scholarly journals Secondary Healthcare Payer

2020 ◽  
Author(s):  
Keyword(s):  
Healthcare Payer

PP339 A Budget Impact Model Of The EluviaTM Drug-Eluting Stent from The Australian Public Hospital And National Payer Perspective

2020 ◽  
Vol 36 (S1) ◽  
pp. 29-29
Author(s):  
Nishath Altaf ◽  
Thathya V. Ariyaratne ◽  
Adrian Peacock ◽  
Irene Deltetto ◽  
Jad El-Hoss ◽  
...  
Keyword(s):  
Lower Limb ◽  
Public Hospital ◽  
Budget Impact ◽  
Healthcare Payer ◽  
Drug Eluting Stent ◽  
Public Healthcare ◽  
Impact Model ◽  
Drug Eluting ◽  
Budget Impact Model ◽  
Zilver Ptx

IntroductionImproving long-term outcomes like target lesions revascularizations (TLRs) is a focus for endovascular interventions aimed at treating symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a paclitaxel-eluting drug-eluting stent (DES) was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent in the IMPERIAL trial, a global, randomized controlled study. This budget-impact evaluation investigated cost-savings from Eluvia-use when compared with Zilver PTX, relying on the 12- to 24-month outcomes from the IMPERIAL trial.MethodsA budget-impact model comparing Eluvia and Zilver PTX was developed from the Australian public healthcare payer, and an individual hospital perspective, with a 5-year time-horizon. Observed trial results were applied to each year's incident population and associated costs, and no extrapolation was conducted. The analysis used publicly available Australian national hospital cost data, population estimates, procedural statistics, epidemiological literature, and data from public hospital audits to verify eligible population for endovascular procedures (EVP) including DES. All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020).ResultsAssuming 80-percent EVP eligibility, and a DES-use range of 10–28 percent, the 5-year model estimated potential national savings of AUD 4.3–12.1 million (M) [USD 3–8.3M] to the public healthcare payer, driven by reduced TLRs from Eluvia-use compared with Zilver-PTX. The model projected potential national savings of AUD 33.1–92.6M (USD 22.8–63.9M) to individual hospitals through reduced hospital bed days for adverse events (AE). The model forecasted 14,428–40,399 treated patients; 1,499–4,198 fewer TLRs; and 16,515–46,243 fewer hospital days for AE. At a state level, projected hospital savings were: New South Wales AUD 10.9–30.7M [USD 7.5–21.1M]; Victoria AUD 8.4–23.4M [USD 5.8–16.1M]; Queensland AUD 6.5–18.3M [USD 4.5–12.6M]; Western Australia AUD 3.4–9.5M [USD 2.3–6.5M]; South Australia AUD 2.3–6.4M [USD 1.6–4.4M].ConclusionsTreatment of symptomatic lower-limb PAD with the Eluvia DES could lead to potential savings for the Australian healthcare system, at the national, state, and the local hospital level, based on improved patient outcomes.

OP64 Economic Impact Of Cardiac Device Remote Monitoring In South Korea

2017 ◽  
Vol 33 (S1) ◽  
pp. 28-28
Author(s):  
Jeonghoon Ahn ◽  
Kim Eung Ju ◽  
Justin Yoo ◽  
Irene Colangelo ◽  
Loredana Morichelli ◽  
...  
Keyword(s):  
South Korea ◽  
Remote Monitoring ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Economic Benefits ◽  
Resource Consumption ◽  
Healthcare Payer ◽  
The South ◽  
South Korean

INTRODUCTION:The reduction of healthcare costs and societal cost due to remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been demonstrated in several countries; however, to the best of our knowledge it does not exist for South Korea. This work aims at providing an estimation of the potential benefit of RM versus standard care (SC) of CIEDs in term of healthcare costs in South Korea, in order to provide additional substance to the currently ongoing societal debate about the value of telemedicine.METHODS:Healthcare resource consumption was taken from the results of the TARIFF study, a prospective, non-randomized, multicenter clinical trial designed in Italy to assess the economic benefits of RM follow-up in comparison with standard follow-up in 209 patients (107 SC, 102 RM). The main results demonstrated that RM reduced healthcare resource consumption by 54 percent from a healthcare services perspective (SC: EUR1,044.89±1,990.47 versus RM: EUR482.87±2488.10, p<.0001 (1).In order to perform a cost analysis from the perspective of the South Korean healthcare payer, the following unit costs were assigned to resources collected in TARIFF (hospitalizations, visits, examinations): fee-for-service tariffs, emergency tariffs and outpatient tariffs. Remote follow-up costs were considered as zero.RESULTS:From the perspective of the South Korean healthcare payer, the overall mean annual cost/patient in the RM group is 53 percent lower than in SC group (SC: EUR405,439±40,135 versus RM: EUR189,96±725,52, p<.0001) (SC: KRW 497,145±49,2137 versus RM: KRW 232,936±890,181, p<.0001). This is mainly due to a significant cost reduction in device-related hospitalizations, examination tests and visits in the follow-up period.CONCLUSIONS:RM of CIED patients is cost-saving from the perspective of the South Korean healthcare system. Introducing appropriate reimbursement for remote monitoring of CIED is not likely to change this result and should make RM sustainable for the provider and encourage widespread adoption of RM.

Six Sigma to reduce claims processing errors in a healthcare payer firm

2019 ◽  
Vol 31 (6) ◽  
pp. 496-511 ◽  
Author(s):  
Vijaya Sunder M ◽  
Nidhin R. Kunnath
Keyword(s):  
Six Sigma ◽  
Healthcare Payer ◽  
Processing Errors

scholarly journals Cost-effectiveness of measles control during elimination in Ontario, Canada, 2015

2019 ◽  
Vol 24 (11) ◽  
Author(s):  
Lauren C Ramsay ◽  
Natasha S Crowcroft ◽  
Shari Thomas ◽  
Elena Aruffo ◽  
Alexandra Teslya ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Laboratory Data ◽  
Healthcare Payer ◽  
Sensitivity Analyses ◽  
Contact Tracing ◽  
Decision Analysis Model ◽  
Outbreak Response ◽  
Measles Outbreak ◽  
Payer Perspective ◽  
Life Years

Background Given that measles is eliminated in Canada and measles immunisation coverage in Ontario is high, it has been questioned whether Ontario’s measles outbreak response is worthwhile. Aim Our objective was to determine cost-effectiveness of measles containment protocols in Ontario from the healthcare payer perspective. Methods We developed a decision-analysis model comparing Ontario’s measles containment strategy (based on actual 2015 outbreak data) with a hypothetical ‘modified response’. The modified scenario assumed 10% response costs with reduced case and contact tracing and no outbreak-associated vaccinations; it was based on local and provincial administrative and laboratory data and parameters from peer-reviewed literature. Short- and long-term health outcomes, quality-adjusted life years (QALYs) and costs discounted at 1.5%, were estimated. We conducted one- and two-way sensitivity analyses. Results The 2015 outbreak in Ontario comprised 16 measles cases and an estimated 3,369 contacts. Predictive modelling suggested that the outbreak response prevented 16 outbreak-associated cases at a cost of CAD 1,213,491 (EUR 861,579). The incremental cost-effectiveness ratio was CAD 739,063 (EUR 524,735) per QALY gained for the outbreak response vs modified response. To meet the commonly accepted cost-effectiveness threshold of CAD 50,000 (EUR 35,500) per QALY gained, the outbreak response would have to prevent 94 measles cases. In sensitivity analyses, the findings were robust. Conclusions Ontario’s measles outbreak response exceeds generally accepted cost-effectiveness thresholds and may not be the most efficient use of public health resources from a healthcare payer perspective. These findings should be balanced against benefits of increased vaccine coverage and maintaining elimination status.

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