Abstract:
AIMS:Percutaneous closure of a patent foramen ovale (PFO) is known to lower the risk of recurrent stroke in patients with a cryptogenic stroke. However, the economic implications of transcatheter PFO closure are less well known. From a UK payer perspective, a detailed economic appraisal of PFO closure was performed for prevention of recurrent ischemic stroke in patients with a PFO who had experienced a cryptogenic stroke. MATERIALS AND METHODS:A Markov cohort model was constructed using a 5-year time-horizon with a patient mean age of 45.2 years, reflecting the characteristics reported in the REDUCE trial. Transition probabilities, clinical inputs, costs, and utility values were ascertained from published and national costing sources. Total costs, incremental costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios were calculated, utilizing a discount rate of 3.5%. A range of univariate and probabilistic sensitivity analyses were also performed. RESULTS:When applying a willingness-to-pay (WTP) threshold of £20,000/QALY in accordance with NICE guidelines, PFO closure compared with antiplatelet therapy alone showed a beneficial cost/QALY of £18,584, attained at 4 years. Applying discount rates of 0% and 6% had a negligible effect on the base-case model findings. PFO closure demonstrated a 76.9% probability of being cost-effective at a WTP threshold of £20,000/QALY at a 5-year time-horizon. LIMITATIONS:This model focused specifically on UK stroke patients and typically enrolled young (mean age <65 years old) patients. Hence, caution should be taken when comparing data vs non-UK populations, and it remains unclear how older patients might have affected cost-effectiveness findings, as the risk of paradoxical embolism can persist as patients age. CONCLUSION:Percutaneous closure of a PFO is cost-effective compared with antiplatelet therapy alone, underlining the economic benefits potentially afforded by this treatment in selected patients.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Hildick-Smith D,Turner M,Shaw L,Nakum M,Hartaigh BÓ,Evans RM,Rhodes JF,Sondergaard L,Kasner SEdoi
10.1080/13696998.2018.1548355subject
Has Abstractpub_date
2019-02-01 00:00:00pages
131-139issue
2eissn
1369-6998issn
1941-837Xjournal_volume
22pub_type
杂志文章abstract:AIMS:This study analyzed discrepancies in the quantity of medical services supplied by physicians under different payment systems for patients with different health statuses and illnesses by means of a field experiment. METHODS:Based on the laboratory experiment of Heike Hennig-Schmidt, we designed a field experiment ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1539399
更新日期:2019-01-01 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: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:PURPOSE:To evaluate the insulin wastage and associated acquisition costs when switching from individual patient supply (IPS) of 3-mL pens of rapid-acting insulin (RAI) aspart to floor stock (FS) dispensing of 3-mL vials of RAI lispro, and with conversion from IPS of 3-mL pens to centralized unit dose (CUD) of 10-mL via...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1288126
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Compare long-term costs and outcomes of lurasidone to aripiprazole among adults with schizophrenia in the US who previously failed ≥1 atypical antipsychotic (olanzapine, risperidone, quetiapine, or ziprasidone) based on an indirect comparison of outcomes data from clinical trials. METHODS:A 5-year Markov coh...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.807813
更新日期:2013-07-01 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: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
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doi:10.1080/13696998.2018.1543189
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abstract:BACKGROUND:Inhibitor development to factor VIII (FVIII) hemophilia therapy results in increased complications and substantial economic costs. The SIPPET study, the first randomized controlled trial to compare the immunogenicity of plasma-derived FVIII (pdFVIII)/von Willebrand factor (VWF) and recombinant-DNA-derived FV...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.1080/13696998.2018.1468335
更新日期:2018-08-01 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::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:BACKGROUND:Growing financial pressure on US dialysis providers requires economic efficiency considerations. The objective of this study was to examine short-term economic efficiencies of a cinacalcet-based treatment approach for secondary hyperparathyroidism. METHODS:This study retrospectively assessed cost per bioche...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696998.2013.826665
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Patients with unresectable, metastatic colorectal cancer with wild type Kirsten ras mutational status are eligible for sequential treatments which include monoclonal antibodies as first line (1L), second line (2L), or third line (3L) regimens. OBJECTIVE:To compare the economic outcomes of different sequence...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.864973
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To estimate the economic implications of introducing dabigatran etexilate ('dabigatran') for anti-coagulation therapy in Danish patients with non-valvular atrial fibrillation based on results of the RE-LY trial. METHODS:The lifetime cost and outcomes of dabigatran and warfarin were estimated using a previous...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.673525
更新日期:2012-01-01 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:BACKGROUND AND AIMS:Randomized controlled trials have shown that a once-daily prolonged-release (PR) tacrolimus formulation (PR tacrolimus; Advagraf * ), is non-inferior to a twice-daily immediate-release (IR) tacrolimus formulation (IR tacrolimus; Prograf † ) in terms of biopsy-proven acute rejection, graft failure an...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.916713
更新日期:2014-07-01 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:AIM:This analysis assessed the direct medical costs of newly-diagnosed, temozolomide (TMZ)-treated glioblastoma (GBM) from the perspective of a US commercial setting. MATERIALS AND METHODS:The analysis included subjects identified from the IMS PharMetrics LifeLink Plus™ claims database from January 1, 2008 to August 3...
journal_title:Journal of medical economics
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更新日期:2017-12-01 00:00:00
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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: This study aimed to examine the long-term clinical and economic burden of adults with congenital heart disease (ACHD) in Hong Kong. Methods: It retrospectively analyzed 336 consecutive ACHD patients who attended the Adult Congenital Heart Clinic between January 1, 2009 and December 31, 2014. Direct medical costs...
journal_title:Journal of medical economics
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journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of medical economics
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更新日期:2009-01-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1362410
更新日期:2017-11-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1066796
更新日期:2015-01-01 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:Ulipristal acetate has been found to be non-inferior to other pre-operative treatments of uterine fibroids, particularly leuprolide. The objective of this study was to assess the pharmacoeconomic profile of ulipristal acetate compared to leuprolide for the pre-operative treatment of moderate-to-severe uterine...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1254090
更新日期:2017-03-01 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
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doi:10.3111/13696998.2010.491435
更新日期:2010-01-01 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:OBJECTIVES:To evaluate the economic burden of herpes zoster (HZ) on the US healthcare system among an immunocompetent population. METHODS:Claims data from the MarketScan Research databases for 2008-2011 were extracted to determine the incremental healthcare resource utilization (RU) and direct medical costs associated...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1187150
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:This analysis was conducted to compare the direct medical costs of treatment with darbepoetin alfa every 3 weeks (Q3W) and epoetin alfa every week (QW) in patients with chemotherapy-induced anaemia (CIA) from the payer's perspective. METHODS:An analysis was conducted from a US health plan perspective to comp...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990801959656
更新日期:2008-01-01 00:00:00