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https://www.readbyqxmd.com/read/29159426/an-initial-cost-effectiveness-analysis-of-intraoperative-magnetic-resonance-imaging-imri-in-pediatric-epilepsy-surgery
#1
Matthew F Sacino, Sean S Huang, Robert F Keating, William D Gaillard, Chima O Oluigbo
PURPOSE: Previous studies have illustrated the clinical utility of the addition of intraoperative magnetic resonance imaging (iMRI) to conventional microsurgical resection. While iMRI requires initial capital cost investment, long-term reduction in costly follow-up management and reoperation costs may prove economically efficacious. The objective of this study is to investigate the cost-effectiveness of the addition of iMRI utilization versus conventional microsurgical techniques in focal cortical dysplasia (FCD) resection in pediatric patients with medically refractory epilepsy...
November 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29159398/cost-effectiveness-of-publicly-funded-treatment-of-opioid-use-disorder-in-california
#2
Emanuel Krebs, Benjamin Enns, Elizabeth Evans, Darren Urada, M Douglas Anglin, Richard A Rawson, Yih-Ing Hser, Bohdan Nosyk
Background: Only 1 in 5 of the nearly 2.4 million Americans with an opioid use disorder received treatment in 2015. Fewer than half of Californians who received treatment in 2014 received opioid agonist treatment (OAT), and regulations for admission to OAT in California are more stringent than federal regulations. Objective: To determine the cost-effectiveness of OAT for all treatment recipients compared with the observed standard of care for patients presenting with opioid use disorder to California's publicly funded treatment facilities...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29157870/cost-utility-of-empagliflozin-in-patients-with-type-2-diabetes-at-high-cardiovascular-risk
#3
Elaine Nguyen, Craig I Coleman, Suresh Nair, Erin R Weeda
AIMS: In the Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG) trial, empagliflozin reduced cardiovascular and all-cause mortality in type 2 diabetes (T2D) patients at high cardiovascular risk. We sought to estimate the cost-effectiveness of empagliflozin versus standard treatment for the prevention of cardiovascular morbidity and mortality in patients with T2D. METHODS: A Markov model was developed to assess the cost-effectiveness of empagliflozin (versus standard treatment) for the prevention of cardiovascular morbidity and mortality in patients with T2D using a 3-month cycle length and a lifetime horizon...
October 14, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29153740/cost-effectiveness-of-transcatheter-aortic-valve-implantation-in-patients-with-aortic-stenosis-in-japan
#4
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Issei Komuro
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment for elderly patients with aortic stenosis. However, the cost of TAVI is a major issue. This study analyzed the cost effectiveness of TAVI in Japan. METHODS: We developed an economic model to evaluate the quality-adjusted life years (QALYs) and costs of TAVI, surgical aortic valve replacement (SAVR), and medical therapy over a 10-year time horizon from the perspective of Japanese public healthcare payers...
November 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29153122/age-specific-cost-effectiveness-of-using-intravenous-recombinant-tissue-plasminogen-activator-for-treating-acute-ischemic-stroke
#5
Heesoo Joo, Guijing Wang, Mary G George
INTRODUCTION: Studies have demonstrated that intravenous recombinant tissue plasminogen activator (IV rtPA) is a cost-effective treatment for acute ischemic stroke. Age-specific cost effectiveness has not been well examined. This study estimated age-specific incremental cost-effectiveness ratios (ICERs) of IV rtPA treatment versus no IV rtPA. METHODS: A Markov model was developed to examine the economic impact of IV rtPA over a 20-year time horizon on four age groups (18-44, 45-64, 65-80, and ≥81 years) from the U...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29153114/cost-effectiveness-analyses-of-antihypertensive-medicines-a-systematic-review
#6
REVIEW
Chanhyun Park, Guijing Wang, Jefferey M Durthaler, Jing Fang
CONTEXT: Hypertension affects one third of the U.S. adult population. Although cost-effectiveness analyses of antihypertensive medicines have been published, a comprehensive systematic review across medicine classes is not available. EVIDENCE ACQUISITION: PubMed, Embase, Cochrane Library, and Health Technology Assessment were searched to identify original cost-effectiveness analyses published from 1990 through August 2016. Results were summarized by medicine class: angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), thiazide-type diuretics, β-blockers, and others...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29152988/value-and-innovation-of-direct-acting-antivirals-long-term-health-outcomes-of-the-strategic-plan-for-the-management-of-hepatitis-c-in-spain
#7
Juan Turnes, Raquel Domínguez-Hernández, Miguel Ángel Casado
OBJECTIVE: To assess the long-term healthcare costs and health outcome in association with the access to new direct-acting antivirals (DAAs), during the first year of the National Strategic Plan for Chronic Hepatitis C (SPCHC) in patients with chronic hepatitis C (CHC) in Spain. METHODS: A decision tree and a lifetime Markov model were developed to simulate the natural history, morbidity, and mortality of a cohort of 51,900 patients with CHC before (pre-DAA strategy) and after (post-DAA strategy) access to DAA, following SPCHC approval...
November 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29151818/lifetime-cost-effectiveness-analysis-of-intraoperative-radiation-therapy-versus-external-beam-radiation-therapy-for-early-stage-breast-cancer
#8
Rakesh Patel, Olga Ivanov, Jeff Voigt
Background: To date no one has examined the quality of life and direct costs of care in treating early stage breast cancer with adjunct intraoperative radiation therapy (IORT) versus external beam radiation therapy (EBRT) over the life of the patient. As well no one has examined the effects of radiation exposure with both therapies on the longer term sequelae. The purpose of this analysis was to examine the cost-effectiveness of IORT vs. EBRT over the life of the patient. Methods: A Markov decision-analytic model evaluated these treatment strategies in terms of the direct costs in treating patients over their lifetime (including the downstream costs associated with radiation exposure) and the resultant quality of life of these patients...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/29151496/cost-effectiveness-analysis-of-cardiovascular-disease-treatment-in-japan
#9
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Hiroshi Akazawa, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#10
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29149882/cost-effectiveness-analysis-of-the-introduction-of-s-1-therapy-for-first-line-metastatic-breast-cancer-treatment-in-japan-results-from-the-randomized-phase-iii-select-bc-trial
#11
Takeru Shiroiwa, Takashi Fukuda, Kojiro Shimozuma, Mitsuko Mouri, Yasuhiro Hagiwara, Takuya Kawahara, Shozo Ohsumi, Yasuo Hozumi, Yoshiaki Sagara, Yasuo Ohashi, Hirofumi Mukai
BACKGROUND: This study evaluated the cost-effectiveness of replacing standard intravenous therapy (taxane) with oral S-1 therapy for first-line metastatic breast cancer treatment. METHODS: This cost-effectiveness analysis was based on data from a randomized phase III trial (SELECT BC). As cost-effectiveness was a secondary endpoint of the SELECT BC trial, some of the randomized patients participated in an EQ-5D survey (N = 391) and health economic survey (N = 146)...
November 17, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29147166/a-cost-utility-analysis-of-endovascular-aneurysm-repair-for-abdominal-aortic-aneurysm
#12
Yutaka Takayama
Objective: To assess medical economic adequacy of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Cost-utility analysis. A total of 21 patients with AAA treated at Ibaraki Prefectural Central Hospital in 2014 were divided into non-ruptured EVAR (Group E) and open surgery (OS) (Group O), and ruptured OS (Group R) groups, and hospital costs were aggregated with a medical accounting system. Mid-level hospital costs were estimated by a diagnosis-procedure-combination analysis system...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146652/dynamic-treatment-selection-and-modification-for-personalised-blood-pressure-therapy-using-a-markov-decision-process-model-a-cost-effectiveness-analysis
#13
Sung Eun Choi, Margaret L Brandeau, Sanjay Basu
OBJECTIVE: Personalised medicine seeks to select and modify treatments based on individual patient characteristics and preferences. We sought to develop an automated strategy to select and modify blood pressure treatments, incorporating the likelihood that patients with different characteristics would benefit from different types of medications and dosages and the potential severity and impact of different side effects among patients with different characteristics. DESIGN, SETTING AND PARTICIPANTS: We developed a Markov decision process (MDP) model to incorporate meta-analytic data and estimate the optimal treatment for maximising discounted lifetime quality-adjusted life-years (QALYs) based on individual patient characteristics, incorporating medication adjustment choices when a patient incurs side effects...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146638/preventing-type-2-diabetes-systematic-review-of-studies-of-cost-effectiveness-of-lifestyle-programmes-and-metformin-with-and-without-screening-for-pre-diabetes
#14
Samantha Roberts, Eleanor Barry, Dawn Craig, Mara Airoldi, Gwyn Bevan, Trisha Greenhalgh
OBJECTIVE: Explore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals. DESIGN: Systematic review of economic evaluations. DATA SOURCES AND ELIGIBILITY CRITERIA: Database searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146589/impact-of-increasing-tobacco-taxes-on-working-age-adults-short-term-health-gain-health-equity-and-cost-savings
#15
Christine L Cleghorn, Tony Blakely, Giorgi Kvizhinadze, Frederieke S van der Deen, Nhung Nghiem, Linda J Cobiac, Nick Wilson
OBJECTIVE: The health gains and cost savings from tobacco tax increase peak many decades into the future. Policy-makers may take a shorter-term perspective and be particularly interested in the health of working-age adults (given their role in economic productivity). Therefore, we estimated the impact of tobacco taxes in this population within a 10-year horizon. METHODS: As per previous modelling work, we used a multistate life table model with 16 tobacco-related diseases in parallel, parameterised with rich national data by sex, age and ethnicity...
November 16, 2017: Tobacco Control
https://www.readbyqxmd.com/read/29143405/cost-effectiveness-modeling-of-repetitive-transcranial-magnetic-stimulation-compared-to-electroconvulsive-therapy-for-treatment-resistant-depression-in-singapore
#16
Ying Jiao Zhao, Phern Chern Tor, Ai Leng Khoo, Monica Teng, Boon Peng Lim, Yee Ming Mok
BACKGROUND: Compared to electroconvulsive therapy (ECT), the cost-effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the management of treatment-resistant depression (TRD) remains unclear. OBJECTIVE/HYPOTHESIS: This study evaluated the cost-effectiveness of rTMS vs. ECT for TRD from Singapore societal perspective. METHODS: We constructed a Markov model to project the cost and benefit of rTMS compared with ECT over one year in patients with TRD...
November 16, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29139314/cost-utility-analysis-of-life-long-prophylaxis-with-recombinant-factor-viii-fc-vs-recombinant-factor-viii-for-the-management-of-severe-haemophilia-a-in-sweden
#17
Nathaniel Henry, Jelena Jovanović, Max Schlueter, Persefoni Kritikou, Koo Wilson, Karl-Johan Myrén
AIMS: Prophylaxis with recombinant factor VIII (rFVIII) is the standard of care for severe haemophilia A in Sweden. The need for frequent injections with existing rFVIII products may, however, result in poor adherence to prophylaxis leading to increased bleeding and long-term joint damage. Recombinant FVIIIFc (rFVIIIFc) is an extended half-life fusion protein which can offer prolonged protection and reduced dosing frequency. The objective of this study was to evaluate the cost-utility of prophylaxis with rFVIIIFc in severe haemophilia A from the perspective of the Swedish health system...
November 15, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29138584/repeated-intermittent-ulipristal-acetate-in-the-treatment-of-uterine-fibroids-a-cost-effectiveness-analysis
#18
Kirk Geale, Ertan Saridogan, Matthieu Lehmann, Pablo Arriagada, Marcus Hultberg, Martin Henriksson
There are limited treatment options available for women with moderate to severe symptoms of uterine fibroids (UFs) who wish to avoid surgery. For these women, treatment with standard pharmaceuticals such as contraceptives is often insufficient to relieve symptoms, and patients may require surgery despite their wish to avoid it. Clinical trials demonstrate that ulipristal acetate 5 mg (UPA) is an effective treatment for this patient group, but its cost-effectiveness has not been assessed in this population. A decision-analytic model was developed to simulate a cohort of patients in this population under treatment with UPA followed by surgery as needed compared to treatment with iron and non-steroidal anti-inflammatory drug (NSAID) followed by surgery as needed (best supportive care, BSC)...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29138135/comparative-clinical-effectiveness-and-cost-effectiveness-of-endovascular-strategy-v-open-repair-for-ruptured-abdominal-aortic-aneurysm-three-year-results-of-the-improve-randomised-trial
#19
(no author information available yet)
Objective To assess the three year clinical outcomes and cost effectiveness of a strategy of endovascular repair (if aortic morphology is suitable, open repair if not) versus open repair for patients with suspected ruptured abdominal aortic aneurysm.Design Randomised controlled trial.Setting 30 vascular centres (29 in UK, one in Canada), 2009-16.Participants 613 eligible patients (480 men) with a clinical diagnosis of ruptured aneurysm, of whom 502 underwent emergency repair for rupture.Interventions 316 patients were randomised to an endovascular strategy (275 with confirmed rupture) and 297 to open repair (261 with confirmed rupture)...
November 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29136117/cost-effectiveness-of-community-based-hiv-self-testing-in-blantyre-malawi
#20
Hendramoorthy Maheswaran, Aileen Clarke, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Stavros Petrou
Background: HIV self-testing (HIVST) is effective, with scale-up underway in sub-Saharan Africa. We assessed cost-effectiveness of adding HIVST to existing facility-based HIV testing and counselling (HTC) services. Both 2010 (initiate at CD4<350 cells/μl) and 2015 (initiate all) WHO guidelines for antiretroviral treatment (ART) were considered. Methods: A microsimulation model was developed that evaluated cost-effectiveness, from both health provider and societal perspectives, of an HIVST service implemented in a cluster-randomised trial (CRT) (ISRCTN02004005) in Malawi...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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