scholarly journals Clinical outcomes and cost effectiveness of computer‐guided versus conventional implant‐retained hybrid prostheses: A long‐term retrospective analysis of treatment protocols

2018 ◽  
Vol 89 (9) ◽  
pp. 1015-1024 ◽  
Author(s):  
Andrea Ravidà ◽  
Shayan Barootchi ◽  
Mustafa Tattan ◽  
Muhammad H. A. Saleh ◽  
Jordi Gargallo‐Albiol ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Treatment Protocols

Brentuximab vedotin in relapsed/refractory Hodgkin lymphoma following autologous stem cell transplant: A cost-effectiveness analysis updated with 5-year follow-up data from the pivotal trial.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 19-19 ◽  
Author(s):  
Christopher Parker ◽  
Gemma Kay ◽  
Esprit Ma ◽  
Beth Woods ◽  
James Eaton ◽  
...  
Keyword(s):  
Stem Cell ◽  
Cost Effectiveness ◽  
Clinical Outcomes ◽  
Brentuximab Vedotin ◽  
Sensitivity Analyses ◽  
Pivotal Trial ◽  
Effectiveness Analysis ◽  
The Cost

19 Background: In 2015, the Scottish Medicines Consortium (SMC) made a positive recommandation for brentuximab vedotin (BV) in patients with relapsed or refractory (R/R) Hodgkin lymphoma (HL) who have received autologous stem cell transplantation (ASCT) based on 3-year follow-up data from the pivotal phase 2 single-arm trial (SG035-0003; NCT00848926). At 3-years, the incremental cost-effectiveness ratio (ICER) for brentuximab vedotin compared with chemotherapy +/- radiotherapy (C/R) was £43,731 per quality-adjusted life year (QALY). This study re-evaluated the cost-effectiveness analysis with 5-year follow-up data from the pivotal trial. Methods: A partitioned survival model was developed using a Scottish health system perspective over a lifetime time-horizon. Three health states were evaluated: progression-free survival (PFS), post-progression survival, and death. The relevant comparators were C/R, or C/R with intent to allogeneic stem cell transplantation. Clinical outcomes (PFS and overall survival [OS]) for BV were estimated based on data from the pivotal trial in 102 patients. A naïve comparison with the specified comparators was conducted using published survival data. ICERs were calculated with measures of the clinical outcomes, direct costs and QALYs. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness of the model. Results: The 5-year follow-up data reduced the base case ICER for BV from £43,731 to £38,769 per QALY versus C/R and increased the probability of cost-effectiveness. The variation in ICER for BV generated by the deterministic sensitivity analyses was also reduced resulting from reduced uncertainty in the estimation of long term clinical outcomes. Conclusions: This update has strengthened the cost-effectiveness evidence for BV in patients with R/R HL post-ASCT. The 5-year follow-up has reduced the uncertainty in the long term outcomes and reduced the ICER, which is low in comparison to other treatments for orphan diseases approved by UK agencies. BV may therefore represent a cost-effective treatment option for this patient group.

scholarly journals What Is Success? A Narrative Review of Research Evaluating Outcomes of Antibiotics Used for Treatment of Clinical Mastitis

2021 ◽  
Vol 8 ◽  
Author(s):  
Pamela L. Ruegg
Keyword(s):  
Clinical Outcomes ◽  
Antimicrobial Therapy ◽  
Clinical Mastitis ◽  
Careful Consideration ◽  
High Rate ◽  
Therapeutic Success ◽  
Treatment Protocols ◽  
Is Success ◽  
Selection Of

Treatment of clinical mastitis is the most common reason that antimicrobials are given to adult dairy cows and careful consideration of treatment protocols is necessary to ensure responsible antimicrobial stewardship. Clinical mastitis is caused by a variety of bacteria which stimulate an immune response that often results in spontaneous bacteriological clearance but can develop into long-term subclinical infections. Use of antimicrobial therapy is most beneficial for cases that are caused by pathogens that have a low rate of spontaneous cure but high rate of therapeutic cure. The purpose of this paper is to review studies that evaluated outcomes of antimicrobial therapy of clinical mastitis. Few studies reported differences in bacteriological cure among treatments and this outcome was rarely associated with clinical outcomes. Return to normal milk appearance was evaluated in most studies but demonstrated little variation and is not a reliable indicator of therapeutic success. Somatic cell count should be measured at quarter-level and will decline gradually after bacteriological clearance. Few researchers have evaluated important clinical outcomes such as post-treatment milk yield or culling. Few differences among approved antimicrobial therapies have been demonstrated and selection of antimicrobial therapy should consider the spectrum of activity relative to etiology.

scholarly journals Lifetime quality of life and cost consequences of delays in endovascular treatment for acute ischaemic stroke: a cost-effectiveness analysis from a Singapore healthcare perspective

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036517
Author(s):  
Weiyi Ni ◽  
Wolfgang Kunz ◽  
Mayank Goyal ◽  
Yu Li Ng ◽  
Kelvin Tan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Willingness To Pay ◽  
Clinical Outcomes ◽  
Acute Ischaemic Stroke ◽  
Symptom Onset ◽  
Time Window ◽  
Stroke Onset ◽  
Short Term ◽  
Healthcare Perspective

ObjectivesEndovascular therapy (EVT) significantly improves clinical outcomes in patients with acute ischaemic stroke (AIS), while the time of EVT initiation after stroke onset influences both patient clinical outcomes and healthcare costs. This study determined the impact of EVT treatment delay on cost effectiveness of EVT in the Singapore healthcare setting.DesignA short-term decision tree and long-term Markov health state transition model was constructed. For each time window of symptom onset to EVT, the probability of receiving EVT or non-EVT treatment was varied, thereby varying clinical outcomes (modified Rankin Scale scores), short-term costs and long-term modelled (lifetime) costs; all of which were used in calculating an incremental cost-effectiveness ratio of EVT vs non-EVT treatment. Clinical outcomes and cost data were derived from clinical trials, literature, expert opinion, electronic medical records and community-based surveys from Singapore. Deterministic one-way and probabilistic sensitivity analyses were performed to assess the uncertainty of the model. The willingness to pay for per quality-adjusted life-year (QALY) was set to Singapore $50 000 (US$36 500).SettingSingapore healthcare perspective.ParticipantsThe model included patients with AIS in Singapore.InterventionsEVT performed within 6 hours of stroke onset.Outcome measuresThe model estimated incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMB) for EVT versus non-EVT treatment, varied by time from symptom onset to time of treatment.ResultsEVT performed between 61 min and 120 min after the stroke onset was most cost-effective time window to perform EVT in the Singapore population, with an ICER of Singapore $7197 per QALY (US$5254) for performing EVT at 61–120 min versus 121–180 min. The resulting incremental NMB associated with receipt of EVT at the earlier time point is Singapore $39 827 (US$29 074) per patient at the willingness-to-pay threshold of Singapore $50 000. Each hour delay in EVT resulted in an average loss of 0.54 QALYs and 195.35 healthy days, with an average net monetary loss of Singapore $26 255 (US$19 166).ConclusionsFrom the Singapore healthcare perspective, although EVT is more expensive than alternative treatments in the short term, the lifetime ICER is below the willingness-to-pay threshold. Thus, healthcare policies and procedures should aim to improve efficiency of pre-hospital and in-hospital workflow processes to reduce the onset-to-puncture duration.

Implementation of a multifaceted sepsis education program in an emerging country setting: clinical outcomes and cost-effectiveness in a long-term follow-up study

2013 ◽  
Vol 40 (2) ◽  
pp. 182-191 ◽  
Author(s):  
Danilo Teixeira Noritomi ◽  
Otavio T. Ranzani ◽  
Mariana Barbosa Monteiro ◽  
Elaine Maria Ferreira ◽  
Sergio Ricardo Santos ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Clinical Outcomes ◽  
Education Program ◽  
Follow Up Study ◽  
Emerging Country ◽  
Long Term Follow Up

Long-term outcomes of medical therapy in patients with acromegaly: a retrospective analysis

2017 ◽  
Author(s):  
Iulia Simona Soare ◽  
Minodora Andreea Betivoiu ◽  
Sorina Carmen Martin ◽  
Anca Elena Sirbu ◽  
Carmen Gabriela Barbu ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Medical Therapy ◽  
Long Term Outcomes
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