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Romanello M, Napoli CD, Green C, Kennard H, Lampard P, Scamman D, Walawender M, Ali Z, Ameli N, Ayeb-Karlsson S, Beggs PJ, Belesova K, Berrang Ford L, Bowen K, Cai W, Callaghan M, Campbell-Lendrum D, Chambers J, Cross TJ, van Daalen KR, Dalin C, Dasandi N, Dasgupta S, Davies M, Dominguez-Salas P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Freyberg C, Gasparyan O, Gordon-Strachan G, Graham H, Gunther SH, Hamilton I, Hang Y, Hänninen R, Hartinger S, He K, Heidecke J, Hess JJ, Hsu SC, Jamart L, Jankin S, Jay O, Kelman I, Kiesewetter G, Kinney P, Kniveton D, Kouznetsov R, Larosa F, Lee JKW, Lemke B, Liu Y, Liu Z, Lott M, Lotto Batista M, Lowe R, Odhiambo Sewe M, Martinez-Urtaza J, Maslin M, McAllister L, McMichael C, Mi Z, Milner J, Minor K, Minx JC, Mohajeri N, Momen NC, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Obradovich N, O'Hare MB, Oliveira C, Oreszczyn T, Otto M, Owfi F, Pearman O, Pega F, Pershing A, Rabbaniha M, Rickman J, Robinson EJZ, Rocklöv J, Salas RN, Semenza JC, Sherman JD, Shumake-Guillemot J, Silbert G, Sofiev M, Springmann M, Stowell JD, Tabatabaei M, Taylor J, Thompson R, Tonne C, Treskova M, Trinanes JA, Wagner F, Warnecke L, Whitcombe H, Winning M, Wyns A, Yglesias-González M, Zhang S, Zhang Y, Zhu Q, Gong P, Montgomery H, Costello A. The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms. Lancet 2023; 402:2346-2394. [PMID: 37977174 DOI: 10.1016/s0140-6736(23)01859-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 08/31/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Marina Romanello
- Institute for Global Health, University College London, London, UK.
| | - Claudia di Napoli
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Carole Green
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | - Pete Lampard
- Department of Health Sciences, University of York, York, UK
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | - Maria Walawender
- Institute for Global Health, University College London, London, UK
| | - Zakari Ali
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Nadia Ameli
- Institute for Sustainable Resources, University College London, London, UK
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Paul J Beggs
- School of Natural Sciences, Macquarie University, Sydney, NSW, Australia
| | | | | | - Kathryn Bowen
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Diarmid Campbell-Lendrum
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Jonathan Chambers
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Troy J Cross
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | | | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Niheer Dasandi
- International Development Department, University of Birmingham, Birmingham, UK
| | - Shouro Dasgupta
- Euro-Mediterranean Center on Climate Change Foundation, Lecce, Italy
| | - Michael Davies
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | | | - Robert Dubrow
- School of Public Health, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Matthew Eckelman
- Department of Civil & Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Chris Freyberg
- Department of Information Systems, Massey University, Palmerston North, New Zealand
| | - Olga Gasparyan
- Department of Political Science, Florida State University, Tallahassee, FL, USA
| | | | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Samuel H Gunther
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Yun Hang
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | | | - Stella Hartinger
- Carlos Vidal Layseca School of Public Health and Management, Cayetano Heredia Pervuvian University, Lima, Peru
| | - Kehan He
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - Julian Heidecke
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Jeremy J Hess
- Centre for Health and the Global Environment, University of Washington, Washington, DC, USA
| | - Shih-Che Hsu
- Energy Institute, University College London, London, UK
| | - Louis Jamart
- Institute for Global Health, University College London, London, UK
| | - Slava Jankin
- Centre for AI in Government, University of Birmingham, Birmingham, UK
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Patrick Kinney
- Department of Environmental Health, Boston University, Boston, MA, USA
| | - Dominic Kniveton
- School of Global Studies, University of Sussex, Brighton and Hove, UK
| | | | - Francesca Larosa
- Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Jason K W Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bruno Lemke
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | - Zhao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Melissa Lott
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | - Rachel Lowe
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- Environmental Studies Program, Denison University, Granville, OH, USA
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Zhifu Mi
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - James Milner
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, NY, USA
| | - Jan C Minx
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Nahid Mohajeri
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Kris A Murray
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Tara Neville
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Maria Nilsson
- Department for Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Megan B O'Hare
- Institute for Global Health, University College London, London, UK
| | - Camile Oliveira
- Institute for Global Health, University College London, London, UK
| | | | - Matthias Otto
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Tehran, Iran
| | - Olivia Pearman
- Center for Science and Technology Policy, University of Colorado Boulder, Boulder, CO, USA
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | | | | | - Jamie Rickman
- Institute for Sustainable Resources, University College London, London, UK
| | - Elizabeth J Z Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science, London, UK
| | - Joacim Rocklöv
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Renee N Salas
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jan C Semenza
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jodi D Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | | | - Grant Silbert
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Marco Springmann
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Meisam Tabatabaei
- Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Marina Treskova
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Joaquin A Trinanes
- Department of Electronics and Computer Science, University of Santiago de Compostela, Santiago, Spain
| | - Fabian Wagner
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Laura Warnecke
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Hannah Whitcombe
- Institute for Global Health, University College London, London, UK
| | - Matthew Winning
- Institute for Sustainable Resources, University College London, London, UK
| | - Arthur Wyns
- Melbourne Climate Futures, The University of Melbourne, Melbourne, VIC, Australia
| | - Marisol Yglesias-González
- Centro Latinoamericano de Excelencia en Cambio Climatico y Salud, Cayetano Heredia Pervuvian University, Lima, Peru
| | - Shihui Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Ying Zhang
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Qiao Zhu
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | - Peng Gong
- Department of Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hugh Montgomery
- Department of Experimental and Translational Medicine and Division of Medicine, University College London, London, UK
| | - Anthony Costello
- Institute for Global Health, University College London, London, UK
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Rocklöv J, Semenza JC, Dasgupta S, Robinson EJ, Abd El Wahed A, Alcayna T, Arnés-Sanz C, Bailey M, Bärnighausen T, Bartumeus F, Borrell C, Bouwer LM, Bretonnière PA, Bunker A, Chavardes C, van Daalen KR, Encarnação J, González-Reviriego N, Guo J, Johnson K, Koopmans MP, Máñez Costa M, Michaelakis A, Montalvo T, Omazic A, Palmer JR, Preet R, Romanello M, Shafiul Alam M, Sikkema RS, Terrado M, Treskova M, Urquiza D, Lowe R. Decision-support tools to build climate resilience against emerging infectious diseases in Europe and beyond. Lancet Reg Health Eur 2023; 32:100701. [PMID: 37583927 PMCID: PMC10424206 DOI: 10.1016/j.lanepe.2023.100701] [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] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023]
Abstract
Climate change is one of several drivers of recurrent outbreaks and geographical range expansion of infectious diseases in Europe. We propose a framework for the co-production of policy-relevant indicators and decision-support tools that track past, present, and future climate-induced disease risks across hazard, exposure, and vulnerability domains at the animal, human, and environmental interface. This entails the co-development of early warning and response systems and tools to assess the costs and benefits of climate change adaptation and mitigation measures across sectors, to increase health system resilience at regional and local levels and reveal novel policy entry points and opportunities. Our approach involves multi-level engagement, innovative methodologies, and novel data streams. We take advantage of intelligence generated locally and empirically to quantify effects in areas experiencing rapid urban transformation and heterogeneous climate-induced disease threats. Our goal is to reduce the knowledge-to-action gap by developing an integrated One Health-Climate Risk framework.
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Affiliation(s)
- Joacim Rocklöv
- Heidelberg Institute of Global Health (HIGH) & Interdisciplinary Centre for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jan C. Semenza
- Heidelberg Institute of Global Health (HIGH) & Interdisciplinary Centre for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shouro Dasgupta
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy
- Graham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, United Kingdom
| | - Elizabeth J.Z. Robinson
- Graham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, United Kingdom
| | - Ahmed Abd El Wahed
- Faculty of Veterinary Medicine, Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany
| | - Tilly Alcayna
- Red Cross Red Crescent Centre on Climate Change and Disaster Preparedness, The Hague, the Netherlands
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
- Health in Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Cristina Arnés-Sanz
- Heidelberg Institute of Global Health (HIGH) & Interdisciplinary Centre for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany
| | - Meghan Bailey
- Red Cross Red Crescent Centre on Climate Change and Disaster Preparedness, The Hague, the Netherlands
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frederic Bartumeus
- Theoretical and Computational Ecology Group, Centre d’Estudis Avançats de Blanes (CEAB-CSIC), Blanes, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
- Centre de Recerca Ecològica i Aplicacions Forestals (CREAF), Barcelona, Spain
| | - Carme Borrell
- Pest Surveillance and Control, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laurens M. Bouwer
- Climate Service Center Germany (GERICS), Helmholtz-Zentrum Hereon, Hamburg, Germany
| | | | - Aditi Bunker
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
- Center for Climate, Health and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Kim R. van Daalen
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom
| | | | | | - Junwen Guo
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Katie Johnson
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy
| | - Marion P.G. Koopmans
- Department of Viroscience, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - María Máñez Costa
- Climate Service Center Germany (GERICS), Helmholtz-Zentrum Hereon, Hamburg, Germany
| | - Antonios Michaelakis
- Laboratory of Insects & Parasites of Medical Importance, Benaki Phytopathological Institute (BPI), Attica, Greece
| | - Tomás Montalvo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Anna Omazic
- Department of Chemistry, Environment, and Feed Hygiene, National Veterinary Institute (SVA), Uppsala, Sweden
| | - John R.B. Palmer
- Department of Political and Social Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Raman Preet
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Marina Romanello
- Institute for Global Health, University College London (UCL), London, United Kingdom
| | - Mohammad Shafiul Alam
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Reina S. Sikkema
- Department of Viroscience, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - Marta Terrado
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Marina Treskova
- Heidelberg Institute of Global Health (HIGH) & Interdisciplinary Centre for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany
| | - Diana Urquiza
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Rachel Lowe
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
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Walde J, Chaturvedi M, Berger T, Bartz A, Killewald R, Tomori DV, Rübsamen N, Lange B, Scholz S, Treskova M, Bucksch K, Jarvis CI, Mikolajczyk R, Karch A, Jaeger VK. Effect of risk status for severe COVID-19 on individual contact behaviour during the SARS-CoV-2 pandemic in 2020/2021-an analysis based on the German COVIMOD study. BMC Infect Dis 2023; 23:205. [PMID: 37024810 PMCID: PMC10078023 DOI: 10.1186/s12879-023-08175-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND One of the primary aims of contact restriction measures during the SARS-CoV-2 pandemic has been to protect people at increased risk of severe disease from the virus. Knowledge about the uptake of contact restriction measures in this group is critical for public health decision-making. We analysed data from the German contact survey COVIMOD to assess differences in contact patterns based on risk status, and compared this to pre-pandemic data to establish whether there was a differential response to contact reduction measures. METHODS We quantified differences in contact patterns according to risk status by fitting a generalised linear model accounting for within-participant clustering to contact data from 31 COVIMOD survey waves (April 2020-December 2021), and estimated the population-averaged ratio of mean contacts of persons with high risk for a severe COVID-19 outcome due to age or underlying health conditions, to those without. We then compared the results to pre-pandemic data from the contact surveys HaBIDS and POLYMOD. RESULTS Averaged across all analysed waves, COVIMOD participants reported a mean of 3.21 (95% confidence interval (95%CI) 3.14,3.28) daily contacts (truncated at 100), compared to 18.10 (95%CI 17.12,19.06) in POLYMOD and 28.27 (95%CI 26.49,30.15) in HaBIDS. After adjusting for confounders, COVIMOD participants aged 65 or above had 0.83 times (95%CI 0.79,0.87) the number of contacts as younger age groups. In POLYMOD, this ratio was 0.36 (95%CI 0.30,0.43). There was no clear difference in contact patterns due to increased risk from underlying health conditions in either HaBIDS or COVIMOD. We also found that persons in COVIMOD at high risk due to old age increased their non-household contacts less than those not at such risk after strict restriction measures were lifted. CONCLUSIONS Over the course of the SARS-CoV-2 pandemic, there was a general reduction in contact numbers in the German population and also a differential response to contact restriction measures based on risk status for severe COVID-19. This differential response needs to be taken into account for parametrisations of mathematical models in a pandemic setting.
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Affiliation(s)
- Jasmin Walde
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Madhav Chaturvedi
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Tom Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Antonia Bartz
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Robin Killewald
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Damilola Victoria Tomori
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Nicole Rübsamen
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research, Braunschweig, Germany
| | - Stefan Scholz
- Immunization Unit, Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
| | - Marina Treskova
- Immunization Unit, Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Karolin Bucksch
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | | | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Veronika K Jaeger
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
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Külper-Schiek W, Piechotta V, Pilic A, Batke M, Dreveton LS, Geurts B, Koch J, Köppe S, Treskova M, Vygen-Bonnet S, Waize M, Wichmann O, Harder T. Facing the Omicron variant—how well do vaccines protect against mild and severe COVID-19? Third interim analysis of a living systematic review. Front Immunol 2022; 13:940562. [PMID: 36091023 PMCID: PMC9449804 DOI: 10.3389/fimmu.2022.940562] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/20/2022] [Indexed: 01/21/2023] Open
Abstract
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant is currently the dominant variant globally. This third interim analysis of a living systematic review summarizes evidence on the effectiveness of the coronavirus disease 2019 (COVID-19) vaccine (vaccine effectiveness, VE) and duration of protection against Omicron. Methods We systematically searched literature on COVID-19 for controlled studies, evaluating the effectiveness of COVID-19 vaccines approved in the European Union up to 14/01/2022, complemented by hand searches of websites and metasearch engines up to 11/02/2022. We considered the following comparisons: full primary immunization vs. no vaccination, booster immunization vs. no vaccination, and booster vs. full primary immunization. VE against any confirmed SARS-CoV-2 infection, symptomatic, and severe COVID-19 (i.e., COVID-19-related hospitalization, ICU admission, or death) was indicated, providing estimate ranges. Meta-analysis was not performed due to high study heterogeneity. The risk of bias was assessed with ROBINS-I, and the certainty of the evidence was evaluated using GRADE. Results We identified 26 studies, including 430 to 2.2 million participants, which evaluated VE estimates against infections with the SARS-CoV-2 Omicron variant. VE against any confirmed SARS-CoV-2 infection ranged between 0–62% after full primary immunization and between 34–66% after a booster dose compared to no vaccination. VE range for booster vs. full primary immunization was 34–54.6%. After full primary immunization VE against symptomatic COVID-19 ranged between 6-76%. After booster immunization VE ranged between 3-84% compared to no vaccination and between 56-69% compared to full primary immunization. VE against severe COVID-19 ranged between 3-84% after full primary immunization and between 12-100% after booster immunization compared to no vaccination, and 100% (95% CI 71.4-100) compared to full primary immunization (data from only one study). VE was characterized by a moderate to strong decline within 3–6 months for SARS-CoV-2 infections and symptomatic COVID-19. Against severe COVID-19, protection remained robust for at least up to 6 months. Waning immunity was more profound after primary than booster immunization. The risk of bias was moderate to critical across studies and outcomes. GRADE certainty was very low for all outcomes. Conclusions Under the Omicron variant, the effectiveness of EU-licensed COVID-19 vaccines in preventing any SARS-CoV-2 infection is low and only short-lasting after full primary immunization, but can be improved by booster vaccination. VE against severe COVID-19 remains high and is long-lasting, especially after receiving the booster vaccination.
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Affiliation(s)
- Wiebe Külper-Schiek
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- *Correspondence: Wiebe Külper-Schiek,
| | - Vanessa Piechotta
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Antonia Pilic
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Madeleine Batke
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Léa-Sophie Dreveton
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Brogan Geurts
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Judith Koch
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Stefan Köppe
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Marina Treskova
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Vygen-Bonnet
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Maria Waize
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Ole Wichmann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Thomas Harder
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Treskova M, Kuhlmann A, Freise F, Kreienbrock L, Brogden S. Occurrence of Antimicrobial Resistance in the Environment in Germany, Austria, and Switzerland: A Narrative Review of Existing Evidence. Microorganisms 2022; 10:microorganisms10040728. [PMID: 35456779 PMCID: PMC9027620 DOI: 10.3390/microorganisms10040728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
(1) Background: This study summarizes the current research on antibiotic resistance (AR) in the environment conducted in Austria, Germany, and Switzerland; (2) Methods: A narrative systematic literature review of epidemiological studies based on searches in EMBASE and CAB abstracts (up to 16 June2021) was conducted. Environmental reservoirs included water sources, wastewater, animal husbandry, wildlife, soil, and sediment; (3) Results: Four hundred and four records were screened, and 52 studies were included. Thirteen studies examined aquatic environments, and eleven investigated wastewater. Eight studies investigated both wildlife and animal husbandry. Less evidence was available for sediments, soil, and air. Considerable heterogeneity in research focus, study design, sampling, and measurement of resistance was observed. Resistance to all categories of antimicrobials in the WHO CIA list was identified. Resistance to critically important and highly important substances was reported most frequently; (4) Conclusions: The current research scope presents data-gathering efforts. Usage of a unified protocol for isolate collection, selecting sampling sites, and susceptibility testing is required to provide results that can be compared between the studies and reservoirs. Epidemiological, environmental, and ecological factors should be considered in surveys of the environmental dissemination of AR. Systematic epidemiological studies investigating AR at the interface of human, animal, and environmental health are needed.
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Affiliation(s)
- Marina Treskova
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (M.T.); (F.F.); (L.K.)
- Heidelberg Institute of Global Health, Faculty of Medicine, University Heidelberg, 69120 Heidelberg, Germany
| | - Alexander Kuhlmann
- Faculty of Medicine, Martin Luther University of Halle Wittenberg, 06108 Halle (Saale), Germany;
| | - Fritjof Freise
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (M.T.); (F.F.); (L.K.)
| | - Lothar Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (M.T.); (F.F.); (L.K.)
| | - Sandra Brogden
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (M.T.); (F.F.); (L.K.)
- Correspondence:
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Treskova M, Pozo-Martin F, Scholz S, Schönfeld V, Wichmann O, Harder T. Assessment of the Effects of Active Immunisation against Respiratory Syncytial Virus (RSV) using Decision-Analytic Models: A Systematic Review with a Focus on Vaccination Strategies, Modelling Methods and Input Data. Pharmacoeconomics 2021; 39:287-315. [PMID: 33462760 PMCID: PMC7813556 DOI: 10.1007/s40273-020-00991-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Several vaccine and antibody candidates are currently in development for the prevention of lower respiratory tract infections caused by the respiratory syncytial virus (RSV). METHODS We searched MEDLINE, Embase, and SCOPUS and included model-based evaluations of RSV vaccinations. Two reviewers performed the selection, data extraction, and quality evaluation with EVIDEM. Cost-effectiveness (CE) estimates were converted to $US purchasing power parity (PPP), year 2018 values. Potential economic and epidemiological outcomes were summarised for maternal, infant, children, and elderly vaccinations. The PROSPERO identifier is CRD42019122570. RESULTS In total, 22 model-based studies were reviewed. On average, a potential 27% reduction in RSV hospitalisations in infants was projected for maternal vaccination and 50% for direct infant immunisation. The CE of maternal vaccination was $US1766-5857 PPP 2018/disability-adjusted life-years (DALYs) for Global Alliance for Vaccines and Immunisation (Gavi)-eligible countries. For England, the maximum cost-effective price of maternal vaccination was estimated at $US81.5 PPP 2018. Infant vaccination was associated with higher CE ratios in low- and high-income settings. Vaccination of neonates born before the RSV season was the most cost effective in high-income settings. Higher values for vaccine effectiveness, duration of protection, and vaccine uptake increased the benefits. Due to indirect effects, the vaccination of school-age children and a cocooning strategy were effective alternatives to protect infants, and the vaccination of children aged < 5 years had a beneficial impact on the elderly. CONCLUSION RSV vaccines with anticipated characteristics may reduce a sizeable proportion of the RSV burden. The results are subject to uncertainty because of the limited epidemiological and clinical data. Data on RSV incidence and hospitalisation risk for granular age strata should be prioritised to facilitate the evaluation of RSV interventions and decision making.
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Affiliation(s)
- Marina Treskova
- Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany.
| | | | - Stefan Scholz
- Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Viktoria Schönfeld
- Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Thomas Harder
- Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
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Treskova M, Scholz SM, Kuhlmann A. Cost Effectiveness of Elderly Pneumococcal Vaccination in Presence of Higher-Valent Pneumococcal Conjugate Childhood Vaccination: Systematic Literature Review with Focus on Methods and Assumptions. Pharmacoeconomics 2019; 37:1093-1127. [PMID: 31025189 DOI: 10.1007/s40273-019-00805-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Previous systematic reviews concluded that pneumococcal vaccination in the elderly was cost effective. However, recently published economic evaluations state that it may not be cost effective when children are vaccinated with higher-valent pneumococcal conjugate vaccines. The literature suggests that the outcomes of vaccination in the elderly are strongly influenced by the vaccine effectiveness (VE) against the vaccine-type pneumococcal diseases (PD) and the impact of childhood vaccination on the vaccine-type PD incidence in the elderly, but the extent remains unclear. METHODS We conducted a systematic literature search of cost-effectiveness studies on vaccination in the elderly in the PubMed database starting from 2006. We included studies that consider the presence of a childhood vaccination with pneumococcal conjugate vaccine (PCV) 10 and PCV13. We focus on methods and assumptions used in modeling VE and epidemiology of PD over time. RESULTS Twenty-eight economic evaluations underwent full-text review and data extraction. Thirteen were selected for quality assessment. The studies with a higher quality score provide evidence that vaccinating the elderly with PCV13 is not cost effective, when an ongoing rapid decline in the incidence of PCV13-type PD is modeled. A moderate persistence of PCV13 serotypes, in particular due to PCV10 childhood vaccination, makes vaccination of the elderly with PCV13 more attractive. There is no agreement that combining PCV13 with polysaccharide vaccine PPSV23 is cost effective. PPSV23 is attractive when it is effective against non-invasive PD. CONCLUSION Methodological approaches and assumptions in modeling VE and the indirect effects of childhood vaccination have a major impact on outcomes of decision-analytic models and cost-effectiveness estimates. Considering recently observed trends in the epidemiology of pneumococcal serotypes, there is currently inconclusive evidence regarding the cost effectiveness of pneumococcal vaccination of the elderly due to lack of studies that model key serotypes such as serotype 3 separately from other groups of serotypes.
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Affiliation(s)
- Marina Treskova
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany.
| | - Stefan M Scholz
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
- Department of Health Economics and Health Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Alexander Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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Kuhlmann A, Schmidt T, Treskova M, Golpon H, Welte T, Von Der Schulenburg J.G. P3.07-013 Cost-Effectiveness of Immune Checkpoint Inhibitors in the Treatment of Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kuhlmann A, Treskova M, Aumann I, Golpon H, Vogel-Claussen J, Welte T, Von Der Schulenburg J.G. OA 15.02 Benefits, Harms, and Economic Efficiency of Low-Dose CT Lung Cancer Screening Strategies in a Population-Based Setting. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Treskova M, Aumann I, Golpon H, Vogel-Claussen J, Welte T, Kuhlmann A. Kosteneffektivität des Lungenkarzinomscreenings mittels low-dose CT in Deutschland. Pneumologie 2017. [DOI: 10.1055/s-0037-1598334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Treskova
- Center for Health Economics Research Hannover, Leibniz Universität Hannover
| | - I Aumann
- Center for Health Economics Research Hannover, Leibniz Universität Hannover
| | - H Golpon
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | | | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - A Kuhlmann
- Center for Health Economics Research Hannover, Leibniz Universität Hannover
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Aumann I, Treskova M, Hagemann N, von der Schulenburg JM. Analysis of Driving Factors of Willingness to Use and Willingness to Pay for Existing Pharmacological Smoking Cessation Aids Among Young and Middle-Aged Adults in Germany. Appl Health Econ Health Policy 2016; 14:441-452. [PMID: 27021824 DOI: 10.1007/s40258-016-0239-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Smoking cessation is a challenging task with a high risk of relapse. Depending on the choice of medication and duration of therapy, the costs of using a smoking cessation aid can be high. Additionally, these costs are not covered by health insurance in Germany. Information on willingness to use (WTU) and willingness to pay (WTP) for smoking cessation aids is valuable for developing different smoking cessation strategies. OBJECTIVES The study analyses WTU and WTP for three pharmacological smoking cessation aids (nicotine replacement therapy (NRT), bupropion and varenicline) among young and middle-aged adults in Germany and attempts to determine their major driving factors. METHODS Two cross-sectional internet-based surveys of smokers over 18 years of age were conducted in 2014 and 2015 in Germany. Respondents were asked about smoking-related issues and WTU and WTP for each therapy. The contingent valuation method with payment cards was used to measure WTP. Descriptive statistics, logistical regression and accelerated failure-time regression models were performed. RESULTS The total sample size is 505. Half of the respondents are willing to use NRT and one-third are willing to use bupropion and/or varenicline. WTU induces positive WTP; however, the magnitude of WTP is beneath the market price. WTU significantly increases with a higher addiction level and if smokers have previously heard about the therapy. CONCLUSION This study indicates different points to be considered for policy development. Promotion information and improving awareness about medication aids might increase WTU, and development of monetary incentives for young smokers could create a better chance for successful smoking cessation.
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Affiliation(s)
- I Aumann
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany.
- Biomedical Research in Endstage and Obstructive Lung Disease Hanover (BREATH), Member of the German Center for Lung Research (DZL), Hanover, Germany.
| | - M Treskova
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany
| | - N Hagemann
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany
| | - J-M von der Schulenburg
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hanover (BREATH), Member of the German Center for Lung Research (DZL), Hanover, Germany
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Treskova M, Kuhlmann A, Bogner J, Hower M, Heiken H, Stellbrink HJ, Mahlich J, von der Schulenburg JMG, Stoll M. Analysis of contemporary HIV/AIDS health care costs in Germany: Driving factors and distribution across antiretroviral therapy lines. Medicine (Baltimore) 2016; 95:e3961. [PMID: 27367993 PMCID: PMC4937907 DOI: 10.1097/md.0000000000003961] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To analyze contemporary costs of HIV health care and the cost distribution across lines of combination antiretroviral therapy (cART). To identify variations in expenditures with patient characteristics and to identify main cost determinants. To compute cost ratios between patients with varying characteristics.Empirical data on costs are collected in Germany within a 2-year prospective observational noninterventional multicenter study. The database contains information for 1154 HIV-infected patients from 8 medical centers.Means and standard deviations of the total costs are estimated for each cost fraction and across cART lines and regimens. The costs are regressed against various patient characteristics using a generalized linear model. Relative costs are calculated using the resultant coefficients.The average annual total costs (SD) per patient are &OV0556;22,231.03 (8786.13) with a maximum of &OV0556;83,970. cART medication is the major cost fraction (83.8%) with a mean of &OV0556;18,688.62 (5289.48). The major cost-driving factors are cART regimen, CD4-T cell count, cART drug resistance, and concomitant diseases. Viral load, pathology tests, and demographics have no significant impact. Standard non-nucleoside reverse transcriptase inhibitor-based regimens induce 28% lower total costs compared with standard PI/r regimens. Resistance to 3 or more antiretroviral classes induces a significant increase in costs.HIV treatment in Germany continues to be expensive. Majority of costs are attributable to cART. Main cost determinants are CD4-T cells count, comorbidity, genotypic antiviral resistance, and therapy regimen. Combinations of characteristics associated with higher expenditures enhance the increasing effect on the costs and induce high cost cases.
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Affiliation(s)
- Marina Treskova
- Center for Health Economics Research Hannover, Hannover
- Correspondence: Marina Treskova, Gottfried Wilhelm Leibniz Universität Hannover, Center for Health Economics Research Hannover Institut für Versicherungsbetriebslehre Otto-Brenner-Str. 1, 30159 Hannover, Germany (e-mail: )
| | | | - Johannes Bogner
- Sektion Klinische Infektiologie, Med IV, Klinikum der Universität München, Munich
| | - Martin Hower
- ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund
| | - Hans Heiken
- Innere Medizin, Praxis Georgstraße, Hannover
| | | | - Jörg Mahlich
- Health Economics & Pricing, Janssen-Cilag GmbH, Neuss
| | | | - Matthias Stoll
- Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover, Germany
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Kuhlmann A, Schmidt T, Treskova M, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Kanavos P, Taruscio D, Schieppati A, Iskrov G, Péntek M, Delgado C, von der Schulenburg JM, Persson U, Chevreul K, Fattore G. Social/economic costs and health-related quality of life in patients with juvenile idiopathic arthritis in Europe. Eur J Health Econ 2016; 17 Suppl 1:79-87. [PMID: 27086322 DOI: 10.1007/s10198-016-0786-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with juvenile idiopathic arthritis (JIA) in Europe. METHODS We conducted a cross-sectional study of patients with JIA from Germany, Italy, Spain, France, the United Kingdom, Bulgaria, and Sweden. Data on demographic characteristics, healthcare resource utilization, informal care, labor productivity losses, and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D-5L) questionnaire. RESULTS A total of 162 patients (67 Germany, 34 Sweden, 33 Italy, 23 United Kingdom, 4 France, and 1 Bulgaria) completed the questionnaire. Excluding Bulgarian results, due to small sample size, country-specific annual health care costs ranged from €18,913 to €36,396 (reference year: 2012). Estimated direct healthcare costs ranged from €11,068 to €22,138; direct non-healthcare costs ranged from €7837 to €14,155 and labor productivity losses ranged from €0 to €8715. Costs are also shown to differ between children and adults. The mean EQ-5D index score for JIA patients was estimated at between 0.44 and 0.88, and the mean EQ-5D visual analogue scale score was estimated at between 62 and 79. CONCLUSIONS JIA patients incur considerable societal costs and experience substantial deterioration in HRQOL in some countries. Compared with previous studies, our results show a remarkable increase in annual healthcare costs for JIA patients. Reasons for the increase are the inclusion of non-professional caregiver costs, a wider use of biologics, and longer hospital stays.
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Affiliation(s)
- A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany.
| | - T Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - M Treskova
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - J López-Bastida
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - R Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - J Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universidad de Castilla-La Mancha, Toledo, Spain
| | - P Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - M Posada-de-la-Paz
- Institute of Rare Diseases Research, ISCIII, SpainRDR & CIBERER, Madrid, Spain
| | - P Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, United Kingdom
| | - D Taruscio
- National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | - G Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - C Delgado
- Federación Española de Enfermedades Raras (FEDER), Madrid, Spain
| | - J M von der Schulenburg
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - U Persson
- Swedish Institute for Health Economics, Lund, Sweden
| | - K Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - G Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Aumann I, Treskova M, Hagemann N, Graf von der Schulenburg JM. Willingness to use and pay for pharmacological smoking cessation therapies among smokers in Germany. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kuhlmann A, Treskova M, Braun S, Graf von der Schulenburg JM. The Role of decision-analytic modelling in German health technology assessments. Health Econ Rev 2015; 5:7. [PMID: 25853005 PMCID: PMC4385016 DOI: 10.1186/s13561-014-0039-x] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 12/16/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Decision-analytic modelling (DAM) has become a widespread method in health technology assessments (HTA), but the extent to which modelling is used differs among international HTA institutions. In Germany, the use of DAM is optional within HTAs of the German Institute of Medical Documentation and Information (DIMDI). Our study examines the use of DAM in DIMDI HTA reports and its effect on the quality of information provided for health policies. METHODS A review of all DIMDI HTA reports (from 1998 to September 2012) incorporating an economic assessment was performed. All included reports were divided into two groups: HTAs with DAM and HTAs without DAM. In both groups, reports were categorized according to the quality of information provided for healthcare decision making. RESULTS Of the sample of 107 DIMDI HTA reports, 17 (15.9%) used DAM for economic assessment. In the group without DAM, conclusions were limited by the quality of economic information in 51.1% of the reports, whereas we did not find limited conclusions in the group with DAM. Furthermore, 24 reports without DAM (26.7%) stated that using DAM would likely improve the quality of information of the economic assessment. CONCLUSION The use of DAM techniques can improve the quality of HTAs in Germany. When, after a systematic review of existing literature within a HTA, it is clear that DAM is likely to positively affect the quality of the economic assessment DAM should be used.
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Affiliation(s)
- Alexander Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover, Germany
| | - Marina Treskova
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover, Germany
| | - Sebastian Braun
- Xcenda GmbH- Health Economic Research & Consulting, Hannover, Germany
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