Abstract:
BACKGROUND:There is limited understanding of the health economic implications of cervical screening with human papillomavirus (HPV)-16/18 genotyping. OBJECTIVE:The aim of this study was to evaluate the cost effectiveness of cervical cancer primary screening with a HPV-16/18 genotyping test which simultaneously detects 12 other high-risk HPV types. METHODS:A Markov cohort model compared four strategies: (1) cytology with reflex HPV testing for atypical squamous cells of undetermined significance (ASC-US); (2) co-testing with cytology and HPV testing; (3) HPV with reflex to cytology; and (4) HPV with 16/18 genotyping and reflex cytology (ASC-US threshold). Screening began at age 30 and was performed triennially over 40 years. Screening sensitivity and specificity values for cervical intraepithelial neoplasia (CIN) 3 were obtained from the Addressing THE Need for Advanced HPV Diagnostics (ATHENA) trial. Outcomes for a 1-year follow-up scenario wherein persistent disease was detected were estimated. Screening and cancer treatment costs were calculated from a US payer's perspective in 2013. Costs and quality-adjusted life-years (QALYs) were discounted at 3 % annually. RESULTS:Applying a US$50,000/QALY threshold, strategy (4) dominated strategies (2) and (3) by reducing costs and cancer incidence and improving QALYs, and was cost effective versus strategy (1). Accounting for persistent ≥CIN 3 at 1 year, strategy (4) was cost effective versus all other strategies. Detecting HPV-16/18 resulted in earlier diagnosis of clinically relevant ≥CIN 3 at initial screening and efficient use of follow-up resources. Outcomes were most influenced by strategy performance. CONCLUSIONS:Incorporating HPV-16/18 genotyping is cost effective and may improve detection of CIN, thereby preventing cervical cancer.
journal_name
Appl Health Econ Health Policyjournal_title
Applied health economics and health policyauthors
Huh WK,Williams E,Huang J,Bramley T,Poulios Ndoi
10.1007/s40258-014-0135-4subject
Has Abstractpub_date
2015-02-01 00:00:00pages
95-107issue
1eissn
1175-5652issn
1179-1896journal_volume
13pub_type
杂志文章abstract:BACKGROUND:European guidelines advocate the measurement of on-treatment hepatitis C virus (HCV) RNA in order to determine optimal therapy duration (response-guided therapy [RGT]) in patients with rapid virological response (RVR) or delayed virological response (DVR). Treatment response is highly dependent upon the exte...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-012-0002-0
更新日期:2013-02-01 00:00:00
abstract::There is wide consensus that the ways in which providers are reimbursed by third parties will affect their behaviour and, hence, the efficient use of limited resources and the performance of health systems. However, there seems to be little evidence on how payment to hospital-based doctors affects hospital performance...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::This paper examines the use of propensity score matching in economic analyses of observational data. Several excellent papers have previously reviewed practical aspects of propensity score estimation and other aspects of the propensity score literature. The purpose of this paper is to compare the conceptual foundation...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-013-0075-4
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abstract::This paper reconsiders the evidence and several of the key arguments associated with the theory of supplier-induced demand (SID). It proposes a new theory to explain how ethical behaviour is consistent with SID. The purpose of a theory of demand and one criterion for the evaluation of a theory is the provision of a pl...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
doi:10.2165/00148365-200605020-00003
更新日期:2006-01-01 00:00:00
abstract::Healthcare reforms aim to change certain parts of the health system to improve quality of care, access, or financial sustainability. Traditionally, healthcare reform is understood as an action undertaken by a government at a national or local level. However, bottom-up changes can also lead to improvements in the healt...
journal_title:Applied health economics and health policy
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abstract:BACKGROUND:Cervical cancer ranks fourth amongst the commonest malignancies worldwide and the second most prevalent cancer afflicting women in low-to-middle income countries (LMICs), hence, of great public health importance. LMICs are the most affected regions as evidenced by their high prevalence of the disease. Mortal...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
doi:10.1007/s40258-020-00576-7
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Although the costs of treating inflammatory bowel disease (IBD) in developed countries are well established, they remain largely unknown in countries with recent histories of socio-economic transition including Serbia. OBJECTIVE:To estimate the costs of treatment including the resources used by patients wit...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-016-0272-z
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The Xpert® MTB/RIF (Xpert) test has been shown to be effective and cost-effective for diagnosing tuberculosis (TB) under conditions with high HIV prevalence and HIV-TB co-infection but less is known about Xpert's cost in low HIV prevalence settings. Cambodia, a country with low HIV prevalence (0.7%), high TB...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-018-0397-3
更新日期:2018-08-01 00:00:00
abstract::Blockchain technology is a decentralized database that stores a registry of assets and transactions across a peer-to-peer computer network, which is secured through cryptography, and over time, its history gets locked in blocks of data that are cryptographically linked together and secured. So far, there have been use...
journal_title:Applied health economics and health policy
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journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
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更新日期:2006-01-01 00:00:00
abstract::Central venous catheters are commonly used to deliver therapies and to monitor patients, and require securing at the point of percutaneous entry to avoid dislodgement. SecurAcath is a catheter securement device designed for central venous catheters. The National Institute for Health and Care Excellence, as a part of i...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
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更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) affects approximately 3 million people in the UK. An 8-week pulmonary rehabilitation (PR) course is recommended under current guidelines. However, studies show that initial benefits diminish over time. OBJECTIVE:We present here an economic evaluation conducted al...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40258-015-0199-9
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Immunization rates for human papillomavirus (HPV) infections remain low among teenagers despite strong evidence of the effectiveness of vaccines. Physician recommendations of the vaccine are far from universal. Several states have enacted policies that mandate HPV vaccination or distribute educational materi...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-016-0225-6
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Price, income and health status are likely to affect the demand for healthcare in developing countries, and their quantitative effects are unclear in the literature. Some studies report that prices are not important determinants, while others conclude that prices are important determinants of the demand for ...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/BF03256160
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Although suicide-prevention campaigns have been implemented in numerous countries, Canada has yet to implement a strategy nationally. This is the first study to examine the cost utility of the implementation of a multidimensional suicide-prevention program that combines several interventions over a 50-year t...
journal_title:Applied health economics and health policy
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更新日期:2020-04-01 00:00:00
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journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-014-0144-3
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Cost-effectiveness analyses (CEAs) have been performed for oral non-disease-altering osteoarthritis (OA) treatments for well over a decade. During that period the methods for performing these analyses have evolved as pharmacoeconomic methods have advanced, new treatments have been introduced, and the knowled...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
doi:10.1007/s40258-013-0061-x
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Pricing drugs in the California Workers' Compensation System (CAWCS) has become more difficult as there are increasingly fewer drugs listed in the Medi-Cal primary fee schedule, which is used as the source for CAWCS drug prices. This presents a challenge of providing timely and accurate CAWCS reimbursement. ...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-018-0442-2
更新日期:2019-04-01 00:00:00
abstract::The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on c...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.2165/11590150-000000000-00000
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. OBJECTIVE:To determine cancer-related medical care costs for long-term survivors of HCC. METHODS:The estimation of the lifetim...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.2165/00148365-200806010-00005
更新日期:2008-01-01 00:00:00
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journal_title:Applied health economics and health policy
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doi:10.2165/00148365-200403010-00009
更新日期:2004-01-01 00:00:00
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journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
doi:10.1007/s40258-014-0117-6
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:The objective of the present work was to assess the level of evidence in economic evaluations of percutaneous left atrial appendage closure devices, and to test the complementarity of three different tools for assessing the quality of economic evaluations. METHODS:We conducted a systematic review of article...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-018-0429-z
更新日期:2018-12-01 00:00:00
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journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
doi:10.1007/BF03261872
更新日期:2012-11-01 00:00:00
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journal_title:Applied health economics and health policy
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doi:10.2165/11592430-000000000-00000
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:Invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) still represent a significant medical burden in children < 5 years of age in New Zealand (NZ), with marked disparities across socio-economic and ethnic groups. This cost-effectiveness evaluation aims to compare the potential impact o...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/s40258-018-0387-5
更新日期:2018-06-01 00:00:00
abstract::The mandatory nature of recommendations made by the National Institute for Health and Clinical Excellence (NICE) in the UK has highlighted inherent difficulties in the process of disinvestment in existing technologies to fund NICE-approved technologies. A lack of evidence on candidate technologies means that the proce...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
doi:10.1007/BF03256137
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:There is obscurity regarding how US hospitals determine patients' charges. Whether insurance status influences a patient's hospital charge has not been explored. OBJECTIVE:The objective of this study was to determine whether hospitals charge patients differently based on their insurance status. METHODS:Thi...
journal_title:Applied health economics and health policy
pub_type: 杂志文章
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更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Low back pain (LBP) is a major health problem, having a substantial effect on peoples' quality of life and placing a significant economic burden on healthcare systems and, more broadly, societies. Many interventions to alleviate LBP are available but their cost effectiveness is unclear. OBJECTIVES:To identi...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
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更新日期:2017-04-01 00:00:00
abstract::The South Korean Government recently announced a reform in the drug anti-rebate law, with the purpose of eradicating pervasive, unethical, and illegal rebate practices in pharmaceutical marketing. The main objective of this reform is to have the ability to bring criminal charges against doctors and pharmacists for rec...
journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
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更新日期:2013-08-01 00:00:00