Objectives: To identify local resource use such as pharmaceutical treatment, medical follow-up, and patient hospitalization and estimate the budget impact of simeprevir (SMV) plus pegylated interferon (P)/ribavirin (R...Objectives: To identify local resource use such as pharmaceutical treatment, medical follow-up, and patient hospitalization and estimate the budget impact of simeprevir (SMV) plus pegylated interferon (P)/ribavirin (R) as a treatment option in the early stages of the disease in Greece. Methods: A budget impact tool was developed with a two-year time horizon, which estimated the impact on the Social Insurance Funds (SIFs) of introducing SMV + PR in the management of the early disease stages. Total direct and indirect costs were estimated for each of the following health states: non-cirrhotic chronic Hepatitis C (and within that by fibrosis stage), compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma. Data gaps on treatment algorithms, resource use and productivity losses were covered via an expert panel of eight leading hepatologists. Epidemiology data were taken from the published literature. Unit costs were obtained from the Ministry of Health and SIFs. The perspective was that of the SIF and the cost base year was 2015. Results: The total (direct and indirect) cost per patient per year (excluding cost of antiviral treatment) was estimated at €647, €703, €5,753, €16,313 and €37,237 for non-cirrhotic CHC, compensated cirrhosis, decompensated cirrhosis, HCC and liver transplantation, respectively. The budget impact analysis showed that adding SMV to PR in the early stages of the disease would lead to an increase in the cost of antiviral treatment by €2.03 million. Conclusions: Costs of managing CHC increase dramatically with disease severity. SMV + PR for naive patients at early disease stages has a significant but manageable budget impact, and could prevent high costs in advanced stages.展开更多
The aim of this study is to compute the budget impact of adopting Kiovig, a new ready-to-use 10% liquid immunoglobulin preparation, as a treatment for primary immunodeficiency from the perspective of the Belgian healt...The aim of this study is to compute the budget impact of adopting Kiovig, a new ready-to-use 10% liquid immunoglobulin preparation, as a treatment for primary immunodeficiency from the perspective of the Belgian health care payer. The analysis compared the “world with Kiovig” to the “world without Kiovig” and calculated how a change in the mix of immunoglobulins used to treat primary immunodeficiency would impact drug spending during 2010-2014. Data on the number of patients, immunoglobulin market shares and drug unit costs were derived from the IMS Health hospital disease database and from Belgian sources. The number of Belgian patients suffering from primary immunodefi-ciency is expected to increase from 2,378 pa-tients in 2010 to 2,447 patients in 2014. The budget impact of adopting Kiovig is likely to be modest, raising the immunoglobulin drug bud- get for this patient population by 0.4%-1.3% per year. The budgetary increase originated from the higher price of Kiovig as compared with other products, although the impact of Kiovig was limited by its anticipated slow market penetra-tion. There is a need for more and better data on the Belgian immunoglobulin market.展开更多
目的通过评估我国公开发表的医保预算影响分析(BIA)研究文献,探讨我国医保BIA研究预测的准确性,并分析其影响因素,以期为我国医保决策提供参考。方法通过PubMed、Web of Science、CNKI、万方和维普等数据库检索BIA研究的相关文献,使用...目的通过评估我国公开发表的医保预算影响分析(BIA)研究文献,探讨我国医保BIA研究预测的准确性,并分析其影响因素,以期为我国医保决策提供参考。方法通过PubMed、Web of Science、CNKI、万方和维普等数据库检索BIA研究的相关文献,使用医保预算影响分析质量评估量表对纳入研究的文献质量进行定量评估,准确性分析指标为药品销售金额预测值与其实际值的比值,使用t检验进行单因素分析、多重线性回归进行多因素分析。结果最终纳入11篇文献,文献评估得分为0.7503±0.0309。共有24项数据纳入分析,单因素分析结果显示文献评分对BIA预测准确性差异有统计学意义(P<0.05),多因素分析显示BIA预测准确性受到文献评分、年均/疗程药品成本的影响(F=7.844,P<0.05)。结论我国医保BIA相关文献质量总体较好,但在数据引用、分析内容与结果呈现等方面仍存在一定问题;研究预测结果的准确性存在欠缺,预测值普遍高于实际值。建议提高对医保BIA研究质量的重视程度,加强医保BIA准确性的相关研究。展开更多
Background: Chronic kidney disease is a serious public health issue in Egypt. An estimated 13% of individuals in Egypt are expected to have CKD, with a higher prevalence among older adults and in rural regions. The pr...Background: Chronic kidney disease is a serious public health issue in Egypt. An estimated 13% of individuals in Egypt are expected to have CKD, with a higher prevalence among older adults and in rural regions. The primary goal of the study was to compare the cost-utility of the standard of care alone against add-on medication, dapagliflozin, as a preventative measure against complications of CKD in cases with or without diabetes mellitus. Methods: A lifetime Markov state transition model with a 3-month cycle was employed based on the clinical evidence from the DAPA-CKD clinical trial. The model was to provide estimates of the long-term economic and health impact of managing CKD patients. Cost-effectiveness is assessed regarding the cost per quality-adjusted life year (QALY) gained. This economic evaluation study used a payer perspective. Moreover, the study evaluated the impact on the budget due to the undertaking of dapagliflozin. One-way deterministic sensitivity analyses, as well as a probabilistic sensitivity analysis, were employed. Results: During a lifetime horizon, the difference in cost between dapagliflozin and SOC was EGP -65,212 (USD 2126.89). The difference in QALY between dapagliflozin and SOC was 4.3. In CKD patients, adding dapagliflozin to ramipril generates better QALYs and lower costs than ramipril alone. Dapagliflozin improved the outcomes and generated cost savings. A deterministic one was sensitivity analysis revealed that the model is robust to changes in all variables included. Probabilistic sensitivity analysis using Monte Carlo simulation with 10,000 iterations showed that in about 82.64% of trials, dapagliflozin is cost-saving. The undertaking of dapagliflozin by any percent will have a positive impact on the budget. Conclusion: During the lifetime horizon, dapagliflozin is cost-saving;it benefits the quality of life and the total cost. The addition of dapagliflozin to SOC has a saving effect of 11.9% of the budget.展开更多
文摘Objectives: To identify local resource use such as pharmaceutical treatment, medical follow-up, and patient hospitalization and estimate the budget impact of simeprevir (SMV) plus pegylated interferon (P)/ribavirin (R) as a treatment option in the early stages of the disease in Greece. Methods: A budget impact tool was developed with a two-year time horizon, which estimated the impact on the Social Insurance Funds (SIFs) of introducing SMV + PR in the management of the early disease stages. Total direct and indirect costs were estimated for each of the following health states: non-cirrhotic chronic Hepatitis C (and within that by fibrosis stage), compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma. Data gaps on treatment algorithms, resource use and productivity losses were covered via an expert panel of eight leading hepatologists. Epidemiology data were taken from the published literature. Unit costs were obtained from the Ministry of Health and SIFs. The perspective was that of the SIF and the cost base year was 2015. Results: The total (direct and indirect) cost per patient per year (excluding cost of antiviral treatment) was estimated at €647, €703, €5,753, €16,313 and €37,237 for non-cirrhotic CHC, compensated cirrhosis, decompensated cirrhosis, HCC and liver transplantation, respectively. The budget impact analysis showed that adding SMV to PR in the early stages of the disease would lead to an increase in the cost of antiviral treatment by €2.03 million. Conclusions: Costs of managing CHC increase dramatically with disease severity. SMV + PR for naive patients at early disease stages has a significant but manageable budget impact, and could prevent high costs in advanced stages.
文摘The aim of this study is to compute the budget impact of adopting Kiovig, a new ready-to-use 10% liquid immunoglobulin preparation, as a treatment for primary immunodeficiency from the perspective of the Belgian health care payer. The analysis compared the “world with Kiovig” to the “world without Kiovig” and calculated how a change in the mix of immunoglobulins used to treat primary immunodeficiency would impact drug spending during 2010-2014. Data on the number of patients, immunoglobulin market shares and drug unit costs were derived from the IMS Health hospital disease database and from Belgian sources. The number of Belgian patients suffering from primary immunodefi-ciency is expected to increase from 2,378 pa-tients in 2010 to 2,447 patients in 2014. The budget impact of adopting Kiovig is likely to be modest, raising the immunoglobulin drug bud- get for this patient population by 0.4%-1.3% per year. The budgetary increase originated from the higher price of Kiovig as compared with other products, although the impact of Kiovig was limited by its anticipated slow market penetra-tion. There is a need for more and better data on the Belgian immunoglobulin market.
文摘目的通过评估我国公开发表的医保预算影响分析(BIA)研究文献,探讨我国医保BIA研究预测的准确性,并分析其影响因素,以期为我国医保决策提供参考。方法通过PubMed、Web of Science、CNKI、万方和维普等数据库检索BIA研究的相关文献,使用医保预算影响分析质量评估量表对纳入研究的文献质量进行定量评估,准确性分析指标为药品销售金额预测值与其实际值的比值,使用t检验进行单因素分析、多重线性回归进行多因素分析。结果最终纳入11篇文献,文献评估得分为0.7503±0.0309。共有24项数据纳入分析,单因素分析结果显示文献评分对BIA预测准确性差异有统计学意义(P<0.05),多因素分析显示BIA预测准确性受到文献评分、年均/疗程药品成本的影响(F=7.844,P<0.05)。结论我国医保BIA相关文献质量总体较好,但在数据引用、分析内容与结果呈现等方面仍存在一定问题;研究预测结果的准确性存在欠缺,预测值普遍高于实际值。建议提高对医保BIA研究质量的重视程度,加强医保BIA准确性的相关研究。
文摘Background: Chronic kidney disease is a serious public health issue in Egypt. An estimated 13% of individuals in Egypt are expected to have CKD, with a higher prevalence among older adults and in rural regions. The primary goal of the study was to compare the cost-utility of the standard of care alone against add-on medication, dapagliflozin, as a preventative measure against complications of CKD in cases with or without diabetes mellitus. Methods: A lifetime Markov state transition model with a 3-month cycle was employed based on the clinical evidence from the DAPA-CKD clinical trial. The model was to provide estimates of the long-term economic and health impact of managing CKD patients. Cost-effectiveness is assessed regarding the cost per quality-adjusted life year (QALY) gained. This economic evaluation study used a payer perspective. Moreover, the study evaluated the impact on the budget due to the undertaking of dapagliflozin. One-way deterministic sensitivity analyses, as well as a probabilistic sensitivity analysis, were employed. Results: During a lifetime horizon, the difference in cost between dapagliflozin and SOC was EGP -65,212 (USD 2126.89). The difference in QALY between dapagliflozin and SOC was 4.3. In CKD patients, adding dapagliflozin to ramipril generates better QALYs and lower costs than ramipril alone. Dapagliflozin improved the outcomes and generated cost savings. A deterministic one was sensitivity analysis revealed that the model is robust to changes in all variables included. Probabilistic sensitivity analysis using Monte Carlo simulation with 10,000 iterations showed that in about 82.64% of trials, dapagliflozin is cost-saving. The undertaking of dapagliflozin by any percent will have a positive impact on the budget. Conclusion: During the lifetime horizon, dapagliflozin is cost-saving;it benefits the quality of life and the total cost. The addition of dapagliflozin to SOC has a saving effect of 11.9% of the budget.
