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 address uncertainty and produce reasonable estimates of the economic impact of switches for payers. This article presents a critical literature review of existing models which assess the economic impact of Rx-to-OTC switches, and provides guidelines in which future economic evaluations of Rx-to-OTC switches could be improved. METHODS:A comprehensive search strategy was implemented in Medline and Embase, to retrieve published economic evaluations on Rx-to-OTC switches from 1995-2010. The research digest of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) was reviewed for potentially relevant abstracts for the past 3 years. Each model used was critically evaluated in terms of structure, relevance of inputs, methodology used, and robustness of results. RESULTS:Worldwide, the economic impact of Rx-to-OTC switches has only been evaluated in a total of 12 peer-reviewed publications. Ten out of 12 studies were US-based, and two European-based. The models covered various disease categories, including allergy, hypercholesterolemia, gastroenterology, contraception, pulmonology, and virology. Seventy-five per cent of the models predicted cost savings for payers and patients. Limitations of the models mainly included use of strong assumptions and non-inclusion of specific populations due to lack of data. Guidelines were developed to help future model development. They cover structural issues on decision context, health states, and clinical outcomes, and other considerations for model specifications. CONCLUSIONS:Although reviewed studies lacked quality, this review of economic evidence of Rx-to-OTC switches suggests that switches may produce cost savings to public and private payers. This is especially important in light of the trend towards more switches.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Cohen J,Millier A,Karray S,Toumi Mdoi
10.3111/13696998.2013.793693subject
Has Abstractpub_date
2013-01-01 00:00:00pages
835-44issue
6eissn
1369-6998issn
1941-837Xjournal_volume
16pub_type
杂志文章,评审abstract:OBJECTIVE:Few studies have examined the costs associated with differing first-line chemotherapy regimens in patients with metastatic breast cancer (MBC). This study compares the relative cost impact of women starting first-line chemotherapy with capecitabine versus taxanes. METHODS:Women receiving first-line chemother...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990903269673
更新日期:2009-09-01 00:00:00
abstract:AIMS:Fast-acting insulin analogues (FAIAs) reduce hypoglycaemia and improve administration flexibility compared with short-acting human insulin (SHI). This analysis examines whether these benefits translate into cost offsets when comparing the total treatment costs for FAIA versus SHI used as basal-bolus therapy for tr...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.588892
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Bipolar 1 disorders (BPD) are a chronic disorder with prevalence rates of up to 2.6% of the adult population or higher and appreciable direct and indirect costs. As a result, these are a concern to health authorities especially given the low age of onset. Consequently, there is a need to treat BPD patients w...
journal_title:Journal of medical economics
pub_type: 评论,社论
doi:10.3111/13696998.2015.1073736
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To assess patient characteristics, treatment patterns, and healthcare resource utilization (HRU)/costs of individuals treated for neuroendocrine tumors (NETs) in the US. METHODS:Using a US administrative claims database, this study identified commercially-insured adults newly diagnosed with carcinoid tumors ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.975233
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:To evaluate total annual all-cause, gastrointestinal-related, and symptom-related healthcare costs among chronic constipation (CC) patients and estimate incremental all-cause healthcare costs of CC patients relative to matched controls. METHODS:Patients aged ≥18 years with continuous medical and pharmacy ben...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.860375
更新日期:2014-02-01 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:To estimate the lifetime economic consequences of glaucoma in France. METHODS:A Markov model estimated the average discounted outcome and cost of glaucoma treatment over a patient's lifetime. Clinical states were defined as first- to fourth-line drugs, no treatment, laser therapy, surgery, blindness and deat...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990902728729
更新日期:2009-03-01 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:BACKGROUND:Alemtuzumab and natalizumab are approved as second-line therapies for relapsing-remitting multiple sclerosis (RRMS) patients in Iran who have shown an inadequate response to other disease-modifying therapy (DMT). In the absence of head-to-head trials, evaluations based on decision analytic modeling may be a ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1543189
更新日期:2019-01-01 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: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: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: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::Aims: To estimate the budgetary impact of providing additional reimbursement for long acting injections for schizophrenia patients in psychiatric hospital settings in Japan to improve patient outcomes in schizophrenia.Methods: Budget impact analysis of change in reimbursement policy using a prevalence-based model over...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1754229
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:Atazanavir (ATV) and darunavir (DRV) are protease inhibitors approved for HIV treatment in combination with ritonavir (/r). The objectives of this study were to compare persistence (time to treatment discontinuation/modification), adherence, and healthcare costs among patients with human immunodeficiency vir...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1128942
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:OBJECTIVES:To describe the changes in resource utilization in seven European countries (Germany, Greece, Portugal, Romania, Sweden, Spain, and Turkey) and direct costs in four European countries (Germany, Spain, Sweden, and Greece) over the first 12 months of insulin treatment in patients with type 2 diabetes mellitus ...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究
doi:10.3111/13696998.2013.812040
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Allergic rhinitis (AR) is a chronic disease with a substantial clinical and economic burden. This study estimated the potential budget impact (BI) associated with market entry of Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract Tablet for Sublingual Use ('5...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1061533
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To quantify the health economic impact of managing cow milk allergy (CMA) in South Africa, from the perspective of healthcare insurers in both the private and public sectors and parents/carers of CMA sufferers. METHODS:A decision model depicting the management of CMA in South Africa was constructed, using in...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.482904
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Two human papillomavirus (HPV) vaccines are on the market. Based on expected differences in sustained- and cross-protection between the two vaccines, their long-term economic value is modelled and compared for France, Ireland and Italy. METHODS:A Markov cohort model reproducing the natural history of HPV inf...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.490481
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To estimate direct medical costs and resource use for commercially-insured patients within two pulmonary hypertension sub-groups: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). RESEARCH DESIGN AND METHODS:Using a retrospective cohort design, subjects (≥18 yea...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.665109
更新日期:2012-01-01 00:00:00
abstract:PURPOSE:The purpose of this study was to describe the health-related quality-of-life (QoL) in patients after elective surgery for abdominal aortic aneurysm (AAA) compared to a normal population and to study the association between QoL and number of years since surgery. METHODS:All Danish men who underwent elective sur...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.626822
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To assess the cost-effectiveness of insulin detemir compared with Neutral Protamine Hagedorn (NPH) insulin when initiating insulin treatment in people with type 2 diabetes mellitus (T2DM) in Denmark, Finland, Norway, and Sweden. METHODS:Efficacy and safety data were derived from a 20-week multi-centre random...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3111/13696998.2013.768999
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:To perform a cost-utility analysis of a new formulation of mesalazine (Mezavant XL, MMX mesalazine) versus an existing oral mesalazine (Asacol; mesalazine) from the UK National Health Service perspective. METHODS:A 5-year Markov cohort model was developed. Costs were obtained from the literature and utiliti...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990903562861
更新日期:2010-03-01 00:00:00
abstract:AIMS:Hormonal imbalances can affect a woman's physical and mental condition, impacting her daily life and productivity. A mobile application, "Karada-no-kimochi", predicts the menstrual cycle based on recorded data, and provides the information regarding menstruation. This study investigates the effectiveness of the ap...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.1080/13696998.2018.1515082
更新日期:2018-11-01 00:00:00
abstract:AIMS:Tuberous sclerosis complex (TSC) is a multi-organ autosomal-dominant, genetic disorder with incomplete penetrance. The multiple manifestations of TSC and impacts to numerous organ systems represent significant disease, healthcare, and treatment burden. The economic and employment burden of the disease on individua...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1487447
更新日期:2018-10-01 00:00:00
abstract:AIMS:This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. MATERIALS AND METHODS:A questionnaire was developed to capture the demographics, disease characteristics, healthc...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1427100
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:The spectrum of diseases caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) represents a large burden on healthcare systems around the world. Meningitis, bacteraemia, community-acquired pneumonia (CAP), and acute otitis media (AOM) are vaccine-preventable infectious diseases tha...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.622323
更新日期:2012-01-01 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:In the phase III SECURE trial, isavuconazole was non-inferior to voriconazole for all-cause mortality for the primary treatment of invasive mold disease (IMD) caused by Aspergillus spp. and other filamentous fungi. This analysis assessed whether hospital resource utilization was different between patients tre...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3111/13696998.2016.1164175
更新日期:2016-07-01 00:00:00