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Franck Maunoury, Aurore Clément, Chizoba Nwankwo, Laurie Levy-Bachelot, Armand Abergel, Vincent Di Martino, Eric Thervet, Isabelle Durand-Zaleski
OBJECTIVE: To assess the cost-effectiveness of the elbasvir/grazoprevir (EBR/GZR) regimen in patients with genotype 1 chronic hepatitis C virus (HCV) infection with severe and end-stage renal disease compared to no treatment. DESIGN: This study uses a health economic model to estimate the cost-effectiveness of treating previously untreated and treatment experienced chronic hepatitis C patients who have severe and end stage renal disease with the elbasvir-grazoprevir regimen versus no treatment in the French context...
2018: PloS One
Manuela Deidda, Kathleen Anne Boyd, Helen Minnis, Julia Donaldson, Kevin Brown, Nicole R S Boyer, Emma McIntosh
INTRODUCTION: Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited...
March 14, 2018: BMJ Open
Rachael M Hunter, Naomi J Fulop, Ruth J Boaden, Christopher McKevitt, Catherine Perry, Angus I G Ramsay, Anthony G Rudd, Simon J Turner, Pippa J Tyrrell, Charles D A Wolfe, Stephen Morris
BACKGROUND: The economic implications of major system change are an important component of the decision to implement health service reconfigurations. Little is known about how best to report the results of economic evaluations of major system change to inform decision-makers. Reconfiguration of acute stroke care in two metropolitan areas in England, namely London and Greater Manchester (GM), was used to analyse the economic implications of two different implementation strategies for major system change...
March 14, 2018: Health Research Policy and Systems
Jannik B Bertelsen, Nasrin Tayyari Dehbarez, Jens Refsgaard, Helle Kanstrup, Søren P Johnsen, Ina Qvist, Bo Christensen, Rikke Søgaard, Kent L Christensen
Background: Changes in the organisation of chronic healthcare, an increased awareness of costs and challenges of low adherence in cardiac rehabilitation (CR) call for the exploration of more flexible CR programmes as alternatives to hospital-based CR (H-CR). A model of shared care cardiac rehabilitation (SC-CR) that included general practitioners and the municipality was developed. The aim of this study was to analyse the cost utility of SC-CR versus H-CR. Methods: The cost-utility analysis was based on a randomised controlled trial of 212 patients who were allocated to SC-CR or H-CR and followed up for 12 months...
2018: Open Heart
Jared D Ament, Tejas Karnati, Edwin Kulubya, Kee D Kim, J Patrick Johnson
Background: The surgical treatment of cervical radiculopathy has centered around anterior cervical discectomy and fusion (ACDF). Alternatively, the posterior cervical laminoforaminotomy/microdiscectomy (PCF/PCM), which results in comparable outcomes and is more cost-effective, has been underutilized. Methods: Here, we compared the direct/indirect costs, reoperation rates, and outcome for ACDF and PCF vs. PCM using PubMed, Medline, and Embase databases. Results: There were no significant differences between the re-operative rates of PCF/PCM (2% to 9...
2018: Surgical Neurology International
Gisela Cristiane Miyamoto, Katherinne Ferro Moura Franco, Johanna M van Dongen, Yuri Rafael Dos Santos Franco, Naiane Teixeira Bastos de Oliveira, Diego Diulgeroglo Vicco Amaral, Amanda Nery Castelo Branco, Maria Liliane da Silva, Maurits W van Tulder, Cristina Maria Nunes Cabral
OBJECTIVES: To evaluate the effectiveness and cost-utility of the addition of different doses of Pilates to an advice for non-specific chronic low back pain (NSCLBP) from a societal perspective. DESIGN: Randomised controlled trial with economic evaluation. SETTING: Physiotherapy clinic in São Paulo, Brazil. PARTICIPANTS: 296 patients with NSCLBP. INTERVENTIONS: All patients received advice and were randomly allocated to four groups (n=74 per group): booklet group (BG), Pilates once a week (Pilates group 1, PG1), Pilates twice a week (Pilates group 2, PG2) and Pilates three times a week (Pilates group 3, PG3)...
March 10, 2018: British Journal of Sports Medicine
Lan Yang, Jing Wang, Juan Cheng, Yuan Wang, Wenli Lu
BACKGROUND: We aimed to clarify the feasibility of a community-based screening strategy for breast cancer in Tianjin, China; to identify the factors that most significantly influenced its feasibility; and to identify the reference range for quality control. METHODS: A state-transition Markov model simulated a hypothetical cohort of 100,000 healthy women, the start aged was set at 35 years and the time horizon was set to 50 years. The primary outcome for the model was the incremental cost-utility ratio (ICUR), defined as the program's cost per quality-adjusted life year (QALY) gained...
March 7, 2018: BMC Cancer
Miguel Areia, Manon Cw Spaander, Ernst J Kuipers, Mário Dinis-Ribeiro
Background: Endoscopic screening for gastric cancer is debatable in countries with an intermediate risk. Objective: The objective of this article is to determine the cost-utility of screening strategies for gastric cancer in a European country. Methods: We conducted a cost-utility analysis using a Markov model comparing three screening strategies versus no screening: stand-alone upper endoscopy, endoscopy combined with a colorectal cancer screening colonoscopy after a positive faecal occult blood test or pepsinogens serologic screening...
March 2018: United European Gastroenterology Journal
Daniel Altman, Kirk Geale, Christian Falconer, Edward Morcos
INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the use of a generic and globally accessible instrument for assessing health-related quality of life (HR-QoL) in pelvic organ prolapse (POP) surgery. METHODS: In a prospective multicenter setting, 207 women underwent surgery for apical prolapse [stage ≥2, Pelvic Organ Prolapse Quantificcation (POP-Q) system] with or without anterior wall defect. Demographic and surgical characteristics were collected before surgery...
March 6, 2018: International Urogynecology Journal
Monali S Malvankar-Mehta, Ryan Wilson, Erik Leci, Kelly Hatch, Sapna Sharan
Background: The objective of this research was to conduct a systematic review and cost analysis to summarize, from the Ministry of Health perspective, the costs families might incur because of their child's prescription for refractive errors and amblyopia correction. Methods: Databases including MEDLINE, Embase, BIOSIS, CINAHL, HEED, ISI Web of Science, and the Cochrane Library as well as the gray literature were searched. Systematic review was conducted using EPPI-Reviewer 4...
2018: Risk Management and Healthcare Policy
Gregory W Poorman, Peter G Passias, Rabia Qureshi, Hamid Hassanzadeh, Samantha Horn, Cole Bortz, Frank Segreto, Amit Jain, Michael Kelly, Richard Hostin, Christopher Ames, Justin Smith, Virginie LaFage, Douglas Burton, Shay Bess, Chris Shaffrey, Frank Schwab, Munish Gupta
OBJECT: Cost-utility analysis, a special case of cost-effectiveness analysis, estimates the ratio between the cost of an intervention to the benefit it produces in number of quality-adjusted life years. Cervical deformity correction has not been evaluated in terms of cost-utility and in the context of value-based health care. Our objective, therefore, was to determine the cost-utility ratio of cervical deformity correction. METHODS: Retrospective review of a prospective, multicenter cervical deformity database...
February 27, 2018: Spine Journal: Official Journal of the North American Spine Society
Shyam Ajay Gokani, Karl O Elmqvist, Osman El-Koubani, Javier Ash, Sudeep K Biswas, Maxime Rigaudy
Purpose: This study aimed to perform an economic evaluation of small bite sutures versus large bite sutures in the closure of midline laparotomies in the United Kingdom National Health Service (NHS). Methods: A cost-utility analysis was conducted using data from a systematic literature review. Large bite sutures placed 10 mm from the wound edge were compared to small bite sutures 3-6 mm from the wound edge. The analysis used a 3-year time horizon in order to take into account complications including incisional hernias and surgical site infections (SSIs)...
2018: ClinicoEconomics and Outcomes Research: CEOR
Irma H J Everink, Jolanda C M van Haastregt, Silvia M A A Evers, Gertrudis I J M Kempen, Jos M G A Schols
BACKGROUND: Integrated care pathways which cover multiple care settings are increasingly used as a tool to structure care, enhance coordination and improve transitions between care settings. However, little is known about their economic impact. The objective of this study is to determine the cost-effectiveness and cost-utility of an integrated care pathway designed for patients with complex health problems transferring from the hospital, a geriatric rehabilitation facility and primary care...
2018: PloS One
Josh J Carlson, Kangho Suh, Panos Orfanos, William Wong
BACKGROUND: The recently completed ALEX trial demonstrated that alectinib improved progression-free survival, and delayed time to central nervous system progression compared with crizotinib in patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer. However, the long-term clinical and economic impact of using alectinib vs. crizotinib has not been evaluated. The objective of this study was to determine the potential cost utility of alectinib vs. crizotinib from a US payer perspective...
February 27, 2018: PharmacoEconomics
Wei-Lun Chang, Carit Jacques Andersen, Besa Shatri Berisha, Olena Estrup, Shr-Jie Wang
OBJECTIVE: Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective. DESIGN: Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial. PATIENTS: Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013. METHODS: Participants were randomly assigned to an "intervention" and a "waiting-list" group...
February 28, 2018: Journal of Rehabilitation Medicine
Jurgen Cornelis, Ansam Barakat, Jack Dekker, Tessy Schut, Sandra Berk, Hans Nusselder, Nikander Ruhl, Jeroen Zoeteman, Rien Van, Aartjan Beekman, Matthijs Blankers
BACKGROUND: Hospitalization is a common method to intensify care for patients experiencing a psychiatric crisis. A short-term, specialised, out-patient crisis intervention by a Crisis Resolution Team (CRT) in the Netherlands, called Intensive Home Treatment (IHT), is a viable intervention which may help reduce hospital admission days. However, research on the (cost-)effectiveness of alternatives to hospitalisation such as IHT are scarce. In the study presented in this protocol, IHT will be compared to care-as-usual (CAU) in a randomized controlled trial (RCT)...
February 27, 2018: BMC Psychiatry
Kinley Dorji, Sonam Phuntsho, Pempa, Suthasinee Kumluang, Sarayuth Khuntha, Wantanee Kulpeng, Sneha Rajbhandari, Yot Teerawattananon
BACKGROUND: Due to competing health priorities and limited resources, many low-income countries, even those with a high disease burden, are not able to introduce pneumococcal conjugate vaccines. OBJECTIVE: To determine the cost-utility of 10- and 13-valent pneumococcal conjugate vaccines (PCV10 and PCV13) compared to no vaccination in Bhutan. METHODS: A model-based cost-utility analysis was performed in the Bhutanese context using a government perspective...
February 22, 2018: Vaccine
Michela Meregaglia, John Cairns, Lisa Licitra, Paolo Bossi
BACKGROUND: There is uncertainty around the optimal surveillance of head and neck cancer patients after the primary curative treatment. This study aims at assessing the cost-effectiveness of a post-treatment programme of frequent radiological assessments (maximal approach) compared with a symptom-driven surveillance (minimal approach). MATERIALS AND METHODS: A decision-analytic Markov model is developed to assess the cost utility of two alternative follow-up programmes with a lifetime horizon...
February 22, 2018: European Journal of Cancer
Gary C Brown, Melissa M Brown, Joshua D Stein, William E Smiddy
PURPOSE: To present ophthalmic patient time-tradeoff vision utilities for quantifying vision-related quality-of-life when the fellow eye still has good vision. These utilities are important for performing reliable cost-utility analyses. DESIGN: Consecutive time-tradeoff vision utilities were obtained from ophthalmic patients with good vision (20/20-20/25) in one eye and vision ranging from 20/20 to no light perception in the fellow eye over a 15-year period from 2000 through 2014...
February 21, 2018: Ophthalmology
Sabrina Storgaard Sørensen, Morten Berg Jensen, Kjeld Møller Pedersen, Lars Ehlers
OBJECTIVES: To examine the heterogeneity in cost-effectiveness analyses of patient-tailored complex interventions. METHODS: Latent class analysis (LCA) was performed on data from a randomized controlled trial evaluating a patient-tailored case management strategy for patients suffering from chronic obstructive pulmonary disease (COPD). LCA was conducted on detailed process variables representing service variation in the intervention group. Features of the identified latent classes were compared for consistency with baseline demographic, clinical, and economic characteristics for each class...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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