clinical response to treatment and the number of QALYs per patient accrued during the study. Only direct medical costs (drug acquisition, administration and hospitalization costs) were incorporated in the model, as the analysis was conducted from a third-party payer perspective. With respect to administration cost, two alternative scenarios were considered in the base case analysis: administration in day-case unit and administration in the hospital outpatient department. Probabilistic sensitivity analysis was conducted. Primary outcomes were quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER). Results: In the base case analysis, QALYs of FCM treated patients were higher compared to no iron treated patients by 0.04 QALYs. The total 24-week cost of FCM was higher by € 969 and € 204, it the two scenarios respectively. This difference was mainly attributed to the administration cost and drug acquisition cost related to FMC. Incremental cost effectiveness analysis showed that treatment with FCM was a cost-effective option resulting in an ICER of € 25,506 and € 5,368 per QALY gained in the scenarios respectively. Probabilistic sensitivity analysis revealed that FCM was likely to be cost-effective in over 80% and 99% in the two scenarios respectively, at a willingness-to-pay threshold of € 34,000 per QALY gained. ConClusions: Ferric carboxymaltose may be a cost -effective option in relation to no iron treatment for the management of iron deficiency of HF patients in Greece.objeCtives: Non-adherence to drug therapy poses a significant problem in the treatment of patients with presumed resistant hypertension (RH). It has been shown that therapeutic drug monitoring (TDM) is a useful tool for detecting non-adherence and identifying barriers to treatment adherence, leading to effective blood pressure (BP) control. However, the cost-effectiveness of TDM in the management of RH has not been investigated. Methods: A Markov model was used to evaluate life-years, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios in RH patients receiving either TDM optimized therapy or standard best medical therapy. The model ran from the age of 30 to 100 years or death, using a cycle length of 1 year. Efficacy of TDM was modeled by reducing risk of hypertension-related morbidity and mortality. Cost analyses were performed from a payer's perspective. Deterministic and probabilistic sensitivity analyses were conducted. Results: In the age group of 60-year olds, TDM gained 1.07 QALYs in men and 0.97 QALYs in women at additional costs of € 3,854 and € 3,922, respectively. Given a willingness-to-pay threshold of € 35,000 per QALY gained, the probability of TDM being cost-effective was ≥ 95% in all age groups from 30 to 90 years. Results were influenced mostly by the frequency of TDM testing, the rate of non-responders to TDM, and the magnitude of effect of TDM on BP. ConClusions: Therapeutic drug monitoring presents a potentialy highly cost-effective health care intervention in patie...
A487ing cardiovascular mortality, myocardial infarction (MI), or stroke among patients with acute coronary syndrome (ACS) compared to clopidogrel but without a significant increase in major bleedings. In Hong Kong, generic clopidogrel was introduced in 2012. This study aimed to evaluate the long-term cost-effectiveness of ticagrelor in ACS patients in Hong Kong (HK) from a public hospital's perspective. Methods: A two-phase Markov model was used to estimate the short-and long-term costeffectiveness measured as cost per quality-adjusted-life-year (QALY) and cost per life-year-gained (LYG) over 1 year, 5 years and patients' lifetime. Direct medical costs were HK-specific and patients' resource use, rate of cardiovascular events (i.e. MI and stroke) and utility data were from published literature. All costs were presented as 2014 figures, cost and effectiveness were both discounted at 3% per annum. Sensitivity analyses were performed to test model robustness. Results: Despite the great difference in the daily drug cost of ticagrelor and generic clopidogrel (US2.8, vs US0.10,1US= 7.8HK), the overall cost of management between the 2 groups remains similar. Our study shows that the incremental cost-effectiveness ratios (ICER) of ticagrelor were reduced substantially from US16,071/LYG and US19,493/ QALY in the first year to US302/LYG and US357/QALY over a lifetime time horizon due to improvements in health outcomes. The ICER values were all cost-effective based on the WHO 3xGDP criteria (GDP 2013= US37,860). The results are sensitive to cost of generic clopidogrel. ConClusions: Treating ACS patients with lifetime use of ticagrelor can potentially reduce the cost of management and increase the cost-effectiveness due to better health outcomes as compared to generic clopidogrel. Ticagrelor therapy appears to be cost-effective both on short-and long-term assessment in the public health care sector of Hong Kong.
A479ates the financial impact of apixaban introduction by comparing expected 1,2, and 3 years costs in hypothetical scenarios: with and without apixaban. Italian NVAF patient population estimation is based on official apixaban reimbursement criteria, applying the characteristics of the trial population to national epidemiologic data. Sensitivity analysis is performed on an alternative non-experimental population of NVAF patients. Results: Among available NOACs, apixaban is expected to be the least expensive at 1,2, and 3 years in an estimated patient population of 364,000 Italian patients, allowing for savings of over 5 million € by the third year. Results of the simulation run on an alternative non-experimental population of NVAF patients yields comparable estimates. Exclusive use of apixaban for three years in the identified population would allow for savings of € 8,832,500, € 14,446,551 and € 27,282,998 when compared with dabigatran (110 mg), dabigatran (150 mg) and rivaroxaban, respectively. ConClusions: The different safety and effectiveness profiles of the available NOACs emerging from the adjusted indirect comparison indicate that the introduction of apixaban could improve health care expenditure control while maintaining or increasing therapeutic appropriateness in the Italian NVAF population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.