scholarly journals Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

2014 ◽  
Vol 8 (12) ◽  
pp. 1552-1562 ◽  
Author(s):  
Edward Mezones-Holguín ◽  
Rafael Bolaños-Díaz ◽  
Víctor Fiestas ◽  
César Sanabria ◽  
Alfonso Gutiérrez-Aguado ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Preventive Measure ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Effectiveness Analysis ◽  
Effectiveness Model ◽  
Isolation Probability

Introduction: Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 years-old. Methodology: A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. Results: The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, andUSD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). Conclusions: PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.

Cost-Effectiveness Analysis of Active Surveillance Screening for Methicillin-Resistant Staphylococcus aureus in an Academic Hospital Setting

2012 ◽  
Vol 33 (5) ◽  
pp. 477-486 ◽  
Author(s):  
JaHyun Kang ◽  
Paul Mandsager ◽  
Andrea K. Biddle ◽  
David J. Weber
Keyword(s):  
Staphylococcus Aureus ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Active Surveillance ◽  
Hospital Setting ◽  
Cost Effective ◽  
Dominant Strategy ◽  
Cost Effectiveness Analysis ◽  
Academic Hospital ◽  
Effectiveness Analysis

Objective.To evaluate the cost-effectiveness of 3 alternative active screening strategies for methicillin-resistant Staphylococcus aureus (MRSA): universal surveillance screening for all hospital admissions, targeted surveillance screening for intensive care unit admissions, and no surveillance screening.Design.Cost-effectiveness analysis using decision modeling.Methods.Cost-effectiveness was evaluated from the perspective of an 800-bed academic hospital with 40,000 annual admissions over the time horizon of a hospitalization. All input probabilities, costs, and outcome data were obtained through a comprehensive literature review. Effectiveness outcome was MRSA healthcare-associated infections (HAIs). One-way and probabilistic sensitivity analyses were conducted.Results.In the base case, targeted surveillance screening was a dominant strategy (ie, was associated with lower costs and resulted in better outcomes) for preventing MRSA HAL Universal surveillance screening was associated with an incremental cost-effectiveness ratio of $14,955 per MRSA HAL In one-way sensitivity analysis, targeted surveillance screening was a dominant strategy across most parameter ranges. Probabilistic sensitivity analysis also demonstrated that targeted surveillance screening was the most cost-effective strategy when willingness to pay to prevent a case of MRSA HAI was less than $71,300.Conclusion.Targeted active surveillance screening for MRSA is the most cost-effective screening strategy in an academic hospital setting. Additional studies that are based on actual hospital data are needed to validate this model. However, the model supports current recommendations to use active surveillance to detect MRSA.

Cost Effectiveness Analysis of Antipsychotic Medications in the Management of Schizophrenia in Benin City

2019 ◽  
Vol 1 (1) ◽  
pp. 46-56
Author(s):  
J.W. Edefo ◽  
◽  
S.F. Usifoh ◽  
A.W. Udezi ◽  
◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Rating Scale ◽  
Response Rate ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Antipsychotic Medications ◽  
Stable Relationship ◽  
Effectiveness Analysis ◽  
The Impact

Background: Studies on cost effectiveness analysis (CEA) of typical versus atypical antipsychotics in the management of schizophrenia are still lacking in Nigeria thus the objectives of this study are to determine which of the class of antipsychotics is more cost-effective as well as the impact of socio-demographic factors on the response rate to antipsychotics. Method: The effectiveness was measured by Brief Psychiatric rating scale (BPRS) and costs were in Nigerian naira (NGN). The impact of different socio-demographics on the mean BPRScore ± Standard deviation (SD) reduction was determined. The study was conducted from patient’s perspective with decision tree analysis model using two-way sensitivity analysis. The model was used to explore incremental cost effectiveness ratios (ICER) of oral antipsychotic medications Haloperidol /Trifluoperazine versus Olanzepine /Risperidone over a 24-week study period. Results: Cost effectiveness analysis with 1st scenario sensitivity test of medications, trifluoperazine 17.81±2.51mg is more cost effective than olanzapine 10mg, while haloperidol 10mg is more cost effective than risperidone 3.5± 0.51mg. In the second scenario of sensitivity analysis, olanzapine is more cost effective than trifluoperazine only when the savings of making one person free from schizophrenia in a month is worth more than NGN537 while risperidone is more cost effective than haloperidol only when the savings of making one person free from schizophrenia in a month is worth more than NGN2524.1. The effect on response rate to antipsychotics gave p=0.0251, P=0.009, P<0.0001 for educational status, income, stable relationship respectively. Conclusion: Atypical antipsychotic medications are not more cost effective compared to the typical antipsychotics. Higher educational level, income and stable relationship positively affected the outcome of effectiveness of antipsychotics.

scholarly journals Cost-Effectiveness Analysis of the Prophylactic Use of Ertapenem for the Prevention of Surgical Site Infections after Elective Colorectal Surgery

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 259
Author(s):  
Costanza Vicentini ◽  
Maria Michela Gianino ◽  
Alessio Corradi ◽  
Noemi Marengo ◽  
Valerio Bordino ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Colorectal Surgery ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effective Strategy ◽  
Elective Colorectal Surgery ◽  
Effectiveness Analysis ◽  
Amoxicillin Clavulanate

Standard surgical antimicrobial prophylaxis (SAP) regimens are less effective in preventing surgical site infections (SSIs) due to rising antimicrobial resistance (AMR) rates, particularly for patients undergoing colorectal surgery. This study aimed to evaluate whether ertapenem should be a preferred strategy for the prevention of SSIs following elective colorectal surgery compared to three standard SAP regimens: amoxicillin-clavulanate, cefoxitin, and cefazolin plus metronidazole. A cost-effectiveness analysis was conducted using decision tree models. Probabilities of SSIs and AMR-SSIs, costs, and effects (in terms of quality-adjusted life-years) were considered in the assessment of the alternative strategies. Input parameters integrated real data from the Italian surveillance system for SSIs with data from the published literature. A sensitivity analysis was conducted to assess the potential impact of the decreasing efficacy of standard SAP regimens in preventing SSIs. According to our models, ertapenem was the most cost-effective strategy only when compared to amoxicillin-clavulanate, but it did not prove to be superior to cefoxitin and cefazolin plus metronidazole. The sensitivity analysis found ertapenem would be the most cost-effective strategy compared to these agents if their failure rate was more than doubled. The findings of this study suggest ertapenem should not be a preferred strategy for SAP in elective colorectal surgery.

scholarly journals Cost-effectiveness analysis of 10- and 13-valent pneumococcal conjugate vaccines in Peru

Vaccine ◽  
2015 ◽  
Vol 33 ◽  
pp. A154-A166 ◽  
Author(s):  
Edward Mezones-Holguin ◽  
Carlos Canelo-Aybar ◽  
Andrew David Clark ◽  
Cara Bess Janusz ◽  
Bárbara Jaúregui ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Effectiveness Analysis

Cost-effectiveness analysis of the 10- and 13-valent pneumococcal conjugate vaccines in Argentina

Vaccine ◽  
2011 ◽  
Vol 29 (31) ◽  
pp. 4963-4972 ◽  
Author(s):  
Analía Urueña ◽  
Tomás Pippo ◽  
María Sol Betelu ◽  
Federico Virgilio ◽  
Norberto Giglio ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Effectiveness Analysis

Cost-effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

2021 ◽  
pp. 019459982110268
Author(s):  
Joseph R. Acevedo ◽  
Ashley C. Hsu ◽  
Jeffrey C. Yu ◽  
Dale H. Rice ◽  
Daniel I. Kwon ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Submandibular Gland ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Probability Of Success ◽  
Markov Decision Model ◽  
The Cost

Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.

scholarly journals Very-low-dose aspirin and surveillance colonoscopy is cost-effective in secondary prevention of colorectal cancer in individuals with advanced adenomas: network meta-analysis and cost-effectiveness analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajesh K. Veettil ◽  
Siang Tong Kew ◽  
Kean Ghee Lim ◽  
Pochamana Phisalprapa ◽  
Suresh Kumar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Secondary Prevention ◽  
Low Dose ◽  
Meta Analysis ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Surveillance Colonoscopy ◽  
Combination Strategy ◽  
Effectiveness Analysis

Abstract Background Individuals with advanced colorectal adenomas (ACAs) are at high risk for colorectal cancer (CRC), and it is unclear which chemopreventive agent (CPA) is safe and cost-effective for secondary prevention. We aimed to determine, firstly, the most suitable CPA using network meta-analysis (NMA) and secondly, cost-effectiveness of CPA with or without surveillance colonoscopy (SC). Methods Systematic review and NMA of randomised controlled trials were performed, and the most suitable CPA was chosen based on efficacy and the most favourable risk–benefit profile. The economic benefits of CPA alone, 3 yearly SC alone, and a combination of CPA and SC were determined using the cost-effectiveness analysis (CEA) in the Malaysian health-care perspective. Outcomes were reported as incremental cost-effectiveness ratios (ICERs) in 2018 US Dollars ($) per quality-adjusted life-year (QALY), and life-years (LYs) gained. Results According to NMA, the risk–benefit profile favours the use of aspirin at very-low-dose (ASAVLD, ≤ 100 mg/day) for secondary prevention in individuals with previous ACAs. Celecoxib is the most effective CPA but the cardiovascular adverse events are of concern. According to CEA, the combination strategy (ASAVLD with 3-yearly SC) was cost-saving and dominates its competitors as the best buy option. The probability of being cost-effective for ASAVLD alone, 3-yearly SC alone, and combination strategy were 22%, 26%, and 53%, respectively. Extending the SC interval to five years in combination strategy was more cost-effective when compared to 3-yearly SC alone (ICER of $484/LY gain and $1875/QALY). However, extending to ten years in combination strategy was not cost-effective. Conclusion ASAVLD combined with 3-yearly SC in individuals with ACAs may be a cost-effective strategy for CRC prevention. An extension of SC intervals to five years can be considered in resource-limited countries.

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