A 3 4 7 -A 7 6 6 A723 the average hospitalization cost per patient associated with 3D virtual surgical planning was lower than a traditional technique (€ 20,342.27 versus € 26,163.02; p< 0.01) showing an average cost savings of € 5,820.76 for patient. ConClusions: The analysis showed that the 3D virtual planning and customized implants, including pre-operative planning, surgical hardware and patient-customized implants, has a lower economic impact than traditional technique, guaranteeing optimal clinical outcomes and constituting the best option in mandibular reconstruction.
analysis, showed 89.2% of iterations favored denosumab. CONCLUSIONS: Denosumab was cost-effective over zoledronate from the private health care setting perspective in Brazil, adding gains in benefits at a lower cost in preventing osteoporotic fractures in postmenopausal women.
OBJECTIVES:To explore the cost-utility of adding tocilizumab (TCZ) monotherapy to current monotherapy treatment sequences in moderate/severe adult rheumatoid arthritis (RA) patients with inadequate response to one or more disease-modifying antirheumatic drugs (DMARD-IR) and intolerance/contra-indication to methotrexate (MTX) in Portugal. METHODS: A cost-utility analysis was conducted with a societal perspective. The analysis considered two scenarios: a treatment sequence starting with TCZ followed by two tumor necrosis factor inhibitors (anti-TNF), adalimumab (ADA) and etanercept (ETA) and palliative care (PC) -scenario 1 -or ETA, ADA and PC -scenario 2 -compared to the same treatment sequence without TCZ. Patients characteristics (age, starting HAQ-DI score and gender) were based on TCZ randomized clinical trial (RCT) data in monotherapy. ACR response data for the other biologic treatments were sourced from corresponding published RCTs in monotherapy. A mapping model was used to assign QALYs to patients based on HAQ-DI scores and EQ-5D collected in other RCTs (Kremer J, 2008; Smolen JS, 2008). Resource utilization was estimated based on a Portuguese rheumatolo-gists= expert panel. Unit costs were obtained from Portuguese official sources. Costs and QALYs were discounted annually at 5%. Uncertainty around the model key parameters was explored via probabilistic sensitivity analysis (PSA). RESULTS: The model estimated that the treatment sequences starting with TCZ result in higher QALYs and additional costs versus comparator sequences. The incremental costeffectiveness ratios (ICER) in both scenarios is below a threshold of 30.000€ per QALY gained. Sensitivity analysis and PSA showed that results are robust to parameter changes. CONCLUSIONS: Results of this analysis suggest that TCZ in monotherapy, added as first line biologic to currently used anti-TNF monotherapy sequences, represents an efficacious and cost-effective alternative to sequences currently used for treating MTX intolerant/contra-indicated RA patients in Portugal.
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