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Microsimulation

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https://www.readbyqxmd.com/read/28224411/personalized-medicine-for-prevention-can-risk-stratified-screening-decrease-colorectal-cancer-mortality-at-an-acceptable-cost
#1
Sujha Subramanian, Georgiy Bobashev, Robert J Morris, Sonja Hoover
PURPOSE: Tailored health care interventions are expected to transform clinical practice. The objective of this study was to develop an innovative model to assess the effectiveness, cost, and harms of risk stratified colorectal cancer screening. METHODS: We updated a previously validated microsimulation model consisting of three interlinked components: risk assessment, natural history, and screening/treatment modules. We used data from representative national surveys and the literature to create a synthetic population that mimics the family history and genetic profile of the US population...
February 21, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28210776/cost-effectiveness-of-denosumab-versus-oral-alendronate-for-elderly-osteoporotic-women-in-japan
#2
T Mori, C J Crandall, D A Ganz
: We constructed a Markov microsimulation model among hypothetical cohorts of community-dwelling elderly osteoporotic Japanese women without prior hip or vertebral fractures over a lifetime horizon. Compared with weekly oral alendronate for 5 years, denosumab every 6 months for 5 years is cost-saving or cost-effective at a conventionally accepted threshold. INTRODUCTION: The objective of the study was to examine the cost-effectiveness of subcutaneous denosumab every 6 months for 5 years compared with weekly oral alendronate for 5 years in Japan...
February 17, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28181868/the-distributional-impact-of-social-security-policy-options
#3
Kenneth A Couch, Gayle L Reznik, Christopher R Tamborini, Howard M Iams
Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security's eligibility rules or benefit structure to reflect changes in women's labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage...
January 2017: Research on Aging
https://www.readbyqxmd.com/read/28181866/raising-the-social-security-entitlement-age
#4
Julie Zissimopoulos, Barbara Blaylock, Dana P Goldman, John W Rowe
An aging America presents challenges but also brings social and economic capital. We quantify public revenues from, and public expenditures on, Americans aged 65 and older, the value of their unpaid, productive activities and financial gifts to family. Using microsimulation, we project the value of these activities, and government revenues and expenditures, under different scenarios of change to the Old Age and Survivors Insurance eligibility age through 2050. We find the value of unpaid productive activities and financial gifts are US$721 billion in 2010, while net (of tax revenues) spending on the 65 years and older is US$984 billion...
January 2017: Research on Aging
https://www.readbyqxmd.com/read/28170394/performance-and-cost-effectiveness-of-computed-tomography-lung-cancer-screening-scenarios-in-a-population-based-setting-a-microsimulation-modeling-analysis-in-ontario-canada
#5
Kevin Ten Haaf, Martin C Tammemägi, Susan J Bondy, Carlijn M van der Aalst, Sumei Gu, S Elizabeth McGregor, Garth Nicholas, Harry J de Koning, Lawrence F Paszat
BACKGROUND: The National Lung Screening Trial (NLST) results indicate that computed tomography (CT) lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with >3 screening rounds is uncertain. Therefore, the objective of this study was to estimate the cost-effectiveness of lung cancer screening in a population-based setting in Ontario, Canada, and evaluate the effects of screening eligibility criteria...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28153648/cost-effectiveness-of-subsidizing-fruit-and-vegetable-purchases-through-the-supplemental-nutrition-assistance-program
#6
Sung Eun Choi, Hilary Seligman, Sanjay Basu
INTRODUCTION: A diet high in fruits and vegetables (FV) is associated with reduced risk of chronic disease. One strategy to incentivize FV consumption among low-income households is to make them more affordable through the Supplemental Nutrition Assistance Program (SNAP). This study aims to identify the cost effectiveness of subsidizing FV purchases among the one in seven Americans who participate in SNAP. METHODS: A cost-effectiveness analysis was conducted from a societal perspective to estimate lifetime costs and health gains associated with subsidizing FV purchases...
January 30, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28127767/perspectives-using-results-from-hrsa-s-health-workforce-simulation-model-to-examine-the-geography-of-primary-care
#7
Robin A Streeter, George A Zangaro, Arpita Chattopadhyay
OBJECTIVE: Inform health planning and policy discussions by describing Health Resources and Services Administration's (HRSA's) Health Workforce Simulation Model (HWSM) and examining the HWSM's 2025 supply and demand projections for primary care physicians, nurse practitioners (NPs), and physician assistants (PAs). DATA SOURCES: HRSA's recently published projections for primary care providers derive from an integrated microsimulation model that estimates health workforce supply and demand at national, regional, and state levels...
February 2017: Health Services Research
https://www.readbyqxmd.com/read/28120297/personalizing-bridging-anticoagulation-in-patients-with-nonvalvular-atrial-fibrillation-a-microsimulation-analysis
#8
Matthew A Pappas, Geoffrey D Barnes, Sandeep Vijan
BACKGROUND: Bridging anticoagulation is commonly prescribed to patients with atrial fibrillation who are initiating warfarin or require interruption of anticoagulation. Current guidelines recommend bridging for patients at high risk of stroke. Among patients with atrial fibrillation and one or more risk factors for ischemic stroke, the recently published BRIDGE trial found forgoing bridging during interruption to be, on average, noninferior to bridging with respect to ischemic complications, with significantly fewer hemorrhagic complications...
January 24, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28119387/estimated-reductions-in-cardiovascular-and-gastric-cancer-disease-burden-through-salt-policies-in-england-an-impactncd-microsimulation-study
#9
Chris Kypridemos, Maria Guzman-Castillo, Lirije Hyseni, Graeme L Hickey, Piotr Bandosz, Iain Buchan, Simon Capewell, Martin O'Flaherty
OBJECTIVE: To estimate the impact and equity of existing and potential UK salt reduction policies on primary prevention of cardiovascular disease (CVD) and gastric cancer (GCa) in England. DESIGN: A microsimulation study of a close-to-reality synthetic population. In the first period, 2003-2015, we compared the impact of current policy against a counterfactual 'no intervention' scenario, which assumed salt consumption persisted at 2003 levels. For 2016-2030, we assumed additional legislative policies could achieve a steeper salt decline and we compared this against the counterfactual scenario that the downward trend in salt consumption observed between 2001 and 2011 would continue up to 2030...
January 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28078600/net-budgetary-impact-of-ferric-citrate-as-a-first-line-phosphate-binder-for-the-treatment-of-hyperphosphatemia-a-markov-microsimulation-model
#10
Steven M Brunelli, Scott P Sibbel, David Van Wyck, Amit Sharma, Andrew Hsieh, Glenn M Chertow
Ferric citrate (FC) has demonstrated efficacy as a phosphate binder and reduces the requirements for erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron in dialysis patients. We developed a net budgetary impact model to evaluate FC vs. other phosphate binders from the vantage of a large dialysis provider. We used a Markov microsimulation model to simulate mutually referential longitudinal effects between serum phosphate and phosphate binder dose; categories of these defined health states. Health states probabilistically determined treatment attendance and utilization of ESA and IV iron...
January 11, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28077465/cost-effectiveness-of-the-polypill-versus-risk-assessment-for-prevention-of-cardiovascular-disease
#11
Bart S Ferket, M G Myriam Hunink, Mohammed Khanji, Isha Agarwal, Kirsten E Fleischmann, Steffen E Petersen
OBJECTIVE: There is an international trend towards recommending medication to prevent cardiovascular disease (CVD) in individuals at increasingly lower cardiovascular risk. We assessed the cost-effectiveness of a population approach with a polypill including a statin (simvastatin 20 mg) and three antihypertensive agents (amlodipine 2.5 mg, losartan 25 mg and hydrochlorothiazide 12.5 mg) and periodic risk assessment with different risk thresholds. METHODS: We developed a microsimulation model for lifetime predictions of CVD events, diabetes, and death in 259 146 asymptomatic UK Biobank participants aged 40-69 years...
January 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28077155/modem-a-comprehensive-approach-to-modelling-outcome-and-costs-impacts-of-interventions-for-dementia-protocol-paper
#12
Adelina Comas-Herrera, Martin Knapp, Raphael Wittenberg, Sube Banerjee, Ann Bowling, Emily Grundy, Carol Jagger, Nicolas Farina, Daniel Lombard, Klara Lorenz, David McDaid
BACKGROUND: The MODEM project (A comprehensive approach to MODelling outcome and costs impacts of interventions for DEMentia) explores how changes in arrangements for the future treatment and care of people living with dementia, and support for family and other unpaid carers, could result in better outcomes and more efficient use of resources. METHODS: MODEM starts with a systematic mapping of the literature on effective and (potentially) cost-effective interventions in dementia care...
January 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28069621/the-costs-of-diabetes-among-australians-aged-45-64%C3%A2-years-from-2015-to-2030-projections-of-lost-productive-life-years-plys-lost-personal-income-lost-taxation-revenue-extra-welfare-payments-and-lost-gross-domestic-product-from-health-wealthmod2030
#13
Deborah Schofield, Rupendra N Shrestha, Michelle M Cunich, Megan E Passey, Lennert Veerman, Robert Tanton, Simon J Kelly
OBJECTIVES: To project the number of people aged 45-64 years with lost productive life years (PLYs) due to diabetes and related costs (lost income, extra welfare payments, lost taxation revenue); and lost gross domestic product (GDP) attributable to diabetes in Australia from 2015 to 2030. DESIGN: A simulation study of how the number of people aged 45-64 years with diabetes increases over time (based on population growth and disease trend data) and the economic losses incurred by individuals and the government...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28055048/detecting-heterogeneous-treatment-effects-to-guide-personalized-blood-pressure-treatment-a-modeling-study-of-randomized-clinical-trials
#14
Sanjay Basu, Jeremy B Sussman, Rod A Hayward
Background: Two recent randomized trials produced discordant results when testing the benefits and harms of treatment to reduce blood pressure (BP) in patients with cardiovascular disease (CVD). Objective: To perform a theoretical modeling study to identify whether large, clinically important differences in benefit and harm among patients (heterogeneous treatment effects [HTEs]) can be hidden in, and explain discordant results between, treat-to-target BP trials...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28045931/effect-of-meat-price-on-race-and-gender-disparities-in-obesity-mortality-and-quality-of-life-in-the-us-a-model-based-analysis
#15
Allison Pitt, Eran Bendavid
INTRODUCTION: There are large differences in the burden and health implications of obesity by race and gender in the US. It is unclear to what extent policies modifying caloric consumption change the distribution of the burden of obesity and related health outcomes. Meat is a large component of the American diet. We investigate how changing meat prices (that may result from policies or from exogenous factors that reduce supply) might impact the burden of obesity by race and gender. METHODS: We construct a microsimulation model that evaluates the 15-year body-mass index (BMI) and mortality impact of changes in meat price (5, 10, 25, and 50% increase) in the US adult population stratified by age, gender, race, and BMI...
2017: PloS One
https://www.readbyqxmd.com/read/28039844/low-molecular-weight-heparin-versus-vitamin-k-antagonists-for-the-treatment-of-cancer-associated-thrombosis-a-cost-effectiveness-analysis
#16
Nathan T Connell, Gregory A Abel, Jean M Connors
INTRODUCTION: Cancer-associated venous thromboembolism (VTE) is primarily treated with low-molecular weight heparin (LMWH), a strategy based on studies showing it to be superior to the vitamin K antagonist (VKA) warfarin for preventing VTE recurrence. Subsequent analyses suggest that the magnitude of this benefit might be less than previously determined. Neither patient-focused measures of utility nor the costs of each strategy have been evaluated in the current treatment era. METHODS: This is a cost-effectiveness analysis of VKA and LMWH for the treatment of cancer-associated thrombosis through use of a microsimulation model of outcomes for competing anticoagulation management strategies from a 2014 United States societal perspective...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28024314/modeling-health-care-spending-growth-of-older-adults
#17
Laura A Hatfield, Melissa M Favreault, Thomas G McGuire, Michael E Chernew
OBJECTIVE: To forecast out-of-pocket health care spending among older adults. Long-term forecasts allow policy makers to explore potential impacts of policy scenarios, but existing microsimulations do not incorporate details of supplemental insurance coverage and income effects on health care spending. DATA SOURCES: Dynamic microsimulation calibrated to survey and administrative data. STUDY DESIGN: We augment Urban Institute's Dynamic Simulation of Income Model (DYNASIM) with modules that incorporate demand responses and economic equilibria, with dynamics driven by exogenous technological change...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28001196/-financial-impact-of-smoking-on-health-systems-in-latin-america-a-study-of-seven-countries-and-extrapolation-to-the-regional-level
#18
Andrés Pichon-Riviere, Ariel Bardach, Federico Augustovski, Andrea Alcaraz, Luz Myriam Reynales-Shigematsu, Márcia Teixeira Pinto, Marianela Castillo-Riquelme, Esperanza Peña Torres, Diana Isabel Osorio, Leandro Huayanay, César Loza Munarriz, Belén Sáenz de Miera-Juárez, Verónica Gallegos-Rivero, Catherine De La Puente, María Del Pilar Navia-Bueno, Joaquín Caporale
Objective: Estimate smoking-attributable direct medical costs in Latin American health systems. Methods: A microsimulation model was used to quantify financial impact of cardiovascular and cerebrovascular disease, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and nine other neoplasms. A systematic search for epidemiological data and event costs was carried out. The model was calibrated and validated for Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, countries that account for 78% of Latin America's population; the results were then extrapolated to the regional level...
October 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28001195/-burden-of-disease-attributable-to-tobacco-use-in-argentina-and-potential-impact-of-price-increases-through-taxes
#19
Andrea Alcaraz, Joaquín Caporale, Ariel Bardach, Federico Augustovski, Andrés Pichon-Riviere
Objective: Evaluate burden of disease associated with tobacco use in Argentina and estimate health and economic impacts of cigarette price increases through taxes. Methods: A microsimulation model was used to quantify smoking-attributable impact on mortality, quality of life, and costs for cardiovascular, cerebrovascular, and chronic obstructive pulmonary disease; pneumonia; and ten cancers. Modeling was done for effect of different price increase scenarios on tobacco use and their impact on health and economics...
October 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27987629/translating-pharmacometrics-to-a-pharmacoeconomic-model-of-copd
#20
Julia F Slejko, Richard J Willke, Jakob Ribbing, Peter Milligan
BACKGROUND: A model-based meta-analysis (MBMA) is a type of meta-regression that uses nonlinear mixed-effects models estimated on trial-level data to relate patient and trial characteristics, dosing, biomarkers, and outcomes of treatment. OBJECTIVES: To use a pharmacometric MBMA within a pharmacoeconomic model of chronic obstructive pulmonary disease (COPD). METHODS: A Markov microsimulation model was developed to estimate monthly changes in the key disease severity metrics of COPD (forced expiratory volume in 1 second [FEV1] and exacerbations) to compare a hypothetical drug that increases FEV1 to usual care...
December 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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