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Journal of Medical Economics

Weiting Liao, Jiaxing Huang, David Hutton, Qiu Li
PURPOSE: Pembrolizumab was recently approved in several countries as a first-line treatment for patients with PD-L1 positive, non-small cell lung cancer (NSCLC). However, it is expensive. This study aimed to assess the cost-effectiveness of pembrolizumab in treating advanced NSCLC patients with PD-L1 positive cancer in China. METHODS: A Markov model was developed to compare the cost-effectiveness of pembrolizumab with chemotherapy for patients with PD-L1 expression on at least 50% of NSCLC tumor cells...
January 16, 2019: Journal of Medical Economics
Petri Mankinen, Ville Vihervaara, Saku Torvinen, Janne Martikainen, Erkki Soini
AIM: To estimate the drug administration, travelling, and productivity costs associated with infusion or subcutaneous proteasome inhibitor (PI) treatments (specifically carfilzomib and bortezomib) for multiple myeloma (MM) patients in Finland. MATERIALS AND METHODS: Price tariffs of Finnish hospital districts are used as the basis of invoicing sent to health care service payers. A review of these price tariff lists was conducted and obtained data analyzed to estimate the mean unit cost of PI administration visit...
January 15, 2019: Journal of Medical Economics
Edward J Gibson, Najida Begum, Ian Koblbauer, George Dranitsaris, Danny Liew, Phil McEwan, Yong Yuan, Ariadna Juarez-Garcia, David Tyas, Clive Pritchard
BACKGROUND: Model structure, despite being a key source of uncertainty in economic evaluations, is often not treated as a priority for model development. In oncology, partitioned survival models (PSMs) and Markov models, both types of cohort model, are commonly used but patient responses to newer immuno-oncology (I-O) agents suggest that more innovative model frameworks should be explored. OBJECTIVE: A discussion of the theoretical pros and cons of cohort-level versus patient-level simulation (PLS) models provides the background for an illustrative comparison of I-O therapies, namely nivolumab/ipilimumab combination and ipilimumab alone using patient level data from the CheckMate 067 trial in metastatic melanoma...
January 14, 2019: Journal of Medical Economics
Lisa Aniek de Jong, Judith J Gout-Zwart, Marina van den Bosch, Mike Koops, Maarten J Postma
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of our study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies...
January 7, 2019: Journal of Medical Economics
Laurel Trantham, Mirko V Sikirica, Sean D Candrilli, Victoria S Benson, Divya Mohan, David Neil, Ashish V Joshi
AIMS: Muscle weakness (MW)-attributable healthcare resource utilization (HCRU) and costs in patients with chronic obstructive pulmonary disease (COPD) have not been well-characterized in United States insurance claims databases. The primary objective of this study was to estimate HCRU in patients with evidence of COPD with and without MW diagnosis codes. MATERIALS AND METHODS: This retrospective analysis used the MarketScan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases...
December 24, 2018: Journal of Medical Economics
Rhiannon Kamstra, Mike Durkin, Jennifer Cai, Brahim Bookhart, Marie-Hélène Lafeuille, Dominic Pilon, Sean Tiggelaar, Ameur M Manceur, Patrick Lefebvre
AIMS: To model direct medical costs associated with reductions in cardiovascular disease (CVD) events in T2DM patients reported in the CANVAS and EMPA-REG trials, which assessed the cardiovascular safety of canagliflozin and empagliflozin, respectively. MATERIALS AND METHODS: Costs were modeled from a US managed care organization (MCO) perspective for the CVD outcomes included in both trials: three-point major adverse cardiovascular event (MACE) and its components (cardiovascular-related death, nonfatal myocardial infarction, nonfatal stroke), as well as heart failure requiring hospitalization...
December 21, 2018: Journal of Medical Economics
Mehdi Rezaee, Sadegh Izadi, Khosro Keshavarz, Afshin Borhanihaghighi, Ramin Ravangard
AIMS: Multiple sclerosis (MS) is a chronic, autoimmune and inflammatory disease. If the first-line medicines are not effective enough, specialists will prescribe second-line medicines, such as natalizumab and fingolimod. This study aimed to compare the cost-effectiveness and cost-utility of fingolimod with those of natalizumab in patients with relapsing-remitting multiple sclerosis (RRMS) in Iran, Fars province in 2016. MATERIALS AND METHODS: This study was a cost-effectiveness and cost-utility study in which a Markov model was used...
December 18, 2018: Journal of Medical Economics
June Wy Choon, David Bc Wu, H Y Chong, William Tl Lo, Catherine Sy Chong, W S Chung, Eileena Mc Chui, Brian Tomlinson, Vivian Wy Lee, S C Lee, Kenneth Kc Lee
BACKGROUND: Very few data are available to demonstrate the economic benefit of early paliperidone palmitate once-monthly long-acting injectable (PP1M) treatment in patients with schizophrenia or schizoaffective disorder. METHODS AND MATERIALS: We have retrospectively compared the health care utilization and associated costs of pre and post PPIM treatment in 413 patients with schizophrenia or schizoaffective disorder recruited from 3 major public hospitals providing psychiatric services in Hong Kong...
December 18, 2018: Journal of Medical Economics
Stephen P McKenna, Alice Heaney, Jeanette Wilburn
All instruments designed to measure latent (unobservable) variables, such as patient-reported outcomes (PROs), have three major requirements; a coherent construct theory, a specification equation and the applications of an appropriate response model. The theory guides the selection of content for the questionnaire and the specification equation links the construct theory to scores produced with the instrument. For the specification equation to perform this role, the patient-reported outcome measure (PROM) must employ a response model that generates values for its individual items...
December 17, 2018: Journal of Medical Economics
Stephen P McKenna, Alice Heaney, Jeanette Wilburn, A Jackson Stenner
Patient-reported outcome measures (PROMs) are used to collect information directly from patients. They may cover several different types of outcomes ranging from symptoms, functioning, utility, satisfaction through to quality of life (QoL). They generally consist of self-completed questionnaires that can be administered by means of hard copies or in a range of electronic formats. PROMs vary considerably in terms of the constructs they assess, the care with which they are developed and their scientific quality...
December 17, 2018: Journal of Medical Economics
Shigehiko Kitano, Taiji Sakamoto, Rei Goto, Ayako Fukushima, Anne-Lise Vataire, Yusuke Hikichi
AIMS: To estimate the impact of anti-vascular endothelial growth factor (VEGF) agents on visual impairment and blindness avoided in patients with diabetic macular edema (DME) and on associated patient and caregiver productivity loss in Japan. METHODS: We compared the impact of current care (estimated at 53.8% utilization of anti-VEGF agents using current data) with that of hypothetical care (characterized by a higher utilization of anti-VEGF agents [80.0%], as estimated by an expert panel) of DME patients...
December 14, 2018: Journal of Medical Economics
Samer Tannus, Michael H Dahan
In recent years, the prevalence of infertility has increased due to delayed child bearing and increase in the rate of male infertility. Given the high cost of fertility treatment, this option is not valid for families with low income, and those who can afford it usually choose to have multiple embryo transfers, which has led to an increase in multiple birth rates and increase in the cost of perinatal care. Due to the expected increase in infertility and decrease in the national live birth rate, the United States should set a plan to fund infertility treatment and lead a policy for single embryo transfer...
December 14, 2018: Journal of Medical Economics
Gordon Goodall, Mark Lamotte, Mafalda Ramos, Franck Maunoury, Barbora Pejchalova, Gerard de Pouvourville
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has become the therapy of choice for treating severe aortic stenosis in patients at high-risk for surgery or where it is considered too risky to attempt. This uptake varies across geographies however and its cost or value has frequently been cited as the reason for this. We sought to evaluate the potential cost and clinical impact of TAVI in intermediate risk patients from a French collective perspective. MATERIALS AND METHODS: The analysis was performed using a novel Markov model with data derived from the PARTNER II randomized controlled trial for survival, clinical event rates, and quality of life...
December 14, 2018: Journal of Medical Economics
Yudong Miao, Xiangdong Yuan, Jianqin Gu, Liang Zhang, Ruibo He, Sandeep Sandeep, Jian Wu
OBJECTIVE: To construct a value-based healthcare system for rural Chinese hypertensive patients through increasing outpatient care reimbursement ratio. METHODS: This comparative study sampled two similar counties, Dangyang County and Zhijiang County, in Hubei Province of China, as the intervention group and the control group, respectively. The Social Health Insurance Fund of the intervention group budgeted 600 yuan per capita per year to insured patients with third stage hypertension to cover their outpatient expenditures, while the outpatient expenditures of the control group were not covered by its Social Health Insurance Fund...
December 14, 2018: Journal of Medical Economics
Berna Demiralp, Samuel Soltoff, Lane Koenig
AIMS: We examine the effects of recent changes in Medicare long-term care hospital (LTCH) payments on treatment patterns and outcomes for severe wound patients discharged from short-term acute care hospitals (STACHs). MATERIALS AND METHODS: We used the rolling implementation of a new Medicare payment policy to develop a difference-in-difference model. The study population consisted of Medicare beneficiaries subjected to the payment policy changes and hospitalized for stage 3, 4, or unstageable wounds; nonhealing surgical wounds; and fistula...
December 14, 2018: Journal of Medical Economics
Dominic Pilon, Amanda Teeple, Masha Zhdanava, Martin Ladouceur, Hoi Ching Cheung, Erik Muser, Patrick Lefebvre
OBJECTIVE: To evaluate the impact of comorbidities on healthcare resource use (HRU), and direct and indirect work-loss-related costs in psoriasis patients. METHODS: Adults with psoriasis (≥2 diagnoses, the first designated as the index date) and non-psoriasis controls (no psoriasis diagnoses, randomly generated index date) were identified in a US healthcare claims database of privately-insured patients (data between 01/2010 and 03/2017 were used). Psoriasis patients were stratified based on the number of psoriasis-related comorbidities (0, 1-2, or ≥3) developed during the 12 months post-index...
December 7, 2018: Journal of Medical Economics
Madhuri Pattamatta, Silvia M A A Evers, Boudewijn J J Smeets, Emmeline G Peters, Misha D P Luyer, Mickael Hiligsmann
AIMS: The objective of this (trial based) economic evaluation was to assess, from a societal perspective, the cost-effectiveness of perioperative enteral nutrition compared with standard care in patients undergoing colorectal surgery. MATERIALS AND METHODS: Alongside the SANICS II randomized controlled trial, global quality of life, utilities (measured by EQ-5D-5L), healthcare costs, production losses, and patient and family costs were assessed at baseline, 3 months, and 6 months...
December 7, 2018: Journal of Medical Economics
Lei Wu, Lixian Zhong
AIMS: This study aimed to evaluate the budget impact of niraparib and olaparib in patients with platinum-sensitive, recurrent ovarian cancer from a US third party payer perspective. MATERIALS AND METHODS: A budget impact model was constructed to assess the additional per member per month (PMPM) costs associated with the introduction of niraparib and olaparib, two poly ADP ribose polymerase (PARP) inhibitors recently approved to be used in platinum-sensitive, recurrent ovarian cancer patients with and without a BRCA mutation...
December 7, 2018: Journal of Medical Economics
Evelyn Walter, Thomas Berger, Barbara Bajer-Kornek, Florian Deisenhammer
BACKGROUND: Multiple sclerosis (MS), a chronic progressive, demyelinating, inflammatory disease, affects 2.5 million people worldwide. Approximately 63% of cases are classified as relapsing-remitting MS (RRMS) at the time of diagnosis. The aim of this cost-utility analysis is to evaluate alemtuzumab versus interferon beta (intramuscular [IM] interferon beta-1a, subcutaneous [SC] interferon beta-1a, SC interferon beta-1b, and SC pegylated interferon beta-1a) in previously treated and versus SC interferon beta-1a, fingolimod, and natalizumab in untreated RRMS patients to determine the incremental cost-effectiveness ratio among the treatment alternatives as prices, the route, and the frequency of administration of considered products vary significantly...
December 7, 2018: Journal of Medical Economics
Joran Lokkerbol, Amber Geomini, Jule van Voorthuijsen, Annemieke van Straten, Bea Tiemens, Filip Smit, Anneriek Risseeuw, Mickaël Hiligsmann
AIMS: There is an increasing interest in understanding patients' preferences in the area of healthcare decision making to better match treatment with patients' preferences and improve treatment uptake and adherence. The aim of this study was to elicit the preferences of patients with a depressive disorder regarding treatment modalities. MATERIALS AND METHODS: In a discrete-choice experiment, patients chose repetitively between two hypothetical depression treatments that varied in four treatment attributes: waiting time until the start of treatment, treatment intensity, level of digitalisation, and group size...
December 1, 2018: Journal of Medical Economics
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