How French general practitioners respond to declining medical density: a study on prescription practices, with an insight into opioids use
AbstractDisparities in physicians' geographical distribution lead to highly unequal access to healthcare, which may impact quality of care in both high and low-income countries. This paper uses a 2013 –2014 nationally representative survey of French general practitioners (GPs) matched with corresponding administrative data to analyze the effects of practicing in an area with weaker medical density. To avoid the endogeneity issue on physicians' choice of the location, we enriched our variable of interest, practicing in a relatively underserved area, with considering changes in medical density between 2007 and 2013, th...
Source: The European Journal of Health Economics - August 3, 2020 Category: Health Management Source Type: research

The role of income disparities on survival in metastatic clear cell renal cell carcinoma in the targeted therapy era
This study aimed to assess the role of income disparities on prognosis of mRCC in the targeted therapy era.Patients and methodsData of patients with mRCC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Median household income (MHI) was used to represent patients ’ socioeconomic status, and its role on overall survival (OS) and cancer-specific survival (CSS) was evaluated.ResultsA total of 3791 patients with clear cell mRCC diagnosed between 2010 and 2015 were enrolled in cohort one. There was an obvious imbalance of race and insurance status in patients with difference MHI. Compar...
Source: The European Journal of Health Economics - July 29, 2020 Category: Health Management Source Type: research

The impact of the diabetes management incentive on diabetes-related services: evidence from Ontario, Canada
AbstractFinancial incentives have been introduced in several countries to improve diabetes management. In Ontario, the most populous province in Canada, a Diabetes Management Incentive (DMI) was introduced to family physicians practicing in patient enrollment models in 2006. This paper examines the impact of the DMI on diabetes-related services provided to individuals with diabetes in Ontario. Longitudinal health administrative data were obtained for adults diagnosed with diabetes and their family physicians. The study population consisted of two groups: DMI group (patients enrolled with a family physician exposed to DMI f...
Source: The European Journal of Health Economics - July 16, 2020 Category: Health Management Source Type: research

The effect of long-term care public benefits and insurance on informal care from outside the household: empirical evidence from Italy and Spain
This article uses cross-sectional data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) database to test the effect of both long-term care (LTC) public benefits and insurance on the receipt of informal care provided by family members living outside the household in Italy and Spain. The choice of Italy and Spain comes from the fact that informal care is rather similar in these two countries while their respective public LTC financing systems are different. Our results support the hypothesis of LTC public support decreasing the receipt of informal care for Spain while reject it for Italy. They tend to conf...
Source: The European Journal of Health Economics - July 11, 2020 Category: Health Management Source Type: research

Budget impact analysis of the use of oral and intravenous therapy regimens for the treatment of relapsed or refractory multiple myeloma in Germany
ConclusionAmong the regimens of interest, the oral-based therapy regimens offered cost advantages over intravenous-based therapy regimens. The higher overall costs of intravenous therapy regimens were attributed primarily to higher drug acquisition  costs. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - July 11, 2020 Category: Health Management Source Type: research

‘Relative Consent’ or ‘Presumed Consent’? Organ donation attitudes and behaviour
AbstractLegislation, in the form of presumed consent, has been argued to boost organ donation but most evidence disregards the practice of seeking relative ’s consent, which can either ‘veto’ donation decisions, or ‘legitimize them’, by removing any possible conflict with the donor’s family. We study the effect of presumed consent alongside family consent on individuals’ willingness to donate (WTD) one’s own and relatives’ organs, and on actual organ donation behaviours. Using data from 28 European countries for the period 2002–2010, we found that presumed consent...
Source: The European Journal of Health Economics - July 10, 2020 Category: Health Management Source Type: research

Cost and effects of integrated care: a systematic literature review and meta-analysis
ConclusionOur findings suggest that integrated care is likely to reduce cost and improve outcome. However, existing evidence varies largely and is of moderate quality. Future economic evaluation should target methodological issues to aid policy decisions with more robust evidence on the cost-effectiveness of integrated care. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - July 6, 2020 Category: Health Management Source Type: research

Correction to: Defensive medicine in Europe: a ‘full circle’?
The Editorial “Defensive medicine in Europe: a ‘full circle’?” (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - July 1, 2020 Category: Health Management Source Type: research

Using machine learning to assess the predictive potential of standardized nursing data for home healthcare case-mix classification
DiscussionThe existing preliminary Dutch case-mix system distinguishes client needs to some degree, but not sufficiently. The results indicate that routinely collected SNT data contain sufficient additional predictive value to warrant further research for use in case-mix system design. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 29, 2020 Category: Health Management Source Type: research

Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 26, 2020 Category: Health Management Source Type: research

Pricing vaccines and drugs in Europe: worth differentiating?
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 23, 2020 Category: Health Management Source Type: research

Something borrowed, something new: measuring hospital performance in the context of value based health care
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 16, 2020 Category: Health Management Source Type: research

The impact of the great economic crisis on mental health care in Italy
AbstractThe great economic crisis in 2008 has affected the welfare of the population in countries such as Italy. Although there is abundant literature on the impact of the crisis on physical health, very few studies have focused on the causal implications for mental health and health care. This paper, therefore, investigates the impact of the recent economic crisis on hospital admissions for severe mental disorder at small geographic levels in Italy and assesses whether there are heterogeneous effects across areas with distinct levels of income. We exploit 9-year (2007 –2015) panel data on hospital discharges, which ...
Source: The European Journal of Health Economics - June 13, 2020 Category: Health Management Source Type: research

Which multi-attribute utility instruments are recommended for use in cost-utility analysis? A review of national health technology assessment (HTA) guidelines
ConclusionsThe EQ-5D, HUI, and SF-6D were the three MAUIs most frequently mentioned in guidelines. The most commonly cited MAUI (in 85% of PE guidelines) was EQ-5D, either as a preferred MAUI or as an example of a suitable MAUI for use in CUA in HTA. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 8, 2020 Category: Health Management Source Type: research

An exploration of methods for obtaining 0  = dead anchors for latent scale EQ-5D-Y values
DiscussionThere was broad agreement across methods. Potential criteria for selecting a preferred anchoring method are presented. We conclude by discussing the decision-making circumstances under which utilities and QALY estimates for children and adults need to be commensurate to achieve allocative efficiency. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 6, 2020 Category: Health Management Source Type: research

Cost-utility analysis of inotuzumab ozogamicin for relapsed or refractory B cell acute lymphoblastic leukemia from the perspective of Taiwan ’s health care system
ConclusionsINO versus SOC has higher costs but is more effective. The use of INO is favorable for patients in the early treatment course and when more future benefit associated with INO is considered. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 6, 2020 Category: Health Management Source Type: research

Historical evidence for economic effects of COVID-19
AbstractLike wars and socio-politic shifts, contagious diseases have changed the economics and politics of the world throughout history. In 2020, the world faced COVID-19, a globally effective virus leading to mass losses and socio-economic panic. Due to apparent psycho-social conditions, analyzing the potential economic effects of the COVID-19 pandemic was inevitable. Thus, discussing economic effects of previous global and regional epidemics is considered beneficial. This research evaluated most of the known epidemics and their effects on economics and socio-politics by reviewing scientific literature. In addition to the...
Source: The European Journal of Health Economics - June 4, 2020 Category: Health Management Source Type: research

The “red herring” after 20 years: ageing and health care expenditures
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 4, 2020 Category: Health Management Source Type: research

Modelling Covid-19 under uncertainty: what can we expect?
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - June 3, 2020 Category: Health Management Source Type: research

How expensive are post-traumatic stress disorders? Estimating incremental health care and economic costs on anonymised claims data
ConclusionsIndividuals with PTSD seem to suffer from far more impairments in their general health conditions and incur many more costs than average insurants. Most of these seem to be caused by co-occurring mental disorders and show their maximum in the index year. Nevertheless, as costs decrease to their initial level, treatments seem to have counterbalanced the impairments due to PTSD. Thus, treatments for PTSD can be considered as beneficial and their cost-effectiveness should be further investigated. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 26, 2020 Category: Health Management Source Type: research

The excess economic burden of mental disorders: findings from a cross-sectional prevalence survey in Austria
This study provides the first representative estimates about the overall utilisation of resources by people with MDs and the excess healthcare and productivity loss costs associated with MDs in Austria. Data were collected in a cross-sectional survey conducted on a representative sample (n = 1008) between June 2015 and June 2016. Information on mental health diagnoses, 12-month health and social care use, medication use, comorbidities, informal care, early retirement, sick leave and unemployment was collected via face-to-face interviews. Generalised linear model was used to asses s the excess cost of MDs. The...
Source: The European Journal of Health Economics - May 26, 2020 Category: Health Management Source Type: research

Modeling Personalized Adjuvant TreaTment in EaRly stage coloN cancer (PATTERN)
ConclusionThis model can be used to evaluate strategies for the allocation of adjuvant chemotherapy in stage II CC patients. In future studies, the model will be used to estimate population-level long-term health gain and cost-effectiveness of biomarker-based selection strategies. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 26, 2020 Category: Health Management Source Type: research

Predictors of negotiated prices for new drugs in Germany
ConclusionsThe analysis was able to confirm that variables whose consideration is mandated by law are, in fact, the key drivers of negotiated prices. Somewhat puzzling, the analysis also found an increase in AEs to move prices significantly upward. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 25, 2020 Category: Health Management Source Type: research

Measuring intangible cost-of-morbidity due to substance dependence: implications of using alternative preference-based instruments
ConclusionsThe SF-6DPG instrument emerges as a good candidate to avoid under-estimating intangible costs within the cost-of-illness framework. However, further research is needed to assess the validity of our results in the context of other health problems. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 17, 2020 Category: Health Management Source Type: research

Impacts of air pollution on health: evidence from longitudinal cohort data of patients with cardiovascular diseases
This study uses longitudinal cohort data to estimate the impacts of air pollution on health outcomes among people first hospitalised with heart diseases. Despite the generally low level of pollution in Australia, we find that acute exposure to pollution increases readmissions to hospitals within 3 –12 months after discharge and is more evident among those suffering from heart failure. We further show that chronic exposure to air pollution increases the risk of death within 72 months, hospital admissions and general practitioner (GP) visits. Patients with coronary heart disease or cerebrov ascular disease ar...
Source: The European Journal of Health Economics - May 15, 2020 Category: Health Management Source Type: research

Patterns of care and cost profiles of women with breast cancer in Italy: EPICOST study based on real world data
ConclusionsThis paper represents the first attempt in Italy to estimate the economic burden of cancer at population level taking into account the entire disease pathway and using multiple current health care databases. The evidence produced by the study can be used to better plan resources allocation. The model proposed is replicable to countries with individual health care information on services and claims. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 12, 2020 Category: Health Management Source Type: research

Quantifying the economic impact of caregiving for Duchenne muscular dystrophy (DMD) in Spain
AbstractAimTo establish the potential economic burden in caregivers to patients with DMD and the potential causative factors.MethodCaregivers to patients with DMD were recruited through the DMD patients Register and questioned about several economic aspects using “ad-hoc” questionnaires.ResultsAll families, apart from one (97.2%n = 36), incurred in monthly medical costs (44% of the families more than 50 euros/month). 97.2% of the households considered looking after a patient of DMD as financially burdensome, and 80.5% of households declared to have suffered work changes, especially the mother...
Source: The European Journal of Health Economics - May 12, 2020 Category: Health Management Source Type: research

Awaiting the “catharsis”
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 9, 2020 Category: Health Management Source Type: research

Cost-effectiveness of biennial screening for diabetes related retinopathy in people with type 1 and type 2 diabetes compared to annual screening
ConclusionsBase case and sensitivity analyses indicate biennial screening to be cost-effective for T2DM irrespective of HbA1c and duration of diabetes. However, the uncertainty around the DCER indicates that annual screening should be maintained for those with T1DM especially when the HbA1c exceeds 80  mmol/mol (9.5%) and duration of diabetes is greater than 12 years. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 8, 2020 Category: Health Management Source Type: research

Efficiency ratio and rocketing drug prices: old concerns and new possibilities
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 5, 2020 Category: Health Management Source Type: research

Discrete choice experiments to generate utility values for multi-attribute utility instruments: a systematic review of methods
ConclusionDCEs are an important approach to measure utility values for both generic and condition-specific instruments. However, a gold standard method cannot yet be recommended. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 4, 2020 Category: Health Management Source Type: research

Accountability for an unhealthy lifestyle
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - May 2, 2020 Category: Health Management Source Type: research

Lifetime cost of unilateral cochlear implants in adults: a Monte Carlo simulation
ConclusionCI-related cost for statutory health insurance crucially depends on the patient-side demand for cochlear implants. Therefore, cost forecasts must also consider the development of demand. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 24, 2020 Category: Health Management Source Type: research

The effect of time to death on health care expenditures: taking into account the endogeneity and right censoring of time to death
AbstractThis paper provides new estimates of the impact of the time to death on health care expenditures when the time to death is assumed endogenous. It further proposes estimation methods that take into account the right censoring of time to death. The data consist of twins from Denmark aged over 70 in 1999. The age of death of the mother and the living status of the co-twin are used as instruments for time to death. The results show that IV estimators give estimates higher than those obtained in previous studies when the time to death is assumed exogenous. Furthermore, the estimators proposed in this paper provide estim...
Source: The European Journal of Health Economics - April 23, 2020 Category: Health Management Source Type: research

Budget impact of sequential treatment with first-line afatinib versus first-line osimertinib in non-small-cell lung cancer patients with common EGFR mutations
ConclusionsFirst-line afatinib treatment in patients with EGFR-mutant NSCLC had a lower financial impact on the Dutch healthcare budget with a higher mean ToT and QALM compared to osimertinib sequential treatment. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 23, 2020 Category: Health Management Source Type: research

Does linear equating improve prediction in mapping? Crosswalking MacNew onto EQ-5D-5L value sets
ConclusionsThe preferred mapping function enables to predict utilities for MacNew data from the EQ-5D-5L value sets recently developed in England and the US with better accuracy. This allows studies, which have included the MacNew to be used in cost-utility analyses and thus, the comparison of services with interventions across the health system. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 16, 2020 Category: Health Management Source Type: research

Should health technology assessment be more patient centric? If so, how?
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 16, 2020 Category: Health Management Source Type: research

Do European pharmacists really have to trespass on medicine?
(Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 11, 2020 Category: Health Management Source Type: research

A novel method for predicting the budget impact of innovative medicines: validation study for oncolytics
ConclusionsThe validation shows that the method can relatively accurately predict BI. For payers or policymakers, this approach can yield a valuable addition to current BI predictions due to its ease of use, independence of indications and ability to update predictions to the most recent data. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 4, 2020 Category: Health Management Source Type: research

Health-related quality of life in elderly people with hypertension and the estimation of minimally important difference using EQ-5D-5L in Hong Kong SAR, China
ConclusionThe HRQoL and MID estimate of EQ-5D for elderly individuals with hypertension was reported, which provide valuable information for assisting health-care professionals in making clinical decisions in hypertensive care. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - April 2, 2020 Category: Health Management Source Type: research

The pass-through of alcohol excise taxes to prices in OECD countries
AbstractTax pass-through rates to prices measure how much prices increase when taxes are increased by one unit, which will in turn determine the effectiveness of taxation policies in reducing substance use. Using longitudinal data of alcohol prices and excise taxes from 27 Organization for Economic Cooperation and Development (OECD) countries from 2003 to 2016, we estimate the tax pass-through rates to prices for a variety of alcoholic beverages —beer (1.24; 95% CIs: [0.67, 1.81]), wine (2.4; 95% CIs: [1.7, 3.11]), Cognac (1.71; 95% CIs: [1.07, 2.35]), Gin (0.85; 95% CIs: [0.34, 1.35]), Scotch whisky (1.14; 95% CIs: ...
Source: The European Journal of Health Economics - March 31, 2020 Category: Health Management Source Type: research

Determination of the target population in early benefit assessments in Germany: challenges for non-small-cell lung cancer
DiscussionThe calculation methods applied and the target population sizes reported in NSCLC dossiers vary considerably. A consensus with regard to the databases and calculation methods used to determine the target population in NSCLC would be helpful to reduce variations. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - March 31, 2020 Category: Health Management Source Type: research

A retrospective analysis of budget impact models submitted to the National Centre for Pharmacoeconomics in Ireland
ConclusionThis research has demonstrated that budget impact models submitted to a national HTA agency have limited accuracy in predicting realised utilisation, and there is inconsistency among the parameters included. An electronic budget impact template for applicants has been developed, as a more systematic approach, for their submissions to the NCPE. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - March 30, 2020 Category: Health Management Source Type: research

Cost-effectiveness of a non-pharmacological treatment vs. “care as usual” in day care centers for community-dwelling older people with cognitive impairment: results from the German randomized controlled DeTaMAKS-trial
ConclusionsMAKS is a cost-effective treatment to stabilize the ability to perform activities of daily living and cognitive abilities of people with MCI or mild to moderate dementia in German DCCs. Thus, MAKS should be implemented in DCCs. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - March 26, 2020 Category: Health Management Source Type: research

How does the integration of collaborative care elements in a gatekeeping system affect the costs for mental health care in Germany?
AbstractMental disorders are widespread, debilitating and associated with high costs. In Germany, usual care (UC) for mental disorders is afflicted by poor coordination between providers and long waiting times. Recently, the primary alternative to UC —the gatekeeping-based general practitioners (GP) program—was extended by the collaborative Psychiatry–Neurology–Psychotherapy (PNP) program, which is a selective contract designed to improve mental health care and the allocation of resources. Here, we assess the effects of the GP program an d the PNP program on costs for mental health care. We analyzed...
Source: The European Journal of Health Economics - March 17, 2020 Category: Health Management Source Type: research

The Amsterdam Wrist Rules: how much money can they save?
ConclusionImplementation of the AWR has been shown to reduce direct and indirect costs and can, therefore, result in considerable savings of healthcare consumption and expenditure. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - March 17, 2020 Category: Health Management Source Type: research

Incidence and costs of hospitalized adult influenza patients in The Netherlands: a retrospective observational study
ConclusionsInfluenza virus infections lead to 1.8 –3.5 hospitalised patients per 10,000 persons, with mean hospitalisation costs of €6100–€8300 per adult patient, resulting in 20–28 million euros annually in The Netherlands. The highest arithmetic mean hospitalisation costs per patient were found in the 45–64 year age group. These influ enza burden estimates could be used for future influenza cost-effectiveness and impact studies. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - March 16, 2020 Category: Health Management Source Type: research

Willingness to pay for an early warning system for infectious diseases
AbstractEarly warning systems for infectious diseases and foodborne outbreaks are designed with the aim of increasing the health safety of citizens. As a first step to determine whether investing in such a system offers value for money, this study used contingent valuation to estimate people ’s willingness to pay for such an early warning system in six European countries. The contingent valuation experiment was conducted through online questionnaires administered in February to March 2018 to cross-sectional, representative samples in the UK, Denmark, Germany, Hungary, Italy, and The N etherlands, yielding a total sam...
Source: The European Journal of Health Economics - March 16, 2020 Category: Health Management Source Type: research

Transforming discrete choice experiment latent scale values for EQ-5D-3L using the visual analogue scale
ConclusionDCE-VAS is a feasible way of anchoring DCE results to a 0 –1 anchored scale with low additional respondent burden. (Source: The European Journal of Health Economics)
Source: The European Journal of Health Economics - March 16, 2020 Category: Health Management Source Type: research

Healthcare expenditure and carbon footprint in the USA: evidence from hidden cointegration approach
AbstractThe priority aim of this study is to investigate the effect of carbon footprint, which is an indicator of environmental degradation, on health expenditures for the USA. In the study, cointegration analysis was performed for the period 1970 –2016 by using health expenditures, carbon footprint, gross domestic product per capita and life expectancy at birth variables. According to the results of standard cointegration analysis, only cointegration relationship between health expenditures and income was found. In the models with carbon f ootprint, no cointegration relationship was discovered between the original v...
Source: The European Journal of Health Economics - March 14, 2020 Category: Health Management Source Type: research