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Health Economics Review

Jörg Ruof, Thomas Staab, Charalabos-Markos Dintsios, Jakob Schröter, Friedrich Wilhelm Schwartz
OBJECTIVES: The aim of this study was to compare post-authorisation measures (PAMs) from the European Medicines Agency (EMA) with data requests in fixed-termed conditional appraisals of early benefit assessments from the German Federal Joint Committee (G-BA). METHODS: Medicinal products with completed benefit assessments during an assessment period of 3.5 years were considered. PAMs extracted from European Public Assessment Reports (EPARs) were compared with data requests issued by the G-BA in the context of conditional appraisals...
December 2016: Health Economics Review
Fuhmei Wang, Jung-Der Wang, Yu-Xiu Huang
BACKGROUND: Countries with limited resources in economic downturns often reduce government expenditures, of which spending on preventive healthcare with no apparent immediate health impact might be cut down first. This research aims to find the optimum share of preventive health expenditure to gross domestic product (GDP) and investigate the implications of preventive health services on economic performance and the population's wellbeing. METHODS: We develop the economic growth model to undertake health-economic analyses and parameterize for Taiwan setting...
December 2016: Health Economics Review
Mehdi Ammi, Christine Peyron
Despite increasing popularity, quality improvement programs (QIP) have had modest and variable impacts on enhancing the quality of physician practice. We investigate the heterogeneity of physicians' preferences as a potential explanation of these mixed results in France, where the national voluntary QIP - the CAPI - has been cancelled due to its unpopularity. We rely on a discrete choice experiment to elicit heterogeneity in physicians' preferences for the financial and non-financial components of QIP. Using mixed and latent class logit models, results show that the two models should be used in concert to shed light on different aspects of the heterogeneity in preferences...
December 2016: Health Economics Review
Stephen Kwasi Opoku Duku, Francis Asenso-Boadi, Edward Nketiah-Amponsah, Daniel Kojo Arhinful
BACKGROUND: Utilization of healthcare in Ghana's novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme's financial sustainability. This paper investigates the presence of adverse selection by assessing the effect of healthcare utilization and frequency of use on NHIS renewal. METHOD: Routine enrolment and utilization data from 2008 to 2013 in two regions in Ghana was analyzed...
December 2016: Health Economics Review
Robert Weiss
Treatment of chronic illness accounts for over 90 % of Medicare spending. Chronic lymphedema places over 3 million Americans at risk of recurrent cellulitis. Health insurers and legislators have taken an active role in fighting attempts to mandate the treatment of lymphedema for fear that provision of the physical therapy and compression materials would result in large and uncontrollable claim costs. The author knows of no open source of lymphedema treatment cost data based on population coverage or claims...
December 2016: Health Economics Review
Reinhard Rychlik, Fabian Kreimendahl, Nicole Schnur, Judith Lambert-Baumann, Dirk Dressler
No abstract text is available yet for this article.
December 2016: Health Economics Review
Richard Gearhart
Since 2000 several papers have examined the efficiency of healthcare delivery systems worldwide. These papers have extended the literature using drastically different input and output combinations from one another, with little theoretical or empirical support backing these specifications. Issues arise that many of these inputs and outputs are available for a subset of OECD countries each year. Using a common estimator and the different specifications proposed leads to the result that efficiency rankings across papers can diverge quite significantly, with several countries being highly efficient in one specification and highly inefficient in another...
December 2016: Health Economics Review
Robert Kaba Alhassan, Edward Nketiah-Amponsah
BACKGROUND: The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015...
December 2016: Health Economics Review
Adnan M S Fakir
OBJECTIVE: The causal link between a household's economic standing and child health is known to suffer from endogeneity. While past studies have exemplified the causal link to be small, albeit statistically significant, this paper aims to estimate the causal effect to investigate whether the effect of income after controlling for the endogeneity remains small in the long run. By correcting for the bias, and knowing the bias direction, one can also infer about the underlying backward effect...
December 2016: Health Economics Review
Hannah Weyer-Wendl, Peter Walter
PURPOSE: The purpose of this research is to quantify the cost burden, care times and the impact on the quality of life (QoL) of informal caring relatives caring for patients with wet age-related macular degeneration (wet AMD). Moreover we investigated the impact of care times on the QoL. METHODS: Through a specifically designed questionnaire, 150 caring relatives were interviewed retrospectively on all accrued financial costs, caring times incurred and the current QoL, assessed by a Visual Analogue Scale for happiness (VAS)...
December 2016: Health Economics Review
Kim Jeong, John Cairns
Cost-utility analyses undertaken to inform decision making regarding colorectal cancer (CRC) require a set of health state utility values (HSUVs) so that the time CRC patients spend in different health states can be aggregated into quality-adjusted life-years (QALY). This study reviews CRC-related HSUVs that could be used in economic evaluation and assesses their advantages and disadvantages with respect to valuation methods used and CRC clinical pathways. Fifty-seven potentially relevant studies were identified which collectively report 321 CRC-related HSUVs...
December 2016: Health Economics Review
Fernando Antoñanzas, Carmelo A Juárez-Castelló, Roberto Rodríguez-Ibeas
Although personalized medicine is becoming the new paradigm to manage some diseases, the economics of personalized medicine have only focused on assessing the efficiency of specific treatments, lacking a theoretical framework analyzing the interactions between pharmaceutical firms and healthcare systems leading to the implementation of personalized treatments. We model the interaction between the hospitals and the manufacturer of a new treatment as an adverse selection problem where the firm does not have perfect information on the prevalence across hospitals of the genetic characteristics of the patients making them eligible to receive a new treatment...
December 2016: Health Economics Review
Cuong Nguyen
This study assesses the impact of children's health insurance programs on health care utilization and health care expenditures of children from 6 to 14 years old in Vietnam using four rounds of the Vietnam Household Living Standard Surveys from 2006 to 2012. We find a positive effect of both student and free health insurance programs on the number of health care visits. This positive impact tends to increase over time, and the impact of the free health insurance program is larger than the impact of the student health insurance program...
December 2016: Health Economics Review
Ulrike Theidel, J-Matthias Graf von der Schulenburg
BACKGROUND: The AMNOG regulation, introduced in 2011 in Germany, changed the game for new drugs. Now, the industry is required to submit a dossier to the GBA (the central decision body in the German sickness fund system) to show additional benefit. After granting the magnitude of the additional benefit by the GBA, the manufacturer is entitled to negotiate the reimbursement price with the GKV-SV (National Association of Statutory Health Insurance Funds). The reimbursement price is defined as a discount on the drug price at launch...
December 2016: Health Economics Review
Kathrin Damm, Janina Volk, Andreas Horn, Jean-Pierre Allam, Ninette Troensegaard-Petersen, Niels Serup-Hansen, Thomas Winkler, Ivonne Thiessen, Kathrin Borchert, Eike G Wüstenberg, Thomas Mittendorf
BACKGROUND: Allergic Rhinitis (AR) is a common disorder in Europe with Allergic Asthma (AA) as a frequent comorbidity. Allergy immunotherapy (AIT) is the only causal therapy of AR and AA, and can be administered as subcutaneous injections at the physician or as sublingual drops or tablets at home. The usual treatment duration is 3 years. OBJECTIVE: This study aimed to elicit patient preferences to identify the AIT administration mode preferred by patients. METHODS: A discrete-choice-experiment (DCE) was developed to determine how people weight different treatment options using a paper-based questionnaire from June to September 2014, including 16 study centres...
December 2016: Health Economics Review
Michela Tinelli, Mandy Ryan, Christine Bond
BACKGROUND: Economic evaluation focuses on Quality-Adjusted-Life-Years (QALYs) as the main valuation method. However, it is well known that factors beyond health related quality of life are important to patients and the public. Whilst discrete-choice-experiments (DCE) have been extensively used to value such factors, their incorporation within an economic evaluation framework is limited. This study is the first to incorporate patient preferences for factors beyond QALYs into an economic evaluation and compare results with the standard cost-per-QALY approach, using randomised-controlled-trial (RCT) participants...
December 2016: Health Economics Review
Anne-Marie Turcotte-Tremblay, Jessica Spagnolo, Manuela De Allegri, Valéry Ridde
Governments of low- and middle-income countries (LMICs) are widely implementing performance-based financing (PBF) to improve healthcare services. However, it is unclear whether PBF provides good value for money compared to status quo or other interventions aimed at strengthening the healthcare system in LMICs. The objective of this systematic review is to identify and synthesize the existing literature that examines whether PBF represents an efficient manner of investing resources. We considered PBF to be efficient when improved care quality or quantity was achieved with equal or lower costs, or alternatively, when the same quality of care was achieved using less financial resources...
December 2016: Health Economics Review
Jana Votapkova, Pavlina Zilova
This paper estimates the effect of the abolition of user charges for children's outpatient care (30 CZK/1.2 EUR) in 2009 on the demand for ambulatory doctor visits in the Czech Republic. Because the reform applied only to children, we can employ the difference-in-differences approach, where children constitute a treatment group and adults serve as a control group. The dataset covers 1841 observations. Aside from the treatment effect, we control for a number of personal characteristics using micro-level data (European Union Statistics on Income and Living Conditions)...
December 2016: Health Economics Review
Stefan Kohler, Damin Abdurakhimovich Asadov, Andreas Bründer, Sean Healy, Atadjan Karimovich Khamraev, Natalia Sergeeva, Peter Tinnemann
Uzbekistan inherited a hospital-based health system from the Soviet Union. We explore the health system-related challenges faced during the scale-up of ambulatory (outpatient) treatment for drug-susceptible and drug-resistant tuberculosis (TB) in Karakalpakstan in Uzbekistan. Semi-structured interviews were conducted with key informants of the TB services, the ministries of health and finance, and their TB control partners. Structural challenges and resource needs were both discussed as obstacles to the expansion of ambulatory TB treatment...
December 2016: Health Economics Review
Reinhard Rychlik, Fabian Kreimendahl, Nicole Schnur, Judith Lambert-Baumann, Dirk Dressler
OBJECTIVE: To gather data about the medical and non-medical health service in patients suffering from post-stroke spasticity of the upper limb and evaluate treatment effectiveness and tolerability as well as costs over the treatment period of one year. METHODS: Prospective, non-interventional, multicenter, parallel-group study comparing effectivenessand costs of incobotulinumtoxinA (INCO) treatment (n = 118) to conventional (CON) antispastic therapy (n = 110) for upper limb spasticity after stroke in 47 clinical practices across Germany over a 1-year treatment period...
December 2016: Health Economics Review
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