Abstract Introduction Abemaciclib is an oral inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6). Data from the clinical trial monarchE (2023) showed improved survival from invasive disease. The aim of the present article was to conduct an economic assessment of adjuvant treatment with abemaciclib in women with luminal, HER2- and node-positive breast cancer. Methods A Markov model was constructed with four mutually exclusive health states (disease-free, local recurrence, distal recurrence and death). Analyses were based on the clinical trial monarchE which compared an intervention group (ab ..read more

Abstract Background Spinal muscular atrophy (SMA) is a rare, progressive, neuromuscular disorder. Recent advances in treatment require an updated assessment of burden to inform reimbursement decisions. Objectives To quantify healthcare resource utilisation (HCRU) and cost of care for patients with SMA. Methods Cohort study of patients with SMA identified in the Swedish National Patient Registry (2007–2018), matched to a reference cohort grouped into four SMA types (1, 2, 3, unspecified adult onset [UAO]). HCRU included inpatient admissions, outpatient visits, procedures, and dispensed medicati ..read more

Abstract Background There is a dearth of research on the cost-effectiveness of intensive home treatment (IHT), an alternative to psychiatric hospitalisation for patients experiencing psychiatric crises. We therefore present a health economic evaluation alongside a pre-randomised controlled trial of IHT compared to care as usual (CAU). Method Patients were pre-randomised to IHT or CAU using a double-consent open-label Zelen design. For the cost-utility analysis, the EuroQol 5-dimensional instrument was used. The cost-effectiveness was assessed using the Brief Psychiatric Rating Scale (BPRS). Re ..read more

Abstract Purpose The recently developed EQ Health and Wellbeing Instrument (EQ-HWB) is a broad, generic measure of quality-of-life designed to be suitable for caregivers. The aim of this study was to investigate performance and validity of the 9-item version (EQ-HWB-S) for caregivers where families had experienced adverse-life-events. Methods Using survey data from caregivers of children aged 0–8 years attending a community-health centre in 2021–2022, the general performance, feasibility, convergent and known-group validity, responsiveness-to-change, and test–retest reliability of the EQ ..read more

Abstract Objective This study aims at evaluating the cost-of-illness (COI) of patients diagnosed with Behcet’s syndrome (BS) in Italy, trying to depict the impact of different costs’ components to the overall economic burden and analysing the variability of costs according to years since diagnosis and age at first symptoms. Methods With a cross-sectional evaluation, we surveyed a large sample of BS patients in Italy assessing several dimensions related to BS, also including fact related to the use of health resources utilization, formal and informal care, and productivity losses. Overall costs ..read more

Abstract Background In the recent Evolut Low Risk randomized trial, transcatheter aortic valve implantation (TAVI) was shown to be non-inferior to surgery (SAVR) regarding the composite end point of all-cause mortality or disabling stroke at 24 months. Aims To evaluate the cost-effectiveness of self-expandable TAVI in low-risk patients, using the French healthcare system as the basis for analysis. Methods Mortality, health-related quality of life, and clinical event rates through two-year follow-up were derived from trial data (N = 725 TAVI and N = 678 SAVR; mean age: 73.9 years; mea ..read more

Abstract Efficiently allocating scarce healthcare resources requires nuanced understanding of individual and collective interests as well as relative concerns, which may overlap or conflict. This paper is the first to empirically investigate whether and to what extent self-interest (SI), positional concerns (PC) and distributional considerations (DC) simultaneously explain individual decision making related to access to healthcare services. Our investigation is based on a stated choice experiment conducted in two countries with different healthcare systems, the United States (US) and the Unite ..read more

Abstract Studies report an unexplained variation in physicians’ care. This variation may to some extent be explained by differences in their work motivation. However, empirical evidence on the link between physician motivation and care is scarce. We estimate the associations between different types of work motivation and care. Motivation is measured using validated questions from a nation-wide survey of Danish general practices and linked to high-quality register data on their care in 2019. Using a series of regression models, we find that more financially motivated practices generate more fee ..read more

Abstract Objective Clinical studies commonly use disease-specific measures to assess patients’ health-related quality of life. However, economic evaluation often requires preference-based utility index scores to calculate cost per quality-adjusted life-year (QALY). When utility index scores are not directly available, mappings are useful. To our knowledge, no mapping exists for the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Our aim was to develop a mapping from SIBDQ to the EQ-5D-5L index score with German weights for inflammatory bowel disease (IBD) patients. Methods We used ..read more

Abstract We use 2015–2018 European Union Statistics on Income and Living Conditions longitudinal data for four European countries (the UK, Germany, France, and Italy) and a dynamic trivariate panel data model to analyze the complex relationship between poverty, work intensity, and disability. We find evidence of genuine state dependence in the three processes and feedback effects from past poverty to work intensity in all countries and from past poverty to disability in the UK, Germany, and Italy. Disability is detrimental to poverty, despite the mitigating role played by disability cash benef ..read more