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Cost Effectiveness and Resource Allocation: C/E

Sara Michelly Gonçalves Brandão, Paulo Cury Rezende, Hans-Peter Brunner-La Rocca, Yang Ting Ju, Antonio Carlos Pedroso de Lima, Myrthes Emy Takiuti, Whady Hueb, Edimar Alcides Bocchi
Background: The costs for treating coronary artery disease (CAD) are high worldwide. We performed a prespecified analyses of cost-effectiveness of three therapeutic strategies for multivessel CAD. Methods: From May 1995 to May 2000, a total of 611 patients were randomly assigned to coronary artery bypass graft (CABG), n = 203; percutaneous coronary intervention (PCI), n = 205; or medical treatment (MT), n = 203. This cost analysis study was based on the perspective of the Public Health Care System...
2018: Cost Effectiveness and Resource Allocation: C/E
S Bautista-Arredondo, N Nance, A Salas-Ortiz, D Akeju, A G Oluwayinka, I Ezirim, J Anenih, C Chima, O Amanze, G Omoregie, K Ogungbemi, S H Aliyu
Background: While the world has made much global progress toward the reduction of new HIV infections, HIV continues to be an important public health problem. In the face of constantly constrained resources, donors and grantees alike must seek to optimize resources and deliver HIV services as efficiently as possible. While there is evidence that management practices can affect efficiency, this has yet to be rigorously tested in the context of HIV service delivery. Methods: The present protocol describes the design of a cluster-randomized control trial to estimate the effect of management practices on efficiency...
2018: Cost Effectiveness and Resource Allocation: C/E
Yee Vern Yong, Asrul Akmal Shafie
Background: Respiratory Medication Therapy Adherence Clinic (RMTAC) is an initiative by the Ministry of Health (MOH) Malaysia to improve patients' medication adherence, as an adjunct to the usual physician care (UC). This study aimed to evaluate the cost-effectiveness of combined strategy of RMTAC and UC (RMTAC + UC) vs. UC alone in asthma patients, from the MOH Malaysia perspective. Methods: A lifetime horizon dynamic adherence Markov model with monthly cycle was developed, for quality-adjusted life year (QALY) gained and hospitalization averted outcomes...
2018: Cost Effectiveness and Resource Allocation: C/E
Abdelbaste Hrifach, Christell Ganne, Sandrine Couray-Targe, Coralie Brault, Pascale Guerre, Hassan Serrier, Hugo Rabier, Gwen Grguric, Pierre Farge, Cyrille Colin
Background: The choice of cost data sources is crucial, because it influences the results of cost studies, decisions of hospital managers and ultimately national directives of policy makers. The main objective of this study was to compare a hospital cost accounting system in a French hospital group and the national cost study (ENC) considering the cost of organ recovery procedures. The secondary objective was to compare these approaches to the weighting method used in the ENC to assess organ recovery costs...
2018: Cost Effectiveness and Resource Allocation: C/E
Christian Becker, Reiner Leidl, Eva Schildmann, Farina Hodiamont, Claudia Bausewein
Background: Specialist palliative care in the hospital addresses a heterogeneous patient population with complex care needs. In Germany, palliative care patients are classified based on their primary diagnosis to determine reimbursement despite findings that other factors describe patient needs better. To facilitate adequate resource allocation in this setting, in Australia and in the UK important steps have been undertaken towards identifying drivers of palliative care resource use and classifying patients accordingly...
2018: Cost Effectiveness and Resource Allocation: C/E
Gabriel Tremblay, Mike Dolph, Sachin Patel, Patricia Brandt, Anna Forsythe
Aims: Midostaurin (MIDO) has been proposed for the treatment of newly-diagnosed adult patients with FMS-like tyrosine kinase 3 mutation-positive (FLT3+) acute myeloid leukemia (AML) in combination with standard chemotherapy. The cost-effectiveness of MIDO and standard of care (SOC) followed by MIDO monotherapy was compared to SOC alone for newly-diagnosed FLT3+ AML in the UK. Methods: A partitioned survival model was developed from a UK public healthcare system perspective to compare the cost-effectiveness of MIDO plus SOC and SOC over a lifetime horizon...
2018: Cost Effectiveness and Resource Allocation: C/E
Cesar Augusto Guevara-Cuellar, Victoria Eugenia Soto, María Isabel Molina-Echeverry
Background: Hypertension represents a high burden of disease in different healthcare systems. Recent guideline published in 2017 by the American Heart Association and the American College of Cardiology has generated a debate between clinicians and policymakers due to the lowering of diagnosis threshold and the subsequent increase of the prevalence and healthcare costs. No empirical research exists addressing the question about the pressure on healthcare costs generated by new standards...
2018: Cost Effectiveness and Resource Allocation: C/E
Kimia Pourmohammadi, Payam Shojaei, Hamed Rahimi, Peivand Bastani
Background: Sufficient and sustainable financing of the health system is essential for improving the health of the community. The health systems financing of the EMR countries is facing the challenge. Assessment and ranking of healthcare financing can help identify and resolve some challenges of health systems. So, the aim of this study is to evaluate and rank the condition of the health sector financing in the EMR countries. Methods: This study was a cross-sectional study...
2018: Cost Effectiveness and Resource Allocation: C/E
Amanda Hansson-Hedblom, Chrissy Almond, Fredrik Borgström, Indeg Sly, Dana Enkusson, Anders Troelsgaard Buchholt, Linda Karlsson
Background: Human monoclonal antibody ustekinumab is a novel Crohn's disease (CD) treatment blocking pro-inflammatory cytokines interleukin-12 and 23. The study's objective was to assess cost-effectiveness of ustekinumab in moderate to severely active CD in Sweden. Methods: A cost-effectiveness model with an induction phase decision-tree structure and a maintenance phase Markov cohort structure was constructed. CD was represented by five health-states: remission, mild, moderate-severe, surgery and death...
2018: Cost Effectiveness and Resource Allocation: C/E
Shukui Qin, Eliza Kruger, Seng Chuen Tan, Shuqun Cheng, Nanya Wang, Jun Liang
Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths globally. In China, sorafenib and oxaliplatin plus infusional-fluorouracil/leucovorin (FOLFOX4) are approved for the systemic treatment of advanced HCC. This study compared the cost-effectiveness of these therapies from a healthcare system perspective and a patient perspectives. Methods: A Markov model was constructed using overall and progression-free survival rates and adverse event (AE) rate from two randomized controlled studies of advanced HCC patients from Asia: EACH for FOLFOX4 and ORIENTAL for sorafenib...
2018: Cost Effectiveness and Resource Allocation: C/E
Fiammetta M Bozzani, Don Mudzengi, Tom Sumner, Gabriela B Gomez, Piotr Hippner, Vicky Cardenas, Salome Charalambous, Richard White, Anna Vassall
Background: Evidence on the relative costs and effects of interventions that do not consider 'real-world' constraints on implementation may be misleading. However, in many low- and middle-income countries, time and data scarcity mean that incorporating health system constraints in priority setting can be challenging. Methods: We developed a 'proof of concept' method to empirically estimate health system constraints for inclusion in model-based economic evaluations, using intensified case-finding strategies (ICF) for tuberculosis (TB) in South Africa as an example...
2018: Cost Effectiveness and Resource Allocation: C/E
Fatime Arenliu Qosaj, Guenter Froeschl, Merita Berisha, Bashkim Bellaqa, Rolf Holle
Background: The current health system reforms in Kosovo aim to improve health status through universal health coverage. Risk pooling and ensuring access to necessary care without financial hardship are envisaged through compulsory health insurance. We measure the level of financial risk protection through two commonly applied concepts: catastrophic health expenditures and impoverishment. Methods: Data from the 2014 Kosovo Household Budget Survey were used to estimate catastrophic health expenditures as a percentage of household consumption expenditures at different thresholds...
2018: Cost Effectiveness and Resource Allocation: C/E
Shankar Prinja, Pankaj Bahuguna, Aditi Gupta, Ruby Nimesh, Madhu Gupta, Jarnail Singh Thakur
Background: A variety of mobile-based health technologies (mHealth) have been developed for use by community health workers to augment their performance. One such mHealth intervention-ReMiND program, was implemented in a poor performing district of India. Despite some research on the extent of its effectiveness, there is significant dearth of evidence on cost-effectiveness of such mHealth interventions. In this paper we evaluated the incremental cost per disability adjusted life year (DALY) averted as a result of ReMiND intervention as compared to routine maternal and child health programs without ReMiND...
2018: Cost Effectiveness and Resource Allocation: C/E
Leopold Ndemnge Aminde, Noah Fongwen Takah, Belen Zapata-Diomedi, J Lennert Veerman
Background: Cardiovascular disease (CVD) is the leading cause of deaths globally, with greatest premature mortality in the low- and middle-income countries (LMIC). Many of these countries, especially in sub-Saharan Africa, have significant budget constraints. The need for current evidence on which interventions offer good value for money to stem this CVD epidemic motivates this study. Methods: In this systematic review, we included studies reporting full economic evaluations of individual and population-based interventions (pharmacologic and non-pharmacologic), for primary and secondary prevention of CVD among adults in LMIC...
2018: Cost Effectiveness and Resource Allocation: C/E
Thomas Desplanches, Catherine Lejeune, Jonathan Cottenet, Paul Sagot, Catherine Quantin
Background: Previous studies have showed that the early diagnosis of threatened preterm labor decreases neonatal morbidity and mortality, avoids maternal morbidity induced by antepartum bed rest and unnecessary treatment, and reduces costs. Although there are many diagnostic tests, none is clearly recommended by international guidelines. The aim of our study was to compare seven diagnostic methods in terms of effectiveness and cost using a decision analysis model in singleton pregnancy presenting threatened preterm labor, between 24 and 34 weeks of gestation...
2018: Cost Effectiveness and Resource Allocation: C/E
Nelya Melnitchouk, Djøra I Soeteman, Jennifer S Davids, Adam Fields, Joshua Cohen, Farzad Noubary, Andrey Lukashenko, Olena O Kolesnik, Karen M Freund
Background: Colorectal cancer is one of the most common cancers worldwide and is associated with high mortality when detected at a later stage. There is a paucity of studies from low and middle income countries to support the cost-effectiveness of colorectal cancer screening. We aim to analyze the cost-effectiveness of colorectal cancer screening compared to no screening in Ukraine, a lower-middle income country. Methods: We developed a deterministic Markov cohort model to assess the cost-effectiveness of three colorectal cancer screening strategies [fecal occult blood test (FOBT) every year, flexible sigmoidoscopy with FOBT every 5 years, and colonoscopy every 10 years] compared to no screening...
2018: Cost Effectiveness and Resource Allocation: C/E
Rebecca Dwommoh, Katherine Sorsdahl, Bronwyn Myers, Kwaku Poku Asante, Tracey Naledi, Dan J Stein, Susan Cleary
Background: There are limited data describing the cost-effectiveness of brief interventions for substance use in resource-poor settings. Using a patient and provider perspective, this study investigates the cost-effectiveness of a brief motivational interviewing (MI) intervention versus a combined intervention of MI and problem solving therapy (MI-PST) for reducing substance use among patients presenting to emergency departments, in comparison to a control group. Methods: Effectiveness data were extracted from Project STRIVE (Substance use and Trauma InterVention) conducted in South Africa...
2018: Cost Effectiveness and Resource Allocation: C/E
Gimon de Graaf, Douwe Postmus, Jan Westerink, Erik Buskens
Background: Translating prognostic and diagnostic biomarker candidates into clinical applications takes time, is very costly, and many candidates fail. It is therefore crucial to be able to select those biomarker candidates that have the highest chance of successfully being adopted in the clinic. This requires an early estimate of the potential clinical impact and commercial value. In this paper, we aim to demonstratively evaluate a set of novel biomarkers in terms of clinical impact and commercial value, using occurrence of cardiovascular disease (CVD) in type-2 diabetes (DM2) patients as a case study...
2018: Cost Effectiveness and Resource Allocation: C/E
Jörg Mahlich, Piyameth Dilokthornsakul, Rosarin Sruamsiri, Nathorn Chaiyakunapruk
Background: Health-care utilities differ considerably from country to country. Our objective was to examine the association of cultural values based on Hofstede's cultural dimensions' theory with utility values that were identified using the time trade off method. Methods: We performed a literature search to determine preference-based value algorithms in the general population of a given country. We then fitted a second-order quadratic function to assess the utility function curve that links health status with health-care utilities...
2018: Cost Effectiveness and Resource Allocation: C/E
Marie-Anne Boujaoude, Andrew J Mirelman, Kim Dalziel, Natalie Carvalho
Background: Cost-effectiveness analysis (CEA) is frequently used as an input for guiding priority setting in health. However, CEA seldom incorporates information about trade-offs between total health gains and equity impacts of interventions. This study investigates to what extent equity considerations have been taken into account in CEA in low- and middle-income countries (LMICs), using rotavirus vaccination as a case study. Methods: Specific equity-related indicators for vaccination were first mapped to the Guidance on Priority Setting in Health Care (GPS-Health) checklist criteria...
2018: Cost Effectiveness and Resource Allocation: C/E
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