Global & Regional Health Technology Assessment最新文献

Background: Health technology assessment (HTA) is a process evaluating various aspects of healthcare technologies to support evidence-based decisions. Benign prostatic hyperplasia (BPH) is a common condition among aging men, significantly affecting QoL. Traditional treatments like transurethral resection of the prostate (TURP) and Holmium Laser Enucleation (HoLEP) are effective but often associated with complications and sexual dysfunction. The Prostatic Urethral Lift (PUL) system (UroLift) offers a minimally invasive alternative, preserving sexual function and ensuring faster recovery.

Methods: Using the EUnetHTA Core Model 3.0, UroLift was evaluated across nine domains, combining a systematic review of literature, expert consultation, and real-world evidence. A Budget Impact Model (BIM) simulated treatment pathways over five years, comparing UroLift with TURP and HoLEP.

Results: As the analysis shows, despite the higher initial acquisition cost, UroLift generates savings for the NHS in all the years considered within the analysis. Specifically, savings are derived from the lower incidence of adverse events and complications, both post-operative and in the long term, implying lower inpatient costs and less use of human resources. As anticipated, savings begin in the first year with a differential between the two scenarios considered at 57,747.40 and peak in the fifth year with savings of approximately €1.35 million, for a total estimated savings over the considered time horizon, considering the market shares, of €3,154,997.63.

Conclusions: UroLift demonstrates clinical efficacy, faster recovery, and sexual function preservation while generating cost savings, supporting its integration into BPH management pathways in Italy.

Introduction: Inpatient treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) involves a significant economic burden on the healthcare system.The aim of the present analysis was to estimate the expenditure, in terms of direct and indirect healthcare costs, for patients hospitalized with a confirmed diagnosis of ABSSSI, evaluating the impact of dalbavancin, compared to the other Standard of Care of the same IV antibiotic class, analyzed in the REDS study.

Methods: The analysis was carried out using data collected as part of the study "Retrospective Effectiveness study of dalbavancin and other Standard of care of the same class IV lipo and glycopeptides) in patients with ABSSSI" (REDS study).In the present analysis, the economic impact of managing patients hospitalized for ABSSSI was estimated by evaluating both the direct healthcare costs relating to hospital and pharmaceutical care and the indirect costs relating to the loss of productivity due to the pathology.

Results and conclusions: The analysis of data from the REDS study made it possible to estimate the economic impact of the management of patients hospitalized for ABSSSI, depending on the treatment received during hospitalization.The results highlighted a reduction in costs for patients treated with dalbavancin, both for direct healthcare costs and indirect costs, over the entire observation period. Again, the reduction increases, reaching statistical significance, and the costs are evaluated from the beginning of the treatment.

Background: Immunoglobulin A nephropathy (IgAN) is a rare disease poorly described in real-world settings. This observational retrospective study aimed to assess the direct healthcare burden of new IgAN patients on the Italian National Healthcare Service (SSN).

Methods: From the Fondazione Ricerca e Salute's database (administrative healthcare data of ~5.5 million inhabitants/year), inpatients with new potential in-hospital biopsy-verified IgAN from 2016 to 2019 were identified. Dispensations of IgAN-recommended and other drugs, kidney replacement therapies (KRT), hospital and emergency department (ED) admissions, local outpatient specialist care, and related direct costs were assessed throughout a 3-year follow-up.

Results: New IgAN patients (n = 292) were identified (incidence/year: 1.25/100 000 inhabitants); 64% of patients were male; the median age was 41 (27; 57) years. Annual consumption of most healthcare resources decreased from Year 1 to 3: from 90% to 84% of patients received ≥1 IgAN-recommended drug; from 100% (due to selection criteria) to 15% of patients underwent overnight hospitalizations; from 8% to 3% patients underwent day hospitalizations; from 31% to 21% patients underwent ≥1 ED access; from 87% to 85% patients received local outpatient specialist services. Of all patients, 2-4% were treated with KRT, and ~91% received other drugs. The per capita mean total annual cost was €7441 in Year 1 (hospitalizations accounting for 73% due to selection criteria), €3497 in Year 2, and €3243 in Year 3 (drugs accounting for 51%, mostly attributable to other drugs).

Conclusion: This real-world study shows a substantial direct healthcare burden for new IgAN patients arising from IgAN-specific care and comorbidities.

Introduction: This study assesses the cost-effectiveness of cenobamate relative to brivaracetam, lacosamide, eslicarbazepine acetate, and perampanel in the management of focal onset seizures (FOS). The objective is to determine whether cenobamate offers enhanced therapeutic benefits and economic viability.

Methods: A comprehensive cost-effectiveness analysis was performed using a lifetime horizon model that encompassed drug acquisition costs, background therapy, monitoring, and seizure management expenses. The incremental cost-effectiveness ratio (ICER) was calculated to evaluate the quality-adjusted life years (QALYs) gained from cenobamate compared to its alternatives.

Results: Findings revealed that cenobamate while incurring slightly higher initial acquisition costs, leads to significant cost offsets due to reductions in overall seizure management expenses and minimized reliance on subsequent anti-seizure medications (ASMs). Additionally, cenobamate significantly enhances patient quality of life, demonstrated by superior response rates (seizure reduction >50%) and remission rates (100% seizure reduction) compared to the analyzed comparators. The cost-effectiveness analysis established that cenobamate is dominant across all evaluated treatment options, achieving greater QALYs at a lower total cost.

Conclusion: Cenobamate represents a more effective and economically advantageous treatment for patients with FOS when compared to brivaracetam, lacosamide, eslicarbazepine acetate, and perampanel. Its capacity to improve seizure control and enhance the quality of life, alongside favorable economic implications, underscores its position as the preferred therapeutic option in this patient population.