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Moradi N, Zarei L, Hajimoladarvish N, Meshkani Z, Zanganeh M, Babapour J, Lankarani KB. Public Preference for Financing Preventive Vaccines in Health Shocks: The Case of COVID-19 Vaccines in a Middle-Income Country. Pharmacoecon Open 2024:10.1007/s41669-024-00494-7. [PMID: 38761343 DOI: 10.1007/s41669-024-00494-7] [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: 04/22/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND To effectively manage health crises such as disease pandemics, health authorities require reliable information regarding people's preferences. This helps to ensure timely and targeted interventions and avoids increasing societal costs through developing evidence-based policies. This study investigates the Iranian people's preference for financing coronavirus disease 2019 (COVID-19) vaccines and the factors affecting this. METHODS A cross-sectional survey was performed during the third-wave peak of COVID-19 in Iran from 1 to 20 February 2021 utilizing various data collection methods. The public preference regarding imported and domestically produced vaccines, their willingness to fully or partially contribute to the financing of these vaccines, and their willingness to pay (WTP) for domestically produced vaccines using the contingent valuation method was assessed in different scenarios. The determinants of the probability of positive financing preferences were evaluated using an ordered probit regression model. RESULTS Among the 2071 survey respondents, approximately 60% stated willingness to contribute to vaccine financing in the form of partial or full user fee payments. Forty percent of respondents are willing to be vaccinated if it is provided for free by the government. Interestingly, people's preference for financing the vaccine was not related to the type of vaccine. The regression analysis showed that income, having supplementary insurance, being male, perceived COVID-19 risk, education, and working in the health sector are significantly related to a higher probability of contribution to vaccine financing. CONCLUSIONS Regardless of country of origin of COVID-19 vaccines, vaccination is very important for the Iranian people, and the majority of respondents in our study showed an inclination to contribute to vaccine funding, from partial to full user fees, to achieve higher protection against COVID-19 disease. Hence, ensuring timely access to vaccines during health crises such as pandemics is imperative, as it saves lives and reduces the economic burden of disease. This commitment from the health system can be supported by financial contributions from the general public. In this regard, considering public preferences is strongly advised to policymakers.
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Affiliation(s)
- Najmeh Moradi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Leila Zarei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, No. 2, 8th floor, Zand St., PO Box 71348-45794, Shiraz, Iran.
| | | | - Zahra Meshkani
- Department of Health Economics, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Marzieh Zanganeh
- College of Pharmacy and Health Sciences, Long Island University, Brookville, NY, USA
| | - Jafar Babapour
- Department of Clinical Sciences, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, No. 2, 8th floor, Zand St., PO Box 71348-45794, Shiraz, Iran
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Vosoogh S, Zanganeh M, Gonabadi B. Efficacy of rectal progesterone on maternal and neonatal outcomes in pregnant women with Preterm Premature Rupture of membranes: a triple-blind randomised clinical trial. Horm Mol Biol Clin Investig 2022; 43:463-468. [PMID: 36327309 DOI: 10.1515/hmbci-2021-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study was conducted to evaluate the efficacy of rectal progesterone suppositories on pregnancy outcomes of pregnant women diagnosed with PPROM at the gestational age of 26-34 weeks, as well as on maternal and neonatal outcomes. METHODS This is a double-blind, randomized clinical trial in pregnant women with PROM with gestational age of 26-24 weeks, conducted between February 2020 and December 2020 in Sayyad Shirazi Hospital, Gorgan, Iran. RESULTS According to the results of the present study; Rectal progesterone suppository in pregnant women with PPROM is associated with improved delivery outcomes such as neonatal APGAR score, increased latent delivery stage without complications or severe and dangerous complications, without increased risk of mortality and NICU hospitalization in infants, so prescribing suppository rectal progesterone in pregnant women with PPROM with a gestational age of 26 to 34 weeks is associated with positive outcomes and is recommended based on the findings and opinions of the researchers. CONCLUSIONS According to the results of the present study; Rectal progesterone suppository in pregnant women with PPROM is associated with improved delivery outcomes such as neonatal APGAR score, increased latent delivery stage without complications or severe and dangerous complications, without increased risk of mortality and NICU hospitalization in infants, so prescribing suppository rectal progesterone in pregnant women with PPROM with a gestational age of 26 to 34 weeks is associated with positive outcomes and is recommended based on the findings and opinions of the researchers.
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Affiliation(s)
- Shohre Vosoogh
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Marzieh Zanganeh
- Department of Obstetrics and Gynecology, School of Medicine, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Behnaz Gonabadi
- Department of Obstetrics and Gynecology, School of Medicine, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
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Nejati M, Razavi M, Harirchi I, Zanganeh M, Salari G, Tabatabaee SM. Resource Use and Costs Associated to the Initial Phase of Treatment for Patients with Colorectal Cancer Receiving Post-Surgery Chemotherapy: A Cost Analysis from a Healthcare Perspective. Iran J Public Health 2021; 50:1887-1896. [PMID: 34722385 PMCID: PMC8542811 DOI: 10.18502/ijph.v50i9.7062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/22/2020] [Indexed: 12/09/2022]
Abstract
Background: To estimate the resource use and costs associated to the initial phase of treatment for colorectal cancer in Iran. Methods: A retrospective study was conducted using routinely collected data within Electronic Health Records System (SEPAS), a national database representing public hospitals in Iran between March 20, 2016 and March 19, 2017. Primary end points included healthcare resource use, direct medical and non-medical costs of care in the 12-month study period. Results: The study population included 657 patients with colorectal cancer who underwent surgery and the follow-up chemotherapy. We estimated a total direct cost of $21,407 per patient. The results indicated that direct medical costs were primarily driven by inpatient hospital care, followed by surgery, chemotherapy, and diagnostic services. Conclusion: The initial 12-month of treatment for colorectal cancer, including surgery and the follow-up chemotherapy, is resource intensive. The total direct costs associated to the disease are remarkable, with Inpatient hospital services being the main contributor followed by surgery and chemotherapy.
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Affiliation(s)
- Mina Nejati
- The Cancer Institute at Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Moaven Razavi
- The Schneider Institutes for Health Policy at the Heller School of Brandeis University, Waltham, MA, USA
| | - Iraj Harirchi
- The Cancer Institute at Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Zanganeh
- Deputy of Medical Affairs, Ministry of Health and Medical Education, Tehran, Iran
| | - Gholamreza Salari
- Iran Small Businesses and Industrial Parks Organization, Qazvin, Iran
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Zanganeh M, Moradi N, Zarei L, Rezapour A, Bagheri Lankarani K. COVID-19: The Challenge of Disadvantaged Groups and their Access to Care. Arch Iran Med 2020; 23:647-648. [PMID: 32979915 DOI: 10.34172/aim.2020.79] [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] [Received: 04/16/2020] [Accepted: 05/15/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Marzieh Zanganeh
- Health Insurance Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Najmeh Moradi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Zarei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Moradi N, Rashidian A, Nosratnejad S, Olyaeemanesh A, Zanganeh M, Zarei L. The Worth of a Quality-Adjusted Life-Year in Patients with Diabetes: An Investigation Study using a Willingness-to-Pay Method. Pharmacoecon Open 2019; 3:311-319. [PMID: 30617954 PMCID: PMC6710303 DOI: 10.1007/s41669-018-0111-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND A limited number of studies have specifically examined the value of quality-adjusted life-years (QALYs) from the patient's perspective. OBJECTIVE The goal of this study was to investigate the worth of QALYs from the perspectives of patients with diabetes using health and willingness-to-pay (WTP) measures. METHODS A hypothetical treatment characterized by a permanent cure was presented to 149 patients with diabetes in Tehran, Iran, to elicit the monetary value that they attach to QALYs. The QALY gains of the participants were determined using the EuroQol-5 Dimensions, 3 Levels instrument, the visual analogue scale, and the time trade-off method. A mixed closed-ended WTP model supported by an open-ended question was used to ascertain the monetary value of a QALY gained. Finally, we used each respondent's ratio of WTP to QALY gained and the mean of the ratios to estimate the worth of a QALY to all respondents. RESULTS In total, 96% of respondents were willing to pay out of pocket for the restoration of full health, whereas 4% exhibited a zero WTP because of an inability to pay. The mean WTP per QALY varied depending on the health measure and discount rate used, ranging from $US1191 to $US5043 in sensitivity analysis, which is equal to 0.23-0.95 of Iran's gross domestic product (GDP) per capita in 2015. CONCLUSION Applying the upper limit of the World Health Organization's (WHO) cost-effectiveness threshold (i.e., three times the local GDP per capita) in resource allocation decisions requires caution and investigation, particularly in low- and middle-income countries with limited healthcare resources. To generalize our findings, especially for application to decision making, additional surveys involving more representative samples from different settings are recommended.
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Affiliation(s)
- Najme Moradi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Nosratnejad
- Department of Health Economics, Iranian Centre of Excellence in Health Service Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Olyaeemanesh
- Health Economics Department, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
- Health Equity Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Zanganeh
- Head of Health Insurance Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Leila Zarei
- Health Policy Research Center, Institute of Heath, Shiraz University of Medical Sciences, Tehran, Iran
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Moradi N, Rashidian A, Nosratnejad S, Olyaeemanesh A, Zanganeh M, Zarei L. Willingness to pay for one quality-adjusted life year in Iran. Cost Eff Resour Alloc 2019; 17:4. [PMID: 30867654 PMCID: PMC6396529 DOI: 10.1186/s12962-019-0172-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 04/19/2018] [Accepted: 02/12/2019] [Indexed: 02/27/2024] Open
Abstract
Background Recent years have witnessed a strong tendency to apply economic evidence as a guide for making health resource allocation decisions, especially those related to reimbursement policies. One such measure is the use of the cost-effectiveness threshold as a benchmark. This study explored the threshold for use in the health system of Iran by determining society’s preferences. Methods A cross-sectional household survey based on the contingent valuation method was administered to a representative general population of 1002 in Tehran, Iran from April to June 2015. The survey was intended to estimate the respondents’ willingness-to-pay (WTP) preferences for one quality-adjusted life year (QALY) gained. The valuation scenarios featured 12 vignettes on mild to severe diseases that can change people’s quality of life. The mean of WTP for QALY was estimated using different health instruments, and the determinants of such willingness were analyzed using the Heckman selection model. Results WTP for QALY varied depending on the severity of a disease and the instrument used to determine health preferences. Mean low health state value were associated with high valuation. The best estimated WTP values ranged from US$1032 to US$2666 and 0.22–0.56 of Iran’s local gross domestic product (GDP) per capita in 2014. Except for educational level, significant variables differed across different disease scenarios. Generally, a high health state valuation for target diseases, high income, high educational level, and being married were associated with high WTP for QALY. Conclusion From the general public’s perspective, the monetary value of QALY for mild to severe diseases with no risk of death was less than one GDP per capita. Therefore, the obtained valuation range is recommended as reference only for the adoption of interventions designed to improve quality of life. Future studies should estimate the threshold of interventions for life-threatening diseases or formulate transparent policies in such contexts. Electronic supplementary material The online version of this article (10.1186/s12962-019-0172-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Najmeh Moradi
- 1Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- 2School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Nosratnejad
- 3Iranian Center of Excellence in Health Service Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Olyaeemanesh
- 4Health Economics Department, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Zanganeh
- 5Health Insurance Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Leila Zarei
- 6Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Yeganeh-Bakhtiary A, Zanganeh M, Kazemi E, Cheng L, Abd Wahab AK. Euler–Lagrange Two-Phase Model for Simulating Live-Bed Scour Beneath Marine Pipelines. Journal of Offshore Mechanics and Arctic Engineering 2013; 135. [DOI: 10.1115/1.4023200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
In this study, an Euler–Lagrange coupling two-phase flow model, namely movable bed simulator (MBS)-two-dimensional (2D) model was employed to explore the current-induced live-bed scour beneath marine pipelines. The fluid phase characteristics, such as velocity and pressure, were obtained by the Reynolds-averaged Navier–Stokes (RANS) equations with a k-ε turbulence closure model in a two-dimensional Eulerian grid, whereas the seabed beneath pipelines was traced as an assembly of discrete sand grains from the Lagrangian point of view. The live-bed scour was evolved as the motion of a granular media based on distinct element method (DEM) formulation, in which the frequent interparticle collision was described with a spring and dashpot system. The fluid flow was coupled to the sediment phase, considering the acting drag forces between. Comparison between the numerical result and experimental measurement confirms that the numerical model successfully estimates the bed profile and flow velocity field. It is evident that the fluid shear stress decreases with the increasing of gap ratio e/D. The numerical model provides a useful approach to improve mechanistic understanding of hydrodynamic and sediment transport in live-bed scour beneath a marine pipeline.
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Affiliation(s)
- A. Yeganeh-Bakhtiary
- Enviro-Hydroinformatics COE and School of Civil Engineering, Iran University of Science & Technology (IUST), Tehran 16846-13114, Iran; Hydro-environmental Research Centre, School of Engineering, Cardiff University, Queen's Buildings, The Parade Cardiff, CF24-3AA, Wales, UK e-mail: &
| | | | - E. Kazemi
- School of Civil Engineering, IUST, Tehran 16848-13114, Iran
| | - L. Cheng
- School of Civil and Resource Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - A. K. Abd Wahab
- Coastal & Offshore Engineering Institute, Universiti Teknologi Malaysia (UTM), International Campus, Kuala Lumpur 54100, Malaysia
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