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 cost-effectiveness of a combination of oxycodone for the management of pain and naloxone for the relief of OIC has not previously been evaluated for Canada. METHODS:A decision analytic model was developed to estimate the cost-utility of combination oxycodone/naloxone compared to oxycodone alone in four populations. Drug costs for managing pain and healthcare costs related to managing OIC were included in the analysis and the primary measure of effectiveness was quality adjusted life years (QALYs) derived from OIC rates observed in clinical trials. The analysis was conducted from a healthcare system perspective, used a 1-year time horizon, and results were expressed in 2015 Canadian dollars. RESULTS:In all four patient populations, there was a trade-off between slightly higher total expected costs for Targin treated patients compared to oxycodone treated patients, but also improved clinical benefits in terms of reduced OIC, which resulted in higher QALYs for patients. Although analgesic costs were found to be slightly higher for Targin treated patients, Targin also resulted in cost offsets to the healthcare system in terms of less rescue laxative drug use and other resources required for the management of OIC. The resulting 1-year cost-utility of Targin compared to oxycodone ranged from $2178-$7732 per QALY gained in the base case analysis, and it was found that these cost-utility results remained robust and at low values throughout a series of one-way deterministic analyses of uncertainty. CONCLUSION:The clinical effectiveness of oxycodone/naloxone in managing pain and OIC compared to CR oxycodone alone resulted in low cost-utility estimates.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Goeree R,Goeree Jdoi
10.3111/13696998.2015.1116992subject
Has Abstractpub_date
2016-01-01 00:00:00pages
277-91issue
3eissn
1369-6998issn
1941-837Xjournal_volume
19pub_type
杂志文章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: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: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:INTRODUCTION:Lung cancer is a highly prevalent condition with non-small cell lung cancer (NSCLC), representing ∼ 80%. Given its high prevalence and poor survival rates, it is important to understand costs associated with NSCLC treatment. OBJECTIVES:To carry out an incidence-based study in three European countries: Fra...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1032974
更新日期:2015-01-01 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::Aims: To evaluate total costs and health consequences of a colorectal cancer (CRC) screening program with colonoscopy, fecal immunochemical tests (FIT), and expanded use of multitarget stool DNA (mt-sDNA) from the perspectives of Integrated Delivery Networks (IDNs) and payers in the United States.Materials and methods...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1730123
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The cost effectiveness of pregabalin as an add-on to the standard treatment of Belgian patients with post-herpetic neuralgia (PHN) had been demonstrated in a previously published Markov model. The purpose of this study was to update that model with more recent cost data and clinical evidence, ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.773333
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:The patient cost burden of oral anticancer medicines has been associated with prescription abandonment, delayed treatment initiation, and poorer health outcomes in the US. Since 2011, several small molecule tyrosine kinase inhibitors have been approved for the treatment of non-small cell lung cancer (NSCLC...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1580200
更新日期:2019-05-01 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::Aims: Estimate the direct costs of high-risk patients presenting with coronary artery disease (CAD) or peripheral artery disease (PAD) in France.Materials and methods: This retrospective cohort study used a representative claims database, the "Echantillon Généraliste de Bénéficiaires" (EGB), to identify patients prese...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1715415
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To study outcomes of multiple sclerosis (MS) patients treated with either glatiramer acetate (Copaxone) or interferon beta-1a for once-weekly, intramuscular administration (Avonex). METHODS:An 'intent-to-treat' (ITT) cohort (n=1282) was established, consisting of patients diagnosed with MS who began therapy ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.496650
更新日期:2010-01-01 00:00:00
abstract::Aims: Allopurinol is the most common urate lowering therapy (ULT) used to treat gout but may cause life-threatening severe cutaneous adverse reactions (SCAR) in a small number of patients. Risk of SCAR is increased for patients with the HLA-B*58:01 genotype. When alternative ULT is required, febuxostat or probenecid a...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1757456
更新日期:2020-08-01 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
abstract::Background: Guidelines recommend febrile neutropenia (FN) prophylaxis following myelotoxic chemotherapy with either daily injections of filgrastim (Neupogen®) or biosimilar filgrastim-sndz (Zarzio/Zarxio®), single-injection pegfilgrastim (Neulasta®), or pegfilgrastim administered through an on-body injector (PEG-OBI; ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1658591
更新日期:2020-01-01 00:00:00
abstract:AIMS:Improvements in information technology have granted the recent development of rapid, cloud-enabled, onsite laboratory testing for rheumatoid arthritis (RA). This study aims to quantify the value to payers of such technologies. MATERIALS AND METHODS:To calculate the value of rapid, cloud-enabled, onsite laboratory...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1502191
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyse hospital incidence of osteogenesis imperfecta (OI) in Spanish hospitals and the associated medical costs from a healthcare system perspective. METHODS:To this aim, a retrospective multicentre study was designed analysing admission records from patients admitted with...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1834402
更新日期:2020-10-21 00:00:00
abstract:BACKGROUND:Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOAC...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究
doi:10.1080/13696998.2018.1563404
更新日期:2019-04-01 00:00:00
abstract:AIMS:The prevalence of atrial fibrillation (AF) has increased over the past years due to aging of the population, and healthcare costs associated with AF reflect a significant financial burden. The aim of this study was to explore predictors for the real-world AF-related in-hospital costs in patients that recently init...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1363766
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the cost effectiveness (from a payer's perspective) of adding clostridial collagenase ointment (CCO) to selective debridement compared with selective debridement alone (non-CCO) in the treatment of stage IV pressure ulcers among patients identified from the US Wound ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1252381
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:In the last decade, the number of new agents, including monoclonal antibodies, being developed to treat metastatic colorectal cancer (mCRC) increased rapidly. While improving outcomes, these new treatments also have distinct and known safety profiles with toxicities that may require hospitalizations. However...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.610394
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:This retrospective study aims to examine the association between prescribing information (PI)-concordant oral antidiabetic drug (OAD) treatment and clinical and economic outcomes in patients with type 2 diabetes mellitus and stages 3-5 chronic kidney disease (CKD). METHODS:The study used a large, national a...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.775135
更新日期:2013-01-01 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::Aims: To evaluate costs in patients with diabetes who experienced a macrovascular complication from a Brazilian public healthcare system perspective.Materials and methods: A retrospective, observational study that utilized the database of the Brazilian Unified Health System (DATASUS). Data for direct medical costs (ho...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1764966
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Global budget (GB) is considered one of the most important payment methods available. Since a new round of healthcare system reforms in 2009, the Chinese government has been paying attention to this prospective payment. However, it is unclear whether GB has influenced cost control and how it works in rural C...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1336448
更新日期:2017-09-01 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:The objective of the current study was to propose an alternative method for measuring individual operator and peer volumes to use as predictors for adverse outcomes. STUDY DESIGN:A retrospective analysis was performed to assess the volume-outcome relationship for percutaneous coronary intervention (PCI) perf...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990701815578
更新日期:2008-01-01 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 review, summarize, and analyze both similarities and differences of pharmacoeconomic (PE) guidelines, to enable researchers to access their characteristics and the current state of PE guidelines; furthermore, to learn which methodological issues still remain contested and to promote the methodological deve...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1387118
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To characterize patient and physician satisfaction with current standard-of-care botulinum toxin treatment regimens for symptom control in patients with post-stroke spasticity using structured interviews with patients and physicians. RESEARCH DESIGN AND METHODS:Two cross-sectional surveys were conducted in C...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.925462
更新日期:2014-09-01 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