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Cost Utility (cost + utility)

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Medical Sciences100%

Terms modified by Cost Utility

  • cost utility analysis
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    Selected Abstracts

    Cost utility in the United States of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone for the treatment of elderly patients with diffuse large B-cell lymphoma,

    CANCER, Issue 8 2005
    John C. Hornberger M.D., M.S.
    Abstract BACKGROUND Findings from the Groupe d'Etude des Lymphomes Adultes LNH 98-5 study showed that rituximab added to combined cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) prolonged progression-free survival and overall survival in adults age , 60 years with diffuse large B-cell non-Hodgkin lymphoma (DLBCL). The current study was conducted to investigate the incremental cost utility of the addition of rituximab to CHOP (R-CHOP) compared with CHOP alone. METHODS Clinical prognosis of the time to disease progression and death was estimated using published evidence from the LNH 98-5 study (n = 399 patients) that was linked mathematically to published long-term outcome data on patients with DLBCL. Drug-acquisition costs were based on published data from formulary pricing sources, and the costs of cancer surveillance and end-of-life care were based on published literature sources. The authors assessed cost utility as the difference in costs between R-CHOP and CHOP divided by the increase in expected overall survival adjusted for quality of life. RESULTS Over 5 years, it was projected that R-CHOP would prolong overall survival by 1.04 years. The mean cumulative cost of CHOP was $3358, and the mean cost of R-CHOP was $17,225, resulting in a cumulative net increase of $13,867. The posttreatment cancer surveillance cost for CHOP was $3950, compared with $5202 for R-CHOP. It was estimated that R-CHOP would have a cost-utility ratio of $19,297 per year of life gained compared with CHOP when adjusted for quality of life. R-CHOP remained cost effective over wide ranges of variables in sensitivity analyses. CONCLUSIONS Compared with CHOP alone, it was predicted that R-CHOP would be cost effective in elderly patients with DLBCL. Cancer 2005. © 2005 American Cancer Society. [source]

    Four-Year Cost-Utility Analyses of Sealed and Nonsealed First Permanent Molars in Iowa Medicaid-Enrolled Children

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2007
    Patita Bhuridej DDS
    Abstract Objectives: Dental sealants, by their ability to prevent caries and maintain teeth in better health, have some inherent utility to individuals, programs, or society. This study assessed the 4-year incremental cost utility of sealing first permanent molars of 6-year-old Iowa Medicaid enrollees from a societal perspective and identified the group of teeth or children in whom sealants are most cost effective. Methods: Dental services for first permanent molars were assessed using claims and encounter data for a group of continuously enrolled Medicaid enrollees who turned 6 between 1996 and 1999. Previously published utilities were used to weight the different health states. The weighted sum of outcomes [Quality-Adjusted Tooth-Years (QATYs)] was the measure of effectiveness. Costs and QATYs were discounted to the time of the child's sixth birthday. Results: For all first molars, the cost of treatment associated with sealed teeth was higher but the utility was also slightly higher over the 4-year period. The relative incremental cost per 0.19 QATY ratio [changing the health state from a restored tooth (utility=0.81) to a nonrestored tooth (utility =1)] by sealing the molar ranged from $36.7 to $83.5 per 0.19 QATY. The incremental cost/QATY ratio was lower for sealing lower utilizers and for mandibular versus maxillary molars. Conclusions: Sealants improved overall utility of first permanent molars after 4 years. The 4-year cost/QATY ratio of sealing the first permanent molar varied by arch and type of utilizers. Sealing first permanent molars in lower dental utilizers is the most cost-effective approach for prioritizing limited resources. [source]

    Cost utility analysis of physical activity counselling in general practice

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2006
    Kim Dalziel
    Objective:To evaluate the economic performance of the ,Green Prescription' physical activity counselling program in general practice. Methods:Cost utility analysis using a Markov model was used to estimate the cost utility of the Green Prescription program over full life expectancy. Program effectiveness was based on published trial data (878 inactive patients presenting to NZ general practice). Costs were based on detailed costing information and were discounted at 5% per anum. The main outcome measure is cost per quality adjusted life year (QALY) gained. Extensive one-way sensitivity analyses were performed along with probabilistic (stochastic) analysis. Results:Incremental, modelled cost utility of the Green Prescription program compared with ,usual care' was NZ2,053 per QALY gained over full life expectancy (range NZ827 to NZ37,516 per QALY). Based on the probabilistic sensitivity analysis, 90% of ICERs fell below NZ7,500 per QALY. Conclusions:Based on a plausible and conservative set of assumptions, if decision makers are willing to pay at least NZ2,000 per QALY gained the Green Prescription program is likely to represent better value for money than ,usual care'. Implications:The Green Prescription program performs well, representing a good buy relative to other published cost effectiveness estimates. Policy makers should consider encouraging general practitioners to prescribe physical activity advice in the primary care setting, in association with support from exercise specialists. [source]

    Lacosamide as treatment of epileptic seizures , cost utility results for Sweden

    ACTA NEUROLOGICA SCANDINAVICA, Issue 6 2010
    K. Bolin
    Bolin K, Berggren F, Forsgren L. Lacosamide as treatment of epileptic seizures , cost utility results for Sweden. Acta Neurol Scand: 2010: 121: 406,412. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objectives,,, To calculate cost per additional quality-adjusted life-year (QALY) for lacosamide as adjunctive treatment for patients with uncontrolled partial-onset seizures as compared to no adjunctive treatment. Materials and methods,,, A decision-tree simulation model was constructed to calculate the number of seizures and health-care utilization for treated and untreated with lacosamide, respectively. Prices from 2007 were used for all costs. Results,,, All results were calculated for a 24-, 18-, 12- and 6-months follow-up. The cost per additional QALY was estimated to , 27,641 (24 months). Using a willingness-to-pay threshold for a QALY of , 50,000 the net marginal value of using lacosamide was estimated to about , 850,000 per 1000 patients. Conclusions,,, The estimated cost per QALY gained falls within the range of reported estimates of the willingness-to-pay for an additional QALY. The results imply that lacosamide is cost-effective in the treatment of uncontrolled partial-onset seizures (1 , , 9.6 SEK). [source]

    Cost utility in the United States of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone for the treatment of elderly patients with diffuse large B-cell lymphoma,

    CANCER, Issue 8 2005
    John C. Hornberger M.D., M.S.
    Abstract BACKGROUND Findings from the Groupe d'Etude des Lymphomes Adultes LNH 98-5 study showed that rituximab added to combined cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) prolonged progression-free survival and overall survival in adults age , 60 years with diffuse large B-cell non-Hodgkin lymphoma (DLBCL). The current study was conducted to investigate the incremental cost utility of the addition of rituximab to CHOP (R-CHOP) compared with CHOP alone. METHODS Clinical prognosis of the time to disease progression and death was estimated using published evidence from the LNH 98-5 study (n = 399 patients) that was linked mathematically to published long-term outcome data on patients with DLBCL. Drug-acquisition costs were based on published data from formulary pricing sources, and the costs of cancer surveillance and end-of-life care were based on published literature sources. The authors assessed cost utility as the difference in costs between R-CHOP and CHOP divided by the increase in expected overall survival adjusted for quality of life. RESULTS Over 5 years, it was projected that R-CHOP would prolong overall survival by 1.04 years. The mean cumulative cost of CHOP was $3358, and the mean cost of R-CHOP was $17,225, resulting in a cumulative net increase of $13,867. The posttreatment cancer surveillance cost for CHOP was $3950, compared with $5202 for R-CHOP. It was estimated that R-CHOP would have a cost-utility ratio of $19,297 per year of life gained compared with CHOP when adjusted for quality of life. R-CHOP remained cost effective over wide ranges of variables in sensitivity analyses. CONCLUSIONS Compared with CHOP alone, it was predicted that R-CHOP would be cost effective in elderly patients with DLBCL. Cancer 2005. © 2005 American Cancer Society. [source]