scholarly journals Benefits of Home-Based Solutions for Diagnosis and Treatment of Acute Coronary Syndromes on Health Care Costs: A Systematic Review

Sensors ◽  
2020 ◽  
Vol 20 (17) ◽  
pp. 5006
Author(s):  
Pau Redón ◽  
Atif Shahzad ◽  
Talha Iqbal ◽  
William Wijns
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Costs ◽  
Acute Coronary Syndromes ◽  
Clinical Evidence ◽  
Home Based ◽  
Risk Patients ◽  
Coronary Syndromes ◽  
Care Costs

Diagnosing and treating acute coronary syndromes consumes a significant fraction of the healthcare budget worldwide. The pressure on resources is expected to increase with the continuing rise of cardiovascular disease, other chronic diseases and extended life expectancy, while expenditure is constrained. The objective of this review is to assess if home-based solutions for measuring chemical cardiac biomarkers can mitigate or reduce the continued rise in the costs of ACS treatment. A systematic review was performed considering published literature in several relevant public databases (i.e., PUBMED, Cochrane, Embase and Scopus) focusing on current biomarker practices in high-risk patients, their cost-effectiveness and the clinical evidence and feasibility of implementation. Out of 26,000 references screened, 86 met the inclusion criteria after independent full-text review. Current clinical evidence highlights that home-based solutions implemented in primary and secondary prevention reduce health care costs by earlier diagnosis, improved patient outcomes and quality of life, as well as by avoidance of unnecessary use of resources. Economical evidence suggests their potential to reduce health care costs if the incremental cost-effectiveness ratio or the willingness-to-pay does not surpass £20,000/QALY or €50,000 limit per 20,000 patients, respectively. The cost-effectiveness of these solutions increases when applied to high-risk patients.

Economic health care costs of blood culture contamination: A systematic review

2019 ◽  
Vol 47 (8) ◽  
pp. 963-967 ◽  
Author(s):  
Casey Dempsey ◽  
Erik Skoglund ◽  
Kenneth L. Muldrew ◽  
Kevin W. Garey
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Blood Culture ◽  
Health Care Costs ◽  
Economic Health ◽  
Care Costs

Cost-effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints

2006 ◽  
Vol 22 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Jacques J. X. R. Geraets ◽  
Mariëlle E. J. B. Goossens ◽  
Camiel P. C. de Bruijn ◽  
Imelda J. M. de Groot ◽  
Albère J. S. Köke ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Treatment Period ◽  
Health Care Costs ◽  
Daily Activities ◽  
Graded Exercise Therapy ◽  
Graded Exercise ◽  
Health Related ◽  
Care Costs

Objectives:The present study evaluated the cost-effectiveness of a behavioral graded exercise therapy (GET) program compared with usual care (UC) in terms of the performance of daily activities by patients with chronic shoulder complaints in primary care.Methods:A total of 176 patients were randomly assigned either to GET (n=87) or to UC (n=89). Clinical outcomes (main complaints, shoulder disability [SDQ] and generic health-related quality of life [EQ-5D], and costs [intervention costs, direct health care costs, direct non–health-related costs, and indirect costs]) were assessed during the 12-week treatment period and at 52 weeks of follow-up.Results:Results showed that GET was more effective than UC in restoring daily activities as assessed by the main complaints instrument after the 12-week treatment period (p=.049; mean difference, 7.5; confidence interval [CI], 0.0–15.0). These effects lasted for at least 52 weeks (p=.025; mean difference 9.2; CI, 1.2–17.3). No statistically significant differences were found on the SDQ or EQ5D. GET significantly reduced direct health care costs (p=.000) and direct non–health care costs (p=.029). Nevertheless, total costs during the 1-year follow-up period were significantly higher (p=.001; GET=€530 versus UC=€377) due to the higher costs of the intervention. Incremental cost-effectiveness ratios for the main complaints (0–100), SDQ (0–100), and EQ-5D (−1.0–1.0) were €17, €74, and €5,278 per unit of improvement, respectively.Conclusions:GET proved to be more effective in the short- and long-term and reduces direct health care costs and direct non–health care costs but is associated with higher costs of the intervention itself.

scholarly journals Direct access physiotherapy for patients with musculoskeletal disorders: a systematic review

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Demont ◽  
A Bourmaud ◽  
A Kechichian ◽  
F Desmeules
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Adverse Events ◽  
Usual Care ◽  
Musculoskeletal Disorders ◽  
Health Care Costs ◽  
Family Physician ◽  
Direct Access ◽  
The Impact ◽  
Care Costs

Abstract Background Although the benefits of physiotherapy is well supported in the literature, the impact of having direct access to physiotherapy is not well established. Update of the current available evidence is warranted. The aim of this systematic review was to update the current evidence regarding the impact of direct access physiotherapy compared to usual care for patients with musculoskeletal disorders. Methods Systematic searches were conducted in 5 bibliographic databases up until May 2018. Two independent raters reviewed studies and used the Quality Assessment Tool for Quantitative Studies to conduct the methodological quality assessment and a data extraction regarding patient outcomes, adverse events, health care utilization and processes, patient satisfaction and health care costs. Results Sixteen studies of weak to moderate quality were included. Five studies found no significant differences in pain reduction between usual family physician led care and direct access physiotherapy. However, three studies reported better clinical outcomes in patients with direct access in terms of function and quality of life. Five studies did not observe any adverse events with direct access physiotherapy. Three studies showed shorter waiting time and four studies reported fewer number of physiotherapy visits with direct access. Three studies showed that patients with direct access were less likely to have medication and imaging tests prescribed compared to usual care. Five studies reported higher levels of satisfaction for direct access. In terms of health care costs, four studies demonstrated that costs were lower with direct access and one study reported similar costs between both types of care. Conclusions Emerging evidence, although of weak to moderate quality, suggest that direct access physiotherapy provides equal or better outcomes than family physician led care models for musculoskeletal disorders patients. More methodologically strong studies are needed. Key messages This review supports the efficacy, safety and cost-effectiveness of direct access PT, while increasing access to care with a more efficient use of resources. There is a need for more methodologically strong studies to evaluate the efficiency of direct access models of care of physiotherapy for patients with MSKD.

scholarly journals PDB38 Obesity and Weight Change Effects on Health Care Costs of Diabetes: A Systematic Review Study

2012 ◽  
Vol 15 (4) ◽  
pp. A177
Author(s):  
A. Sharifi ◽  
A. Farshchi ◽  
M. Naghavi ◽  
A. Esteghamati
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Costs ◽  
Weight Change ◽  
Review Study ◽  
Care Costs

scholarly journals Cost-Effectiveness Analysis of Brentuximab Vedotin With Chemotherapy in Newly Diagnosed Stage III and IV Hodgkin Lymphoma

2018 ◽  
Vol 36 (33) ◽  
pp. 3307-3314 ◽  
Author(s):  
Scott F. Huntington ◽  
Gottfried von Keudell ◽  
Amy J. Davidoff ◽  
Cary P. Gross ◽  
Sapna A. Prasad
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Costs ◽  
Brentuximab Vedotin ◽  
Stage Iii ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Line Setting ◽  
Care Costs

Purpose In a recent randomized, open-label trial (ECHELON-1), brentuximab vedotin (BV) combined with doxorubicin, vinblastine, and dacarbazine (AVD+BV) decreased the risk of progression in adults diagnosed with stage III or IV Hodgkin lymphoma (HL) compared with standard bleomycin-containing chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]). However, the cost effectiveness of incorporating BV (US$6,970 per 50-mg vial) into the first-line setting is unknown. Patients and Methods We constructed a Markov decision-analytic model to measure the costs and clinical outcomes for AVD+BV compared with ABVD as first-line therapy in a cohort of patients with stage III or IV HL. Transition probabilities were estimated from ECHELON-1 by fitting parametric survival distributions. Lifetime direct health care costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for AVD+BV compared with ABVD from a US payer perspective. Our model was also used to estimate BV price reductions that would achieve more favorable cost effectiveness under indication-specific pricing. Results AVD+BV was associated with an improvement of 0.56 QALYs compared with treatment with standard ABVD. However, incorporating BV into first-line therapy led to significantly higher lifetime health care costs ($361,137 v $184,291), causing the ICER for AVD+BV to be $317,254 per QALY. If indication-specific pricing were implemented, acquisition costs for BV used in the first-line setting would need to be reduced by 56% to 73% for ICERs of $150,000 to $100,000 per QALY, respectively. Conclusion Substituting BV for bleomycin during first-line therapy for stage III or IV HL is unlikely to be cost effective under current drug pricing. Should indication-specific pricing be implemented, significant price reductions for BV used in the first-line setting would be needed to reduce ICERs to more widely acceptable values.

Is it cost-effective to add erlotinib to gemcitabine in advanced pancreatic cancer?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6048-6048 ◽  
Author(s):  
S. S. Grubbs ◽  
P. A. Grusenmeyer ◽  
N. J. Petrelli ◽  
R. J. Gralla
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Health Care Costs ◽  
Advanced Pancreatic Cancer ◽  
Cost Effective ◽  
Significant Difference ◽  
The Impact ◽  
Care Costs

6048 Background: Single agent gemcitabine has been considered the standard of care in advanced pancreatic cancer since 1996. A recent 569 patient randomized trial comparing gemcitabine alone with gemcitabine + erlotinib as first line therapy found a small but statistically significant difference in survival (6.0 vs 6.4 months, respectively, p = .028). The impact on survival may be small, but with nearly 33,000 new cases of pancreatic cancer per year, the impact on health care costs with the use of the combined regimen may be large. Using the known survival data and costs, we analyzed the incremental cost-effectiveness of adding erlotinib. Methods: Costs for a six month course of gemcitabine were developed using Medicare reimbursement from the January, 2006 CMS Drug Payment Table and Physician Fee Schedule assuming no change in infusion reimbursement. Since erlotinib is not approved as a Medicare Part B drug, costs were developed from wholesale and retail sources. Drug dosing and schedules were based on the clinical trial protocol leading to approval. Incremental cost effectiveness of adding erlotinib was calculated. Results: Six month course of gemcitabine alone costs $23,493. The addition of erlotinib increases cost by $12,156 wholesale or $16,613 retail. Given an increase of 0.4 months in median survival over gemcitabine alone, the addition of erlotinib costs $364,680 per year of life gained (YLG) wholesale and $498,379/YLG retail. Sensitivity analyses were conducted assuming shorter therapy of 4 and 5 months. In order to be cost effective even at the $100,000/YLG level, six months of erlotinib would have to be reduced to 20% of the current retail cost (lowered to $18.52 per tablet.) Conclusions: Adding erlotinib to gemcitabine does not approach cost effectiveness at even the highest year per life gained parameters. Such impacts on health care costs, especially for very small gains, become more pressing as all health care costs continue to increase. [Table: see text] [Table: see text]

scholarly journals Resource Use And Health Care Costs Of Copd Patients At The End Of Life: A Systematic Review

2015 ◽  
Vol 18 (7) ◽  
pp. A507
Author(s):  
K Faes ◽  
V De Frène ◽  
J Cohen ◽  
L Annemans
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
End Of Life ◽  
Health Care Costs ◽  
Resource Use ◽  
Copd Patients ◽  
Care Costs
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