Value in health regional issues最新文献

Cost-Effectiveness Analysis of Mammography-Based Breast Cancer Screening in Indonesia

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-04-02 DOI: 10.1016/j.vhri.2025.101112

Ajeng V. Icanervilia PhD , Keris Poelhekken MSc , Jarir At Thobari PhD , Lina Choridah PhD , Susanna H. Hutajulu PhD , Geertruida H. de Bock PhD , Maarten J. Postma PhD , Marcel J.W. Greuter PhD , Antoinette D.I. van Asselt PhD

Objectives

The Indonesian government has not implemented mammography as national screening program. Therefore, we evaluated the cost-effectiveness of mammography-based breast cancer screening strategy in Indonesia from a societal perspective.

Methods

The Simulation Model on radiation Risk and breast cancer Screening was used to examine various breast cancer screening scenarios, including different screening age (40-65 vs 35-65 years), frequency (every 2, 3, 4, or 5 years), and participation rate (50%, 70%, and 100%). The model’s input parameters were independently derived from published population statistics and systematic literature.

Results

Our findings indicate that, across all scenarios, mammography screening was cost-effective compared with no screening under the following conditions: (1) screening women aged 40 to 65 every 4 years at 50% participation rate, (2) screening women aged 40 to 65 every 4 years at 70% participation rate, (3) screening women aged 40 to 65 every 3 years at 70% participation rate, and (4) screening women aged 40 to 65 every 2 years at 100% participation rate. The incremental cost-effectiveness ratios these scenarios compared with the next best alternative were $4758 per life year gained (US dollars/LYG), $5263/LYG, $5436/LYG, and $7569/LYG, respectively, all of which were less than 3 times Indonesia’s gross domestic product per capita.

Conclusions

We recommend implementing mammography screening as a national program in Indonesia. The cost-effectiveness of screening strategies depends on factors such as participation rates, screening age, frequency, and the government’s willingness-to-pay threshold. We recognize Indonesia’s competing health priorities and limited resources. Acknowledging these priorities will help policymakers in making informed decisions about resource allocation.

{"title":"Cost-Effectiveness Analysis of Mammography-Based Breast Cancer Screening in Indonesia","authors":"Ajeng V. Icanervilia PhD , Keris Poelhekken MSc , Jarir At Thobari PhD , Lina Choridah PhD , Susanna H. Hutajulu PhD , Geertruida H. de Bock PhD , Maarten J. Postma PhD , Marcel J.W. Greuter PhD , Antoinette D.I. van Asselt PhD","doi":"10.1016/j.vhri.2025.101112","DOIUrl":"10.1016/j.vhri.2025.101112","url":null,"abstract":"<div><h3>Objectives</h3><div>The Indonesian government has not implemented mammography as national screening program. Therefore, we evaluated the cost-effectiveness of mammography-based breast cancer screening strategy in Indonesia from a societal perspective.</div></div><div><h3>Methods</h3><div>The Simulation Model on radiation Risk and breast cancer Screening was used to examine various breast cancer screening scenarios, including different screening age (40-65 vs 35-65 years), frequency (every 2, 3, 4, or 5 years), and participation rate (50%, 70%, and 100%). The model’s input parameters were independently derived from published population statistics and systematic literature.</div></div><div><h3>Results</h3><div>Our findings indicate that, across all scenarios, mammography screening was cost-effective compared with no screening under the following conditions: (1) screening women aged 40 to 65 every 4 years at 50% participation rate, (2) screening women aged 40 to 65 every 4 years at 70% participation rate, (3) screening women aged 40 to 65 every 3 years at 70% participation rate, and (4) screening women aged 40 to 65 every 2 years at 100% participation rate. The incremental cost-effectiveness ratios these scenarios compared with the next best alternative were $4758 per life year gained (US dollars/LYG), $5263/LYG, $5436/LYG, and $7569/LYG, respectively, all of which were less than 3 times Indonesia’s gross domestic product per capita.</div></div><div><h3>Conclusions</h3><div>We recommend implementing mammography screening as a national program in Indonesia. The cost-effectiveness of screening strategies depends on factors such as participation rates, screening age, frequency, and the government’s willingness-to-pay threshold. We recognize Indonesia’s competing health priorities and limited resources. Acknowledging these priorities will help policymakers in making informed decisions about resource allocation.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101112"},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761153","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

Toward Better Measurement of Financial Risk Protection in Health Expenditure: The Case of Chile

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-28 DOI: 10.1016/j.vhri.2025.101086

Joaquín Prieto PhD , Lorena Hoffmeister PhD

Objectives

Our study highlights the impact of out-of-pocket health expenditure (OOPHE) in highly unequal countries, where the middle class is particularly vulnerable to declines in well-being. We modify 2 financial protection measures—impoverishment and catastrophic health expenditure (CHE)—to address this issue. The first adjustment improves the classification of households based on their risk of poverty due to OOPHE, whereas the second corrects the underestimation of CHE for poorer households and the overestimation for the richest.

Methods

We applied our adjusted financial protection measures to data from the Chilean Household Budget Surveys (2006-2007, 2011-2012, 2016-2017, and 2021-2022) and compared the results with conventional CHE and impoverishment measures. Logistic regressions were used to identify factors associated with CHE.

Results

Our impoverishment risk indicator indicates that approximately 10% of Chilean households entered poverty, became poorer, or were at high risk due to OOPHE in 20. Our revised CHE measure suggests that approximately 15.8% of households faced financial hardship, with both figures exceeding conventional estimates. Households with more women and an older average age were more likely to experience CHE.

Conclusions

Effective and equitable access to health services, along with adequate financial protection, is critical to achieving universal health coverage. However, in countries with high-income inequality and a high proportion of nonpoor households close to the poverty line, conventional measures may have blind spots for monitoring and analyzing financial hardship in health spending. This research provides evidence to open the debate on this issue.

{"title":"Toward Better Measurement of Financial Risk Protection in Health Expenditure: The Case of Chile","authors":"Joaquín Prieto PhD , Lorena Hoffmeister PhD","doi":"10.1016/j.vhri.2025.101086","DOIUrl":"10.1016/j.vhri.2025.101086","url":null,"abstract":"<div><h3>Objectives</h3><div>Our study highlights the impact of out-of-pocket health expenditure (OOPHE) in highly unequal countries, where the middle class is particularly vulnerable to declines in well-being. We modify 2 financial protection measures—impoverishment and catastrophic health expenditure (CHE)—to address this issue. The first adjustment improves the classification of households based on their risk of poverty due to OOPHE, whereas the second corrects the underestimation of CHE for poorer households and the overestimation for the richest.</div></div><div><h3>Methods</h3><div>We applied our adjusted financial protection measures to data from the Chilean Household Budget Surveys (2006-2007, 2011-2012, 2016-2017, and 2021-2022) and compared the results with conventional CHE and impoverishment measures. Logistic regressions were used to identify factors associated with CHE.</div></div><div><h3>Results</h3><div>Our impoverishment risk indicator indicates that approximately 10% of Chilean households entered poverty, became poorer, or were at high risk due to OOPHE in 20. Our revised CHE measure suggests that approximately 15.8% of households faced financial hardship, with both figures exceeding conventional estimates. Households with more women and an older average age were more likely to experience CHE.</div></div><div><h3>Conclusions</h3><div>Effective and equitable access to health services, along with adequate financial protection, is critical to achieving universal health coverage. However, in countries with high-income inequality and a high proportion of nonpoor households close to the poverty line, conventional measures may have blind spots for monitoring and analyzing financial hardship in health spending. This research provides evidence to open the debate on this issue.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101086"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724893","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 of the Kidney Transplant Compared With Hemodialysis in End-Stage Renal Disease in Dubai, the United Arab Emirates: A Cost-Utility Study

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-26 DOI: 10.1016/j.vhri.2025.101109

Meenu Mahak Soni MBBS, MSc , Heba M. Mamdouh PhD , Sebastien Cochinard PhD , Diego Rosselli MD, MSc

Objectives

This study aims to examine the cost-effectiveness of renal transplantation and hemodialysis among patients with end-stage renal disease in Dubai, the United Arab Emirates.

Methods

A Markov model was developed to examine the cost-effectiveness of hemodialysis and renal transplant over a 5-year time horizon from the payer perspective, using empirical data on treatment costs from private hospitals in Dubai, utilities from Tufts Cost-Effectiveness Analysis Registry, and transition probabilities from European Renal Association-European Dialysis and Transplant Association registry data.

Results

In the base-case analysis, the discounted average total cost for 5 years was AED 961, 323 ($261 941) for transplantation and AED 971 538 ($264 724) for hemodialysis, with 3.4 and 2.1 quality-adjusted life years (QALY), respectively. The costs of first-year transplant and hemodialysis were AED 470 000 ($128 065) and AED 276 000 ($75 204) with 0.72 and 0.55 QALY, respectively. Transplantation became the dominant treatment strategy by the fourth year and was a cost-effective alternative from the second year on with an incremental cost-effectiveness ratio of AED 53 205 ($14 497 per QALY) (for a cost difference of AED 36 712 ($10 003) and QALY gain of 0.69).

Conclusions

Although the cost of the first year after transplantation was high, transplantation was more effective than hemodialysis over 2 years and was less costly over a longer period. The study suggests that performing renal transplants for patients with end-stage renal disease is more cost-effective than hemodialysis.

{"title":"Cost-Effectiveness of the Kidney Transplant Compared With Hemodialysis in End-Stage Renal Disease in Dubai, the United Arab Emirates: A Cost-Utility Study","authors":"Meenu Mahak Soni MBBS, MSc , Heba M. Mamdouh PhD , Sebastien Cochinard PhD , Diego Rosselli MD, MSc","doi":"10.1016/j.vhri.2025.101109","DOIUrl":"10.1016/j.vhri.2025.101109","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to examine the cost-effectiveness of renal transplantation and hemodialysis among patients with end-stage renal disease in Dubai, the United Arab Emirates.</div></div><div><h3>Methods</h3><div>A Markov model was developed to examine the cost-effectiveness of hemodialysis and renal transplant over a 5-year time horizon from the payer perspective, using empirical data on treatment costs from private hospitals in Dubai, utilities from Tufts Cost-Effectiveness Analysis Registry, and transition probabilities from European Renal Association-European Dialysis and Transplant Association registry data.</div></div><div><h3>Results</h3><div>In the base-case analysis, the discounted average total cost for 5 years was AED 961, 323 ($261 941) for transplantation and AED 971 538 ($264 724) for hemodialysis, with 3.4 and 2.1 quality-adjusted life years (QALY), respectively. The costs of first-year transplant and hemodialysis were AED 470 000 ($128 065) and AED 276 000 ($75 204) with 0.72 and 0.55 QALY, respectively. Transplantation became the dominant treatment strategy by the fourth year and was a cost-effective alternative from the second year on with an incremental cost-effectiveness ratio of AED 53 205 ($14 497 per QALY) (for a cost difference of AED 36 712 ($10 003) and QALY gain of 0.69).</div></div><div><h3>Conclusions</h3><div>Although the cost of the first year after transplantation was high, transplantation was more effective than hemodialysis over 2 years and was less costly over a longer period. The study suggests that performing renal transplants for patients with end-stage renal disease is more cost-effective than hemodialysis.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101109"},"PeriodicalIF":1.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697543","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

The Quality of Economic Evaluations of Interventions to Improve Women and Child Health in Latin America: A Systematic Review

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-25 DOI: 10.1016/j.vhri.2025.101101

Youssef Al Ghouch MD, MSc , María J. Mendoza-Jiménez MSc , Job van Exel PhD

Objectives

This study aims to characterize and assess the reporting and methodological quality of health economic evaluations (HEEs) of interventions to improve women’s and children’s health in Latin America from 2004 to 2023.

Methods

A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed was searched for HEEs published between 2004 and 2023. The search terms included HEEs or cost-benefit analysis, Latin America or Latin American countries, and pediatrics and/or gynecology. Articles were eligible for inclusion if they were HEEs; published in English, Spanish, or Portuguese; and focused on pediatrics and/or gynecology in Latin America. Data extraction included study characteristics, methodological aspects, reporting, and methodological quality based on the Consolidated Health Economic Evaluation Reporting Standards 2013 and Quality of Health Economic Studies checklists.

Results

Of 141 articles identified, 55 met the inclusion criteria. Most articles were cost-effectiveness evaluations conducted in Colombia and were aimed at pediatric patients. The quality assessment revealed that most Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies items were reported in at least 60% of the articles and that the study setting, justification for study perspective, bias acknowledgment, and subgroup analyses were the least frequently reported items.

Conclusions

This study highlights that although the number of HEEs in pediatrics and/or gynecology in Latin American countries is growing, to improve the transparency and generalizability of HEEs, the reporting and methodological quality of HEEs need to be improved. Seven key areas were identified for improving adherence to international quality standards.

{"title":"The Quality of Economic Evaluations of Interventions to Improve Women and Child Health in Latin America: A Systematic Review","authors":"Youssef Al Ghouch MD, MSc , María J. Mendoza-Jiménez MSc , Job van Exel PhD","doi":"10.1016/j.vhri.2025.101101","DOIUrl":"10.1016/j.vhri.2025.101101","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to characterize and assess the reporting and methodological quality of health economic evaluations (HEEs) of interventions to improve women’s and children’s health in Latin America from 2004 to 2023.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed was searched for HEEs published between 2004 and 2023. The search terms included HEEs or cost-benefit analysis, Latin America or Latin American countries, and pediatrics and/or gynecology. Articles were eligible for inclusion if they were HEEs; published in English, Spanish, or Portuguese; and focused on pediatrics and/or gynecology in Latin America. Data extraction included study characteristics, methodological aspects, reporting, and methodological quality based on the Consolidated Health Economic Evaluation Reporting Standards 2013 and Quality of Health Economic Studies checklists.</div></div><div><h3>Results</h3><div>Of 141 articles identified, 55 met the inclusion criteria. Most articles were cost-effectiveness evaluations conducted in Colombia and were aimed at pediatric patients. The quality assessment revealed that most Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies items were reported in at least 60% of the articles and that the study setting, justification for study perspective, bias acknowledgment, and subgroup analyses were the least frequently reported items.</div></div><div><h3>Conclusions</h3><div>This study highlights that although the number of HEEs in pediatrics and/or gynecology in Latin American countries is growing, to improve the transparency and generalizability of HEEs, the reporting and methodological quality of HEEs need to be improved. Seven key areas were identified for improving adherence to international quality standards.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101101"},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696912","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

Assessing Women’s Preference and Willingness to Pay for Breast Cancer Screening: A Discrete Choice Experiment Approach

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-24 DOI: 10.1016/j.vhri.2025.101110

Reyhane Tahal MHE , Azin Nahvijou MD, PhD , Ali Akbari Sari MD, PhD , Rajabali Daroudi PhD

Objectives

This study aimed to explore women’s preferences regarding breast cancer screening using a discrete choice experiment and willingness-to-pay analysis.

Methods

A discrete-choice experiment was conducted among 255 women aged 40 to 65 years who were referred to health centers in Tehran city. The experiment included attributes such as screening methods (clinical examination and mammography), number of deaths prevented, possibility of misdiagnosis and unnecessary biopsy, screening intervals, and cost of the screening test. A conditional logit model was used to estimate preferences, and willingness-to-pay values were derived from the model coefficients.

Results

Women revealed a strong preference for mammography over clinical examination(odds ratio [OR] 1.73; 95% CI 1.47-2.04; P < .001). Compared with 1 death prevented per 1000 women, the ORs for 3 and 6 deaths prevented per 1000 women were 18.1 (95% CI 12.72-25.75; P < .001) and 74.48 (95% CI 49.41-112.27; P < .001), respectively. The ORs for misdiagnosis and unnecessary biopsy rates of 10 of 100 people were 0.006 (95% CI 0.003-0.012; P < .001). Preferences for screening intervals varied, with a higher preference for screening every 4 years (OR 2.77; 95% CI 1.73-4.43; P < .001) compared with annual screening. The cost was also a significant factor, with a decrease in the odds of choosing a screening option as the cost increased (OR 0.139; 95% CI 0.1396-0.1399; P = .001).

Conclusions

This study provides valuable insights into women’s preferences for breast cancer screening in Iran.

{"title":"Assessing Women’s Preference and Willingness to Pay for Breast Cancer Screening: A Discrete Choice Experiment Approach","authors":"Reyhane Tahal MHE , Azin Nahvijou MD, PhD , Ali Akbari Sari MD, PhD , Rajabali Daroudi PhD","doi":"10.1016/j.vhri.2025.101110","DOIUrl":"10.1016/j.vhri.2025.101110","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore women’s preferences regarding breast cancer screening using a discrete choice experiment and willingness-to-pay analysis.</div></div><div><h3>Methods</h3><div>A discrete-choice experiment was conducted among 255 women aged 40 to 65 years who were referred to health centers in Tehran city. The experiment included attributes such as screening methods (clinical examination and mammography), number of deaths prevented, possibility of misdiagnosis and unnecessary biopsy, screening intervals, and cost of the screening test. A conditional logit model was used to estimate preferences, and willingness-to-pay values were derived from the model coefficients.</div></div><div><h3>Results</h3><div>Women revealed a strong preference for mammography over clinical examination(odds ratio [OR] 1.73; 95% CI 1.47-2.04; <em>P</em> < .001). Compared with 1 death prevented per 1000 women, the ORs for 3 and 6 deaths prevented per 1000 women were 18.1 (95% CI 12.72-25.75; <em>P</em> < .001) and 74.48 (95% CI 49.41-112.27; <em>P</em> < .001), respectively. The ORs for misdiagnosis and unnecessary biopsy rates of 10 of 100 people were 0.006 (95% CI 0.003-0.012; <em>P</em> < .001). Preferences for screening intervals varied, with a higher preference for screening every 4 years (OR 2.77; 95% CI 1.73-4.43; <em>P</em> < .001) compared with annual screening. The cost was also a significant factor, with a decrease in the odds of choosing a screening option as the cost increased (OR 0.139; 95% CI 0.1396-0.1399; <em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>This study provides valuable insights into women’s preferences for breast cancer screening in Iran.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101110"},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681536","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

Diabetes Mellitus in Colombia: Estimates of the Years of Life Lost

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-14 DOI: 10.1016/j.vhri.2025.101100

Pablo Chaparro-Narváez MD, PhD , Diana Díaz-Jiménez BSHA, MSc , Nelson J. Alvis-Zakzuk BEcon, MSc , Carlos Castañeda-Orjuela MD, MSc, PhD

Objectives

Accurate estimates of years of life lost (YLLs) are necessary to assess the management of diabetes mellitus (DM) and to understand the burden of the disease on society. We aimed to quantify the impact of mortality because of DM by estimating the YLLs in Colombia between 1979 and 2017.

Methods

An ecological study was conducted using mortality data from the National Administrative Department of Statistics of Colombia. YLLs attributable to DM and trends in the rates of YLLs by sex and age group were estimated using Joinpoint Regression. Forecasts of YLLs because of DM were performed using autoregressive integrated moving average models.

Results

Between 1979 and 2017, 200 650 deaths were registered, whose basic cause of death was DM. Up to 69 years of age, it was observed for both sexes that the older the age group, the higher the proportion of YLLs. The trend of the adjusted rate of the YLLs estimated for DM increased between 1979 and 2000 to 2001 and later decreased more sharply among women, and the reduction was high for the 65 and over age groups. The 2018 to 2025 YLL rates for DM in Colombia are predicted to have the highest values in the total series in April 2024 (13 514/1000 population).

Conclusions

In Colombia, between 1979 and 2017, the YLLs and age-adjusted rates of YLLs because of DM showed a slight decrease in both men and women.

目标准确估算生命损失年数（YLLs）对于评估糖尿病（DM）的管理和了解该疾病对社会造成的负担十分必要。我们的目的是通过估算 1979 年至 2017 年间哥伦比亚糖尿病患者的寿命损失年数，量化糖尿病对死亡率的影响。方法利用哥伦比亚国家统计局的死亡率数据开展了一项生态研究。使用连接点回归法估算了因 DM 导致的年死亡率以及按性别和年龄组分列的年死亡率趋势。结果1979年至2017年间，登记的死亡人数为200 650人，基本死因为糖尿病。在69岁以下的男性和女性中，可以观察到年龄越大，永利国际的比例越高。1979年至2000年至2001年期间，DM估计的调整后永利国际娱乐平台欢迎您！率呈上升趋势，随后女性永利国际娱乐平台欢迎您！率下降幅度更大，65岁及以上年龄组永利国际娱乐平台欢迎您！率下降幅度较大。据预测，2018 年至 2025 年哥伦比亚 DM 的 YLL 率将在 2024 年 4 月达到总序列中的最高值（13 514/1000 人）。结论在 1979 年至 2017 年期间，哥伦比亚男性和女性因 DM 导致的 YLL 和年龄调整后的 YLL 率均略有下降。

{"title":"Diabetes Mellitus in Colombia: Estimates of the Years of Life Lost","authors":"Pablo Chaparro-Narváez MD, PhD , Diana Díaz-Jiménez BSHA, MSc , Nelson J. Alvis-Zakzuk BEcon, MSc , Carlos Castañeda-Orjuela MD, MSc, PhD","doi":"10.1016/j.vhri.2025.101100","DOIUrl":"10.1016/j.vhri.2025.101100","url":null,"abstract":"<div><h3>Objectives</h3><div>Accurate estimates of years of life lost (YLLs) are necessary to assess the management of diabetes mellitus (DM) and to understand the burden of the disease on society. We aimed to quantify the impact of mortality because of DM by estimating the YLLs in Colombia between 1979 and 2017.</div></div><div><h3>Methods</h3><div>An ecological study was conducted using mortality data from the National Administrative Department of Statistics of Colombia. YLLs attributable to DM and trends in the rates of YLLs by sex and age group were estimated using Joinpoint Regression. Forecasts of YLLs because of DM were performed using autoregressive integrated moving average models.</div></div><div><h3>Results</h3><div>Between 1979 and 2017, 200 650 deaths were registered, whose basic cause of death was DM. Up to 69 years of age, it was observed for both sexes that the older the age group, the higher the proportion of YLLs. The trend of the adjusted rate of the YLLs estimated for DM increased between 1979 and 2000 to 2001 and later decreased more sharply among women, and the reduction was high for the 65 and over age groups. The 2018 to 2025 YLL rates for DM in Colombia are predicted to have the highest values in the total series in April 2024 (13 514/1000 population).</div></div><div><h3>Conclusions</h3><div>In Colombia, between 1979 and 2017, the YLLs and age-adjusted rates of YLLs because of DM showed a slight decrease in both men and women.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101100"},"PeriodicalIF":1.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628105","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 of 13-Valent Pneumococcal Conjugate Vaccine Among Adults in the Philippines

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-11 DOI: 10.1016/j.vhri.2025.101095

Joel Santiaguel MD , Ahuva Averin MPP , Winniefer Nua MSc , Mark Atwood MS , Liping Huang MD , Dhwani Hariharan PhD , Josephine Guerrero MD , Ricardo Zotomayor MD , Aileen David-Wang MD

Objectives

The Philippine National Immunization Program guidelines recommend using the 23-valent pneumococcal polysaccharide vaccine (PPV23) among senior citizens. We conducted cost-effectiveness analyses to assess the impact of replacing 2-dose PPV23 with PCV13 in all adults aged ≥60 years and expanding the recommendation to include PCV13 for adults aged 18 to 59 years at elevated risk of disease (moderate-/high-risk).

Methods

Lifetime risks and costs of invasive pneumococcal disease, nonbacteremic pneumococcal pneumonia (NBPP), and expected impact of vaccination were projected using a probabilistic cohort model. Base-case analyses compared PCV13 with 2-dose PPV23 (PPV23 + PPV23) among older adults (60-99y). Scenario analyses evaluated PCV13 use among older and moderate-/high-risk adults aged 18 to 59 years versus a combined strategy (18-49 y: no vaccine; 50-59 y: single-dose PPV23; 60-99 y: PPV23 + PPV23). Cost per quality-adjusted life year (QALY) gained was evaluated from healthcare system and societal perspectives (discounting 7%/year). Deterministic and probabilistic sensitivity analyses were conducted.

Results

In the base case, PCV13 instead of PPV23 + PPV23 would reduce cases of invasive pneumococcal disease by 698, NBPP by 915, and deaths by 333 among adults aged 60 to 99 years (N = 10 583 924). With QALYs higher by 848 and net societal (ie, direct + indirect) costs of ₱26.2 million, cost per QALY was ₱30 855. PCV13 was cost-effective in 98.8% of 1000 probabilistic sensitivity analyses simulations in the base-case population. In scenario analyses, PCV13 was also cost-effective (₱423 770/QALY).

Conclusions

Findings support replacing the two-dose PPV23 recommendation with 1 dose of PCV13 in adults aged ≥60 years and expanding the recommendation to include the use of PCV13 among moderate-/high-risk adults aged 18 to 59 years.

{"title":"Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Among Adults in the Philippines","authors":"Joel Santiaguel MD , Ahuva Averin MPP , Winniefer Nua MSc , Mark Atwood MS , Liping Huang MD , Dhwani Hariharan PhD , Josephine Guerrero MD , Ricardo Zotomayor MD , Aileen David-Wang MD","doi":"10.1016/j.vhri.2025.101095","DOIUrl":"10.1016/j.vhri.2025.101095","url":null,"abstract":"<div><h3>Objectives</h3><div>The Philippine National Immunization Program guidelines recommend using the 23-valent pneumococcal polysaccharide vaccine (PPV23) among senior citizens. We conducted cost-effectiveness analyses to assess the impact of replacing 2-dose PPV23 with PCV13 in all adults aged ≥60 years and expanding the recommendation to include PCV13 for adults aged 18 to 59 years at elevated risk of disease (moderate-/high-risk).</div></div><div><h3>Methods</h3><div>Lifetime risks and costs of invasive pneumococcal disease, nonbacteremic pneumococcal pneumonia (NBPP), and expected impact of vaccination were projected using a probabilistic cohort model. Base-case analyses compared PCV13 with 2-dose PPV23 (PPV23 + PPV23) among older adults (60-99y). Scenario analyses evaluated PCV13 use among older and moderate-/high-risk adults aged 18 to 59 years versus a combined strategy (18-49 y: no vaccine; 50-59 y: single-dose PPV23; 60-99 y: PPV23 + PPV23). Cost per quality-adjusted life year (QALY) gained was evaluated from healthcare system and societal perspectives (discounting 7%/year). Deterministic and probabilistic sensitivity analyses were conducted.</div></div><div><h3>Results</h3><div>In the base case, PCV13 instead of PPV23 + PPV23 would reduce cases of invasive pneumococcal disease by 698, NBPP by 915, and deaths by 333 among adults aged 60 to 99 years (<em>N</em> = 10 583 924). With QALYs higher by 848 and net societal (ie, direct + indirect) costs of ₱26.2 million, cost per QALY was ₱30 855. PCV13 was cost-effective in 98.8% of 1000 probabilistic sensitivity analyses simulations in the base-case population. In scenario analyses, PCV13 was also cost-effective (₱423 770/QALY).</div></div><div><h3>Conclusions</h3><div>Findings support replacing the two-dose PPV23 recommendation with 1 dose of PCV13 in adults aged ≥60 years and expanding the recommendation to include the use of PCV13 among moderate-/high-risk adults aged 18 to 59 years.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101095"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593156","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

Economic and Disease Burden of Multiple Sclerosis in Colombia

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-10 DOI: 10.1016/j.vhri.2025.101096

Ana Lozano MD, MSc , Juan Camilo Gutiérrez-Clavijo MSc , Jean Carlo Pineda-Lozano OT , Simón Cárdenas-Robledo MD , Adriana Casallas-Vanegas MD , Nelson J. Alvis-Zakzuk BEcon, MSc

Objectives

Multiple sclerosis (MS) is a debilitating condition that primarily affects young adults. The recent development of more effective yet costly drugs aimed at delaying the progression of the disease further adds to the necessity of evaluating the costs associated with MS from the societal perspective and the disease burden. We aimed to estimate the disease and economic burden of MS from the societal perspective in Colombia during 2020.

Methods

The disease burden was estimated following the methodology proposed by Global Burden of Disease Study 2019. Regarding the economic burden, an average cost per patient was estimated and applied to national MS cases. Specifically, the average direct medical costs per patient were obtained from an insurance company’s database and validated by 2 clinical experts. Nonmedical direct and indirect costs were estimated based on the data collected from a sample of MS patients.

Results

Colombia lost an estimated 3455 disability-adjusted life years because of MS in 2020. The disease burden was mainly attributed to deaths (65.5%, 2264 years of life lost). Disability-adjusted life years were 1.7 times higher in women than in men. Risaralda was the municipality with the highest population-adjusted MS disease burden, followed by Bogotá, DC. The associated cost of MS was USD $88.2 million, of which 88% was attributed to direct medical costs.

Conclusions

MS is a high-cost disease in Colombia with an increasing prevalence. The results presented in this study will help determine the allocation of resources when planning health care services.

{"title":"Economic and Disease Burden of Multiple Sclerosis in Colombia","authors":"Ana Lozano MD, MSc , Juan Camilo Gutiérrez-Clavijo MSc , Jean Carlo Pineda-Lozano OT , Simón Cárdenas-Robledo MD , Adriana Casallas-Vanegas MD , Nelson J. Alvis-Zakzuk BEcon, MSc","doi":"10.1016/j.vhri.2025.101096","DOIUrl":"10.1016/j.vhri.2025.101096","url":null,"abstract":"<div><h3>Objectives</h3><div>Multiple sclerosis (MS) is a debilitating condition that primarily affects young adults. The recent development of more effective yet costly drugs aimed at delaying the progression of the disease further adds to the necessity of evaluating the costs associated with MS from the societal perspective and the disease burden. We aimed to estimate the disease and economic burden of MS from the societal perspective in Colombia during 2020.</div></div><div><h3>Methods</h3><div>The disease burden was estimated following the methodology proposed by Global Burden of Disease Study 2019. Regarding the economic burden, an average cost per patient was estimated and applied to national MS cases. Specifically, the average direct medical costs per patient were obtained from an insurance company’s database and validated by 2 clinical experts. Nonmedical direct and indirect costs were estimated based on the data collected from a sample of MS patients.</div></div><div><h3>Results</h3><div>Colombia lost an estimated 3455 disability-adjusted life years because of MS in 2020. The disease burden was mainly attributed to deaths (65.5%, 2264 years of life lost). Disability-adjusted life years were 1.7 times higher in women than in men. Risaralda was the municipality with the highest population-adjusted MS disease burden, followed by Bogotá, DC. The associated cost of MS was USD $88.2 million, of which 88% was attributed to direct medical costs.</div></div><div><h3>Conclusions</h3><div>MS is a high-cost disease in Colombia with an increasing prevalence. The results presented in this study will help determine the allocation of resources when planning health care services.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101096"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580419","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

Mapping KDQOL-36 Onto EQ-5D-5L and SF-6Dv2 in Patients Undergoing Dialysis in China

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-08 DOI: 10.1016/j.vhri.2025.101103

Zeyuan Chen BA , Li Yang PhD , Ye Zhang PhD

Objectives

To develop mapping algorithms based on Kidney Disease Quality of Life-36 (KDQOL-36) scores to the EQ-5D-5L and SF-6Dv2 utility values among dialysis patients in China.

Methods

We used data from a cross-sectional multicenter survey in China to map the KDQOL-36 to the EQ-5D-5L and SF-6Dv2. The conceptual overlap between the KDQOL-36 and the EQ-5D-5L or SF-6Dv2 was evaluated using Spearman’s correlation coefficients. Direct mapping, including ordinary least squares, generalized linear model, beta regression model, Tobit regression model (TRM), censored least absolute deviations model, adjusted limited dependent variable mixture model (ALDVMM), response mapping, and seemingly unrelated ordered probit model, were used to derive mapping functions using the data set. Model performance was assessed by the mean absolute error (MAE) and root mean square error (RMSE) using cross-validation.

Results

A total of 378 patients (50.53% female; mean [SD] age: 49.05 [13.34]) were included in this study. The mean utility values of EQ-5D-5L and SF-6Dv2 were 0.72 and 0.57, respectively. When mapping to the EQ-5D-5L, the ALDVMM with 1 component was the best-performing model (MAE = 0.1579, RMSE = 0.2289). When mapping to SF-6Dv2, TRM was the best-performing model (MAE = 0.1108, RMSE = 0.1508). Generally, KDQOL-36 subscale scores and their squares were the optimal predictor set for each model. Overall, the models using KDQOL-36 subscale scores showed a better fit than those using the Kidney Disease Component Summary.

Conclusions

The ALDVMM and TRM models with the KDQOL-36 scores can be used to predict the EQ-5D-5L and SF-6Dv2 utility values, respectively, among dialysis patients in China.

{"title":"Mapping KDQOL-36 Onto EQ-5D-5L and SF-6Dv2 in Patients Undergoing Dialysis in China","authors":"Zeyuan Chen BA , Li Yang PhD , Ye Zhang PhD","doi":"10.1016/j.vhri.2025.101103","DOIUrl":"10.1016/j.vhri.2025.101103","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop mapping algorithms based on Kidney Disease Quality of Life-36 (KDQOL-36) scores to the EQ-5D-5L and SF-6Dv2 utility values among dialysis patients in China.</div></div><div><h3>Methods</h3><div>We used data from a cross-sectional multicenter survey in China to map the KDQOL-36 to the EQ-5D-5L and SF-6Dv2. The conceptual overlap between the KDQOL-36 and the EQ-5D-5L or SF-6Dv2 was evaluated using Spearman’s correlation coefficients. Direct mapping, including ordinary least squares, generalized linear model, beta regression model, Tobit regression model (TRM), censored least absolute deviations model, adjusted limited dependent variable mixture model (ALDVMM), response mapping, and seemingly unrelated ordered probit model, were used to derive mapping functions using the data set. Model performance was assessed by the mean absolute error (MAE) and root mean square error (RMSE) using cross-validation.</div></div><div><h3>Results</h3><div>A total of 378 patients (50.53% female; mean [SD] age: 49.05 [13.34]) were included in this study. The mean utility values of EQ-5D-5L and SF-6Dv2 were 0.72 and 0.57, respectively. When mapping to the EQ-5D-5L, the ALDVMM with 1 component was the best-performing model (MAE = 0.1579, RMSE = 0.2289). When mapping to SF-6Dv2, TRM was the best-performing model (MAE = 0.1108, RMSE = 0.1508). Generally, KDQOL-36 subscale scores and their squares were the optimal predictor set for each model. Overall, the models using KDQOL-36 subscale scores showed a better fit than those using the Kidney Disease Component Summary.</div></div><div><h3>Conclusions</h3><div>The ALDVMM and TRM models with the KDQOL-36 scores can be used to predict the EQ-5D-5L and SF-6Dv2 utility values, respectively, among dialysis patients in China.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"48 ","pages":"Article 101103"},"PeriodicalIF":1.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577881","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

Patient-Reported Experience and Outcome Measures of Patients Living With Diabetes: Associations Among Different Factors

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-03-07 DOI: 10.1016/j.vhri.2025.101082

Eszter Sághy MRes , Dalma Erdősi MSc , Bertalan Németh PhD , Sándor Kovács PhD , István Wittmann PhD , Antal Zemplényi PhD

Objectives

This study aimed to explore the association between demographic characteristics and patient-reported experiences (PREs) and patient-reported outcomes (PROs) in individuals living with diabetes, using the Swedish National Diabetes Register questionnaire. The study sought to understand how baseline attributes such as age, gender, and education affect patients’ experiences and management of diabetes.

Methods

We used a cross-sectional survey approach with 544 patients diagnosed as having type 1 or type 2 diabetes mellitus at the University of Pécs. An exploratory factor analysis was conducted to identify the key dimensions of diabetes-related experiences, followed by a confirmatory factor analysis to validate these dimensions. Regression analysis was used to examine the impact of demographic variables on the derived factors.

Results

The factor analysis revealed 5 key dimensions: diabetes-related obstacles, diabetes coping mechanisms, flexibility of healthcare providers, general well-being, and social support. Regression analysis indicated that older patients perceived fewer obstacles and demonstrated better coping mechanisms. Higher educational levels were significantly associated with greater satisfaction with healthcare provider flexibility. Females reported poorer overall well-being but better coping mechanisms than males.

Conclusions

The findings suggest that demographic characteristics significantly influence patient experiences and outcomes in diabetes care. Tailored interventions that address specific demographic needs can enhance patient-centered care and improve management strategies. These insights underscore the importance of considering patient diversity in developing healthcare interventions and underscore the utility of the Swedish National Diabetes Register questionnaire in assessing diverse patient experiences in diabetes management.

{"title":"Patient-Reported Experience and Outcome Measures of Patients Living With Diabetes: Associations Among Different Factors","authors":"Eszter Sághy MRes , Dalma Erdősi MSc , Bertalan Németh PhD , Sándor Kovács PhD , István Wittmann PhD , Antal Zemplényi PhD","doi":"10.1016/j.vhri.2025.101082","DOIUrl":"10.1016/j.vhri.2025.101082","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore the association between demographic characteristics and patient-reported experiences (PREs) and patient-reported outcomes (PROs) in individuals living with diabetes, using the Swedish National Diabetes Register questionnaire. The study sought to understand how baseline attributes such as age, gender, and education affect patients’ experiences and management of diabetes.</div></div><div><h3>Methods</h3><div>We used a cross-sectional survey approach with 544 patients diagnosed as having type 1 or type 2 diabetes mellitus at the University of Pécs. An exploratory factor analysis was conducted to identify the key dimensions of diabetes-related experiences, followed by a confirmatory factor analysis to validate these dimensions. Regression analysis was used to examine the impact of demographic variables on the derived factors.</div></div><div><h3>Results</h3><div>The factor analysis revealed 5 key dimensions: diabetes-related obstacles, diabetes coping mechanisms, flexibility of healthcare providers, general well-being, and social support. Regression analysis indicated that older patients perceived fewer obstacles and demonstrated better coping mechanisms. Higher educational levels were significantly associated with greater satisfaction with healthcare provider flexibility. Females reported poorer overall well-being but better coping mechanisms than males.</div></div><div><h3>Conclusions</h3><div>The findings suggest that demographic characteristics significantly influence patient experiences and outcomes in diabetes care. Tailored interventions that address specific demographic needs can enhance patient-centered care and improve management strategies. These insights underscore the importance of considering patient diversity in developing healthcare interventions and underscore the utility of the Swedish National Diabetes Register questionnaire in assessing diverse patient experiences in diabetes management.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"47 ","pages":"Article 101082"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563595","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