Does meta-analysis of economic evaluations have the potential to play a role in healthcare decision-making in the United States?

Veettil, Sajesh K.; Syeed, M Sakil; Noviyan, Rini; Thakkinstian, Ammarin; Chaiyakunapruk, Nathorn

doi:10.1080/13696998.2022.2083347

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Each INB and its variance were calculated per the approaches described previously [41,45,46,51,52] (a detailed description is provided in Appendix S3). If a study presented results of more than one comparison (e.g.…”

Section: Discussionmentioning

confidence: 99%

Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta‐analysis of economic evaluation studies

Chaisai,

Patikorn,

Thavorn

et al. 2024

Addiction

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AimsTo conduct a systematic review and meta‐analysis and pool the incremental net benefits (INBs) of varenicline compared with behaviour support with bupropion or nicotine replacement therapy (NRT), behaviour support alone and unaided cessation in adult smokers making a first‐time attempt to quit.MethodsA search for economic evaluation studies was conducted from inception to 30 September 2022, on PubMed, Embase, Cost‐Effectiveness Analysis (CEA) Registry by Tufts Medical Centre, EconLit and the NHS Economic Evaluation Database (NHS EED). Eligible studies were included if they were (1) conducted among adults ages 18 years old and older who were smokers attempting to quit for the first time; (2) compared varenicline to behaviour support with bupropion or NRT, behaviour support alone and unaided cessation; and (3) performed a CEA or cost‐utility analysis. The INBs were calculated and pooled across studies stratified by country income level and study perspective using the random‐effects model. Statistical heterogeneity between studies was assessed using the I2 statistic and Cochrane Q statistic.ResultsOf the 1433 identified studies, 18 studies were included in our review. Our findings from healthcare system/payer perspective suggested that the use of varenicline is statistically significantly cost‐effective compared with bupropion (pooled INB, $830.75 [95% confidence interval, $208.23, $1453.28]), NRTs ($636.16 [$192.48, $1079.84]) and unaided cessation ($4212.35 [$1755.79, $6668.92]) in high‐income countries. Similarly, varenicline is also found to be cost‐effective compared to bupropion ($2706.27 [$1284.44, $4128.11]), NRTs ($3310.01 [$1781.53, $4838.50]) and behavioural support alone ($5438.22 [$4105.99, $6770.46]) in low‐ and middle‐income countries.ConclusionVarenicline is cost‐effective as a smoking cessation aid when compared with behavioural support with bupropion or nicotine replacement therapies and behavioural support alone in both high‐income countries and low‐ and middle‐income countries, from the healthcare system/payer perspective in adult smokers who attempt to quit for the first time.

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Section: Discussionmentioning

confidence: 99%

Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta‐analysis of economic evaluation studies

Chaisai,

Patikorn,

Thavorn

et al. 2024

Addiction

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“…The economic evaluation characteristics and results of each review were extracted, including the number of economic evaluations, method of analysis, study design, valuation of outcomes, and key economic findings. There is debate in the literature regarding the value of meta-analysis for economic evaluations that are heterogeneous [ 27 , 28 ]; therefore, a narrative approach was taken to summarise the study findings. Intuitive conclusions were drawn from the economic evidence within each focus area, classified into the following categories: cost-effective, not cost-effective, lack of evidence, and unclear, based on the criteria reported in Table 3 .…”

Section: Methodsmentioning

confidence: 99%

A Scoping Review of Economic Evaluations to Inform the Reorientation of Preventive Health Services in Australia

Taylor,

Sullivan,

Reeves

et al. 2023

IJERPH

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The Australian National Preventive Health Strategy 2021–2030 recommended the establishment of evidence-based frameworks to enable local public health services to identify strategies and interventions that deliver value for money. This study aimed to review the cost-effectiveness of preventive health strategies to inform the reorientation of local public health services towards preventive health interventions that are financially sustainable. Four electronic databases were searched for reviews published between 2005 and February 2022. Reviews that met the following criteria were included: population: human studies, any age or sex; concept 1: primary and/or secondary prevention interventions; concept 2: full economic evaluation; context: local public health services as the provider of concept 1. The search identified 472 articles; 26 were included. Focus health areas included mental health (n = 3 reviews), obesity (n = 1), type 2 diabetes (n = 3), dental caries (n = 2), public health (n = 4), chronic disease (n = 5), sexual health (n = 1), immunisation (n = 1), smoking cessation (n = 3), reducing alcohol (n = 1), and fractures (n = 2). Interventions that targeted obesity, type 2 diabetes, smoking cessation, and fractures were deemed cost-effective, however, more studies are needed, especially those that consider equity in priority populations.

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“… 1 However, heterogeneity is still present after stratified analyses, i.e., about two-thirds of recently published meta-analyses of CEA results showed substantial heterogeneity. 2 A recent study indicated that the variation in willingness-to-pay (WTP) might play a major role; applying a uniform WTP threshold across studies was a successful strategy to mitigate heterogeneity. 2 However, other sources of heterogeneity remain to be explored and addressed by different strategies.…”

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confidence: 99%

“… 2 A recent study indicated that the variation in willingness-to-pay (WTP) might play a major role; applying a uniform WTP threshold across studies was a successful strategy to mitigate heterogeneity. 2 However, other sources of heterogeneity remain to be explored and addressed by different strategies.…”

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confidence: 99%

Combining cost-effectiveness results into a single measurement: What is the value?: Authors response

et al. 2022

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Does meta-analysis of economic evaluations have the potential to play a role in healthcare decision-making in the United States?

Cited by 4 publications

References 14 publications

Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta‐analysis of economic evaluation studies

Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta‐analysis of economic evaluation studies

A Scoping Review of Economic Evaluations to Inform the Reorientation of Preventive Health Services in Australia

Combining cost-effectiveness results into a single measurement: What is the value?: Authors response

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