scholarly journals Cost-Utility Analysis of the EVOLVO Study on Remote Monitoring for Heart Failure Patients With Implantable Defibrillators: Randomized Controlled Trial

2013 ◽  
Vol 15 (5) ◽  
pp. e106 ◽  
Author(s):  
Paolo Zanaboni ◽  
Maurizio Landolina ◽  
Maurizio Marzegalli ◽  
Maurizio Lunati ◽  
Giovanni B Perego ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomized Controlled Trial ◽  
Remote Monitoring ◽  
Controlled Trial ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Implantable Defibrillators ◽  
Utility Analysis ◽  
Heart Failure Patients ◽  
Randomized Controlled

scholarly journals Percutaneous laser disc decompression versus microdiscectomy for sciatica: Cost utility analysis alongside a randomized controlled trial

2017 ◽  
Vol 23 (5) ◽  
pp. 538-545 ◽  
Author(s):  
M Elske van den Akker-van Marle ◽  
Patrick A Brouwer ◽  
Ronald Brand ◽  
Bart Koes ◽  
Wilbert B van den Hout ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Health Care Use ◽  
Utility Analysis ◽  
Conventional Surgery ◽  
Societal Costs ◽  
Randomized Controlled ◽  
Laser Disc

Background Percutaneous laser disc decompression (PLDD) for patients with lumbar disc herniation is believed to be cheaper than surgery. However, cost-effectiveness has never been studied. Materials and Methods A cost utility analysis was performed alongside a randomized controlled trial comparing PLDD and conventional surgery. Patients reported their quality of life using the EuroQol five dimensions questionnaire (EQ-5D), 36-item short form health survey (SF-36 and derived SF-6D) and a visual analogue scale (VAS). Using cost diaries patients reported health care use, non-health care use and hours of absenteeism from work. The 1-year societal costs were compared with 1-year quality adjusted life years (QALYs) based on the United States (US) EQ-5D. Sensitivity analyses were carried out on the use of different utility measures (Netherland (NL) EQ-5D, SF-6D, or VAS) and on the perspective (societal or healthcare). Results On the US EQ-5D, conventional surgery provided a non-significant gain in QALYs of 0.033 (95% confidence interval (CI) −0.026 to 0.093) in the first year. PLDD resulted in significantly lower healthcare costs (difference €1771, 95% CI €303 to €3238) and non-significantly lower societal costs (difference €2379, 95% CI −€2860 to €7618). For low values of the willingness to pay for a QALY, the probability of being cost-effective is in favor of PLDD. For higher values of the willingness to pay, between €30,000 and €70,000, conventional microdiscectomy becomes favorable. Conclusions From a healthcare perspective PLDD, followed by surgery when needed, results in significantly lower 1-year costs than conventional surgery. From a societal perspective PLDD appears to be an economically neutral innovation.

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