Applied Health Economics and Health Policy最新文献

{"title":"Value is Gendered: The Need for Sex and Gender Considerations in Health Economic Evaluations","authors":"Martina Mchenga,&nbsp;Lavanya Vijayasingham,&nbsp;Rajalakshmi RamPrakash,&nbsp;Michelle Remme","doi":"10.1007/s40258-024-00930-z","DOIUrl":"10.1007/s40258-024-00930-z","url":null,"abstract":"<div><p>Economic evaluations play a crucial role in health resource allocation by assessing the costs and effects of various interventions. However, existing methodologies often overlook significant differences related to sex and gender, leading to a ‘blind spot’ in understanding patient heterogeneity. This paper highlights how biological and social factors influence costs and health outcomes differently for women, emphasising the need for a more explicit consideration of these differences in economic evaluations to ensure efficient and equitable resource allocation. The paper is structured to first outline how sex and gender factors impact costs and outcomes. It then identifies biases in current economic evaluation methods and practices, using real-world examples to illustrate the implications of these biases on policymaking and health equity. Notably, we argue that neglecting gender considerations can lead to inefficiencies and inequities in healthcare resource distribution. Key areas of gender bias include the estimation of productivity losses, quality of life variations and the secondary household effects of interventions. The analysis reveals that women often face higher healthcare costs and experience different health outcomes due to systemic biases in treatment and care. The paper concludes with practical recommendations for analysts, decision makers and research funders, advocating for the integration of sex and gender-responsive methodologies in health economic evaluations. Ultimately, this work calls for a paradigm shift in health economics to better reflect the complexities of sex and gender and improve health outcomes for all.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 2","pages":"171 - 181"},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-024-00930-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811932","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":"Assessing the Direct Impact of Death on Discrete Choice Experiment Utilities","authors":"Hossein Ameri,&nbsp;Thomas G. Poder","doi":"10.1007/s40258-024-00929-6","DOIUrl":"10.1007/s40258-024-00929-6","url":null,"abstract":"<div><h3>Background</h3><p>The dead state can affect the value sets derived from discrete choice experiments (DCEs). Our aim was to empirically assess the direct impact of the immediate death state on health utilities using discrete choice experiment with time (DCE_TTO).</p><h3>Methods</h3><p>A sample of the general population in Quebec, Canada, completed two approaches: DCE_TTO followed by a best-worst scaling with time (BWS_TTO) (hereafter referred to as DCE_BWS), versus DCE_TTO followed by the dominated option and the immediate death state (hereafter referred to as DCE_DOD), both designed with the SF-6Dv2. In DCE_BWS, all participants first completed 10 DCE_TTO choices (i.e., option A vs B), followed by 3 BWS_TTO. In DCE_DOD, the same participants first completed the same 10 DCE_TTO choices, followed by a repeated choice between the dominated option (i.e., A or B) and the immediate death state. A conditional logit model was used to estimate value sets. The performance of models was assessed using goodness of fit using Bayesian information criterion, parameters’ logical consistency, and levels’ significance. The direct impact of the death state on DCE latent utilities was evaluated by examining the magnitude of coefficients, assessing the agreement among the value sets estimated by DCE_TTO with DCE_BWS and with DCE_DOD using Bland-Altman plots, the proportion of worst-than-dead (WTD) health states, and analyzing the range of estimated values.</p><h3>Results</h3><p>From 398 participants, a total of 348 participants were included for final analysis. The number of parameters with illogical consistency and non-significant coefficients was lower in DCE_BWS. The observed consistency in the relative importance of dimensions across all approaches suggests a stable and reliable ranking. The utility range for DCE_DOD (− 0.921 to 1) was narrower than for DCE_TTO (− 1.578 to 1) and DCE_BWS (− 1.150 to 1). The DCE_DOD estimated a lower percentage of WTD health states (20.01 %) compared to DCE_TTO (47.19 %) and DCE_BWS (33.73 %). The agreement between DCE_TTO and DCE_BWS was slightly stronger than between DCE_TTO and DCE_DOD, and the mean utility values were higher in DCE_DOD than in DCE_BWS.</p><h3>Conclusions</h3><p>The inclusion of the immediate death state directly within DCE increased utility values. This increase was higher when the immediate death was included in a sequence within a DCE_TTO (i.e., DCE_DOD) than when it was included in a continuum of DCE_TTO (i.e., DCE_BWS). The use of DCE_DOD was potentially better suited to incorporate the dead state into a DCE.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 2","pages":"319 - 327"},"PeriodicalIF":3.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791077","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":"Acknowledgement to Referees","authors":"","doi":"10.1007/s40258-024-00931-y","DOIUrl":"10.1007/s40258-024-00931-y","url":null,"abstract":"","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 1","pages":"1 - 3"},"PeriodicalIF":3.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783619","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":"Evaluating the Cost-Effectiveness of Etranacogene Dezaparvovec Gene Therapy for Hemophilia B Treatment in the USA.","authors":"Jyotirmoy Sarker, Jeffrey A Tice, David M Rind, Surrey M Walton","doi":"10.1007/s40258-024-00932-x","DOIUrl":"https://doi.org/10.1007/s40258-024-00932-x","url":null,"abstract":"<p><strong>Background: </strong>Hemophilia B, a severe genetic disorder, involves substantial treatment costs and frequent interventions. Etranacogene dezaparvovec (EDZ) is a recently approved gene therapy for hemophilia B.</p><p><strong>Objective: </strong>This study evaluates the cost-effectiveness of EDZ compared with conventional factor IX (FIX) prophylaxis.</p><p><strong>Methods: </strong>A semi-Markov model simulated a cohort of adult males with severe hemophilia B to assess the economic impact of EDZ versus FIX prophylaxis over a lifetime horizon from a health system perspective in the USA. Inputs derived from clinical trials included therapy durability and transition probabilities based on Pettersson Scores. Scenario analyses incorporated frameworks suggested by the Institute for Clinical and Economic Review for single or short-term transformative therapies.</p><p><strong>Results: </strong>Base-case analysis showed that at a cost of US$3.5 million, EDZ led to lifetime cost savings of US$11 million and an additional 0.64 quality-adjusted life years (QALYs) compared with FIX. However, FIX has extremely high annual costs. When annual cost offsets attributed to EDZ were capped at US$150,000, EDZ was found to have a threshold price of US$3.1 million at a willingness-to-pay of US$150,000 per QALY.</p><p><strong>Conclusion: </strong>EDZ proved to be a dominant strategy over FIX prophylaxis in the base-case scenario, providing large cost savings and slightly better outcomes. The substantial costs associated with FIX are a primary driver behind these results. The introduction of cost-offset caps significantly affects the value-based price of EDZ. Using caps on cost offsets in considering price can help to balance affordability and value in the health system.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765795","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":"Assessing the Value of New Antimicrobials: Evaluations of Cefiderocol and Ceftazidime-Avibactam to Inform Delinked Payments by the NHS in England","authors":"Beth Woods,&nbsp;Ben Kearns,&nbsp;Laetitia Schmitt,&nbsp;Dina Jankovic,&nbsp;Claire Rothery,&nbsp;Sue Harnan,&nbsp;Jean Hamilton,&nbsp;Alison Scope,&nbsp;Shijie Ren,&nbsp;Laura Bojke,&nbsp;Mark Wilcox,&nbsp;William Hope,&nbsp;Colm Leonard,&nbsp;Philip Howard,&nbsp;David Jenkins,&nbsp;Alan Ashworth,&nbsp;Andrew Bentley,&nbsp;Mark Sculpher","doi":"10.1007/s40258-024-00924-x","DOIUrl":"10.1007/s40258-024-00924-x","url":null,"abstract":"<div><h3>Objectives</h3><p>The UK has recently established subscription-payment agreements for two antimicrobials: cefiderocol and ceftazidime-avibactam. This article summarises the novel value assessments that informed this process and lessons learned for future pricing and funding decisions.</p><h3>Methods</h3><p>The evaluations used decision modelling to predict population incremental net health effects (INHEs), informed by systematic reviews, evidence syntheses, national surveillance data and structured expert elicitation.</p><h3>Results</h3><p>Significant challenges faced during the development of the evaluations led to profound uncertainty in the estimates of INHEs. The value assessment required definition of the population expected to receive the new antimicrobials; estimating value within this heterogenous population; assessing comparative efficacy using antimicrobial susceptibility data due to the absence of relevant clinical data; and predicting population-level benefits despite poor data on current numbers of drug-resistant infections and uncertainties around emerging resistance. Though both antimicrobials offer the potential to treat multi-drug resistant infections, the benefits estimated were modest due to the rarity of true pan-resistance, low life expectancy of the patient population and difficulty of identifying and quantifying additional sources of value.</p><h3>Conclusions</h3><p>Assessing the population INHEs of new antimicrobials was complex and resource intensive. Future evaluations should continue to assemble evidence relating to areas of expected usage, patient numbers over time and comparative effectiveness and safety. Projections of patient numbers could be greatly enhanced by the development of national level linked clinical, prescribing and laboratory data. A practical approach to synthesising these data would be to combine expert assessments of key parameters with a simple generic decision model.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 1","pages":"5 - 17"},"PeriodicalIF":3.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765794","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":"Estimating a Drug’s Price After Loss of Exclusivity as a Function of Its Cost of Goods Sold","authors":"Melanie D. Whittington,&nbsp;T. Joseph Mattingly","doi":"10.1007/s40258-024-00928-7","DOIUrl":"10.1007/s40258-024-00928-7","url":null,"abstract":"<div><h3>Background</h3><p>The majority of cost-effectiveness analyses of pharmaceuticals do not incorporate future price changes that are expected once generic competition enters the market. A common rationale for not doing so is the uncertainty around what postloss of exclusivity price to model. The objective of this study is to assess if a drug’s price postloss of exclusivity can be estimated on the basis of its cost of goods sold (COGS).</p><h3>Methods</h3><p>First, stakeholders were engaged to understand pricing practices for generic drugs. Then peer-reviewed literature, gray literature, and manufacturer financial statements were reviewed to estimate the typical manufacturer profit margin over COGS. Using pricing data from the Mark Cuban CostPlus Drug Company (MCCPDC), estimates of COGS were calculated by drug form. Finally, a COGS-based approach to estimating a drug’s price postloss of exclusivity was tested.</p><h3>Results</h3><p>COGS were estimated for 2168 unique National Drug Codes (NDCs) reported in the MCCPDC price list by removing the typical manufacturer profit margin (50%) from the manufacturer prices (net of any markup or fees from the MCCPDC). A tablet/capsule, the most common form in the price list, had a median COGS of $0.10 per tablet/capsule. Estimating a drug’s price postloss of exclusivity as the median COGS for that drug form times two (to reflect a 50% profit margin), produces estimates of postloss of exclusivity prices that account for drug-specific attributes.</p><h3>Conclusions</h3><p>This study provides an evidence-based approach to estimate a drug’s price postloss of exclusivity as a function of its COGS for incorporation into cost-effectiveness analyses.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 1","pages":"75 - 83"},"PeriodicalIF":3.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724967","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":"Exploratory Cost-Utility Analysis of a 37-Gene Panel Versus Usual Care to Guide Therapy for Patients with Intermediate-Risk Myeloid Malignancies.","authors":"Daniel Lindsay, Andrea Henden, Ricky Nelles, Thomas M Elliott, Louisa G Collins","doi":"10.1007/s40258-024-00927-8","DOIUrl":"https://doi.org/10.1007/s40258-024-00927-8","url":null,"abstract":"<p><strong>Objective: </strong>Genomic risk stratification methods for myeloid malignancies have moved beyond conventional karyotyping and single gene approaches to better define disease behaviour. Next-generation sequencing has been established as the new standard-of-care tool to accurately define prognosis at diagnosis and guide therapy decisions. We aimed to determine the economic value of a 37-gene panel test for informing subsequent care for patients with intermediate-risk myeloid malignancies.</p><p><strong>Method: </strong>We performed an exploratory cost-utility analysis of a 37-gene panel test to inform stem cell transplantation therapy in patients with myeloid malignancies in Queensland, Australia. Clinician surveys provided data on management choice with and without genomics information while both published and individual-level data were used for healthcare costs, quality of life, relapse rates and survival data. We used a decision-analytic cohort model with Markov chains and 5000 simulations to derive the incremental cost per quality-adjusted life year (QALY) gained. Scenario, one-way and probabilistic sensitivity analyses were undertaken to test input variation on the stability of the main findings.</p><p><strong>Results: </strong>Over 10 years, the model predicted mean costs of AU$125,561 for the panel testing strategy and AU$117,045 for usual care, indicating an incremental cost of AU$8516 for panel testing. The corresponding mean QALYs were 4.52 for panel testing and 4.46 for usual care, producing a cost of AU$153,854 per QALY gained. In the Australian system, the likelihood that panel testing would be cost effective was <1 % and would have a more favourable cost-effective profile at a willingness-to-pay of AU$140,000 per QALY gained.</p><p><strong>Conclusions: </strong>Driven by small gains in survival and relapse rates following therapies, genomic panel sequencing for myeloid malignancies in people with intermediate-risk disease is unlikely to be cost effective in Australia.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613634","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":"Using Genomic Heterogeneity to Inform Therapeutic Decisions for Metastatic Colorectal Cancer: An Application of the Value of Heterogeneity Framework.","authors":"Reka E Pataky, Stuart Peacock, Stirling Bryan, Mohsen Sadatsafavi, Dean A Regier","doi":"10.1007/s40258-024-00926-9","DOIUrl":"https://doi.org/10.1007/s40258-024-00926-9","url":null,"abstract":"<p><strong>Background and objective: </strong>Mutations in KRAS and NRAS are predictive of poor response to cetuximab and panitumumab, two anti-epidermal growth factor receptor (EGFR) monoclonal antibodies used in metastatic colorectal cancer (mCRC). Our objective was to explore the value of using KRAS and NRAS mutation status to inform third-line anti-EGFR therapy for mCRC using the value of heterogeneity (VOH) framework.</p><p><strong>Methods: </strong>We used administrative data to identify mCRC patients who were potentially eligible for third-line therapy in 2006-2019 in British Columbia (BC), Canada. We compared three alternative stratification policies in place during the study period: the unstratified policy where anti-EGFR therapy was not offered (2006-2009), stratification by KRAS mutation (2009-2016), and stratification by KRAS+NRAS mutation (2016-2019). We used inverse-probability-of-treatment weighting to balance covariates across the three groups. Cost and survival time were calculated using a 3-year time horizon and adjusted for censoring, with bootstrapping to characterize uncertainty. Mean net monetary benefit (NMB) was calculated at a range of threshold values. The VOH of using KRAS and NRAS mutation status to inform treatment selection was calculated as the change in NMB with increasing stratification, under current (static VOH) or perfect (dynamic VOH) information.</p><p><strong>Results: </strong>We included 2664 patients in the analysis. At a willingness-to-pay of CA$100,000/ life-year gained (LYG), stratification on KRAS mutation status provided a static VOH of CA$1565 per patient; further stratification on KRAS+NRAS provided additional static VOH of CA$594. The static VOH exceeded the marginal cost of genomic testing under both policies.</p><p><strong>Conclusions: </strong>Stratification of anti-EGFR therapy by KRAS and NRAS mutation status can provide additional value at a threshold of CA$100,000/LYG. There is diminishing marginal value and increasing marginal costs as the policy becomes more stratified. The VOH framework can illustrate the value of subgroup-specific decisions in a comprehensive way, to better inform targeted treatment policies.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613635","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":"Budget Impact Analysis of Implementing Antenatal Care Recommendations for Positive Pregnancy Outcomes at Public Primary Facilities in Tanzania","authors":"Amisa Tindamanyile Chamani,&nbsp;Bjarne Robberstad,&nbsp;Amani Thomas Mori","doi":"10.1007/s40258-024-00923-y","DOIUrl":"10.1007/s40258-024-00923-y","url":null,"abstract":"<div><h3>Background</h3><p>Tanzania recently changed its antenatal care (ANC) guidelines to reduce perinatal mortality and improve the experience of pregnancy care. The new guideline recommends increasing the number of ANC visits from four to eight and introducing one routine ultrasound scan, among other recommendations. We estimated the budget impact of implementing the new guideline compared to the previous focused ANC guideline at public dispensaries and health centers.</p><h3>Method</h3><p>In a dynamic Markov model, we prospectively followed annual cohorts of between 2.3 and 2.6 million pregnant women who will be attending ANC at dispensaries and health centers for 5 years. We allowed a population of pregnant women into the model every year and women exit the model at delivery. We calculated the cost of medicines, medical supplies, and laboratory supplies required to produce services from a public health system perspective. Our model neither estimated condition-related costs nor health effects. The budget impact was calculated as the difference in the estimated costs between the two guidelines. We conducted scenario analyses to explore attending more visits and different assumptions to calculate the target population.</p><h3>Results</h3><p>We estimated that implementing the new ANC guideline would have a cumulative budget impact of around US$154 million over 5 years. The budget required will increase from US$137 million under the focused ANC guideline to US$291 million under the new guideline. Laboratory supplies will consume 47% of the estimated budget under the new guideline. We expect the annual budget impact to be US$38 million in the first year of implementation and US$32 million in the fifth year. We assumed that by the fifth year, 82% of all pregnant women would have had four or more visits. The budget impact would increase to US$214 million, with the proportion of pregnant women attending four or more ANC visits reaching 90% within 5 years.</p><h3>Conclusion</h3><p>Scaling up the implementation of the new ANC guideline at public dispensaries and health centers may substantially increase the supplies required to produce ANC services, particularly laboratory supplies. Studies on the health impact of the new guideline are warranted to estimate the value for money.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 1","pages":"93 - 104"},"PeriodicalIF":3.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-024-00923-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493486","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":"Cost-Effectiveness of Perinatal Depression Screening: A Scoping Review","authors":"Xinyue Xie,&nbsp;Sihan Lin,&nbsp;Yi Xia,&nbsp;Di Liang","doi":"10.1007/s40258-024-00922-z","DOIUrl":"10.1007/s40258-024-00922-z","url":null,"abstract":"<div><h3>Objective</h3><p>Perinatal depression (PND) has emerged as a significant public health concern. There is no consensus among countries or organizations on whether to screen for PND. Despite the growing body of evidence regarding the economic value of PND screening, its cost-effectiveness remains inadequately understood due to the heterogeneity of existing studies. This study aims to synthesize the available global evidence on the cost-effectiveness of PND screening compared to routine or usual care to provide a clearer understanding of its economic value.</p><h3>Methods</h3><p>A detailed search strategy was predetermined to identify peer-reviewed publications that evaluated the cost-effectiveness of PND screening. We designed a scoping literature review protocol and searched electronic databases, including MEDLINE, EMBASE, and Web of Science, for studies published from inception to 10 December 2023. We included studies that conducted full economic evaluations comparing PND screening with usual care or other comparators and excluded studies that were not in English or lacked full texts. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to evaluate the reporting quality of the studies. Then, the data regarding costs and effectiveness were extracted and summarized narratively.</p><h3>Results</h3><p>A total of ten eligible studies were included, all of which were evaluated as being of high reporting quality. Nine of these studies compared the economic value of PND screening with usual care without screening, with eight finding that PND screening was generally more cost-effective. The remaining study evaluated the cost-effectiveness of two psychosocial assessment models and indicated that both effectively identified women “at risk”. Across studies, PND screening ranged from being dominant (cheaper and more effective than usual care without screening) to costing USD 17,644 per quality adjusted life year (QALY) gained. Most included studies used decision trees or Markov models to test if PND screening was cost-effective. Although current economic evaluation studies have mostly suggested PND screening could be more cost-effective than usual care without screening, there is high heterogeneity in terms of participants, screening strategies, screening settings, and perspectives across studies.</p><h3>Conclusions</h3><p>Despite varied settings and designs, most studies consistently indicate PND screening as cost-effective. Further evidence is also required from low- and middle-income countries (LMIC), non-Western countries, and randomized controlled trials (RCTs) to draw a more robust conclusion.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"23 1","pages":"51 - 64"},"PeriodicalIF":3.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493487","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}