Abstract:
OBJECTIVE:A new and smaller percutaneous ventricular assist device (pVAD, Impella, Abiomed, Danvers, MA) has been developed to provide circulatory support in hemodynamically unstable patients and to prevent hemodynamic collapse during high-risk percutaneous coronary interventions (PCI). The objective of the study was to assess the cost-effectiveness of this specific device compared to the intra-aortic balloon pump (IABP) from the European perspective. Additional analysis on extracorporeal membrane oxygenation was conducted for observational purposes only, given its use in some European countries. METHODS:A combination of a decision tree and Markov model was developed to assess the cost-effectiveness of the small, pVAD. The short-term (30-day) effectiveness and safety (early survival, risk of bleeding, and stroke) were modeled, as well as long-term risk of major adverse cardiovascular events (recurrent myocardial infarction, stroke, and heart failure). The short-term effectiveness and safety data for the device were obtained from two registries (the Europella and USpella), both of which are large multi-center studies in high-risk patient groups. Probabilities of long-term major adverse cardiovascular events were obtained from various published clinical studies. The economic analysis was conducted from a German statutory health insurance perspective and only direct medical costs were included. Cost-effectiveness was estimated over a 10-year time horizon. RESULTS:Compared with IABP, the pVAD generated an incremental quality-adjusted life-year (QALY) of 0.22 (with Euro-registry data) and 0.27 (with US-registry data). The incremental cost-effectiveness ratio (ICER) of the device varied between €38,069 (with Euro-registry data) and €31,727 (with US-registry data) per QALY compared with IABP. KEY LIMITATIONS:Unadjusted, indirect comparisons of short-term effectiveness and safety between the interventions were used in the model. Cost and utility data were retrieved from various sources. Therefore, differences in patient populations may bias the estimated cost-effectiveness. CONCLUSIONS:Compared with IABP, the pVAD is a cost-effective intervention for high-risk PCI patients, with ICERs well-below the conventional cost-effectiveness threshold.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Roos JB,Doshi SN,Konorza T,Palacios I,Schreiber T,Borisenko OV,Henriques JPdoi
10.3111/13696998.2012.762004subject
Has Abstractpub_date
2013-01-01 00:00:00pages
381-90issue
3eissn
1369-6998issn
1941-837Xjournal_volume
16pub_type
杂志文章abstract:BACKGROUND:Approximately 20-30% of Canadians suffer from chronic pain. Guidelines for the management of chronic pain support the use of controlled-release (CR) opioids to treat chronic pain. Although effective in managing chronic pain, oxycodone is associated with high rates of opioid-induced constipation (OIC). The co...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1116992
更新日期:2016-01-01 00:00:00
abstract::Background: The potential impact of disease management to optimize quality of care, health outcomes, and total healthcare costs across a range of cardiac disease states is unknown. Methods: A trial-based cost-utility analysis was conducted alongside a randomized controlled trial of 335 patients with chronic, non-valvu...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1080/13696998.2019.1631831
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Iso-osmolar Iodixanol is associated with a lower rate of contrast-induced acute kidney injury (CI-AKI) in patients at increased risk compared to low-osmolar contrast media (LOCM). The aim of this study was to assess the financial consequences of CI-AKI risk reduction in patients undergoing coronary angiograph...
journal_title:Journal of medical economics
pub_type: 杂志文章,meta分析,评审
doi:10.3111/13696998.2015.1105809
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:The first objective was to assess the effect of the chondroitin 4 and 6 sulphate (CS) on health-related quality of life using utility values in patients with knee osteoarthritis (OA) during a 24-month treatment course. The second objective was, using these data, to conduct economic analyses. METHODS:Data fr...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696990903438617
更新日期:2009-01-01 00:00:00
abstract::Objectives: Aging populations are contributing to an increased volume of osteoporotic fractures. The goals of this study were to (1) develop a scorecard on epidemiological burden, policy framework, service provision, and service uptake for osteoporosis in Saudi Arabia and (2) estimate the direct costs of managing oste...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1737536
更新日期:2020-07-01 00:00:00
abstract:INTRODUCTION:Myelofibrosis is a non-frequent chronic myeloproliferative Philadelphia-negative chromosome neoplasm. It is a heavy incapacitating orphan disease and associated with high morbidity and mortality. In this context, indirect and non-medical costs are expected to be high. The main objective of this project is ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.903257
更新日期:2014-06-01 00:00:00
abstract:AIM:Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. METHODS:This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy tri...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1207653
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The economic implications from the US Medicare perspective of adopting alternative treatment strategies for acute bacterial skin and skin structure infections (ABSSSIs) are substantial. The objective of this study is to describe a modeling framework that explores the impact of decisions related to both the lo...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.941065
更新日期:2014-10-01 00:00:00
abstract:AIMS:In this pharmacoeconomic simulation, we: (1) modeled the cost-efficiency of converting patients from reference pegfilgrastim to biosimilar pegfilgrastim-cbqv for prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN) from the US payer perspective, (2) simulated how savings enable, on a budget-neutral b...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1833339
更新日期:2020-10-24 00:00:00
abstract:BACKGROUND:Many countries have various requirements for local economic analyses to assess the value of a new health technology and/or to secure reimbursement. This study presents a case study of an economic model developed to assess the cost-effectiveness of posaconazole vs standard azole therapy (fluconazole/itraconaz...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.761633
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:In patients with significant mitral regurgitation (MR) at high risk of mortality and morbidity from mitral valve surgery, transcatheter mitral valve repair with the MitraClip System is associated with a reduction in MR and improved quality-of-life and functional status compared with baseline. The objective wa...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.923892
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:The Czech Republic is faced with making choices between pharmaceutical products, including depot injectable antipsychotics. A pharmacoeconomic analysis was conducted to determine the cost-effectiveness of atypical depots. METHODS:An existing 1-year decision-analytic framework was adapted to model drug use in t...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.820193
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The Affordable Care Act (ACA) established the Hospital-Acquired Condition (HAC) Reduction Program. The Centers for Medicare and Medicaid Services (CMS) established a total HAC scoring methodology to rank hospitals based upon their HAC performance. Hospitals that rank in the lowest quartile based on their HAC ...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1396993
更新日期:2018-01-01 00:00:00
abstract::Aims: Cumulative exogenous factor VIII (FVIII) exposure is an important predictor of developing neutralizing antibodies (inhibitors) to FVIII in patients with persons with hemophilia A (PwHA). The aim of this study was to model the costs of emicizumab versus FVIII prophylaxis and total treatment costs for patients wit...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1669614
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:EOX (epirubicin, oxaliplatin, Xeloda; capecitabine) and FOLFOX4 (5-fluorouracil (5-FU), leucovorin, oxaliplatin) are the common chemotherapy regimens used in the treatment of advanced gastric cancer (aGC) in Hong Kong. This study aimed to compare the costs of these therapies for aGC patients from both the he...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1296452
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Reduction in health-related quality of life is common in children born small for gestational age (SGA) or children with growth hormone deficiency (GHD). Growth hormone treatment with somatropin in these children leads to normalisation of height. The aim of this study was to determine whether somatropin is a c...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696991003652248
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To estimate the annualized differences in direct medical and indirect costs associated with improvement in fibromyalgia (FM) severity among pregabalin-treated patients. METHODS:Data from three clinical trials of pregabalin in patients with FM were modeled; efficacy results were extrapolated. Mean annual cost...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.727930
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To critically evaluate published cost-effectiveness studies of novel drug products requiring less-frequent medication dosing compared to conventional formulations of the same drug substance. METHODS:A search was conducted in the Medline and Embase databases for cost-effectiveness studies published before May...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.3111/13696991003757500
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Currently the majority of cancer deaths occur in low- and middle-income countries, where there are appreciable funding concerns. In Kenya, most patients currently pay out of pocket for treatment, and those who are insured are generally not covered for the full costs of treatment. This places a considerable b...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1484372
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:This study examines the epidemiology and economic impact of chronic obstructive pulmonary disease (COPD) at a nationwide level in South Korea. METHODS:This retrospective analysis used the societal cost-of-illness framework, consisting of direct medical costs, direct non-medical costs, and indirect costs. In...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1100114
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Switching drugs from prescription to non-prescription status (Rx-to-OTC) presents a unique set of challenges and opportunities to policy-makers and the industry in terms of managing health outcomes, pharmaceutical spending, and steering of consumer choices of therapy. Decision-analytic models are used to a...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.3111/13696998.2013.793693
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To describe costs, healthcare resource utilization, and adherence of US patients receiving human regular U-500 insulin (U-500R), compared to patients receiving high-dose (>200 units/day) U-100 insulins (U-100) by subcutaneous injection for the treatment of diabetes. METHODS:A retrospective analysis of data f...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.772059
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:To model the economic impact of annual relapses/relapse-related hospitalizations among adults with schizophrenia treated with lurasidone or quetiapine extended-release (XR). METHODS:A probabilistic model estimating per-patient-per-year (PPPY) direct mental healthcare (MH) cost differences due to relapses/relap...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696998.2013.809353
更新日期:2013-08-01 00:00:00
abstract:AIMS:Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients' health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to asse...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1572015
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To investigate adherence to dornase alfa therapy among commercially-insured patients with cystic fibrosis (CF) and to examine the impact of adherence on health and economic outcomes. METHODS:This retrospective cohort analysis included CF patients with ≥1 dornase alfa (Pulmozyme) pharmacy claim between 1 Octo...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.787427
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To assess the economic impact of initial and repeat hospitalizations associated with acute coronary syndrome (ACS) over 1 year (2009). DESIGN AND METHODS:National- and state-level data on length of stay (LOS) and related charges for ACS-associated hospital admissions were assessed using two Healthcare Utiliz...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.885907
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To describe treatment patterns and healthcare burden among individuals with suspected pulmonary arterial hypertension (PAH), as identified through a practice guideline-based healthcare claims algorithm. METHODS:Adults with evidence of PAH from 1 January 2004 (commercial and Medicaid) or 1 July 2006 (Medicar...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.690801
更新日期:2012-01-01 00:00:00
abstract:AIMS:The study compared all-cause and major depressive disorder (MDD)-related healthcare resource use (HRU) and costs in patients with MDD treated with atypical antipsychotic (AAP) adjunctive therapy early or later in treatment. MATERIALS AND METHODS:Adults with MDD and antidepressant treatment (ADT) who newly initiat...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1484373
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of biphasic insulin lispro mix 75/25 (LM75/25) and mix 50/50 (LM50/50) compared with a long-acting analog insulin (LAAI) regimen from the perspective of a US healthcare payer. METHODS:A published computer simulation model of diabetes was used to evaluate the cost-effectiven...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.675890
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Prostate cancer is a leading cause of cancer death in men in the US. Castration-resistant prostate cancer (CRPC) is an advanced form of the disease and has a poor prognosis and limited treatment options. The objective of this study was to identify patients with CRPC from a medical claims database, and determi...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.491435
更新日期:2010-01-01 00:00:00