How do we evaluate the economics of health care?

Kumar, Sanjay; Williams, Alan G.; Sandy, Jonathan R

doi:10.1093/ejo/cjl046

Cited by 31 publications

(29 citation statements)

References 31 publications

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“…These models usually consider a lifetime horizon that is beyond the scope of this analysis. [42,43] Finally, these findings also only apply to highly treatment-experienced patients with a profile similar to the POWER population. In the phase III TITAN trial, which enrolled less treatment-experienced patients, the superior virological response achieved with DRV/r compared with lopinavir/ritonavir-based HAART was not associated with a higher CD4 cell count increase from baseline after 48 weeks of therapy.…”

Section: Discussionmentioning

confidence: 95%

Predicting Direct Costs of HIV Care During the First Year of Darunavir-Based Highly Active Antiretroviral Therapy Using CD4 Cell Counts

et al. 2010

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Section: Discussionmentioning

confidence: 95%

Predicting Direct Costs of HIV Care During the First Year of Darunavir-Based Highly Active Antiretroviral Therapy Using CD4 Cell Counts

et al. 2010

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“…In cardiovascular and respiratory diseases, for example, authors have previously reported the cost per cardiovascular event avoided, [41] whereas the cost per additional pain-free day has been calculated in the management of pain, [42] and the cost per additional symptom-free day is a common cost-effectiveness measure for asthma drugs. [43] A similar approach has been used to estimate the incremental drug cost per additional patient with an undetectable plasma HIV-RNA level at 48 weeks for HAART regimens containing DRV/r 600/100 mg bid compared with HAART regimens containing either investigator-selected control PIs or LPV/r 400/100 mg bid, using the 48-week efficacy results of the pooled POWER 1 and 2 trials.…”

Section: Cost-effectiveness Analyses Of Darunavir With Ritonavir At Amentioning

confidence: 99%

A Review of Economic Evaluations of Darunavir Boosted by Low-Dose Ritonavir in Treatment-Experienced Persons Living with HIV Infection

et al. 2010

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Darunavir boosted by low-dose ritonavir (DRV/r), at a daily dose of 600/100 mg twice a day (bid), has been shown to be superior to alternative highly active antiretroviral therapy (HAART) regimens for the management of treatment-experienced, HIV-infected adults in the phase IIb POWER trials and the phase III TITAN trial. Economic analyses of different types that have been performed for several countries to investigate the cost effectiveness and budgetary impact of DRV/r 600/100 mg bid for treatment-experienced people living with HIV (PLHIV) based on the clinical data gathered in the POWER and TITAN trials are reviewed for consistency and their value to different decision-makers is assessed. Cost-utility analyses for the USA and several European countries indicate that DRV/r-based HAART is cost effective compared with other standard of care protease inhibitor (PI)-based regimens in PLHIV with evidence of PI resistance. For all of these countries, the estimated cost-utility ratio is well below typical benchmark values and these ratios are robust, as demonstrated by one-way sensitivity and variability analyses and multi-way probabilistic sensitivity analyses. Studies using other metrics including the average 1-year drug cost per patient with a plasma HIV-RNA level less than 50 copies/mL at 48 weeks, the incremental drug cost per additional patient with a plasma HIV-RNA level less than 50 copies/mL at 48 weeks, the total (antiretroviral and non-antiretroviral) costs during the first year of treatment, and the total healthcare budget impact during the first 5 years of treatment provided further evidence of the positive economic outcomes with the use of DRV/r in treatment-experienced PLHIV. Different measures of economic outcomes are useful for different types of decision-makers and different types of decisions. In general, the results of these different types of analyses will be consistent with each other. For darunavir, the economic analyses reviewed in this paper demonstrate that the use of DRV/r 600/100 mg bid in the management of HIV-infected, treatment-experienced adults who have failed at least one of the other currently available PIs is cost effective and may be cost saving.

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“…There are numerous approaches to the assessment of economic impact in the health sector [13][14][15]. Some, such as the Health Impact Assessment approach [16,17], extend beyond economic aspects to deal with broader societal impact, often referred to as socioeconomic impact [18].…”

Section: Introductionmentioning

confidence: 99%

Applicability of the Five Case Model to African eHealth investment decisions

Broomhead

Mars

Scott

et al. 2020

Preprint

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Background: eHealth programmes in African countries face fierce competition for scarce resources. Such initiatives should not proceed without adequate appraisal of their probable impacts, thereby acknowledging their opportunity costs and the need for appraisals to promote optimal use of available resources. However, since there is no broadly accepted eHealth impact appraisal framework available to provide guidance, and local expertise is limited, African health ministries have difficulty completing such appraisals. The Five Case Model, used in several countries outside Africa, has the potential to function as a decision-making tool in African eHealth environments and serve as a key component of an eHealth impact model for Africa. Methods: This study identifies internationally recognised metrics and readily accessible data sources to assess the applicability of the model’s five cases to African countries. Results: Ten metrics are identified that align with the Five Case Model’s five cases, including nine component metrics and one summary metric that aggregates the nine. The metrics cover the eHealth environment, human capital and governance, technology development, and finance and economics. Fifty-four African countries are scored for each metric. Visualisation of the metric scores using spider charts reveals profiles of the countries’ relative performance and provides an eHealth Investment Readiness Assessment Tool. Conclusion: The utility of these comparisons to strengthen eHealth investment planning suggests that the five cases are applicable to African countries’ eHealth investment decisions. The potential for the Five Case Model to have a role in an eHealth impact appraisal framework for Africa should be validated through field testing.

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How do we evaluate the economics of health care?

Cited by 31 publications

References 31 publications

Predicting Direct Costs of HIV Care During the First Year of Darunavir-Based Highly Active Antiretroviral Therapy Using CD4 Cell Counts

Predicting Direct Costs of HIV Care During the First Year of Darunavir-Based Highly Active Antiretroviral Therapy Using CD4 Cell Counts

A Review of Economic Evaluations of Darunavir Boosted by Low-Dose Ritonavir in Treatment-Experienced Persons Living with HIV Infection

Applicability of the Five Case Model to African eHealth investment decisions

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