Value in health regional issues最新文献_第9页

Public Preferences for Reducing Health Inequality in Japan: A National Survey 日本公众对减少健康不平等的偏好：一项全国性调查。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-01-01 Epub Date: 2025-04-04 DOI: 10.1016/j.vhri.2025.101111

Kyoko Shimamoto PhD , Tim Doran PhD , Richard Cookson PhD

Objectives

Making health programs more equitable sometimes reduces their health benefit per unit of cost. Policy makers therefore need to understand public preferences for reducing health inequalities; however, this evidence has been restricted to Europe, with no estimates available in Asia. Thus, this study aimed to gauge health inequality aversion in Japan in comparison with the UK populations.

Methods

National online survey of Japanese adults (aged 18-69), using a Japanese version of a UK benefit trade-off questionnaire, involving pairwise policy choices with different levels of health benefit and inequality. Attitudes toward reducing health inequality were classified using the same approach as the original UK study. Regression analyses were conducted to explore heterogeneity by age, gender, income, education, and geographic region.

Results

On average, respondents in the analytic sample (n = 473) weighed health gains to the poorest fifth of people approximately 6 times more highly than health gains to the richest fifth; 76.9% had positive health inequality aversion. Health inequality aversion was higher in the poorest fifth of respondents and in the northern region of Japan, but otherwise was not closely correlated with other characteristics. There was a higher proportion of invalid responses in Japan (67.9%) than the United Kingdom (47.0%).

Conclusions

Most people in Japan appear willing to forgo gains in total population health to reduce health inequality, such as in the United Kingdom. However, more research is needed to understand the high rate of inconsistent responses to the online version of this questionnaire, which was even higher in Japan than in the United Kingdom.

目标：使卫生项目更加公平有时会降低单位成本的卫生效益。因此，决策者需要了解公众对减少卫生不平等的偏好；然而，这一证据仅限于欧洲，在亚洲尚无估计数据。因此，本研究旨在衡量日本人对健康不平等的厌恶程度，并将其与英国人进行比较。方法：对日本成年人（18-69岁）进行全国在线调查，使用日本版的英国福利权衡问卷，涉及不同健康福利和不平等水平的两两政策选择。对减少健康不平等的态度采用与最初英国研究相同的方法进行分类。进行回归分析，探讨年龄、性别、收入、教育程度和地理区域的异质性。结果：平均而言，分析样本中的答复者（n = 473）认为最贫穷的五分之一人口的健康收益比最富有的五分之一人口的健康收益高约6倍；76.9%的人厌恶健康不平等。在最贫穷的五分之一受访者和日本北部地区，对健康不平等的厌恶程度更高，但除此之外，与其他特征的关系并不密切。无效应答的比例在日本（67.9%）高于英国（47.0%）。结论：大多数日本人似乎愿意放弃在总人口健康方面的收益，以减少健康不平等，例如在英国。然而，需要更多的研究来理解对该在线问卷的不一致回答的高比率，这在日本甚至比在英国更高。

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引用次数: 0

From Model to Clinic: Practical Considerations for Applying the Chinese Diabetes Risk Score in Prediabetes Screening 从模型到临床：中国糖尿病风险评分在糖尿病前期筛查中的应用

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-01-01 Epub Date: 2025-11-06 DOI: 10.1016/j.vhri.2025.101517

Hui Zi PhD

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 : 2026-01-01 Epub 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 : 2026-01-01 Epub 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

Cost and Budget Impact of Layering Depression Care Onto Existing HIV and Noncommunicable Disease Care Services in Western Kenya 在肯尼亚西部，将抑郁症护理分层到现有艾滋病毒和非传染性疾病护理服务上的成本和预算影响

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-11-01 Epub Date: 2025-08-26 DOI: 10.1016/j.vhri.2025.101171

Faith Yego PhD , Sharon Sawe MSc , Brianna Osetinsky PhD , Marta Wilson-Barthes MSPH , Omar Galárraga PhD

Objectives

The World Health Organization Mental Health Action Plan aims to increase mental healthcare coverage by half, by 2030. Reaching this target requires context-specific financial assessments. We estimated the cost and budget impact of integrating depression care into HIV, diabetes, and hypertension care programs in county-level health facilities in Kenya.

Methods

We modeled the additional health system costs to provide depression care within chronic disease programs in 6 counties in western Kenya. We estimated per-patient-per-visit costs under 4 scenarios: a facility-based additive scenario; 2 economies of scale and scope scenarios: group session psychotherapy (GSP) delivered by a trained provider within a group of 5 to 10 patients, with and without artistic therapy; and a community-based task-shifting scenario with chronic disease care provided by psychiatry nurses. For each scenario, we estimated the annual budget impact of increasing service coverage for depression to 50% of each county’s eligible population.

Results

Offering facility-based GSP without artistic therapy was the least expensive scenario in all counties, with a pooled median per-patient cost of $6.74 (95% CI 6.08-7.40) per depression care visit. Facility-based GSP with artistic therapy was the most expensive scenario with a median per-patient-per-visit cost of $9.79 (8.83-10.7). An additional 3.54% (3.36-3.72) of 2023 county health budgets would be needed to increase mental health service coverage by 50% by 2030.

Conclusions

Integrating facility-based GSP within chronic disease care platforms offers a low-cost strategy for depression care provision. Reaching mental health service targets in Kenya may require 3% more of current health budgets.

世界卫生组织精神卫生行动计划的目标是到2030年将精神卫生保健覆盖面增加一半。实现这一目标需要根据具体情况进行财务评估。我们估计了肯尼亚县级卫生机构将抑郁症护理纳入艾滋病毒、糖尿病和高血压护理项目的成本和预算影响。方法我们模拟了肯尼亚西部6个县慢性疾病项目中提供抑郁症治疗的额外卫生系统成本。我们在4种情况下估计了每位患者每次就诊的成本：基于设施的附加情景；2 .规模经济和范围经济方案：由训练有素的提供者在5至10名患者中提供小组心理治疗（GSP），有或没有艺术治疗；以及由精神科护士提供慢性病护理的以社区为基础的任务转移情景。对于每一种情况，我们估计将抑郁症服务覆盖率提高到每个县符合条件人口的50%的年度预算影响。结果在所有县中，提供以设施为基础的无艺术治疗的GSP是最便宜的方案，每次抑郁症护理就诊的平均每位患者费用为6.74美元（95% CI 6.08-7.40）。以设施为基础的GSP结合艺术治疗是最昂贵的方案，每位患者每次就诊的平均费用为9.79美元（8.83-10.7）。到2030年，要将精神卫生服务覆盖率提高50%，还需要2023年县卫生预算的3.54%（3.36-3.72）。结论在慢性病护理平台中整合基于设施的GSP为抑郁症护理提供了一种低成本的策略。在肯尼亚实现精神卫生服务目标可能需要比目前卫生预算多3%。

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引用次数: 0

Cost-Effectiveness Analysis Comparing Ceftazidime/Avibactam With Standard of Care in the Treatment of Hospital and Ventilator-Acquired Pneumonia in the Philippines. 比较头孢他啶/阿维巴坦与标准护理在菲律宾医院和呼吸机获得性肺炎治疗中的成本-效果分析

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-11-01 Epub Date: 2025-08-07 DOI: 10.1016/j.vhri.2025.101158

Rontgene M Solante, Dionisio Tiu, Kezia Tan, Jia Hao Wong, Kaywei Low, Evan Payawal, Winniefer Nua

Objectives: Ceftazidime/avibactam (CAZ-AVI) is a novel antibiotic approved for hospital-acquired pneumonia, including ventilator-associated pneumonia (HAP/VAP). This study evaluated the cost-effectiveness of CAZ-AVI as second-line therapy, after meropenem, in patients with HAP/VAP. Its economic benefits are assessed against available second-line comparators from the societal perspective in the Philippines.

Methods: A patient-level, sequential simulation model of the HAP/VAP clinical course was developed using Excel. Data inputs were collected between June 2023 and August 2023. Costs and benefits to society were discounted at 7% over a 5-year time horizon. Clinical data were sourced from the REPROVE trial, other published literature and expert opinion. The model also incorporated the impact of resistant pathogens using global and local surveillance data, as well as expert insights.

Results: The base-case analysis demonstrated that the intervention sequence (empiric meropenem followed by CAZ-AVI) had a higher clinical cure rate (+9.82%) versus the comparator sequence (empiric meropenem followed by colistin + high-dose meropenem). This led to a shorter hospital stay (-1.57 days per patient) and incremental quality-adjusted life-years gains (+0.08) per patient. The intervention sequence also reduced costs by 218 405 PHP per patient, yielding an incremental cost-effectiveness ratio of -2 859 584 PHP/quality-adjusted life-year. The incremental cost-effectiveness ratio was robust across a range of sensitivity and scenario analyses.

Conclusions: CAZ-AVI is expected to be a highly cost-effective second-line treatment compared with colistin + high-dose meropenem from the societal perspective in the Philippines.

目的：头孢他啶/阿维巴坦（CAZ-AVI）是一种被批准用于医院获得性肺炎，包括呼吸机相关性肺炎（HAP/VAP）的新型抗生素。本研究评估了CAZ-AVI在HAP/VAP患者中作为美罗培南之后的二线治疗的成本-效果。从菲律宾的社会角度对其经济效益与现有的二线比较物进行了评估。方法：采用Excel软件建立患者水平的HAP/VAP临床过程序列模拟模型。数据输入的收集时间为2023年6月至2023年8月。在5年的时间里，对社会的成本和收益按7%折现。临床数据来源于REPROVE试验、其他已发表的文献和专家意见。该模型还利用全球和地方监测数据以及专家见解纳入了耐药病原体的影响。结果：基础病例分析表明，干预序列（经验美罗培南+ CAZ-AVI）比对照序列（经验美罗培南+粘菌素+大剂量美罗培南）具有更高的临床治愈率（+9.82%）。这导致住院时间缩短（每位患者-1.57天），每位患者的质量调整生命年增加（+0.08）。干预顺序还使每位患者的成本降低了218 405 PHP，产生了-2 859 584 PHP/质量调整生命年的增量成本-效果比。增量成本效益比在一系列敏感性和情景分析中都是稳健的。结论：从菲律宾的社会角度来看，CAZ-AVI与粘菌素+大剂量美罗培南相比，有望成为一种高成本效益的二线治疗方法。

{"title":"Cost-Effectiveness Analysis Comparing Ceftazidime/Avibactam With Standard of Care in the Treatment of Hospital and Ventilator-Acquired Pneumonia in the Philippines.","authors":"Rontgene M Solante, Dionisio Tiu, Kezia Tan, Jia Hao Wong, Kaywei Low, Evan Payawal, Winniefer Nua","doi":"10.1016/j.vhri.2025.101158","DOIUrl":"10.1016/j.vhri.2025.101158","url":null,"abstract":"<p><strong>Objectives: </strong>Ceftazidime/avibactam (CAZ-AVI) is a novel antibiotic approved for hospital-acquired pneumonia, including ventilator-associated pneumonia (HAP/VAP). This study evaluated the cost-effectiveness of CAZ-AVI as second-line therapy, after meropenem, in patients with HAP/VAP. Its economic benefits are assessed against available second-line comparators from the societal perspective in the Philippines.</p><p><strong>Methods: </strong>A patient-level, sequential simulation model of the HAP/VAP clinical course was developed using Excel. Data inputs were collected between June 2023 and August 2023. Costs and benefits to society were discounted at 7% over a 5-year time horizon. Clinical data were sourced from the REPROVE trial, other published literature and expert opinion. The model also incorporated the impact of resistant pathogens using global and local surveillance data, as well as expert insights.</p><p><strong>Results: </strong>The base-case analysis demonstrated that the intervention sequence (empiric meropenem followed by CAZ-AVI) had a higher clinical cure rate (+9.82%) versus the comparator sequence (empiric meropenem followed by colistin + high-dose meropenem). This led to a shorter hospital stay (-1.57 days per patient) and incremental quality-adjusted life-years gains (+0.08) per patient. The intervention sequence also reduced costs by 218 405 PHP per patient, yielding an incremental cost-effectiveness ratio of -2 859 584 PHP/quality-adjusted life-year. The incremental cost-effectiveness ratio was robust across a range of sensitivity and scenario analyses.</p><p><strong>Conclusions: </strong>CAZ-AVI is expected to be a highly cost-effective second-line treatment compared with colistin + high-dose meropenem from the societal perspective in the Philippines.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"50 ","pages":"101158"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804930","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

Predicting the EQ-5D-5L Utility Scores From the Impact of Vision Impairment Questionnaire in Thai Patients 从泰国患者视力障碍问卷的影响预测EQ-5D-5L效用评分

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-11-01 Epub Date: 2025-07-23 DOI: 10.1016/j.vhri.2025.101159

Emilia A.T. Pasenggong MSc , Phantipa Sakthong PhD , Pear F. Pongsachareonnont MD, PhD , Pankaew Tantirattanakulchai PhD

Objectives

This study aims to predict the EQ-5D-5L utility scores from the impact of vision impairment (IVI) questionnaire in Thai patients using mapping techniques.

Methods

This is a secondary data analysis. A total of 499 patients with multiple levels of visual impairment were recruited from King Chulalongkorn Memorial Hospital in Thailand between February and July 2022. Ordinary least square, Tobit, censored least absolute deviation, and adjusted limited dependent variable mixture model regression models were used to map the IVI questionnaire onto EQ-5D-5L index scores. IVI domain scores, IVI total score, gender, age, employment status, and best corrected visual acuity were included as predictors. Performance metrics including root mean square error, mean absolute error, and adjusted R² were used to determine the best predictive model.

Results

The results indicated that EQ-5D-5L index scores were significantly associated with the reading and emotional well-being domains of the IVI. Among sociodemographic and clinical variables, higher age score was significantly associated with lower EQ-5D index scores (P < .01). The mean predicted EQ-5D-5L value (0.803) was lower than the mean observed value (0.808). The adjusted limited dependent variable mixture model 1-component model demonstrated the best predictive performance (root mean square error 0.137, mean absolute error 0.101, adjusted R² 0.689).

Conclusions

Mapping techniques effectively predicted EQ-5D-5L utility scores from the IVI questionnaire in Thai patients. The predicted model enhances decision analysis by capturing health utility values, informing quality-adjusted life-years, and supporting health economic evaluations when vision-specific measures are available.

目的本研究旨在利用制图技术预测泰国患者视力障碍（IVI）问卷的EQ-5D-5L效用评分。方法采用二次数据分析方法。研究人员于2022年2月至7月期间从泰国朱拉隆功国王纪念医院招募了499名患有不同程度视力障碍的患者。采用普通最小二乘、Tobit、删节最小绝对偏差和调整的有限因变量混合模型回归模型将IVI问卷映射到EQ-5D-5L指标得分。IVI域评分、IVI总分、性别、年龄、就业状况和最佳矫正视力作为预测因子。使用均方根误差、平均绝对误差和调整后的R2等性能指标来确定最佳预测模型。结果EQ-5D-5L指数得分与IVI的阅读和情绪健康域显著相关。在社会人口学和临床变量中，年龄得分越高，EQ-5D指数得分越低(P <；. 01)。EQ-5D-5L平均预测值（0.803）低于平均观测值（0.808）。调整后的有限因变量混合模型- 1组分模型预测效果最佳（均方根误差0.137，平均绝对误差0.101，调整后R2 0.689）。结论smapping技术可有效预测泰国患者IVI问卷中EQ-5D-5L效用评分。预测模型通过捕获健康效用值、告知质量调整生命年以及在可获得特定视力措施时支持健康经济评估来增强决策分析。

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引用次数: 0

Disseminated Histoplasmosis in People Living With HIV: What Are the Care Costs for Brazil? 艾滋病毒感染者的播散性组织胞浆菌病：巴西的护理费用是多少？

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-11-01 Epub Date: 2025-08-07 DOI: 10.1016/j.vhri.2025.101166

Raissa Allan Santos Domingues, Maria Regina Fernandes de Oliveira

Objectives: To estimate the direct and indirect costs of disseminated histoplasmosis in people living with HIV in Brazil in 2023.

Methods: The cost-of-illness study was conducted from the perspective of the Brazilian public health system and society. A hypothetical cohort was developed based on epidemiological data on HIV and histoplasmosis cases reported by the Brazilian Ministry of Health in 2023. Direct medical costs for diagnostic, treatment, and care provided to patients with disseminated histoplasmosis and HIV were calculated using the top-down approach. The indirect costs related to productivity loss due to premature mortality and morbidity were estimated using the human-capital method. A multivariate deterministic sensitivity analysis was performed because of uncertainties in some model parameters.

Results: The cohort began with reported cases of HIV, focusing on individuals estimated to develop symptoms of disseminated histoplasmosis requiring hospitalization. Cases were confirmed through clinical examinations and conventional laboratory methods. Treatment primarily involves amphotericin B. The analysis included patients who were discharged from the hospital, underwent secondary prophylaxis, potentially required treatment for reinfection or reactivation, necessitating additional hospitalization and who died. In 2023, the total cost of disseminated histoplasmosis in people living with HIV in Brazil was US dollars ($) 455 723 307.45, varying, according to the sensitivity analysis, from $283 862 967.76 to $635 305 985.67. Most costs (46%) were associated with indirect costs.

Conclusions: disseminated histoplasmosis represents a significant and costly health problem for both the Brazilian public health system and society, primarily because of productivity loss resulting from premature mortality.

目的：估计2023年巴西艾滋病毒感染者中播散性组织胞浆菌病的直接和间接成本。方法：从巴西公共卫生系统和社会的角度进行疾病成本研究。根据巴西卫生部在2023年报告的艾滋病毒和组织胞浆菌病病例的流行病学数据，建立了一个假设队列。采用自上而下的方法计算弥散性组织胞浆菌病和HIV患者的诊断、治疗和护理的直接医疗费用。使用人力资本方法估计了因过早死亡和发病而造成的生产力损失的间接成本。由于模型参数的不确定性，进行了多变量确定性敏感性分析。结果：队列从报告的HIV病例开始，重点关注估计出现弥散性组织胞浆菌病症状需要住院治疗的个体。病例通过临床检查和常规实验室方法确诊。治疗主要涉及两性霉素b。分析包括出院、接受二级预防、可能需要治疗再感染或再激活、需要额外住院和死亡的患者。2023年，巴西艾滋病毒感染者的播散性组织胞浆菌病总成本为455 723 307.45美元，根据敏感性分析，从283 862 967.76美元到635 305 985.67美元不等。大多数成本（46%）与间接成本有关。结论：播散性组织胞浆菌病对巴西公共卫生系统和社会来说都是一个重大且代价高昂的健康问题，主要是因为过早死亡造成的生产力损失。

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引用次数: 0

Impact of Severe Hemophilia on Costs and Quality of Life in South American Men: Findings From the CHESS LATAM Study 严重血友病对南美男性成本和生活质量的影响：来自CHESS LATAM研究的结果

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-11-01 Epub Date: 2025-08-28 DOI: 10.1016/j.vhri.2025.101167

J. Evans MSc , T. Burke MSc , M. Skerritt BSc , I. Rodriguez Santana MSc , T.M.O. Pietrobelli , S. Robledo MD , A.G. Cavallini , D. Neme MD , K. Khair PhD , A. Finnegan PhD

Objectives

Severe hemophilia is a rare bleeding disorder, associated with high socioeconomic costs and burden. The “Cost of Hemophilia in Latin America: A Socioeconomic Survey” (CHESS LATAM) study aimed to quantify this burden across 4 Latin American countries; Argentina, Brazil, Chile, and Colombia.

Methods

Demographic, clinical, and medical data of patients were captured through their hemophilia specialists during the period between September 2020 and May 2021. Direct medical resource use was captured by a physician survey, and direct nonmedical and indirect costs were captured via a patient survey. Health-related quality of life was also captured from a patient perspective. Local country-specific unit costs were applied to resource use to calculate per-patient costs over a 12-month period.

Results

Physician data were captured for a total of 830 patients. For a subsample, 153 (18% of the sample) associated patient surveys were completed. Annual cost of severe hemophilia across the 4 countries was estimated at less than US$ 104 000 (International$ 234 237) per patient. Factor replacement therapy accounted for the majority of costs (up to 99%). Indirect costs were driven by patient and caregiver work loss.

Conclusions

The results of the CHESS LATAM study highlight the large burden faced by patients with severe hemophilia A and B in Latin America. Despite the dominating treatment costs, the indirect impact of hemophilia on the patients and those who care for them was still substantial and should not be dismissed.

目的：重度血友病是一种罕见的出血性疾病，具有较高的社会经济成本和负担。“拉丁美洲血友病的成本：一项社会经济调查”（CHESS LATAM）研究旨在量化4个拉丁美洲国家的血友病负担；阿根廷、巴西、智利和哥伦比亚。方法通过血友病专家收集2020年9月至2021年5月期间患者的人口统计学、临床和医疗数据。直接医疗资源的使用通过医生调查获得，直接非医疗和间接成本通过患者调查获得。还从患者的角度捕捉了与健康有关的生活质量。将当地具体国家单位成本应用于资源使用，以计算12个月期间的每位患者成本。结果共收集了830例患者的临床资料。在一个亚样本中，完成了153例（占样本的18%）相关的患者调查。据估计，这4个国家严重血友病的年费用低于每位患者10.4万美元（国际234 237美元）。因子替代疗法占大部分费用（高达99%）。间接成本是由病人和护理人员的工作损失造成的。CHESS LATAM研究的结果强调了拉丁美洲严重血友病A和B患者面临的巨大负担。尽管血友病的治疗费用占主导地位，但对患者和照顾他们的人的间接影响仍然很大，不应被忽视。

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引用次数: 0

Self-Reported Health-Related Quality of Life in Patients With Ischemic Heart Disease: A Randomized Controlled Trial on Digital Health Pharmacist Interventions 缺血性心脏病患者自我报告的健康相关生活质量：数字健康药剂师干预的随机对照试验

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2025-11-01 Epub Date: 2025-08-21 DOI: 10.1016/j.vhri.2025.101174

Umm-e-Kalsoom MPhil , Amjad Khan PhD , Tahir Mehmood PhD , Hafsa Kanwal MPhil , Nafees Ahmed PhD , Saima Mushtaq PhD , Yu Fang PhD

Objectives

Digital health programs have been suggested as one possible framework to improve health-related quality of life (HRQoL). This study investigates the impact of a digital health pharmacy interventions (DHPIs) on self-reported HRQoL and quality-adjusted life-years in patients with ischemic heart disease.

Methods

A 1-year follow-up randomized controlled trial was conducted from September, 2022 to August, 2023, at the Punjab Institute of Cardiology in Lahore. Adults with ischemic heart disease (IHD) (n = 332) were randomly allocated to either the intervention group (n = 166) or the control group (n = 166). The responses were evaluated using 2 validated questionnaires, namely, the SF-12 and EQ-5D-5L. The McNemar test, independent-sample t test, multivariate analysis of variance, and principal component analysis models were used to analyze the data. The P value less than .05 value was considered as a significant.

Results

The study results showed that 119 (48%) females and 129 (52.01%) males completed the 1 year’ follow-up study, and 36% were above 60 years old. The HRQoL of patients with ischemia in the intervention group showed a significant improvement over time with mean ± SD value of 30.81 ± 12.42 at baseline, whereas 38.94 ± 20.13 at 6 months and 43.53 ± 16.26 at 12 months. Moreover, DHPIs had a 75% impact on overall health, 97% on mental health, 91% on physical health, and 88% on social health among the patients with ischemia.

Conclusions

There is a significant improvement in HRQoL among patients with IHD, suggesting that the implementation of DHPIs may an effective strategy for management of IHD.

目的数字健康计划被认为是改善健康相关生活质量（HRQoL）的一个可能框架。本研究探讨了数字健康药房干预（dhpi）对缺血性心脏病患者自我报告的HRQoL和质量调整生命年的影响。方法于2022年9月至2023年8月在拉合尔旁遮普心脏病研究所进行1年随访的随机对照试验。患有缺血性心脏病（IHD）的成年人（n = 332）被随机分为干预组（n = 166）和对照组（n = 166）。采用SF-12和EQ-5D-5L两份有效问卷进行评价。采用McNemar检验、独立样本t检验、多元方差分析和主成分分析模型对数据进行分析。P值小于。0.05值为显著性。结果女性119例（48%），男性129例（52.01%）完成了1年随访研究，其中年龄在60岁以上的占36%。干预组缺血患者的HRQoL随着时间的推移有显著改善，基线时的平均值±SD值为30.81±12.42，而6个月时的平均值为38.94±20.13,12个月时的平均值为43.53±16.26。此外，dhpi对缺血患者整体健康的影响为75%，对心理健康的影响为97%，对身体健康的影响为91%，对社会健康的影响为88%。结论IHD患者HRQoL有明显改善，提示实施dhpi可能是治疗IHD的有效策略。

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