Background:This study evaluates the impact of a point-of-care (POC) testing strategy and subsequent treatments for respiratory tract infections (RTIs) on patients' health-related quality of life (QoL). Materials and Methods:The PRUDENCE trial, with a sample of 2639 patients, showed that a POC testing strategy for RTIs (C-reactive protein, group A streptococcus, and influenza A/B, with optional SARS-CoV-2 testing) did not reduce antibiotic prescribing nor had a measurable impact on time to patient recovery compared to usual care. However, differences in patient-reported QoL may still exist, as utility can capture more subtle changes in symptom burden and well-being. The EQ-5D-5L questionnaire was completed by PRUDENCE trial patients at days 1, 14, and 28 of follow-up. Quality-adjusted life-year (QALY) gains were estimated. Static and dynamic analyses were performed to assess changes in utility values. Results:No statistically significant differences in utility scores were observed between the usual care and POC testing groups at any time point during the 28-day study period. However, both groups demonstrated statistically significant improvements in patient-reported utility scores over the 28-day period, corresponding to gains of 0.00502 QALYs in the usual care group and 0.00525 QALYs in the POC testing group. These improvements were already apparent by day 14 of follow-up. Conclusion:Improvements in utility scores over time were similar in both groups and likely reflected the natural clinical recovery from RTIs rather than the effect of the diagnostic strategy itself. Measures such as symptom relief, full recovery and side effects may better capture the intervention's impact. Trial Registration Number:ISRCTN13336322.
Paula Rojas-Garcia,1 Reyes Lorente,1 Marino J González,1 Carmelo A Juárez-Castelló,1 Fernando Antoñanzas,1 Pim WM Van Dorst,2 Clazinus Veijer,2 Simon Van der Pol,2 Christopher C Butler,3,4 Alike W Van der Velden,5 Herman Goossens,6 Antoinette D I Van Asselt,2,7 Maarten J Postma2,8– 101Department of Economics, University of La Rioja, Logrono, Spain; 2Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 3Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; 4NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK; 5Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 6Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; 7Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 8Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, Groningen, the Netherlands; 9Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia; 10Division of Pharmacology & Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaCorrespondence: Fernando Antoñanzas, Department of Economics, University of La Rioja, Logrono, Spain, Email fernando.antonanzas@unirioja.esBackground: This study evaluates the impact of a point-of-care (POC) testing strategy and subsequent treatments for respiratory tract infections (RTIs) on patients’ health-related quality of life (QoL).Materials and Methods: The PRUDENCE trial, with a sample of 2639 patients, showed that a POC testing strategy for RTIs (C-reactive protein, group A streptococcus, and influenza A/B, with optional SARS-CoV-2 testing) did not reduce antibiotic prescribing nor had a measurable impact on time to patient recovery compared to usual care. However, differences in patient-reported QoL may still exist, as utility can capture more subtle changes in symptom burden and well-being. The EQ-5D-5L questionnaire was completed by PRUDENCE trial patients at days 1, 14, and 28 of follow-up. Quality-adjusted life-year (QALY) gains were estimated. Static and dynamic analyses were performed to assess changes in utility values.Results: No statistically significant differences in utility scores were observed between the usual care and POC testing groups at any time point during the 28-day study period. However, both groups demonstrated statistically significant improvements in patient-reported utility scores over the 28-day period, corresponding to gains of 0.00502 QALYs in the usual care group and 0.00525 QALYs in the POC testing group. These improvements were already apparent by day 14 of follow-up.Conclusion: Improvements in utility scores over time were similar in both groups and likely reflected the natural clinical recovery from RTIs rather than the effect of the diagnostic strategy itself. Measures such as symptom relief, full recovery and side effects may better capture the intervention’s impact.Trial Registration Number: ISRCTN13336322.Keywords: antibiotics, EQ-5D-5L, POC, QALY, QoL, RTIs
Dina Abushanab,1 Nader Al-Dewik,2–6 Reem AlNasr,2 Reem Alenany,7 Lana Kattan,7 Ghaith Alali,7 Alaa Al-Naama,8 Moza Al-Hail,9 Thomas Farrell,8 Haseebur Rahman Khan Mohammed,9 Wessam Elkassem,9 Abdulrouf Pallivalapila,10 Binny Thomas,9 Daoud Al-Badriyeh71Office of Vice President for Health and Medical Sciences, QU Health, Qatar University, Doha, Qatar; 2Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar; 3Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar; 4Translational and Precision Medicine Research and Interim Translational Research Institute (Itri), Hamad Medical Corporation, Doha, Qatar; 5Faculty of Health and Social Care Sciences, Kingston University and St. George’s University of London, London, UK; 6Genomics and Precision Medicine, College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar; 7College of Pharmacy, QU Health, Qatar University, Doha, Qatar; 8Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar; 9Pharmacy Department, Hamad Medical Corporation, Doha, Qatar; 10Clinical Trial Unit, Hamad Medical Corporation, Doha, QatarCorrespondence: Dina Abushanab, Email dina.abushanab@qu.edu.qa
Güney SarıoğluDepartment of Cardiology, Ministry of Health, Battalgazi State Hospital, Malatya, 44320, TurkeyCorrespondence: Güney Sarıoğlu, Department of Cardiology, Ministry of Health, Battalgazi State Hospital, Fırat Mah. Kürsü Sok. No: 2, Malatya, 44320, Turkey, Tel +90 506 543 01 71, Fax +90 422 504 88 24, Email guneysarioglu@outlook.com
Introduction:The fetal fibronectin (fFN) test is used to predict true preterm delivery. This study aims to evaluate the cost-effectiveness of fFN testing versus no-fFN testing in identifying true preterm labor among women with preterm labor symptoms at risk for premature birth. Methods:This retrospective cohort-based study was conducted among women who presented with symptoms of preterm labor between 24 and 34 weeks of gestation at a tertiary care hospital in Qatar and compared outcomes between those who received fetal fibronectin (fFN) testing and those who did not. A decision-tree model compared fFN testing to no testing, with the primary outcome being the incremental cost-effectiveness ratio, representing the additional cost for a successful delivery within 48 hours of admission. Clinical data were collected from HMC medical records, and direct medical costs was locally obtained, reflecting the Qatari hospital perspective. Sensitivity analyses confirmed the study results. Results:A total of 519 women were analyzed. Significant baseline differences were observed between groups. The proportion of delivery within 48 hours was higher in the fFN group (94% vs 80%, P<0.0001). fFN testing was associated with a cost saving of QAR6,470 (US$1,777) per successful delivery. Conclusion:fFN testing was associated with better short-term clinical outcomes and lower healthcare costs. Nonetheless, due to the retrospective observational nature of the study and differences in baseline characteristics between groups, these results should be interpreted cautiously.
Objective:As COVID-19 transitions to an endemic stage, low- and middle-income countries face fiscal challenges in sustaining fully subsidized vaccination programs. This study aims to estimate the willingness to pay (WTP) for COVID-19 booster doses and identify determinants of demand among Vietnamese adults during the transition to a user-fee mechanism. Methods:A cross-sectional survey was conducted in 2024 in Thanh Hoa Province, Vietnam, involving 405 adult participants recruited through convenience sampling from a single hospital setting. Data were collected through direct interviews using a structured questionnaire. The Contingent Valuation Method utilizing a double-bounded dichotomous choice format was employed to elicit WTP. Multivariable logistic regression was applied to determine factors associated with willingness to pay, while linear regression analysis was applied to examine determinants of the payment amount. Results:Among 405 participants, the estimated mean WTP for a COVID-19 booster dose was VND 410,046 (approx. US$ 15.7), whereas the median WTP was significantly lower at VND 201,307 (approx. US$ 7.7), indicating a right-skewed distribution. Multivariable logistic regression showed that married participants and those in higher income groups were more likely to report willingness to pay, whereas poor self-rated health and prior adverse events following vaccination were associated with lower willingness to pay. Linear regression analysis indicated that female participants and older individuals reported lower payment amounts, while those with a prior history of COVID-19 infection reported higher payment amounts. Notably, the median WTP was substantially lower than the estimated market price of imported mRNA vaccines, indicating a potential affordability gap between stated valuation and prevailing market prices for COVID-19 booster vaccination. Conclusion:These findings emphasize the necessity of flexible financing approaches to maintain vaccine uptake and prevent widening disparities during the transition to paid vaccination. As the study was conducted using convenience sampling at a single hospital, the findings should be interpreted with consideration of limited generalizability.
Introduction:ST-segment-elevation myocardial infarction (STEMI) affects approximately 250,000 people in the U.S. annually, causing substantial morbidity and mortality. One-year outcomes following percutaneous coronary intervention (PCI) for STEMI vary across studies. Aim:To assess clinical and economic outcomes following PCI among patients with STEMI. Methods:This study analyzed adult patients with STEMI undergoing PCI between 2016 and 2021, using Premier Healthcare Database and additional mortality and claims data. Clinical outcomes, healthcare resource use, and costs following first PCI discharge (index visit) were assessed for at least 1 year, with outcomes at 3-year follow-up assessed among a subset of patients. Multivariable regression (Cox, logistic or generalized linear) was used to identify risk factors for key outcomes. Results:A total of 180,691 patients underwent PCI for STEMI in 633 US hospitals during the study period. The median age was 62 years, most were male (71%), non-Hispanic White (62.7%), and had Medicare as the primary payor (42.9%). At index visit, 13.8% had ventricular tachycardia, 8.8% had ventricular fibrillation, with a median cost of $17,582, and a mortality rate of 5.5%. Within 1 year, there were 1,966 (1.1%) additional deaths, 17.4% were readmitted, 13.4% developed heart failure (HF), 2.5% were hospitalized primarily for HF (HHF), 3.9% had atrial fibrillation, and 1% experienced recurrent STEMI. The median total study cost by 1 year was $21,010. A Charlson Comorbidity Index (CCI) score of ≥4 (vs <4) at index visit was most strongly associated with higher risk of death at 1 year: hazard ratio: 4.1, (95% CI: 3.66 to 4.49), higher odds of readmissions (OR: 2.6, 95% CI: 2.50 to 2.70), HHF (OR: 4.1 (95% CI: 3.83 to 4.42)), and 74% higher costs (p<0.05). Similar associations were observed at 3-year follow-up (n=59,714). Conclusion:This study identified risk factors associated with one-year negative clinical outcomes and increased cost following PCI for the treatment of STEMI.
Purpose: Facioscapulohumeral muscular dystrophy (FSHD) is a rare, progressive genetic disorder characterized by asymmetric muscle weakness and functional decline. Although it is one of the most common muscular dystrophies, its economic burden in the United States (US) is largely unknown. This study aimed to provide an initial, conservative estimate of annual medical claims costs and identify comorbidities disproportionately affecting individuals with FSHD in the US. Patients and Methods: This retrospective, 1:5 matched case-control study analyzed de-identified claims data from Medicare and commercially insured enrollees from 2018 to 2021. Medical and prescription costs were aggregated and described as means with 95% confidence intervals. T-tests with Bonferroni correction and chi-square tests were used to compare comorbidity prevalence. Results: The study included 383 individuals with FSHD and 1915 matched controls. The mean annual medical claims cost for the FSHD cohort was $19,370 per person with commercial insurance and $11,704 with Medicare, compared with $5250 among controls. Individuals with FSHD also incurred higher prescription claims costs in commercial and Medicare subgroups without comorbidities. The prevalence of cerebrovascular disease (10.18% vs 4.44%) and ear disorders (8.09% vs. 3.39%) was significantly greater in the FSHD cohort (P<0.05). Conclusion: This exploratory study provides the first US-based description of the direct medical costs of FSHD, demonstrating a substantially higher healthcare burden than that of matched controls. Because the study design likely underestimates costs, the true economic impact may be even greater. These findings establish a critical foundation for future research into the lifetime medical, nonmedical, and caregiver-related costs of FSHD, and highlight the urgent need for effective therapies and supportive care strategies.
Background:Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in Western countries, mainly affecting older people. Targeted agents have reshaped first-line (1L) strategies, making real-world evidence important to complement clinical trials. Objective:To estimate the incidence of Italian patients initiating first-line CLL therapy (2019-2022) and describe demographics/clinical profile, treatment patterns, adherence, outcomes (overall survival [OS], time to next treatment [TTNT]), and healthcare costs from the perspective of the Italian National Health System (NHS). Methods:A retrospective observational study using administrative healthcare databases (~9 million residents) was conducted on CLL patients starting 1L therapy (index-date) for CLL. Baseline characteristics were assessed in the 12 months pre-index; follow-up was ≥12 months. Drug use, adherence (medication possession ratio), dose adjustments, OS, TTNT, and direct costs were analyzed with descriptive and multivariable methods. Results:A total of 1479 patients initiated 1L therapy: 63.9% chemotherapy (CHT), 23.2% ibrutinib, 3.2% acalabrutinib, and 9.7% other regimens. CHT remained common, especially among older and more comorbid patients. Ibrutinib showed lower mortality versus CHT (HR 0.663; p=0.002) and longer TTNT (median not reached). Dose adjustments were frequent; extended refill intervals did not appear to reduce drug survival. Mean annual cost per patient was €38,573, mainly driven by drug acquisition; ibrutinib users had lower hospitalization and outpatient costs than other 1L groups. Conclusion:In Italian practice, ibrutinib was the main targeted 1L option and was associated with improved survival and delayed progression versus CHT. Despite higher drug costs, reduced hospital-based resource use suggests favourable overall clinical and economic impact.
Objective: Microbiology laboratories face increasing challenges related to rising sample volumes, workforce constraints, and the need for improved diagnostic accuracy and efficiency. Total Laboratory Automation (TLA) has emerged as a transformative solution to optimize workflows, enhance safety, and improve resource utilization. This study focuses on urine cultures and the follow-up of positive blood cultures and evaluates the impact of TLA implementation in a microbiology laboratory, assessing efficiency, economic sustainability, and healthcare professionals' perceptions. Methods: A Health Technology Assessment (HTA) approach was employed, integrating real-life data from a single-center hospital laboratory in Italy before and after TLA implementation. Key performance indicators (KPIs) were defined through a literature review and expert consensus. Real-life data were collected over two time periods: the pre-automation phase (manual workflow) and postautomation phase (TLA) for urine culture and positive blood culture. The economic and organizational impact was assessed by quantifying human resource efforts, while a qualitative survey captured healthcare professionals' perceptions regarding automation. Results: TLA significantly reduced sample processing times, with a 67% decrease in check-in time and a significant reduction in inoculation (up to 100%) and plate reading (-69%) times, respectively. Economic analysis indicated a 67% reduction in costs for personnel time required to process urine cultures and perform initial workups of positive blood cultures on annual basis with consequent organizational benefits, in terms of time spent in sample processing (-71%). Healthcare professionals reported improved safety and reduced workload, making them more inclined to adopt TLA, perceived as useful and capable to offer high-quality and demonstrable results. Conclusion: Findings emphasize TLA potentialities in the management of microbiology procedures overall improvement, empowering the laboratory efficiency and organizational capacity, allowing better investment of the human resources involved.
Background:While chemotherapy is the standard treatment for adults with newly diagnosed Philadelphia chromosome-negative (Ph-) B-cell precursor acute lymphoblastic leukemia (ALL), long-term remission remains difficult to achieve. Blinatumomab, an immunotherapy drug, has shown survival benefits when alternated with consolidation chemotherapy in patients with CD19-positive Ph- B-cell ALL, but its economic value had not been assessed in Italy. Methods:This study evaluated the cost-effectiveness of alternating blinatumomab with standard consolidation chemotherapy compared with chemotherapy alone, using data from the ECOG-ACRIN E1910 Phase III trial. A model was developed to estimate lifetime health outcomes and costs from the perspective of the Italian National Health Service. Results:Patients who received blinatumomab lived on average 5.06 years longer and gained 4.56 more quality-adjusted life years, but incurred higher healthcare costs, with an incremental cost of €165,401 per patient, primarily due to drug acquisition. The incremental cost-effectiveness ratio (ICER) was €36,261 per quality-adjusted life year gained, within the range of values typically considered acceptable in Italy. These results were confirmed in sensitivity analyses, with the ICER ranging from €28,082 to €49,034 under various assumptions. Conclusion:The alternation of blinatumomab with chemotherapy provides a substantial clinical benefit at a cost that is likely acceptable to the Italian healthcare system. These findings support the value of blinatumomab in improving outcomes in adult patients newly diagnosed with Ph- CD19-positive B-cell ALL. Results were consistent across sensitivity analyses, supporting the robustness of the findings.
Objective:Atopic dermatitis (AD) is a prevalent dermatological disease in Saudi Arabia. This study aimed to estimate the cost-effectiveness and budget impact of upadacitinib in adults and adolescents with moderate-to-severe AD in Saudi Arabia. Methods:A 1-year decision tree model followed by a lifetime Markov model was developed to estimate the cost-effectiveness of upadacitinib compared to dupilumab and other novel AD treatments in moderate-to-severe AD patients aged ≥12 years in Saudi Arabia from the public payer perspective. In addition, we developed a 5-year budget impact model to estimate the financial consequences of increasing the market share of upadacitinib. Probabilistic and deterministic sensitivity analyses were conducted to test the model's robustness. Results:Over a lifetime horizon, upadacitinib 15 mg was associated with 0.21 additional quality-adjusted life years (QALYs) and lower costs by 148,068 SAR (39,484 USD) compared with dupilumab 300 mg. The net monetary benefit of upadacitinib 15 mg versus dupilumab 300 mg was 158,656 SAR (42,308 USD). For the budget impact, increasing the market share of upadacitinib over 5 years was associated with estimated savings of 1.5 billion SAR (412 million USD). Sensitivity analyses results supported the direction of the base-case findings. Conclusion:Upadacitinib may be a cost-effective treatment for moderate-to-severe AD in Saudi Arabia. Increasing its market share could be considered for the target population and may reduce public healthcare costs over 5 years. However, these model-based estimates should be interpreted with uncertainty due to input assumptions and local data limitations.
Purpose:This study was conducted to analyse cancer medication consumption in Vietnam between 2019 and 2023. Materials and Methods:This was a cross-sectional study using data of cancer medication consumption that was publicly announced by Drug Administration of Vietnam (DAV) as a proxy. Data on expenditures and purchasing characteristics were extracted from every bidding package and contract implemented throughout the period. They afterwards were quantified and categorised by bidding technical groups, chemical classes, procurement levels, manufacturing origins and administration routes. Descriptive and statistical analyses were performed to explore the relationship between consumption, price and bidding mechanisms. Results:The total consumption of cancer medications between 2019 and 2023 in Vietnam was estimated to be about $1.4 billion. Of which the number slightly increased in 2020 before dropping sharply to 2022 and finally rebounding and reaching its peak in 2023 with $359.5 million. Targeted therapies consistently accounted for the largest proportion (44-48%), followed by chemotherapies with 34-39% and immunotherapies with 8-16%. Most expenditures were attributed to originator products and high-quality generics (Group 1), contributing 73-85% annually. Overall, the mean price per milligram decreased over time, with notable variation driven by shifts in the distribution of bidding technical groups while the centralized national-bidding was generally more efficient than regional procurements. Conclusion:Cancer medication consumption in Vietnam fluctuated substantially between 2019 and 2023, accompanied by significant changes in procurement patterns and the pandemic. Strengthened and targeted policies are required to optimize the economic impact of this group of medication, while broader efforts are needed to alleviate the cancer burden in Vietnam.
Background:Radical prostatectomy is a potentially curative treatment for localized prostate cancer (LPC), but there is limited literature comprehensively describing clinical and economic outcomes stratified by risk group. This study compared survival and healthcare costs following radical prostatectomy between patients with high-risk and low/intermediate-risk LPC in routine urology practice in the US. Methods:Linked electronic medical records and administrative claims were used to identify men with LPC undergoing radical prostatectomy (index date). Patients were classified into high-risk or low/intermediate-risk cohorts based on staging, prostate-specific antigen test results, and Gleason score, in alignment with the National Comprehensive Cancer Network®. Cohorts were balanced using inverse probability of treatment weighting. Metastasis-free survival and event-free survival post index were compared between cohorts using a weighted Cox proportional hazards model. All-cause/prostate cancer (PC)-related healthcare costs were compared post index using weighted ordinary least squares regression in a subgroup of patients with 12 months of continuous insurance eligibility prior to/including index. Results:Patients in the high-risk cohort (N=7542) had significantly higher rates of metastasis (36 months: hazard ratio [95% confidence interval (CI)]: 3.80 [3.31, 4.38], p<0.001; 60 months: 3.59 [3.19, 4.04], p<0.001) and disease progression (36 months: 3.49 [3.28, 3.71], p<0.001; 60 months: 3.37 [3.18, 3.57], p<0.001) compared to patients in the low/intermediate-risk cohort (N=11,429). In the cost subgroup, the high-risk cohort (N=1488) incurred significantly higher mean total all-cause healthcare costs (cost difference [95% CI]: $9134 [5999, 12,400] per-patient-per-year, p<0.001) and mean total PC-related healthcare costs ($7502 [4718, 10,279] per-patient-per-year, p<0.001) compared to the low/intermediate-risk cohort (N=2572) post index. Conclusion:In this real-world analysis of patients with LPC who underwent radical prostatectomy, high-risk disease was significantly associated with poorer survival and higher healthcare costs post-procedure compared to low/intermediate-risk LPC. These findings demonstrate the heightened clinical and economic burden observed with high-risk LPC.
Background:Preterm birth remains a leading cause of newborn death, disability, and long-term health challenges globally, with a substantial impact on families, the health system, and society. Omega-3 supplementation in women with low omega-3 status in early pregnancy has been shown to reduce the risk of preterm birth, particularly early preterm birth (<34 weeks of gestation). The cost implications of incorporating omega-3 testing and targeted supplementation into routine antenatal care to reduce early preterm birth in Australia are unclear. Methods:A decision analytic model was developed using Australian epidemiological, clinical, and cost data to compare routine omega-3 testing and targeted supplementation with current practice. The model predicted the number of early preterm births prevented and associated cost savings over an 18-year time horizon. Deterministic sensitivity analyses were conducted to examine uncertainty in key model inputs. Results:Among 289,195 singleton pregnancies in 2022, an estimated 17.5% of women would have low omega-3 status and be eligible for supplementation. Making conservative assumptions, the model predicted that, relative to current practice, omega-3 testing and supplementation would be a dominant strategy, preventing 640 early preterm births, with projected savings of $26.1 million in direct healthcare costs. Sensitivity analyses indicated that the results were robust across most scenarios and identified the treatment effect estimate as the strongest driver of model predictions. Conclusion:Omega-3 testing in early pregnancy with targeted supplementation may offer a scalable and cost-effective strategy to reduce early preterm birth with potential benefits for mothers, infants, and the health system. The modelling suggests meaningful health and economic benefits. Cost savings were robust across most plausible scenarios, supporting the potential value of this approach on a national scale.
Purpose:To assess the socioeconomic impact of increased uptake of long-acting injectable buprenorphine (LAIB) for opioid use disorder (OUD) in England. Materials and Methods:A cost-benefit analysis was conducted from a societal perspective over a one-year time horizon. An economic model compared existing standard of care for OUD with a scenario in which a proportion of individuals switched to LAIB and additional individuals not currently in treatment initiated care with LAIB, based on uptake and retention assumptions. Areas of impact (e.g., crime, healthcare, and employment) were identified and quantified using a targeted literature review and published unit cost estimates. Results:Assuming approximately 30,000 people could receive LAIB, the annual cost is estimated at £77 million, while the projected benefits total £236 million, resulting in a benefit-cost ratio of 3.1. The greatest savings are expected to be derived from reductions in crime and incarceration, followed by socioeconomic gains through increased employment, improved quality of life, prevented fatalities, decreased healthcare burden, and reduced social care costs. Conclusion:Despite higher acquisition costs than current standard treatments, LAIB was estimated to be cost-beneficial, with potential to improve outcomes for individuals while generating substantial value for society.
Objective: To evaluate the cost-effectiveness of nivolumab plus doxorubicin/vinblastine/dacarbazine (N-AVD) versus brentuximab vedotin-AVD (BV-AVD) as first-line treatment for advanced-stage classical Hodgkin lymphoma. Design: Cost-effectiveness analysis using a Markov model based on the S1826 trial (n=970). We estimated total direct costs, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER). Sensitivity analyses assessed robustness. Results: Nivolumab-AVD yielded 6.560 QALYs and 15.659 LYs, representing gains of 0.504 QALYs and 0.551 LYs over Brentuximab vedotin-AVD. Total costs were $784,839 for Nivolumab-AVD compared with $789,205 for Brentuximab vedotin-AVD. Nivolumab-AVD was associated with negative incremental cost-effectiveness ratios (-$8,656 per QALY;-$7,926 per LY) and was dominant, offering superior health outcomes at a lower overall cost. Conclusion: From a Chinese healthcare payer perspective, nivolumab-AVD is more cost-effective than brentuximab vedotin-AVD for advanced-stage classical Hodgkin lymphoma, offering lower costs and better health outcomes.
