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Rodríguez-Sánchez B, Daugbjerg S, Peña-Longobardo LM, Oliva-Moreno J, Aranda-Reneo I, Cicchetti A, López-Bastida J. Does the inclusion of societal costs change the economic evaluations recommendations? A systematic review for multiple sclerosis disease. Eur J Health Econ 2023; 24:247-277. [PMID: 35596098 PMCID: PMC9985586 DOI: 10.1007/s10198-022-01471-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 04/19/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Multiple sclerosis imposes a heavy burden on the person who suffers from it and on the relatives, due to the caregiving load involved. The objective was to analyse whether the inclusion of social costs in economic evaluations of multiple sclerosis-related interventions changed results and/or conclusions. METHODS A systematic review was launched using Medline and the Cost-Effectiveness Analysis Registry of Tufts University (2000-2019). Included studies should: (1) be an original study published in a scientific journal, (2) be an economic evaluation of any multiple sclerosis-related intervention, (3) include productivity losses and/or informal care costs (social costs), (4) be written in English, (5) use quality-adjusted life years as outcome, and (6) separate the results according to the perspective applied. RESULTS Twenty-nine articles were selected, resulting in 67 economic evaluation estimations. Social costs were included in 47% of the studies. Productivity losses were assessed in 90% of the estimations (the human capital approach was the most frequently used method), whereas informal care costs were included in nearly two-thirds of the estimations (applying the opportunity and the replacement-cost methods equally). The inclusion of social costs modified the figures for incremental costs in 15 estimations, leading to a change in the conclusions in 10 estimations, 6 of them changing from not recommended from the healthcare perspective to implemented from the societal perspective. The inclusion of social costs also altered the results from cost-effective to dominant in five additional estimations. CONCLUSIONS The inclusion of social costs affected the results/conclusions in multiple sclerosis-related interventions, helping to identify the most appropriate interventions for reducing its economic burden from a broader perspective.
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Affiliation(s)
- B Rodríguez-Sánchez
- Department of Applied Economics, Public Economics and Political Economy, University Complutense of Madrid, Pl. Menéndez Pelayo 4, 28040, Madrid, Spain
| | - S Daugbjerg
- Graduate School of Health Economics and Management (Alta Scuola Di Economia E Management Dei Sistemi Sanitari), Universitá Cattolica del Sacro Cuore, Rome, Italy
| | - L M Peña-Longobardo
- Economic Analysis and Finance Department, Faculty of Law and Social Sciences, University of Castilla-La Mancha, 45071, Toledo, Spain
| | - J Oliva-Moreno
- Economic Analysis and Finance Department, Faculty of Law and Social Sciences, University of Castilla-La Mancha, 45071, Toledo, Spain
| | - I Aranda-Reneo
- Economic Analysis and Finance Department, Faculty of Social Sciences, University of Castilla-La Mancha, Avda. Real Fábrica de Seda s/n, 45600, Talavera de la Reina, Toledo, Spain.
| | - A Cicchetti
- Graduate School of Health Economics and Management (Alta Scuola Di Economia E Management Dei Sistemi Sanitari), Universitá Cattolica del Sacro Cuore, Rome, Italy
| | - J López-Bastida
- Faculty of Health Sciences, Universidad Castilla-La Mancha, 45600, Talavera de la Reina, Toledo, Spain
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Lopez-Bastida J, Aranda-Reneo I, Rodríguez-Sánchez B, Peña-Longobardo LM, Ye X, Laeis P, Fronk EM, Palmerini E, Leithner A, Van de Sande MAJ. Economic burden and health-related quality of life in tenosynovial giant-cell tumour patients in Europe: an observational disease registry. Orphanet J Rare Dis 2021; 16:294. [PMID: 34215312 PMCID: PMC8254314 DOI: 10.1186/s13023-021-01883-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/21/2021] [Indexed: 12/24/2022] Open
Abstract
Background Tenosynovial Giant-Cell Tumour (TGCT) is a benign clonal neoplastic proliferation arising from the synovium, causing a variety of symptoms and often requiring repetitive surgery. This study aims to define the economic burden—from a societal perspective—associated with TGCT patients and their health-related quality of life (HRQOL) in six European countries. Methods This article analyses data from a multinational, multicentre, prospective observational registry, the TGCT Observational Platform Project (TOPP), involving hospitals and tertiary sarcoma centres from six European countries (Austria, France, Germany, Italy, the Netherlands, and Spain). It includes information on TGCT patients’ health-related quality of life and healthcare and non-healthcare resources used at baseline (the 12-month period prior to the patients entering the registry) and after 12 months of follow-up. Results 146 TGCT patients enrolled for the study, of which 137 fulfilled the inclusion criteria. Their mean age was 44.5 years, and 62% were female. The annual average total costs associated with TGCT were €4866 at baseline and €5160 at the 12-month follow-up visit. The annual average healthcare costs associated with TGCT were €4620 at baseline, of which 67% and 18% corresponded to surgery and medical visits, respectively. At the 12-month follow-up, the mean healthcare costs amounted to €5094, with surgery representing 70% of total costs. Loss of productivity represented, on average, 5% of the total cost at baseline and 1.3% at follow-up. The most-affected HRQOL dimensions, measured with the EQ-5D-5L instrument, were pain or discomfort, mobility, and the performance of usual activities, both at baseline and at the follow-up visit. Regarding HRQOL, patients declared a mean index score of 0.75 at baseline and 0.76 at the 12-month follow-up. Conclusion The results suggest that TGCT places a heavy burden on its sufferers, which increases after one year of follow-up, mainly due to the healthcare resources required—in particular, surgical procedures. As a result, this condition has a high economic impact on healthcare budgets, while the HRQOL of TGCT patients substantially deteriorates over time. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01883-5.
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Affiliation(s)
- J Lopez-Bastida
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Toledo, Spain
| | - I Aranda-Reneo
- Economic Analysis and Finance Department, Faculty of Social Sciences, University of Castilla-La Mancha, Avda. Real Fábrica de Seda S/N, 45600, Talavera de la Reina, Toledo, Spain.
| | - B Rodríguez-Sánchez
- Faculty of Communication and Humanities, Faculty of Science and Technology, University Camilo José Cela, Madrid, Spain
| | - L M Peña-Longobardo
- Economic Analysis and Finance Department, Faculty of Law and Social Sciences, University of Castilla-La Mancha, 45071, Toledo, Spain
| | - X Ye
- Daiichi Sankyo Inc., Basking Ridge, USA
| | - P Laeis
- Daiichi Sankyo Europe, München, Germany
| | - E M Fronk
- Daiichi Sankyo Europe, München, Germany
| | - E Palmerini
- IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
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Peña-Longobardo LM, Rodríguez-Sánchez B, Oliva-Moreno J, Aranda-Reneo I, López-Bastida J. Correction to: How relevant are social costs in economic evaluations? The case of Alzheimer's disease. Eur J Health Econ 2021; 22:849. [PMID: 34032969 PMCID: PMC8496565 DOI: 10.1007/s10198-021-01323-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 06/12/2023]
Abstract
A correction to this paper has been published: https://doi.org/10.1007/s10198-021-01323-y
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Affiliation(s)
- L M Peña-Longobardo
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de La Reina, Spain.
| | - B Rodríguez-Sánchez
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de La Reina, Spain
| | - J Oliva-Moreno
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de La Reina, Spain
| | - I Aranda-Reneo
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de La Reina, Spain
| | - J López-Bastida
- Faculty of Health Science, University of Castilla-La Mancha, Talavera de La Reina, Spain
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Peña-Longobardo LM, Rodríguez-Sánchez B, Oliva-Moreno J, Aranda-Reneo I, López-Bastida J. How relevant are social costs in economic evaluations? The case of Alzheimer's disease. Eur J Health Econ 2019; 20:1207-1236. [PMID: 31342208 PMCID: PMC8149344 DOI: 10.1007/s10198-019-01087-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/09/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND The main objective of this study was to analyse how the inclusion (exclusion) of social costs can alter the results and conclusions of economic evaluations in the field of Alzheimer's disease interventions. METHODS We designed a systematic review that included economic evaluations in Alzheimer's disease. The search strategy was launched in 2000 and ran until November 2018. The inclusion criteria were: being an original study published in a scientific journal, being an economic evaluation of any intervention related to Alzheimer's disease, including social costs (informal care costs and/or productivity losses), being written in English, using QALYs as an outcome for the incremental cost-utility analysis, and separating the results according to the perspective applied. RESULTS It was finally included 27 studies and 55 economic evaluations. Around 11% of economic evaluations changed their main conclusions. More precisely, three of them concluded that the new intervention became cost-effective when the societal perspective was considered, whereas when using just the health care payer perspective, the new intervention did not result in a cost-utility ratio below the threshold considered. Nevertheless, the inclusion of social cost can also influence the results, as 37% of the economic evaluations included became the dominant strategy after including social costs when they were already cost-effective in the health care perspective. CONCLUSIONS Social costs can substantially modify the results of the economic evaluations. Therefore, taking into account social costs in diseases such as Alzheimer's can be a key element in making decisions about public financing and pricing of health interventions.
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Affiliation(s)
- L M Peña-Longobardo
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de la Reina, Spain.
| | - B Rodríguez-Sánchez
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - J Oliva-Moreno
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - I Aranda-Reneo
- Faculty of Social Science and Law, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - J López-Bastida
- Faculty of Health Science, University of Castilla-La Mancha, Talavera de la Reina, Spain
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López-Bastida J, Ramos-Goñi JM, Aranda-Reneo I, Trapero-Bertran M, Kanavos P, Rodriguez Martin B. Using a stated preference discrete choice experiment to assess societal value from the perspective of decision-makers in Europe. Does it work for rare diseases? Health Policy 2018; 123:152-158. [PMID: 30528244 DOI: 10.1016/j.healthpol.2018.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To pilot the feasibility of using a discrete choice experiment (DCE) design to investigate individual preferences from the decision-maker perspective regarding the use of public funding for orphan drugs and generate prior information for future experimental designs. METHODS A DCE was used on a convenience sample of participants from five European countries (England, France, Germany, Italy and Spain), exploring their preferences in distinct healthcare scenarios involving orphan drugs. A preliminary review of the empirical literature on distributive preferences informed the selection of attributes and their levels in the design. An online questionnaire was used to conduct the DCE survey. RESULTS A total of 199 questionnaires were completed. The five country model showed relative preference for some attributes over others: cost of treatment, improvement in health, value for money and availability of treatment alternatives received the greatest attention. However, disease severity, beginning of life, waiting times and side effects were also shown to be important social values that should not be ignored. CONCLUSIONS The findings presented in this study provide insight about the preferences that can influence decisions on orphan drugs in different countries. This study also provides valuable prior information that could inform future DCE designs in this area.
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Affiliation(s)
- J López-Bastida
- University of Castilla-La Mancha, Faculty of Occupational Therapy, Speech Therapy and Nursing, Talavera de la Reina, Toledo, Spain.
| | | | - I Aranda-Reneo
- University of Castilla-La Mancha, Faculty of Social Science, Talavera de la Reina, Toledo, Spain
| | - M Trapero-Bertran
- Universitat Internacional de Catalunya (UIC), Faculty of Economics and Social Sciences, Barcelona, Spain
| | - P Kanavos
- London School of Economics and Political Science, London, UK
| | - B Rodriguez Martin
- University of Castilla-La Mancha, Faculty of Occupational Therapy, Speech Therapy and Nursing, Talavera de la Reina, Toledo, Spain
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García-Nogueras I, Aranda-Reneo I, Peña-Longobardo LM, Oliva-Moreno J, Abizanda P. Use of Health Resources and Healthcare Costs associated with Frailty: The FRADEA Study. J Nutr Health Aging 2017; 21:207-214. [PMID: 28112778 DOI: 10.1007/s12603-016-0727-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Frailty is associated with adverse health outcomes, but its association with hospital healthcare costs has not been analyzed. The main objective was to estimate the adjusted annual costs and use of hospital healthcare resources in frail older adults compared to non frail ones. DESIGN FRADEA Study. Mean follow-up 1044 days (SD 314). SETTING Albacete city, Spain. PARTICIPANTS 830 adults ≥70 years. MEASUREMENTS Age, sex, comorbidity measured with the Charlson index and Fried´s Frailty phenotype as independent variables, and use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs as outcome variables. Outcome data were collected from Minimum Data Set of the Complejo Hospitalario Universitario Albacete. The cost base year was 2013. Logistic regression and two-part models were used to analyze the association between frailty and the use of healthcare resources. Generalized Linear Models were applied to estimate the impact of frailty and comorbidity on the healthcare costs. RESULTS The average cost associated with the use of health resources was 1,922€/year. Frail participants had an average total cost of health resources of 2,476€/year, pre-frail 2,056€/year, and non-frail 1,217€/year. 67% of the total health cost was associated with hospital admission cost, 29% with specialist visits cost and 4% with emergency visits cost. Frailty and comorbidity were the most important factors associated with the use of hospital healthcare resources. Adjusted healthcare costs were 592€/year and 458€/year greater in frail and pre-frail participants respectively, compared to non-frail ones, and having a Charlson index ≥ 3, was associated with an increased costs of 2,289€/year. CONCLUSION Frailty and comorbidity are meaningful and complementary associated with increased hospital healthcare resources use, and related costs.
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Affiliation(s)
- I García-Nogueras
- Pedro Abizanda, Head of the Geriatrics Department, Hospital Perpetuo Socorro, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain, Tfn: +34967597651 Fax: +34967597635,
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