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Wheaton J, Ford B, Nairn A, Collard S. Towards a conceptual framework for the prevention of gambling-related harms: Findings from a scoping review. PLoS One 2024; 19:e0298005. [PMID: 38517885 PMCID: PMC10959398 DOI: 10.1371/journal.pone.0298005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/16/2024] [Indexed: 03/24/2024] Open
Abstract
The global gambling sector has grown significantly over recent years due to liberal deregulation and digital transformation. Likewise, concerns around gambling-related harms-experienced by individuals, their families, their local communities or societies-have also developed, with growing calls that they should be addressed by a public health approach. A public health approach towards gambling-related harms requires a multifaceted strategy, comprising initiatives promoting health protection, harm minimization and health surveillance across different strata of society. However, there is little research exploring how a public health approach to gambling-related harms can learn from similar approaches to other potentially harmful but legal sectors such as the alcohol sector, the tobacco sector, and the high in fat, salt and sugar product sector. Therefore, this paper presents a conceptual framework that was developed following a scoping review of public health approaches towards the above sectors. Specifically, we synthesize strategies from each sector to develop an overarching set of public health goals and strategies which-when interlinked and incorporated with a socio-ecological model-can be deployed by a range of stakeholders, including academics and treatment providers, to minimise gambling-related harms. We demonstrate the significance of the conceptual framework by highlighting its use in mapping initiatives as well as unifying stakeholders towards the minimization of gambling-related harms, and the protection of communities and societies alike.
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Affiliation(s)
- Jamie Wheaton
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
| | - Ben Ford
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Psychological Sciences, School of Natural and Social Sciences, University of Gloucestershire, Cheltenham, United Kingdom
- The Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Agnes Nairn
- University of Bristol Business School, University of Bristol, Bristol, United Kingdom
| | - Sharon Collard
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
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2
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Mela A, Lis D, Rdzanek E, Jaroszyński J, Furtak-Niczyporuk M, Drop B, Blicharski T, Niewada M. AOTMiT reimbursement recommendations compared to other HTA agencies. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01655-x. [PMID: 38261131 DOI: 10.1007/s10198-023-01655-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 11/24/2023] [Indexed: 01/24/2024]
Abstract
Our objective was to compare AOTMiT (Polish: Agencja Oceny Technologii Medycznych i Taryfikacji) recommendations to other HTA (Health Technology Assessment) agencies for newly registered drugs and new registration indications issued by the European Medicines Agency between 2014 and 2019. The study aims to assess the consistency and justifications of AOTMiT recommendations compared to that of other HTA agencies in 11 countries. A total of 2494 reimbursement recommendations published by 12 HTA agencies for 464 medicinal products and 525 indications were analyzed. Our analysis confirmed that the Polish AOTMiT agency seems to bear the closest resemblance to the corresponding HTA agencies from Canada (CADTH) and New Zealand (PHARMAC), when it comes to the outcome of HTA recommendations (positive or negative). Poland had a general scheme for justifying recommendations, similar to that of Ireland-four aspects (i.e., clinical efficacy, safety profile, cost-effectiveness, and impact on the payer's budget) are important for Poland when formulating the final decision. Compared to other countries, Poland shows a noticeably different pattern of justifying reimbursement recommendations, as revealed primarily in terms of budget impact and somewhat less so for cost-effectiveness rationales.
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Affiliation(s)
- Aneta Mela
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Banacha 1B, 02-097, Warsaw, Poland.
| | - Dorota Lis
- HealthQuest Sp z o.o. Sp. K, 01-625, Warsaw, Poland
| | - Elżbieta Rdzanek
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Banacha 1B, 02-097, Warsaw, Poland
| | - Janusz Jaroszyński
- Department of Administrative Procedure, Faculty of Law and Administration, Maria Curie-Skłodowska University of Lublin, Marii Curie-Skłodowskiej 5, 20-031, Lublin, Poland
| | | | - Bartłomiej Drop
- Department of Information Technology and Medical Statistics, Faculty of Health Sciences, Medical University of Lublin, 20-093, Lublin, Poland
| | - Tomasz Blicharski
- Department of Orthopeadics and Rehabilitation, Medical University of Lublin, K. Jaczewskiego 8, 20-090, Lublin, Poland
| | - Maciej Niewada
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Banacha 1B, 02-097, Warsaw, Poland
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Mela A, Rdzanek E, Jaroszyński J, Furtak-Niczyporuk M, Jabłoński M, Niewada M. Reimbursement decision-making system in Poland systematically compared to other countries. Front Pharmacol 2023; 14:1153680. [PMID: 37900165 PMCID: PMC10611478 DOI: 10.3389/fphar.2023.1153680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/24/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction: Our objective was to analyze and compare systematically and structurally reimbursement systems in Poland and other countries. Methods: The systems were selected based on recommendations issued by the Polish Agency for Health Technology Assessment and Tariffication (AHTAPol), which explicitly referred to other countries and agencies). Consequently, apart from Poland, the countries included in the analysis were England, Scotland, Wales, Ireland, France, Netherlands, Germany, Norway, Sweden, Canada, Australia and New Zealand. Relevant information and data were collected through a systematic search of PubMed (Medline), Embase and The Cochrane Library as well as competent authority websites and grey literature sources. Results and discussion: In most of the countries, the submission of a reimbursement application is initiated by a pharmaceutical company, and only a few countries allow it before a product is approved for marketing. All of the agencies analyzed are independent and some have regulatory function of reimbursement decision making body. A key criterion differentiating the various agencies in terms of HTA is the cost-effectiveness threshold. Most of the countries have specific mechanisms to improve access to expensive specialty drugs, including cancer drugs and those used for rare diseases. Reimbursement systems often lack consistency in appreciating the same stages, leading to heterogeneous decision-making processes. The analysis of recommendations issued in different countries for the same medicinal product will allow a better understanding of the relations between the reimbursement system, HTA assessment, stakeholders involvement and decision on reimbursement of innovative drugs.
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Affiliation(s)
- Aneta Mela
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Elżbieta Rdzanek
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Janusz Jaroszyński
- Department of Administrative Proceedings, Faculty of Law and Administration, Marie Curie-Sklodowska University, Lublin, Poland
| | | | - Mirosław Jabłoński
- Department of Orthopeadics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Maciej Niewada
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
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Zhao Q, Li C, Zhang Y, Tang HT, Wang J, Yu XH, Zhao Y, Xing Y, Yu J, Ye J, Shan EF, Li XW. Economic evaluations of electronic health interventions for people with age-related cognitive impairment and their caregivers: A systematic review. Int J Geriatr Psychiatry 2023; 38:e5990. [PMID: 37655517 DOI: 10.1002/gps.5990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 08/12/2023] [Indexed: 09/02/2023]
Abstract
OBJECTS Dementia has physical, social and economic impacts, causing considerable distress for people with age-related cognitive impairment (PWACI) and their caregivers. Electronic health (e-health) interventions can provide convenient education to improve the coping competence of caregivers and have become an important approach to supporting them. Understanding the economic evidence of e-health interventions will facilitate the decision making and implementation of integrating e-health into routine health services. The present review aimed to appraise economic evidence related to e-health interventions for PWACI and their caregivers. METHODS We systematically searched multiple cross-disciplinary databases from inception to February 28, 2023. Two reviewers independently selected the trials, assessed the quality, and checked the data. A descriptive-analytical narrative method was used to analyze the review findings. RESULTS Thirteen studies were analyzed, including 12 randomized controlled trials and one quasi-experimental study. All included studies were conducted in developed countries. The included studies reported limited economic information. There were six cost-effectiveness analysis, five cost-consequence analysis and one partial economic evaluation. The included studies were heterogeneous, and varied in quality. The results demonstrated that e-health multicomponent interventions can reduce the cost of health service utilization in short term (10-104 weeks). CONCLUSIONS Few studies calculated the incremental cost-effectiveness ratio to evaluate the cost-effectiveness of e-health interventions. Preliminary evidence indicates that e-health interventions can reduce the cost of health service utilization in the short term, but the cost-effectiveness of e-health interventions hasn't been identified. More robust evidence is needed to clarify the value of e-health interventions for PWACI and their caregivers.
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Affiliation(s)
- Qing Zhao
- School of Public Health, Southern Medical University, Guangzhou, China
- School of Health Management, Southern Medical University, Guangzhou, China
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Cheng Li
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yu Zhang
- School of Humanities, Changzhou Vocational Institute of Textile and Garment, Changzhou, China
| | - Hui-Ting Tang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jing Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiao-Hong Yu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yue Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Ying Xing
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jie Yu
- Department of Biomedical Engineering, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Juan Ye
- Department of Internal Neurology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - En-Fang Shan
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xian-Wen Li
- School of Nursing, Nanjing Medical University, Nanjing, China
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Commissioning [Integrated] Care in England: An Analysis of the Current Decision Context. Int J Integr Care 2022; 22:3. [PMID: 36304783 PMCID: PMC9541117 DOI: 10.5334/ijic.6693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Methods: Results: Conclusion:
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6
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Comans TA, Nguyen KH, Ratcliffe J, Rowen D, Mulhern B. Valuing the AD-5D Dementia Utility Instrument: An Estimation of a General Population Tariff. PHARMACOECONOMICS 2020; 38:871-881. [PMID: 32314315 DOI: 10.1007/s40273-020-00913-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE This paper reports on the valuation of quality-of-life states in the Alzheimer's Disease Five Dimensions (AD-5D) instrument in a representative sample of the general population in Australia using the discrete-choice experiment with duration (DCETTO) elicitation technique. METHOD A DCE with 200 choice sets of two quality-of-life (QoL) state-duration combinations blocked into 20 survey versions, with ten choice sets in each version, was designed and administered online to a sample representative of the Australian population. Two additional choice sets comprising internal consistency and dominance checks were included in each survey version. A range of model specifications investigating preferences with respect to duration and interactions between AD-5D dimension levels were estimated. Utility weights were developed, with estimated coefficients transformed to the 0 (being dead) to 1 (full health) scale, suitable for the calculation of quality-adjusted life-year (QALY) weights for use in economic evaluation. RESULTS In total, 1999 respondents completed the choice experiment. Overall, respondents were slightly better educated and had higher annual incomes than the Australian general population. The estimation results from different specifications and models were broadly consistent with the monotonic nature of the AD-5D: utility increased with increased life expectancy and decreased as the severity level for each dimension worsened. A utility value set was generated for the calculation of utilities for all QoL states defined by the AD-5D descriptive system. CONCLUSION The DCE-based utility value set is now available to use to generate QALYs for the economic evaluation of treatments and interventions targeting people with dementia and/or their family caregivers.
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Affiliation(s)
- Tracy A Comans
- The Centre for Health Services Research, University of Queensland, St. Lucia, Brisbane, QLD, Australia.
- NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People, Sydney, NSW, Australia.
| | - Kim-Huong Nguyen
- The Centre for Health Services Research, University of Queensland, St. Lucia, Brisbane, QLD, Australia
- NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People, Sydney, NSW, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Donna Rowen
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
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7
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Corbacho B, Drummond M, Santos R, Jones E, Borràs JM, Mestre-Ferrandiz J, Espín J, Henry N, Prat A. Does the use of health technology assessment have an impact on the utilisation of health care resources? Evidence from two European countries. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:621-634. [PMID: 32026155 PMCID: PMC7214388 DOI: 10.1007/s10198-020-01160-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES A centralised approach to health technology assessment (HTA) may facilitate optimal use of HTA resources. A regional approach may increase the chances of local implementation of recommendations. This study aimed to compare assessment procedures in England (centralised HTA approach) with Spain (regional HTA approach) discussing key challenges and opportunities from both approaches. METHODS We compared technology assessments of anticancer medicines in the two jurisdictions from 2008 to 2015. To assess the implementation of HTA recommendations, we assessed trends in medicine usage using regression methods. We used IQVIA data, from 2011 to 2016, for a sample of 11 medicines. We used CatSalut data from Catalonia to assess the implementation of local recommendations. RESULTS In England, 66 assessments were undertaken by the National Institute for Health and Care Excellence (NICE), using a standardised methodology. In Spain, there were 79 reports undertaken by a range of bodies using a shared process and coordinated through the GENESIS collaboration; the assessment methods used varied substantially. Overall, the recommendations in the two jurisdictions were similar. Regression analyses indicate that where there is a positive recommendation by HTA bodies, the usage of the medicine responds most strongly (p < 0.001) in Catalonia (4.892), followed by England (3.120) and Spain (1.693). CONCLUSIONS This study suggests that medicine utilisation does respond to the positive recommendations of HTA bodies. However, if HTA capacity is organised primarily regionally, considerable effort may be required in coordination, to ensure consistent and rigorous assessments and adequate implementation of HTA findings.
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Affiliation(s)
- B Corbacho
- York Trials Unit, ARRC Building, Department of Health Sciences, University of York, York, UK.
| | - M Drummond
- Centre for Health Economics, University of York, York, UK
| | - R Santos
- Centre for Health Economics, University of York, York, UK
| | | | - J M Borràs
- Department Clinical Sciences, Universidad de Barcelona, Barcelona, Spain
| | | | - J Espín
- Escuela Andaluza de Salud Publica, Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - N Henry
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IQVIA, London, UK
| | - A Prat
- Pharmacy and Medicines Department, Servei Catala` de la Salut (CatSalut), Barcelona, Spain
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8
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Oliva-Moreno J, Puig-Junoy J, Trapero-Bertran M, Epstein D, Pinyol C, Sacristán JA. Economic Evaluation for Pricing and Reimbursement of New Drugs in Spain: Fable or Desideratum? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:25-31. [PMID: 31952669 DOI: 10.1016/j.jval.2019.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/23/2019] [Accepted: 06/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The economic evaluation of healthcare technologies has become in many countries a basic tool for reimbursement, pricing and purchasing decisions. OBJECTIVE The objective of this article is to examine the institutional, legal, and political factors that have impeded the application of economic evaluation and the criterion of efficiency in the process of pricing and reimbursement of new medicines in Spain. METHODS Narrative description of the current institutional framework for the use of economic evaluation in pricing and reimbursement in Spain, legal and policy framework in the field of evaluation of new medicines, and stakeholder initiatives and policies related to the use of economic evaluation outside of the pricing and reimbursement process. RESULTS Spain has an institutional framework created and established over the last years that could have facilitated a formal use of economic evaluation in the process of pricing and reimbursement. Nevertheless, the real use of economic evaluation at the central or regional level is still unknown, although application of the efficiency criterion, linking to cost-effectiveness, has been clearly required by Spanish laws and regulations at the national level. We highlight a certain degree of moral hazard from the central government that is not directly responsible for the budget impact of reimbursement and pricing decisions. There are currently a number of ongoing initiatives in the field of economic evaluation by various agents, but they remain uncoordinated. CONCLUSIONS Poor governance at the highest level of decision making is the main reason for the lack of interest in economic evaluation. A profound political change, supported by transparency and accountability, is required before the criterion of efficiency can be fully considered in the process of pricing and reimbursement of new medicines in Spain.
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Affiliation(s)
- Juan Oliva-Moreno
- Department of Economic Analysis and Finance, Universidad de Castilla La-Mancha, Toledo, Spain.
| | - Jaume Puig-Junoy
- Barcelona School of Management, Universitat Pompeu Fabra, Barcelona, Spain
| | - Marta Trapero-Bertran
- Institut de Recerca en Avaluació i Polítiques Públiques, Universitat Internacional de Catalunya, Barcelona, Spain
| | - David Epstein
- Department of Applied Economics, University of Granada, Granada, Spain
| | - Carme Pinyol
- Market Access Department, Pierre Fabre Ibérica, Barcelona, Spain; ISPOR Spain Chapter, Barcelona, Spain
| | - José Antonio Sacristán
- Department of Epidemiology and Public Health, Universidad Autonoma de Madrid, Madrid, Spain; Medical Department, Lilly, Madrid, Spain
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Bulamu NB, Kaambwa B, Ratcliffe J. Economic evaluations in community aged care: a systematic review. BMC Health Serv Res 2018; 18:967. [PMID: 30547788 PMCID: PMC6295002 DOI: 10.1186/s12913-018-3785-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 12/02/2018] [Indexed: 12/21/2022] Open
Abstract
Background This paper reports the methods and findings from a systematic review of economic evaluations conducted in the community aged care sector between 2000 and 2016. Methods Online databases searched were PubMed, Medline, Scopus, and web of science, CINAHL and informit. Studies were included if they 1) were full economic evaluations that compared both the costs and outcomes of two or more interventions 2) in study population of people aged 65 years and over 3) dependent older people living in the community 4) alternatives being compared were care models or service delivery interventions in the community aged care sector (a group of programs that have been established as a support system to allow older people to remain living in their own homes for as long as possible, as an alternative to institutional or residential care) and 5) published in the English language between 2000 and November 2016. Results Eleven studies reporting upon economic evaluations of service delivery interventions in community aged care were identified; the majority of which were undertaken in Europe. Critical appraisal of the identified studies highlighted the methodological rigour in these evaluations. Conclusion This systematic review highlights the paucity of economic evaluation studies conducted to date in the community aged care sector. The findings highlight the importance of cost utility analysis methodology as it allows for a uniform outcome measure, that facilitates the comparison of different interventions. In addition, multi-attribute utility measures that represent those quality of life domains that are most important to older people should be used and attention must be paid to the inclusion of informal care costs and outcomes as this is a key resource in community aged care service delivery.
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Affiliation(s)
- Norma B Bulamu
- Health Economics Unit, Flinders Health Care and Workforce Innovations, School of Medicine, Flinders University, Adelaide, SA, Australia.
| | - Billingsley Kaambwa
- Health Economics Unit, Flinders Health Care and Workforce Innovations, School of Medicine, Flinders University, Adelaide, SA, Australia
| | - Julie Ratcliffe
- Institute for Choice, University of South Australia Business School, Adelaide, SA, Australia
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Torbica A, Tarricone R, Drummond M. Does the approach to economic evaluation in health care depend on culture, values, and institutional context? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:769-774. [PMID: 29209854 DOI: 10.1007/s10198-017-0943-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Aleksandra Torbica
- Centre for Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, Milan, Italy
| | - Rosanna Tarricone
- Centre for Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, Milan, Italy
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Oreja-Guevara C, Kobelt G, Berg J, Capsa D, Eriksson J. New insights into the burden and costs of multiple sclerosis in Europe: Results for Spain. Mult Scler 2018. [PMID: 28643597 DOI: 10.1177/1352458517708672] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In order to estimate the value of interventions in multiple sclerosis (MS) where lifetime costs and outcomes cannot be observed, outcome data have to be combined with costs. This requires that cost data be regularly updated. OBJECTIVES AND METHODS This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption, work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in EUR 2015. RESULTS A total of 462 patients (mean age 43 years) participated in Spain; 96% were below retirement age and of these, 45% were employed. Employment was related to disability, and MS affected productivity at work for 72% of those working. Overall, 92% and 64% of patients experienced fatigue and cognitive difficulties as a problem, respectively. Mean utility and total annual costs were estimated at 0.772 and €20,600 at Expanded Disability Status Scale (EDSS) 0-3, 0.486 and €48,500 at EDSS 4-6.5 and 0.182 and €68,700 at EDSS 7-9, respectively. The mean cost of a relapse was €2050. CONCLUSION This study illustrates the burden of MS on Spanish patients and provides current data that are important for development of health policies.
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Affiliation(s)
- Celia Oreja-Guevara
- Department of Neurology, IdISSC, Hospital Universitario Clinico San Carlos, Madrid, Spain
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Avilés Blanco MV, Brey R, Araña J, Pinto Prades JL. Emotions and scope effects in the monetary valuation of health. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:315-325. [PMID: 28341905 DOI: 10.1007/s10198-017-0885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 03/09/2017] [Indexed: 06/06/2023]
Abstract
This study presents evidence on the role of emotions in the monetary evaluation of health technologies, namely, drug-eluting stents (DES) in our case. It is shown that subjects who are very afraid of having to undergo an angioplasty are: (a) less sensitive to the size of the risk reduction provided by DES and (b) willing to pay more. The lack of scope sensitivity questions the normative validity of the responses of highly emotional subjects. We provide evidence of this effect using what we call the cognitive-emotional random utility model and the responses of a face-to-face, computer-assisted personal interview survey conducted in a representative sample of the Spanish general population (n = 1663).
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Affiliation(s)
| | - Raúl Brey
- University Pablo de Olavide, Seville, Spain
| | - Jorge Araña
- University of Las Palmas de Gran Canaria, Las Palmas, Spain
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Angelis A, Lange A, Kanavos P. Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:123-152. [PMID: 28303438 PMCID: PMC5773640 DOI: 10.1007/s10198-017-0871-0] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 01/17/2017] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. OBJECTIVE To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment. METHODS A systematic (peer review and grey) literature review was conducted using an analytical framework examining: (1) 'Responsibilities and structure of HTA agencies'; (2) 'Evidence and evaluation criteria considered in HTAs'; (3) 'Methods and techniques applied in HTAs'; and (4) 'Outcomes and implementation of HTAs'. Study countries were France, Germany, England, Sweden, Italy, Netherlands, Poland and Spain. Evidence from the literature was validated and updated through two rounds of feedback involving primary data collection from national experts. RESULTS All countries assess similar types of evidence; however, the specific criteria/endpoints used, their level of provision and requirement, and the way they are incorporated (e.g. explicitly vs. implicitly) varies across countries, with their relative importance remaining generally unknown. Incorporation of additional 'social value judgements' (beyond clinical benefit assessment) and economic evaluation could help explain heterogeneity in coverage recommendations and decision-making. CONCLUSION More comprehensive and systematic assessment procedures characterised by increased transparency, in terms of selection of evaluation criteria, their importance and intensity of use, could lead to more rational evidence-based decision-making, possibly improving efficiency in resource allocation, while also raising public confidence and fairness.
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Affiliation(s)
- Aris Angelis
- Department of Social Policy and Medical Technology Research Group, LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Ansgar Lange
- Department of Social Policy and Medical Technology Research Group, LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Panos Kanavos
- Department of Social Policy and Medical Technology Research Group, LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
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Differences in cancer drug assessment between Spain and the United Kingdom. Eur J Cancer 2015; 51:1843-52. [DOI: 10.1016/j.ejca.2015.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 11/18/2022]
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Iannazzo S, De Francesco M, Gomez-Ulloa D, Benucci M. A review of cost-effectiveness evaluations as part of national health technology assessments of biologic DMARDs in the treatment of rheumatoid arthritis. Expert Rev Pharmacoecon Outcomes Res 2014; 13:455-68. [PMID: 23977974 DOI: 10.1586/14737167.2013.814937] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rheumatoid arthritis (RA) is an autoimmune chronic disease which is associated with an increasing disability in patients and high socioeconomic burden. Given the large number of economic evaluations considered by national health technology assessments (HTAs), this review attempts to clarify whether results from biologic disease-modifying antirheumatic drugs (DMARDs) economic evaluations form the basis of official recommendation by national HTA agencies in Australia, Canada, Scotland and England. The results show that evidence of cost-effectiveness was not equally perceived by decision makers and did not have equal weightage in defining the official listing of biologic DMARDs for the treatment of RA. As it has been demonstrated in previous studies, major barriers exist for the integration of cost-effectiveness and cost-utility results with national HTA activity. In fact, as shown in this review, even when such analysis are available, cost-minimization and comparative effectiveness studies seemed to be preferred by some HTA agencies as tools to inform allocation of healthcare resources.
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