Introduction of sFlt-1/PlGF into hospital practice is cost-saving. Savings are generated primarily through improvement in diagnostic accuracy and reduction in unnecessary hospitalization for women before PE's onset.
Objective
Non-invasive prenatal testing (NIPT) based on cell-free fetal DNA (cffDNA) is highly accurate in the detection of common fetal autosomal trisomies. Aim of this project was to investigate short-term costs and clinical outcomes of the contingent use of cffDNA for prenatal screening of trisomies 21, 18, 13 within a national health service (NHS).
Methods
An economic analysis was developed from the perspective of the Italian NHS to compare two possible scenarios for managing pregnant women: women managed according to the Standard of Care screening (SoC) vs a cffDNA scenario, where Harmony Prenatal Test was introduced as a second line screening choice for women with an “at risk” result from SoC screening.
Results
The introduction of cffDNA as a second line screening test, conditional to a risk ≥ 1:1,000 from SoC screening, showed a 3% increase in the detection of trisomies, with a 71% decrease in the number of invasive tests performed. Total short-term costs (pregnancy management until childbirth) decreased by € 19 million (from € 84.5 to 65.5 million).
Conclusion
The adoption of the Harmony Prenatal Test in women resulting at risk from SoC screening, implied a greater number of trisomies detection, together with a reduction of the healthcare costs.
Patients with anaplastic lymphoma kinase-positive (ALK D) advanced nonesmall-cell lung cancer should benefit from targeted therapy. The effect of increased use of an immunohistochemical technique was estimated using a health careeeconomics analysis. Extensive use of D5F3 has resulted in a diagnostic costs decrease. These savings could be reinvested to test a greater number of patients (53% vs. 75%). Reinvesting the saving would lead to an overall survival gain (D20%). Background: To ensure identification of anaplastic lymphoma kinase-positive (ALK þ) patients, the Italian Drug Agency suggested a testing algorithm based on the use of fluorescence in situ hybridization (FISH) and/or immunohistochemistry. The aim was to evaluate the clinical and economic effects of adopting an immunohistochemical test (Ventana ALK D5F3) as an option for detecting ALK protein expression in advanced nonesmall cell lung cancer (NSCLC) patients. Materials and Methods: A budget impact model was developed by adopting the Italian National Health Service (NHS) perspective and a 5-year period to compare 2 scenarios: the current use of D5F3 (28%; current scenario) and increased use of D5F3 (60%; alternative scenario). The testing cost and the number and cost of the identified ALK þ patients were evaluated. Results: A more extensive use of D5F3 in the alternative scenario showed a decrease in diagnostic costs of wV468,000 compared with current scenario when considering all advanced NSCLC patients. If these savings were allocated to test more NSCLC patients (75% vs. 53%), an incremental cost per identified ALK þ patient of V63 would be required, leading to an overall survival gain for the alternative scenario compared with the current scenario (32.4 vs. 27.1 months; relative increase, 20%). Conclusion: The use of D5F3 would provide a cost savings for the NHS owing to a lower acquisition cost than FISH and a comparable detection rate. The savings could be reinvested to test a greater number of patients, leading to more efficient identification, use of targeted therapy, and improvement in clinical outcomes of ALK þ patients.
The results of this study indicate that bedaquiline is a cost-effective option for the treatment of MDR (including XDR-TB patients) in the Korean settings when compared to standard treatment alone.
When all costs are considered from an inpatient setting, LUTONIX® 035 DCB is predicted to result in total cost-savings compared with PTA. Sensitivity analyses demonstrate consistent results across a range of scenarios and a potential for cost savings from inpatient settings. ConClusions: The economic analysis predicted LUTONIX® 035 DCB may be cost-effective. The cost per reintervention avoided for LUTONIX® 035 DCB is comparable to other published studies of cost-effective DCBs.
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