Femke J. C. Jacobs, Tim M. Govers, Jurgen J. Fütterer, Annenienke van de Ven, Maroeska M. Rovers
{"title":"提高库欣病垂体手术成功率的创新方法：成本效益视角","authors":"Femke J. C. Jacobs, Tim M. Govers, Jurgen J. Fütterer, Annenienke van de Ven, Maroeska M. Rovers","doi":"10.1111/cen.15263","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>Patients require additional treatment when pituitary surgery for Cushing's disease is unsuccessful. Exciting innovations in pituitary surgery bring hope for achieving better outcomes. Quantifying the potential value of these innovations using early health economic modelling can provide guidance throughout their development. The aim of this study was to explore the conditions for success of these innovations using cost-effectiveness analyses.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>The model consists of a decision tree and state-transition model with a 10-year time horizon.</p>\n </section>\n \n <section>\n \n <h3> Patients</h3>\n \n <p>The model simulates the clinical management of patients with Cushing's disease and pituitary surgery as primary treatment.</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>Model input was derived from literature and expert opinion. Model outcomes were incremental healthcare costs and incremental quality-adjusted life-years (QALY). We performed scenario analyses, including a headroom and threshold analysis, to determine the maximum innovation price for cost-effectiveness. Probabilistic sensitivity analysis and one-way sensitivity analyses were performed to address the impact of uncertainty on outcome parameters.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The headroom analysis showed that per patient 0.028 QALYs could be gained and 2082 euros could be saved over 10 years. With a willingness to pay of 80,000 euros, the maximum price of an innovation is 4288 euros (95% CI: 3377–5181) to reach cost-effectiveness. Sensitivity analyses showed that utility values mainly determined cost-effectiveness.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Our early health economic model exploring the conditions for success of innovations in pituitary surgery shows room for improvement, but also the importance of accurate health-related quality of life data to assess the economic value of innovations in individuals with CD.</p>\n </section>\n </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"216-224"},"PeriodicalIF":2.4000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15263","citationCount":"0","resultStr":"{\"title\":\"Innovative Approaches to Improve the Success of Pituitary Surgery in Cushing's Disease: A Cost-Effectiveness Perspective\",\"authors\":\"Femke J. C. Jacobs, Tim M. Govers, Jurgen J. Fütterer, Annenienke van de Ven, Maroeska M. Rovers\",\"doi\":\"10.1111/cen.15263\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>Patients require additional treatment when pituitary surgery for Cushing's disease is unsuccessful. Exciting innovations in pituitary surgery bring hope for achieving better outcomes. Quantifying the potential value of these innovations using early health economic modelling can provide guidance throughout their development. The aim of this study was to explore the conditions for success of these innovations using cost-effectiveness analyses.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>The model consists of a decision tree and state-transition model with a 10-year time horizon.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Patients</h3>\\n \\n <p>The model simulates the clinical management of patients with Cushing's disease and pituitary surgery as primary treatment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Measurements</h3>\\n \\n <p>Model input was derived from literature and expert opinion. Model outcomes were incremental healthcare costs and incremental quality-adjusted life-years (QALY). We performed scenario analyses, including a headroom and threshold analysis, to determine the maximum innovation price for cost-effectiveness. Probabilistic sensitivity analysis and one-way sensitivity analyses were performed to address the impact of uncertainty on outcome parameters.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The headroom analysis showed that per patient 0.028 QALYs could be gained and 2082 euros could be saved over 10 years. With a willingness to pay of 80,000 euros, the maximum price of an innovation is 4288 euros (95% CI: 3377–5181) to reach cost-effectiveness. 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Innovative Approaches to Improve the Success of Pituitary Surgery in Cushing's Disease: A Cost-Effectiveness Perspective
Objective
Patients require additional treatment when pituitary surgery for Cushing's disease is unsuccessful. Exciting innovations in pituitary surgery bring hope for achieving better outcomes. Quantifying the potential value of these innovations using early health economic modelling can provide guidance throughout their development. The aim of this study was to explore the conditions for success of these innovations using cost-effectiveness analyses.
Design
The model consists of a decision tree and state-transition model with a 10-year time horizon.
Patients
The model simulates the clinical management of patients with Cushing's disease and pituitary surgery as primary treatment.
Measurements
Model input was derived from literature and expert opinion. Model outcomes were incremental healthcare costs and incremental quality-adjusted life-years (QALY). We performed scenario analyses, including a headroom and threshold analysis, to determine the maximum innovation price for cost-effectiveness. Probabilistic sensitivity analysis and one-way sensitivity analyses were performed to address the impact of uncertainty on outcome parameters.
Results
The headroom analysis showed that per patient 0.028 QALYs could be gained and 2082 euros could be saved over 10 years. With a willingness to pay of 80,000 euros, the maximum price of an innovation is 4288 euros (95% CI: 3377–5181) to reach cost-effectiveness. Sensitivity analyses showed that utility values mainly determined cost-effectiveness.
Conclusion
Our early health economic model exploring the conditions for success of innovations in pituitary surgery shows room for improvement, but also the importance of accurate health-related quality of life data to assess the economic value of innovations in individuals with CD.
期刊介绍：
Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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