Journal of Health Economics and Outcomes Research最新文献_第6页

Cryoballoon Ablation With the POLARx FIT or the Arctic Front Advance Pro for Paroxysmal Atrial Fibrillation: A Health Economic Analysis. 使用polar FIT或Arctic Front Advance Pro冷冻球囊消融治疗阵发性心房颤动：健康经济学分析。

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-04-21 eCollection Date: 2025-01-01 DOI: 10.36469/001c.133223

Luigi Pannone, Steffen Uffenorde, Antonia Bosworth Smith, Domenico Giovanni Della Rocca, Pasquale Vergara, Ioannis Doundoulakis, Antonio Sorgente, Alvise Del Monte, Giacomo Talevi, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Ali Gharaviri, Mark La Meir, Pedro Brugada, Andrea Sarkozy, Gian Battista Chierchia, Carlo de Asmundis

Background: Pulmonary vein isolation (PVI) is the main ablation strategy for the treatment of paroxysmal atrial fibrillation. Different technologies are available for PVI, including various cryoballoon catheters (CB-A). Compared with the Arctic Front Advance Pro™, the novel POLARx FIT™ CB-A might reduce costs for atrial fibrillation ablation. Objective: The aim of this study is to perform a health economic evaluation of two cryoballoon systems for PVI procedures. Methods: All patients undergoing their first PVI procedure with POLARx FIT™ CB-A or the Arctic Front Advance Pro™ CB-A were prospectively enrolled. The health economic analysis was performed on the index hospitalization and procedure. The primary safety endpoint included procedure-related adverse events within the index hospitalization. A decision tree model was built to estimate downstream costs. Results: A total of 80 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed, with 40 patients in each arm. Compared with the Arctic Front Advance Pro™ CB-A, POLARx FIT™ CB-A showed a lower procedure time, left-atrium dwell time, and fluoroscopy time. The complication rate was low (6.3%) and included 3 reversible phrenic nerve palsies in the POLARx FIT™ CB-A group vs 2 in the Arctic Front Advance Pro™ CB-A group. Compared with the Arctic Front Advance Pro, the POLARx FIT™ CB-A was associated with lower procedural costs (€2069.7 ± €165.2 vs €2239.5 ± €366.0; P =.009). Conclusion: The POLARx FIT™ CB-A was associated with a shorter procedure time, translating into lower procedural costs, compared with the Arctic Front Advance Pro. Complications were rare and comparable between the two technologies.

背景：肺静脉隔离（PVI）是治疗阵发性心房颤动的主要消融策略。不同的技术可用于PVI，包括各种低温球囊导管（CB-A）。与Arctic Front Advance Pro™相比，新型的POLARx FIT™CB-A可能会降低房颤消融的成本。目的：本研究的目的是对两种用于PVI手术的冷冻球囊系统进行健康经济评估。方法：前瞻性纳入所有使用POLARx FIT™CB-A或Arctic Front Advance Pro™CB-A进行首次PVI手术的患者。对指标、住院时间和手术过程进行卫生经济学分析。主要安全终点包括指数住院期间与手术相关的不良事件。建立了一个决策树模型来估计下游成本。结果：共分析80例阵发性心房颤动患者行PVI，每组40例。与Arctic Front Advance Pro™CB-A相比，POLARx FIT™CB-A显示出更短的手术时间、左心房停留时间和透视时间。并发症发生率较低（6.3%），在POLARx FIT™CB-A组中有3例可逆性膈神经麻痹，而在Arctic Front Advance Pro™CB-A组中有2例。与Arctic Front Advance Pro相比，POLARx FIT™CB-A的操作成本更低(2069.7±165.2欧元vs 2239.5±366.0欧元；P = .009)。结论：与Arctic Front Advance Pro相比，POLARx FIT™CB-A具有更短的手术时间，转化为更低的手术成本。两种技术之间的并发症非常罕见且具有可比性。

{"title":"Cryoballoon Ablation With the POLARx FIT or the Arctic Front Advance Pro for Paroxysmal Atrial Fibrillation: A Health Economic Analysis.","authors":"Luigi Pannone, Steffen Uffenorde, Antonia Bosworth Smith, Domenico Giovanni Della Rocca, Pasquale Vergara, Ioannis Doundoulakis, Antonio Sorgente, Alvise Del Monte, Giacomo Talevi, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Ali Gharaviri, Mark La Meir, Pedro Brugada, Andrea Sarkozy, Gian Battista Chierchia, Carlo de Asmundis","doi":"10.36469/001c.133223","DOIUrl":"https://doi.org/10.36469/001c.133223","url":null,"abstract":"Background: Pulmonary vein isolation (PVI) is the main ablation strategy for the treatment of paroxysmal atrial fibrillation. Different technologies are available for PVI, including various cryoballoon catheters (CB-A). Compared with the Arctic Front Advance Pro™, the novel POLARx FIT™ CB-A might reduce costs for atrial fibrillation ablation. Objective: The aim of this study is to perform a health economic evaluation of two cryoballoon systems for PVI procedures. Methods: All patients undergoing their first PVI procedure with POLARx FIT™ CB-A or the Arctic Front Advance Pro™ CB-A were prospectively enrolled. The health economic analysis was performed on the index hospitalization and procedure. The primary safety endpoint included procedure-related adverse events within the index hospitalization. A decision tree model was built to estimate downstream costs. Results: A total of 80 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed, with 40 patients in each arm. Compared with the Arctic Front Advance Pro™ CB-A, POLARx FIT™ CB-A showed a lower procedure time, left-atrium dwell time, and fluoroscopy time. The complication rate was low (6.3%) and included 3 reversible phrenic nerve palsies in the POLARx FIT™ CB-A group vs 2 in the Arctic Front Advance Pro™ CB-A group. Compared with the Arctic Front Advance Pro, the POLARx FIT™ CB-A was associated with lower procedural costs (€2069.7 ± €165.2 vs €2239.5 ± €366.0; P =.009). Conclusion: The POLARx FIT™ CB-A was associated with a shorter procedure time, translating into lower procedural costs, compared with the Arctic Front Advance Pro. Complications were rare and comparable between the two technologies.","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"155-161"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estimating the Fiscal Value of Children Conceived from Assisted Reproduction Technology in Australia Applying a Public Economic Perspective. 从公共经济角度估计澳大利亚辅助生殖技术受孕儿童的财政价值。

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-04-18 eCollection Date: 2025-01-01 DOI: 10.36469/001c.133796

Mark Connolly, Nikos Kotsopoulos, Jinjing Li, Georgina Chambers

Background: Public funding for assisted reproduction varies across countries, which can influence the numbers of infertile couples treated annually, and consequently the numbers of children born each year from this technology. As infertility is a medical condition treated within the healthcare system, it must compete against all other medical interventions for funding. This raises questions about how to evaluate a technology that gives rise to human life compared with other healthcare interventions that reduce morbidity and mortality. Objective: To evaluate annual public spending on assisted reproduction technology (ART) in Australia to determine the likely fiscal impact for government over the projected lifetime of an ART-conceived birth cohort. Methods: A public economic framework was used to evaluate the number of children born from ART procedures performed in Australia in 2021 based on projected future lifetime tax contributions and public benefits received. We leveraged data from the Survey of Income and Housing conducted by the Australian Bureau of Statistics and imputations from tax-transfer microsimulations over the lifetime of the cohort estimating cumulative net-taxes. Public spending per pupil for education and lifetime health costs (in Australian dollars) were included in the benefits estimates. Results: We estimated lifetime gross taxes per individual of A <math><mn>841</mn> <mrow><mo> </mo></mrow> <mn>631</mn> <mo>,</mo> <mi>c</mi> <mi>o</mi> <mi>n</mi> <mi>s</mi> <mi>i</mi> <mi>s</mi> <mi>t</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>o</mi> <mi>f</mi> <mi>A</mi></math> 580 182 in direct taxation of earnings and A <math><mn>261</mn> <mrow><mo> </mo></mrow> <mn>448</mn> <mi>i</mi> <mi>n</mi> <mi>c</mi> <mi>o</mi> <mi>n</mi> <mi>s</mi> <mi>u</mi> <mi>m</mi> <mi>p</mi> <mi>t</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mi>t</mi> <mi>a</mi> <mi>x</mi> <mi>e</mi> <mi>s</mi> <mo>.</mo> <mi>A</mi> <mi>f</mi> <mi>t</mi> <mi>e</mi> <mi>r</mi> <mi>d</mi> <mi>e</mi> <mi>d</mi> <mi>u</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>l</mi> <mi>i</mi> <mi>f</mi> <mi>e</mi> <mi>t</mi> <mi>i</mi> <mi>m</mi> <mi>e</mi> <mi>t</mi> <mi>r</mi> <mi>a</mi> <mi>n</mi> <mi>s</mi> <mi>f</mi> <mi>e</mi> <mi>r</mi> <mi>s</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>e</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>d</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>A</mi> <mi>R</mi> <mi>T</mi> <mi>t</mi> <mi>r</mi> <mi>e</mi> <mi>a</mi> <mi>t</mi> <mi>m</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mo>,</mo> <mi>a</mi> <mi>n</mi> <mi>A</mi> <mi>R</mi> <mi>T</mi> <mo>-</mo> <mi>c</mi> <mi>o</mi> <mi>n</mi> <mi>c</mi> <mi>e</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>d</mi> <mi>c</mi> <mi>h</mi> <mi>i</mi> <mi>l</mi> <mi>d</mi> <mi>w</mi> <mi>a</mi> <mi>s</mi> <mi>p</mi> <mi>r</mi> <mi>o</mi> <mi>j</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>e</mi> <mi>d</mi> <mi>t</mi> <mi>o</mi> <mi>g</mi> <m

背景：各国对辅助生殖的公共资助各不相同，这可能影响每年接受治疗的不育夫妇的数量，从而影响每年通过这项技术出生的儿童的数量。由于不孕症是在医疗保健系统内治疗的一种医疗状况，它必须与所有其他医疗干预措施竞争资金。这就提出了一个问题，即与其他降低发病率和死亡率的医疗保健干预措施相比，如何评估一项提高人类生命的技术。目的：评估澳大利亚在辅助生殖技术（ART）上的年度公共支出，以确定政府在ART受孕队列的预计寿命期间可能产生的财政影响。方法：根据预计的未来终身税收贡献和收到的公共福利，使用公共经济框架评估2021年澳大利亚ART手术中出生的儿童数量。我们利用了澳大利亚统计局进行的收入和住房调查的数据，以及在估计累计净税收的队列的整个生命周期中从税收转移微观模拟中推算出的数据。每个学生的教育和终身保健费用的公共支出（以澳元计算）已列入福利估计数。结果：我们估计每个人一生的总税收为841 631澳元，其中581 182澳元为收入直接税，261 448澳元为收入直接税。f t e r d e d u c t我n g l f e t m e t r n s f e r s r e n c e i v e d d r t t r e A t m e n c o s t s n r t - c o n c e i v e d c h i l d w s p r o j e c t e d t o g e n e r t e 70 688打折一生中净税收收入。根据每个儿童的平均政府支出，可以观察到终身财政收益-成本比为2.68。根据2021年ART治疗队列，预计在18364名出生儿童的一生中，政府将净赚12.9亿澳元的未来税收。结论：当前政府在抗逆转录病毒治疗方面的支出实现了正的净财政收益。我们观察到，每增加1澳元，就会有2.68澳元的未来折现净税收，而每增加1澳元，就会有2.68澳元的未来折现净税收。这些发现对未来工资增长和通货膨胀等经济状况很敏感。

{"title":"Estimating the Fiscal Value of Children Conceived from Assisted Reproduction Technology in Australia Applying a Public Economic Perspective.","authors":"Mark Connolly, Nikos Kotsopoulos, Jinjing Li, Georgina Chambers","doi":"10.36469/001c.133796","DOIUrl":"https://doi.org/10.36469/001c.133796","url":null,"abstract":"Background: Public funding for assisted reproduction varies across countries, which can influence the numbers of infertile couples treated annually, and consequently the numbers of children born each year from this technology. As infertility is a medical condition treated within the healthcare system, it must compete against all other medical interventions for funding. This raises questions about how to evaluate a technology that gives rise to human life compared with other healthcare interventions that reduce morbidity and mortality. Objective: To evaluate annual public spending on assisted reproduction technology (ART) in Australia to determine the likely fiscal impact for government over the projected lifetime of an ART-conceived birth cohort. Methods: A public economic framework was used to evaluate the number of children born from ART procedures performed in Australia in 2021 based on projected future lifetime tax contributions and public benefits received. We leveraged data from the Survey of Income and Housing conducted by the Australian Bureau of Statistics and imputations from tax-transfer microsimulations over the lifetime of the cohort estimating cumulative net-taxes. Public spending per pupil for education and lifetime health costs (in Australian dollars) were included in the benefits estimates. Results: We estimated lifetime gross taxes per individual of A <math><mn>841</mn> <mrow><mo> </mo></mrow> <mn>631</mn> <mo>,</mo> <mi>c</mi> <mi>o</mi> <mi>n</mi> <mi>s</mi> <mi>i</mi> <mi>s</mi> <mi>t</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>o</mi> <mi>f</mi> <mi>A</mi></math> 580 182 in direct taxation of earnings and A <math><mn>261</mn> <mrow><mo> </mo></mrow> <mn>448</mn> <mi>i</mi> <mi>n</mi> <mi>c</mi> <mi>o</mi> <mi>n</mi> <mi>s</mi> <mi>u</mi> <mi>m</mi> <mi>p</mi> <mi>t</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mi>t</mi> <mi>a</mi> <mi>x</mi> <mi>e</mi> <mi>s</mi> <mo>.</mo> <mi>A</mi> <mi>f</mi> <mi>t</mi> <mi>e</mi> <mi>r</mi> <mi>d</mi> <mi>e</mi> <mi>d</mi> <mi>u</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>l</mi> <mi>i</mi> <mi>f</mi> <mi>e</mi> <mi>t</mi> <mi>i</mi> <mi>m</mi> <mi>e</mi> <mi>t</mi> <mi>r</mi> <mi>a</mi> <mi>n</mi> <mi>s</mi> <mi>f</mi> <mi>e</mi> <mi>r</mi> <mi>s</mi> <mi>r</mi> <mi>e</mi> <mi>c</mi> <mi>e</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>d</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>A</mi> <mi>R</mi> <mi>T</mi> <mi>t</mi> <mi>r</mi> <mi>e</mi> <mi>a</mi> <mi>t</mi> <mi>m</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mo>,</mo> <mi>a</mi> <mi>n</mi> <mi>A</mi> <mi>R</mi> <mi>T</mi> <mo>-</mo> <mi>c</mi> <mi>o</mi> <mi>n</mi> <mi>c</mi> <mi>e</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>d</mi> <mi>c</mi> <mi>h</mi> <mi>i</mi> <mi>l</mi> <mi>d</mi> <mi>w</mi> <mi>a</mi> <mi>s</mi> <mi>p</mi> <mi>r</mi> <mi>o</mi> <mi>j</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>e</mi> <mi>d</mi> <mi>t</mi> <mi>o</mi> <mi>g</mi> <m","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"148-154"},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum: Article Correction: We Are on the Verge of Breakthrough Cures for Type 1 Diabetes, but Who Are the 2 Million Americans Who Have It? 文章更正：我们正处于突破1型糖尿病治疗的边缘，但200万美国人是谁？

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-04-18 eCollection Date: 2025-01-01 DOI: 10.36469/001c.134140

Rebecca Smith, Samara Eisenberg, Aaron Turner-Phifer, Jacqueline LeGrand, Sarah Pincus, Yousra Omer, Fei Wang, Bruce Pyenson

[This corrects the article DOI: 10.36469/jheor.2024.124604.].

[这更正了文章DOI: 10.36469/jheor.2024.124604.]。

引用次数: 0

Unveiling the Public Economic Burden of Migraine in Argentina. 揭示阿根廷偏头痛的公共经济负担。

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-04-09 eCollection Date: 2025-01-01 DOI: 10.36469/001c.133639

Zrinka Orlović, Lucila Rey-Ares, María Florencia Viozzi, Rui Martins, Juliana Villarreal Ramírez, Santiago Veiga, Mark P Connolly

Background: Migraine is a prevalent, underdiagnosed, highly debilitating neurological condition that affects individuals' quality of life and often negatively influences normal daily activities. Objectives: The study objective is to estimate the economic burden of migraine to the Argentine government by assessing the impact of the disease on tax revenue, absenteeism, and social support transfers. Methods: The analysis combines a cross-sectional model utilizing national demographic data and published migraine prevalence rates to estimate the annual burden for the entire migraine-affected cohort, and a longitudinal model assessing the average burden per individual from the age of 40, over a 20-year horizon. A fiscal framework based on generational accounting evaluated the impact of migraine on government finances. Sources of revenue such as direct and indirect taxes were weighted against elements of public expenditure (public sector absenteeism, healthcare expenses, and financial support) and compared with the general population. The effect of migraine on occupational outcomes was sourced from peer-reviewed publications, and costs were sourced from national databases. Results were reported as incremental fiscal consequences (2023 US dollars) and were discounted at 3% annually. Results: The fiscal burden of migraine in Argentina was estimated to be $6505 p e r i n d i v i d u a l a n d$ 1237 million across the entire migraine population. Annually, 29% of government costs were due to public sector absenteeism, 39% related to healthcare costs, 19% to foregone direct and indirect tax revenue, and 12% to foregone corporation taxes. Additional government transfers represented a minor contribution to the overall fiscal impact of migraine in Argentina. Discussion: The high rate of informal employment is likely to undermine disease burden estimates. Gender disparities were notable, with women bearing 76% of the burden, highlighting the need for gender-specific interventions. Conclusions: This study reveals a significant economic burden of migraine to the Argentinian government, primarily driven by absenteeism, healthcare costs, and foregone tax contributions. Targeted, gender-responsive healthcare and labor policies, especially for sectors with high informal employment, could help reduce these fiscal impacts.

背景：偏头痛是一种普遍的、未被诊断的、高度衰弱的神经系统疾病，它会影响个体的生活质量，并经常对正常的日常活动产生负面影响。目的：研究目的是通过评估偏头痛对税收、缺勤和社会支持转移的影响，估计偏头痛给阿根廷政府带来的经济负担。方法：该分析结合了一个利用国家人口统计数据和公布的偏头痛患病率的横断面模型来估计整个偏头痛影响队列的年负担，以及一个纵向模型来评估从40岁开始20年的人均负担。一个基于代际会计的财政框架评估了偏头痛对政府财政的影响。将直接税和间接税等收入来源与公共支出要素（公共部门缺勤、医疗保健费用和财政支助）进行加权，并与一般人口进行比较。偏头痛对职业结果的影响来源于同行评审的出版物，成本来源于国家数据库。结果报告为增量财政结果（2023美元），并按每年3%的折现率计算。结果：阿根廷偏头痛的财政负担估计为每年6505英镑，而整个偏头痛人群的财政负担为1237亿英镑。每年，29%的政府成本是由于公共部门的旷工，39%与医疗保健费用有关，19%是由于放弃的直接和间接税收，12%是由于放弃的公司税。额外的政府转移支付对阿根廷偏头痛的总体财政影响贡献不大。讨论：非正规就业的高比率可能破坏疾病负担的估计。性别差异明显，妇女承担了76%的负担，突出表明需要采取针对性别的干预措施。结论：本研究揭示了偏头痛给阿根廷政府带来的重大经济负担，主要是由缺勤、医疗保健成本和放弃的税收贡献造成的。有针对性的、注重性别平等的保健和劳工政策，特别是针对非正规就业高的部门，可以帮助减少这些财政影响。

{"title":"Unveiling the Public Economic Burden of Migraine in Argentina.","authors":"Zrinka Orlović, Lucila Rey-Ares, María Florencia Viozzi, Rui Martins, Juliana Villarreal Ramírez, Santiago Veiga, Mark P Connolly","doi":"10.36469/001c.133639","DOIUrl":"https://doi.org/10.36469/001c.133639","url":null,"abstract":"Background: Migraine is a prevalent, underdiagnosed, highly debilitating neurological condition that affects individuals' quality of life and often negatively influences normal daily activities. Objectives: The study objective is to estimate the economic burden of migraine to the Argentine government by assessing the impact of the disease on tax revenue, absenteeism, and social support transfers. Methods: The analysis combines a cross-sectional model utilizing national demographic data and published migraine prevalence rates to estimate the annual burden for the entire migraine-affected cohort, and a longitudinal model assessing the average burden per individual from the age of 40, over a 20-year horizon. A fiscal framework based on generational accounting evaluated the impact of migraine on government finances. Sources of revenue such as direct and indirect taxes were weighted against elements of public expenditure (public sector absenteeism, healthcare expenses, and financial support) and compared with the general population. The effect of migraine on occupational outcomes was sourced from peer-reviewed publications, and costs were sourced from national databases. Results were reported as incremental fiscal consequences (2023 US dollars) and were discounted at 3% annually. Results: The fiscal burden of migraine in Argentina was estimated to be <math><mn>6505</mn> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mi>i</mi> <mi>n</mi> <mi>d</mi> <mi>i</mi> <mi>v</mi> <mi>i</mi> <mi>d</mi> <mi>u</mi> <mi>a</mi> <mi>l</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi></math> 1237 million across the entire migraine population. Annually, 29% of government costs were due to public sector absenteeism, 39% related to healthcare costs, 19% to foregone direct and indirect tax revenue, and 12% to foregone corporation taxes. Additional government transfers represented a minor contribution to the overall fiscal impact of migraine in Argentina. Discussion: The high rate of informal employment is likely to undermine disease burden estimates. Gender disparities were notable, with women bearing 76% of the burden, highlighting the need for gender-specific interventions. Conclusions: This study reveals a significant economic burden of migraine to the Argentinian government, primarily driven by absenteeism, healthcare costs, and foregone tax contributions. Targeted, gender-responsive healthcare and labor policies, especially for sectors with high informal employment, could help reduce these fiscal impacts.","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"129-137"},"PeriodicalIF":2.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

People and Families Affected by Glycogen Storage Disease Type Ia: An Analysis of Narrative Accounts Written by Individuals Living with GSDIa and Their Caregivers. 受Ia型糖原储存病影响的人和家庭：GSDIa患者及其照护者所写的叙述分析

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-04-03 eCollection Date: 2025-01-01 DOI: 10.36469/001c.131811

Eliza Kruger, Hayley M de Freitas, Iris Ferrecchia, Millie Gaydon, Andrew Lloyd

Background: Glycogen storage disease type Ia (GSDIa) is a rare inherited disorder that can lead to renal and hepatic complications, brain damage, and death. There is a lack of qualitative research describing the impact of GSDIa on individuals and their caregivers. Objective: This study was designed to describe the individual experiences of those affected by GSDIa through qualitative methods. Methods: Individuals with GSDIa and caregivers were recruited through two patient associations (US, UK). Participants were asked to write narratives about their experiences with GSDIa in their own words, with no set questions or topics. The resulting narrative accounts were analyzed thematically using a primarily inductive approach. Themes describing the impact of GSDIa on individuals and caregivers were identified. Results: Eight caregivers, three of whom had lost a child to GSDIa, and 11 individuals living with GSDIa provided written summaries of their experiences of life with the condition. Participants described symptoms, the burden of managing frequent cornstarch feeds, and the broader impacts of GSDIa. These included effects on daily activities, family, emotional and social functioning, romantic relationships, and educational/professional impacts. Participants also described challenges related to obtaining diagnosis and support, and the lack of GSDIa knowledge from healthcare professionals. Discussion: This study provided novel insights into the impact of GSDIa on individuals living with the condition and their caregivers. Participants reported a wide range of issues in their narratives and openly shared sensitive information about their experiences, which may not have been captured if they had taken part in a semi-structured interview format. Conclusion: The narrative method yielded a rich data set that provided details of the varied and individual experiences of GSDIa not captured by traditional quantitative methods or structured interviews. The narratives highlighted the unmet needs of both caregivers of and patients with GSDIa around cornstarch management, obstacles to proper treatment from healthcare professionals, and the absence of effective treatments. The open-ended narrative approach had advantages over standard qualitative methods to capture greater insight into individual experiences directly from participants in their own words.

背景：Ia型糖原储存病（GSDIa）是一种罕见的遗传性疾病，可导致肾脏和肝脏并发症、脑损伤和死亡。目前缺乏描述GSDIa对个体及其照顾者影响的定性研究。目的：本研究旨在通过定性方法描述GSDIa患者的个体体验。方法：通过两个患者协会（美国、英国）招募GSDIa患者和护理人员。参与者被要求用自己的话描述他们在GSDIa的经历，没有固定的问题或主题。由此产生的叙事叙述使用主要归纳方法进行主题分析。确定了描述GSDIa对个人和照顾者影响的主题。结果：8名照顾者（其中3人因GSDIa失去了孩子）和11名患有GSDIa的人提供了他们患有这种疾病的生活经历的书面总结。与会者描述了症状、管理频繁玉米淀粉饲料的负担以及GSDIa的更广泛影响。这些影响包括对日常活动、家庭、情感和社会功能、恋爱关系以及教育/职业的影响。与会者还描述了与获得诊断和支持有关的挑战，以及卫生保健专业人员缺乏GSDIa知识。讨论：本研究为GSDIa对患者及其护理者的影响提供了新的见解。参与者在他们的叙述中报告了广泛的问题，并公开分享了关于他们经历的敏感信息，如果他们参加半结构化的采访形式，这些信息可能不会被捕捉到。结论：叙述方法产生了丰富的数据集，提供了传统定量方法或结构化访谈无法捕获的GSDIa的各种个人经历的细节。这些叙述强调了GSDIa护理人员和患者在玉米淀粉管理方面的未满足需求，卫生保健专业人员对适当治疗的障碍，以及缺乏有效治疗。开放式叙述方法比标准定性方法更有优势，可以直接从参与者自己的话中获得更深入的个人体验。

{"title":"People and Families Affected by Glycogen Storage Disease Type Ia: An Analysis of Narrative Accounts Written by Individuals Living with GSDIa and Their Caregivers.","authors":"Eliza Kruger, Hayley M de Freitas, Iris Ferrecchia, Millie Gaydon, Andrew Lloyd","doi":"10.36469/001c.131811","DOIUrl":"10.36469/001c.131811","url":null,"abstract":"Background: Glycogen storage disease type Ia (GSDIa) is a rare inherited disorder that can lead to renal and hepatic complications, brain damage, and death. There is a lack of qualitative research describing the impact of GSDIa on individuals and their caregivers. Objective: This study was designed to describe the individual experiences of those affected by GSDIa through qualitative methods. Methods: Individuals with GSDIa and caregivers were recruited through two patient associations (US, UK). Participants were asked to write narratives about their experiences with GSDIa in their own words, with no set questions or topics. The resulting narrative accounts were analyzed thematically using a primarily inductive approach. Themes describing the impact of GSDIa on individuals and caregivers were identified. Results: Eight caregivers, three of whom had lost a child to GSDIa, and 11 individuals living with GSDIa provided written summaries of their experiences of life with the condition. Participants described symptoms, the burden of managing frequent cornstarch feeds, and the broader impacts of GSDIa. These included effects on daily activities, family, emotional and social functioning, romantic relationships, and educational/professional impacts. Participants also described challenges related to obtaining diagnosis and support, and the lack of GSDIa knowledge from healthcare professionals. Discussion: This study provided novel insights into the impact of GSDIa on individuals living with the condition and their caregivers. Participants reported a wide range of issues in their narratives and openly shared sensitive information about their experiences, which may not have been captured if they had taken part in a semi-structured interview format. Conclusion: The narrative method yielded a rich data set that provided details of the varied and individual experiences of GSDIa not captured by traditional quantitative methods or structured interviews. The narratives highlighted the unmet needs of both caregivers of and patients with GSDIa around cornstarch management, obstacles to proper treatment from healthcare professionals, and the absence of effective treatments. The open-ended narrative approach had advantages over standard qualitative methods to capture greater insight into individual experiences directly from participants in their own words.","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"120-128"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-Effectiveness Analysis of a Heart Failure Management System in the United States. 美国心力衰竭管理系统的成本-效果分析。

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI: 10.36469/001c.130066

Antonia Bosworth Smith, Ubong Silas, Alex Veloz, Peter Mallow, Barbara Pisani, Diana Bonderman, Rhodri Saunders

Background: The disease burden of heart failure is mainly driven by high hospital readmission rates. Remote monitoring devices can be used to assess the status of patients after discharge and identify early signs of worsening symptoms. Initial studies indicated that Heart Failure Management System (HFMS), a novel monitoring device, can prevent hospital readmission. Objective: To determine the cost effectiveness of HFMS compared with standard of care (SOC) in the United States. Methods: A Markov model was developed to follow patients after their discharge from index hospitalization for heart failure. The costs and outcomes were estimated for 5 years. The patient cohort was initially in "outpatient care," where they are at risk of an emergency room visit or hospital readmission. If hospitalized, patients returned to a second outpatient care health state. An "escalation of care" (eg, surgical intervention) may have removed patients from the intervention. The model took the payer perspective with costs in 2022 US dollars. The incremental cost-effectiveness ratio measured effectiveness through hospital readmissions. The willingness-to-pay threshold was set to the published cost of a heart failure rehospitalization ($10 737). Sensitivity and scenario analyses explored the robustness of the model to changes in inputs. Results: Compared with SOC, HFMS reduced the mean cost of care by $6723 ($ 155 122 vs $161 846) over the 5-year period. The mean number of hospital readmissions was reduced to 1.075 with HFMS from 1.201 with SOC (-0.126 events). The incremental cost-effectiveness ratio showed that HFMS was a dominant strategy compared with SOC, leading to reduced costs and hospital readmissions in 93.4% of the 1000 Monte Carlo simulations; 94.1% of the simulations fell below the willingness-topay threshold. Savings with HFMS emerged from the third month. Discussion: The results indicated the cost-effectiveness of HFMS compared with SOC. The sensitivity analyses supported this finding. Reducing costly hospital readmissions may help to alleviate the burden of heart failure. Longer-term data on HFMS are encouraged to confirm or contest the model outcomes. Conclusions: The use of HFMS is expected to save costs and reduce hospitalizations over a 5-year period compared with the current SOC.

背景：心力衰竭的疾病负担主要是由高再入院率引起的。远程监测设备可用于评估患者出院后的状态，并识别症状恶化的早期迹象。初步研究表明，心衰管理系统（HFMS）是一种新型的监测设备，可以预防再入院。目的：比较美国HFMS与标准护理（SOC）的成本效益。方法：建立马尔可夫模型，对心力衰竭住院患者出院后进行随访。估计了5年的费用和结果。患者队列最初是在“门诊护理”，在那里他们有去急诊室或再次住院的风险。如果住院，患者返回到第二个门诊护理健康状态。“护理升级”（如手术干预）可能使患者脱离干预。该模型采用付款人视角，成本以2022年美元计算。增量成本效益比通过再入院率来衡量有效性。支付意愿门槛设定为公布的心力衰竭再住院费用（10737美元）。敏感性和情景分析探讨了模型对输入变化的鲁棒性。结果：与SOC相比，HFMS在5年期间降低了平均护理成本6723美元（155 122美元对161 846美元）。HFMS患者的平均再入院次数从SOC患者的1.201例减少到1.075例（-0.126例）。增量成本-效果比表明，与SOC相比，HFMS是一种优势策略，在1000个蒙特卡罗模拟中，93.4%的HFMS降低了成本和住院再入院率；94.1%的模拟低于愿意支付的阈值。从第三个月开始，HFMS出现了节省。讨论：结果表明HFMS与SOC的成本-效果比较。敏感性分析支持这一发现。减少昂贵的再入院可能有助于减轻心力衰竭的负担。鼓励HFMS的长期数据来证实或质疑模型的结果。结论：与目前的SOC相比，使用HFMS有望在5年内节省成本并减少住院次数。

{"title":"Cost-Effectiveness Analysis of a Heart Failure Management System in the United States.","authors":"Antonia Bosworth Smith, Ubong Silas, Alex Veloz, Peter Mallow, Barbara Pisani, Diana Bonderman, Rhodri Saunders","doi":"10.36469/001c.130066","DOIUrl":"10.36469/001c.130066","url":null,"abstract":"Background: The disease burden of heart failure is mainly driven by high hospital readmission rates. Remote monitoring devices can be used to assess the status of patients after discharge and identify early signs of worsening symptoms. Initial studies indicated that Heart Failure Management System (HFMS), a novel monitoring device, can prevent hospital readmission. Objective: To determine the cost effectiveness of HFMS compared with standard of care (SOC) in the United States. Methods: A Markov model was developed to follow patients after their discharge from index hospitalization for heart failure. The costs and outcomes were estimated for 5 years. The patient cohort was initially in \"outpatient care,\" where they are at risk of an emergency room visit or hospital readmission. If hospitalized, patients returned to a second outpatient care health state. An \"escalation of care\" (eg, surgical intervention) may have removed patients from the intervention. The model took the payer perspective with costs in 2022 US dollars. The incremental cost-effectiveness ratio measured effectiveness through hospital readmissions. The willingness-to-pay threshold was set to the published cost of a heart failure rehospitalization ($10 737). Sensitivity and scenario analyses explored the robustness of the model to changes in inputs. Results: Compared with SOC, HFMS reduced the mean cost of care by <math><mn>6723</mn> <mo>(</mo></math> 155 122 vs $161 846) over the 5-year period. The mean number of hospital readmissions was reduced to 1.075 with HFMS from 1.201 with SOC (-0.126 events). The incremental cost-effectiveness ratio showed that HFMS was a dominant strategy compared with SOC, leading to reduced costs and hospital readmissions in 93.4% of the 1000 Monte Carlo simulations; 94.1% of the simulations fell below the willingness-topay threshold. Savings with HFMS emerged from the third month. Discussion: The results indicated the cost-effectiveness of HFMS compared with SOC. The sensitivity analyses supported this finding. Reducing costly hospital readmissions may help to alleviate the burden of heart failure. Longer-term data on HFMS are encouraged to confirm or contest the model outcomes. Conclusions: The use of HFMS is expected to save costs and reduce hospitalizations over a 5-year period compared with the current SOC.","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"113-119"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Costs of Adverse Event Management Associated with First-Line Cetuximab or Panitumumab in Metastatic Colorectal Cancer Patients in Saudi Arabia. 沙特阿拉伯转移性结直肠癌患者一线西妥昔单抗或帕尼单抗相关的不良事件管理成本

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research

Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI: 10.36469/001c.130878

Gihan Elsisi, Hana Abdul Kareem, Abdelaziz Alaseiri, Abdullah Alsharm, Mohamed Al Garni, Hajer Al-Mudaiheem, Fouad Alnagar, Hazem Lotfy, Mohamed Ouda, Ahmed Elshehri