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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
Pharmacologic alternatives to blood
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
The results of a clinical trial of EPO therapy in patients undergoing total hip replacement surgery have been published recently. Feagan et al27 conducted a multicenter randomized double-blinded study in 211 patients, comparing placebo with two EPO regimens administered as four weekly doses: 40 000 u (‘standard’), equivalent to approximately 600 u/kg for a 70 kg patient) and 20 000 u (approximately 300 u/kg, or a ‘low dose’). All patients received oral iron supplementation for at least 6 weeks before surgery. Both EPO regimens significantly reduced the need for allogeneic blood transfusion: 11.4% of patients in the standard-EPO-dose cohort and 22.8% of patients in the low-EPO-dose cohort, compared with 44.9% of patients receiving placebo. The incidence of thromboembolic events did not differ among the groups. A limitation in this study was the absence of a cost-effectiveness analysis.
Healthcare Politics
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
The field of economics offers several analytic tools that can be useful in health policymaking/decision-making as well as evaluation of health programs to determine its impact, effectiveness, and efficiency. Some of these tools include the following: cost–benefit analysis in the healthcare field can provide an analysis of expenditure of health resources relative to benefits. Such analysis can help determine whether the cost of a given program can be justified compared to the benefit it provides. It can also help in setting priorities when decisions or choices must be made in the face of limited resources. Risk–benefit analysis can allow policymakers to weigh the potential for undesirable outcomes and side-effects against the potential positive outcome of a policy/program or a medical treatment. Cost-effectiveness analysis involves comparing several different intervention strategies using common units of costs and benefits. The Center for Disease Control and Prevention (CDC) utilizes cost analysis, economic evaluation, regulatory and budget impact analysis, and health impact assessment in public health programs (“Public Health Economics and Methods” n.d.). Almost all state governments conduct cost–benefit analysis but the quality and impact of such analysis vary. At the federal level, the use of cost–benefit analysis is required in many federal agencies particularly with respect to regulatory decision-making (White and Silloway 2016).
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-effectiveness of single-inhaler triple therapy for patients with severe COPD: a systematic literature review
Published in Expert Review of Respiratory Medicine, 2022
Rezwanul Hasan Rana, Khorshed Alam, Syed Afroz Keramat, Jeff Gow
COPD is associated with a considerable burden in terms of mortality, morbidity, hospital admissions, and higher numbers of doctor and emergency room visits. As a result, COPD places an enormous economic burden on the global healthcare system through higher health services utilization. Poor adherence to treatment, given the complexity of treatment for COPD patients’ results in poor clinical and health outcomes compared to peers with better adherence [4,5]. Reducing the complexity of treatment may lead to better adherence rates and, therefore, improve clinical and health outcomes in COPD patients with acute exacerbations and reduce associated healthcare costs [6,7]. Single-inhaler triple therapy effectively reduces the complexity of treatment in COPD patients [8]. Given the range of treatments for COPD patients, it is crucial to conduct an economic evaluation to ensure the efficient allocation of healthcare resources. Economic evaluation, such as cost-effectiveness analysis, compares clinical effectiveness and the costs of an intervention to allocate healthcare resources optimally. Until recently, dual therapy and triple therapy using multiple-inhaler regimens have been widely utilized for treating COPD.
A cost-effectiveness analysis of the prophylaxis versus on-demand regimens in severe hemophilia A patients under 12 years old in southern Iran
Published in Hematology, 2021
Zohreh Zahedi, Mehran Karimi, Khosro Keshavarz, Sezaneh Haghpanah, Ramin Ravangard
Regarding the time horizon, which was more than one year, the economic and clinical outcomes were discounted with an annual rate of 5% and 3%, respectively. These rates have also been used in other published economic evaluation studies in Iran [25]. Key assumptions of the model: o All participants entered the model as ‘alive’.o At the end of the first cycle, the patient either stays ‘alive’ or enters the states of ‘with target joint’ or ‘dead’.o Those who entered ‘with target joint’ can either enter ‘alive’ or ‘dead’ states, or stay in the ‘with target joint’ state.o According to Colombo et al.'s study, it is assumed that the life expectancy of the severe hemophilia A patients is equal to that of the general population of Iran [4].o According to the clinical expert's opinion, having ‘target joint’ does not affect the death.Cost-Effectiveness Analysis: