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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
Dhvani Shah, Maurice Driessen, Nancy Risebrough, Timothy Baker, Ian Naya, Andrew Briggs, Afisi S Ismaila
Background: Cost-effectiveness of once-daily umeclidinium bromide (UMEC) was compared with once-daily tiotropium (TIO) and once-daily glycopyrronium (GLY) in patients with chronic obstructive pulmonary disease (COPD) from a UK National Health Service (NHS) perspective. Methods: A linked-equation model was implemented to estimate COPD progression, associated healthcare costs, exacerbations rates, life years (LY) and quality-adjusted LY (QALYs). Statistical risk equations for endpoints and resource use were derived from the ECLIPSE and TORCH studies, respectively...
2018: Cost Effectiveness and Resource Allocation: C/E
Karin M Vermeulen, Paul F M Krabbe
Background: The healthcare sector is evolving while life expectancy is increasing. These trends put greater pressure on healthcare resources, prompt healthcare reforms, and demand transparent arguments and criteria to assess the overall value of health interventions. There is no consensus on the core criteria by which to value and prioritize interventions, and individual stakeholders might value specific elements differently. The present study is based on a literature review that retrieved the most widely recognized arguments and criteria used in decision-making...
2018: Cost Effectiveness and Resource Allocation: C/E
Oriana Ciani, David Epstein, Claire Rothery, Rod S Taylor, Mark Sculpher
Background: Fenestrated endovascular aneurysm repair (fEVAR) is a new approach for complex abdominal aortic aneurysms, limited to a few specialist centers, with limited evidence base. We developed a cost-effectiveness decision model of fEVAR compared to open surgical repair (OSR) to investigate the likely direction of costs and benefits and inform further research projects on this technology. Methods: A systematic review with meta-analysis and a four-state Markov model were used to estimate the cost-effectiveness of fEVAR versus OSR...
2018: Cost Effectiveness and Resource Allocation: C/E
Kai Huter, Katarzyna Dubas-Jakóbczyk, Ewa Kocot, Katarzyna Kissimova-Skarbek, Heinz Rothgang
Background: In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of 'beyond-health' benefits...
2018: Cost Effectiveness and Resource Allocation: C/E
Chloe Puett, Cécile Salpéteur, Freddy Houngbe, Karen Martínez, Dieynaba S N'Diaye, Audrey Tonguet-Papucci
Background: This study assessed the costs and cost-efficiency of a mobile cash transfer implemented in Tapoa Province, Burkina Faso in the MAM'Out randomized controlled trial from June 2013 to December 2014, using mixed methods and taking a societal perspective by including costs to implementing partners and beneficiary households. Methods: Data were collected via interviews with implementing staff from the humanitarian agency and the private partner delivering the mobile money, focus group discussions with beneficiaries, and review of accounting databases...
2018: Cost Effectiveness and Resource Allocation: C/E
Ichiro Arakawa, Mikio Momoeda, Yutaka Osuga, Ikuko Ota, Kaori Koga
Background and objective: This study aims to assess the cost-effectiveness of early physician consultation and guideline-based intervention to prevent endometriosis and/or disease progression using oral contraceptive (OC) and progestin compared to follow-up of self-care for dysmenorrhea in Japan. Methods: A yearly-transmitted Markov model of five major health states with four sub-medical states was constructed. Transition probabilities among health and medical states were derived from Japanese epidemiological patient surveys and converted to appropriate parameters for inputting into the model...
2018: Cost Effectiveness and Resource Allocation: C/E
Karin Stenberg, Jeremy A Lauer, Georgios Gkountouras, Christopher Fitzpatrick, Anderson Stanciole
Background: Policy makers require information on costs related to inpatient and outpatient health services to inform resource allocation decisions. Methods: Country data sets were gathered in 2008-2010 through literature reviews, website searches and a public call for cost data. Multivariate regression analysis was used to explore the determinants of variability in unit costs using data from 30 countries. Two models were designed, with the inpatient and outpatient models drawing upon 3407 and 9028 observations respectively...
2018: Cost Effectiveness and Resource Allocation: C/E
Juliana Serje, Melanie Y Bertram, Callum Brindley, Jeremy A Lauer
Background: Human resources are consistently cited as a leading contributor to health care costs; however the availability of internationally comparable data on health worker earnings for all countries is a challenge for estimating the costs of health care services. This paper describes an econometric model using cross sectional earnings data from the International Labour Organization (ILO) that the World Health Organizations (WHO)-Choosing Interventions that are Cost-effective programme (CHOICE) has used to prepare estimates of health worker earnings (in 2010 USD) for all WHO member states...
2018: Cost Effectiveness and Resource Allocation: C/E
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