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Applied Health Economics and Health Policy

Firdaus Hafidz, Tim Ensor, Sandy Tubeuf
BACKGROUND: Limited healthcare resources in low- and middle-income countries (LMICs) have led policy-makers to improve healthcare efficiency. Therefore, it is essential to understand how efficiency has been measured in the LMIC setting. OBJECTIVE: This paper reviews methodologies used for efficiency studies in health facilities in LMICs. METHODS: We searched MEDLINE, Embase, Global Health, EconLit and ProQuest Dissertations and Theses databases to Week 6 in 2018...
April 20, 2018: Applied Health Economics and Health Policy
Micaela Pinho, Anabela Botelho
OBJECTIVES: This article develops two inference procedures to calculate the inequality aversion and alpha parameters of a health-related social welfare function with constant elasticity (CES-HRSWF) using stated preferences. Based on the relative concept of inequality, a range of values were proposed for the trade-offs between improving total population health and reducing health inequalities. METHODS: A self-administered questionnaire was used to collect data from a sample of 422 college students in Portugal...
April 20, 2018: Applied Health Economics and Health Policy
Barbara de Graaff, Kwang Chien Yee, Philip Clarke, Andrew Palmer
BACKGROUND: Direct-acting antiviral agents (DAAs) have revolutionised treatment for the hepatitis C virus (HCV). Currently, treatment costs between 20,000 and 80,000 Australian dollars ($A) per patient. The Australian Federal Government provided $A1 billion over 5 years to subsidise these drugs. OBJECTIVE: The aim of this paper was to evaluate the uptake and financial impact of DAA prescribing in Australia. METHODS: We undertook a retrospective analysis of Medicare prescription and expenditure data for March 2016 to August 2017...
April 19, 2018: Applied Health Economics and Health Policy
Tracy Yuen, Melissa T Carter, Peter Szatmari, Wendy J Ungar
BACKGROUND: Genome (GS) and exome sequencing (ES) could potentially identify pathogenic variants with greater sensitivity than chromosomal microarray (CMA) in autism spectrum disorder (ASD) but are costlier and result interpretation can be uncertain. Study objective was to compare the costs and outcomes of four genetic testing strategies in children with ASD. METHODS: A microsimulation model estimated the outcomes and costs (in societal and public payer perspectives in Ontario, Canada) of four genetic testing strategies: CMA for all, CMA for all followed by ES for those with negative CMA and syndromic features (CMA+ES), ES or GS for all...
April 12, 2018: Applied Health Economics and Health Policy
Diana Pacheco Barzallo
BACKGROUND: Care and support of people dealing with long-term disabilities involves the entire family. OBJECTIVE: This paper evaluates the effect of living with a relative dealing with a long-term disability on the health status of all family members in the household. METHODS: Using information from the Swiss household panel from the year 1999 to 2003 (n = 18,030), a linear regression is implemented to compare the health status of family members cohabiting with individuals dealing with a long-term disability with the health status of individuals of similar characteristics in the general population...
April 12, 2018: Applied Health Economics and Health Policy
Lijoy Varghese, Louise Talbot, Andrea Govender, Xu-Hao Zhang, Bruce A Mungall
OBJECTIVES: Invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) still represent a significant medical burden in children < 5 years of age in New Zealand (NZ), with marked disparities across socio-economic and ethnic groups. This cost-effectiveness evaluation aims to compare the potential impact of two childhood universal immunisation strategies: vaccination with a 3 + 1 schedule of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix, GSK) and the 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13, Pfizer)...
April 9, 2018: Applied Health Economics and Health Policy
Paul E Orzechowski
This article advocates for a regulated private monopoly as an audacious solution to replace Obamacare, help manage Medicare and Medicaid and reform the US healthcare insurance industry. Contemporary economics vilifies monopolies and praises the 'magic wand' of perfect competition without much debate on the merits of these assumptions. The problems with the perfect competition model as applied to healthcare insurance are well established, but exploration of other possible economic models (i.e. monopoly and oligopoly) as a replacement for Obamacare is non-existent...
April 6, 2018: Applied Health Economics and Health Policy
Emily Eaton Turner, Michelle Jenks, Rachael McCool, Chris Marshall, Liesl Millar, Hannah Wood, Alison Peel, Joyce Craig, Andrew J Sims
Memokath-051 is a thermo-expandable, nickel-titanium alloy spiral stent used to treat ureteric obstruction resulting from malignant or benign strictures. The National Institute for Health and Care Excellence (NICE) selected Memokath-051 for evaluation. The company, PNN Medical, claimed Memokath-051 has clinical superiority and cost savings compared with double-J stents. It identified five studies reporting clinical evidence on Memokath-051 and constructed a de novo cost model comparing Memokath-051 to double-J stents...
April 3, 2018: Applied Health Economics and Health Policy
Indrani Gupta, Arjun Roy
BACKGROUND: The burden from non-communicable diseases and injuries (NCDI) in India is increasing rapidly. With low public sector investment in the health sector generally, and a high financial burden on households for treatment, it is important that economic evidence is used to set priorities in the context of NCDI. OBJECTIVE: Our objective was to understand the extent to which economic analysis has been used in India to (1) analyze the impact of NCDI and (2) evaluate prevention and treatment interventions...
April 2, 2018: Applied Health Economics and Health Policy
John M Brooks, Cole G Chapman, Mary C Schroeder
BACKGROUND: Patient-centred care requires evidence of treatment effects across many outcomes. Outcomes can be beneficial (e.g. increased survival or cure rates) or detrimental (e.g. adverse events, pain associated with treatment, treatment costs, time required for treatment). Treatment effects may also be heterogeneous across outcomes and across patients. Randomized controlled trials are usually insufficient to supply evidence across outcomes. Observational data analysis is an alternative, with the caveat that the treatments observed are choices...
March 27, 2018: Applied Health Economics and Health Policy
Margit Sommersguter-Reichmann, Claudia Wild, Adolf Stepan, Gerhard Reichmann, Andrea Fried
In recent years, the fight against healthcare corruption has intensified. Estimates from the European Healthcare Fraud and Corruption Network calculate an approximate €56 billion annual loss to Europe as a result of corruption. To promote understanding of the complexity and interconnection of corrupt activities, we aim to present healthcare-related corruption typologies of the European Union and European Healthcare Fraud and Corruption Network. We subsequently link them to the typology of individual and institutional corruption introduced by Dennis Thompson in the context of investigating misconduct of US Congressional members...
March 23, 2018: Applied Health Economics and Health Policy
Vasilios D Kosteas, Francesco Renna
BACKGROUND: Over the first ten years of this century, the share of the US population covered by employer-sponsored health insurance plans experienced a significant decline. A decrease in the take-up rate accounts for about a quarter of this decline. Usually, the increasing share of the premium that is paid by workers is used to explain the decline in the take-up rate. However, in recent years the increase in copayments, deductible and coinsurance rate has far outpaced the increase in worker contribution...
June 2018: Applied Health Economics and Health Policy
Padraig Dixon, Kinta Beaver, Susan Williamson, Chris Sutton, Pierre Martin-Hirsch, William Hollingworth
BACKGROUND: Regular outpatient follow-up programmes are usually offered to patients following treatment for gynaecological and other cancers. Despite the substantial resources involved in providing these programmes, there is evidence that routine follow-up programmes do not affect survival or the likelihood of detecting recurrence and may not meet patient needs. Alternative follow-up modalities may offer the same outcomes at lower cost. We examined the costs of using telephone-based routine follow-up of women treated for endometrial cancer undertaken by specialist gynaecology oncology nurses in comparison to routine hospital-based follow-up...
June 2018: Applied Health Economics and Health Policy
Ka Keat Lim, Sook Yee Yoon, Nur Aishah Mohd Taib, Fatiha Hana Shabaruddin, Maznah Dahlui, Yin Ling Woo, Meow Keong Thong, Soo Hwang Teo, Nathorn Chaiyakunapruk
OBJECTIVE: Previous studies showed that offering BRCA mutation testing to population subgroups at high risk of harbouring the mutation may be cost effective, yet no evidence is available for low- or middle-income countries (LMIC) and in Asia. We estimated the cost effectiveness of BRCA mutation testing in early-stage breast cancer patients with high pre-test probability of harbouring the mutation in Malaysia, an LMIC in Asia. METHODS: We developed a decision analytic model to estimate the lifetime costs and quality-adjusted life-years (QALYs) accrued through BRCA mutation testing or routine clinical surveillance (RCS) for a hypothetical cohort of 1000 early-stage breast cancer patients aged 40 years...
June 2018: Applied Health Economics and Health Policy
Pilar García-Gómez, Toni Mora, Jaume Puig-Junoy
BACKGROUND: Increasing patient contributions and reducing the population exempt from pharmaceutical co-payment and co-insurance rates were one of the most common measures in the reforms adopted in Europe during 2010-2015. OBJECTIVE: We estimated the association between the introduction of a capped co-payment of €1 per prescription and drug consumption of the publicly insured population of Catalonia (Spain). METHODS: We used administrative data on monthly pharmaceutical consumption (defined daily doses [DDDs]) from January 2012 to December 2014, for a representative sample of 85,000 people...
June 2018: Applied Health Economics and Health Policy
Adam Martin, Rupert Payne, Edward Cf Wilson
BACKGROUND: The National Health Service (NHS) in England spends over £9 billion on prescription medicines dispensed in primary care, of which over two-thirds is accounted for by repeat prescriptions. Recently, GPs in England have been urged to limit the duration of repeat prescriptions, where clinically appropriate, to 28 days to reduce wastage and hence contain costs. However, shorter prescriptions will increase transaction costs and thus may not be cost saving. Furthermore, there is evidence to suggest that shorter prescriptions are associated with lower adherence, which would be expected to lead to lower clinical benefit...
June 2018: Applied Health Economics and Health Policy
William J Valentine, Kate Van Brunt, Kristina S Boye, Richard F Pollock
OBJECTIVE: The aim of the present study was to evaluate the cost effectiveness of rapid-acting analog insulin relative to regular human insulin in adults with type 1 diabetes mellitus in Germany. METHODS: The PRIME Diabetes Model, a patient-level, discrete event simulation model, was used to project long-term clinical and cost outcomes for patients with type 1 diabetes from the perspective of a German healthcare payer. Simulated patients had a mean age of 21.5 years, duration of diabetes of 8...
June 2018: Applied Health Economics and Health Policy
Livio Garattini, Anna Padula
No abstract text is available yet for this article.
June 2018: Applied Health Economics and Health Policy
Shamsul Arifeen Khan Mamun, Rasheda Khanam, Mohammad Mafizur Rahman
BACKGROUND: The Government of Bangladesh has a National Healthcare Strategy 2012-2032 that reiterates a goal to achieve universal health coverage (UHC) by the year 2032. To achieve the goal, the government has set up a strategy to reduce the share of out-of-pocket (OOP) expenditure from the current 64% of the total household healthcare costs to 32% at the national level. As the majority of the people live in the rural areas, and the rural people are generally poor, the success of the strategy relies predominantly on any type of pro-poor healthcare policy and strategy...
April 2018: Applied Health Economics and Health Policy
David Caldicott, Justin Sinclair, Lynnaire Sheridan, Simon Eckermann
No abstract text is available yet for this article.
April 2018: Applied Health Economics and Health Policy
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