Abstract:
:Aims: OnabotulinumtoxinA is recommended by NICE for the treatment of chronic migraine. This economic evaluation provides updated estimates of the cost-effectiveness of onabotulinumtoxinA for chronic migraine using new utility estimates in an existing model structure.Methods: A previously published model was revised to include EQ-5D utility estimates from a large observational study (REPOSE; n = 633). Efficacy data were taken from the pooled phase III PREEMPT clinical trial program, while resource utilization estimates were obtained from the International Burden of Migraine Study (IBMS). The model estimated costs and quality-adjusted life years (QALYs) gained over 2 years from the UK NHS perspective.Results: OnabotulinumtoxinA treatment resulted in total discounted incremental costs of £1,204 and an incremental discounted QALY gain of 0.07 compared with placebo in patients with chronic migraine who have previously failed three or more preventive treatments, corresponding to an incremental cost-effectiveness ratio (ICER) of £16,306 per QALY gained. Scenario analysis showed that the administration of onabotulinumtoxinA by a specialist nurse rather than a neurology consultant reduced the ICER from £16,306 to £13,832 per QALY gained. Removal of the positive stopping rule recommended in current NICE guidance increased the ICER to £20,768 per QALY for onabotulinumtoxinA vs. placebo. Combining these two scenarios produced an ICER of £17,686 per QALY gained.Conclusion: NICE recommended onabotulinumtoxinA for the prevention of chronic migraine in 2012 amid concerns about the uncertainty of ICER estimates, with a positive stopping rule used to manage some of these uncertainties. Since the publication of the NICE guidance, the REPOSE study provides a more recent source of utility data based on real-world evidence. The results of analyses including these utilities suggest that the application of the positive stopping rule may not be necessary to ensure cost-effectiveness and that this aspect of the current NICE guidance for onabotulinumtoxinA may merit reconsideration.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Hollier-Hann G,Curry A,Onishchenko K,Akehurst R,Ahmed F,Davies B,Keyzor Idoi
10.1080/13696998.2019.1675417subject
Has Abstractpub_date
2020-01-01 00:00:00pages
113-123issue
1eissn
1369-6998issn
1941-837Xjournal_volume
23pub_type
杂志文章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: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: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: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: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::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: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:To compare all-cause and diabetes-related resource utilization and healthcare charges among adults with type 2 diabetes mellitus who initiated therapy with mealtime insulin disposable pens or vials. METHODS:Data were obtained from the Innovus inVision database from January 1, 2006 through June 30, 2010. Gene...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.823091
更新日期:2013-10-01 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: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:AIM:Prescription drug prices in the United States are considered rather extreme. Americans spend over $460 billion on drugs annually, or almost 17 percent of total national healthcare spending. How innovation incentives and insurance coverage drive pricing, diffusion, and utilization of drugs, under conditions of risk ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1772797
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Epilepsy surgery is one of the most effective treatments in modern medicine. Yet, it remains largely under-utilized, in spite of its proven efficacy. The referrals for epilepsy surgery are often delayed until it is too late to prevent the detrimental psychosocial effects of refractory seizures. The reluctance...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1412975
更新日期:2018-05-01 00:00:00
abstract::Aims: Due to the lack of studies evaluating compliance or persistence with Alzheimer's Disease (AD) treatment outside High-Income Countries (HICs), this study aimed to assess compliance, persistence, and factors associated with non-compliance and non-persistence by utilizing existing "real-world" information from mult...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1534739
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Validation of overall survival (OS) extrapolations of immune-checkpoint inhibitors (ICIs) during the National Institute for Health and Care Excellence (NICE) Single Technology Assessment (STA) process is limited due to data still maturing at the time of submission. Inaccurate extrapolation may lead to inappr...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2018.1547303
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:A cost analysis of once-daily insulin glargine versus three-times daily insulin lispro in combination with oral antidiabetic drugs (OADs) for insulin-naive type 2 diabetes patients in Germany based on the APOLLO trial (A Parallel design comparing an Oral antidiabetic drug combination therapy with either Lantu...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990902949614
更新日期:2009-06-01 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:AIMS:Six Delta is a six-dimensional independent platform for outcome-based pricing/contracting. The six dimensions have been described separately: (δ1) cost-effectiveness analysis and cost-utility analysis-based pricing; (δ2) willingness-to-pay-based pricing; (δ3) reference-based pricing; (δ4) safety-based pricing; (δ5...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1815031
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To compare outcomes between patients with type 2 diabetes mellitus (T2DM) using fixed-dose combination (FDC) and loose-dose combination (LDC) products. METHODS:This retrospective cohort study used MarketScan Commercial and Medicare Supplemental data from January 1, 2009-December 31, 2013. The identified popu...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1109518
更新日期:2016-01-01 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:OBJECTIVE:To assess the cost-effectiveness of panitumumab in combination with mFOLFOX6 (oxaliplatin, 5-fluorouracil, and leucovorin) vs bevacizumab in combination with mFOLFOX6 as first-line treatment of patients with wild-type RAS metastatic colorectal cancer (mCRC) in Spain. METHODS:A semi-Markov model was developed...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.1080/13696998.2017.1285780
更新日期:2017-06-01 00:00:00
abstract::Background: IVF is now a wide spread procedure globally, and currently 65 countries report annually all or part of their IVF/ICSI cycles, from which the International Committee Monitoring progress in Assisted Reproduction Technology (ICMART) published its report. There is considerable variation in the utilization (num...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1609484
更新日期:2019-09-01 00:00:00
abstract:AIM:Disease-modifying therapies (DMTs) impact the natural history of relapsing forms of multiple sclerosis (RRMS) by reducing annual relapse rates and slowing disability progression. The effect of DMTs on indirect costs has not been consistently explored in cost-effectiveness studies thus far. The value to patients of ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1357564
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:The ECHELON-1 trial demonstrated efficacy and safety of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as frontline therapy for stage III/IV classical Hodgkin lymphoma. This analysis evaluated the cost-effectiveness o...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1080/13696998.2018.1542599
更新日期:2019-02-01 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:Until recently, standard treatment of venous thromboembolism (VTE) concerned a combination of short-term low-molecular-weight heparin (LMWH) and long-term vitamin-K antagonist (VKA). Risk of bleeding and the requirement for regular anticoagulation monitoring are, however, limiting their use. Rivaroxaban is a...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.1080/13696998.2017.1331912
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:This study compared real-world treatment patterns and healthcare costs among biologic-naive psoriasis patients initiating apremilast or biologics. METHODS:A retrospective cohort study was conducted using the Optum Clinformatics™ claims database. Patients with psoriasis were selected if they had initiated apr...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1571500
更新日期:2019-04-01 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: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::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: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