Expert Review of Pharmacoeconomics & Outcomes Research最新文献

Background: This inquiry assesses the willingness to pay (WTP) for a COVID-19 vaccination in Vietnam, and uses a mixed-method approach to investigate how economic, social, and health factors influence acceptance of a vaccine and payment preferences.

Methods: The research agenda was implemented via a Discrete Choice Experiment (DCE) with 685 Vietnamese respondents aged 18 years and older from June to September 2024, to measure preferences based on vaccine attributes such as cost, safety, side effects, and duration of protection. WTP was estimated using Binary Logistic Regression. In addition, semi-structured interviews were carried out with 26 community members to explore perceptions, beliefs, and trust in government health messages.

Results: Quantitative findings indicated that increased WTP was significantly associated with income, education, and perceived vaccine safety. The qualitative findings also raised concerns regarding vaccine side effects and trust in public health communications. Citizens who are higher in socioeconomic status are more likely to accept and pay for the vaccine.

Conclusions: The study shows that there are behavioral as well as economic factors influencing vaccinations. The findings may inform targeted strategies to increase vaccine acceptance among poor communities. Limitations include a cross-sectional design and self-reported attitudes, which may be subject to recall bias.

Background: Cystoscopy is a high-frequency endoscopic procedure requiring sustainable and evidence-based device management strategies.

Research design and methods: This institutional cost-opportunity analysis compared disposable and reusable cystoscope devices in a high-volume oncology center. Retrospective real-world data on disposable use were combined with theoretical modeling for reusable systems under three operational scenarios: disposable, reusable with standard sterilization, and reusable with urgent sterilization, each analyzed in optimized and maximal-cost conditions.

Results: Disposable cystoscopes cost €188.75 per procedure, halved procedural time (15 vs. 30 minutes), and ensured workflow continuity. Reusable systems were economically sustainable only under optimized reprocessing (two cystoscopes per cycle, €180.88 per procedure). Under urgent or single-scope sterilization, per-procedure costs increased to €198.88, with annual excesses of up to €79,820.88 compared to disposable systems. Disposable devices minimized downtime and logistical complexity, particularly in high-demand settings.

Conclusions: Reusable cystoscopes achieve economic sustainability only when supported by standardized, high-efficiency workflows, while disposables provide flexibility and reliability in routine and urgent care. Despite its single-center, retrospective design, this framework provides transferable insights for healthcare institutions aiming to align cost management, service quality, and sustainability in cystoscopic practice. Future multicentric studies are warranted to validate these findings across diverse organizational settings.

Background: One of the novel methods of blood glucose monitoring is continuous glucose monitoring (CGM). This study aims to evaluate the cost-effectiveness of CGM versus self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes (T2D) in Iran.

Methods: A cost-effectiveness analysis with a lifetime horizon was conducted to compare the two monitoring strategies. The patient-level United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model was employed, and clinical and demographic data from Iranian patients enrolled in the Diabetes Care study were extracted for the analysis. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs), expressed as cost per QALY gained. Uncertainty in the model was addressed through probabilistic sensitivity analysis using 100 bootstrap iterations.

Results: The cost-effectiveness analysis showed that the expected cost of CGM compared to SMBG was $40,444.2. The incremental gain in QALYs was 0.096, resulting in an ICER of $397,644.7 per QALY gained. Based on bootstrap analysis, the 95% CI for the ICER ranged from $271,157.3 to $600,185.2.

Conclusion: CGM does not represent a cost-effective alternative to SMBG for patients with T2D in Iran. This finding was supported by bootstrap analysis, which demonstrated a lack of cost-effectiveness across all simulated scenarios.

Background: Low back pain (LBP) is a disabling condition affecting all age groups globally. Exercise is safe and cost-effective for managing LBP. Pilates is an effective exercise modality recommended for LBP but is not reimbursed by the Brazilian Public Health System. This study aimed to estimate the budget impact of implementing Pilates for LBP patients within the Brazilian public health system compared to usual care.

Research design and methods: A budget impact analysis (BIA) was conducted over a five-year horizon, from healthcare and societal perspectives. Costs were extracted in local currency and converted to international dollars using purchasing power parities. Deterministic sensitivity analyses were performed.

Results: Over five years, healthcare costs in the usual care were Int$860.8 million, while Pilates reached Int$958 million, resulting in an incremental impact of Int$97.2 million. From the societal perspective, the usual care cost was Int$4.32 billion, and the Pilates scenario was Int$4.15 billion, indicating savings of Int$172.2 million. The incremental budget impact was negative, meaning that Pilates would provide savings of Int$172,203,216.

Conclusion: Implementing a group-based Pilates program for LBP in the Brazilian public health system would increase healthcare costs by Int$97 million but generate societal savings of Int$172 million over five years.

Introduction: Despite decades of HIV prevention efforts, key populations - MSM, transgender people, PWUD, sex workers, and migrants - remain disproportionately affected by HIV. Although prevention tools are widely available, global targets remain unmet, largely due to persistent structural and sociocultural barriers, resulting in an important societal cost.

Areas covered: This scoping review analyzes 197 studies (2018-2022) quantitative and qualitative, from 48 countries to map barriers to HIV prevention across five key populations and five continents, using Medline and Scopus databases according to the PRISMA-ScR methodology. It reveals widespread legal and institutional obstacles: lack of health insurance, criminalization of their condition, stigma (including HIV and internalized stigma), violence, poverty, low health literacy, and healthcare mistrust. It also identifies major gaps in research coverage around the world.

Expert opinion: Despite major progress in HIV prevention, inequities persist in implementation and access. Our study highlights the urgent need of coordinated governmental and institutional efforts to ensure universal access to prevention tools, social protection, and stigma reduction interventions, as requested by UNAIDS. An intersectional approach that responds to the overlapping vulnerabilities faced by key populations is essential. Without systemic change, biomedical progress alone will not be sufficient to put an end to HIV.

Objective: To evaluate the effects of standardized pharmaceutical service (SPS) on medication adherence, anxiety, and depression in patients with chronic obstructive pulmonary disease (COPD).

Research design and methods: A prospective, randomized controlled study design was adopted. 184 COPD patients hospitalized at the First Hospital of Putian City between March and August 2023 were randomly assigned to a control group receiving routine care or observation group receiving SPS provided by clinical pharmacists. SPS included health records establishment, education, medication guidance, psychological support and medication simplification. Patients were followed for 6 months. Eight-Item Morisky Medication Adherence Scale (MMAS-8), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were used to assess outcomes.

Results: At 3- and 6-month, the observation group had higher MMAS-8 scores (P < 0.05) and a greater of good-to-moderate adherence at 6 months (66.30% vs.35.87%; P < 0.01). Moderate-to-severe anxiety and depression rates were significantly lower in the observation group (53.26% and 54.35%) than in controls (P < 0.001). Fewer adverse events were recorded in the observation group (3 vs. 8), though not statistically significant.

Conclusion: SPS enhance medication adherence and reduce anxiety and depression in COPD patients, supporting its integration into routine COPD management.

Introduction: Antimicrobial resistance (AMR) is a complex global health challenge with significant, yet underutilized economic dimensions. Beyond the clinical aspect, this growing threat demands interdisciplinary solutions that bridge economic theory and practice.

Areas covered: This scoping review synthesizes economic perspectives on AMR through systematic analysis from Ovid MEDLINE, Scopus, EconLit, and PubMed (December 2023 to June 2025). We examine four critical domains: (1) foundational economic theories explaining AMR drivers through public goods theory, tragedy of commons, externalities, and market failures; (2) real-world market dynamics including supply-demand imbalances and principal-agent relationships in clinical settings; (3) policy interventions spanning regulatory frameworks, fiscal measures, and behavioral economics applications in antimicrobial stewardship; and (4) economic evaluation methodologies encompassing descriptive, evaluative, and predictive analyses. Our analysis reveals how theoretical economic frameworks arise in healthcare practice and why comprehensive multi-component interventions outperform single-approach strategies.

Expert opinion: Sustainable AMR mitigation requires fundamentally rethinking policy design through these interconnected economic lenses, transitioning from fragmented interventions to economically coherent frameworks that align short-term clinical decisions with long-term antimicrobial preservation. These changes demand unprecedented collaboration between economists, clinicians, and policymakers to align individual incentives with collective health security.

Background: Atopic dermatitis (AD) is a chronic skin disease that affects patients' quality of life. Adequate treatment is important but patients' preferences are not fully understood. This study aimed to investigate which treatment attributes are most important for adult European AD patients.

Research design and methods: A discrete choice experiment was conducted. Participants were asked to choose their preferred hypothetical treatment option in 15 choice sets. Six included attributes were identified by consulting literature, patients, physicians, and preference experts. A mixed logit model was applied to estimate preference coefficients.

Results: All attributes were important for seventy-five participants (79% female, mean age 37.8 years). Itch reduction was most relevant (55.95%), followed by infection risk (15.96%), mode of administration (9.64%), long-term diseases management (8.11%), onset time (5.33%), and availability on the market (5.01%). Participants prefer emollients without preservatives and oral pills, while emollients with preservatives and self-injections are associated with utility loss.

Conclusions: This study identified most important treatment attributes for AD patients. It could improve AD patients' access to suitable therapies as findings might support development of better aligned treatments and provide new perspectives for joint treatment decision-making. Main limitation was low number of participants, although significant results were still achieved.

Background: One approach to address the limitations of the EQ-5D-5L questionnaire is to add additional dimensions. This study investigated the effect of adding a vision dimension to the EQ-5D-5L questionnaire on health state valuations in people with visual impairments.

Methods: This cross-sectional study was conducted using both the standard EQ-5D-5L and an expanded version (EQ-5D-5L + V, including a vision dimension) through face-to-face interviews with 300 individuals with visual impairments. Twenty health states, with and without the vision dimension, were assessed using the Time Trade-Off (TTO) method according to the EQ-VT protocol. Data were analyzed using Chi-square and Fisher's exact tests, independent t-tests, and multivariate regression.

Results: The addition of the vision dimension significantly increased the differences in health state valuations, particularly for severe health states (P < 0.001). The largest differences in TTO scores were observed for severe health states 555555, 555553, 532441, and 351431.

Conclusion: Adding a vision dimension to the EQ-5D-5L instrument significantly affects health state valuations, especially for severe levels (4 and 5) and severe health states. Future studies should further explore the impact of adding vision and other bolt-on dimensions, focusing on the levels of the added dimensions.

Background: Cancer survivors face ongoing health challenges that can reduce work capacity, yet the economic impact of workplace productivity losses remains underexamined. We aim to estimate workplace productivity losses, specifically absenteeism and presenteeism, among Australian cancer survivors and quantified associated wage costs.

Methods: We analyzed four waves (2009-2021) of the Household, Income and Labour Dynamics in Australia (HILDA) Survey, including adults aged ≥15 years in the labor force reporting cancer, non-cancer serious illness, or no serious illness. Absenteeism (annual days off work) was modeled using zero-inflated Poisson regression, and presenteeism (self-reported reduced work performance) using logistic regression, adjusting for sociodemographic, health, and employment factors. Sensitivity analyses explored alternative absenteeism definitions.

Results: Cancer survivors had a 33% higher rate of absenteeism (Incidence Rate Ratio [IRR]: 1.33; 95% CI: 1.31-1.35, p-value < 0.001) and approximately double the odds of presenteeism (Adjsusted Odds Ratio [aOR] : 2.04; 95% CI: 1.71-2.43; p-value < 0.001) compared with individuals without serious illness. Estimated average annual absenteeism-related wage loss was AU$1425.45, predominantly among working-age adults (25-64 years).

Conclusion: Cancer imposes substantial workplace productivity losses with significant economic implications. Findings support the development of evidence-based workplace policies and targeted occupational health interventions to sustain employment and reduce economic burden among cancer survivors.