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    641 results match your criteria Applied Health Economics and Health Policy [Journal]

    1 OF 13

    Healthcare Finance in the Kingdom of Saudi Arabia: A Qualitative Study of Householders' Attitudes.
    Appl Health Econ Health Policy 2017 Sep 20. Epub 2017 Sep 20.
    Economics, Finance and Entrepreneurship Group, Aston Business School, Aston University, Birmingham, UK.
    Background: The public sector healthcare system in Saudi Arabia, essentially financed by oil revenues and 'free at the point of delivery', is coming under increasing strain due to escalating expenditure and an increasingly volatile oil market and is likely to be unsustainable in the medium to long term.

    Objectives: This study examines how satisfied the Saudi people are with their public sector healthcare services and assesses their willingness to contribute to financing the system through a national health insurance scheme. The study also examines public preferences and expectations of a future national health insurance system. Read More

    Erratum to: Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis.
    Appl Health Econ Health Policy 2017 Sep 12. Epub 2017 Sep 12.
    Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Q4006, Australia.
    The last word in the first paragraph which previously read AU$25 million should read 25 million as this relates to population size. Read More

    A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management.
    Appl Health Econ Health Policy 2017 Sep 4. Epub 2017 Sep 4.
    MedCom, Forskerparken 10, 5230, Odense M, Denmark.
    Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. Read More

    Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.
    Appl Health Econ Health Policy 2017 Sep 4. Epub 2017 Sep 4.
    University of Bologna, Bologna, Italy.
    Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Read More

    Dutch Economic Value of Radium-223 in Metastatic Castration-Resistant Prostate Cancer.
    Appl Health Econ Health Policy 2017 Sep 2. Epub 2017 Sep 2.
    Real World Strategy and Analytics, Mapi Group, The Translation and Innovation Hub Building, 5th Floor, 80 Wood Lane, White City, London, W12 OBZ, UK.
    Background: The treatment of metastatic castration-resistant prostate cancer has changed with the introduction of radium-223, cabazitaxel, abiraterone and enzalutamide. To assess value for money, their cost effectiveness in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel from the Dutch societal perspective was investigated.

    Methods: A cost-effectiveness analysis was conducted using efficacy, symptomatic skeletal-related event and safety data obtained from indirect treatment comparisons. Read More

    A Systematic Review of Cost-of-Illness Studies of Multimorbidity.
    Appl Health Econ Health Policy 2017 Aug 30. Epub 2017 Aug 30.
    School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
    Objectives: The economic burden of multimorbidity is considerable. This review analyzed the methods of cost-of-illness (COI) studies and summarized the economic outcomes of multimorbidity.

    Methods: A systematic review (2000-2016) was performed, which was registered with Prospero, reported according to PRISMA, and used a quality checklist adapted for COI studies. Read More

    Health Expenditure and All-Cause Mortality in the 'Galaxy' of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis.
    Appl Health Econ Health Policy 2017 Aug 21. Epub 2017 Aug 21.
    Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
    Background: The sustainability of healthcare systems is a topic of major interest. During periods of economic instability, policy makers typically reallocate resources and execute linear cuts in different areas of public spending, including healthcare.

    Objectives: The aim of this paper was to examine whether and how per capita public healthcare expenditure (PHE) in the Italian regions was related to the all-cause mortality rate (MR) between 1999 and 2013 and to determine which expenditure item most affected mortality in the short and very short term. Read More

    A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland.
    Appl Health Econ Health Policy 2017 Aug 21. Epub 2017 Aug 21.
    National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland.
    Background: The Irish government has committed to expand midwifery-led care alongside consultant-led care nationally, although very little is known about the potential net benefits of this reconfiguration.

    Objectives: To formally compare the costs and benefits of the major models of care in Ireland, with a view to informing priority setting using the contingent valuation technique and cost-benefit analysis.

    Methods: A marginal payment scale willingness-to-pay question was adopted from an ex ante perspective. Read More

    Economic Evaluation of Interventions for Children with Neurodevelopmental Disorders: Opportunities and Challenges.
    Appl Health Econ Health Policy 2017 Aug 18. Epub 2017 Aug 18.
    School of Public Policy, University of Calgary, 906-8th Avenue SW, Calgary, AB T2P 1H9, Canada.
    Economic evaluation is a tool used to inform decision makers on the efficiency of comparative healthcare interventions and inform resource allocation decisions. There is a growing need for the use of economic evaluations to assess the value of interventions for children with neurodevelopmental disorders (NDDs), a population that has increasing demands for healthcare services. Unfortunately, few evaluations have been conducted to date, perhaps stemming from challenges in applying existing economic evaluation methodologies in this heterogeneous population. Read More

    Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis.
    Appl Health Econ Health Policy 2017 Jul 29. Epub 2017 Jul 29.
    Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Q4006, Australia.
    Background: Skin cancer exerts a large and growing burden on health systems. With new pharmacotherapies for metastatic melanoma now available, a contemporary understanding of the cost burden of melanoma control is warranted.

    Objective: To comprehensively assess the healthcare costs of malignant melanoma diagnosis and treatment in Australia, over 3 years after diagnosis. Read More

    Private Health Insurance Incentives in Australia: In Search of Cost-Effective Adjustments.
    Appl Health Econ Health Policy 2017 Jul 12. Epub 2017 Jul 12.
    Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
    Background: The appropriate structure, scope and cost of government incentives in the private health insurance (PHI) market is a matter of ongoing debate.

    Objective: In order to inform policy decisions we designed a two-stage study to (1) model the uptake of PHI covering hospital treatment in Australia, and (2) identify the costs of various policy scenarios to the government.

    Methods: Using a microsimulation with a cost-benefit component, we modelled the insurance decisions made by individuals who collectively represented the Australian insurance population in the financial year 2014-15. Read More

    Towards a Transparent, Credible, Evidence-Based Decision-Making Process of New Drug Listing on the Hong Kong Hospital Authority Drug Formulary: Challenges and Suggestions.
    Appl Health Econ Health Policy 2017 Jul 12. Epub 2017 Jul 12.
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong.
    The aim of this article is to describe the process, evaluation criteria, and possible outcomes of decision-making for new drugs listed in the Hong Kong Hospital Authority Drug Formulary in comparison to the health technology assessment (HTA) policy overseas. Details of decision-making processes including the new drug listing submission, Drug Advisory Committee (DAC) meeting, and procedures prior to and following the meeting, were extracted from the official Hong Kong Hospital Authority drug formulary management website and manual. Publicly-available information related to the new drug decision-making process for five HTA agencies [the National Institute of Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC), the Australia Pharmaceutical Benefits Advisory Committee (PBAC), the Canadian Agency for Drugs and Technologies in Health (CADTH), and the New Zealand Pharmaceutical Management Agency (PHARMAC)] were reviewed and retrieved from official documents from public domains. Read More

    Robustness and Effectiveness of the Triage System in the Pediatric Context.
    Appl Health Econ Health Policy 2017 Jul 10. Epub 2017 Jul 10.
    IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genoa, Italy.
    Background: The increasing use of emergency departments (EDs) potentially compromises their effectiveness and quality. The evaluation of the performance of the triage code system in a pediatric context is important because waiting time affects the quality of care for acutely ill patients.

    Objective: In this study, we aimed to assess the effectiveness and robustness of the triage code system in a pediatric context and identify the determinants of waiting times for urgent and non-urgent patients. Read More

    The XprESS Multi-Sinus Dilation System for the Treatment of Chronic Sinusitis: A NICE Medical Technology Guidance.
    Appl Health Econ Health Policy 2017 Jul 1. Epub 2017 Jul 1.
    Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK.
    The XprESS multi-sinus dilation system (XprESS) is a minimally invasive alternative to functional endoscopic sinus surgery (FESS) used in the treatment of people with chronic or recurrent acute sinusitis refractory to medical treatment. The manufacturer of XprESS, Entellus Medical, claims the technology is as effective as FESS in improving quality of life and is associated with quicker recovery times and reduced costs. The Medical Technologies Advisory Committee (MTAC) at the National Institute for Health and Care Excellence (NICE) selected XprESS for evaluation. Read More

    Role of Cost on Failure to Access Prescribed Pharmaceuticals: The Case of Statins.
    Appl Health Econ Health Policy 2017 Jun 28. Epub 2017 Jun 28.
    Department of Health Services Research and Policy, Research School of Population Health, The Australian National University, 62A Mills Road, Acton, ACT, Australia.
    Background: In Australia, as in many other Western countries, patient surveys suggest the costs of medicines lead to deferring or avoiding filling of prescriptions. The Australian Pharmaceutical Benefits Scheme provides approved prescription medicines at subsidised prices with relatively low patient co-payments. The Pharmaceutical Benefits Scheme defines patient co-payment levels per script depending on whether patients are "concessional" (holding prescribed pension or other government concession cards) or "general", and whether they have reached a safety net defined by total out-of-pocket costs for Pharmaceutical Benefits Scheme-approved medicines. Read More

    Competitive Health Markets and Risk Equalisation in Australia: Lessons Learnt from Other Countries.
    Appl Health Econ Health Policy 2017 Apr 24. Epub 2017 Apr 24.
    Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia.
    The aims of this paper are to evaluate the risk equalisation (RE) arrangement in Australia's private health insurance against practices in other countries with similar arrangements and to propose ways of improving the system to advance economic efficiency and solidarity. Possible regulatory responses to insurance market failures are reviewed based on standard economic arguments. We describe various regulatory strategies used elsewhere to identify essential system features against which the Australian system is compared. Read More

    Stated Uptake of Physical Activity Rewards Programmes Among Active and Insufficiently Active Full-Time Employees.
    Appl Health Econ Health Policy 2017 Apr 22. Epub 2017 Apr 22.
    Programme in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore.
    Background: Employers are increasingly relying on rewards programmes in an effort to promote greater levels of activity among employees; however, if enrolment in these programmes is dominated by active employees, then they are unlikely to be a good use of resources.

    Objective: This study uses a stated-preference survey to better understand who participates in rewards-based physical activity programmes, and to quantify stated uptake by active and insufficiently active employees.

    Methods: The survey was fielded to a national sample of 950 full-time employees in Singapore between 2012 and 2013. Read More

    Out-of-Pocket Payments and Subjective Unmet Need of Healthcare.
    Appl Health Econ Health Policy 2017 Apr 21. Epub 2017 Apr 21.
    Department of Economics, KU Leuven, Louvain, Belgium.
    We present a critical review of the literature that discusses the link between the level of out-of-pocket payments in developed countries and the share of people in these countries reporting that they postpone or forgo healthcare for financial reasons. We discuss the pros and cons of measuring access problems with this subjective variable. Whereas the quantitative findings in terms of numbers of people postponing care must be interpreted with utmost caution, the picture for the vulnerable groups in society is reasonably robust and unsurprising: people with low incomes and high morbidity and incomplete (or non-existent) insurance coverage are most likely to postpone or forgo healthcare for financial reasons. Read More

    Cost of Trauma Care in Secondary- and Tertiary-Care Public Sector Hospitals in North India.
    Appl Health Econ Health Policy 2017 Apr 13. Epub 2017 Apr 13.
    The George Institute for Global Health, University of Sydney, Sydney, Australia.
    Background: Several initiatives to provide trauma care, including ambulance services, creation of a network of trauma hospitals and insurance schemes for cashless treatment, are currently being implemented in India. However, lack of information on the cost of trauma care is an impediment to the evidence-based planning for such initiatives. In this study, we aim to bridge this gap in evidence by estimating the unit cost of an outpatient consultation, inpatient bed-day of hospitalization, surgical procedure and diagnostics for providing trauma care through secondary- and tertiary-level hospitals in India. Read More

    Predicting Productivity Losses from Health-Related Quality of Life Using Patient Data.
    Appl Health Econ Health Policy 2017 Mar 31. Epub 2017 Mar 31.
    School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
    Objective: This paper estimates productivity loss using the health of the patient in order to allow indirect estimation of these costs for inclusion in economic evaluation.

    Methods: Data from two surveys of inpatients [Health outcomes data repository (HODaR) sample (n = 42,442) and health improvement and patient outcomes (HIPO) sample (n = 6046)] were used. The number of days off paid employment or normal activities (excluding paid employment) was modelled using the health of the patients measured by the EQ-5D, international classification of diseases (ICD) chapters, and other health and sociodemographic data. Read More

    User Fees in General Practice: Willingness to Pay and Potential Substitution Patterns-Results from a Danish GP Patient Survey.
    Appl Health Econ Health Policy 2017 Mar 31. Epub 2017 Mar 31.
    Lægerne Nyenstad, Nyenstad 31, 5800, Nyborg, Denmark.
    Background: Increases in public expenditures to general practitioner (GP) services and specialist care have spurred debate over whether to implement user fees for healthcare services such as GP consultations in Denmark.

    Objective: The objective of this study was to examine Danish patients' attitudes towards user fees and their willingness to pay (WTP) for a consultation, and to investigate how user charges may impact patients' behaviour.

    Methods: A questionnaire survey was conducted in a GP clinic. Read More

    A Cost-Effectiveness Model for Frail Older Persons: Development and Application to a Physiotherapy-Based Intervention.
    Appl Health Econ Health Policy 2017 Mar 27. Epub 2017 Mar 27.
    Centre for Research Excellence in Frailty and Healthy Ageing, University of Adelaide, Adelaide, SA, 5005, Australia.
    Introduction: The clinical importance of frailty is increasing. Existing economic evaluations of interventions to manage frailty have limited time horizons, but even in older populations there may be important longer-term differences in costs and outcomes. This paper reports on the development of a cost-effectiveness model to predict publicly funded health and aged care costs and quality-adjusted life years (QALYs) over the remaining lifetime of frail Australians and a model-based cost-utility analysis of a physiotherapy-based intervention for frail individuals. Read More

    Cost-Effectiveness Analysis of Obinutuzumab for Previously Untreated Chronic Lymphocytic Leukaemia in Portuguese Patients who are Unsuitable for Full-Dose Fludarabine-Based Therapy.
    Appl Health Econ Health Policy 2017 Aug;15(4):501-512
    CISEP - Research Centre on the Portuguese Economy, ISEG, Universidade de Lisboa, Lisbon, Portugal.
    Background: Chronic lymphocytic leukaemia (CLL) mostly affects patients with comorbidities and limited therapeutic options. Obinutuzumab in combination with chlorambucil (GClb) is a new therapeutic option for previously untreated CLL patients who are unsuitable for full-dose fludarabine-based therapy. This combination delays disease progression but incurs additional costs; thus, an assessment of its value for money is relevant. Read More

    Estimating Willingness to Pay for Online Health Services with Discrete-Choice Experiments.
    Appl Health Econ Health Policy 2017 Aug;15(4):491-500
    Department of Economics, University of Colorado Boulder, 256 UCB, Boulder, CO, 80309, USA.
    Background: Research has outlined the benefits and costs of online health services, but these studies have typically focused on a specific geographic region or disease. Very few studies have estimated consumer demand for online health services.

    Objective: This study estimated household's willingness to pay (WTP) for the ability to receive remote diagnosis, treatment, monitoring and consultations online (telehealth). Read More

    A Head-to-Head Comparison of UK SF-6D and Thai and UK EQ-5D-5L Value Sets in Thai Patients with Chronic Diseases.
    Appl Health Econ Health Policy 2017 Mar 13. Epub 2017 Mar 13.
    Pharmacy Unit, Phramongkutklao Hospital, Bangkok, Thailand.
    Purpose: Little was known about the head-to-head comparison of psychometric properties between SF-6D and EQ-5D-5L or the different value sets of EQ-5D-5L. Therefore, this study set out to compare the psychometric properties including agreement, convergent, and known-group validity between the SF-6D and the EQ-5D-5L using the real value sets from Thailand and the UK in patients with chronic diseases.

    Methods: 356 adults taking a medication for at least 3 months were identified from a university hospital in Bangkok, Thailand, between July 2014 and March 2015. Read More

    Economic Evaluations of Thrombophilia Screening Prior to Prescribing Combined Oral Contraceptives: A Systematic and Critical Review.
    Appl Health Econ Health Policy 2017 Mar 13. Epub 2017 Mar 13.
    College of Nursing, Seattle University, 901 12th Avenue, Seattle, WA, 98122, USA.
    Background: Combined oral contraceptives (COCs) increase the risk of venous thromboembolism (VTE), particularly among women with inherited clotting disorders. The World Health Organization classifies combined hormonal contraception as an "unacceptable health risk" for women with thrombogenic mutations but advises against universal thrombophilia screening before prescribing COCs given the low prevalence of thrombophilia and high screening costs.

    Objective: Through the lens of lifetime costs and benefits, this paper systematically and critically reviews all published economic evaluations of thrombophilia screening prior to prescribing COCs. Read More

    How a Bottom-Up Multi-Stakeholder Initiative Helped Transform the Renal Replacement Therapy Landscape in Spain.
    Appl Health Econ Health Policy 2017 Mar 6. Epub 2017 Mar 6.
    Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
    Healthcare reforms aim to change certain parts of the health system to improve quality of care, access, or financial sustainability. Traditionally, healthcare reform is understood as an action undertaken by a government at a national or local level. However, bottom-up changes can also lead to improvements in the health system. Read More

    Cost Effectiveness of Genotype-Guided Warfarin Dosing in Patients with Mechanical Heart Valve Replacement Under the Fee-for-Service System.
    Appl Health Econ Health Policy 2017 Feb 28. Epub 2017 Feb 28.
    Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, 633-165 Gaegum 2-dong, Busan Jin-gu, Busan, Republic of Korea.
    Background: Although studies assessing the cost effectiveness of genotype-guided warfarin dosing for the management of atrial fibrillation, deep vein thrombosis, and pulmonary embolism have been reported, no publications have addressed genotype-guided warfarin therapy in mechanical heart valve replacement (MHVR) patients or genotype-guided warfarin therapy under the fee-for-service (FFS) insurance system.

    Objective: The aim of this study was to evaluate the cost effectiveness of genotype-guided warfarin dosing in patients with MHVR under the FFS system from the Korea healthcare sector perspective.

    Methods: A decision-analytic Markov model was developed to evaluate the cost effectiveness of genotype-guided warfarin dosing compared with standard dosing. Read More

    The Medicaid Rebate: Changes in Oncology Drug Prices After the Affordable Care Act.
    Appl Health Econ Health Policy 2017 Aug;15(4):513-520
    Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, 410 N 12th Street, Richmond, VA, 23219, USA.
    Background: Prescription drug spending is a significant component of Medicaid total expenditures. The Affordable Care Act (ACA) includes a provision that increases the Medicaid rebate for both brand-name and generic drugs. This study examines the extent to which oncology drug prices changed after the increase in the Medicaid rebate in 2010. Read More

    Economic Analysis and Budget Impact of Tenofovir and Entecavir in the First-Line Treatment of Hepatitis B Virus in Italy.
    Appl Health Econ Health Policy 2017 Aug;15(4):479-490
    Catholic University of Sacred Heart, Rome, Italy.
    Background: Chronic hepatitis B is a common, progressive disease, particularly when viral replication is detected. Oral antivirals can suppress viral replication and prevent or delay the development of cirrhosis and liver-related complications. The treatments of chronic hepatitis B cannot totally cure the disease but can prevent its progression to hepatocellular carcinoma, decreasing the levels of both morbidity and mortality. Read More

    EQ-5D and the EuroQol Group: Past, Present and Future.
    Appl Health Econ Health Policy 2017 Apr;15(2):127-137
    EuroQol Group, Rotterdam, The Netherlands.
    Over the period 1987-1991 an inter-disciplinary five-country group developed the EuroQol instrument, a five-dimensional three-level generic measure subsequently termed the 'EQ-5D'. It was designed to measure and value health status. The salient features of its development and its consolidation and expansion are discussed. Read More

    Cost-Effectiveness Models in Breast Cancer Screening in the General Population: A Systematic Review.
    Appl Health Econ Health Policy 2017 Jun;15(3):333-351
    Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
    Background: Many Western countries have long-established population-based mammography screening programs. Prior to implementing these programs, decision-analytic modeling was widely used to inform decisions.

    Objective: The aim of this study was to perform a systematic review of cost-effectiveness models in breast cancer screening in the general population to analyze their structural and methodological approaches. Read More

    Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy.
    Appl Health Econ Health Policy 2017 Jun;15(3):299-306
    Nuffield Department of Medicine, University of Oxford, Oxford, UK.
    Healthcare services are often provided to a country as a whole, though in many cases the available resources can be more effectively targeted to specific geographically defined populations. In the case of malaria, risk is highly geographically heterogeneous, and many interventions, such as insecticide-treated bed nets and malaria community health workers, can be targeted to populations in a way that maximises impact for the resources available. This paper describes a framework for geographically targeted budget allocation based on the principles of cost-effectiveness analysis and applied to priority setting in malaria control and elimination. Read More

    Does Insurance Status Influence a Patient's Hospital Charge?
    Appl Health Econ Health Policy 2017 Jun;15(3):353-362
    Department of Emergency Medicine, University of California, Davis, School of Medicine, Sacramento, CA, USA.
    Background: There is obscurity regarding how US hospitals determine patients' charges. Whether insurance status influences a patient's hospital charge has not been explored.

    Objective: The objective of this study was to determine whether hospitals charge patients differently based on their insurance status. Read More

    Drug Pricing in South Korea.
    Appl Health Econ Health Policy 2017 Aug;15(4):447-453
    Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden.
    Between 2000 and 2013, spending on medicines in Korea increased by 275.3%. In order to curb this trend, several pricing policies and measures were introduced. Read More

    A Review of NICE Methods and Processes Across Health Technology Assessment Programmes: Why the Differences and What is the Impact?
    Appl Health Econ Health Policy 2017 Aug;15(4):469-477
    Office of Health Economics, 7th floor, 105 Victoria Street, London, SW1E 6QT, UK.
    Background: Decisions made by the National Institute for Health and Care Excellence (NICE) exert an influence on the allocation of resources within 'fixed' National Health Service budgets. Yet guidance for different types of health interventions is handled via different 'programmes' within NICE, which follow different methods and processes.

    Objective: The objective of this research was to identify differences in the processes and methods of NICE health technology assessment programmes and to explore how these could impact on allocative efficiency within the National Health Service. Read More

    Is Compulsory Licensing Bad for Public Health? Some Critical Comments on Drug Accessibility in Developing Countries.
    Appl Health Econ Health Policy 2017 Jan 24. Epub 2017 Jan 24.
    CNRS Partner Lab, Centre d'économie de l'Université Paris Nord, 99 avenue J.B. Clément, 93430, Villetaneuse, France.
    As one of the flexibilities provided by the agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) establishing minimum standards for the protection of property rights, compulsory license (CL) represents a means towards the protection of public health issues within a context of stringent protection of intellectual property rights (IPRs), most notably in poor-resource settings. However, recent literature asserts that CL constitutes a serious limitation to the full enjoyment of property rights by innovators and may therefore threaten drug accessibility in developing countries. This paper outlines the impact of CL on drug accessibility in developing countries by addressing the three main dimensions of accessibility (availability, affordability and quality) and proceeding to a literature survey of key arguments for and against CL. Read More

    Spectra Optia(®) for Automated Red Blood Cell Exchange in Patients with Sickle Cell Disease: A NICE Medical Technology Guidance.
    Appl Health Econ Health Policy 2017 Aug;15(4):455-468
    Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK.
    The Spectra Optia(®) automated apheresis system, indicated for red blood cell exchange in people with sickle cell disease, underwent evaluation by the National Institute for Health and Care Excellence, which uses its Medical Technologies Advisory Committee to make recommendations. The company (Terumo Medical Corporation) produced a submission making a case for adoption of its technology, which was critiqued by the Newcastle and York external assessment centre. Thirty retrospective observational studies were identified in their clinical submission. Read More

    Malaria and Economic Evaluation Methods: Challenges and Opportunities.
    Appl Health Econ Health Policy 2017 Jun;15(3):291-297
    Nuffield Department of Medicine, University of Oxford, Oxford, UK.
    There is a growing evidence base on the cost effectiveness of malaria interventions. However, certain characteristics of malaria decision problems present a challenge to the application of healthcare economic evaluation methods. This paper identifies five such challenges. Read More

    Assessing Equity in the Provision of Primary Healthcare Centers in Buenos Aires Province (Argentina): A Stochastic Frontier Analysis.
    Appl Health Econ Health Policy 2017 Jun;15(3):425-433
    Department of Economics, Universidad Nacional del Sur, IIESS, Bahía Blanca, Argentina.
    Background: Unequal access to healthcare between individuals or populations does not imply the existence of inequities as it must be controlled for differences in need. This is usually done either via direct or indirect standardization methods.

    Objective: We study the degree of equity in the availability of public primary healthcare centers between the 134 municipalities of the Buenos Aires province (Argentina) with a novel application of an existing statistical tool. Read More

    Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden.
    Appl Health Econ Health Policy 2017 Apr;15(2):237-248
    IHE, The Swedish Institute for Health Economics, Lund, Sweden.
    Background: Patients with uncontrolled type 2 diabetes mellitus (T2DM) are a priority group for intensified therapy without weight gain and with low risk of hypoglycaemia.

    Objective: This study evaluates the cost effectiveness of insulin degludec plus liraglutide (IDegLira, Xultophy(®)) compared with six potential intensification treatment options for patients with T2DM that is uncontrolled with basal insulin.

    Methods: The Swedish Institute for Health Economics (IHE) Cohort Model of Type 2 Diabetes was used with Swedish input data, a 40-year time frame and a societal perspective. Read More

    How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries.
    Appl Health Econ Health Policy 2017 Jun;15(3):307-321
    School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Mail Bag, 92019, Auckland, New Zealand.
    This article discusses pharmaceutical pricing and reimbursement policies in European countries with regard to their ability to ensure affordable access to medicines. A frequently applied pricing policy is external price referencing. While it provides some benchmark for policy-makers and has been shown to be able to generate savings, it may also contribute to delay in product launch in countries where medicine prices are low. Read More

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