributable cost of resistant infections ranged from EUR₂₀₂₂ - 21,629 to EUR₂₀₂₂ 74,452 per patient episode (with Pseudomonas spp. causing the highest costs). The majority of studies (93%) found that patients with ABR incurred higher costs than their susceptible counterparts (72% report statistically significantly higher costs). Results from meta-analysis indicated that, on average, the excess in hospital stay attributable to resistant infections was 8.72 days (95% confidence interval (CI) [6.42; 11.02], SMD = 0.91) and the odds of premature death were significantly higher in the resistance group, with a risk increase of 65% (OR 95% CI [1.44; 1.88]). Conclusion The findings of this study take the first steps in providing reliable evidence; they could be valuable to researchers, policymakers and clinicians involved in ABR control and health promotion across countries. Similarly, the reported estimates may prove useful for future modelling studies aimed at assessing the long-term economic impact of ABR.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940027","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":"Healthcare Costs and Carbon Emissions of Stage III Melanoma Surveillance Imaging.","authors":"Jake T W Williams, Mbathio Dieng, Katy Bell, Scott McAlister, Rachael L Morton","doi":"10.1007/s40258-025-00998-1","DOIUrl":"https://doi.org/10.1007/s40258-025-00998-1","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to estimate the health system cost and carbon emissions of diagnostic imaging tests undertaken by patients on different surveillance schedules for follow-up of stage III melanoma. We also aimed to demonstrate how different monetary valuations of carbon emissions affect overall cost.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of administrative data from the Melanoma Institute Australia's Melanoma Research Database for patients diagnosed with stage III melanoma between 2000 and 2014 and followed them until 2023. Imaging tests (computed tomography [CT], positron emission tomography [PET], PET-CT, ultrasound, X-ray, and magnetic resonance imaging [MRI]) undertaken during follow-up were described. Healthcare costs were estimated per patient-year using data from the Medicare Benefits Schedule. Carbon emissions from tests and transport were estimated per patient-year using life cycle assessment and valued using New South Wales carbon values.</p><p><strong>Results: </strong>Overall, 553 patients were included in this study: 115 in the 3-6-monthly surveillance imaging group, 273 in the 12-monthly surveillance imaging group, and 165 in the no routine imaging surveillance group. Healthcare costs and carbon emissions were highest in the 3-6-monthly group (Australian dollar [AUD] $1098 and 226 kg carbon dioxide equivalent emissions [CO₂-e] per patient-year) followed by the 12-monthly imaging group (AUD $767 and 150 kg CO₂-e per patient-year), and the no routine imaging group (AUD $319 and 50 kg CO₂-e per patient-year). When carbon emissions were valued in Australian dollars they accounted for 1.8-2.6% of total costs.</p><p><strong>Conclusions: </strong>More frequent surveillance imaging of patients with stage III melanoma is associated with higher healthcare costs and environmental impacts, the latter of which are responsible for a small proportion of total costs when valued in dollars.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940024","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":"The Economic Cost of Obesity: A Cost-of-Illness Study in Greece.","authors":"Panagiotis Papantoniou, Nikolaos Maniadakis","doi":"10.1007/s40258-025-01002-6","DOIUrl":"https://doi.org/10.1007/s40258-025-01002-6","url":null,"abstract":"<p><strong>Background: </strong>Obesity represents a significant public health and economic problem worldwide. In Greece, where the prevalence of adult obesity is among the highest in Europe, no prior study has examined its economic impact among adults. This study estimates the total economic burden of obesity in Greece for 2024, adopting a societal perspective and considering both direct and indirect costs.</p><p><strong>Methods: </strong>A prevalence-based, top-down cost-of-illness approach was used. Direct costs included obesity pharmacotherapy, bariatric surgery, weight-loss supplements, and 33 obesity-related comorbidities. Indirect costs encompassed productivity losses due to absenteeism, presenteeism, and premature mortality. Epidemiological, demographic, clinical, and cost data were retrieved from national and international sources. Population-attributable fractions were used to link obesity with comorbidity costs. All costs were adjusted to 2024 euros. Deterministic and probabilistic sensitivity analyses assessed the robustness of the base-case results.</p><p><strong>Results: </strong>The total economic burden of obesity in Greece for 2024 was estimated at €4.92 billion, equivalent to 2.07% of GDP. Direct medical costs accounted for €2.593 billion (52.71%), with obesity-related comorbidities representing 99.6% of this amount. Indirect costs totalled €2.327 billion, driven primarily by premature mortality (€1.30 billion). Absenteeism and presenteeism costs were €469 million and €555 million, respectively. Sensitivity analyses confirmed robustness, with total costs averaging €4.89 billion (95% CI: €3.21-€7.29 billion).</p><p><strong>Conclusion: </strong>Obesity imposes a considerable economic burden on Greece, threatening the sustainability of the healthcare system and broader social well-being. Immediate and drastic coordinated, multisectoral, and multidisciplinary strategies are needed to curb the prevalence and fiscal impact of obesity.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940012","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":"Mechanisms Considering Public Investment in Pricing and Reimbursement Decisions of Medicines and Other Health Technologies: A Scoping Review.","authors":"Mario García-Díaz, Zuzana Špacírová, Leticia García-Mochón, Jaime Espín","doi":"10.1007/s40258-025-00994-5","DOIUrl":"https://doi.org/10.1007/s40258-025-00994-5","url":null,"abstract":"<p><strong>Background: </strong>Pricing and reimbursement (P&R) systems do not normally use public investments in research and development (R&D) as criteria when negotiating the prices and reimbursement of health technologies.</p><p><strong>Objective: </strong>The objective was to find mechanisms that consider public investment in R&D when negotiating P&R or obtaining a fair return on this public investment METHODS: We conducted a scoping review. A total of four databases (PubMed, Embase, Scopus and Web of Science) and a grey literature information source (Google Scholar) were searched. Eligible articles were published before 2024 and described how public sector investment in R&D is considered in price negotiations or how the public sector can obtain a return on R&D investment.</p><p><strong>Results: </strong>The review found 28 papers referring to mechanisms that take into account public investment in R&D to reduce prices in the P&R negotiation (e.g. delinkage R&D model, advance purchase agreement and government patent use), to obtain a fair return on investment (e.g. royalties and venture philanthropy) or to save costs or share risks (e.g. social impact bonds and prize fund). Examples are provided of health technologies that used these mechanisms.</p><p><strong>Conclusions: </strong>Policymakers have several resources they can draw from to ensure a fair and efficient use of public R&D funds. However, there is little evidence that these instruments are widely used in practice, and there is no political consensus on what mechanism is the most appropriate and why. In view of the above, it is essential to create a common framework that will ensure a fairer and more affordable system for public health budgets.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940063","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":"Structured Expert Elicitation to Inform Long-Term Survival Extrapolations in Advanced Renal Cell Carcinoma","authors":"Dawn Lee,&nbsp;Zain Ahmad,&nbsp;James M. G. Larkin,&nbsp;Amit Bahl,&nbsp;G. J. Melendez-Torres","doi":"10.1007/s40258-025-01000-8","DOIUrl":"10.1007/s40258-025-01000-8","url":null,"abstract":"<div><h3>Background</h3><p>In the absence of long-term data, structured expert elicitation gathers expert judgments and associated uncertainties to assess the clinical plausibility of long-term extrapolations.</p><h3>Objective</h3><p>The objective of this study was to obtain expert estimates of expected long-term outcomes for advanced renal cell carcinoma treatments to inform cost-effectiveness analysis for National Institute for Health and Care Excellence (NICE)’s pathways pilot.</p><h3>Methods</h3><p>Using materials from the structured expert elicitation resources (STEER) repository, aligned with the Medical Research Council (MRC) protocol, the exercise was planned and conducted. Aiming for 5–10 oncologists from diverse UK geographies and settings, experts estimated progression-free survival (PFS) at three landmark timepoints for 21 disease-risk-prior treatment combinations and overall survival for best supportive care. Within an 8-week timeframe, we piloted with one clinician, conducted online training, collected responses via an online survey using the roulette method and mathematically aggregated results through linear opinion pooling.</p><h3>Results</h3><p>Nine experts participated (question response rate: 95%). For first-line intermediate/poor-risk patients, clinicians projected similar PFS for three immune oncology/tyrosine kinase inhibitor (TKI) combinations from 5 years onward and comparable PFS for two TKI monotherapies. Nivolumab + ipilimumab was anticipated to achieve the highest PFS amongst first-line therapies. Expert reasoning incorporated treatment class, clinical experience, and awareness of trial data optimism. Expert estimates were generally somewhat optimistic compared with observed UK real-world evidence and pessimistic compared with observed trial data.</p><h3>Conclusions</h3><p>Structured expert elicitation is a pragmatic, efficient approach for informing long-term survival extrapolations in the context of a rapidly evolving treatment pathway. We demonstrated that expert elicitation is possible even for complex decision problems in a relatively short timeframe.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 6","pages":"1073 - 1083"},"PeriodicalIF":3.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940039","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 Deep Brain Stimulation for Advanced Parkinson's Disease in Egypt.","authors":"Hesham Radwan, Zeiad Yousry Fayed, Tarek Elserry, Mazen T Alkarras, Ali Shalash, Zahraa Hassan Shehata, Nour Walid Noureldin, Andrew Metry, Ahmed Kamel Basha","doi":"10.1007/s40258-025-00999-0","DOIUrl":"https://doi.org/10.1007/s40258-025-00999-0","url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation (DBS) has proven efficacy in advanced Parkinson's disease (PD) and is the current standard of care for these patients. However, its cost-effectiveness in low- and middle-income settings has not been assessed before.</p><p><strong>Objectives: </strong>This study aims to assess the cost-effectiveness of DBS compared with best medical therapy (BMT) in advanced PD from a societal perspective in Egypt.</p><p><strong>Methods: </strong>We developed a Markov model with a 15-year time horizon and annual cycles to compare DBS with BMT. The cohort was aged 55-years-old at model entry and transitioned between three states: DBS, BMT, or death. Effectiveness was measured by improvement in the Unified Parkinson's Disease Rating Scale (UPDRS) and reduction in drug doses. The main outcome was quality-adjusted life years (QALYs) mapped from the UPDRS scores. The model included medical, informal care, and indirect costs. Both costs and utilities were discounted at an annual rate of 3.5%.</p><p><strong>Results: </strong>DBS had yielded an increase of 1.4 QALYs per patient at an additional cost of 1,159,150 Egyptian pounds (EGP)/patient ($25,566). This results in an incremental cost-effectiveness ratio (ICER) of 830,726 EGP/QALY ($18,322/QALY). Patients with DBS have lower costs for medications, hospitalizations, informal care, and productivity loss. The main cost driver in the DBS arm is the device and implantation procedure costs, which accounted for 70% of total costs. The model was most sensitive to informal care costs.</p><p><strong>Conclusions: </strong>DBS markedly improves the quality of life for advanced patients with PD and reduces informal care and indirect costs. However, at its current price, the ICER exceeds the Egyptian cost-effectiveness threshold.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940019","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":"Deriving Health Utility Values Using Mapping Methods Among the Chinese Population: A Systematic Review.","authors":"Shitong Xie, Tianqi Hong, Jialu Geng, Chang Luo, Haoran Fang, Jing Wu","doi":"10.1007/s40258-025-00992-7","DOIUrl":"https://doi.org/10.1007/s40258-025-00992-7","url":null,"abstract":"<p><strong>Objectives: </strong>Despite an increasing number of mapping studies being conducted in China, there is an absence of a systematic reviews, which makes it difficult to inform the applications and further assess the methodological consistency, accuracy, and applicability of existing mapping studies. The objective of this review is to consolidate existing evidence, identify methodological gaps, and provide recommendations for improving mapping studies conducted among the Chinese population.</p><p><strong>Methods: </strong>A systematic literature search was conducted in 14 databases from inception to May 31, 2025 to identify studies that developed mapping algorithms to estimate health utility values, specifically among Chinese populations. A data template was applied to extract dataset information, source and target measures, mapping types (direct vs indirect), models used, goodness-of-fit indicators, validation methods, and the optimal mapping algorithms selected. Potential challenges for future related studies were further discussed.</p><p><strong>Results: </strong>A total of 33 studies was included. Most studies (87.9%) focused on mapping disease-specific non-preference-based measures (PBMs) to generic PBMs. The studies covered a broad range of disease areas, including oncology (36.4%), musculoskeletal disorders (15.2%), metabolic diseases (15.2%), cardiovascular diseases (9.1%), and neurological conditions (6.1%). All studies used direct mapping, with the ordinary least squares model (n = 37) being used most frequently, followed by Tobit model (n = 32) and Beta model (n = 22). Eleven studies explored indirect mapping, with the Ordered Logit and Ordered Probit models being the most employed techniques. Thirty-two studies conducted internal validation, with the N-fold cross-validation being the most used method-no study conducted external validation. The sample size ranged from 133 to 3320, with a median sample size of 553. Conducted conceptual analysis was performed in 81.8% of the studies to assess the degree of overlap between the source measure and target measure; 72.7% of the studies reported the utility/score distributions, and 15.2% of studies further reported the response distributions.</p><p><strong>Conclusion: </strong>This systematic review provides insights into methodologies employed in mapping studies in China and identifies key areas for improvement. Addressing issues related to sample size, conceptual overlap, model selection, and validation methods will enhance the quality and applicability of mapping algorithms, ultimately supporting more robust cost-utility analyses in the Chinese healthcare system.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871093","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 Reconciled Method for Evaluating the Cost-Effectiveness of Implementation Programmes: Illustrated by Quality Improvement Programmes to Increase the Uptake of Magnesium Sulphate in Preterm Births.","authors":"Carlos Sillero-Rejon, William Hollingworth, Brent C Opmeer, Karen Luyt, Hugh McLeod","doi":"10.1007/s40258-025-00993-6","DOIUrl":"https://doi.org/10.1007/s40258-025-00993-6","url":null,"abstract":"<p><strong>Background: </strong>Methods for the economic evaluation of implementation initiatives to increase the uptake of cost-effective healthcare interventions are not standardised. Value of implementation and policy cost-effectiveness are two proposed approaches. This research aims to compare these two methods and propose a standardised approach. To illustrate this, we evaluated two implementation programmes to increase magnesium sulphate (MgSO₄) uptake in preterm labour to reduce the risk of cerebral palsy: (i) the National PReCePT Programme (NPP), which provided regional support and funded clinical time in maternity units in England, and (ii) an enhanced support programme (ESP) with additional unit-level coaching and extra funded time, which was nested within the NPP and subject to a cluster randomised control trial.</p><p><strong>Methods: </strong>After summarising value of implementation and policy cost-effectiveness methods, we explored the extent to which the two methods can be viewed as mathematically equivalent for the purpose of evaluating the NPP (versus pre-existing trends) and the ESP (versus the NPP) calculating their incremental cost-effectiveness ratios, net monetary benefits and their probability of being cost-effective.</p><p><strong>Results: </strong>We demonstrate how the value of implementation and policy cost-effectiveness approaches can be expressed in equivalent terms and set out our standardised stepwise method for evaluating the NPP (versus pre-existing trends) and the ESP (versus the NPP). Our method found that the NPP generated a net monetary benefit of £30,247 per maternity unit over 12 months, with a 98% probability of being cost-effective. In contrast, the ESP generated a net monetary loss of £28,682 per unit compared with the NPP, with a 22% probability of being cost-effective.</p><p><strong>Discussion: </strong>Our standardised method could promote a more systematic assessment of the value for money of implementation interventions.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820427","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":"Measuring and Valuing Health Using EuroQol Instruments: New Developments 2025 and Beyond","authors":"Nancy J. Devlin,&nbsp;Feng Xie,&nbsp;Bernhard Slaap,&nbsp;Elly Stolk","doi":"10.1007/s40258-025-00989-2","DOIUrl":"10.1007/s40258-025-00989-2","url":null,"abstract":"<div><p>The health-related quality of life (HRQoL) instruments developed by EuroQol, an international not-for-profit organisation, have earned a unique position in health economics and outcomes research. The original instrument, EQ-5D-3L, aimed to provide a concise, generic way of measuring and valuing HRQoL in adults that would enable broad comparability of HRQoL across populations and facilitate estimation of quality-adjusted life years (QALYs). These goals remain central to efforts to develop new instruments; to strengthen methods and evidence in measuring and valuing HRQoL; and to expand the use of HRQoL evidence to improve decision making. These initiatives are facilitated by the EuroQol Research Foundation’s funding of research and provision of support for instrument users; the commitment of an international community of researchers; and the support of a professional staff team. This paper provides an overview of EuroQol’s current suite of instruments: EQ-5D-3L and EQ-5D-5L (for adults) and EQ-5D-Y-3L and EQ-5D-Y-5L (for children) and key elements of its current research agenda. We summarise research underway to expand measurement to very young children (EQ-TIPS), and to expand what is measured (the EuroQol Health and Wellbeing instrument EQ-HWB; and the EQ-5D Bolt-on Toolbox). Research is also generating new valuation methods—such as the development of discrete choice experiment methods that incorporate duration and account for time preference—and strengthening the application of instruments, e.g., to monitor population health and health inequalities (EQ-DAPHNIE). We conclude by highlighting ongoing challenges and their implications for the future of measurement and valuation of HRQoL.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 6","pages":"947 - 960"},"PeriodicalIF":3.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-025-00989-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Naloxone Distribution for Opioid Users in the USA: A Cost-Utility Analysis of Academic Detailing to Clinicians","authors":"Olivia Yip,&nbsp;Mark Bounthavong","doi":"10.1007/s40258-025-00991-8","DOIUrl":"10.1007/s40258-025-00991-8","url":null,"abstract":"<div><h3>Background</h3><p>Opioid overdose remains a leading cause of mortality in the USA. Although distributing naloxone to laypersons for use during witnessed opioid overdoses has been shown to effectively reduce overdose deaths, clinician awareness of naloxone prescribing remains low. Academic detailing (AD) has been reported to be an effective strategy to increase naloxone distribution to individuals at risk of opioid-related overdose/death.</p><h3>Objective</h3><p>This study evaluated the cost effectiveness of an academic detailing program aimed at promoting naloxone prescribing for adults at risk of opioid-related overdose compared to no intervention (non-AD program). </p><h3>Methods</h3><p>A Markov model with an integrated decision tree was developed to estimate the costs and outcomes associated with the AD program over a lifetime horizon from the US payer perspective. Model robustness was tested using sensitivity and scenario analyses.</p><h3>Results</h3><p>The results indicated that the AD program incurred a total direct cost of US$6280 and achieved 16.52 quality-adjusted life years (QALYs). In comparison, the non-AD program incurred a total direct cost of US$5971 and achieved 15.92 QALYs. The incremental cost-effectiveness ratio for the AD program was US$514 per QALY gained with an incremental net monetary benefit of US$29,739. Sensitivity and scenario analyses confirmed the robustness of these findings, which suggest that AD is a cost-effective strategy for improving survival and quality of life in individuals at risk of opioid overdose.</p><h3>Conclusions</h3><p>For decision makers seeking to address the opioid crisis, implementing an academic detailing program represents a cost-effective option at a willingness-to-pay threshold of US$50,000 per QALY gained.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 6","pages":"1115 - 1130"},"PeriodicalIF":3.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-025-00991-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}