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Value in Health最新文献

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Cost-Effectiveness of an Extended-Role General Practitioner Clinic for Persistent Physical Symptoms: Results From the Multiple Symptoms Study 3 Pragmatic Randomized Controlled Trial 针对顽固性身体症状的全科医生扩展角色诊所的成本效益：多重症状研究 3 (MSS3) 实用随机对照试验的结果。
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.09.015
Aileen R. Neilson MSc , Cara Mooney MSc , Laura Sutton PhD , David White MPH , Jeremy Dawson PhD , Gillian Rowlands MD , Ruth E. Thomas PhD , Jonathan Woodward MSc , Vincent Deary PhD , Christopher Burton PhD

Objectives

This study aimed to evaluate the cost-effectiveness of an extended-role general practitioner symptoms clinic (SC), added to usual care (UC) for patients with multiple persistent physical symptoms (sometimes known as medically unexplained symptoms).

Methods

This was a 52-week within-trial cost-utility analysis of a pragmatic multicenter randomized controlled trial comparing SC + UC (n = 178) with UC alone (n = 176), conducted from the primary perspective of the UK National Health Service and personal and social services (PSS). Base-case quality-adjusted life-years (QALYs) were measured using EQ-5D-5L. Missing data were imputed using multiple imputation. Cost-effectiveness results were presented as incremental cost-effectiveness ratios and incremental net monetary benefits. Uncertainty was explored using cost-effectiveness acceptability curves (using 1000 nonparametric bootstrapped samples) and sensitivity analysis (including societal costs, using SF-6D and ICECAP-A capability measure for adults outcomes to estimate QALYs and years of full capability, respectively, varying intervention costs, missing data mechanism assumptions).

Results

Multiple imputation analysis showed that compared with UC alone, SC + UC was more expensive (adjusted mean cost difference: 704; 95% CI £605-£807) and more effective (adjusted mean QALY difference: 0.0447; 95% CI 0.0067-0.0826), yielding an incremental cost-effectiveness ratio of £15 765/QALY, incremental net monetary benefit of £189.22 (95% CI −£573.62 to £948.28) and a 69% probability of the SC + UC intervention arm being cost-effective at a threshold of £20 000 per QALY. Results were robust to most sensitivity analyses but sensitive to missing data assumptions (2 of the 8 scenarios investigated), SF-6D, and ICECAP_A capability measure for adults quality-of-life outcomes.

Conclusions

A symptoms clinic is likely to be a potentially cost-effective treatment for patients with persistent physical symptoms.
目的评估在常规护理（UC）的基础上增加全科医生（GP）症状门诊（SC）的成本效益，以治疗具有多种持续性身体症状（有时称为 "医学上无法解释的症状"）的患者：方法：从英国国家医疗服务系统（NHS）和个人与社会服务系统（PSS）的角度出发，对一项实用性多中心随机对照试验进行了为期 52 周的试验成本效用分析，该试验比较了症状门诊+UC（178 人）与单纯 UC（176 人）。基础病例质量调整生命年（QALYs）采用 EQ-5D-5L 进行测量。缺失数据采用多重估算法（MI）进行估算。成本效益结果以增量成本效益比（ICER）和增量净货币效益（INMB）表示。使用成本效益可接受性曲线（使用 1000 个非参数引导样本）和敏感性分析（包括社会成本，使用 SF-6D 和能力 ICECAP-A 结果分别估算 QALYs 和完全能力年数 (YFC)，改变干预成本、缺失数据机制假设）对不确定性进行了探讨：多重估算分析表明，与单独使用 UC 相比，SC+UC 更昂贵[（调整后的平均成本差异：704；95% CI：605 英镑，807 英镑）]，更有效[（调整后的平均 QALY 差异：0.0447（95% CI：0.0067，0.0826）]，ICER 为 15,765 英镑/QALY，INMB 为 189.22 英镑（95% CI：-573.62 英镑，948.28 英镑），在每 QALY 20000 英镑的阈值下，SC+UC 干预组具有成本效益的概率为 69%。结果对大多数敏感性分析都是稳健的，但对缺失数据假设（调查的 8 个方案中的 2 个）、SF-6D 和 ICECAP-A 生活质量结果敏感：症状门诊对于有持续性躯体症状的患者来说可能是一种具有潜在成本效益的治疗方法。
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引用次数: 0
CO9 Systematic Literature Review (SLR) of Disease Burden Related to First-Line (1L) Unresectable, Locally Advanced, or Metastatic Esophageal Squamous Cell Carcinoma (ESCC)
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.086
E Smyth , A Sibiga , AN Nehdi , A Krishna , K Kim , J Coaquira Castro , E Priedane , L Zhan
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引用次数: 0
P54 An Insight Into Real-World Evidence (RWE) As a Component of Submission to NICE & CADTH in the Last 3 Years
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.068
S Heinz , C Kumari , J Ataide , M Bourakkadi
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引用次数: 0
P47 Evaluation of Natural Language Processing (NLP) on Electronic Medical Records: A Proof of Concept on Chronic Graft Versus Host Disease (cGVHD) in France
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.060
S Colas , V Gilles , S Chantepie , E Daguindau , A Huynh , M Loschi , M Robin , N Raus , C Requillard , L Chuttoo , A Poplu , N Allali , D Kiprijanovski , F Leouay , V Jeanbat , J Kirion , J Cottin , N Buchbinder , S François , A Villate , S Bouee
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引用次数: 0
CO27 Comparative Effectiveness of the mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Canadians: A Systematic Literature Review and Meta-Analysis Using the Grade Framework
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.104
X Wang , A Pahwa , P Sharma , A Chitkara , N Mishra , M Malmenas , S Vats , P Jain , R Gupta , E Beck , K Jayasundara , M Blake
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引用次数: 0
P1 Indirect Treatment Comparison of Larotrectinib vs Entrectinib in NTRK-Fusion Solid Tumors: Demonstration of a Novel Bayesian Hierarchical Modelling Approach for Basket Trials
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.002
E Mackay , A Springford , S Dias
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引用次数: 0
P25 REEEVR: A Tool for Automatic Conversion of Models for Health Technology Assessment From Excel to R
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.033
M O'Donnell , Q Xin , G Rogers , A.L. Haji-Ali , H Thom
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引用次数: 0
CO2 Outcomes-Based Agreements and Real-World Data for Health Technology Reassessment of Orphan Drugs: Learnings from Belgium
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.079
A Blonda , K Facey , Van de Vijver I , Y Denier , I Huys , S Simoens
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引用次数: 0
P36 Assessing Methods for Transporting Trial Treatment Effects to Target Real-World Populations Without Individual-Level Data
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.046
N Tikhonovsky , F Ma , X Zhang , S Ramagopalan
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引用次数: 0
P35 Transporting EQ-5D Aggregated Utilities Across Different Value Sets: A Simulation Modelling Approach
IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health
Pub Date : 2024-12-01 DOI: 10.1016/j.jval.2024.10.045
A. Estévez-Carrillo, K Rand
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引用次数: 0
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