Evaluation of Suspected Urinary Tract Infection in Ambulatory Women: A Cost-Utility Analysis of Office-Based Strategies

Barry, Henry C.; Ebell, Mark H.; Hickner, John

doi:10.1016/s0022-5347(01)63668-1

Cited by 47 publications

(72 citation statements)

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“…For UTIs the average of the values of Barry et al 205 of -0.3732 for pyelonephritis and of -0.2894 for dysuria appears to have been coupled with an assumed duration of around 3 days to yield a QALY decrement of -0.00283 per UTI. Apparently no values were found for GTIs and, as a consequence, these had the same disutility applied.…”

Section: Quality Of Lifementioning

confidence: 88%

“…Barry et al 205 used the Index of Wellbeing (IWB) to estimate QoL among young women with UTIs. The IWB is a generic QoL instrument.…”

Section: Quality Of Life: Adverse Eventsmentioning

confidence: 99%

“…The mapping function from the IWB to QoL values was apparently based upon 62 American nurses and non-medical graduate students ranking health states on a 16-point scale. Barry et al 205 report that the IWB includes hospitalisation, self-care and ambulatory status, and permits the inclusion of the following symptoms: pain; bleeding; itching discharge from sexual organs; painful burning or frequent urination; burning or itching rash on large areas of the body; taking medication; fever or chills with aching all over; and pain in the chest, stomach, sides, back or hips. But Barry et al 205 do not describe quite how the QoL values for the health states for their model have been derived.…”

Section: Quality Of Life: Adverse Eventsmentioning

confidence: 99%

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Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Johnston

Uthman

Cummins

et al. 2017

Health Technol Assess

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Background Most people with type 2 diabetes are overweight, so initial treatment is aimed at reducing weight and increasing physical activity. Even modest weight loss can improve control of blood glucose. If drug treatment is necessary, the drug of first choice is metformin. However, some people cannot tolerate metformin, which causes diarrhoea in about 10%, and it cannot be used in people with renal impairment. This review appraises three of the newest class of drugs for monotherapy when metformin cannot be used, the sodium–glucose co-transporter 2 (SGLT2) inhibitors. Objective To review the clinical effectiveness and cost-effectiveness of dapagliflozin (Farxiga, Bristol-Myers Squibb, Luton, UK), canagliflozin (Invokana, Janssen, High Wycombe, UK) and empagliflozin (Jardiance, Boehringer Ingelheim, Ingelheim, Germany/Eli Lilly and Company, Indianapolis, IN, USA), in monotherapy in people who cannot take metformin. Sources MEDLINE (1946 to February 2015) and EMBASE (1974 to February 2015) for randomised controlled trials lasting 24 weeks or more. For adverse events, a wider range of studies was used. Three manufacturers provided submissions. Methods Systematic review and economic evaluation. A network meta-analysis was carried out involving the three SGLT2 inhibitors and key comparators. Critical appraisal of submissions from three manufacturers. Results We included three trials of dapagliflozin and two each for canagliflozin and empagliflozin. The trials were of good quality. The canagliflozin and dapagliflozin trials compared them with placebo, but the two empagliflozin trials included active comparators. All three drugs were shown to be effective in improving glycaemic control, promoting weight loss and lowering blood pressure (BP). Limitations There were no head-to-head trials of the different flozins, and no long-term data on cardiovascular outcomes in this group of patients. Most trials were against placebo. The trials were done in patient groups that were not always comparable, for example in baseline glycated haemoglobin or body mass index. Data on elderly patients were lacking. Conclusions Dapagliflozin, canagliflozin and empagliflozin are effective in improving glycaemic control, with added benefits of some reductions in BP and weight. Adverse effects are urinary and genital tract infections in a small proportion of users. In monotherapy, the three drugs do not appear cost-effective compared with gliclazide or pioglitazone, but may be competitive against sitagliptin (Januvia, Merck Sharp & Dohme Limited, Kenilworth, NJ, USA). Funding The National Institute for Health Research Health Technology Assessment programme.

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Section: Quality Of Lifementioning

confidence: 88%

“…Barry et al 205 used the Index of Wellbeing (IWB) to estimate QoL among young women with UTIs. The IWB is a generic QoL instrument.…”

Section: Quality Of Life: Adverse Eventsmentioning

confidence: 99%

Section: Quality Of Life: Adverse Eventsmentioning

confidence: 99%

See 1 more Smart Citation

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Johnston

Uthman

Cummins

et al. 2017

Health Technol Assess

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“…For those unavailable in UKPDS 62 study, including end-stage renal disease (ESRD) and blindness [78], hypoglycaemia [79], per unit change in BMI [80], gastrointestinal adverse events [81] and urinary tract infection (UTI) [82], values were obtained from other published studies. Given the lack of utility data available for genital infections, it was assumed to be equivalent to that of UTI ( Table 7).…”

Section: Utilitiesmentioning

confidence: 99%

“…Furthermore, patients in the dapagliflozin arm experienced fewer symptomatic and severe hypoglycaemia events than that in the acarbose arm ( Table 8). a Utility decrements for most events were adopted from the UKPDS 62 study [77], except for end-stage renal disease and blindness [78], hypoglycaemia [79], BMI-related changes [80], gastrointestinal adverse events [81] and urinary tract infection [82]. Utility for genital infections was assumed to be equivalent to urinary tract infection.…”

Section: Predicted Health Eventsmentioning

confidence: 99%

Cost-Effectiveness of Dapagliflozin Versus Acarbose as A Monotherapy in Type 2 Diabetes in China

2016

Value in Health

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ObjectiveTo estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China. MethodsThe Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed. ResultsThe model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust. ConclusionDapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM.

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The Impact of Empirical Management of Acute Cystitis on Unnecessary Antibiotic Use

McIsaac¹,

Low²,

Biringer³

et al. 2002

Arch Intern Med

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Evaluation of Suspected Urinary Tract Infection in Ambulatory Women: A Cost-Utility Analysis of Office-Based Strategies

Cited by 47 publications

References 0 publications

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Cost-Effectiveness of Dapagliflozin Versus Acarbose as A Monotherapy in Type 2 Diabetes in China

The Impact of Empirical Management of Acute Cystitis on Unnecessary Antibiotic Use

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