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

    1 OF 14

    Efficiency Measurement in Health Facilities: A Systematic Review in Low- and Middle-Income Countries.
    Appl Health Econ Health Policy 2018 Apr 20. Epub 2018 Apr 20.
    Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
    Background: Limited healthcare resources in low- and middle-income countries (LMICs) have led policy-makers to improve healthcare efficiency. Therefore, it is essential to understand how efficiency has been measured in the LMIC setting.

    Objective: This paper reviews methodologies used for efficiency studies in health facilities in LMICs. Read More

    Inference Procedures to Quantify the Efficiency-Equality Trade-Off in Health from Stated Preferences: A Case Study in Portugal.
    Appl Health Econ Health Policy 2018 Apr 20. Epub 2018 Apr 20.
    Research Unit in Governance, Competitiveness and Public Policies (GOVCOPP), University of Aveiro, Aveiro, Portugal.
    Objectives: This article develops two inference procedures to calculate the inequality aversion and alpha parameters of a health-related social welfare function with constant elasticity (CES-HRSWF) using stated preferences. Based on the relative concept of inequality, a range of values were proposed for the trade-offs between improving total population health and reducing health inequalities.

    Methods: A self-administered questionnaire was used to collect data from a sample of 422 college students in Portugal. Read More

    Uptake of and Expenditure on Direct-Acting Antiviral Agents for Hepatitis C Treatment in Australia.
    Appl Health Econ Health Policy 2018 Apr 19. Epub 2018 Apr 19.
    Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
    Background: Direct-acting antiviral agents (DAAs) have revolutionised treatment for the hepatitis C virus (HCV). Currently, treatment costs between 20,000 and 80,000 Australian dollars ($A) per patient. The Australian Federal Government provided $A1 billion over 5 years to subsidise these drugs. Read More

    Out of Pocket Costs and Health Insurance Take-Up Rates.
    Appl Health Econ Health Policy 2018 Jun;16(3):367-380
    Department of Economics, The University of Akron, 259 South Broadway St., Akron, OH, 44325-1908, USA.
    Background: Over the first ten years of this century, the share of the US population covered by employer-sponsored health insurance plans experienced a significant decline. A decrease in the take-up rate accounts for about a quarter of this decline. Usually, the increasing share of the premium that is paid by workers is used to explain the decline in the take-up rate. Read More

    Cost-Consequence Analysis Alongside a Randomised Controlled Trial of Hospital Versus Telephone Follow-Up after Treatment for Endometrial Cancer.
    Appl Health Econ Health Policy 2018 Jun;16(3):415-427
    Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
    Background: Regular outpatient follow-up programmes are usually offered to patients following treatment for gynaecological and other cancers. Despite the substantial resources involved in providing these programmes, there is evidence that routine follow-up programmes do not affect survival or the likelihood of detecting recurrence and may not meet patient needs. Alternative follow-up modalities may offer the same outcomes at lower cost. Read More

    Cost-effectiveness of Genome and Exome Sequencing in Children Diagnosed with Autism Spectrum Disorder.
    Appl Health Econ Health Policy 2018 Apr 12. Epub 2018 Apr 12.
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
    Background: Genome (GS) and exome sequencing (ES) could potentially identify pathogenic variants with greater sensitivity than chromosomal microarray (CMA) in autism spectrum disorder (ASD) but are costlier and result interpretation can be uncertain. Study objective was to compare the costs and outcomes of four genetic testing strategies in children with ASD.

    Methods: A microsimulation model estimated the outcomes and costs (in societal and public payer perspectives in Ontario, Canada) of four genetic testing strategies: CMA for all, CMA for all followed by ES for those with negative CMA and syndromic features (CMA+ES), ES or GS for all. Read More

    Spillover Effects of Long-Term Disabilities on Close Family Members.
    Appl Health Econ Health Policy 2018 Jun;16(3):347-355
    Health Services, Statistics and Economics Unit, Swiss Paraplegic Research, Nottwil, Switzerland.
    Background: Care and support of people dealing with long-term disabilities involves the entire family.

    Objective: This paper evaluates the effect of living with a relative dealing with a long-term disability on the health status of all family members in the household.

    Methods: Using information from the Swiss household panel from the year 1999 to 2003 (n = 18,030), a linear regression is implemented to compare the health status of family members cohabiting with individuals dealing with a long-term disability with the health status of individuals of similar characteristics in the general population. Read More

    A Cost-Effectiveness Analysis of the 10-Valent Pneumococcal Non-Typeable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) Compared to the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) for Universal Mass Vaccination Implementation in New Zealand.
    Appl Health Econ Health Policy 2018 Jun;16(3):331-345
    GSK Pte Ltd, 23 Rochester Park, Singapore, 139234, Singapore.
    Objectives: Invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) still represent a significant medical burden in children < 5 years of age in New Zealand (NZ), with marked disparities across socio-economic and ethnic groups. This cost-effectiveness evaluation aims to compare the potential impact of two childhood universal immunisation strategies: vaccination with a 3 + 1 schedule of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix, GSK) and the 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13, Pfizer).

    Methods: A static Markov-process cohort model was used to simulate the epidemiological and economic burden of pneumococcal diseases on a single-birth cohort over its lifetime. Read More

    The Case for a Private Healthcare Insurance Monopoly.
    Appl Health Econ Health Policy 2018 Apr 6. Epub 2018 Apr 6.
    College of Staten Island, City University of New York (CUNY), Staten Island, NY, USA.
    This article advocates for a regulated private monopoly as an audacious solution to replace Obamacare, help manage Medicare and Medicaid and reform the US healthcare insurance industry. Contemporary economics vilifies monopolies and praises the 'magic wand' of perfect competition without much debate on the merits of these assumptions. The problems with the perfect competition model as applied to healthcare insurance are well established, but exploration of other possible economic models (i. Read More

    The Memokath-051 Stent for the Treatment of Ureteric Obstruction: A NICE Medical Technology Guidance.
    Appl Health Econ Health Policy 2018 Apr 3. Epub 2018 Apr 3.
    Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK.
    Memokath-051 is a thermo-expandable, nickel-titanium alloy spiral stent used to treat ureteric obstruction resulting from malignant or benign strictures. The National Institute for Health and Care Excellence (NICE) selected Memokath-051 for evaluation. The company, PNN Medical, claimed Memokath-051 has clinical superiority and cost savings compared with double-J stents. Read More

    Economic Studies on Non-Communicable Diseases and Injuries in India: A Systematic Review.
    Appl Health Econ Health Policy 2018 Jun;16(3):303-315
    Institute of Economic Growth, University of Delhi Enclave, Delhi, 110007, India.
    Background: The burden from non-communicable diseases and injuries (NCDI) in India is increasing rapidly. With low public sector investment in the health sector generally, and a high financial burden on households for treatment, it is important that economic evidence is used to set priorities in the context of NCDI.

    Objective: Our objective was to understand the extent to which economic analysis has been used in India to (1) analyze the impact of NCDI and (2) evaluate prevention and treatment interventions. Read More

    Understanding Treatment Effect Estimates When Treatment Effects Are Heterogeneous for More Than One Outcome.
    Appl Health Econ Health Policy 2018 Jun;16(3):381-393
    University of Iowa College of Pharmacy, 115 S Grand Ave, Room S525, Iowa City, IA, 52242, USA.
    Background: Patient-centred care requires evidence of treatment effects across many outcomes. Outcomes can be beneficial (e.g. Read More

    Individual and Institutional Corruption in European and US Healthcare: Overview and Link of Various Corruption Typologies.
    Appl Health Econ Health Policy 2018 Jun;16(3):289-302
    Transparency International-Austrian Chapter, Vienna, Austria.
    In recent years, the fight against healthcare corruption has intensified. Estimates from the European Healthcare Fraud and Corruption Network calculate an approximate €56 billion annual loss to Europe as a result of corruption. To promote understanding of the complexity and interconnection of corrupt activities, we aim to present healthcare-related corruption typologies of the European Union and European Healthcare Fraud and Corruption Network. Read More

    Is BRCA Mutation Testing Cost Effective for Early Stage Breast Cancer Patients Compared to Routine Clinical Surveillance? The Case of an Upper Middle-Income Country in Asia.
    Appl Health Econ Health Policy 2018 Jun;16(3):395-406
    Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Muang, Phitsanulok, Thailand.
    Objective: Previous studies showed that offering BRCA mutation testing to population subgroups at high risk of harbouring the mutation may be cost effective, yet no evidence is available for low- or middle-income countries (LMIC) and in Asia. We estimated the cost effectiveness of BRCA mutation testing in early-stage breast cancer patients with high pre-test probability of harbouring the mutation in Malaysia, an LMIC in Asia.

    Methods: We developed a decision analytic model to estimate the lifetime costs and quality-adjusted life-years (QALYs) accrued through BRCA mutation testing or routine clinical surveillance (RCS) for a hypothetical cohort of 1000 early-stage breast cancer patients aged 40 years. Read More

    Does €1 Per Prescription Make a Difference? Impact of a Capped Low-Intensity Pharmaceutical Co-Payment.
    Appl Health Econ Health Policy 2018 Jun;16(3):407-414
    Department of Economics and Business, Research Centre for Health and Economics (CRES-UPF), Universitat Pompeu Fabra (UPF), Ramón Trias Fargas 25-27, 08005, Barcelona, Spain.
    Background: Increasing patient contributions and reducing the population exempt from pharmaceutical co-payment and co-insurance rates were one of the most common measures in the reforms adopted in Europe during 2010-2015.

    Objective: We estimated the association between the introduction of a capped co-payment of €1 per prescription and drug consumption of the publicly insured population of Catalonia (Spain).

    Methods: We used administrative data on monthly pharmaceutical consumption (defined daily doses [DDDs]) from January 2012 to December 2014, for a representative sample of 85,000 people. Read More

    Long-Term Costs and Health Consequences of Issuing Shorter Duration Prescriptions for Patients with Chronic Health Conditions in the English NHS.
    Appl Health Econ Health Policy 2018 Jun;16(3):317-330
    Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.
    Background: The National Health Service (NHS) in England spends over £9 billion on prescription medicines dispensed in primary care, of which over two-thirds is accounted for by repeat prescriptions. Recently, GPs in England have been urged to limit the duration of repeat prescriptions, where clinically appropriate, to 28 days to reduce wastage and hence contain costs. However, shorter prescriptions will increase transaction costs and thus may not be cost saving. Read More

    Treating Type 1 Diabetes Mellitus with a Rapid-Acting Analog Insulin Regimen vs. Regular Human Insulin in Germany: A Long-Term Cost-Effectiveness Evaluation.
    Appl Health Econ Health Policy 2018 Jun;16(3):357-366
    Ossian Health Economics and Communications GmbH, Bäumleingasse 20, 4051, Basel, Switzerland.
    Objective: The aim of the present study was to evaluate the cost effectiveness of rapid-acting analog insulin relative to regular human insulin in adults with type 1 diabetes mellitus in Germany.

    Methods: The PRIME Diabetes Model, a patient-level, discrete event simulation model, was used to project long-term clinical and cost outcomes for patients with type 1 diabetes from the perspective of a German healthcare payer. Simulated patients had a mean age of 21. Read More

    The Determinants of Household Out-of-Pocket (OOP) Medical Expenditure in Rural Bangladesh.
    Appl Health Econ Health Policy 2018 Apr;16(2):219-234
    School of Commerce, University of Southern Queensland, Toowoomba, QLD, Australia.
    Background: The Government of Bangladesh has a National Healthcare Strategy 2012-2032 that reiterates a goal to achieve universal health coverage (UHC) by the year 2032. To achieve the goal, the government has set up a strategy to reduce the share of out-of-pocket (OOP) expenditure from the current 64% of the total household healthcare costs to 32% at the national level. As the majority of the people live in the rural areas, and the rural people are generally poor, the success of the strategy relies predominantly on any type of pro-poor healthcare policy and strategy. Read More

    Multi-indication and Combination Pricing and Reimbursement of Pharmaceuticals: Opportunities for Improved Health Care through Faster Uptake of New Innovations.
    Appl Health Econ Health Policy 2018 Apr;16(2):157-165
    The Swedish Institute for Health Economics (IHE), Lund, Sweden.
    Many pharmaceuticals are effective in multiple indications and the degree of effectiveness may differ. A product-based pricing and reimbursement system with a single price per product is insufficient to reflect the variable values between different indications. The objective of this article is to present examples of actual pricing and reimbursement decisions using current value-based pricing in Sweden and to discuss their implications and possible solutions. Read More

    Policy Options for Infliximab Biosimilars in Inflammatory Bowel Disease Given Emerging Evidence for Switching.
    Appl Health Econ Health Policy 2018 Jun;16(3):279-288
    Amaris Consulting, London, UK.
    Biosimilars are becoming increasingly available internationally as patents expire on the originator biologic drugs they are intended to copy. Although substitution policies seen with generic drugs are being considered as a means to reduce expenditures on biologics, some biosimilars pose particular challenges in that the act of substitution may eventually lead to increased rates of therapeutic failure. As evidence requirements from regulators do not directly address this challenge, switch trials of biosimilars have emerged that may provide further answers. Read More

    Cost of Illness for Five Major Foodborne Illnesses and Sequelae in Sweden.
    Appl Health Econ Health Policy 2018 Apr;16(2):243-257
    AgriFood Economics Centre, Lund University, Scheelevägen 15 D, 223 63, Lund, Sweden.
    Objectives: The main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs. Read More

    Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia: A Cross-sectional Stated Preference Approach.
    Appl Health Econ Health Policy 2018 Apr;16(2):259-271
    Department of Health Administration and Management, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria.
    Background: The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is 'free at the point of delivery' (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households' willingness to pay (WTP) for a contributory national health insurance scheme. Read More

    A National Budget Impact Analysis of a Specialised Surveillance Programme for Individuals at Very High Risk of Melanoma in Australia.
    Appl Health Econ Health Policy 2018 Apr;16(2):235-242
    Sydney School of Public Health, The University of Sydney, The Lifehouse, Level 6-North, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
    Background: Specialised surveillance using total body photography and digital dermoscopy to monitor people at very high risk of developing a second or subsequent melanoma has been reported as cost effective.

    Objectives: We aimed to estimate the 5-year healthcare budget impact of providing specialised surveillance for people at very high risk of subsequent melanoma from the perspective of the Australian healthcare system.

    Methods: A budget impact model was constructed to assess the costs of monitoring and potential savings compared with current routine care based on identification of patients at the time of a melanoma diagnosis. Read More

    Correction to: Dutch Economic Value of Radium-223 in Metastatic Castration-Resistant Prostate Cancer.
    Appl Health Econ Health Policy 2018 Feb;16(1):145
    Real World Strategy and Analytics, Mapi Group, The Translation and Innovation Hub Building, 5th Floor, 80 Wood Lane, White City, London, W12 OBZ, UK.
    The article Dutch Economic Value of Radium-223 in Metastatic Castration-Resistant Prostate Cancer, written by Michel L. Peters, Claudine de Meijer, Dirk Wyndaele, Walter Noordzij, Annemarie M. Leliveld-Kors, Joan van den Bosch, Pieter H. Read More

    The Direct Medical Costs of Diseases Associated with Human Papillomavirus Infection in Manitoba, Canada.
    Appl Health Econ Health Policy 2018 Apr;16(2):195-205
    Department of Community Health Sciences, Vaccine and Drug Evaluation Centre, University of Manitoba, 337-750 McDermot Avenue, Winnipeg, MB, R3E 0T5, Canada.
    Background: The total direct cost of screening and treating all human papillomavirus-related diseases (HPV-RD) has not been measured in a single study. Accurate cost estimates are needed to inform decisions on intervention priorities and evaluate the cost-effectiveness of existing programs. We used province-wide clinical, administrative, and accounting databases to measure direct medical costs of HPV infection in Manitoba (Canada). Read More

    Rich and Well Educated: Are These Requirements Necessary to Claim Healthcare Tax Credits in Italy?
    Appl Health Econ Health Policy 2018 Apr;16(2):207-217
    Department of Economics and Finance, Università Cattolica del S. Cuore, Milan, Italy.
    Background: The paper investigates the use of healthcare tax credits (HTCs) in Italy through the analysis of a panel data, which provides information on individual income tax from 2008 to 2014. There is evidence of disparities in the per-capita HTCs between Northern and Southern regions, which need to be analyzed and addressed.

    Objective: The aim of the paper is to investigate the socioeconomic determinants in the use of Healthcare Tax Credits in Italy. Read More

    Improving the Hospital Quality of Care during Winter Periods by Optimizing Budget Allocation Between Rotavirus Vaccination and Bed Expansion.
    Appl Health Econ Health Policy 2018 Feb;16(1):123-132
    GSK, Wavre, Belgium.
    Background: During each winter the hospital quality of care (QoC) in pediatric wards decreases due to a surge in pediatric infectious diseases leading to overcrowded units. Bed occupancy rates often surpass the good hospital bed management threshold of 85%, which can result in poor conditions in the workplace. This study explores how QoC-scores could be improved by investing in additional beds and/or better vaccination programs against vaccine-preventable infectious diseases. Read More

    Horses for Courses: Moving India towards Universal Health Coverage through Targeted Policy Design.
    Appl Health Econ Health Policy 2017 Dec;15(6):733-744
    T A Pai Management Institute, Manipal, India.
    The debate on how India's health system should move towards universal health coverage was (meant to be) put to rest by the recent National Health Policy 2017. However, the new policy is silent about tackling bottlenecks mentioned in the said policy proposal. It aims to provide universal access to free primary care by strengthening the public system, and to secondary and tertiary care through strategic purchasing from the private sector, to overcome deficiencies in public provisioning in the short run. Read More

    Scale Effects and Expected Savings from Consolidation Policies of Italian Local Healthcare Authorities.
    Appl Health Econ Health Policy 2018 Feb;16(1):107-122
    Department of Economics, Ca' Foscari University of Venice, Venice, Italy.
    Background: Consolidation is often considered by policymakers as a means to reduce service delivery costs and enhance accountability.

    Objective: The aim of this study was to estimate the potential cost savings that may be derived from consolidation of local health authorities (LHAs) with specific reference to the Italian setting.

    Methods: For our empirical analysis, we use data relating to the costs of the LHAs as reported in the 2012 LHAs' Income Statements published within the New Health Information System (NSIS) by the Ministry of Health. Read More

    Cost-Effectiveness Analysis of the Gonadotropin Treatments HP-hMG and rFSH for Assisted Reproductive Technology in France: A Markov Model Analysis.
    Appl Health Econ Health Policy 2018 Feb;16(1):65-77
    University Hospital of Montpellier - INSERM U1203, 371 Av. Du Doyen Gaston Giraud, 34295, Montpellier, France.
    Objectives: The objectives of this study were to assess (1) the expected cost of a live birth (LB) after in vitro fertilization with two different gonadotropin treatments [high purified human menopausal gonadotropin (HP-hMG) and recombinant follicle-stimulating hormone (rFSH)] as the single cost variable, and (2) the cost effectiveness of HP-hMG relative to rFSH in the context of the routine practice of assisted reproductive technology (ART) in France.

    Methods: A Markov model was developed to simulate the therapeutic management, the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) courses, and the effects of complications in hypothetical cohorts of 30,000 patients undergoing IVF/ICSI with fresh embryo transfer (up to four attempts) using data from the MERIT and MEGASET clinical trials or from French routine ART practice.

    Results: The cost per LB was estimated at €12,145 and at €14,247 with HP-hMG and rFSH, respectively, using efficacy data from published clinical trials. Read More

    Comparative Cost-Effectiveness Analysis of Three Different Automated Medication Systems Implemented in a Danish Hospital Setting.
    Appl Health Econ Health Policy 2018 Feb;16(1):91-106
    Department of Public Health, Centre for Health Economic Research (COHERE), University of Southern Denmark, J.B. Winsløwsvej 9B, 5000, Odense C, Denmark.
    Introduction: Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice.

    Methods: The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). Read More

    ENDURALIFE-Powered Cardiac Resynchronisation Therapy Defibrillator Devices for Treating Heart Failure: A NICE Medical Technology Guidance.
    Appl Health Econ Health Policy 2018 Apr;16(2):177-186
    Cedar Healthcare Technology Research Centre, Cardiff, Wales, UK.
    ENDURALIFE™-powered cardiac resynchronisation therapy defibrillator (CRT-D) devices were the subject of an evaluation by the National Institute for Health and Care Excellence, through its Medical Technologies Evaluation Programme, for the treatment of heart failure. Boston Scientific (manufacturer) submitted a case for the adoption of the technology, claiming that it has a longer battery life resulting in a longer time to CRT-D replacement. Other claimed benefits were fewer complications associated with replacement procedures, fewer hospital admissions, less time spent in hospital and reduced demand on cardiology device implantation rooms. Read More

    Association Between Medicare's Mandatory Hospital Value-Based Purchasing Program and Cost Inefficiency.
    Appl Health Econ Health Policy 2018 Feb;16(1):79-90
    Department of Economics, Eastern Washington University, 311 Patterson Hall, Cheney, WA, 99004-2429, USA.
    Background: The Patient Protection and Affordable Care Act instituted pay-for-performance programs, including Hospital Value-Based Purchasing (HVBP), designed to encourage hospital quality and efficiency.

    Objective And Method: While these programs have been evaluated with respect to their implications for care quality and financial viability, this is the first study to assess the relationship between hospitals' cost inefficiency and their participation in the programs. We estimate a translog specification of a stochastic cost frontier with controls for participation in the HVBP program and clinical and outcome quality for California hospitals for 2012-2015. Read More

    Involving Members of the Public in Health Economics Research: Insights from Selecting Health States for Valuation to Estimate Quality-Adjusted Life-Year (QALY) Weights.
    Appl Health Econ Health Policy 2018 Apr;16(2):187-194
    Health Economics Group, University of Exeter Medical School, University of Exeter, South Cloisters, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK.
    Over recent years, public involvement in health research has expanded considerably. However, public involvement in designing and conducting health economics research is seldom reported. Here we describe the development, delivery and assessment of an approach for involving people in a clearly defined piece of health economics research: selecting health states for valuation in estimating quality-adjusted life-years (QALYs). Read More

    Incremental Cost Effectiveness of Bedaquiline for the Treatment of Rifampicin-Resistant Tuberculosis in South Africa: Model-Based Analysis.
    Appl Health Econ Health Policy 2018 Feb;16(1):43-54
    Health Economics Unit, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
    Background: Nearly 20,000 people were diagnosed with multi-drug and rifampicin-resistant tuberculosis (MDR/RR-TB) in South Africa in 2015, yet only one-half of the patients who start treatment are expected to have a successful outcome. There is increasing evidence of the effectiveness and safety of new drug regimens containing bedaquiline for MDR/RR-TB; however, whether they are affordable for high-burden, limited-resource settings is uncertain.

    Objective: Our objective was to determine the incremental cost effectiveness of a bedaquiline-based regimen for MDR/RR-TB treatment in South Africa compared with the standard kanamycin-based regimen. Read More

    Healthcare Finance in the Kingdom of Saudi Arabia: A Qualitative Study of Householders' Attitudes.
    Appl Health Econ Health Policy 2018 Feb;16(1):55-64
    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 Dec;15(6):817-818
    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 2018 Apr;16(2):167-176
    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 Dec;15(6):697-706
    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 2018 Feb;16(1):133-143
    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 2018 Feb;16(1):15-29
    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 Dec;15(6):773-783
    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 Dec;15(6):785-794
    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 Dec;15(6):763-772
    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 Dec;15(6):805-816
    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

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