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: We developed a budget impact and cost-consequence model that simulates CRC screening for eligible 50- to 75-year-old adults. A status quo scenario and an increased mt-sDNA scenario were modeled. The status quo includes the current screening mix of colonoscopy (83%), FIT (11%), and mt-sDNA (6%) modalities. The increased mt-sDNA scenario increases mt-sDNA utilization to 28% over 10 years. Costs for both the IDN and the payer perspectives incorporated diagnostic and surveillance colonoscopies, adverse events (AEs), and CRC treatment. The IDN perspective included screening program costs, composed of direct nonmedical (e.g. patient navigation) and indirect (e.g. administration) costs. It was assumed that IDNs do not incur the costs for stool-based screening tests or bowel preparation for colonoscopies.Results: In a population of one million covered lives, the 10-year incremental cost savings incurred by increasing mt-sDNA utilization was $16.2 M for the IDN and $3.3 M for the payer. The incremental savings per-person-per-month were $0.14 and $0.03 for the IDN and payer, respectively. For both perspectives, increased diagnostic colonoscopy costs were offset by reductions in screening colonoscopies, surveillance colonoscopies, and AEs. Extending screening eligibility to 45- to 75-year-olds slightly decreased the overall cost savings.Limitations: The natural history of CRC was not simulated; however, many of the utilized parameters were extracted from highly vetted natural history models or published literature. Direct nonmedical and indirect costs for CRC screening programs are applied on a per-person-per modality basis, whereas in reality some of these costs may be fixed.Conclusions: Increased mt-sDNA utilization leads to fewer colonoscopies, less AEs, and lower overall costs for both IDNs and payers, reducing overall screening program costs and increasing the number of cancers detected while maintaining screening adherence rates over 10 years.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Hathway JM,Miller-Wilson LA,Jensen IS,Ozbay B,Regan C,Jena AB,Weinstein MC,Parks PDdoi
10.1080/13696998.2020.1730123subject
Has Abstractpub_date
2020-06-01 00:00:00pages
581-592issue
6eissn
1369-6998issn
1941-837Xjournal_volume
23pub_type
杂志文章abstract:OBJECTIVES:The first objective was to assess the effect of the chondroitin 4 and 6 sulphate (CS) on health-related quality of life using utility values in patients with knee osteoarthritis (OA) during a 24-month treatment course. The second objective was, using these data, to conduct economic analyses. METHODS:Data fr...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696990903438617
更新日期:2009-01-01 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:OBJECTIVE:The past few decades have been marked by a bold increase in national health spending across the globe. Rather successful health reforms in leading emerging markets such as BRICS reveal a reshaping of their medical care-related expenditures. There is a scarcity of evidence explaining differences in long-term m...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1093493
更新日期:2016-01-01 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:OBJECTIVES:To assess the costs of severe hypoglycaemic events (SHEs) in diabetes patients in Germany, Spain and the UK. METHODS:Healthcare resource use was measured by surveying 639 patients aged ≥ 16 years, receiving insulin for type 1 (n=319) or type 2 diabetes (n=320), who experienced ≥ 1 SHE in the preceding year....
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990903336597
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To compare rates of severe relapse and total direct and indirect costs over a 2-year period between US-based employees with multiple sclerosis (MS) who were adherent and non-adherent to disease-modifying drugs (DMDs). METHODS:Employees with ≥1 MS diagnosis (ICD-9-CM: 340.x) and ≥1 DMD pharmacy claim between ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.667027
更新日期:2012-01-01 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:BACKGROUND:Percutaneous pulmonary valve implantation (PPVI) using the Melody * transcatheter pulmonary valve is a new procedure introduced in 2000 as a less invasive treatment for right ventricular outflow tract (RVOT) dysfunction. The aim of this new procedure is to restore pulmonary valve competence without the need ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.545465
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To compare the persistence and costs of brimonidine versus brinzolamide therapy according to data collected by the UK General Practitioner Research Database (GPRD). METHODS:Patients with diagnoses of ocular hypertension or glaucoma, or treated for glaucoma by surgery or laser therapy were identified. Selecte...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990802211107
更新日期:2008-01-01 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: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 carry out a cost-utility analysis comparing initial treatment with solifenacin 5 mg/day vs oxybutynin immediate-release (IR) 15 mg/day for the treatment of patients with overactive bladder (OAB) from the perspective of the U.K. National Health Service (NHS). METHODS:A Markov model with six health states w...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.829079
更新日期:2013-10-01 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: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: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: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 treatment of iron deficiency (ID) with ferric carboxymaltose (FCM) improves the functional class and quality of life of chronic heart failure (CHF) patients with reduced left ventricular ejection fraction (LVEF), and reduces the rate of hospitalization due to worsening CHF. This study aims to evaluate the...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1838872
更新日期:2020-10-30 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: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:Neuroblastoma (NB) is notorious in childhood cancer because of its high incidence and poor prognosis. The Children's Oncology Group reported that the 3-year OS in the high-risk (HR) group is 50%, and the HR-NB with bone marrow metastasis in our center is 43.1%. Thousands of families in China suffer from the ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1786392
更新日期:2020-09-01 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:OBJECTIVE:Reduction in health-related quality of life is common in children born small for gestational age (SGA) or children with growth hormone deficiency (GHD). Growth hormone treatment with somatropin in these children leads to normalisation of height. The aim of this study was to determine whether somatropin is a c...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696991003652248
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Cost-effectiveness analyses of new treatments for cardiovascular disease frequently require input parameters whose values are known with uncertainty due to limited data. The objective of this paper is to examine the extent to which published sensitivity analyses addressing this uncertainty adhere to Health Te...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.3111/13696990903123813
更新日期:2009-06-01 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: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: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:To compare patient characteristics, rates, and costs of medically attended falls among patients with Parkinson's disease (PD) and probable PD plus neurogenic orthostatic hypotension (PD + nOH). MATERIALS AND METHODS:MarketScan Commercial and Medicare Supplemental databases (January 1, 2009-December 31, 2013) were...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2017.1284668
更新日期:2017-05-01 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: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