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Real-World Evidence from Population-Based Cancer Registry Data
Published in Harry Yang, Binbing Yu, Real-World Evidence in Drug Development and Evaluation, 2021
The clinical trial data may provide evidence for the efficacy of the innovative treatment during the study period, but it cannot provide the estimate of long-term cost-effectiveness of the treatment. Cost-effectiveness analysis is an important tool to compare the relative cost and effects of different health technologies and to provide a method of prioritizing the allocation of limited resources for more effective healthcare. The incremental cost-effectiveness ratio (ICER) is a commonly used measure of cost-effectiveness, where
Implications for Risk Management
Published in Samuel C. Morris, Cancer Risk Assessment, 2020
The benefit/cost ratio is only one way to express the results of a quantitative, analytical approach. Cost-effectiveness is a different way of using the same data. Cost-effectiveness is the quotient of the annualized cost of a risk management option divided by a measure of its effectiveness, e.g., dollars per cancer averted. One advantage of this approach is that there is no need to even consider reducing the effects (e.g., cancers) to monetary terms to match the costs. Also unlike benefit/cost analysis, there is usually no attempt made to include all the benefits. Cost-effectiveness generally refers to effectiveness in terms of a particular benefit. It is a single-focus measure. One must, thus, keep in mind that an option that is not cost effective in terms of cancer risk may have a high overall benefit/cost ratio due to other benefits. One study comparing individual risk levels, cost-effectiveness of the proposed action, and after-the-fact information on whether the regulatory agency did impose regulations, found that substances with lifetime cancer risks above 4×10−3 were regulated regardless of cost; for cancer risks below that level, regulation was imposed if the cost-per-cancer-averted was less than about $2 million (Travis et al., 1987). This is simply an observation from a limited data set, however. It implies no absolute rules for risk management decisions. Others cite much higher costs-per-cancer-averted for some actions. It is a useful measure for a decisionmaker to see. A high cost should make one wonder if the money might not be better spent elsewhere.
Enhancing use and delivery of pulmonary rehabilitation
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Emily Hume, Carolyn L. Rochester, Ioannis Vogiatzis
The ATS/ERS PR policy statement emphasized the need for improved communication between healthcare professionals, professional societies (e.g. ATS, ERS and others), payers and health policy authorities regarding the process, benefits and cost-effectiveness of PR (18). Therefore, respiratory disease societies should collaborate with primary care providers and patient advocacy groups to develop ways to communicate the benefits, costs and value of PR to payers. For example, PR programmes should routinely maintain a registry and database of their patient enrolment and clinical outcomes to demonstrate programme efficacy for payers. Programmes must also effectively detail programme costs to payers to advocate for reasonable reimbursement. Real-world studies demonstrating cost-effectiveness of programmes and potential cost-savings related to avoidance of costly acute events such as disease exacerbations and hospitalizations are needed. Combined efforts of healthcare professionals, patients and the general public such as the National Institutes of Health Town Hall Meetings that resulted in the development of the National Action Plan for COPD in the United States (46), may also promote payer recognition of the benefits and support for PR funding over time.
Virtual Reality Exposure Therapy as a Treatment Method Against Anxiety Disorders and Depression-A Structured Literature Review
Published in Issues in Mental Health Nursing, 2023
Omar Hawajri, Jennifer Lindberg, Sakari Suominen
When implementing a new treatment method in healthcare, it is important to consider its effectiveness and cost-effectiveness. Traditional therapies for anxiety-related disorders, as e.g., CBT have been proven to be effective. However, there have also been long-term problems with these therapies that primarily revolve around the costs and risks associated with the components that make up the therapeutic process (Oing & Prescott, 2018). It has also been mentioned by Pitti et al. (2015) that the cost-effectiveness and efficiency of the treatment method are of great importance for implementation. To treat certain types of specific phobias, such as agoraphobia, sessions may need to be held in public, which risks the patient’s confidentiality and the emergence of uncontrollable circumstances, but also involves additional expenses for travel to a particular destination for the patient and therapist (Oing & Prescott, 2018).
Cost-effectiveness analysis of arthroscopic injection of a bioadhesive hydrogel implant in conjunction with microfracture for the treatment of focal chondral defects of the knee – an Australian perspective
Published in Journal of Medical Economics, 2022
George Papadopoulos, Sarah Griffin, Hemant Rathi, Amit Gupta, Bhavna Sharma, Dirk van Bavel
Cost-effectiveness analysis is a comparative assessment of relative costs and health benefits of healthcare interventions, that can inform reimbursement decisions. This study evaluated the cost-effectiveness of a combination of JointRep with microfracture surgery compared to microfracture surgery alone, over a 3-year time horizon, and was conducted from the Australian healthcare system perspective. Although Health Technology Assessment (HTA) bodies in Australia (e.g. PBAC, MSAC or PLAC) do not recommend an explicit cost-effectiveness threshold in their respective guidelines or in their decision-making criteria, it has been observed that ICERs in the range of AU$45,000-AU$75,000 are usually considered cost-effective36–39. The base-case analysis showed that JointRep with microfracture surgery led to an incremental QALY gain of 0.95, at an additional cost of $6,022 compared with microfracture surgery alone, resulting in an ICER of $6,328 per QALY gained. Hence, JointRep with microfracture surgery may be considered highly cost-effective compared to microfracture surgery alone.
Cost utility analysis of intramedullary nailing and skeletal traction treatment for patients with femoral shaft fractures in Malawi
Published in Acta Orthopaedica, 2021
Linda Chokotho, Claire A Donnelley, Sven Young, Brian C Lau, Hao-Hua Wu, Nyengo Mkandawire, Jan-Erik Gjertsen, Geir Hallan, Kiran J Agarwal-Harding, David Shearer
Femoral shaft fractures do not only affect physical function, but also the patient’s social and psychological well-being (Haug et al. 2017, Kohler et al. 2017). Accordingly, better treatment of these fractures should improve quality of life by improving not only physical function but also social and psychological functions. A quality adjusted life year (QALY) is an appropriate measure of outcome as it includes both quantity and quality of life (Stothers 2006). Studies from Malawi and elsewhere have found that treatment with IMN is less costly compared with ST (Gosselin et al. 2009, Opondo et al. 2013, Kamau et al. 2014, Diab et al. 2019). However, these studies did not assess the effectiveness of these 2 treatment modalities using a generic outcome measure such as the QALY. As such it remains unclear which modality represents a better use of limited healthcare resources in terms of costs and QALYs gained. Malawi is a low-income country in Southern Africa with a gross domestic product (GDP) per capita of only US$380 (World Bank 2019a). In a resource-limited setting like Malawi, appropriate resource allocation to ensure optimization of the healthcare budget is a priority. Cost-effectiveness analyses of health care interventions can provide the necessary evidence needed to change clinical practice, funding, and policies for the better.