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Should Canada and the United States universally vaccinate infants against hepatitis B? A cost-effectiveness analysis.

This paper examines the economic attractiveness of universal vaccination of infants with hepatitis B virus (HBV) vaccine by calculating the incremental cost-effectiveness of this strategy when compared with the currently recommended strategy of screening all pregnant women and vaccinating only infants born to HBsAg+ mothers. A decision-analytic model involving a Markov process to model the long-term sequelae of HBV infection was constructed to estimate the expected costs and life expectancies for a cohort of newborns under two strategies: the current screening policy (SELECTIVE), which involve

Cost-effectiveness analysis of prenatal screening and vaccination against hepatitis B virus--the case of Belgium.

The study examines the cost-effectiveness of screening pregnant women in Belgium for the presence of hepatitis B virus (HBV) and of vaccinating the newborns if necessary. The alternative strategy considered is 'doing nothing'. The rate of carriership among a sample of pregnant women in Belgium amounts to 0.67%. If a pregnant woman is a carrier of the virus, there is an average probability of 30% that she will transmit the virus to her newborn. Later in life, this baby will be at risk from serious complications, such as chronic active hepatitis, cirrhosis and primary hepatocellular cancer. Howe

Cost-effectiveness analysis of bevacizumab combined with lomustine in the treatment of progressive glioblastoma using a Markov model simulation analysis.

BACKGROUND: Progressive glioblastoma (GBM) is a malignancy with extremely poor prognosis. Chemotherapy is one of the approved systemic treatment modalities. The aim of this study is to assess the cost-effectiveness of using bevacizumab (BEV) in combination with lomustine (LOM) regimen for the treatment of progressive glioblastoma in China. METHODS: The estimation results are derived from a multicenter randomized phase III trial, which demonstrated improved survival in GBM patients receiving BEV+LOM combination therapy. To calculate the incremental cost-effectiveness ratio (ICER) from the pers

Induction chemotherapy regimes in first-line treatment for locoregionally advanced nasopharyngeal carcinoma: A network meta-analysis and cost-effectiveness analysis.

OBJECTIVE: The aim of this study is to evaluate the efficacy and cost-effectiveness of various induction chemotherapy (IC) regimens as first-line treatment for Locoregionally advanced nasopharyngeal carcinoma (LA-NPC), aiming to provide clinicians and patients with informed insights to aid in treatment decision-making. PATIENTS AND METHODS: We conducted a network meta-analysis (NMA) and cost-effectiveness analysis (CEA) based on data from 10 clinical trials investigating IC regimens for the treatment of LA-NPC. A Bayesian NMA was performed, with the primary outcomes being hazard ratios (HRs) …

Surgical correction of the genital hiatus at the time of sacrocolpopexy - a 7-year Markov analysis: a cost-effectiveness analysis.

INTRODUCTION AND HYPOTHESIS: To perform a cost-effectiveness analysis of concurrent posterior repair performed at the time of laparoscopic hysterectomy with sacrocolpopexy over a 7-year time period. We hypothesize it is not cost-effective to perform a posterior colporrhaphy. METHODS: We used TreeAge Pro® to construct a decision model with Markov modeling to compare sacrocolpopexy with and without concurrent posterior repair (SCP and SCP+PR) over a time horizon of 7 years. Outcomes included probability and costs associated with prolapse recurrence, prolapse retreatment, and complications inclu…

Cost and cost-effectiveness of ivermectin mass drug administration for malaria control in Kwale county, Kenya: a modelling analysis of a cluster-randomised trial.

BACKGROUND: Malaria remains a major health burden in sub-Saharan Africa, where traditional vector control methods are hindered by insecticid … a supplementary vector control tool using data from the BOHEMIA trial in Kenya. METHODS: We did a cost-effectiveness analysis of the BOHEMIA cluster-randomised trial done in Kwale county, Kenya, using a societal perspective to estimate the intervention costs, health system costs, direct household out-of-pocket expenses, and indirect costs from lost wages of iMDA versus a n …

Cost-effectiveness of comparative survey designs for helminth control programs: Post-hoc cost analysis and modelling of the Kenyan national school-based deworming program.

BACKGROUND: Soil-transmitted helminths (STH) and schistosomiasis comprise the most wide-spread NTDs globally. Preventative chemotherapy is a cost-effective approach to controlling morbidity of both diseases, but relies on large scale surveys to determine and revise treatment frequency. Availability of detailed information on survey costs is limited despite recent methodological surveying innovations. We micro-costed a survey of STH and schistosomiasis in Kenya, and linked results to precision estimates of competing survey methods to compare cost-efficiency. METHODS: Costs from a 2017 Kenyan p

Cost-Effectiveness of PHMB & betaine wound bed preparation compared with standard care in venous leg ulcers: A cost-utility analysis in the United Kingdom.

BACKGROUND: Wounds cost £8.3 billion per year in the United Kingdom (UK) annually. Venous leg ulcers (VLUs) account for 15% of wounds and can be complicated to heal, increasing nurse visits and resource costs. Recent wound bed preparation consensus recommends wound cleansing and biofilm disrupting agents. However, inert cleansers such as tap water or saline are inexpensive, an evaluation of evidence is required to justify the higher upfront costs of treatment with active cleansers. We undertook a cost-effectiveness analysis of the use of a biofilm disrupting and cleansing solution and gel, Pro…

Cost and cost-effectiveness analysis of mass drug administration compared to school-based targeted preventive chemotherapy for hookworm control in Dak Lak province, Vietnam.

BACKGROUND: School-based targeted preventive chemotherapy (PC), the main strategy for soil-transmitted helminths (STH) control, excludes other at-risk populations including adults and preschool children. Mass drug administration (MDA), covering all age groups, would bring additional health benefits but also requires greater investment. This cost survey and cost-effectiveness analysis compared MDA with school-based targeted PC for STH control in Dak Lak, Vietnam, where STH are endemic. METHODS: A cost survey was conducted in 2020 to estimate the total and per person economic and financial cost…

Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial.

BACKGROUND: Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with diff…

Simultaneous TEP Inguinal Hernia Repair and Laparoscopic Cholecystectomy: A Retrospective Analysis of Safety, Cost-Effectiveness, and Outcomes.

Background and Objectives: The concurrent management of cholelithiasis and inguinal hernia remains a subject of surgical debate, primarily due to concerns regarding prosthetic mesh infection in a clean-contaminated field. This study evaluates the safety, cost-effectiveness, and functional outcomes of simultaneous totally extraperitoneal (TEP) repair and laparoscopic cholecystectomy (LC). Materials and Methods: A retrospective analysis was conducted on patients treated between 2015 and 2025 using a prospectively maintained institutional registry. The cohort was stratified into two arms: the Sim

The Paradox of Life Extension with Traditional Cost-Effectiveness Analysis: A Case Study with Duchenne Muscular Dystrophy.

BACKGROUND: Traditional quality-adjusted life-year (QALY)-based cost-effectiveness analyses (CEAs) may inadvertently penalize treatments extending survival in populations with disabilities. Duchenne muscular dystrophy (DMD) is a rare, progressive disease diagnosed during childhood with significant morbidity, premature mortality, and considerable healthcare costs. The impact of delaying mortality on CEAs for DMD is unclear. OBJECTIVE: To evaluate the impact of delaying nonfatal progression and/or mortality using a QALY-based CEA for three hypothetical DMD treatments, assessing if treatment val

Clinical value and cost-effectiveness analysis of conditionally approved anticancer drugs in China from 2015 to 2023.

BackgroundThe conditional approval (CA) process in China was established in 2015 to expedite access to urgently-needed drugs, however, the clinical benefits of CA drugs and potential gaps between pre-approval and confirmatory trials remain uncertain. Herein, we aim to compare the clinical values between CA and non-CA anticancer drugs from 2015 to 2023, and to explore the relationship between clinical benefit and average daily cost of treatment of drugs.MethodsThis retrospective study analyzed anticancer drugs first approved in China [2015-2023] using data from National Medical Products Adminis

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… Calculation of treatment cost In this study, “cost-effectiveness analysis” refers to the relationship between average daily treatment cost and clinical benefit indicators (ORR, PFS, and OS). …

Respiratory syncytial virus (RSV) vaccination program for older Australians reduces health inequalities: a distributional cost-effectiveness analysis.

INTRODUCTION: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract disease in individuals aged ≥75 years. Differences in disease burden and vaccine uptake by socio-economic status (SES) are important considerations but are not usually incorporated into traditional cost-effectiveness analyses. We conducted a distributional cost-effectiveness analysis (DCEA) to evaluate RSV vaccination programs for older Australians. METHODS: We utilised a static multi-cohort Markov model to simulate age- and SES-specific RSV disease progression in adults aged ≥75 years, comparing no va…

Cost-effectiveness analysis of upfront HA-WBRT vs. SRS for treatment of brain metastases due to SCLC.

INTRODUCTION: Hippocampal-avoidant whole brain radiation therapy (HA-WBRT) and stereotactic radio surgery (SRS) are standard of care treatments for brain metastases (BM). However, the optimal approach for treating BM originating from small cell lung cancer (SCLC) remains uncertain. We conducted a cost-effectiveness analysis comparing HA-WBRT and SRS for SCLC BMs. METHODS: We constructed a Markov model to evaluate the incremental cost-effectiveness ratio (ICER) of SRS versus HA-WBRT. In this model, patients either receive upfront SRS or HA-WBRT. Those receiving SRS may undergo salvage HA-WBRT …

Cost-effectiveness analysis of the use of PNEU-C-21 in adults aged ≥50 years in Canada.

BACKGROUND: This study analyzed the health and economic outcomes of the 21-valent pneumococcal conjugate vaccine (PNEU-C-21; CAPVAXIVE®) compared to either PNEU-C-20 or PNEU-P-23. Cohorts in the cost-effectiveness analyses included vaccine-naïve 57- and 65-year-olds and vaccine-experienced 70-year-olds. RESEARCH DESIGN AND METHODS: A published Markov model simulated the movement of the Canadian population among four health states: healthy, pneumococcal disease (invasive pneumococcal disease and community-acquired pneumonia attributed to S. pneumoniae), post-meningitis sequelae, and death. The

Delta price cost-effectiveness analysis of PCV21 vs PCV20 use in adults aged ≥65 years in Switzerland.

INTRODUCTION: This study evaluated the health and economic impacts of the 21-valent pneumococcal conjugate vaccine (PCV21) compared to the 20-valent pneumococcal conjugate vaccine (PCV20) in Swiss adults aged 65 years and older using the delta-price approach. METHOD: A published state-transition Markov model was used to track health and economic outcomes of invasive pneumococcal disease (IPD), inpatient non-bacteremic pneumococcal pneumonia (NBPP), and post-meningitis sequelae (PMS). Estimated quality-adjusted life years (QALYs)and cost outcomes were discounted at 3%. All costs were presented

Cost-Effectiveness Analysis of Ritlecitinib Compared With No Treatment in Patients With Severe Alopecia Areata in Japan.

The efficacy and safety of ritlecitinib, a dual inhibitor of Janus kinase 3 (JAK3) and tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinases, have been demonstrated in the ALLEGRO phase 2b/3 trial that enrolled patients aged ≥ 12 years with alopecia areata (AA) and ≥ 50% scalp hair loss. The present analysis evaluated the cost-effectiveness of ritlecitinib compared with no treatment for patients with AA and ≥ 50% scalp hair loss in Japan from a societal perspective. A Markov model stratified by health states based on the Severity of Alopecia Tool (SALT) was developed to es

Comparative Cost-Effectiveness Analysis of First-Line Immunotherapy for Advanced Melanoma Based on 10-Year Clinical Outcomes.

BACKGROUND: Recently, the CheckMate 067, KEYNOTE-006, and RELATIVITY-047 trials demonstrated the long-term efficacy and safety of 5 first-line therapies for advanced melanoma, including nivolumab + relatlimab, with >10 years of follow-up. However, the long-term economic outcomes are still unclear. This study aimed to assess the comparative cost-effectiveness of these strategies from a US health care perspective using more than a decade of clinical trial data. METHODS: Based on the data from clinical trial reports, we simulated a cohort of 1,662 patients with advanced melanoma across 5 treatme

Dedicated day surgery supported by remote patient monitoring for appendicectomy and cholecystectomy procedures: A cost-effectiveness analysis.

BackgroundManaging inpatient demand is challenging, especially for high-volume emergency surgical casemixes such as acute appendicitis and cholecystitis. These conditions drive unplanned admissions and consume significant bed capacity, despite their suitability for accelerated pathways. We evaluated a bundled care model for this casemix, incorporating same-day discharge protocols and remote patient monitoring to reduce unnecessary inpatient stays and optimize hospital resources.MethodsA decision tree model compared the proposed same-day discharge surgical care model supported by remote patient