A Systematic Review of Health Economic Evaluation Studies Using the Patient’s Perspective

Tai, Bik-Wai Bilvick; Bae, Yuna H.; Le, Quang A.

doi:10.1016/j.jval.2016.05.010

Cited by 55 publications

(47 citation statements)

References 41 publications

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“…Analyses incorporating productivity losses/gains have been shown to increase or decrease the incremental costeffectiveness ratio (ICER) (a measure of the difference in cost between two interventions, divided by the difference in their effect), depending on the direction of their impact on costs. Although multiple reports support the inclusion of productivity losses/gains in CEAs [21][22][23][24], a systematic review of all health economic evaluation studies published through May 2014 that employed a patient's perspective found that only half of the included studies examined indirect costs [25]. Moreover, a study conducted in 2000 that examined CUAs found that among 228 studies conducted between 1975 and 1997, only 19 (8.3%) included productivity costs.…”

Section: Key Points For Decision Makersmentioning

confidence: 99%

Use of Productivity Loss/Gain in Cost-Effectiveness Analyses for Drugs: A Systematic Review

Yuasa

Yonemoto

Lopresti³

et al. 2020

PharmacoEconomics

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Background Inclusion of productivity losses and gains in cost-effectiveness analyses for drugs is recommended by pharmacoeconomic guidelines in some countries and is considered optional in others. Often guidelines recommend analysis based on the payer perspective, but suggest that a supplemental analysis based on the societal perspective may be submitted that includes productivity losses/gains. However, there is no universally recognized framework for the approach to including productivity losses and gains in pharmacoeconomic analyses. Objectives This study aimed to systematically review literature on cost-effectiveness analyses of drug interventions that included costs associated with productivity losses/gains and to summarize the types cost elements included and cost calculation methods employed. Moreover, this study examines variations in the calculation of productivity losses/gains by target disease type, geographic region, income group, period of analysis, and analysis time horizon-as well as the impact of their inclusion on the study outcomes. Methods A search of three databases was performed, including MEDLINE, Embase, and the Cochrane Library, to identify cost-effectiveness and cost-utility analyses that included indirect costs such as productivity losses/gains. Publications from January 2010 to October 2019 were examined and selected for inclusion by two independent reviewers. In addition to the citation details, data on the country of analysis, country income group, target disease area, study sponsorship, type of analysis, study design, time horizon, analysis perspective, productivity loss/gain elements included, the approach used to estimate productivity losses/gains, and the impact of their inclusion on the study outcome-namely the incremental cost effectiveness ratio-were extracted and summarized. Results The search strategy identified 5038 unique studies, and 208 were included in the final analysis. Among the studies reviewed, 165 (79%) were conducted in high-income countries and 160 (77%) were conducted for North American and European/Central Asian countries. The productivity loss/gain elements included in the analysis were reported for 169 studies (81%). Absenteeism only was included for 98 studies (47%), and absenteeism plus presenteeism was included for 29 studies (14%). Absenteeism plus some other element such as costs associated with unemployment and/or early retirement was included for 32 studies (15%) examined. Only one out of four of the studies reviewed included information on the approach used to estimate productivity losses/gains, which was predominantly the human capital approach. One-hundred forty-four studies (69%) reported the impact of including productivity losses/gains on the ICER, with 110 studies (53%) reporting that their inclusion contributed to more favorable cost-effectiveness. Conclusions Although inclusion of productivity losses/gains was shown to have a favorable impact on evaluations for many studies, their impact and method of calculation was often not reported or was u...

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Section: Key Points For Decision Makersmentioning

confidence: 99%

Use of Productivity Loss/Gain in Cost-Effectiveness Analyses for Drugs: A Systematic Review

Yuasa

Yonemoto

Lopresti³

et al. 2020

PharmacoEconomics

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“…The cost analysis was performed from a patient perspective and was limited to costs from LH testing to oocyte retrieval. Direct non-medical costs (travel costs) data were based on a previous review (22). The theoretical cost if every patient had come in for serum LH testing, including indirect costs such a travel time and income loss was compared against the cost of a home urine LH kit.…”

Section: Cost Analysismentioning

confidence: 99%

Self-Detection of the LH Surge in Urine After GnRH Agonist Trigger in IVF—How to Minimize Failure to Retrieve Oocytes

et al. 2020

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Research question: Urine LH testing may be useful to confirm an LH surge after the GnRH agonist (GnRHa) trigger prior to oocyte retrieval in IVF.Design: A prospective cohort study, including oocyte donors undergoing ovarian stimulation, treated with a GnRHa trigger for final oocyte maturation. Urine LH testing was performed at home, 12 h after the GnRHa trigger. In the case of a negative result, serum LH and progesterone measurements were done that same day. Donors with no serum LH peak after trigger were re-scheduled using a dual trigger, with GnRHa and hCG.Results: Three hundred and fifty nine oocyte donors were included in the analysis. Three hundred and fifty six donors had positive urine LH tests, followed by oocyte retrieval. In one case, the LH test was positive, however, no oocytes were retrieved (false positive 1/356). Three LH tests were negative in urine: in one of these three cases, LH was tested again in blood, confirming an LH rise, consistent with an optimal response to the GnRHa trigger; in the other two cases, serum LH was <15 mUI/mL, after which the oocyte retrieval was re-scheduled for 36 h after an being re-triggered, resulting in the retrieval of 19 and 22 MII oocytes, respectively. Considering the cost analysis, it would be a significantly cost-saving strategy, as blood testing would have costed 14,840e vs. only 185.5e in urine LH kits.Conclusions: Urinary testing of the LH surge after GnRHa trigger is easy, safe, reliable, and convenient. In addition, LH urine testing allows identifying donors and patients who could benefit from a rescue hCG trigger after an unsuccessful GnRHa trigger.

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“…Currently, not many health economic studies are conducted from the patient perspective. However, both health outcomes and cost will impact the patients' decision on using the therapy and should therefore be more routinely studied [45]. Whilst health economic evaluations have traditionally focused on generic PRO instruments like EQ5D as the basis of the evaluation (e.g., of Quality-Adjusted Life Years), patients often criticize that these generic instruments do not fully capture the aspects that are important to them, and factors beyond Quality of Life are not taken account of in the economic evaluations [6,46].…”

Section: Importance Of Gaining Patient Insights In Early Developmentmentioning

confidence: 99%

The Role of Patients inMarket Access

Holtorf¹,

Cook²

2018

Pharmaceutical Market Access in Developed Markets2018

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A Systematic Review of Health Economic Evaluation Studies Using the Patient’s Perspective

Cited by 55 publications

References 41 publications

Use of Productivity Loss/Gain in Cost-Effectiveness Analyses for Drugs: A Systematic Review

Use of Productivity Loss/Gain in Cost-Effectiveness Analyses for Drugs: A Systematic Review

Self-Detection of the LH Surge in Urine After GnRH Agonist Trigger in IVF—How to Minimize Failure to Retrieve Oocytes

The Role of Patients inMarket Access

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