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Khan S, Ahmad Javid S, Ur Rehman S, Akhtar Y, Amir Khan M. A Systematic Review of Cost-Effectiveness Analyses Examining Treatments for Cachexia Syndrome. Nutr Cancer 2024; 76:584-595. [PMID: 38801296 DOI: 10.1080/01635581.2024.2353939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES This systematic review aims to critically evaluate and synthesize the economic outcomes of various therapeutic strategies employed to manage cachexia patients. METHODS A comprehensive search for randomized controlled trials and observational studies was conducted from January 1, 2000 to December 31, 2023, using PubMed, Google Scholar, Clinical Trials Registry, Cochrane Central Register of Controlled Trials, British Medical Journal, National Health Service Economic Evaluation Database, and ScienceDirect, following PRISMA guidelines. We assessed the quality of the included studies using the Consolidated Health Economic Evaluation Reporting Standards reporting guidelines. RESULTS We identified six high to medium quality economic evaluations in four countries, focusing on cancer, chronic obstructive pulmonary disease, and HIV/AIDS-associated cachexia. The results indicate that combination management strategies, specifically the use of nutritional supplements and exercise, are more cost-effective than usual care for cachexia syndrome. Additionally, two studies showed that dietary supplements alone were more cost-effective than usual care, and pharmacotherapy alone was more cost-effective than a placebo. CONCLUSION Combining several strategies, such as nutritional supplements and exercise, may be the most economically efficient method for managing cachexia compared to usual care or single treatment approaches. However, the restricted and diverse characteristics of the current research hinder the definitive conclusions.
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Affiliation(s)
- Safeer Khan
- Department of Pharmaceutical Sciences, Institute of Chemical Sciences, Government College University, Lahore, Punjab, Pakistan
| | | | - Sabi Ur Rehman
- Department of Pharmacy, Foreman Christian College (A Chartered University), Lahore, Punjab, Pakistan
| | - Yasmeen Akhtar
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Muhammad Amir Khan
- Department of Foreign Medical Education, Fergana Institute of Public Health, Fergana, Uzbekistan
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Halahakone U, Senanayake S, McCreanor V, Parsonage W, Kularatna S, Brain D. Cost-Effectiveness of Screening to Identify Patients With Atrial Fibrillation: A Systematic Review. Heart Lung Circ 2023:S1443-9506(23)00152-X. [PMID: 37100697 DOI: 10.1016/j.hlc.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Screening for Atrial Fibrillation (AF) is recommended for people aged above 65 years. Screening for AF in asymptomatic individuals can be beneficial by enabling earlier diagnosis and the commencement of interventions to reduce the risk of early events, thus improving patient outcomes. This study systematically reviews the literature about the cost-effectiveness of various screening methods for previously undiagnosed AF. METHODS Four databases were searched to identify articles that are cost-effectiveness studies conducted on screening for AF published from January 2000 to August 2022. The Consolidated Health Economic Evaluation Reporting Standards 2022 checklist was used to assess the quality of the selected studies. A previously published approach was used to assess the usefulness of each study for health policy makers. RESULTS The database search yielded 799 results, with 26 articles meeting the inclusion criteria. Articles were categorised into four subgroups: (i) population screening, (ii) opportunistic screening, (iii) targeted, and (iv) mixed methods of screening. Most of the studies screened adults ≥65 years of age. Most studies were performed from a 'health care payer perspective' and almost all studies used 'not screening' as a comparator. Almost all screening methods assessed were found to be cost-effective in comparison to 'not screening'. The reporting quality varied between 58% to 89%. The majority of the studies were found to be of limited usefulness for health policy makers, as none of the studies made any clear statements about policy change or implementation direction. CONCLUSION All approaches of AF screening were found to be cost-effective compared with no screening, while opportunistic screening was found to be the optimal approach in some studies. However, screening for AF in asymptomatic individuals is context specific and likely to be cost-effective depending on the population screened, screening approach, frequency, and the duration of screening.
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Affiliation(s)
- Ureni Halahakone
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia.
| | - Sameera Senanayake
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia
| | - Victoria McCreanor
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia; Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Qld, Australia
| | - William Parsonage
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia; Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Qld, Australia; Digital Health and Informatics Directorate, Metro South Health, Brisbane, Qld, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia
| | - David Brain
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia
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Reporting quality of economic evaluations of the negotiated Traditional Chinese Medicines in national reimbursement drug list of China: A systematic review. Integr Med Res 2023; 12:100915. [PMID: 36632129 PMCID: PMC9826834 DOI: 10.1016/j.imr.2022.100915] [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: 08/19/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background Traditional Medicine (TM) has a wide uptake in most countries. In China, Traditional Chinese Medicine (TCM) is a common kind of primary health because of its beneficial effects. This review aimed to appraise the publication reporting quality of economic evaluations for selective TCM in the National Reimbursement Drug List (NRDL), Version 2020, based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Methods Electronic databases were searched for economic evaluation that supported the TCM negotiations in NRDL (2020 version) published from 2001 to 2021, including PubMed, Web of Science, Embase, CNKI, WanFang, and SinoMed. The CHEERS statement was used to appraise the reporting quality of included TCM economic evaluations. Results A total of 360 articles were retrieved, but only 38 economic evaluations met the inclusion criteria. None of the articles reported all items in the CHEERS checklist. The mean score of included articles is low at 10.93±2.62, with an average scoring rate of 51.31±10.53%. The least reported items included: "Characterizing heterogeneity," "Conflicts of interest", "Discount rate," and "Study perspective," with a reporting rate of 0.00%, 5.26%, 7.89%, and 15.79%, respectively. Conclusion An upward trend occurred in the quantity and quality of the economic evaluation publications of TCM in China. TCM economic evaluations are still at an early stage, with an urgent need for improving reporting quality. It may result from research experiences or different ideas between TCM and Western Medicine. Adhering to reporting guidelines like CHEERS and educating economic evaluation investigators can improve TCM economic evaluations' reporting quality.
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Weiting H, Yaoxian AZ, Keong YK, Lam SW, How LY, Sahlén AO, Pourghaderi A, Che M, Terrance CSJ, Graves N. The clinical value and cost-effectiveness of treatments for patients with coronary artery disease. HEALTH ECONOMICS REVIEW 2022; 12:56. [PMID: 36348165 PMCID: PMC9644580 DOI: 10.1186/s13561-022-00401-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The clinical value and cost-effectiveness of invasive treatments for patients with coronary artery disease is unclear. Invasive treatments such as coronary artery bypass grafting and percutaneous coronary intervention are frequently used as a starting treatment, yet they are much more costly than optimal medical therapy. While patients may transition into other treatments over time, the choices of starting treatments are likely important determinants of costs and health outcomes. The aim is to predict by how much costs and health outcomes will change from a decision to use different starting treatments for patients with coronary artery disease in an Asian setting. METHODS A cost-effectiveness study using a Markov model informed by data from Singapore General Hospital was done. All patients with initial presentations of stable coronary disease and no acute coronary syndromes who received medical treatments and interventional therapies were included. We compare existing practice, where the starting treatment can be medical therapy or stent percutaneous coronary interventions or coronary artery bypass grafting, with alternate starting treatment strategies. RESULTS When compared to 'existing practice' a policy of starting 14% of patients with coronary artery bypass grafting and 86% with optimal medical therapy showed savings of $1,743 per patient and 0.23 additional quality adjusted life years. A change to policy nationwide would save $10 million and generate 1,380 quality adjusted life years. CONCLUSIONS Increasing coronary artery bypass grafting and use of medical therapy in the setting of coronary artery disease is likely to saves costs and improve health outcomes. A definitive study to address the question we investigate would be very difficult to undertake and so using existing data to model the expected outcomes is a useful tool. There are likely to be large and complex barriers to the implementation of any policy change based on the findings of this study.
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Affiliation(s)
| | | | | | - Shao Wei Lam
- Duke NUS Medical School, 8 College Rd, 169857 Singapore, Singapore
| | - Lau Yee How
- Health Services Research Centre, SingHealth, Singapore, Singapore
| | | | | | - Matthew Che
- Health Services Research Centre, SingHealth, Singapore, Singapore
| | | | - Nicholas Graves
- Duke NUS Medical School, 8 College Rd, 169857 Singapore, Singapore
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Brain D, Jadambaa A. Economic Evaluation of Long-Term Survivorship Care for Cancer Patients in OECD Countries: A Systematic Review for Decision-Makers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111558. [PMID: 34770070 PMCID: PMC8582644 DOI: 10.3390/ijerph182111558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 01/23/2023]
Abstract
Long-term cancer survivorship care is a crucial component of an efficient healthcare system. For numerous reasons, there has been an increase in the number of cancer survivors; therefore, healthcare decision-makers are tasked with balancing a finite budget with a strong demand for services. Decision-makers require clear and pragmatic interpretation of results to inform resource allocation decisions. For these reasons, the impact and importance of economic evidence are increasing. The aim of the current study was to conduct a systematic review of economic evaluations of long-term cancer survivorship care in Organization for Economic Co-operation and Development (OECD) member countries and to assess the usefulness of economic evidence for decision-makers. A systematic review of electronic databases, including MEDLINE, PubMed, PsycINFO and others, was conducted. The reporting quality of the included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Each included study’s usefulness for decision-makers was assessed using an adapted version of a previously published approach. Overall, 3597 studies were screened, and of the 235 studies assessed for eligibility, 34 satisfied the pre-determined inclusion criteria. We found that the majority of the included studies had limited value for informing healthcare decision-making and conclude that this represents an ongoing issue in the field. We recommend that authors explicitly include a policy statement as part of their presentation of results.
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Khan S, Qamar N, Ullah I. Health economic evaluation of different treatment strategies for peripheral entrapment mononeuropathies: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2021; 21:943-952. [PMID: 33896326 DOI: 10.1080/14737167.2021.1919088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: In this era of cost-conscious health systems, it is of utmost importance to identify and establish the most cost-effective treatment option. However, in the case of peripheral entrapment mononeuropathies there is alack of data regarding economically effective treatment strategies. Therefore, the objective was to conduct an economic evaluation including both costs and benefits of various treatment strategies applied to peripheral entrapment mononeuropathies to estimate the relative cost-effective treatment regimens.Areas covered: Over the 19 years, seven excellent-high quality economic evaluations of three types of peripheral entrapment mononeuropathies were identified in four countries. Our findings showed that surgery was the most cost-effective therapy followed by same cost efficacy of infiltrative therapy and conservative therapy for peripheral entrapment mononeuropathies. However, the fact that surgery was the most common comparator (n = 6) in our selected studies cannot be neglected.Expert opinion: Due to huge methodological variability, the finding of surgery as the cost-effective treatment strategy remains tentative and the decision about the most suitable clinical and cost-effective therapy should be individualized from case to case. Moreover, the economic evaluation of all possible treatment strategies for peripheral entrapment mononeuropathies over alonger period of analysis is required in future studies.
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Affiliation(s)
- Safeer Khan
- Department of Pharmacy Services, Al-Taaluf National Group of Polyclinics, Makkah, Kingdom of Saudi Arabia
| | - Nauman Qamar
- Department of Production, Frontier Dextrose Limited, Industrial Estate, Haripur, Khyber Pakthunkhwa, Pakistan
| | - Ihsan Ullah
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
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Jafari P, Goudarzi R, Amiresmaeili M, Rashidinejad H. The optimal diagnostic strategies for patient with coronary artery diseases and stable chest pain syndrome: a cost-effectiveness analysis. Egypt Heart J 2020; 72:82. [PMID: 33226507 PMCID: PMC7683761 DOI: 10.1186/s43044-020-00111-y] [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: 07/05/2020] [Accepted: 10/20/2020] [Indexed: 11/22/2022] Open
Abstract
Background Numerous invasive and noninvasive diagnostic tests with different cost and effectiveness exist for detection of coronary artery disease. This diversity leads to unnecessary utilization of health services. For this reason, this study focused on the cost-effectiveness analysis of diagnostic strategies for coronary artery disease from the perspective of the health care system with 1-year time horizon. Results Incremental cost effectiveness ratios of all strategies were less than the threshold except for the electrocardiography-computed tomography angiography-coronary angiography strategy, and cost of the cardiac magnetic resonance imaging-based strategy was higher than the cost of other strategies. Also, the number of correct diagnosis in the electrocardiography-coronary angiography strategy was higher than the other strategies, and its ICER was 15.197 dollars per additional correct diagnosis. Moreover, the sensitivity analysis found that the probability of doing MRI and sensitivity of the exercise electrocardiography had impact on the results. Conclusion The most cost-effective strategy for acute patient is ECG-CA strategy, and for chronic patient, the most cost-effective strategies are electrocardiography-single photon emission computed tomography-coronary angiography and electrocardiography-exercise electrocardiography-coronary angiography. Applying these strategies in the same clinical settings may lead to a better utilization of resources.
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Affiliation(s)
- Parvin Jafari
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Goudarzi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mohammadreza Amiresmaeili
- Department of Health Management and Economics, Faculty of Management and Medical Informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamidreza Rashidinejad
- Cardiovascular Research center,institute of basic and clinical physiology science., Kerman University of Medical Sciences, Kerman, Iran
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Gong L, Xu H, Zhang X, Zhang T, Shi J, Chang H. Oridonin relieves hypoxia-evoked apoptosis and autophagy via modulating microRNA-214 in H9c2 cells. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2019; 47:2585-2592. [PMID: 31220945 DOI: 10.1080/21691401.2019.1628037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/29/2019] [Indexed: 01/05/2023]
Abstract
Oridonin (Orid) has been diffusely applied to remedy dissimilar cancers. Howbeit, the influence of Orid in ischemic heart disease (IHD) remains imprecise. The current study uncovered the functions of Orid in hypoxia-caused apoptosis and autophagy in H9c2 cells. H9c2 cells received hypoxia and Orid manipulation, cell viability, apoptosis, apoptosis-interrelated factors and autophagy-correlative factors were appraised. After the extraordinary vectors transfections, the impacts of miR-214 inhibition on hypoxia-triggered apoptosis and autophagy were investigated. Further, dual luciferase reporter assay was enforced for ascertaining the pertinence between miR-214 and PTEN. PI3K/AKT/mTOR pathway was finally determined using western blot. We found that, Orid significantly alleviated hypoxia-induced apoptosis and autophagy through regulation their associated proteins in H9c2 cells. Up-regulation of miR-214 was found in hypoxia and Orid co-managed cells, meanwhile, repression of miR-214 obviously annulled the modulatory functions of Orid in hypoxia-evoked apoptosis and autophagy. Additionally, PTEN was forecasted to be a firsthand target of miR-214. Besides, we observed that Orid evoked PI3K/AKT/mTOR activation through elevation of miR-214 in hypoxia-managed H9c2 cells. In conclusion, the amusing results corroborated that Orid relieved hypoxia-caused apoptosis and autophagy via adjusting PI3K/AKT/mTOR pathway through enhancement of miR-214 in H9c2 cells.
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Affiliation(s)
- Licheng Gong
- a Department of Cardiology, China-Japan Union Hospital of Jilin University , Changchun , China
| | - Haiming Xu
- a Department of Cardiology, China-Japan Union Hospital of Jilin University , Changchun , China
| | - Xiuli Zhang
- b Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University , Changchun , China
| | - Tao Zhang
- b Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University , Changchun , China
| | - Jingwei Shi
- c Department of Clinical Laboratory, China-Japan Union Hospital of Jilin University , Changchun , China
| | - Hong Chang
- a Department of Cardiology, China-Japan Union Hospital of Jilin University , Changchun , China
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Ribeiro IS, Batel Marques FJ, Alves DG, Alves CMC. A systematic review of the methodological quality of economic studies evaluating ophthalmic drugs. Expert Rev Pharmacoecon Outcomes Res 2019; 19:421-430. [PMID: 30722711 DOI: 10.1080/14737167.2019.1579646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Innovative drugs have been approved in ophthalmology. Thus, the number and importance of economic evaluation studies of ophthalmic drugs have been growing. This study aims to assess the methodological quality of pharmacoeconomic studies of ophthalmic drugs. AREAS COVERED A systematic search was conducted in Pubmed/Embase until November 2018 to identify full pharmacoeconomic studies evaluating ophthalmic drugs. The quality of studies was evaluated using the British Medical Journal (BMJ) checklist. Quality indicators were evaluated by Fisher's exact test. Ninety-five studies were included, 50 (52.6%) cost-utility analysis, 28 (29.5%) cost-effectiveness and 17 (17.9%) cost-effectiveness/cost-utility. All studies presented, at least, three methodological limitations. Cost-utility studies, studies conducted from a health system perspective, with time horizons longer than one-year and that rely on observational or observational and experimental data simultaneously are associated with higher quality. Only eight (8.4%) studies considered two eyes in the economic analysis and only 13 (13.7%) considered the natural history of the disease when extrapolating results for long-term analysis. EXPERT OPINION The majority of the pharmacoeconomic studies were assessed as having good methodological quality, however, the methodological quality scores were sensitive to several indicators. Therefore, improving the quality of studies would enhance their usefulness in the decision-making processes.
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Affiliation(s)
- Inês Souto Ribeiro
- a CHAD - Centre for Health Technology Assessment and Drug Research , AIBILI - Association for Innovation and Biomedical Research on Light and Image , Coimbra , Portugal
- b Faculty of Pharmacy , University of Coimbra , Coimbra , Portugal
| | - Francisco Jorge Batel Marques
- a CHAD - Centre for Health Technology Assessment and Drug Research , AIBILI - Association for Innovation and Biomedical Research on Light and Image , Coimbra , Portugal
- c Laboratory of Social Pharmacy and Public Health, School of Pharmacy , University of Coimbra , Coimbra , Portugal
| | - Dalila Gil Alves
- a CHAD - Centre for Health Technology Assessment and Drug Research , AIBILI - Association for Innovation and Biomedical Research on Light and Image , Coimbra , Portugal
| | - Carlos Miguel Costa Alves
- a CHAD - Centre for Health Technology Assessment and Drug Research , AIBILI - Association for Innovation and Biomedical Research on Light and Image , Coimbra , Portugal
- c Laboratory of Social Pharmacy and Public Health, School of Pharmacy , University of Coimbra , Coimbra , Portugal
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