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An economic evaluation of varicella vaccination in Italian adolescents / Nancy Thiry in Vaccine, 22(2004)27-28 ([09/09/2004])  

[article] An economic evaluation of varicella vaccination in Italian adolescents [printed text] / Nancy Thiry, Author ; Philippe Beutels, Author ; Francesco Tancredi, Author ; A. Zanetti, Author ; Paolo Bonanni, Author ; Giovanni Gabutti, Author ; Pierre Van Damme, Author . - 2004 . - 3546-3562. Languages : English (eng) in Vaccine > 22(2004)27-28 [09/09/2004] . - 3546-3562 Descriptors: Classification W 1 Serials. Periodicals Indexation Adolescent ; Adult ; Age Factors ; Aged ; Chickenpox Vaccine ; Child ; Child, Preschool ; Cost of Illness ; Cost-Benefit Analysis ; Economics ; Encephalitis, Varicella Zoster ; Epidemiology ; Female ; Hospitalization ; Humans ; Italy ; Journal Article ; Male ; Markov Chains ; Mass Immunization ; Middle Aged ; Netherlands ; Peer Review ; prevention and control ; statistics and numerical data [Subheading] Abstract: An economic evaluation was performed to assess five varicella vaccination scenarios targeted to 11-year-old Italian adolescents. The scenarios were: "compulsory vaccination" of all adolescents, recommended vaccination of susceptible adolescents on the basis of an "anamnestic screening", a "blood test" or a combination of both ("both tests") and vaccination of adolescents in the private sector, at the parents' charge ("private vaccination"). Probabilities and unit costs were taken from published sources and experts opinion. The accuracy of the anamnestic screening (81.6% sensitivity and 87.3% specificity) was derived from a separate descriptive study among 344 Italian adolescents. The costs and benefits of each scenario were simulated using a Markov model and cost-effectiveness, budget-impact and cost-benefit analyses were conducted. Of all considered scenarios, "both tests" and "anamnestic screening" were the most appealing options with an estimated net direct cost of 5058 and 8929 per life-year gained (compared to no vaccination) versus 14,693-42,842 for the other scenarios. These two scenarios further resulted in substantial net savings for society (over 600,000 per cohort, BCR: 2.17). The need for a serological confirmation was highly dependent on the sensitivity of the anamnestic screening, which is believed to increase once such a program is launched. For practical considerations, "anamnestic screening" seems to be the most convenient option. Link for e-copy: http://tiny.cc/xktyn Format of e-copy: VDIC IP recognition Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1773 [article]

Cost-effectiveness of human papillomavirus vaccination in Belgium / Nancy Thiry in International Journal of Technology Assessment in Health Care, 25(2009)2 ([04/01/2009])  

[article] Cost-effectiveness of human papillomavirus vaccination in Belgium : do not forget about cervical cancer screening [printed text] / Nancy Thiry, Author ; Chris De Laet , Author ; Frank Hulstaert, Author ; Mattias Neyt , Author ; Huybrechts, Michel, Author ; Irina Cleemput , Author . - 2009 . - 161-170. Languages : English (eng) in International Journal of Technology Assessment in Health Care > 25(2009)2 [04/01/2009] . - 161-170 Descriptors: Classification W 1 Serials. Periodicals Indexation 2007-13 ; Adolescent ; Adult ; Belgium ; Child ; Cohort Studies ; Cost-Benefit Analysis ; Female ; Great Britain ; Health Care Costs ; Humans ; Journal Article ; Markov Chains ; Mass Screening ; Papillomavirus Vaccines ; Peer Review ; Quality-Adjusted Life Years ; R64 ; Uterine Cervical Neoplasms ; Vaccination Abstract: OBJECTIVES: The cost-effectiveness of adding a human papillomavirus (HPV) vaccination program in 12-year-old females to the recommended cervical cancer screening in Belgium is examined. Moreover, the health and economic consequences of a potential decline in screening uptake after initiation of a HPV vaccination program are investigated. METHODS: A static Markov model is developed to estimate the direct effect of vaccination on precancerous lesions and cervical cancers. RESULTS: Vaccination is estimated to avoid 20 percent of the cervical cancers occurring in a 12-year-old girls' cohort and to cost 32,665 euro per quality-adjusted life-year (QALY) gained (95 percent credibility interval [CrI]: 17,447 euro to 68,078 euro), assuming a booster injection after 10 years, a limited duration of protection and discounting costs and effects at 3 percent and 1.5 percent, respectively. Assuming lifelong protection, HPV vaccination is estimated to cost 14,382 euro (95 percent CrI: 9,238 euro to 25,644 euro) per QALY gained, while avoiding 50 percent of the cervical cancer cases. In the base-case, a 10 percent reduction in screening compliance after vaccination obliterates the effect of vaccination on cervical cancer cases avoided, whereas further declines in the level of screening compliance even turned out to be detrimental for the cohort's health, inducing a mean loss in QALYs and life-year gained compared with the situation prevaccination. CONCLUSIONS: An HPV vaccination program should only be considered if the level of screening after vaccination can be maintained. Link for e-copy: http://doi.org/10.1017/S0266462309090217 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2200 [article]

Cost Effectiveness of Implantable Cardioverter-Defibrillators for Primary Prevention in a Belgian Context / Mattias Neyt in Applied Health Economics and Health Policy, 6(2008)1 ([10/01/2008])  

[article] Cost Effectiveness of Implantable Cardioverter-Defibrillators for Primary Prevention in a Belgian Context [printed text] / Mattias Neyt , Author ; Nancy Thiry, Author ; Dirk Ramaekers, Author ; Hans Van Brabandt , Author . - 2008 . - 67-80. Languages : English (eng) in Applied Health Economics and Health Policy > 6(2008)1 [10/01/2008] . - 67-80 Descriptors: Classification W 1 Serials. Periodicals Indexation 2006-07 ; Aged ; Australia ; Belgium ; Cost-Benefit Analysis ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Female ; Humans ; Journal Article ; Male ; Markov Chains ; Middle Aged ; Peer Review ; Primary Prevention ; Quality-Adjusted Life Years ; R58 Abstract: Background: Implantable cardioverter-defibrillator (ICD) therapy was traditionally applied in patients who survived a cardiac arrest or who experienced a symptomatic ventricular tachyarrhythmia. Its use in primary prevention (i.e. in patients who have yet to experience a serious arrhythmic event, but who are considered at high risk for sudden cardiac death) has become more common, and policy makers question whether ICD therapy should be reimbursed in these instances. Objective: To assess the cost effectiveness of primary prevention ICD therapy versus conventional therapy from the perspective of the Belgian health insurance system. Method: A lifetime 1-month cycle Markov model was constructed and populated with clinical and effectiveness data from the SCD-HeFT study and real-world Belgian cost data expressed in year 2005 values. Probabilistic modelling and sensitivity analyses were performed. Results: ICD therapy results in 1.22 life-years gained (LYG) or 1.03 QALYs gained. The lifetime cost-effectiveness and cost-utility ratios were €59 989 (95% CI 35 873, 113 518) per LYG and €71 428 (95% CI 40 225, 134 623) per QALY gained, respectively. A cost-effectiveness ratio <€50 000 per QALY gained was obtained in 15.5% of 1000 simulations. Increasing the service life of the device from 5 to 7 years would improve the cost effectiveness to €57 229 (95% CI 32 568, 106 410) per QALY gained. Conclusions: ICD therapy may not be judged cost effective for the primary prevention of death in patients with a SCD-HeFT profile in the Belgian context using current technology and patient selection. A combination of price reductions and increased service life of the device may alter this conclusion. Link for e-copy: http://doi.org/10.2165/00148365-200806010-00006 Format of e-copy: PDF Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2335 [article]

Pitfalls in economic analysis / Hans Van Brabandt in European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 12(2010)05 ([05/17/2010])  

[article] Pitfalls in economic analysis : Response to letter [printed text] / Hans Van Brabandt , Author ; Mattias Neyt , Author . - 2010 . - 1 p. Languages : English (eng) in European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology > 12(2010)05 [05/17/2010] . - 1 p. Descriptors: Classification W 1 Serials. Periodicals Indexation 2005-18 ; Belgium ; Cost of Illness ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Female ; Great Britain ; Health Care Costs ; Humans ; Journal Article ; Life Expectancy ; Male ; Markov Chains ; Middle Aged ; Peer Review ; R58 ; Risk Assessment ; Risk Factors ; Survival Analysis ; Survival Rate ; Treatment outcome ; Ventricular Dysfunction, Left Link for e-copy: http://dx.doi.org/10.1093/europace/euq105 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2359 [article]

Pitfalls in health-economic evaluations / Hans Van Brabandt in European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 11(2009)12 ([12/01/2009])  

[article] Pitfalls in health-economic evaluations : the case of cost-effectiveness of prophylactic implantable cardioverter-defibrillator therapy in Belgium [printed text] / Hans Van Brabandt , Author ; Mattias Neyt , Author . - 2009 . - 1571-3. Comment on: Cowie MR. Lifetime cost-effectiveness of prophylactic implantation of a cardioverter defibrillator in patients with reduced left ventricular systolic function: results of Markov modelling in a European population. Europace 11 (6): 716-26 Languages : English (eng) in European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology > 11(2009)12 [12/01/2009] . - 1571-3 Descriptors: Classification W 1 Serials. Periodicals Indexation 2006-07 ; Belgium ; Cost of Illness ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Female ; Great Britain ; Health Care Costs ; Humans ; Journal Article ; Life Expectancy ; Male ; Markov Chains ; Middle Aged ; Peer Review ; R58 ; Risk Assessment ; Risk Factors ; Survival Analysis ; Survival Rate ; Treatment outcome ; Ventricular Dysfunction, Left Link for e-copy: http://dx.doi.org/10.1093/europace/eup290 Format of e-copy: PDF VDIC Require subscription Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2346 [article]

The economic implications of non-adherence after renal transplantation / Irina Cleemput in Pharmacoeconomics, 22(2004)18 ([12/01/2004])  

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