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https://www.readbyqxmd.com/read/28340009/designing-an-optimal-screening-program-for-unknown-atrial-fibrillation-a-cost-effectiveness-analysis
#1
Mattias Aronsson, Emma Svennberg, Mårten Rosenqvist, Johan Engdahl, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Lars-Åke Levin
Aims: The primary objective of this study was to use computer simulations to suggest an optimal age for initiation of screening for unknown atrial fibrillation and to evaluate if repeated screening will add value. Methods and results: In the absence of relevant clinical studies, this analysis was based on a simulation model. More than two billion different designs of screening programs for unknown atrial fibrillation were simulated and analysed. Data from the published scientific literature and registries were used to construct the model and estimate lifelong effects and costs...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28337719/an-early-health-economic-analysis-of-the-potential-cost-effectiveness-of-an-adherence-intervention-to-improve-outcomes-for-patients-with-cystic-fibrosis
#2
Paul Tappenden, Susannah Sadler, Martin Wildman
BACKGROUND: Cystic fibrosis (CF) negatively impacts upon health-related quality of life and survival. Adherence to nebulised treatments is low; improving adherence is hypothesised to reduce rates of exacerbation requiring intravenous antibiotics and lung function decline. OBJECTIVE: A state transition model was developed to assess the cost effectiveness of an intervention aimed at increasing patient adherence to nebulised and inhaled antibiotics compared with current CF care, in advance of the forthcoming CFHealthHub randomised controlled trial (RCT)...
March 23, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28335636/utility-values-associated-with-advanced-or-metastatic-non-small-cell-lung-cancer-data-needs-for-economic-modeling
#3
Jacqueline Brown, Keziah Cook, Kelly Adamski, Jocelyn Lau, Danielle Bargo, Sarah Breen, Anita Chawla
Cost-effectiveness analyses often inform healthcare reimbursement decisions. The preferred measure of effectiveness is the quality adjusted life year (QALY) gained, where the quality of life adjustment is measured in terms of utility. Areas Covered: We assessed the availability and variation of utility values for health states associated with advanced or metastatic non-small cell lung cancer (NSCLC) to identify values appropriate for cost-effectiveness models assessing alternative treatments. Our systematic search of six electronic databases (January 2000 to August 2015) found the current literature to be sparse in terms of utility values associated with NSCLC, identifying 27 studies...
March 24, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28333708/cost-effectiveness-of-antihypertensive-medication-exploring-race-and-sex-differences-using-data-from-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#4
Gabriel S Tajeu, Stephen Mennemeyer, Nir Menachemi, Robert Weech-Maldonado, Meredith Kilgore
BACKGROUND: Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks. OBJECTIVE: To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. RESEARCH DESIGN: We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature...
March 22, 2017: Medical Care
https://www.readbyqxmd.com/read/28332433/the-cost-effectiveness-of-alectinib-in-anaplastic-lymphoma-kinase-positive-alk-advanced-nsclc-previously-treated-with-crizotinib
#5
J J Carlson, W Canestaro, A Ravelo, W Wong
Introduction Anaplastic lymphoma kinase (ALK) targeting drugs provide an important option for advanced non-small cell lung cancer patients with this distinct tumor type; however, there is considerable uncertainty as to which drug provides the optimal value after crizotinib treatment. This study estimated the cost-utility of alectinib vs ceritinib from a US payer perspective. Methods A cost-utility model was developed using partition survival methods and three health states: progression-free (PF), post-progression (PP), and death...
March 23, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28329208/differentiated-hiv-rna-viral-load-monitoring-in-resource-limited-settings-an-economic-analysis
#6
Diana M Negoescu, Zhenhuan Zhang, Heiner C Bucher, Eran Bendavid
Background: Viral load (VL) monitoring for patients receiving antiretroviral therapy (ART) is recommended worldwide. However, the costs of frequent monitoring are a barrier to implementation in resource-limited settings. The extent to which personalized monitoring frequencies may be cost-effective is unknown. Methods: We created a simulation model parameterized using person-level longitudinal data to assess the benefits of flexible monitoring frequencies. Our data-driven model tracked HIV+ individuals for 10 years following ART initiation...
March 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328935/intra-articular-hyaluronic-acid-in-the-management-of-knee-osteoarthritis-pharmaco-economic-study-from-the-perspective-of-the-national-health-insurance-system
#7
Thierry Thomas, Françoise Amouroux, Patrice Vincent
INTRODUCTION: Pharmaco-economic data on the management of knee osteoarthritis (OA) with intra articular hyaluronic acid (IA HA) viscosupplementation is limited. We contrasted IA HA with non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: Observational, prospective and multicenter study comparing treatments of knee OA costs and efficacy with either NSAIDs alone, or hyaluronic acid (Arthrum H 2%®), during a 6-month follow-up period. The investigators were pharmacists who recorded data on disease, drug consumption and healthcare circuit...
2017: PloS One
https://www.readbyqxmd.com/read/28327904/the-cost-of-brain-surgery-awake-vs-asleep-craniotomy-for-perirolandic-region-tumors
#8
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Alfredo Quiñones-Hinojosa
BACKGROUND: Cost effectiveness has become an important factor in the health care system, requiring surgeons to improve efficacy of procedures while reducing costs. An awake craniotomy (AC) with direct cortical stimulation (DCS) presents one method to resect eloquent region tumors; however, some authors assert that this procedure is an expensive alternative to surgery under general anesthesia (GA) with neuromonitoring. OBJECTIVE: To evaluate the cost effectiveness and clinical outcomes between AC and GA patients...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28323701/cost-effectiveness-analysis-of-percutaneous-vertebroplasty-for-osteoporotic-compression-fractures
#9
Tomoyuki Takura, Misako Yoshimatsu, Hiroki Sugimori, Kenji Takizawa, Yoshiyuki Furumatsu, Hirotaka Ikeda, Hiroshi Kato, Yukihisa Ogawa, Shingo Hamaguchi, Atsuko Fujikawa, Toshihiko Satoh, Yasuo Nakajima
STUDY DESIGN: Single-center, single-arm, prospective time-series study. OBJECTIVE: To assess the cost-effectiveness and improvement in quality of life (QOL) of percutaneous vertebroplasty (PVP). SUMMARY OF BACKGROUND DATA: PVP is known to relieve back pain and increase QOL for osteoporotic compression fractures. However, the economic value of PVP has never been evaluated in Japan where universal health care system is adopted. METHODS: We prospectively followed up 163 patients with acute vertebral osteoporotic compression fractures, 44 males aged 76...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28322509/teaching-medical-students-about-cost-effectiveness
#10
Mark Iscoe, Robert Lord, John Schulz, David Lee, Danelle Cayea, Amit Pahwa
BACKGROUND: Rising and burdensome health care costs have driven interest in the practice of high-value care (HVC) and have inspired calls for increased HVC training across all levels of medical education, including among undergraduate medical students. CONTEXT: Classroom-based HVC curricula targeted to medical students have not been previously described in the medical literature. INNOVATION: We developed and evaluated a workshop comprising a lecture, a small-group exercise and a group discussion to instruct medical students on interpreting cost-effectiveness analyses (CEA), applying CEA to patient care and discussing the cost of care with patients...
March 21, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28321375/cost-effectiveness-analysis-of-surgical-versus-medical-treatment-of-prolactinomas
#11
Corinna C Zygourakis, Brandon S Imber, Rebecca Chen, Seunggu J Han, Lewis Blevins, Annette Molinaro, James G Kahn, Manish K Aghi
Background Few studies address the cost of treating prolactinomas. We performed a cost-utility analysis of surgical versus medical treatment for prolactinomas. Materials and Methods We determined total hospital costs for surgically and medically treated prolactinoma patients. Decision-tree analysis was performed to determine which treatment produced the highest quality-adjusted life years (QALYs). Outcome data were derived from published studies. Results Average total costs for surgical patients were $19,224 ( ± 18,920)...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28320075/a-cost-utility-analysis-of-high-molecular-weight-hyaluronic-acid-for-knee-osteoarthritis-in-everyday-clinical-care-in-patients-in-the-working-age-an-economic-evaluation-of-a-randomized-clinical-trial
#12
Job Hermans, Max Reijman, Lucas Ma Goossens, Hennie Verburg, Sita Ma Bierma-Zeinstra, Marc A Koopmanschap
Objectives Knee osteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for non-steroidal anti-inflammatory drugs (NSAIDs), which are known for their serious side-effects. The cost-utility of intra-articular HMW-HA treatment in these patients is unknown though and was assessed in this study. Methods Secondary care patients between 18 and 65 with knee OA were randomized to usual care (UC) + HMW-HA (intervention group) or UC only (control group)...
March 20, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28316007/talimogene-laherparepvec-for-treating-metastatic-melanoma-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#13
REVIEW
Nigel Fleeman, Adrian Bagust, Angela Boland, Sophie Beale, Marty Richardson, Ashma Krishan, Angela Stainthorpe, Ahmed Abdulla, Eleanor Kotas, Lindsay Banks, Miranda Payne
The National Institute for Health and Care Excellence (NICE) invited the manufacturer (Amgen) of talimogene laherparepvec (T-VEC) to submit clinical and cost-effectiveness evidence for previously untreated advanced (unresectable or metastatic) melanoma as part of the Institute's Single Technology Appraisal process. The Liverpool Reviews and Implementation Group (LRiG) at the University of Liverpool was commissioned to act as the Evidence Review Group (ERG). This article presents a summary of the company's submission of T-VEC, the ERG review and the resulting NICE guidance (TA410), issued in September 2016...
March 18, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28315575/systematic-review-on-the-cost-effectiveness-of-self-management-education-programme-for-type-2-diabetes-mellitus
#14
REVIEW
J X Lian, S M McGhee, J Chau, Carlos K H Wong, Cindy L K Lam, William C W Wong
OBJECTIVES: A review of cost-effectiveness studies on self-management education programmes for Type 2 diabetes mellitus. METHODS: Cochrane, PubMed and PsycINFO databases were searched for papers published from January 2003 through September 2015. Further hand searching using the reference lists of included papers was carried out. RESULTS: In total, 777 papers were identified and 12 papers were finally included. We found eight programmes whose effectiveness analyses were based on randomised controlled trials and whose costs were comprehensively estimated from the stated perspective...
February 22, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28302164/cost-effectiveness-of-cerebrospinal-biomarkers-for-the-diagnosis-of-alzheimer-s-disease
#15
Spencer A W Lee, Luciano A Sposato, Vladimir Hachinski, Lauren E Cipriano
BACKGROUND: Accurate and timely diagnosis of Alzheimer's disease (AD) is important for prompt initiation of treatment in patients with AD and to avoid inappropriate treatment of patients with false-positive diagnoses. METHODS: Using a Markov model, we estimated the lifetime costs and quality-adjusted life-years (QALYs) of cerebrospinal fluid biomarker analysis in a cohort of patients referred to a neurologist or memory clinic with suspected AD who remained without a definitive diagnosis of AD or another condition after neuroimaging...
March 16, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28301778/risk-stratified-versus-non-risk-stratified-diagnostic-testing-for-management-of-suspected-acute-biliary-obstruction-comparative-effectiveness-costs-and-the-role-of-mr-cholangiopancreatography
#16
Stella K Kang, David Hoffman, Bart Ferket, Michelle I Kim, R Scott Braithwaite
Purpose To analyze the cost effectiveness of the American Society for Gastrointestinal Endoscopy (ASGE) risk stratification guidelines versus magnetic resonance (MR) cholangiopancreatography-based treatment of patients with possible choledocholithiasis. Materials and Methods A decision-analytic model was constructed to compare cost and effectiveness of three diagnostic strategies for gallstone disease with possible choledocholithiasis: noncontrast MR cholangiopancreatography, contrast material-enhanced MR imaging/MR cholangiopancreatography, and ASGE risk stratification guidelines for diagnostic evaluation recommending endoscopy (high risk), MR cholangiopancreatography (intermediate risk), or no test (low risk)...
March 16, 2017: Radiology
https://www.readbyqxmd.com/read/28301684/economic-evaluation-of-nivolumab-as-a-second-line-treatment-for-advanced-renal-cell-carcinoma-from-us-and-chinese-perspectives
#17
Xiao Min Wan, Liu Bao Peng, Jin An Ma, Yuan Jian Li
BACKGROUND: Nivolumab is a new standard of care for patients with metastatic renal cell carcinoma (mRCC) and provides an overall survival benefit of 5.40 months in comparison with everolimus. This study evaluated the cost-effectiveness of nivolumab for the second-line treatment of mRCC from the perspective of US payers and identified the range of drug costs for which the addition of nivolumab to standard therapy could be considered cost-effective from a Chinese perspective. METHODS: A partitioned survival model was constructed to estimate lifetime costs, life-years, and quality-adjusted life-years (QALYs)...
March 16, 2017: Cancer
https://www.readbyqxmd.com/read/28299371/effect-of-mass-paediatric-influenza-vaccination-on-existing-influenza-vaccination-programmes-in-england-and-wales-a-modelling-and-cost-effectiveness-analysis
#18
David Hodgson, Marc Baguelin, Edwin van Leeuwen, Jasmina Panovska-Griffiths, Mary Ramsay, Richard Pebody, Katherine E Atkins
BACKGROUND: In 2013 England and Wales began to fund a live attenuated influenza vaccine programme for individuals aged 2-16 years. Mathematical modelling predicts substantial beneficial herd effects for the entire population as a result of reduced influenza transmission. With a decreased influenza-associated disease burden, existing immunisation programmes might be less cost-effective. The aim of this study was to assess the epidemiological effect and cost-effectiveness of the existing elderly and risk group vaccination programme under the new policy of mass paediatric vaccination in England...
February 2017: Lancet Public Health
https://www.readbyqxmd.com/read/28298567/omeract-quality-adjusted-life-years-qaly-working-group-do-current-qaly-measures-capture-what-matters-to-patients
#19
Logan Trenaman, Annelies Boonen, Francis Guillemin, Mickael Hiligsmann, Alison Hoens, Carlo Marra, Will Taylor, Jennifer Barton, Peter Tugwell, George Wells, Nick Bansback
OBJECTIVE: To understand the limitations with current patient-reported outcome measures (PROM) used to generate quality-adjusted life-years (QALY) in rheumatology, and set a research agenda. METHODS: Two activities were undertaken. The first was a scoping review of published studies that have used PROM to generate QALY in rheumatology between 2011 and 2016. The second was an interactive "eyeball test" exercise at Outcome Measures in Rheumatology 13 that compared subdomains of widely used generic PROM, as identified through the scoping review, to subdomains of the Assessment of SpondyloArthritis Health Index (ASAS-HI) condition-specific PROM for ankylosing spondylitis...
March 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28296927/harms-benefits-and-costs-of-fecal-immunochemical-testing-versus-guaiac-fecal-occult-blood-testing-for-colorectal-cancer-screening
#20
S Lucas Goede, Linda Rabeneck, Marjolein van Ballegooijen, Ann G Zauber, Lawrence F Paszat, Jeffrey S Hoch, Jean H E Yong, Sonja Kroep, Jill Tinmouth, Iris Lansdorp-Vogelaar
BACKGROUND: The ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50-74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms. METHODS: We used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants...
2017: PloS One
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