scholarly journals Cost Comparisons between Home- and Clinic-Based Testing for Sexually Transmitted Diseases in High-Risk Young Women

2007 ◽  
Vol 2007 ◽  
pp. 1-5 ◽  
Author(s):  
Kenneth J. Smith ◽  
Robert L. Cook ◽  
Roberta B. Ness
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Controlled Trial ◽  
Cost Savings ◽  
Indirect Costs ◽  
Sexually Transmitted ◽  
Home Based ◽  
Home Testing ◽  
Testing Cost ◽  
The Cost

Home testing for chlamydia and gonorrhea increases screening rates, but the cost consequences of this intervention are unclear. We examined the cost differences between home-based and clinic-based testing and the cost-effectiveness of home testing based on the DAISY study, a randomized controlled trial. Direct and indirect costs were estimated for home and clinic testing, and cost-effectiveness was calculated as cost per additional test performed. In the clinic testing group, direct costs were $49/test and indirect costs (the costs of seeking or receiving care) were $62/test. Home testing cost was $25/test. We found that home testing was cost saving when all testing for all patients was considered. However cost savings were not seen when only asymptomatic tests or when patient subgroups were considered. A home testing program could be cost saving, depending on whether changes in clinic testing frequency occur when home testing is available.

scholarly journals Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045113
Author(s):  
Constantine Vardavas ◽  
Katerina Nikitara ◽  
Konstantinos Zisis ◽  
Konstantinos Athanasakis ◽  
Revati Phalkey ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Respiratory Disease ◽  
Disease Outbreaks ◽  
Indirect Costs ◽  
Direct And Indirect Costs ◽  
Infectious Disease Outbreaks ◽  
The Cost

ObjectivesRespiratory infectious disease outbreaks pose a threat for loss of life, economic instability and social disruption. We conducted a systematic review of published econometric analyses to assess the direct and indirect costs of infectious respiratory disease outbreaks that occurred between 2003 and 2019.SettingRespiratory infectious disease outbreaks or public health preparedness measures or interventions responding to respiratory outbreaks in OECD countries (excluding South Korea and Japan) so as to assess studies relevant to the European context. The cost-effectiveness of interventions was assessed through a dominance ranking matrix approach. All cost data were adjusted to the 2017 Euro, with interventions compared with the null. We included data from 17 econometric studies.Primary and secondary outcome measuresDirect and indirect costs for disease and preparedness and/or response or cost-benefit and cost-utility were measured.ResultsOverall, the economic burden of infectious respiratory disease outbreaks was found to be significant to healthcare systems and society. Indirect costs were greater than direct costs mainly due to losses of productivity. With regard to non-pharmaceutical strategies, prehospitalisation screening and the use of protective masks were identified as both an effective strategy and cost-saving. Community contact reduction was effective but had ambiguous results for cost saving. School closure was an effective measure, but not cost-saving in the long term. Targeted antiviral prophylaxis was the most cost-saving and effective pharmaceutical intervention.ConclusionsOur cost analysis results provide evidence to policymakers on the cost-effectiveness of pharmaceutical and non-pharmaceutical intervention strategies which may be applied to mitigate or respond to infectious respiratory disease outbreaks.

scholarly journals Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive–compulsive disorder: results from a randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (5) ◽  
pp. e015246 ◽  
Author(s):  
Fabian Lenhard ◽  
Richard Ssegonja ◽  
Erik Andersson ◽  
Inna Feldman ◽  
Christian Rück ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Controlled Trial ◽  
Cost Savings ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Waitlist Control ◽  
Compulsive Disorder ◽  
Cognitive Behaviour ◽  
Randomised Controlled ◽  
The Cost

ObjectivesTo evaluate the cost-effectiveness of a therapist-guided internet-delivered cognitive behaviour therapy (ICBT) intervention for adolescents with obsessive–compulsive disorder (OCD) compared with untreated patients on a waitlist.DesignSingle-blinded randomised controlled trial.SettingA research clinic within the regular child and adolescent mental health service in Stockholm, Sweden.ParticipantsSixty-seven adolescents (12–17 years) with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnosis of OCD.InterventionsEither a 12-week, therapist-guided ICBT intervention or a wait list condition of equal duration.Primary outcome measuresCost data were collected at baseline and after treatment, including healthcare use, supportive resources, prescription drugs, prescription-free drugs, school absence and productivity loss, as well as the cost of ICBT. Health outcomes were defined as treatment responder rate and quality-adjusted life years gain. Bootstrapped mixed model analyses were conducted comparing incremental costs and health outcomes between the groups from the societal and healthcare perspectives.ResultsCompared with waitlist control, ICBT generated substantial societal cost savings averaging US$−144.98 (95% CI −159.79 to –130.16) per patient. The cost reductions were mainly driven by reduced healthcare use in the ICBT group. From the societal perspective, the probability of ICBT being cost saving compared with waitlist control was approximately 60%. From the healthcare perspective, the cost per additional responder to ICBT compared with waitlist control was approximately US$78.ConclusionsThe results suggest that therapist-guided ICBT is a cost-effective treatment and results in societal cost savings, compared with patients who do not receive evidence-based treatment. Since, at present, most patients with OCD do not have access to evidence-based treatments, the results have important implications for the increasingly strained national and healthcare budgets. Future studies should compare the cost-effectiveness of ICBT with regular face-to-face CBT.Trial registration numberNCT02191631.

scholarly journals Cost-effectiveness of financial incentives to improve glycemic control in adults with diabetes: A pilot randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248762
Author(s):  
Leonard E. Egede ◽  
Rebekah J. Walker ◽  
Clara E. Dismuke-Greer ◽  
Sarah Pyzyk ◽  
Aprill Z. Dawson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Time Frame ◽  
Home Testing ◽  
Incentive Structures ◽  
Intervention Cost ◽  
The Cost ◽  
Group 1

Purpose Determine the cost-effectiveness of three financial incentive structures in obtaining a 1% within group drop in HbA1c among adults with diabetes. Methods 60 African Americans with type 2 diabetes were randomized to one of three financial incentive structures and followed for 3-months. Group 1 (low frequency) received a single incentive for absolute HbA1c reduction, Group 2 (moderate frequency) received a two-part incentive for home testing of glucose and absolute HbA1c reduction and Group 3 (high frequency) received a multiple component incentive for home testing, attendance of weekly telephone education classes and absolute HbA1c reduction. The primary clinical outcome was HbA1c reduction within each arm at 3-months. Cost for each arm was calculated based on the cost of the intervention, cost of health care visits during the 3-month time frame, and cost of workdays missed from illness. Incremental cost effectiveness ratios (ICER) were calculated based on achieving a 1% within group drop in HbA1c and were bootstrapped with 1,000 replications. Results The ICER to decrease HbA1c by 1% was $1,100 for all three arms, however, bootstrapped standard errors differed with Group 1 having twice the variation around the ICER coefficient as Groups 2 and 3. ICERs were statistically significant for Groups 2 and 3 (p<0.001) indicating they are cost effective interventions. Conclusions Given ICERs of prior diabetes interventions range from $1,000-$4,000, a cost of $1,100 per 1% within group decrease in HbA1c is a promising intervention. Multi-component incentive structures seem to have the least variation in cost-effectiveness.

Comparing Expenditures in Depressed Patients Treated with Venlafaxine ER and SSRIs

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S13) ◽  
pp. 1-7
Author(s):  
Diane M. Sloan ◽  
Jacques LeLorier
Keyword(s):  
Cost Effectiveness ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Cost Savings ◽  
Indirect Costs ◽  
Patient Characteristics ◽  
Medical Costs ◽  
Direct Medical Costs ◽  
Medical Visits ◽  
Study Results ◽  
The Cost

AbstractDepression is a chronic illness whose true costs to society are unclear. The costs associated with depression are direct (drugs and treatment), indirect (absenteeism and loss of productivity), and intangible (quality of life). Direct costs are usually easy to quantify. Indirect costs often test the ingenuity of researchers whose results are, at best, crude approximations. Intangible costs are elusive and may never be measured with any degree of accuracy. To compound matters further, many patients with depression have never been diagnosed, which complicates the cost accounting analysis of depression from a societal perspective. What is clear is that the worldwide costs of depression are climbing The overall costs of treating depression attributable to drug therapy are modest. The appropriate choice of antidepressant therapy is likely to be the product that provides the highest effectiveness in terms of overall costs. As a result, it is important that prescribers have an idea of the benefit derived from the cost of drugs, and how the cost effectiveness of different drugs compare.Previous studies of antidepressant cost effectiveness have suggested that the use of venlafaxine, which costs more than generic selective serotonin reuptake inhibitors (SSRIs), may be no more costly when total costs (eg, how many drugs were prescribed, how many medical or emergency room visits patients had, and how often they were hospitalized) are calculated. The objectives of this retrospective, populationbased, database study were to identify patient characteristics and factors associated with the choice of antidepressant in order to assess differences in persistence, healthcare utilization, and direct medical costs associated with venlafaxine and SSRI pharmacotherapy.Study results indicated that in this real-world setting, medical costs were similar among depressive patients treated with venlafaxine and SSRIs. The higher purchase price of venlafaxine was balanced by cost savings due to fewer hospitalizations and fewer outpatient medical visits. Differences in drug treatment may also partially explicate the observed differences in average direct medical costs between venlafaxine and SSRIs.

A Cost-Effectiveness Comparison of Surgical Treatments for Mitral Valve Disease

1988 ◽  
Vol 4 (3) ◽  
pp. 447-461
Author(s):  
Basil N. Papageorge ◽  
Stuart O. Schweitzer
Keyword(s):  
Cost Effectiveness ◽  
Mitral Valve ◽  
Cost Savings ◽  
Indirect Costs ◽  
Direct And Indirect Costs ◽  
Mitral Valve Reconstruction ◽  
Valve Reconstruction ◽  
Early Reconstruction ◽  
Surgical Treatments ◽  
The Cost

AbstractThis study compares the cost-effectiveness of mitral valve reconstruction and replacement. Published clinical data were used to determine the effectiveness of each procedure. Both direct and indirect costs were calculated. The findings indicate that reconstruction has lower costs per year of life extended than replacement due to better outcomes. Changing outcome probabilities and discount rates did not alter these results. Cost savings in excess of 40% may be achieved by early reconstruction for suitable patients. These results suggest that the prevailing practice of delaying surgery until replacement is needed should be reconsidered, especially for patients who could benefit from reconstruction.

scholarly journals Tranexamic acid for the prevention of postpartum hemorrhage: a cost-effectiveness analysis

2021 ◽  
Author(s):  
Wayde Dazelle ◽  
Megan Ebner ◽  
Jamil Kazma ◽  
Homa Ahmadzia
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Cost Savings ◽  
The United States ◽  
Status Quo ◽  
Maternal Outcomes ◽  
The Status ◽  
The Cost

Objectives: To estimate the cost-effectiveness of alternative risk-dictated strategies utilizing prophylactic tranexamic acid (TXA) for the prevention of postpartum hemorrhage (PPH). Study Design: We constructed a microsimulation-based Markov decision-analytic model estimating the cost-effectiveness of three alternative risk-dictated strategies for TXA prophylaxis versus the status quo (no TXA) in a cohort of 3.8 million pregnant women delivering in the United States. Each strategy differentially modified risk-specific hemorrhage probabilities by preliminary estimates of TXA’s prophylactic efficacy. Outcome measures included incremental costs, quality-adjusted life-years (QALYs), and adverse maternal outcomes averted. Costs and benefits were considered from the healthcare system and societal perspectives over a lifetime time horizon. Results: All TXA strategies were dominant versus the status quo, implying that they were more effective while also being cost-saving. Providing TXA to all delivering women irrespective of hemorrhage risk produced the most favorable results overall, with estimated cost savings greater than $670 million and up to 149,505 PPH cases, 2,933 hysterectomies, and 70 maternal deaths averted, per annual cohort. Threshold analysis suggested that TXA is likely to be cost-saving for health systems at costs below $184 per gram. Conclusions: Our findings suggest that routine prophylaxis with TXA would likely result in substantial cost-savings and reductions in adverse maternal outcomes in this context. The integrity of this conclusion is maintained across all risk-dictated strategies, even when the cost of TXA is significantly higher than what is supported in the literature.

scholarly journals Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Mori ◽  
Carolyn J. Crandall ◽  
Tomoko Fujii ◽  
David A. Ganz
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Zoledronic Acid ◽  
Cost Saving ◽  
Fragility Fracture ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Term Care ◽  
Lifetime Horizon ◽  
The Cost

Abstract Summary Among hypothetical cohorts of older osteoporotic women without prior fragility fracture in Japan, we evaluated the cost-effectiveness of two treatment strategies using a simulation model. Annual intravenous zoledronic acid for 3 years was cost-saving compared with biannual subcutaneous denosumab for 3 years followed by weekly oral alendronate for 3 years. Purpose Osteoporosis constitutes a major medical and health economic burden to society worldwide. Injectable treatments for osteoporosis require less frequent administration than oral treatments and therefore have higher persistence and adherence with treatment, which could explain better efficacy for fracture prevention. Although annual intravenous zoledronic acid and biannual subcutaneous denosumab are available, it remains unclear which treatment strategy represents a better value from a health economic perspective. Accordingly, we examined the cost-effectiveness of zoledronic acid for 3 years compared with sequential denosumab/alendronate (i.e., denosumab for 3 years followed by oral weekly alendronate for 3 years, making the total treatment duration 6 years) among hypothetical cohorts of community-dwelling osteoporotic women without prior fragility fracture in Japan at ages 65, 70, 75, or 80 years. Methods Using a previously validated and updated Markov microsimulation model, we obtained incremental cost-effectiveness ratios (Japanese yen [¥] (or US dollars [$]) per quality-adjusted life-year [QALY]) from the public healthcare and long-term care payer’s perspective over a lifetime horizon with a willingness-to-pay of ¥5 million (or $47,500) per QALY. Results In the base case, zoledronic acid was cost-saving (i.e., more effective and less expensive) compared with sequential denosumab/alendronate. In deterministic sensitivity analyses, results were sensitive to changes in the efficacy of zoledronic acid or the cumulative persistence rate with zoledronic acid or denosumab. In probabilistic sensitivity analyses, the probabilities of zoledronic acid being cost-effective were 98–100%. Conclusions Among older osteoporotic women without prior fragility fracture in Japan, zoledronic acid was cost-saving compared with sequential denosumab/alendronate.

scholarly journals Cost-effectiveness analysis of an intimate partner violence prevention intervention targeting men, women and couples in rural Ethiopia: evidence from the Unite for a Better Life randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042365
Author(s):  
Jessica Leight ◽  
Negussie Deyessa ◽  
Vandana Sharma
Keyword(s):  
Intimate Partner Violence ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Partner Violence ◽  
Controlled Trial ◽  
Intimate Partner ◽  
Community Level ◽  
Secondary Outcome ◽  
Randomised Controlled ◽  
The Cost

ObjectivesExperience of intimate partner violence (IPV) is associated with adverse health and psychosocial outcomes for women. However, rigorous economic evaluations of interventions targeting IPV prevention are rare. This paper analyses the cost-effectiveness of Unite for a Better Life (UBL), a gender-transformative intervention designed to prevent IPV and HIV risk behaviours among men, women and couples.DesignWe use an economic evaluation nested within a large-scale cluster randomised controlled trial, analysing financial and economic costs tracked contemporaneously.SettingUBL was implemented in rural southern Ethiopia between 2013 and 2015.ParticipantsThe randomised controlled trial included 6770 households in 64 villages.InterventionsUBL is an intervention delivered within the context of the Ethiopian coffee ceremony, a culturally established forum for community discussion, and designed to assist participants to build skills for healthy, non-violent, equitable relationships.Primary and secondary outcome measuresThis paper reports on the unit cost and cost-effectiveness of the interventions implemented. Cost-effectiveness is measured as the cost per case of past-year physical and/or sexual IPV averted.ResultsThe estimated annualised cost of developing and implementing UBL was 2015 US$296 772, or approximately 2015 US$74 per individual directly participating in the intervention and 2015 US$5 per person annually for each community-level beneficiary (woman of reproductive age in intervention communities). The estimated cost per case of past-year physical and/or sexual IPV averted was 2015 US$2726 for the sample of direct beneficiaries, and 2015 US$194 for the sample of all community-level beneficiaries.ConclusionsUBL is an effective and cost-effective intervention for the prevention of IPV in a low and middle-income country setting. Further research should explore strategies to quantify the positive effects of the intervention across other domains.Trial registration numberNCT02311699 (ClinicalTrials.gov); AEARCTR-0000211 (AEA Registry)

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