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Chang X, Zhao Y, Li Y, Bai T, Gao J, Zhao C. Cost-Effectiveness of Life Cycle Cost Theory-Based Large Medical Equipment. Appl Bionics Biomech 2022; 2022:8045401. [PMID: 35469214 PMCID: PMC9034952 DOI: 10.1155/2022/8045401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study is to use the life cycle cost theory to analyze the efficiency of large medical equipment in hospitals, so as to implement life cycle cost (LCC) management and solve the current problems in hospitals. The analysis model of cost benefit of large medical equipment is established, and the cost-effectiveness of 4 large medical equipment between 2019 and 2021 is investigated and analyzed. In terms of the data in each information system of hospitals, the utilization of large medical equipment is quantitatively evaluated and analyzed by life cycle theory. The results show that the Revolution 256 row has the highest revenue of 113.29%. The annual depreciation of Signa 3.0 T HDxt is the highest, amounting to 4,160,000 yuan. However, there is lack of quality control and preventive maintenance of most equipment during use. The cost and benefit of large medical equipment in hospitals are analyzed, which demonstrates that Signa 3.0 T HDxt shows better effectiveness. Too high hospital warranty cost reflects the weak maintenance strength of hospital engineering technicians. The fundamental point of the maintenance and management of large medical equipment is to strengthen the performance evaluation of medical engineering technicians.
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Affiliation(s)
- Xiaoyi Chang
- State-Owned Assets Management, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yongqiang Zhao
- School of Modern Post, Xi'an University of Posts & Telecommunications, Xi'an 710061, China
| | - Yuebin Li
- State-Owned Assets Management, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Ting Bai
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Jungang Gao
- Radiology Department (PET/CT), The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Chao Zhao
- State-Owned Assets Management, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
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Actiste diabetes management as a service innovation – impact on everyday life – Swedish patients experience assessed by validated MedTech20 questionnaire. Cardiovasc Endocrinol Metab 2022. [DOI: 10.1097/xce.0000000000000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kheladze N, Kristensson L, Johansson A, Crang-Svalenius E, Ivarsson B. Experiences of Using a Continuous Glucose Monitoring System in Children-A Descriptive Study with Parents in the Republic of Georgia. Healthcare (Basel) 2021; 9:healthcare9111556. [PMID: 34828602 PMCID: PMC8622911 DOI: 10.3390/healthcare9111556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 12/02/2022] Open
Abstract
The benefits of medical devices are often multifaceted and may have an important impact on patients’ and relatives’ physical, mental and/or social well-being. Diabetes is a metabolic disorder and a continuous subcutaneous glucose monitoring sensor can suggest increasing treatment satisfaction. The purpose of this study was to describe parents’ experiences during their daily lives and support needs when a child uses a Flash Glucose Monitoring system (FGM). Twenty parents (n = 3 men vs. n = 17 women) to children (age ranged between 22 months and 16 years) with diabetes disease type 1, treated with an FGM unit (used for an average of 7 months (range 1–72)) at home, participated in this study. A qualitative questionnaire survey with open questions including follow-up dialogues was distributed to the parents, and collected data were analysed using qualitative content analysis. Overall satisfaction with the Libre device was Md 10 (IQR 9.25–10). One main theme “Advances in technology significantly improved everyday life” emerged from 2 categories: Improvements in quality of life and Elements of challenges. In conclusion, this qualitative study determined that parents of children with DMT1 experience a great improvement in daily life when given the opportunity to use the Libre device.
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Affiliation(s)
- Nino Kheladze
- M.Iashvili Children’s Central Hospital, Evex Medical Corporation, Lubliana Street 2/6, Tiblisi 0159, Georgia
- Correspondence: ; Tel.: +995-322606060
| | - Lars Kristensson
- Office of Medical Services, University Trust, Region Skåne, SE-221 85 Lund, Sweden; (L.K.); (A.J.); (B.I.)
| | - Anders Johansson
- Office of Medical Services, University Trust, Region Skåne, SE-221 85 Lund, Sweden; (L.K.); (A.J.); (B.I.)
- Clinical Sciences, Lund, Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden
| | | | - Bodil Ivarsson
- Office of Medical Services, University Trust, Region Skåne, SE-221 85 Lund, Sweden; (L.K.); (A.J.); (B.I.)
- Clinical Sciences, Lund, Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden
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Hagberg K, Brodtkorb TH. Patient-reported benefits of bone-anchored transfemoral prostheses as assessed by MedTech20: A general outcome measure for medical products. Prosthet Orthot Int 2021; 45:355-361. [PMID: 33856153 DOI: 10.1097/pxr.0000000000000008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 11/27/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND The medical community demands evidence for the benefits of medical devices such as bone-anchored prostheses (BAPs). MedTech20 is a novel instrument aiming to address general benefits of medical devices. OBJECTIVE To describe general patient-reported benefits of BAPs measured with MedTech20. STUDY DESIGN This is a cross-sectional descriptive survey. METHODS Patients treated in Sweden who had used a BAP for >1 year were mailed the MedTech20 Questionnaire. Responses to each attribute were described, and the MedTech20 Index (0-1), in which a higher figure represents larger benefits from the product, was calculated. Index values were compared based on demographic variables (sex, unilateral or bilateral transfemoral amputation (TFA), and those having experienced any complication of implant parts or the prosthetic connection device). RESULTS The response rate was 72%. The 62 participants (41 men and 21 women; mean age 57 years) had 11 ± 6.9 mean years of BAP experience. Single attributes stated as highly relevant and with high benefit for BAPs included perceived reliability, perceived safety, sense of control of the disability, facilitation of movement outside home, no discomfort at use, and ease of use. Attributes with less relevance included aid to remember tasks, reduction of barriers to a good sleep, and reduced sense of compromised integrity. The MedTech20 Index was 0.655 ± 0.188 and was not statistically significantly different based on any of the demographic variables. CONCLUSIONS By using a general measure on attributes of medical devices, this study provides new insights strengthening the evidence regarding the benefits that BAPs provide for patients with TFA who had difficulties with socket-suspended prostheses.
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Affiliation(s)
- Kerstin Hagberg
- Advanced Reconstruction of Extremities and Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Möller S, Ivarsson B, Nordström LÅ, Johansson A. LTOT Patients' Experience of a Portable Oxygen Unit and Health-Related Quality of Life-A Cross-Sectional Study. Healthcare (Basel) 2020; 8:healthcare8020182. [PMID: 32585944 PMCID: PMC7349300 DOI: 10.3390/healthcare8020182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The purpose of the present study was to elucidate the experiences of long-term oxygen therapy (LTOT) patients with a portable oxygen unit and to describe the patients’ self-assessed health-related quality of life (HRQoL). Methods: The study employed a prospective cross-sectional design. Data collection entailed two questionnaires, namely the MedTech20 (patients’ experience of the medical device in four areas) and EQ-5D (HRQoL). The informants consisted of patients (n = 148) treated with such a medical device and that were registered in Skåne University Hospital’s database, Medusa. Results: In the domain Sense of security the informant felt the equipment reliable and safe to use and expressed a sense of control for the user. Regarding Social participation, the responses did not indicate the device to facilitate leisure activities, movement outside the homes, traveling or everyday tasks to a larger extent. The respondents did express a reduced sense of compromised integrity, with a minor effect on Intimacy. With regards to Convenience, the responses indicated the product to provide Adaptability to personal needs. Overall, a strongly affected HRQoL (Your current health condition, EQ-VAS Md = 50 (IQR 36–70)) with strong correlation with EQ-5D was seen. Conclusions: Informants experienced the portable oxygen unit as reliable and safe to use while giving a sense of control over the disease itself. A minor impact on social participation was reported, except for a reduced sense of compromised integrity. The patients also reported a strongly reduced HRQoL.
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Affiliation(s)
- Sebastian Möller
- Department of Information Technology and Biomedical Engineering, Region Skåne, Lasarettsgatan 37, 221 85 Lund, Sweden;
- Department of Clinical Sciences, Lund University, 221 00 Lund, Sweden;
- Correspondence:
| | - Bodil Ivarsson
- Office of Medical Service, Region Skåne, 205 25 Malmö, Sweden;
- Department of Cardiothoracic Surgery, Lund University, 221 00 Lund, Sweden
| | - Lars-Åke Nordström
- Department of Information Technology and Biomedical Engineering, Region Skåne, Lasarettsgatan 37, 221 85 Lund, Sweden;
| | - Anders Johansson
- Department of Clinical Sciences, Lund University, 221 00 Lund, Sweden;
- Office of Medical Service, Region Skåne, 205 25 Malmö, Sweden;
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Tao G, Charm G, Kabacińska K, Miller WC, Robillard JM. Evaluation Tools for Assistive Technologies: A Scoping Review. Arch Phys Med Rehabil 2020; 101:1025-1040. [PMID: 32059944 DOI: 10.1016/j.apmr.2020.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. DATA SOURCES We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. STUDY SELECTION Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. DATA EXTRACTION We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. DATA SYNTHESIS From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. CONCLUSIONS We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement.
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Affiliation(s)
- Gordon Tao
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Geoffrey Charm
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Integrated Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Katarzyna Kabacińska
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia
| | - William C Miller
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Julie M Robillard
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia; British Columbia Women's and Children's Hospital, Vancouver, British Columbia, Canada.
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Blüher M, Saunders SJ, Mittard V, Torrejon Torres R, Davis JA, Saunders R. Critical Review of European Health-Economic Guidelines for the Health Technology Assessment of Medical Devices. Front Med (Lausanne) 2019; 6:278. [PMID: 31850356 PMCID: PMC6895571 DOI: 10.3389/fmed.2019.00278] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 11/14/2019] [Indexed: 01/19/2023] Open
Abstract
Background: Health-technology assessment (HTA) is a recognized mechanism to determine the relative benefits of innovative medical technologies. One aspect is their health-economic impact. While the process and methodology for pharmaceuticals is well-established, guidance for medical devices is sparse. Aim: To provide an overview of the health-economic aspect in current European HTA guidelines concerning medical devices and identifying issues raised and potential improvements proposed in recent literature. Methodology: Available guidelines by European agencies were each reviewed and summarized. To complement this, a full systematic review of current literature concerning potential improvements to existing HTA practices for medical devices, from PubMed and EMBASE, was conducted; the focus was on health economics. Authors could only review documents in English, French, or German. The systematic review yielded 518 unique articles concerning HTA for medical devices, 32 of which were considered for full-text review after screening of all abstracts. Results: There is very limited consensus in—and mostly a complete lack of—guidance specific to medical devices in official HTA guidelines, for both clinical and economic analyses. Twenty two of 41 European countries had published official HTA guidance in English, French, or German. Among these only 4 (England, France, the Netherlands, and Sweden) dedicated a chapter or separate document to medical devices. In the literature, there is sufficient evidence to suggest medical devices need to be addressed separately from pharmaceuticals. However, mostly challenges are discussed rather than implementable solutions offered. We present the following set of frequently discussed issues and summarize any solutions that pertain to them: a weak evidence base, learning-curve effects, organizational impact, incremental innovation, diversity of devices, dynamic pricing, and transferability. We further combine reviewed information to suggest a set of possible best practices for health-economic assessment of medical devices. Conclusion: For greater efficiency in medical-device innovation, European agencies should look to (re-)address the specific requirements of medical devices in their HTA guidelines. When both the health-economic and data requirements for the HTA of medical devices are defined, the development of practical solutions will likely follow.
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Nanda S, Mahapatra S, Lindeen SA, Bernau JL, Cutshall SM, Schierwater B, Chon TY, Wahner-Roedler DL, Bauer BA. Evaluation of a Novel Wellness Assessment Device (Preventiometer): A Feasibility Pilot Study. Glob Adv Health Med 2019; 8:2164956119881096. [PMID: 31637111 PMCID: PMC6785912 DOI: 10.1177/2164956119881096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/14/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022] Open
Abstract
Background Periodic wellness assessments can provide an estimate of a person’s relative risks for major diseases, but wellness visits are underused. Our suggestion is to use a comprehensive device during a single visit. Objective The goal of this pilot study was to evaluate the feasibility of a novel one-stop wellness device (Preventiometer; iPEx5 GmbH, Greifswald, Germany) for performing multiple tests and providing a comprehensive wellness assessment in a short period. Methods A Preventiometer was used to provide wellness assessments for 10 healthy volunteers who then answered a 25-question survey to rate their satisfaction with the testing and their overall impression. Results All volunteers agreed or strongly agreed with the following: The assessment reports were easy to understand, the Preventiometer met their satisfaction, the participants were comfortable during the assessment, and all measurements and testing were well coordinated. Participants liked the instant test result feature. Most (90%) agreed that the machine was useful for a quick health assessment for busy people, and 70% felt that it was time efficient. Conclusion In this feasibility pilot study, the Preventiometer performed multiple tasks and provided a comprehensive wellness assessment in a short period. Participants reported remarkably high satisfaction with the tests. A larger study is needed to prove that this is a pragmatic approach to help individuals improve their health.
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Affiliation(s)
- Sanjeev Nanda
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Saswati Mahapatra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | - Susanne M Cutshall
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Center For Innovation, Mayo Clinic, Rochester, Minnesota
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Wilkinson B, van Boxtel R. The Medical Device Regulation of the European Union Intensifies Focus on Clinical Benefits of Devices. Ther Innov Regul Sci 2019:2168479019870732. [PMID: 31455108 DOI: 10.1177/2168479019870732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
This article comments on the new approach to the clinical evaluation of medical devices in the European Union (EU), which adds consideration of intended clinical benefits to the traditional focus on safety and performance. The article also discusses types of clinical benefits that may be claimed and how evidence for them may be generated. In the EU, determining the benefit-risk profile is an existing core requirement of the clinical evaluation performed according to MEDDEV 2.7/1 Rev 4 guidelines, but under the new Medical Device Regulation (MDR), "intended" clinical benefits must be determined first. The MDR sets high standards for ensuring reliable data are generated from clinical investigations. It stipulates that the endpoints of clinical investigations should include clinical benefits. However, many clinical-use questions arise only after a device is made widely available to patients. For all medical devices, particularly for on-the-market devices never subjected to randomized controlled trials and for new devices developed when these trials were inappropriate/impossible, the postmarket phase of the device is a valuable source of clinical-benefit data. Postmarket clinical follow-up can corroborate and refine predictions of clinical benefits over time. Indirect clinical effects, which may affect treatment adherence and influence patients' well-being, may surface in the postmarket phase. Real-world clinical data will improve the manufacturer's understanding of their device's clinical benefits, potentially changing claims of intended clinical benefits in subsequent clinical evaluations. A paradigm change in clinical evaluation of medical devices in the EU will ensue when manufacturers ensure that their devices deliver real-world clinical benefits.
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Krassioukov A, Igawa Y, Averbeck MA, Madersbacher H, Lloyd AJ, Bøgelund M, Thiruchelvam N. Gains in health utility associated with urinary catheter innovations. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2018; 11:345-351. [PMID: 30319291 PMCID: PMC6171519 DOI: 10.2147/mder.s165778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To estimate gains in health utility for two different catheter features and a support service related to urinary catheters used for intermittent catheterization. Patients and methods Two internet-based time trade-off (TTO) surveys were undertaken to value vignettes describing two innovative catheter features and a support service. The first TTO survey “Size and Service” included catheters with compact design and the availability of a support service for users; the second TTO survey “Phthalates” included avoidance of potentially harmful phthalates in the material of the catheters. All participants were from the UK; they traded health states against a time horizon that matched their total life expectancy. Sensitivity analyses were done to estimate the impact of extreme values on disutilities. Results The participants (n=890) estimated the incremental value of 0.031 (95% CI: 0.024–0.039), 0.009 (95% CI: 0.003–0.015), and 0.037 (95% CI: 0.027–0.046), respectively, for catheters with compact design, availability of support service, and catheters not containing phthalates. Conclusions Participants valued all three improvements in catheter design. To capture the impact of such design improvements on quality of life and utilities, vignette-based approaches can be a useful supplement to the conventional, generic tools.
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Affiliation(s)
- Andrei Krassioukov
- University of British Columbia, International Collaboration On Repair Discoveries (ICORD), Vancouver, British Columbia, Canada, .,Division of Physical Medicine and Rehabilitation, Department of Medicine, G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada,
| | - Yasuhiko Igawa
- Department of Continence Medicine, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan
| | | | | | | | | | - Nikesh Thiruchelvam
- Department of Urology, Cambridge University Hospitals NHS Trust, Cambridge, UK
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Averbeck MA, Krassioukov A, Thiruchelvam N, Madersbacher H, Bøgelund M, Igawa Y. The impact of different scenarios for intermittent bladder catheterization on health state utilities: results from an internet-based time trade-off survey. J Med Econ 2018; 21:945-952. [PMID: 29882712 DOI: 10.1080/13696998.2018.1486846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AIMS Intermittent catheterization (IC) is the gold standard for bladder management in patients with chronic urinary retention. Despite its medical benefits, IC users experience a negative impact on their quality of life (QoL). For health economics based decision making, this impact is normally measured using generic QoL measures (such as EQ-5D) that estimate a single utility score which can be used to calculate quality-adjusted life years (QALYs). But these generic measures may not be sensitive to all relevant aspects of QoL affected by intermittent catheters. This study used alternative methods to estimate the health state utilities associated with different scenarios: using a multiple-use catheter, one-time-use catheter, pre-lubricated one-time-use catheter and pre-lubricated one-time-use catheter with one less urinary tract infection (UTI) per year. METHODS Health state utilities were elicited through an internet-based time trade-off (TTO) survey in adult volunteers representing the general population in Canada and the UK. Health states were developed to represent the catheters based on the following four attributes: steps and time needed for IC process, pain and the frequency of UTIs. RESULTS The survey was completed by 956 respondents. One-time-use catheters, pre-lubricated one-time-use catheters and ready-to-use catheters were preferred to multiple-use catheters. The utility gains were associated with the following features: one time use (Canada: +0.013, UK: +0.021), ready to use (all: +0.017) and one less UTI/year (all: +0.011). LIMITATIONS Internet-based survey responders may have valued health states differently from the rest of the population: this might be a source of bias. CONCLUSION Steps and time needed for the IC process, pain related to IC and the frequency of UTIs have a significant impact on IC related utilities. These values could be incorporated into a cost utility analysis.
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Affiliation(s)
| | - Andrei Krassioukov
- b International Collaboration On Repair Discoveries (ICORD), Department of Medicine , University of British Columbia and G.F. Strong Rehabilitation Centre , Vancouver , BC , Canada
| | - Nikesh Thiruchelvam
- c Department of Urology, Cambridge University Hospitals NHS Trust , Cambridge , UK
| | - Helmut Madersbacher
- d Department of Neurology , Medical University Innsbruck , Innsbruck , Austria
| | | | - Yasuhiko Igawa
- f Department of Continence Medicine , The University of Tokyo , Graduate school of Medicine , Tokyo , Japan
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Welk B, Isaranuwatchai W, Krassioukov A, Husted Torp L, Elterman D. Cost-effectiveness of hydrophilic-coated intermittent catheters compared with uncoated catheters in Canada: a public payer perspective. J Med Econ 2018; 21:639-648. [PMID: 29458282 DOI: 10.1080/13696998.2018.1443112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
STUDY DESIGN A Markov model was used to analyze cost-effectiveness over a lifetime horizon. OBJECTIVE To investigate the cost-effectiveness of hydrophilic-coated intermittent catheters (HCICs) compared with uncoated catheters (UCs) among individuals with neurogenic bladder dysfunction (NB) due to spinal cord injury (SCI). SETTING A Canadian public payer perspective based on data from Ontario; including a scenario analysis from the societal perspective. METHODS A previously published Markov decision model was modified to compare the lifetime costs and quality-adjusted life years (QALYs) for the two interventions. Three renal function and three urinary tract infection (UTI) health states as well as other catheter-related events were included. Scenario analyses, including utility gain from compact catheter and phthalate free catheter use, were performed. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness of the model. RESULTS The model predicted that a 50-year-old patient with SCI would gain an additional 0.72 QALYs if HCICs were used instead of UCs at an incremental cost of $48,016, leading to an incremental cost-effectiveness ratio (ICER) of $66,634/QALY. Moreover, using HCICs could reduce the lifetime number of UTI events by 11%. From the societal perspective, HCICs cost less than UCs, while providing superior outcomes in terms of QALYs, life years gained (LYG), and UTIs. The cost per QALY further decreased when health-related quality-of-life (HRQoL) gains associated with compact HCICs or catheters not containing phthalates were included. CONCLUSION In general, ICERs in the range of CAD$50-100,000 could be considered cost-effective. The ICERs for the base case and sensitivity analyses suggest that HCICs could be cost-effective. From the societal perspective, HCICs were associated with potential cost savings in our model. The results suggest that reimbursement of HCICs should be considered in these settings.
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Affiliation(s)
- Blayne Welk
- a Department of Surgery and Epidemiology & Biostatistics , Western University , London , Ontario , Canada
- b St Joseph's Health Care , London , Ontario , Canada
| | - Wanrudee Isaranuwatchai
- c Center for Excellence in Economic Analysis Research (CLEAR), The HUB, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto , Ontario , Canada
- d Institute of Health Policy, Management and Evaluation, University of Toronto , Toronto , Ontario , Canada
- e Canadian Center for Applied Research in Cancer Control , Vancouver , British Columbia , Canada
| | - Andrei Krassioukov
- f ICORD, Spinal Cord Program, GF Strong Rehabilitation Center, University of British Columbia , Vancouver , British Columbia , Canada
| | | | - Dean Elterman
- h Toronto Western Hospital/Krembil Research Institute , Toronto , Ontario
- i Department of Surgery , University of Toronto , Toronto , Ontario
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