对子宫内腔手术后用于防止宫腔内粘连形成的宫内间隔器进行成本效益分析。

IF 2.9 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Medical Economics Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI:10.1080/13696998.2023.2298584
Luke Schmerold, Coby Martin, Aashay Mehta, Dhruv Sobti, Ajit Kumar Jaiswal, Jatinder Kumar, Ian Feldberg, Malcolm G Munro, Won Chan Lee
{"title":"对子宫内腔手术后用于防止宫腔内粘连形成的宫内间隔器进行成本效益分析。","authors":"Luke Schmerold, Coby Martin, Aashay Mehta, Dhruv Sobti, Ajit Kumar Jaiswal, Jatinder Kumar, Ian Feldberg, Malcolm G Munro, Won Chan Lee","doi":"10.1080/13696998.2023.2298584","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess, from a United States (US) payer's perspective, the cost-effectiveness of gels designed to separate the endometrial surfaces (intrauterine spacers) placed following intrauterine surgery.</p><p><strong>Materials and methods: </strong>A decision tree model was developed to estimate the cost-effectiveness of intrauterine spacers used to facilitate endometrial repair and prevent the formation (primary prevention) and reformation (secondary prevention) of intrauterine adhesions (IUAs) and associated pregnancy- and birth-related adverse outcomes. Event rates and costs were extrapolated from data available in the existing literature. Sensitivity analyses were conducted to corroborate the base case results.</p><p><strong>Results: </strong>In this model, using intrauterine spacers for adhesion prevention led to net cost savings for US payers of $2,905 per patient over a 3.5-year time horizon. These savings were driven by the direct benefit of preventing procedures associated with IUA formation ($2,162 net savings) and the indirect benefit of preventing pregnancy-related complications often associated with IUA formation ($3,002). These factors offset the incremental cost of intrauterine spacer use of $1,539 based on an assumed price of $1,800 and the related increase in normal deliveries of $931. Model outcomes were sensitive to the probability of preterm and normal deliveries. Budget impact analyses show overall cost savings of $19.96 per initial member within a US healthcare plan, translating to $20 million over a 5-year time horizon for a one-million-member plan.</p><p><strong>Limitations: </strong>There are no available data on the effects of intrauterine spacers or IUAs on patients' quality of life. Resultingly, the model could not evaluate patients' utility related to treatment with or without intrauterine spacers and instead focused on costs and events avoided.</p><p><strong>Conclusion: </strong>This analysis robustly demonstrated that intrauterine spacers would be cost-saving to healthcare payers, including both per-patient and per-plan member, through a reduction in IUAs and improvements to patients' pregnancy-related outcomes.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"170-183"},"PeriodicalIF":2.9000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A cost-effectiveness analysis of intrauterine spacers used to prevent the formation of intrauterine adhesions following endometrial cavity surgery.\",\"authors\":\"Luke Schmerold, Coby Martin, Aashay Mehta, Dhruv Sobti, Ajit Kumar Jaiswal, Jatinder Kumar, Ian Feldberg, Malcolm G Munro, Won Chan Lee\",\"doi\":\"10.1080/13696998.2023.2298584\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To assess, from a United States (US) payer's perspective, the cost-effectiveness of gels designed to separate the endometrial surfaces (intrauterine spacers) placed following intrauterine surgery.</p><p><strong>Materials and methods: </strong>A decision tree model was developed to estimate the cost-effectiveness of intrauterine spacers used to facilitate endometrial repair and prevent the formation (primary prevention) and reformation (secondary prevention) of intrauterine adhesions (IUAs) and associated pregnancy- and birth-related adverse outcomes. Event rates and costs were extrapolated from data available in the existing literature. Sensitivity analyses were conducted to corroborate the base case results.</p><p><strong>Results: </strong>In this model, using intrauterine spacers for adhesion prevention led to net cost savings for US payers of $2,905 per patient over a 3.5-year time horizon. These savings were driven by the direct benefit of preventing procedures associated with IUA formation ($2,162 net savings) and the indirect benefit of preventing pregnancy-related complications often associated with IUA formation ($3,002). These factors offset the incremental cost of intrauterine spacer use of $1,539 based on an assumed price of $1,800 and the related increase in normal deliveries of $931. Model outcomes were sensitive to the probability of preterm and normal deliveries. Budget impact analyses show overall cost savings of $19.96 per initial member within a US healthcare plan, translating to $20 million over a 5-year time horizon for a one-million-member plan.</p><p><strong>Limitations: </strong>There are no available data on the effects of intrauterine spacers or IUAs on patients' quality of life. Resultingly, the model could not evaluate patients' utility related to treatment with or without intrauterine spacers and instead focused on costs and events avoided.</p><p><strong>Conclusion: </strong>This analysis robustly demonstrated that intrauterine spacers would be cost-saving to healthcare payers, including both per-patient and per-plan member, through a reduction in IUAs and improvements to patients' pregnancy-related outcomes.</p>\",\"PeriodicalId\":16229,\"journal\":{\"name\":\"Journal of Medical Economics\",\"volume\":\" \",\"pages\":\"170-183\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Economics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13696998.2023.2298584\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Economics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13696998.2023.2298584","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

目的:从美国付款人的角度评估宫腔内手术后立即放置的用于分离子宫内膜表面的凝胶(宫腔内间隔物)的成本效益:我们建立了一个决策树模型来估算宫腔内间隔物的成本效益,宫腔内间隔物用于促进子宫内膜修复、防止宫腔内粘连(IUAs)的形成(一级预防)和复发(二级预防)以及相关的妊娠和分娩不良结局。事件发生率和成本是根据现有文献中的数据推算出来的。进行了敏感性分析以证实基础案例的结果:在该模型中,使用宫腔内垫片预防宫腔粘连可在 3.5 年的时间跨度内为每位患者为美国支付方节省净成本 2,905 美元。这些节省的费用主要来自预防与 IUA 形成相关的手术的直接收益(净节省 2162 美元)和预防通常与 IUA 形成相关的妊娠并发症的间接收益(3002 美元)。这些因素抵消了使用宫内间隔器的增量成本 1,539 美元(假定价格为 1,800 美元)和正常分娩增加的相关费用 931 美元。模型结果对早产和正常分娩的概率很敏感。预算影响分析表明,在美国医疗保健计划中,每名初始成员可节省 19.96 美元的总体成本,对于一个拥有 100 万成员的计划而言,5 年的时间跨度可节省 2,000 万美元:局限性:没有关于宫内间隔器或 IUAs 对患者生活质量影响的可用数据。因此,该模型无法评估患者在使用或不使用宫内间隔器治疗时的效用,而是侧重于成本和避免的事件:该分析有力地证明了宫内节育器可通过减少 IUAs 和改善患者的妊娠相关结果为医疗支付方节省成本,包括为每位患者和每位计划成员节省成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A cost-effectiveness analysis of intrauterine spacers used to prevent the formation of intrauterine adhesions following endometrial cavity surgery.

Aim: To assess, from a United States (US) payer's perspective, the cost-effectiveness of gels designed to separate the endometrial surfaces (intrauterine spacers) placed following intrauterine surgery.

Materials and methods: A decision tree model was developed to estimate the cost-effectiveness of intrauterine spacers used to facilitate endometrial repair and prevent the formation (primary prevention) and reformation (secondary prevention) of intrauterine adhesions (IUAs) and associated pregnancy- and birth-related adverse outcomes. Event rates and costs were extrapolated from data available in the existing literature. Sensitivity analyses were conducted to corroborate the base case results.

Results: In this model, using intrauterine spacers for adhesion prevention led to net cost savings for US payers of $2,905 per patient over a 3.5-year time horizon. These savings were driven by the direct benefit of preventing procedures associated with IUA formation ($2,162 net savings) and the indirect benefit of preventing pregnancy-related complications often associated with IUA formation ($3,002). These factors offset the incremental cost of intrauterine spacer use of $1,539 based on an assumed price of $1,800 and the related increase in normal deliveries of $931. Model outcomes were sensitive to the probability of preterm and normal deliveries. Budget impact analyses show overall cost savings of $19.96 per initial member within a US healthcare plan, translating to $20 million over a 5-year time horizon for a one-million-member plan.

Limitations: There are no available data on the effects of intrauterine spacers or IUAs on patients' quality of life. Resultingly, the model could not evaluate patients' utility related to treatment with or without intrauterine spacers and instead focused on costs and events avoided.

Conclusion: This analysis robustly demonstrated that intrauterine spacers would be cost-saving to healthcare payers, including both per-patient and per-plan member, through a reduction in IUAs and improvements to patients' pregnancy-related outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Medical Economics
Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL
CiteScore
4.50
自引率
4.20%
发文量
122
期刊介绍: Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信