Value in health regional issues最新文献_第6页

Economic Impact of Self-Injected Biologics for Rheumatoid Arthritis in Japan: A Propensity Score-Matched Analysis From a Public Healthcare Payer Perspective 日本自注射类风湿性关节炎生物制剂的经济影响：从公共医疗保健支付者的角度进行倾向评分匹配分析

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-23 DOI: 10.1016/j.vhri.2025.101511

Kazuhiko Takahata MSc , Shingo Akutsu , Eiichi Tanaka MD, PhD , Ryoko Sakai PhD, MPH , Manabu Akazawa PhD, MPH

Objectives

Rheumatoid arthritis (RA) is a chronic inflammatory disease commonly treated with high-cost biologic disease-modifying antirheumatic drugs (bDMARDs). As of May 2025, 12 bDMARDs (9 originators and 3 biosimilars) are approved in Japan, with 10 available for self-injection (SI). Although SI may reduce hospital visits, its overall impact on prescribing patterns and healthcare costs remains unclear.

Methods

We conducted a retrospective cohort study using Japanese health insurance claims data (DeSC Healthcare, April 2014-August 2023). Patients with RA were identified based on diagnostic codes and bDMARDs prescriptions. Patients initiating SI within 3 months of their first bDMARD prescription were classified as the SI group; others were assigned to the non-SI group. Propensity score matching (1:1) was performed using 25 covariates. From the public payer’s perspective, we compared monthly direct healthcare costs, bDMARDs prescription volume, and annual hospital visit frequency.

Results

A total of 6784 patients were matched (mean age: 73.5 years; 73.2% female). The SI group incurred higher monthly healthcare costs ($774.0; 95% confidence interval [CI]: 763.3-784.6) compared with the non-SI group ($608.3; 95% CI 598.3-618.4; P < .05). bDMARDs prescription volume was greater in the SI group (2.9 vs 1.9 units/patient/month; P < .05). However, the SI group had significantly fewer annual hospital visits (9.5 vs 25.0 visits/year; P < .05).

Conclusions

SI increased direct costs because of higher bDMARDs utilization but reduced hospital visits, suggesting a potential for indirect cost savings. These findings may support future reimbursement and care models for RA.

目的类风湿关节炎（RA）是一种慢性炎症性疾病，通常使用高成本的生物抗风湿药物（bDMARDs）治疗。截至2025年5月，日本批准了12个bdmard（9个原研药和3个生物仿制药），其中10个可用于自注射（SI）。虽然SI可能减少医院就诊，但其对处方模式和医疗费用的总体影响尚不清楚。方法采用日本健康保险索赔数据进行回顾性队列研究（DeSC Healthcare， 2014年4月- 2023年8月）。根据诊断代码和bDMARDs处方确定RA患者。首次服用bDMARD后3个月内开始自伤的患者被归类为自伤组；其他人被分配到非si组。使用25个协变量进行倾向评分匹配（1:1）。从公共支付者的角度，我们比较了每月直接医疗费用、bDMARDs处方量和年度医院就诊频率。结果共匹配6784例患者，平均年龄73.5岁，女性73.2%。与非SI组（608.3美元；95%可信区间[CI]: 598.3-618.4; P < 0.05）相比，SI组每月的医疗保健费用更高（774.0美元；95%可信区间[CI]: 763.3-784.6）。bdmard处方量在SI组更大（2.9 vs 1.9单位/患者/月；P < 0.05）。然而，SI组的年度医院就诊次数明显减少（9.5次vs 25.0次/年；P < 0.05）。结论si增加了直接成本，因为bdmard的使用率更高，但减少了医院就诊次数，表明可能节省间接成本。这些发现可能支持未来类风湿关节炎的报销和护理模式。

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引用次数: 0

Incremental Direct Cost of Chronic Obstructive Pulmonary Disease in Colombia Using Doubly Robust Methods on Administrative Data 哥伦比亚慢性阻塞性肺疾病的增量直接成本管理数据双稳健方法

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-23 DOI: 10.1016/j.vhri.2025.101513

Carlos F. Valencia PhD, Juan F. Martínez MSc

Objectives

To estimate incremental healthcare costs associated with chronic obstructive pulmonary disease (COPD) using administrative healthcare data in Colombia.

Methods

We conducted a retrospective cohort analysis using administrative health databases from Colombia’s population covered by the contributory health insurance scheme. Patients with COPD were identified using a specific operative definition, and the control group was randomly selected from the remaining individuals. To estimate the incremental cost of COPD, we applied a causal approach using a doubly robust model, integrating propensity scores and outcome regression models. This ensured accurate estimation by addressing potential confounding, being robust for misspecification both in the propensity score and in the mean outcome. Confidence intervals were obtained using bootstrapping. In addition, we analyzed the incremental effect of common COPD complications, such as cardiovascular diseases and pulmonary infections.

Results

Our group of patients with COPD was comprised 251 060 people, whereas our control group comprised 967 081 people. The estimated incremental cost of a person with COPD was US dollars $1349. The incremental cost of a person with COPD and some type of complication ranged from $1405 to $2935. The most expensive complication was lung cancer, and the least expensive complication was any type of muscular weakness.

Conclusions

The incremental costs of COPD in Colombia align with the average values typically reported for middle-income countries. However, these estimates fall on the lower end of global cost estimations. There was a greater incremental cost found for patients with complications such as lung cancer, cardiovascular diseases, and pulmonary infections.

目的利用哥伦比亚的行政医疗数据估计与慢性阻塞性肺疾病（COPD）相关的增量医疗费用。方法我们利用哥伦比亚的行政卫生数据库对参加缴费式健康保险计划的人口进行了回顾性队列分析。使用特定的手术定义来确定COPD患者，并从其余个体中随机选择对照组。为了估计COPD的增量成本，我们采用了双重稳健模型的因果方法，整合了倾向评分和结果回归模型。这确保了准确的估计，通过解决潜在的混淆，在倾向得分和平均结果中对错误规范都是稳健的。采用自举法获得置信区间。此外，我们还分析了常见COPD并发症（如心血管疾病和肺部感染）的增量效应。结果本组COPD患者共251 060人，对照组967 081人。慢性阻塞性肺病患者的估计增量成本为1349美元。患有慢性阻塞性肺病和某些类型并发症的患者的增量成本从1405美元到2935美元不等。最昂贵的并发症是肺癌，最便宜的并发症是任何类型的肌肉无力。结论：哥伦比亚慢性阻塞性肺病的增量成本与中等收入国家通常报告的平均值一致。然而，这些估计属于全球成本估计的低端。对于肺癌、心血管疾病和肺部感染等并发症患者，增加的费用更大。

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引用次数: 0

Cost Comparison of 2 Different Targets for Glycemic Control in Women With Gestational Diabetes: Evaluation From the TARGET Stepped-Wedge Randomized Trial 妊娠期糖尿病妇女2种不同血糖控制靶点的成本比较：来自TARGET楔形步随机试验的评价

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-22 DOI: 10.1016/j.vhri.2025.101507

Susan E. Francis PGDipPopHlth , Luling Lin PhD , Richard P. Edlin PhD , Greg Gamble MSc , Caroline A. Crowther MD

Objectives

This study compared the costs of tight with less tight glycemic targets in the management of gestational diabetes using data from the TARGET trial.

Methods

The TARGET trial included women with gestational diabetes from 10 District Health Boards in New Zealand. This economic evaluation assessed 2 glycemic control strategies: tight versus less tight targets. Data on healthcare resource use, including antenatal care, birth outcomes, and hospital stay, were collected and analyzed to identify cost differences. The analysis was conducted from the perspective of New Zealand’s public healthcare system. The primary analysis adjusted for gestational age at the time of oral glucose tolerance test; additional analyses accounted for additional maternal and clinical factors.

Results

There were no significant differences in total healthcare costs between the 2 glycemic target groups. After adjusting for gestational age at the time of oral glucose tolerance test, the mean difference in combined maternal and infant costs was $203 (95% CI 1074 to 1479, P = .76). Further adjustment for additional confounders showed a cost difference of −$59 (95% CI: −1318 to 1200; P = .93). Although total combined costs were slightly lower in the tight glycemic group, patterns of resource use varied, particularly in antenatal care and birth outcomes.

Conclusions

Tight glycemic control in gestational diabetes care does not result in higher healthcare costs. However, variations in resource use and birth outcomes warrant further investigation to optimize glycemic control strategies. Future research should explore the long-term impact of different glycemic targets and consider patient-centered outcomes to guide cost-effective policy decisions.

目的：本研究使用TARGET试验的数据比较了严格和不严格血糖目标治疗妊娠糖尿病的成本。方法：TARGET试验包括来自新西兰10个地区卫生局的妊娠糖尿病妇女。这项经济评估评估了两种血糖控制策略：严格控制目标和不严格控制目标。收集并分析了有关医疗资源使用的数据，包括产前护理、分娩结果和住院时间，以确定成本差异。分析是从新西兰公共医疗体系的角度进行的。初步分析调整了口服糖耐量试验时的胎龄；额外的分析解释了额外的产妇和临床因素。结果：2个血糖目标组的总医疗费用无显著差异。在口服葡萄糖耐量试验时调整胎龄后，母婴联合成本的平均差异为203美元（95% CI 1074 ~ 1479, P = 0.76）。进一步调整其他混杂因素显示成本差异为- 59美元（95% CI: -1318至1200；P = 0.93）。虽然血糖控制严密组的总综合费用略低，但资源使用模式各不相同，特别是在产前护理和分娩结果方面。结论：在妊娠期糖尿病护理中严格控制血糖不会导致更高的医疗费用。然而，资源利用和出生结果的差异需要进一步研究以优化血糖控制策略。未来的研究应探索不同血糖目标的长期影响，并考虑以患者为中心的结果，以指导具有成本效益的政策决策。

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引用次数: 0

Averting Cancer: The Economic Case for Expanding HPV Vaccination 预防癌症：扩大HPV疫苗接种的经济案例。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-18 DOI: 10.1016/j.vhri.2025.101512

John Patrick C. Toledo MA, LPT

引用次数: 0

Analysis of Mortality Trajectory Patterns in the Middle East and North Africa: Which Diseases Are the Deadliest? 中东和北非地区死亡率轨迹模式分析：哪些疾病最致命？

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-16 DOI: 10.1016/j.vhri.2025.101509

Sami Khedhiri PhD

Objectives

This study aims to cluster the MENA countries in terms of the shape of their trajectory patterns of mortality related to the leading causes, including communicable diseases, noncommunicable diseases, and injuries. This allows us to distinguish which diseases are the deadliest in what cluster of countries.

Methods

A longitudinal cluster analysis is performed on the annual death counts, which are collected between 2007 and 2023 for the MENA countries. The method enables finding the optimal number of clusters of countries with similar trajectory patterns of mortality related to each category of diseases.

Results

Distinct trajectory patterns of death are identified, and diseases that are the leading causes of fatality in each country are described. Our results point to a concerning health burden expected to be related essentially to neurological conditions, neoplasms, and cardiovascular diseases in specific clusters of MENA countries.

Conclusions

It is argued that rapid increases in death patterns sparked by these causes in the MENA countries require targeted health intervention that deals specifically with how to manage these priority diseases effectively to reverse their expected trend of higher fatalities over time.

目的：本研究旨在根据与主要原因（包括传染病、非传染性疾病和伤害）相关的死亡率轨迹模式的形状对中东和北非国家进行分类。这使我们能够区分哪些疾病在哪个国家群中最致命。方法：对2007年至2023年间收集的中东和北非国家年度死亡人数进行纵向聚类分析。该方法能够找到与每一类疾病相关的死亡率轨迹模式相似的国家群的最佳数量。结果：确定了不同的死亡轨迹模式，并描述了每个国家主要死亡原因的疾病。我们的研究结果表明，在中东和北非国家的特定群体中，令人担忧的健康负担预计主要与神经系统疾病、肿瘤和心血管疾病有关。结论：有人认为，在中东和北非国家，这些原因导致的死亡模式迅速增加，需要有针对性的卫生干预，具体处理如何有效管理这些重点疾病，以扭转其随着时间的推移死亡率更高的预期趋势。

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引用次数: 0

Latin American and Caribbean Trends and Health Priorities in Cost-Effectiveness Studies: A Bibliometric Analysis in Scopus in the 21st Century 成本效益研究中的拉丁美洲和加勒比趋势和卫生优先事项：21世纪Scopus的文献计量学分析。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-07 DOI: 10.1016/j.vhri.2025.101496

Carlos Alva Dìaz MD , Victor Velasquez-Rimachi MD , Cristian Moràn-Mariños MD , Wendy Nieto-Gutierrez MD , Pedro Isaac Torres Balarezo MD , Carlos Quispe-Vicuña MD , Mariela Huerta-Rosario MD , Edward Mezones-Holguin MD

Objectives

To analyze the trends and priorities in the scientific production on cost-effectiveness analysis (CEA) in Latin America and the Caribbean during the first 2 decades of the 21st century.

Methods

We conducted a bibliometric analysis of published studies on CEA in Latin America reported from 2000 to 2021 in journals indexed in Scopus. We extracted annual research, countries, journals, authors, institutions, citation frequency, and journal metrics. In addition, the results of an author and country cooccurrence analysis were presented as network visualization maps using VOSviewer.

Results

A total of 3017 CEA-related publications were identified, and the majority were original articles (65.6%). We found an increasing trend with a significant correlation (R2: 0.981; P < .001) between the number and date of publication. Brazil was the country with the highest number of publications followed by Mexico and Argentina, in which the greatest production was concentrated in countries with medium and high resources. The largest number of research studies with CEA corresponded to the topics of diabetes mellitus and hypertension. The majority of the most productive journals were extraregional with a Q1 quartile.

Conclusions

The trend of publications on CEA is increasing in Latin America and the Caribbean, particularly in countries with higher economic income and collaboration networks. It was observed that the trend in the subject of CEA is related to the epidemiology of the region, with emphasis on chronic and infectious diseases.

目的：分析21世纪头20年拉丁美洲和加勒比地区成本效益分析（CEA）科学生产的趋势和重点。方法：我们对2000年至2021年在Scopus检索的期刊上发表的关于拉丁美洲CEA的文献计量学分析。我们提取了年度研究、国家、期刊、作者、机构、被引频次和期刊指标。此外，利用VOSviewer将作者和国家共同分析的结果以网络可视化地图的形式呈现。结果：共检索到cea相关文献3017篇，以原创文章居多（65.6%）。我们发现数量与发表日期有显著相关（R2: 0.981; P < 0.001）的增加趋势。巴西是出版物数量最多的国家，其次是墨西哥和阿根廷，其中产量最多的国家集中在拥有中等和高资源的国家。与CEA相关的研究最多的是与糖尿病和高血压相关的主题。大多数最高产的期刊都是Q1四分位数的域外期刊。结论：在拉丁美洲和加勒比地区，特别是在经济收入和合作网络较高的国家，关于CEA的出版物呈增加趋势。有人指出，CEA主题的趋势与该区域的流行病学有关，重点是慢性病和传染病。

{"title":"Latin American and Caribbean Trends and Health Priorities in Cost-Effectiveness Studies: A Bibliometric Analysis in Scopus in the 21st Century","authors":"Carlos Alva Dìaz MD , Victor Velasquez-Rimachi MD , Cristian Moràn-Mariños MD , Wendy Nieto-Gutierrez MD , Pedro Isaac Torres Balarezo MD , Carlos Quispe-Vicuña MD , Mariela Huerta-Rosario MD , Edward Mezones-Holguin MD","doi":"10.1016/j.vhri.2025.101496","DOIUrl":"10.1016/j.vhri.2025.101496","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the trends and priorities in the scientific production on cost-effectiveness analysis (CEA) in Latin America and the Caribbean during the first 2 decades of the 21st century.</div></div><div><h3>Methods</h3><div>We conducted a bibliometric analysis of published studies on CEA in Latin America reported from 2000 to 2021 in journals indexed in Scopus. We extracted annual research, countries, journals, authors, institutions, citation frequency, and journal metrics. In addition, the results of an author and country cooccurrence analysis were presented as network visualization maps using VOSviewer.</div></div><div><h3>Results</h3><div>A total of 3017 CEA-related publications were identified, and the majority were original articles (65.6%). We found an increasing trend with a significant correlation (R2: 0.981; <em>P</em> < .001) between the number and date of publication. Brazil was the country with the highest number of publications followed by Mexico and Argentina, in which the greatest production was concentrated in countries with medium and high resources. The largest number of research studies with CEA corresponded to the topics of diabetes mellitus and hypertension. The majority of the most productive journals were extraregional with a Q1 quartile.</div></div><div><h3>Conclusions</h3><div>The trend of publications on CEA is increasing in Latin America and the Caribbean, particularly in countries with higher economic income and collaboration networks. It was observed that the trend in the subject of CEA is related to the epidemiology of the region, with emphasis on chronic and infectious diseases.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"51 ","pages":"Article 101496"},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Team Learning in Head and Neck Surgery: An Economic and Quality Management Perspective 头颈外科的团队学习：经济和质量管理的视角。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-07 DOI: 10.1016/j.vhri.2025.101503

Carsten Bauer PhD , Oliver Unger PhD , Martin Holderried MD Habil, PhD

Objectives

Healthcare systems around the world face significant cost pressure and need to find ways to deal with this challenge without compromising treatment quality. Investigating and using learning effects might be an approach to achieve this goal. This study investigates surgeons’ learning effects of a standard surgical procedure in otorhinolaryngology, the tonsillectomy. It focuses on short-, medium-, and long-term effects using incision-suture times and complications as cost indicators. Surgeons’ experience, measured by qualification level, was also assessed.

Methods

Using process, quality, and economic data from a German tertiary care hospital, the economic effects of team learning processes and medical experience were compared using statistical methods to assess teamwork’s impact on outcomes.

Results

Team learning and increased surgeon experience yielded cost savings and quality improvements across short-, medium-, and long-term periods. Teamwork accelerated learning, reducing operation times compared with individual settings. Resident physicians benefitted from engaging in team surgeries for accelerated knowledge acquisition.

Conclusions

Team learning in tonsillectomies as a very common surgical procedure in the field of otorhinolaryngology offers insights into improving surgical outcomes from an economic and quality management perspective. The importance of teamwork in enhancing learning curves and reducing costs in head and neck surgery is underscored. Recommendations advocate for integrating quality management principles into surgical practices to optimize outcomes and resource utilization.

目标：世界各地的医疗保健系统面临着巨大的成本压力，需要找到不影响治疗质量的方法来应对这一挑战。研究和利用学习效应可能是实现这一目标的一种方法。本研究探讨了耳鼻喉科标准手术扁桃体切除术对外科医生学习效果的影响。它将切口缝合时间和并发症作为成本指标，重点关注短期、中期和长期效果。外科医生的经验，衡量的资格水平，也进行了评估。方法：利用德国一家三级医院的过程、质量和经济数据，采用统计学方法比较团队学习过程和医疗经验的经济效应，以评估团队合作对结果的影响。结果：团队学习和外科医生经验的增加在短期、中期和长期内节省了成本并提高了质量。团队合作加速了学习，与个人设置相比减少了操作时间。住院医师受益于团队手术加速知识获取。结论：扁桃体切除术是耳鼻喉科非常常见的手术方式，团队学习可以从经济和质量管理的角度提高手术效果。强调了团队合作在提高学习曲线和降低头颈部手术成本方面的重要性。建议提倡将质量管理原则整合到外科实践中，以优化结果和资源利用。

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引用次数: 0

Valuation of EQ-5D Health States for Adults in Low-, Lower-Middle, and Upper-Middle-Income Countries: A Systematic Review 对低收入、中低收入和中高收入国家成人EQ-5D健康状态的评估：一项系统综述

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-07 DOI: 10.1016/j.vhri.2025.101505

Marufa Sultana PhD , Thomas Chiu MSS , Mostafa Kamal PhD , Mohammod A. Kabir MSc, MEcon , Sayem Ahmed PhD , Rumana Huque PhD , Jahangir Khan PhD

Objectives

Preference-based measurement of health-related quality of life is crucial for informing resource allocation decisions, with the EQ-5D instrument widely used as a measure of health-related quality of life. Although country-specific value sets are well established in many high-income countries, current summarized evidence from valuation studies in low- and middle-income countries (LMICs) remains limited. This review systematically identified EQ-5D valuation studies in LMICs, summarized methodologies and scoring algorithms by country type, and highlighted key challenges.

Methods

A systematic search was undertaken across 7 academic databases and the EuroQol website. Two independent reviewers screened titles and abstracts and performed full-text reviews and data extraction. Reporting followed Checklist Reporting Valuation Studies of Multi-Attribute Utility-Based Instruments for quality assessment. The synthesis included study characteristics, methodologies, and summarized scoring algorithms from the best-performing models, highlighting variations across countries.

Results

Through screening 9378 studies, 35 studies from 22 LMICs were included. Of these, 20 (58%) were from upper-middle-income countries, whereas low-middle and low-income countries accounted for 13 (37%) and 2 (6%) studies, respectively. Eighteen (51%) studies reported EQ-5D-5L valuations. Sample sizes ranged from 148 to 5503, with the time trade-off method being predominant. Scoring algorithms showed no significant variation between upper-middle- and low-middle-income countries, except for the pain/discomfort dimension in EQ-5D-5L. Mobility was the most reported utility decrement among studies.

Conclusions

There is a growing trend in developing country-specific value sets in LMICs. Contextually relevant designs and adequate pilot studies could enhance the accuracy of value sets in culturally diverse settings, particularly where severe health states are commonly reported.

目标：基于偏好的健康相关生活质量测量对于为资源分配决策提供信息至关重要，EQ-5D仪器被广泛用作健康相关生活质量的测量。虽然在许多高收入国家已经建立了具体国家的价值集，但目前在低收入和中等收入国家（LMICs）进行的估值研究总结的证据仍然有限。本综述系统地确定了中低收入国家的EQ-5D评估研究，按国家类型总结了方法和评分算法，并强调了主要挑战。方法：系统检索7个学术数据库和EuroQol网站。两名独立审稿人筛选标题和摘要，并进行全文审查和数据提取。报告遵循清单报告评估研究多属性实用工具的质量评估。综合包括研究特征、方法，并总结了表现最好的模型的评分算法，突出了各国的差异。结果：共筛选9378项研究，纳入22个低收入国家的35项研究。其中，20项（58%）研究来自中高收入国家，而中低收入和低收入国家分别占13项（37%）和2项（6%）研究。18项（51%）研究报告了EQ-5D-5L的估值。样本量从148到5503不等，时间权衡法占主导地位。评分算法显示，除了EQ-5D-5L的疼痛/不适维度外，中高收入国家和中低收入国家之间没有显著差异。在所有研究中，流动性是报告最多的效用递减。结论：在中低收入国家中，发展中国家特有的价值设置有日益增长的趋势。与环境相关的设计和充分的试点研究可以提高文化多样化环境中价值设定的准确性，特别是在普遍报告严重健康状况的情况下。

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引用次数: 0

Prevention of Heart Failure With Icosapent Ethyl Results in Cost-Savings in the Spanish Population With Established Cardiovascular Disease 在西班牙有心血管疾病的人群中，用乙基戊二醇预防心力衰竭可节省费用。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-07 DOI: 10.1016/j.vhri.2025.101500

Laurence Tilley MPharmacol , Rory McAtamney BSc , Charlotte Heeks MSc , Kenneth Agyei-Kyeremateng MSc , Sabine Gaugris MSc , Gustavo Vitale MD, MSc, MBA , David Jakouloff MD , María Basalo MD, PhD , Josep Comin-Colet MD, PhD

Objectives

To estimate the budget impact resulting from reducing heart failure incidence through the introduction of icosapent ethyl to the Spanish healthcare system.

Methods

A cost-offset model was developed to estimate the budget impact resulting from introducing icosapent ethyl in Spanish hospitals in patients at high risk for cardiovascular diseases with established cardiovascular disease. Population and cost inputs were sourced from Spanish databases and clinically validated published literature. Clinical inputs were sourced from clinical trials or clinically validated published literature. The comparator was best supportive care, consisting of background statin with or without ezetimibe therapy, which reflects current treatments used in Spanish centers for the target population.

Results

Over 5 years, icosapent ethyl prevented 383 heart failures, corresponding to 1722 total days spent in hospital. This resulted in cost savings of €2 469 888 (1.8%).

Conclusions

This study demonstrated that the use of icosapent ethyl in patients at high risk for cardiovascular diseases with established cardiovascular disease will result in cost savings in Spanish hospitals, as the benefits of preventing heart failure outweigh the acquisition costs of icosapent ethyl.

目的：估计通过在西班牙医疗保健系统中引入乙基戊二烯降低心力衰竭发生率所产生的预算影响。方法：建立了一个成本抵消模型，以估计在西班牙医院对已确诊心血管疾病的心血管疾病高危患者引入乙基二十苯乙烯对预算的影响。人口和成本输入来自西班牙数据库和临床验证的已发表文献。临床输入来源于临床试验或经临床验证的已发表文献。比较物是最佳支持治疗，包括背景他汀类药物加或不加依折麦布治疗，这反映了西班牙中心针对目标人群使用的当前治疗方法。结果：在5年多的时间里，icosapent乙酯预防了383例心力衰竭，相当于住院总天数1722天。这导致成本节省2469 888欧元（1.8%）。结论：本研究表明，在心血管疾病高风险患者中使用icosapent ethyl将节省西班牙医院的成本，因为预防心力衰竭的益处超过了icosapent ethyl的获取成本。

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引用次数: 0

Economic Burden of Ischemic Heart Disease in Morocco: Evidence From a Teaching Hospital, a Cost-of-Illness Study 摩洛哥缺血性心脏病的经济负担：来自教学医院的证据，一项疾病成本研究

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-10-03 DOI: 10.1016/j.vhri.2025.101504

Moncef Maiouak MD , Mohammed Cherti MD, PhD , Mohamed Youbi MD , Latifa Belakhel MD , Loubna Abouselham MD , Samira El Fakir MD, PhD , Mohamed Berraho MD, PhD , Imane El Menchawy MD , Fatima Zahra Benmessaoud MD , Nabil Tachfouti MD, MPH, PhD

Objectives

To estimate the direct and indirect costs of ischemic heart disease (IHD) in Morocco and identify its main determinants.

Methods

A retrospective prevalence-based cost-of-illness study was carried out in patients with IHD admitted to a university hospital in 2019. Collected data included sociodemographic data, clinical profiles, and healthcare utilization. Direct medical costs were estimated using national insurance rates. Indirect costs, due to productivity loss, were calculated using the human capital approach and limited to working-age individuals based on Morocco’s retirement age. A bottom-up approach from a societal perspective was used over a 12-month period. The mean total cost was compared according to sociodemographic and clinical characteristics.

Results

The study included 180 patients; 58.3% were male, mean age was 62.1 years, and 46.1% were current or former smokers. Mean direct medical cost per patient was $3519.9 (95% CI $3141.8-$3898.0), with revascularization and medications as the main cost components. The mean indirect cost was $336.4 (95% CI $313.7-$359.0), with a mean productivity loss of 41.8 days. The mean total cost was $3856.3 (95% CI $3349.1-$4129.2), significantly higher for males (P = .015) and smokers (P < .001). The national economic burden of IHD was approximately $1.23 billion annually.

Conclusions

IHD imposes a substantial economic burden in Morocco, particularly among high-risk populations. Beyond tobacco control, integrated prevention strategies, including early detection and risk factor management, are urgently needed. In addition, healthcare resource planning and equitable access to medications are essential to reduce the burden of IHD.

目的估计摩洛哥缺血性心脏病（IHD）的直接和间接成本，并确定其主要决定因素。方法对2019年某大学医院收治的IHD患者进行回顾性基于患病率的疾病成本研究。收集的数据包括社会人口统计数据、临床概况和医疗保健利用情况。直接医疗费用是根据国民保险费率估算的。由于生产力损失造成的间接成本是用人力资本法计算的，并根据摩洛哥的退休年龄限于工作年龄的个人。在12个月的时间里，从社会角度采用了自下而上的方法。根据社会人口学和临床特征比较平均总费用。结果纳入180例患者；58.3%为男性，平均年龄62.1岁，46.1%为当前或曾经吸烟者。每位患者的平均直接医疗费用为3519.9美元（95% CI为3141.8- 3898.0美元），其中血运重建术和药物是主要的费用组成部分。平均间接成本为336.4美元（95% CI为313.7- 359.0美元），平均产能损失为41.8天。平均总成本为3856.3美元（95% CI为3349.1- 4129.2美元），男性（P = 0.015）和吸烟者（P < .001）明显更高。IHD的国家经济负担每年约为12.3亿美元。结论艾滋病在摩洛哥造成了巨大的经济负担，特别是在高危人群中。除了烟草控制之外，还迫切需要综合预防战略，包括早期发现和风险因素管理。此外，卫生保健资源规划和公平获得药物对减轻IHD负担至关重要。

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