ReCell ® Spray-On Skin System for Treating Skin Loss, Scarring and Depigmentation after Burn Injury: A NICE Medical Technology Guidance
AbstractThe gold standard treatment for deep burns is an autologous skin graft; in larger burns this may be meshed to increase the area covered. However, long-term aesthetic and functional outcomes of graft scars may be poor. ReCell® is a medical device that processes skin samples in the operating theatre into a cell suspension to be sprayed or dripped onto a wound. It is claimed to improve healing and scar appearance. This device was evaluated by the National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme. Two groups were defined: ReCell compared to conventional dressings in ...
Source: Applied Health Economics and Health Policy - January 11, 2019 Category: Health Management Source Type: research

Real-World Cost Effectiveness of Mandatory Folic Acid Fortification of Bread-Making Flour in Australia
ConclusionsThis study calculated the value of mandatory folic acid fortification using real-world registry data and demonstrated that the attained benefit was comparable to the modelled expected benefits. Mandatory folic acid fortification (in addition to policies including advice on supplementation and education) improved equity in certain populations and was effective and highly cost effective for the Australian population. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - January 8, 2019 Category: Health Management Source Type: research

The Association Between Adiposity and Inpatient Hospital Costs in the UK Biobank Cohort
ConclusionsHigher adiposity is associated with higher inpatient hospital costs. Further scrutiny using causal inferential methods is warranted to establish if further public health investments are required to manage the large healthcare costs observationally associated with overweight and obesity. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - December 31, 2018 Category: Health Management Source Type: research

Modelled Economic Evaluation of Nivolumab for the Treatment of Second-Line Advanced or Metastatic Squamous Non-Small-Cell Lung Cancer in Australia Using Both Partition Survival and Markov Models
ConclusionsUsing an often-quoted willingness-to-pay per QALY threshold in Australia (i.e. A$50,000), the treatment with nivolumab cannot be considered cost-effective. It might be funded publicly by special arrangements given unmet clinical needs for patients. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - December 10, 2018 Category: Health Management Source Type: research

Reducing Drug Wastage in Pharmaceuticals Dosed by Weight or Body Surface Areas by Optimising Vial Sizes
ConclusionsReductions in wastage have the potential to reduce the cost of manufacturing medicines, which is not necessarily low for novel products. These cost reductions could lead to increased profit (at the same prices), constant profit with a better return rate (at lower prices), or a combination of the two. Most importantly, they would improve the efficiency of the health-care sector, increasing funding available to treat patients. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - December 5, 2018 Category: Health Management Source Type: research

A Payer Perspective of the Hospital Inpatient Additional Care Costs of Antimicrobial Resistance in France: A Matched Case –Control Study
ConclusionAMR causes substantial cost burden in France for the public health insurance. Our study confirms the need to reinforce programs to prevent AMR infection and thereby reduce their economic burden. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - December 3, 2018 Category: Health Management Source Type: research

Financial Impact of Alternative Pricing Benchmarks for Physician-Dispensed Drugs in the California Workers ’ Compensation System
ConclusionsThe CAWCS current Medi-Cal pricing for physician-dispensed drugs is better than all alternatives in terms of price availability, transparency, and budget neutrality, but pricing availability may decrease over time as Medi-Cal moves to managed care. National average drug acquisition cost is the next best alternative, but it requires combinations of pricing benchmarks to maximize its price availability. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - November 28, 2018 Category: Health Management Source Type: research

Comment on: “Does MCDA Trump CEA?”
(Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - November 21, 2018 Category: Health Management Source Type: research

Cost Effectiveness of New Diagnostic Tools for Cutaneous Leishmaniasis in Afghanistan
ConclusionsWhen taking advantage of their respective strengths, LAMP and RDT can prove to be cost-effective alternatives to using microscopy alone at the reference clinic. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - November 21, 2018 Category: Health Management Source Type: research

Authors ’ Reply to Angelis and Kanavos: “Does MCDA Trump CEA?”
(Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - November 21, 2018 Category: Health Management Source Type: research

Peristeen Transanal Irrigation System to Manage Bowel Dysfunction: A NICE Medical Technology Guidance
AbstractThe Peristeen transanal irrigation system is intended to allow people with bowel dysfunction to flush out the lower part of the bowel as part of their bowel management strategy. Peristeen was the subject of an evaluation by the National Institute for Health and Care Excellence, through its Medical Technologies Evaluation Programme, for the management of bowel dysfunction. The company, Coloplast, submitted a case for adoption of the technology, claiming that the technology improves the severity of chronic constipation or faecal incontinence and improves quality of life for people with bowel dysfunction. Other claime...
Source: Applied Health Economics and Health Policy - November 14, 2018 Category: Health Management Source Type: research

Acknowledgement to Referees
(Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - November 12, 2018 Category: Health Management Source Type: research

The Effect of Medical Insurance on Outpatient Visits by the Elderly: An Empirical Study with China Health and Retirement Longitudinal Study Data
ConclusionEnrollment in BMI was found to be significantly associated with an increased number of outpatient visits, whereas supplementary medical insurance membership did not have a significant effect. The effects of BMI enrollment also differed by scheme and age. For those with a high rate of outpatient medical services utilization, the enhancing effect of BMI on the number of outpatient visits was not significant, so new medical insurance policies should be provided to the elderly population in China. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - November 9, 2018 Category: Health Management Source Type: research

Comment on: “The Impact of Patent Expiry on Drug Prices: A Systematic Literature Review”
(Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 29, 2018 Category: Health Management Source Type: research

Effectiveness of National Pricing Policies for Patent-Protected Pharmaceuticals in the OECD: A Systematic Literature Review
ConclusionsWe found evidence that TRP may reduce pharmaceutical prices and expenditures in the short term. Furthermore, TRP may lead to substitution effects towards lower-priced pharmaceuticals. The effects of TRP on patient access, healthcare utilisation and R&D investments were found to be uncertain. No conclusions were drawn for ERP and VBP. No evidence was found for the effects on health outcomes for any of the analysed policies. There is a strong need for evidence generation regarding effective pricing policies, particularly for VBP, managed entry agreements and non-financial outcomes. (Source: Applied Health Econ...
Source: Applied Health Economics and Health Policy - October 27, 2018 Category: Health Management Source Type: research

Assessment of Devices, Diagnostics and Digital Technologies: A Review of NICE Medical Technologies Guidance
ConclusionsThe main drivers of the decision-making process are the quality and quantity of the submitted evidence supporting the technologies, as well as the economic evaluation results. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 26, 2018 Category: Health Management Source Type: research

Using Post-market Utilisation Analysis to Support Medicines Pricing Policy: An Australian Case Study of Aflibercept and Ranibizumab Use
ConclusionsContrary to clinical trial protocols, post-market utilisation research for ranibizumab and aflibercept demonstrates equivalent use in practice in terms of dose frequency, and the demographic and clinical characteristics of initiators. This supports Australia ’s decision to pay the same price for each rather than giving a premium to aflibercept. Many other countries are likely overpaying for aflibercept if their utilization patterns are similar to Australia’s, and could benefit from incorporating routine utilisation assessment. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 25, 2018 Category: Health Management Source Type: research

A Systematic Review of Cost-Effectiveness Analyses of Left Ventricular Assist Devices: Issues and Challenges
ConclusionsNo study found LVADs to be cost effective for DT or BTT with base case assumptions, although incremental cost-effectiveness ratios met thresholds for cost effectiveness in some probabilistic analyses. With constant improvements in LVADs and expanding indications, understanding and re-evaluating the cost effectiveness of their use will be critical to making treatment decisions. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 22, 2018 Category: Health Management Source Type: research

Family Spillover Effects in Pediatric Cost-Utility Analyses
ConclusionMost pediatric CUAs conducted from a societal perspective include family costs but fewer include family health effects. Inclusion of family spillover effects tends to make CUA results more favorable. Future pediatric CUAs should aim to more fully incorporate the family burden of illness. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 22, 2018 Category: Health Management Source Type: research

The Economic Burden of Chronic Obstructive Pulmonary Disease in Greece
ConclusionInvestment in interventions aiming at delaying progression of disease, preventing acute exacerbations, and managing chronic symptoms are required to reduce the overall economic burden of COPD in Greece. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 17, 2018 Category: Health Management Source Type: research

Re-design of Aged Care Environments is Key to Improved Care Quality and Cost Effective Reform of Aged and Health System Care
(Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 16, 2018 Category: Health Management Source Type: research

Reliability and Validity of the Contingent Valuation Method for Estimating Willingness to Pay: A Case of In Vitro Fertilisation
ConclusionThe CV method holds promise for eliciting the value of interventions, such as fertility treatment, that have significant health and non-health outcomes. Survey instruments that prevent starting point bias are essential. Comparing the results of CV methods to other value elicitation methods is needed to confirm convergent validity. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 13, 2018 Category: Health Management Source Type: research

Did we see it Coming? An Evaluation of the Swedish Early Awareness and Alert System
ConclusionsThe Swedish Early Awareness and Alert System identified all new medicines that would go on to have substantial economic impact and prioritized most of these medicines. Our findings provide reassurance to decision makers who rely on the outputs of the Swedish Early Awareness and Alert System to keep informed about new medicines. Moreover, this study also provides valuable insights to stakeholders willing to establish or evaluate their own early awareness and alert activities and systems. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 4, 2018 Category: Health Management Source Type: research

Impact of Reducing Glycated Hemoglobin on Healthcare Costs Among a Population with Uncontrolled Diabetes
DiscussionIn our analysis, A1C reduction among patients with T1DM and T2DM was associated with slower growth in healthcare costs within 1 –2 years. These findings suggest that programs aimed at reducing A1C over a short timeframe may lead to substantial savings and may be worth pursuing by health plans and other payers. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017
ConclusionsThis systematic literature review shows that abuse of prescription opioids is characterized by substantial direct healthcare costs, medical utilization, and related societal costs. Future research should further investigate the indirect costs of opioid abuse. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Economic Evaluations of Guideline-Based Care for Chronic Wounds: a Systematic Review
Conclusions and Implications of Key FindingsWe found that guideline-based care may be cost-saving or cost-effective in most circumstances. The quality and usefulness of reviewed studies for decision making were variable. Better information and higher-quality economic evaluations will increase decision makers ’ confidence to promote guideline-based care.Systematic Review Registration NumberPROSPERO CRD42017051859. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil
ConclusionsAtypical antipsychotics were responsible for the majority of the schizophrenia treatment costs, and psychiatric hospitalization costs were the highest mean annual cost per patient. Authorities should ensure efficient use of atypical antipsychotics and encourage outpatient psychiatric care over psychiatric hospitalization where possible. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Shaping Pharmaceutical Tenders for Effectiveness and Sustainability in Countries with Expanding Healthcare Coverage
AbstractPolicy makers in countries, aiming to build and expand their healthcare systems and coverage, need effective procedures to support the most efficient use of limited financial resources. Tendering is commonly deployed to minimize and fix the purchasing price for the contract duration, especially for off-patent pharmaceuticals. While tenders can reduce acquisition costs, they may also expose the healthcare systems to risks including drug shortages, quality trade-offs, and ultimately, compromised patient health outcomes. Careful planning is therefore required. The effectiveness and impact of tendering were examined in...
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

The Choice of Transcatheter Aortic Valve Implementation (TAVI): Do Patient Co-morbidity and Hospital Ownership Type Matter?
ConclusionOverall, the effects of co-morbidity suggest that providers acted responsibly when adopting TAVI while evidence was still emerging. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

The Real-World Cost-Effectiveness of Coronary Artery Bypass Surgery Versus Stenting in High-Risk Patients: Propensity Score-Matched Analysis of a Single-Centre Experience
ConclusionsAt early follow-up, high-risk subgroups had lower ICERs than the overall cohort when CABG was compared with PCI. A personalised, multidisciplinary approach to treatment of patients may enhance cost containment, as well as improving clinical outcomes following revascularisation strategies. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Cost-Effectiveness Analysis of Early Treatment of Chronic HCV with Sofosbuvir/Velpatasvir in Italy
ConclusionsExtending the treatment of HCV to patients at an early stage of HCV infection is estimated to be cost effective from the perspective of the Italian Healthcare System. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Integrating Qualitative Techniques in Model Development: A Case Study Using the Framework Approach
ConclusionThe two settings in Ghana have different care pathways and any cost-effectiveness analysis should consider the alternative pathways separately. This study demonstrated that framework analysis is a qualitative methodology that is likely to be accessible and feasible across a wide range of health economic settings. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Development of Conversion Functions Mapping the FACT-B Total Score to the EQ-5D-5L Utility Value by Three Linking Methods and Comparison with the Ordinary Least Square Method
ConclusionThe problem of shrinkage in the variance occurred in the OLS method, but it provided an unbiased estimate for the mean and better agreement. Among the other three linking methods, the mean rank method better described the distribution, whereas the equipercentile and linear equating methods better assessed the association with risk factors. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Opportunities for Use of Blockchain Technology in Medicine
AbstractBlockchain technology is a decentralized database that stores a registry of assets and transactions across a peer-to-peer computer network, which is secured through cryptography, and over time, its history gets locked in blocks of data that are cryptographically linked together and secured. So far, there have been use cases of this technology for cryptocurrencies, digital contracts, financial and public records, and property ownership. It is expected that future uses will expand into medicine, science, education, intellectual property, and supply chain management. Likely applications in the field of medicine could ...
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Gun Policy in the United States: Evidence-Based Strategies to Reduce Gun Violence
(Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

The Impact of Patent Expiry on Drug Prices: A Systematic Literature Review
ConclusionDrug prices decrease significantly after patent expiry. The extent of this price reduction varied greatly between products and countries. For this reason, country-specific analyses on price developments after patent expiry should be used when these are considered in decision making. Future research should be dedicated to gathering more country-specific data to reduce the uncertainty with regard to price developments. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - October 1, 2018 Category: Health Management Source Type: research

Trends and Factors Associated with Hospitalization Costs for Inflammatory Bowel Disease in the United States
AbstractBackgroundFew studies have addressed recent trends in hospitalization costs for inflammatory bowel disease (IBD).ObjectiveWe explored trends and described patient and hospital factors associated with hospitalization costs for IBD.MethodsUsing data from the 2003 –2014 National Inpatient Sample for adults aged ≥ 18 years, we estimated costs using multivariable linear models and assessed linear trends by time periods using piecewise linear regressions.ResultsIn 2014, there were an estimated 56,290 hospitalizations for Crohn ’s disease (CD), with a mean cost of US$11,345 and median cos...
Source: Applied Health Economics and Health Policy - September 27, 2018 Category: Health Management Source Type: research

Cost-Effectiveness of Scaling Up Modern Family Planning Interventions in Low- and Middle-Income Countries: An Economic Modeling Analysis in Indonesia and Uganda
ConclusionScaling up family planning interventions could improve women ’s health outcomes substantially and be cost-effective or even cost saving across a range of scenarios compared to the current situation. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - September 4, 2018 Category: Health Management Source Type: research

Budget Impact Analysis of a Renal Point-of-Care Test in Dutch Community Pharmacies to Prevent Antibiotic-Related Hospitalizations
ConclusionObtaining and evaluating renal function in community pharmacies by point of care tests is expected to be cost-saving in the Netherlands. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - September 3, 2018 Category: Health Management Source Type: research

Level of Evidence in Economic Evaluations of Left Atrial Appendage Closure Devices: A Systematic Review
ConclusionsDespite the recent development of left atrial appendage closure devices, most economic evaluations conducted here were well-designed studies. Furthermore, different tools used to assess the quality of these studies were complementary, but none gave a global vision of the quality of economic studies. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - August 31, 2018 Category: Health Management Source Type: research

Ethically Acceptable Compensation for Living Donations of Organs, Tissues, and Cells: An Unexploited Potential?
We present and discuss three categories of compensation with the potential to increase donation rates in an ethically acceptable way. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - August 25, 2018 Category: Health Management Source Type: research

Projections of the Healthcare Costs and Disease Burden due to Hepatitis C Infection under Different Treatment Policies in Malaysia, 2018 –2040
ConclusionsThe scale-up to meet the WHO 2030 target may be achievable with appropriately high governmental commitment to the expansion of HCV screening to bring sufficient undiagnosed chronically infected patients into the treatment pathway. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - August 25, 2018 Category: Health Management Source Type: research

Projections of the Healthcare Costs and Disease Burden due to Hepatitis C Infection under Different Treatment Policies in Malaysia, 2018 –2040
AbstractIntroductionThe World Health Organisation (WHO) has set ambitious goals to reduce the global disease burden associated with, and eventually eliminate, viral hepatitis. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - August 25, 2018 Category: Health Management Source Type: research

Ethically Acceptable Compensation for Living Donations of Organs, Tissues, and Cells: An Unexploited Potential?
We present and discuss three categories of compensation with the potential to increase donation rates in an ethically acceptable way. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - August 25, 2018 Category: Health Management Source Type: research

Effects of the ACA on Preventive Care Disparities
ConclusionsEarly effects of the ACA ’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits. (Source: Applied Health Economics and Health Policy)
Source: Applied Health Economics and Health Policy - August 24, 2018 Category: Health Management Source Type: research