The Cost-Effectiveness of Hypertension Pharmacotherapy in Serbia: A Markov Model

Lakic, Dragana; Petrova, Guenka; Bogavac-Stanojević, Nataša; Jelić‐Ivanović, Zorana; Kos, Mitja

doi:10.5504/bbeq.2012.0009

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…Among studies that evaluated the cost-effectiveness of single anti-hypertensive drugs, diuretics were found to be the most cost-effective; for initiation as monotherapy [ 35 ], for use in high risk groups [ 16 ], and at various absolute CVD risk levels [ 36 ]. Other BP-lowering medication had comparatively higher cost-effectiveness ratios or were cost-ineffective [ 16 , 18 , 35 , 36 ] except for Candesartan, which was found to be cost-effective compared to other Angiotensin II receptor blockers in South Africa [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…A societal perspective was used in 12 studies; however in eight, there was no estimation of productivity loss [ 17 , 21 , 24 , 30 , 40 , 47 , 51 , 64 ]. Two studies used the third party payer perspective [ 35 , 36 ], one used the patient perspective [ 34 ] and two did not state their perspective [ 26 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…As regards discounting, 40 out of the 50 used discounting for cost and outcomes, most (n = 37) used 3% as their discounting factor. Two of them used 5% [ 33 , 35 ] and one used 7% [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

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Primary and secondary prevention interventions for cardiovascular disease in low-income and middle-income countries: a systematic review of economic evaluations

Aminde

Fongwen

Zapata-Diomedi

et al. 2018

Cost Eff Resour Alloc

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BackgroundCardiovascular disease (CVD) is the leading cause of deaths globally, with greatest premature mortality in the low- and middle-income countries (LMIC). Many of these countries, especially in sub-Saharan Africa, have significant budget constraints. The need for current evidence on which interventions offer good value for money to stem this CVD epidemic motivates this study.MethodsIn this systematic review, we included studies reporting full economic evaluations of individual and population-based interventions (pharmacologic and non-pharmacologic), for primary and secondary prevention of CVD among adults in LMIC. Several medical (PubMed, EMBASE, SCOPUS, Web of Science) and economic (EconLit, NHS EED) databases and grey literature were searched. Screening of studies and data extraction was done independently by two reviewers. Drummond’s checklist and the National Institute for Health and Care Excellence quality rating scale were used in the quality appraisal for all studies used to inform this evidence synthesis.ResultsFrom a pool of 4059 records, 94 full texts were read and 50 studies, which met our inclusion criteria, were retained for our narrative synthesis. Most of the studies were from middle-income countries and predominantly of high quality. The majority were modelled evaluations, and there was significant heterogeneity in methods. Primary prevention studies dominated secondary prevention. Most of the economic evaluations were performed for pharmacological interventions focusing on blood pressure, cholesterol lowering and antiplatelet aggregants. The greatest majority were cost-effective. Compared to individual-based interventions, population-based interventions were few and mostly targeted reduction in sodium intake and tobacco control strategies. These were very cost-effective with many being cost-saving.ConclusionsThis evidence synthesis provides a contemporary update on interventions that offer good value for money in LMICs. Population-based interventions especially those targeting reduction in salt intake and tobacco control are very cost-effective in LMICs with potential to generate economic gains that can be reinvested to improve health and/or other sectors. While this evidence is relevant for policy across these regions, decision makers should additionally take into account other multi-sectoral perspectives, including considerations in budget impact, fairness, affordability and implementation while setting priorities for resource allocation.Electronic supplementary materialThe online version of this article (10.1186/s12962-018-0108-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Primary and secondary prevention interventions for cardiovascular disease in low-income and middle-income countries: a systematic review of economic evaluations

Aminde

Fongwen

Zapata-Diomedi

et al. 2018

Cost Eff Resour Alloc

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“…The practical application of the Markov model in Serbia has been recognized in different diseases (19)(20)(21)(22), and within biochemical markers (23,24).…”

Section: Hipotetički Izgled Markovljevog Modelamentioning

confidence: 99%

Modelling in economic evaluations of medicines

Lakic¹,

Stević²,

Odalović³

et al. 2021

Arhiv za farmaciju

Self Cite

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Economic evaluation in health (also known as pharmacoeconomic in case of medicines) identifies, measures, and values costs and outcomes of alternative healthcare technologies, and can be performed alongside controlled clinical trials, but analytical modelling is usually used. Decision trees and Markov models are the two most common approaches used in economic evaluation. The biggest advantages of a decision tree are clarity, simplicity, and straightforwardness. On the other hand, the main advantage of the Markov model is its ability to incorporate complex events into the simulation, which is practically impossible to do with a decision tree. Reimbursement policy in Serbia mandatorily incorporates economic evaluations to promote availability and accessibility of the prescription medicines. To show current pharmacoeconomic value of a medicine, budget impact analysis and the cost-effectiveness analysis should be included. The latter should be conducted using appropriate modelling techniques. However, since no official methodological guidelines about the modelling and economic analysis exist, the submissions by marketing authorization holders vary greatly. The future of pharmacoeconomic modelling depends on the research area of interest, with new frameworks and approaches being developed.

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Reviewing Transferability in Economic Evaluations Originating From Eastern Europe

Mandrik

Knies

Kaló

et al. 2015

Int J Technol Assess Health Care

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Objectives: The aim of this study is to analyze the quality and transferability issues reported in published peer-reviewed English-language economic evaluations based in healthcare settings of the Central and Eastern European (CEE) and former Soviet countries.Methods: A systematic search of economic evaluations of healthcare interventions was performed for Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Turkmenistan, Kazakhstan, Lithuania, the former Yugoslav Republic of Macedonia, Republic of Moldova, Romania, the Russian Federation, Serbia, Slovenia, and Ukraine. The included studies were assessed according to their characteristics, quality (using Drummond's checklist), use of local data, and the transferability of inputs and results, if addressed.Results: Most of the thirty-four economic evaluations identified were conducted from a healthcare or payer perspective (74 percent), with 47 percent of studies focusing on infectious diseases. The least frequently and transparently addressed parameters were the items’ stated perspectives, relevant costs included, accurately measured costs in appropriate units, outcomes and costs credibly valued, and uncertainties addressed. Local data were often used to assess unit costs, baseline risk, and resource usage, while jurisdiction-specific utilities were included in only one study. Only 32 percent of relevant studies discussed the limitations of using foreign data, and 36 percent of studies discussed the transferability of their own study results to other jurisdictions.Conclusions: Transferability of the results is not sufficiently discussed in published economic evaluations. To simplify the transferability of studies to other jurisdictions, the following should be comprehensively addressed: uncertainty, impact of influential parameters, and data transferability. The transparency of reporting should be improved.

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The Cost-Effectiveness of Hypertension Pharmacotherapy in Serbia: A Markov Model

Cited by 4 publications

References 40 publications

Primary and secondary prevention interventions for cardiovascular disease in low-income and middle-income countries: a systematic review of economic evaluations

Primary and secondary prevention interventions for cardiovascular disease in low-income and middle-income countries: a systematic review of economic evaluations

Modelling in economic evaluations of medicines

Reviewing Transferability in Economic Evaluations Originating From Eastern Europe

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