Developing Open-Source Models for the US Health System: Practical Experiences and Challenges to Date with the Open-Source Value Project

AbstractThe Innovation and Value Initiative started the Open-Source Value Project with the aim to improve the credibility and relevance of model-based value assessment in the context of the US healthcare environment. As a core activity of the Open-Source Value Project, the Innovation and Value Initiative develops and provides access to flexible open-source economic models that are developed iteratively based on public feedback and input. In this article, we describe our experience to date with the development of two currently released, Open-Source Value Project models, one in rheumatoid arthritis and one in epidermal growth factor receptor-positive non-small-cell lung cancer. We developed both Open-Source Value Project models using the statistical programming language R instead of spreadsheet software (i.e., Excel), which allows the models to capture multiple model structures, model sequential treatment with individual patient simulations, and improve integration with formal evidence synthesis. By developing the models in R, we were also able to use version control systems to manage changes to the source code, which is needed for iterative and collaborative model development. Similarly, Open-Source Value Project models are freely available to the public to provide maximum transparency and facilitate collaboration. Development of the rheumatoid arthritis and non-small-cell lung cancer model platforms has presented multiple challenges. The development of multiple components of ...
Source: PharmacoEconomics - Category: Health Management Source Type: research

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Authors: Herth FJF, Reinmuth N, Wormanns D, Antoch G, Biederer J, Vogel-Claussen J, Kauczor HU, Pfeifer M, Vorstand der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin, Vorstand der Deutschen Röntgengesellschaft Abstract Substantial new data on early detection of lung cancer with low-dose CT has become available since the last joint statement of the German Roentgenological Society and the German Respiratory Society was published in 2011. The German S3 guideline on lung cancer was revised in 2018 and now contains a weak recommendation towards early detection of lung cancer with low-dose CT in a...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
Publication date: 21–27 September 2019Source: The Lancet, Volume 394, Issue 10203Author(s): The Lancet
Source: The Lancet - Category: General Medicine Source Type: research
Discussion MDSCs violently emerge in pathological conditions in an attempt to limit potentially harmful immune and inflammatory responses. Mechanisms supporting their expansion and survival are deeply investigated in cancer, in the perspective to reactivate specific antitumor responses and prevent their contribution to disease evolution. These findings will likely contribute to improve the targeting of MDSCs in anticancer immunotherapies, either alone or in combination with immune checkpoint inhibitors. New evidence indicates that the expansion of myeloid cell differentiation in pathology is subject to fine-tuning, as its...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions This review describes how leukocyte-heparanase can be a double-edged sword in tumor progression; it can enhance tumor immune surveillance and tumor cell clearance, but also promote tumor survival and growth. We also discuss the potential of using heparanase in leukocyte therapies against tumors, and the effects of heparanase inhibitors on tumor progression and immunity. We are just beginning to understand the influence of heparanase on a pro/anti-tumor immune response, and there are still many questions to answer. How do the pro/anti-tumorigenic effects of heparanase differ across different cancer types? Does...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions and Perspectives In this review, we have discussed important milestones from the early description of “Serum-sickness” as being due to antibodies directed against Neu5Gc epitopes all the way to the present-day therapeutic implications of these antibodies in cancer therapy. Some of these milestones have been represented in a concise timeline (Figure 6). While the “Xenosialitis” hypothesis is well-supported in the human-like mouse models, it has yet to be conclusively proven in humans. It remains to be seen if “Xenosialitis” plays a role in other uniquely-human diseases. FI...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsThis is the first report of ILH induced by pembrolizumab in a patient with lung adenocarcinoma.
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Authors: Alexander W Abstract Notable American Society of Clinical Oncology sessions focused on prostate cancer, non-small-cell lung cancer, and hepatocellular carcinoma. Subjects at the European Congress of Rheumatology included rheumatoid arthritis and axial spondyloarthritis. PMID: 28781508 [PubMed]
Source: P and T - Category: Drugs & Pharmacology Tags: P T Source Type: research
Conclusion Outcomes-based agreements are a natural extension of a health care delivery-and-reimbursement environment that is moving toward value. With provider organizations taking increasing accountability for both costs and outcomes, it is becoming incumbent upon manufacturers to demonstrate the economic, clinical, and quality-of-life benefits of their medicines. The pilot described here was successful in that Genentech and Priority Health both learned how to overcome clinical, operational, and contractual challenges and demonstrated that this type of agreement is feasible. Genentech and Priority Health believe pilots li...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Drugs and Medical Innovation Payment Policy Outcomes-based agreements Source Type: blogs
PMID: 27992901 [PubMed - in process]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) selectively induces carcinoma cell death through the extrinsic pathway of apoptosis. Preclinical trials of gene therapy have been conducted using viral transfer of the TRAIL transgene into prostate, bladder, breast, kidney, liver, non-small cell lung cancer and also glioblastoma cells. Experiments in vitro demonstrated the extensive apoptosis of target cells as well as frequent disease regression or remission. TRAIL transfer did not show any side effects, opposite to chemotherapy. Encouraging results of TRAIL-related gene therapy were observed in rheumatoid ar...
Source: Postepy higieny i medycyny doswiadczalnej - Category: Research Tags: Review article Source Type: research
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