Pub Date : 2024-02-09DOI: 10.1016/j.vhri.2024.01.001
Lütfiye Tekpınar PhD , Vahit Yiğit PhD
Objectives
The most cost-effective option for replacing lost teeth is not evident because there is a dearth of evidence-based information on implant-supported single crowns versus tooth-supported fixed dental prostheses. This study conducted the analysis of cost-effectiveness of implant-supported single crown and tooth-supported fixed dental prostheses from a social perspective in Türkiye.
Methods
Costs were calculated in the analysis from a social perspective for 2021. Costs and quality-adjusted prosthesis year (QAPY) values were computed over a 20-year period in the study using the Markov model. The computed values were discounted by 5%. The results are presented as the incremental cost-effectiveness ratio. To assess the impact of uncertainty on cost-effectiveness analyses, a tornado diagram and Monte Carlo simulations were created.
Results
Throughout the 20-year time horizon, tooth-supported fixed dental prostheses cost $985.58 cumulatively, whereas implant-supported single crown cost $2161.64 (US $1 = 9.22 ₺ as of 15 October 2021). The calculated incremental cost-effectiveness ratio is 1.333 per QAPY. Compared with the implant-supported single crown tooth-supported fixed dental prostheses, it offers a QAPY of 0.882 over a 20-year period, while costing an additional $1176.06.
Conclusions
These results suggest that the implant-supported single crown provided higher QAPY value but was costlier. When the research’s findings are compared with the literature, it becomes clear that Türkiye has lower dental care expenses than most other nations.
{"title":"Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye","authors":"Lütfiye Tekpınar PhD , Vahit Yiğit PhD","doi":"10.1016/j.vhri.2024.01.001","DOIUrl":"10.1016/j.vhri.2024.01.001","url":null,"abstract":"<div><h3>Objectives</h3><p>The most cost-effective option for replacing lost teeth is not evident because there is a dearth of evidence-based information on implant-supported single crowns versus tooth-supported fixed dental prostheses. This study conducted the analysis of cost-effectiveness of implant-supported single crown and tooth-supported fixed dental prostheses from a social perspective in Türkiye.</p></div><div><h3>Methods</h3><p>Costs were calculated in the analysis from a social perspective for 2021. Costs and quality-adjusted prosthesis year (QAPY) values were computed over a 20-year period in the study using the Markov model. The computed values were discounted by 5%. The results are presented as the incremental cost-effectiveness ratio. To assess the impact of uncertainty on cost-effectiveness analyses, a tornado diagram and Monte Carlo simulations were created.</p></div><div><h3>Results</h3><p>Throughout the 20-year time horizon, tooth-supported fixed dental prostheses cost $985.58 cumulatively, whereas implant-supported single crown cost $2161.64 (US $1 = 9.22 ₺ as of 15 October 2021). The calculated incremental cost-effectiveness ratio is 1.333 per QAPY. Compared with the implant-supported single crown tooth-supported fixed dental prostheses, it offers a QAPY of 0.882 over a 20-year period, while costing an additional $1176.06.</p></div><div><h3>Conclusions</h3><p>These results suggest that the implant-supported single crown provided higher QAPY value but was costlier. When the research’s findings are compared with the literature, it becomes clear that Türkiye has lower dental care expenses than most other nations.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Pages 11-17"},"PeriodicalIF":2.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716475","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}
Pub Date : 2024-02-09DOI: 10.1016/j.vhri.2023.12.008
Samer A. Kharroubi PhD , Clara Mukuria PhD , Dalia Dawoud PhD , Donna Rowen PhD
Objectives
The SF-6Dv1 is a preference-based measure derived from the SF-36 for use in quality-adjusted life-year estimation for cost-utility analysis. Country-specific value sets for SF-6Dv1 are needed to reflect societal preferences but none are available for Lebanon and other Arabic countries. This study aimed to generate a value set for SF-6Dv1 for Lebanon and to compare results with the UK set.
Methods
A sample of 249 health states defined by the SF-6Dv1 were valued by a representative sample of 577 members of the Lebanon general population, using standard gamble. Several multivariate regression models at mean and individual level were fitted to estimate utilities for all SF-6Dv1 states with selection of best fitting models based on predictive ability, consistency, and model fit. The best fitting models were compared with those fitted in the UK study.
Results
Data from 553 eligible respondents providing 3308 valuations were used for the analysis. Lebanese values were consistently higher than UK values, indicating differences in preferences, and there were no negative values. The random effects model using only main effects was the best performing model. There were inconsistencies in 2 dimensions, thereby consistent models were estimated with values ranging from 0.367 to 1. The results are consistent with the UK results.
Conclusions
This study provides the first population-based value set for SF-6Dv1 health states for Lebanon, making it possible to generate quality-adjusted life-years for cost-utility analysis studies. The potential for applications of a standardized utility measure is enormous both in Lebanon and all Arab countries.
{"title":"Estimating the SF-6Dv1 Value Set for a Population-Based Sample in Lebanon","authors":"Samer A. Kharroubi PhD , Clara Mukuria PhD , Dalia Dawoud PhD , Donna Rowen PhD","doi":"10.1016/j.vhri.2023.12.008","DOIUrl":"10.1016/j.vhri.2023.12.008","url":null,"abstract":"<div><h3>Objectives</h3><p>The SF-6Dv1 is a preference-based measure derived from the SF-36 for use in quality-adjusted life-year estimation for cost-utility analysis. Country-specific value sets for SF-6Dv1 are needed to reflect societal preferences but none are available for Lebanon and other Arabic countries. This study aimed to generate a value set for SF-6Dv1 for Lebanon and to compare results with the UK set.</p></div><div><h3>Methods</h3><p>A sample of 249 health states defined by the SF-6Dv1 were valued by a representative sample of 577 members of the Lebanon general population, using standard gamble. Several multivariate regression models at mean and individual level were fitted to estimate utilities for all SF-6Dv1 states with selection of best fitting models based on predictive ability, consistency, and model fit. The best fitting models were compared with those fitted in the UK study.</p></div><div><h3>Results</h3><p>Data from 553 eligible respondents providing 3308 valuations were used for the analysis. Lebanese values were consistently higher than UK values, indicating differences in preferences, and there were no negative values. The random effects model using only main effects was the best performing model. There were inconsistencies in 2 dimensions, thereby consistent models were estimated with values ranging from 0.367 to 1. The results are consistent with the UK results.</p></div><div><h3>Conclusions</h3><p>This study provides the first population-based value set for SF-6Dv1 health states for Lebanon, making it possible to generate quality-adjusted life-years for cost-utility analysis studies. The potential for applications of a standardized utility measure is enormous both in Lebanon and all Arab countries.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"42 ","pages":"Pages 1-10"},"PeriodicalIF":2.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716476","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}
Pub Date : 2024-02-06DOI: 10.1016/j.vhri.2023.12.004
Marisol Torres-Toledano ScM , Víctor Granados-García ScD , Laura Cortés-Sanabria ScD , Alfonso Martín Cueto-Manzano PharmD , Yvonne N. Flores PhD , Jorge Salmerón ScD
Objectives
This study aimed to determine the hospital service utilization patterns and direct healthcare hospital costs before and during peritoneal dialysis (PD) at home.
Methods
A retrospective cohort study of patients with kidney failure (KF) was conducted at a Mexican Social Security Institute hospital for the year 2014. Cost categories included inpatient emergency room stays, inpatient services at internal medicine or surgery, and hospital PD. The study groups were (1) patients with KF before initiating home PD, (2) patients with less than 1 year of home PD (incident), and (3) patients with more than 1 year of home PD (prevalent). Costs were actualized to international dollars (Int$) 2023.
Results
We found that 53% of patients with KF used home PD services, 42% had not received any type of PD, and 5% had hospital dialysis while waiting for home PD. The estimated costs adjusting for age and sex were Int$5339 (95% CI 4680-9746) for patients without home PD, Int$17 556 (95% CI 15 314-19 789) for incident patients, and Int$7872 (95% CI 5994-9749) for prevalent patients; with significantly different averages for the 3 groups (P < .001).
Conclusions
Although the use of services and cost is highest at the time of initiating PD, over time, using home PD leads to a significant reduction in use of hospital services, which translates into institutional cost savings. Our findings, especially considering the high rates of KF in Mexico, suggest a pressing need for interventions that can reduce healthcare costs at the beginning of renal replacement therapy.
{"title":"Service Utilization Patterns and Direct Medical Costs of Hospitalization in Patients With Renal Failure Before and After Initiating Home Peritoneal Dialysis","authors":"Marisol Torres-Toledano ScM , Víctor Granados-García ScD , Laura Cortés-Sanabria ScD , Alfonso Martín Cueto-Manzano PharmD , Yvonne N. Flores PhD , Jorge Salmerón ScD","doi":"10.1016/j.vhri.2023.12.004","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.004","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to determine the hospital service utilization patterns and direct healthcare hospital costs before and during peritoneal dialysis (PD) at home.</p></div><div><h3>Methods</h3><p>A retrospective cohort study of patients with kidney failure (KF) was conducted at a Mexican Social Security Institute hospital for the year 2014. Cost categories included inpatient emergency room stays, inpatient services at internal medicine or surgery, and hospital PD. The study groups were (1) patients with KF before initiating home PD, (2) patients with less than 1 year of home PD (incident), and (3) patients with more than 1 year of home PD (prevalent). Costs were actualized to international dollars (Int$) 2023.</p></div><div><h3>Results</h3><p>We found that 53% of patients with KF used home PD services, 42% had not received any type of PD, and 5% had hospital dialysis while waiting for home PD. The estimated costs adjusting for age and sex were Int$5339 (95% CI 4680-9746) for patients without home PD, Int$17 556 (95% CI 15 314-19 789) for incident patients, and Int$7872 (95% CI 5994-9749) for prevalent patients; with significantly different averages for the 3 groups (<em>P</em> < .001).</p></div><div><h3>Conclusions</h3><p>Although the use of services and cost is highest at the time of initiating PD, over time, using home PD leads to a significant reduction in use of hospital services, which translates into institutional cost savings. Our findings, especially considering the high rates of KF in Mexico, suggest a pressing need for interventions that can reduce healthcare costs at the beginning of renal replacement therapy.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 114-122"},"PeriodicalIF":2.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699484","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}
Pub Date : 2024-02-05DOI: 10.1016/j.vhri.2023.12.007
Jack Garcia Uranga Romano MSc , Samuel Joseph Paul Malkin MSc , Barnaby Hunt MSc
Objectives
The real-world ARISE study demonstrated initiation of fixed-ratio combination insulin degludec and aspart (IDegAsp) led to improvements in people achieving key glycemic control targets compared with prior therapies in Australia and India. This study evaluated the short-term cost-effectiveness of IDegAsp in these countries, in terms of the cost per patient achieving these targets.
Methods
A model was developed to evaluate the cost of control (treatment costs divided by the proportion of patients achieving each target) of IDegAsp versus prior therapies received in ARISE for 2 endpoints: glycated hemoglobin (HbA1c) <7.0%, and HbA1c less than a predefined individual treatment target. Costs, expressed from a healthcare payer perspective, were captured in 2022 Australian dollars (AUD) and 2022 Indian rupees (INR).
Results
The number of patients needed to treat to bring one to endpoints of HbA1c <7.0% and less than an individualized target with IDegAsp was 51% and 87% lower, respectively, than with prior therapies in Australia, and 52% and 66% lower, respectively, versus prior therapies in India. Cost of control was AUD 2449 higher and AUD 64 863 lower with IDegAsp versus prior therapies for endpoints of HbA1c <7.0% and less than an individualized target, respectively, in Australia and INR 211 142 and INR 537 490 lower with IDegAsp compared with prior therapies in India.
Conclusions
IDegAsp was estimated to be cost-effective versus prior therapies when considering an individualized HbA1c target in Australia, and when considering an individualized HbA1c target and HbA1c <7.0% in India.
{"title":"The Short-Term Cost-Effectiveness of a Fixed-Ratio Combination of Insulin Degludec and Aspart: A Cost of Control Analysis in Australia and India","authors":"Jack Garcia Uranga Romano MSc , Samuel Joseph Paul Malkin MSc , Barnaby Hunt MSc","doi":"10.1016/j.vhri.2023.12.007","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.007","url":null,"abstract":"<div><h3>Objectives</h3><p>The real-world ARISE study demonstrated initiation of fixed-ratio combination insulin degludec and aspart (IDegAsp) led to improvements in people achieving key glycemic control targets compared with prior therapies in Australia and India. This study evaluated the short-term cost-effectiveness of IDegAsp in these countries, in terms of the cost per patient achieving these targets.</p></div><div><h3>Methods</h3><p>A model was developed to evaluate the cost of control (treatment costs divided by the proportion of patients achieving each target) of IDegAsp versus prior therapies received in ARISE for 2 endpoints: glycated hemoglobin (HbA1c) <7.0%, and HbA1c less than a predefined individual treatment target. Costs, expressed from a healthcare payer perspective, were captured in 2022 Australian dollars (AUD) and 2022 Indian rupees (INR).</p></div><div><h3>Results</h3><p>The number of patients needed to treat to bring one to endpoints of HbA1c <7.0% and less than an individualized target with IDegAsp was 51% and 87% lower, respectively, than with prior therapies in Australia, and 52% and 66% lower, respectively, versus prior therapies in India. Cost of control was AUD 2449 higher and AUD 64 863 lower with IDegAsp versus prior therapies for endpoints of HbA1c <7.0% and less than an individualized target, respectively, in Australia and INR 211 142 and INR 537 490 lower with IDegAsp compared with prior therapies in India.</p></div><div><h3>Conclusions</h3><p>IDegAsp was estimated to be cost-effective versus prior therapies when considering an individualized HbA1c target in Australia, and when considering an individualized HbA1c target and HbA1c <7.0% in India.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 108-113"},"PeriodicalIF":2.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000037/pdfft?md5=f8266d7c483af8b55f41e71ce159f7b9&pid=1-s2.0-S2212109924000037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694019","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}
Pub Date : 2024-02-02DOI: 10.1016/j.vhri.2023.12.005
Ahmed Al-Jedai MBA , Hajer Almudaiheem PharmD , Yazeed Alruthia PhD , Abdullah Althemery PhD , Hana Alabdulkarim PharmD , Rita Ojeil MSc , Ali Alrumaih PharmD , Suliman AlGhannam MD , AbdulAali AlMutairi PhD , Zuhair Hasnan MD
Objectives
To assess the feasibility of implementing multi-criteria decision analysis (MCDA) and to select the criteria for preparing a national MCDA framework for health technology assessment of orphan drugs in the Kingdom of Saudi Arabia (KSA).
Methods
The study was conducted in 3 phases. In phase I, a targeted literature review was performed to gather relevant information on the implementation of MCDA in healthcare decision making. Phase II was a cross-sectional survey, conducted to obtain insights from different stakeholders and key opinion leaders on specific topics from the KSA perspective. Phase III included a round-table discussion involving experts to validate the results obtained in the phase II survey and further elaborate on specific requirements that may be critical for developing the first national MCDA framework in the KSA.
Results
All the key opinion leaders involved in the study acknowledged the importance of implementing MCDA in the KSA. The Ministry of Health was assigned the responsibility of chairing the MCDA decision process. The experts selected the quantitative, qualitative, and economic criteria to be considered for the MCDA framework. The stakeholders decided to initiate a pilot phase using the deliberative MCDA methodology for the assessment of orphan drugs based on the selected criteria for a period of 1 year and then reevaluate the need to adapt the pragmatic MCDA model.
Conclusion
This article describes the novel initiative that examined the feasibility and process required for the development of the first MCDA framework in the KSA to support healthcare decision making.
{"title":"A Step Toward the Development of the First National Multi-Criteria Decision Analysis Framework to Support Healthcare Decision Making in Saudi Arabia","authors":"Ahmed Al-Jedai MBA , Hajer Almudaiheem PharmD , Yazeed Alruthia PhD , Abdullah Althemery PhD , Hana Alabdulkarim PharmD , Rita Ojeil MSc , Ali Alrumaih PharmD , Suliman AlGhannam MD , AbdulAali AlMutairi PhD , Zuhair Hasnan MD","doi":"10.1016/j.vhri.2023.12.005","DOIUrl":"10.1016/j.vhri.2023.12.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the feasibility of implementing multi-criteria decision analysis (MCDA) and to select the criteria for preparing a national MCDA framework for health technology assessment of orphan drugs in the Kingdom of Saudi Arabia (KSA).</p></div><div><h3>Methods</h3><p>The study was conducted in 3 phases. In phase I, a targeted literature review was performed to gather relevant information on the implementation of MCDA in healthcare decision making. Phase II was a cross-sectional survey, conducted to obtain insights from different stakeholders and key opinion leaders on specific topics from the KSA perspective. Phase III included a round-table discussion involving experts to validate the results obtained in the phase II survey and further elaborate on specific requirements that may be critical for developing the first national MCDA framework in the KSA.</p></div><div><h3>Results</h3><p>All the key opinion leaders involved in the study acknowledged the importance of implementing MCDA in the KSA. The Ministry of Health was assigned the responsibility of chairing the MCDA decision process. The experts selected the quantitative, qualitative, and economic criteria to be considered for the MCDA framework. The stakeholders decided to initiate a pilot phase using the deliberative MCDA methodology for the assessment of orphan drugs based on the selected criteria for a period of 1 year and then reevaluate the need to adapt the pragmatic MCDA model.</p></div><div><h3>Conclusion</h3><p>This article describes the novel initiative that examined the feasibility and process required for the development of the first MCDA framework in the KSA to support healthcare decision making.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 100-107"},"PeriodicalIF":2.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000013/pdfft?md5=9d066ce5a51135997270f99f78adc5c3&pid=1-s2.0-S2212109924000013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672789","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}
Non–small cell lung cancer (NSCLC) is Argentina’s first cause of cancer death. Most patients have an advanced stage at diagnosis, with poor expected survival. This study aimed to characterize the health-related quality of life (HRQOL) and economic impact of patients treated in the private healthcare sector and compare it with that of the public sector.
Methods
We undertook an observational cross-sectional study that extended a previous study to a referral private center in Argentina. Outcomes included the EuroQol EQ-5D-3L (to assess HRQOL), Comprehensive Score for Financial Toxicity (financial toxicity instrument), Work Productivity and Activity Impairment – General Health (to assess productivity loss), and out-of-pocket expenses in adults diagnosed of NSCLC.
Results
We included 30 consecutive patients from a private healthcare center (July 2021 to March 2022), totaling 131 patients (n = 101 from previous public study). The whole sample had low quality of life and relevant economic impact. Patients in the private healthcare sector showed lower disease severity and higher educational level and household income. In addition, private healthcare system patients showed higher utility (0.77 vs 0.73; P < .05) and lower impairment of daily activities (41% vs 59%; P = .01). Private health system patients also showed lower financial toxicity as measured by the Comprehensive Score for Financial Toxicity score (23.9 vs 20.14; P < .05) but showed no differences when financial toxicity was assessed as a dichotomic variable.
Conclusions
Although patients with NSCLC treated in a private healthcare center in Argentina showed a relevant HRQOL and economic impact, this impact was smaller than the one observed in publicly funded hospitals.
{"title":"Impact of Lung Cancer on Health-Related Quality of Life, Financial Toxicity, and Household Economics in Patients From the Public and the Private Healthcare Sector in Argentina","authors":"Federico Augustovski PhD , Florencia Tsou MD , Lucas González MSc , Claudio Martín MD , Silvina Vigo MD , Carolina Gabay MD , Andrea Alcaraz MSc , Fernando Argento MSc","doi":"10.1016/j.vhri.2023.12.001","DOIUrl":"10.1016/j.vhri.2023.12.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Non–small cell lung cancer (NSCLC) is Argentina’s first cause of cancer death. Most patients have an advanced stage at diagnosis, with poor expected survival. This study aimed to characterize the health-related quality of life (HRQOL) and economic impact of patients treated in the private healthcare sector and compare it with that of the public sector.</p></div><div><h3>Methods</h3><p>We undertook an observational cross-sectional study that extended a previous study to a referral private center in Argentina. Outcomes included the EuroQol EQ-5D-3L (to assess HRQOL), Comprehensive Score for Financial Toxicity (financial toxicity instrument), Work Productivity and Activity Impairment – General Health (to assess productivity loss), and out-of-pocket expenses in adults diagnosed of NSCLC.</p></div><div><h3>Results</h3><p>We included 30 consecutive patients from a private healthcare center (July 2021 to March 2022), totaling 131 patients (n = 101 from previous public study). The whole sample had low quality of life and relevant economic impact. Patients in the private healthcare sector showed lower disease severity and higher educational level and household income. In addition, private healthcare system patients showed higher utility (0.77 vs 0.73; <em>P</em> < .05) and lower impairment of daily activities (41% vs 59%; <em>P</em><span> = .01). Private health system patients also showed lower financial toxicity as measured by the Comprehensive Score for Financial Toxicity score (23.9 vs 20.14; </span><em>P</em> < .05) but showed no differences when financial toxicity was assessed as a dichotomic variable.</p></div><div><h3>Conclusions</h3><p>Although patients with NSCLC treated in a private healthcare center in Argentina showed a relevant HRQOL and economic impact, this impact was smaller than the one observed in publicly funded hospitals.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 94-99"},"PeriodicalIF":2.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643010","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}
Cancer and its treatments significantly impact individuals’ lives and quality of life (QOL). Research on QOL examines these effects, encompassing physical, psychological, and social aspects. Understanding QOL factors is vital for both patients and clinicians. The evaluation of QOL of patients with cancer and its associated predictive factors has not been previously investigated within the Beni Mellal-Khenifra region of Morocco. Our primary aim was to assess the QOL experienced by patients while simultaneously identifying the determinants and predictors influencing it.
Methods
Patients were enrolled in a cross-sectional study conducted at the Beni Mellal Oncology Center. Each participant was required to fill out the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire, along with a supplemental questionnaire gathering sociodemographic information. A linear regression analysis was executed to ascertain predictors of the Global Health Status (GHS) and 5 functional scales. The statistical analysis was carried out using Statistical Package for Social Science (SPSS) v25 software.
Results
Our study included 369 patients, with an average age of 52.89. The mean score on the QLQC30 GHS Scale was 64.97. Notably, this score exhibited positive correlations with emotional, social, and role functioning scales, while demonstrating negative correlations with prostate and lung cancers, as well as the presence of pain. Furthermore, the presence of fatigue exhibited associations with all functioning scales, except for social functioning.
Conclusions
Patients exhibited a favorable GHS. However, it is noteworthy that prostate cancer, lung cancer, the presence of pain, and diminished emotional, social, and role functioning emerged as independent factors significantly associated with poorer GHS.
目的：癌症及其治疗对患者的生活和生命质量（QOL）有重大影响。有关 QOL 的研究探讨了这些影响，包括生理、心理和社会方面。了解 QOL 因素对患者和临床医生都至关重要。此前，摩洛哥贝尼梅拉尔-凯尼夫拉地区尚未对癌症患者的 QOL 及其相关预测因素进行过调查。我们的主要目的是评估患者的 QOL，同时确定影响 QOL 的决定因素和预测因素：贝尼梅拉尔肿瘤中心开展的一项横断面研究对患者进行了登记。每位参与者都必须填写欧洲癌症研究和治疗组织 QLQ-C30 问卷的摩洛哥语阿拉伯语版本，以及一份收集社会人口学信息的补充问卷。为确定全球健康状况（GHS）和 5 个功能量表的预测因素，进行了线性回归分析。统计分析使用社会科学统计软件包（SPSS）v25 软件进行：研究共纳入 369 名患者，平均年龄为 52.89 岁。QLQC30 GHS 量表的平均得分为 64.97 分。值得注意的是，该分数与情感、社交和角色功能量表呈正相关，而与前列腺癌、肺癌以及疼痛呈负相关。此外，除社交功能外，疲劳的存在与所有功能量表都有关联：结论：患者的全球健康状况良好。然而，值得注意的是，前列腺癌、肺癌、疼痛的存在以及情感、社交和角色功能的减退是与较差的 GHS 显著相关的独立因素。
{"title":"Quality of Life of Patients With Cancer at the Beni Mellal Oncology Center","authors":"Mohamed Aboufaras PhD , Karima Selmaoui PhD , Nadia Ouzennou PhD","doi":"10.1016/j.vhri.2023.12.002","DOIUrl":"10.1016/j.vhri.2023.12.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Cancer and its treatments<span> significantly impact individuals’ lives and quality of life<span> (QOL). Research on QOL examines these effects, encompassing physical, psychological, and social aspects. Understanding QOL factors is vital for both patients and clinicians. The evaluation of QOL of patients with cancer and its associated predictive factors has not been previously investigated within the Beni Mellal-Khenifra region of Morocco. Our primary aim was to assess the QOL experienced by patients while simultaneously identifying the determinants and predictors influencing it.</span></span></p></div><div><h3>Methods</h3><p><span><span>Patients were enrolled in a cross-sectional study conducted at the Beni Mellal Oncology Center. Each participant was required to fill out the Moroccan Arabic version of the European Organization for Research and </span>Treatment of Cancer QLQ-C30 questionnaire, along with a supplemental questionnaire gathering sociodemographic information. A </span>linear regression analysis was executed to ascertain predictors of the Global Health Status (GHS) and 5 functional scales. The statistical analysis was carried out using Statistical Package for Social Science (SPSS) v25 software.</p></div><div><h3>Results</h3><p>Our study included 369 patients, with an average age of 52.89. The mean score on the QLQC30 GHS Scale was 64.97. Notably, this score exhibited positive correlations with emotional, social, and role functioning scales, while demonstrating negative correlations with prostate and lung cancers, as well as the presence of pain. Furthermore, the presence of fatigue exhibited associations with all functioning scales, except for social functioning.</p></div><div><h3>Conclusions</h3><p>Patients exhibited a favorable GHS. However, it is noteworthy that prostate cancer, lung cancer, the presence of pain, and diminished emotional, social, and role functioning emerged as independent factors significantly associated with poorer GHS.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 86-93"},"PeriodicalIF":2.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563884","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}
Pub Date : 2024-01-22DOI: 10.1016/j.vhri.2023.11.011
Sofia Oliveira-Martins PhD , Miguel Costa Lopes MPharm , Alexandra Cardoso dos Santos MA, MBA , Ana Margarida Advinha PhD
Objectives
Access to innovative and effective medication is a citizen’s right. The main objectives of this study were to build an indicator to measure access to medicines within hospitals, the Global Medicines Access Index, and to identify the main existing barriers.
Methods
Cross-sectional study carried out in Portuguese National Health Service hospitals. A consensus methodology (expert panel of 7 members) was used to define which dimensions should be included in the index and the weighting that each should take. The panel identified 6 dimensions: access to innovative medicines, proximity distribution, shortages, access to medicines before financing decision, value-based healthcare, and access to medication depending on cost/funding. Data were collected through an electronic questionnaire (September 2021).
Results
The response rate was 61.2%. Most hospitals used medicines with and without marketing authorization before the funding decision. Monitoring and generating evidence of new therapies results is still insufficient. The identified barriers were the administrative burden as the major barrier in purchasing medicines, with a relevant impact on shortages of medicines. Most respondents (87%) had a proximity distribution program, mainly implemented in the pandemic context, and the price/funding model was only identified by 10% as a barrier to access. The 2021 Global Medicines Access Index was 66%. Shortages and value-based use of medicines were the dimensions that had more influence in lowering the index value.
Conclusions
The new formula used to obtain a unique and multidimensional index for access to hospital medicines seems to be more sensitive and objective and will be used to monitor access.
{"title":"Portuguese Global Medicines Access Index 2021—An Indicator to Measure Access to Hospital Medicines","authors":"Sofia Oliveira-Martins PhD , Miguel Costa Lopes MPharm , Alexandra Cardoso dos Santos MA, MBA , Ana Margarida Advinha PhD","doi":"10.1016/j.vhri.2023.11.011","DOIUrl":"10.1016/j.vhri.2023.11.011","url":null,"abstract":"<div><h3>Objectives</h3><p>Access to innovative and effective medication is a citizen’s right. The main objectives of this study were to build an indicator to measure access to medicines within hospitals, the Global Medicines Access Index, and to identify the main existing barriers.</p></div><div><h3>Methods</h3><p>Cross-sectional study carried out in Portuguese National Health Service hospitals. A consensus methodology (expert panel of 7 members) was used to define which dimensions should be included in the index and the weighting that each should take. The panel identified 6 dimensions: access to innovative medicines, proximity distribution, shortages, access to medicines before financing decision, value-based healthcare, and access to medication depending on cost/funding. Data were collected through an electronic questionnaire (September 2021).</p></div><div><h3>Results</h3><p>The response rate was 61.2%. Most hospitals used medicines with and without marketing authorization before the funding decision. Monitoring and generating evidence of new therapies results is still insufficient. The identified barriers were the administrative burden as the major barrier in purchasing medicines, with a relevant impact on shortages of medicines. Most respondents (87%) had a proximity distribution program, mainly implemented in the pandemic context, and the price/funding model was only identified by 10% as a barrier to access. The 2021 Global Medicines Access Index was 66%. Shortages and value-based use of medicines were the dimensions that had more influence in lowering the index value.</p></div><div><h3>Conclusions</h3><p>The new formula used to obtain a unique and multidimensional index for access to hospital medicines seems to be more sensitive and objective and will be used to monitor access.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 80-85"},"PeriodicalIF":2.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543096","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}
Pub Date : 2024-01-20DOI: 10.1016/j.vhri.2023.11.009
Shnece Duncan MCom , Hans Ulrich Bergler MSc , Andrea Menclova PhD , John W. Pickering PhD , Prasad S. Nishtala PhD , Nagham Ailabouni PhD , Sarah N. Hilmer PhD , Dee Mangin MBChB , Hamish Jamieson PhD
Objectives
Frailty is common in older people and is associated with increased use of healthcare services and ongoing use of multiple medications. This study provides insights into the healthcare cost structure of a frail group of older adults in Aotearoa, New Zealand. Furthermore, we investigated the relationship between participants’ anticholinergic and sedative medication burden and their total healthcare costs to explore the viability of deprescribing interventions within this cohort.
Methods
Healthcare cost analysis was conducted using data collected during a randomized controlled trial within a frail, older cohort. The collected information included participant demographics, medications used, frailty, cost of service use of aged residential care and outpatient hospital services, hospital admissions, and dispensed medications.
Results
Data from 338 study participants recruited between 25 September 2018 and 30 October 2020 with a mean age of 80 years were analyzed. The total cost of healthcare per participant ranged from New Zealand $15 (US dollar $10) to New Zealand $270 681 (US dollar $175 943) over 6 months postrecruitment into the study. Four individuals accounted for 26% of this cohort’s total healthcare cost. We found frailty to be associated with increased healthcare costs, whereas the drug burden was only associated with increased pharmaceutical costs, not overall healthcare costs.
Conclusions
With no relationship found between a patient’s anticholinergic and sedative medication burden and their total healthcare costs, more research is required to understand how and where to unlock healthcare cost savings within frail, older populations.
{"title":"The Drug Burden Index and Level of Frailty as Determinants of Healthcare Costs in a Cohort of Older Frail Adults in New Zealand","authors":"Shnece Duncan MCom , Hans Ulrich Bergler MSc , Andrea Menclova PhD , John W. Pickering PhD , Prasad S. Nishtala PhD , Nagham Ailabouni PhD , Sarah N. Hilmer PhD , Dee Mangin MBChB , Hamish Jamieson PhD","doi":"10.1016/j.vhri.2023.11.009","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.009","url":null,"abstract":"<div><h3>Objectives</h3><p>Frailty is common in older people and is associated with increased use of healthcare services and ongoing use of multiple medications. This study provides insights into the healthcare cost structure of a frail group of older adults in Aotearoa, New Zealand. Furthermore, we investigated the relationship between participants’ anticholinergic and sedative medication burden and their total healthcare costs to explore the viability of deprescribing interventions within this cohort.</p></div><div><h3>Methods</h3><p>Healthcare cost analysis was conducted using data collected during a randomized controlled trial within a frail, older cohort. The collected information included participant demographics, medications used, frailty, cost of service use of aged residential care and outpatient hospital services, hospital admissions, and dispensed medications.</p></div><div><h3>Results</h3><p>Data from 338 study participants recruited between 25 September 2018 and 30 October 2020 with a mean age of 80 years were analyzed. The total cost of healthcare per participant ranged from New Zealand $15 (US dollar $10) to New Zealand $270 681 (US dollar $175 943) over 6 months postrecruitment into the study. Four individuals accounted for 26% of this cohort’s total healthcare cost. We found frailty to be associated with increased healthcare costs, whereas the drug burden was only associated with increased pharmaceutical costs, not overall healthcare costs.</p></div><div><h3>Conclusions</h3><p>With no relationship found between a patient’s anticholinergic and sedative medication burden and their total healthcare costs, more research is required to understand how and where to unlock healthcare cost savings within frail, older populations.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 72-79"},"PeriodicalIF":2.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001383/pdfft?md5=9d42d9941cddc2639bddf749f8b4391a&pid=1-s2.0-S2212109923001383-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503662","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}
Pub Date : 2024-01-18DOI: 10.1016/j.vhri.2023.12.003
Andrés Felipe Patiño-Benavidez MD , Giancarlo Buitrago MD, MSc, PhD , Nicolás Rozo-Agudelo MD , Laura Estefanía Saldaña-Espinel MD , Óscar Andrés Gamboa-Garay MD , Javier Eslava-Schmalbach MD, MSc, PhD , Carlos Bonilla-González MD , Óscar Guevara-Cruz MD , Rubén Ernesto Caycedo MD , Edgar Germán Junca MD , Ricardo Sánchez-Pedraza MD, MSc
Objectives
The objective of this study was to identify the association between healthcare fragmentation and survival for patients with colorectal cancer in Colombia.
Methods
A retrospective cohort study was performed using administrative databases, with an electronic algorithm to identify patients with colorectal cancer based on codes. The patients were enrolled between January 1, 2013, and December 31, 2016. The exposure variable was fragmentation, which was measured based on the number of different healthcare institutions that treated a patient during the first year after diagnosis. Matching was performed using propensity scores to control for confounding, and the hazard ratio for exposure to higher fragmentation was calculated for the matched sample.
Results
A total of 5036 patients with colorectal cancer were identified, 2525 (49.88%) of whom were women. The mean number of network healthcare institutions for the total sample was 5.71 (SD 1.98). The patients in the quartile with higher fragmentation had the highest mortality rate, 35.67 (95% CI 33.63-38.06) per 100 patients. The comparison of higher and lower quartiles of fragmentation resulted in an incidence rate ratio of 1.23 (95% CI 1.04-1.45; P = .02). Of the 5036 patients, 422 (8.38%) were classified as the exposed cohort (higher fragmentation). The total matched sample consisted of 844 subjects, and an HR of 1.26 (95%CI; 1.05-1.51) was estimated.
Conclusions
Exposure to more highly fragmented healthcare networks decreases overall 4-year survival for patients with colorectal cancer in Colombia.
{"title":"Association of Healthcare Fragmentation and the Survival of Patients with Colorectal Cancer in Colombia","authors":"Andrés Felipe Patiño-Benavidez MD , Giancarlo Buitrago MD, MSc, PhD , Nicolás Rozo-Agudelo MD , Laura Estefanía Saldaña-Espinel MD , Óscar Andrés Gamboa-Garay MD , Javier Eslava-Schmalbach MD, MSc, PhD , Carlos Bonilla-González MD , Óscar Guevara-Cruz MD , Rubén Ernesto Caycedo MD , Edgar Germán Junca MD , Ricardo Sánchez-Pedraza MD, MSc","doi":"10.1016/j.vhri.2023.12.003","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.12.003","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to identify the association between healthcare fragmentation and survival for patients with colorectal cancer in Colombia.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was performed using administrative databases, with an electronic algorithm to identify patients with colorectal cancer based on codes. The patients were enrolled between January 1, 2013, and December 31, 2016. The exposure variable was fragmentation, which was measured based on the number of different healthcare institutions that treated a patient during the first year after diagnosis. Matching was performed using propensity scores to control for confounding, and the hazard ratio for exposure to higher fragmentation was calculated for the matched sample.</p></div><div><h3>Results</h3><p>A total of 5036 patients with colorectal cancer were identified, 2525 (49.88%) of whom were women. The mean number of network healthcare institutions for the total sample was 5.71 (SD 1.98). The patients in the quartile with higher fragmentation had the highest mortality rate, 35.67 (95% CI 33.63-38.06) per 100 patients. The comparison of higher and lower quartiles of fragmentation resulted in an incidence rate ratio of 1.23 (95% CI 1.04-1.45; <em>P</em> = .02). Of the 5036 patients, 422 (8.38%) were classified as the exposed cohort (higher fragmentation). The total matched sample consisted of 844 subjects, and an HR of 1.26 (95%CI; 1.05-1.51) was estimated.</p></div><div><h3>Conclusions</h3><p>Exposure to more highly fragmented healthcare networks decreases overall 4-year survival for patients with colorectal cancer in Colombia.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"41 ","pages":"Pages 63-71"},"PeriodicalIF":2.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001425/pdfft?md5=0839f20a8e3133bcfbd75fb3e288a1fa&pid=1-s2.0-S2212109923001425-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139493687","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}
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