Non-randomized clinical trial has shown that Magnetic Resonance guided High-intensity focused ultrasound (MR-HIFU) leads to faster pain relief compared to the current standard of care External Beam Radiotherapy (EBRT).

To evaluate the comparative performance of SF-6Dv2 and EQ-5D-5L in the general population of Quebec (Canada), Tehran (Iran), and Japan.

Children with disabilities and special healthcare needs can considerably affect parental employment and family financial stability. This study aims to investigate the effects of children's disabilities, special healthcare needs, and their coexistence on parental employment in Australia.

Biologic therapies are increasingly used in multiple sclerosis (MS), but often provoke anti-drug antibodies, potentially leading to treatment failure. Testing for anti-drug antibodies to guide treatment switching could improve clinical- and cost- effectiveness of MS treatment. We assess the value of testing for anti-drug antibodies to alemtuzumab, an effective but immunogenic MS therapy. We developed a microsimulation model to project disease progression, quality of life, and cost outcomes in people with relapsing-remitting MS initiating alemtuzumab treatment without and with alemtuzumab anti-body testing. Risk of anti-drug antibody development was informed by a UK cohort study of alemtuzumab-treated people with MS. UK guidance informed MS treatment strategies. Alemtuzumab anti-drug antibody test-directed treatment switching resulted in 0.02 fewer MS relapses per person; prolonged time to secondary progressive disease by 0.06 years; and yielded 0.02 additional years of life (0.06 Quality-Adjusted Life Years (QALY)). At £25/test, incremental cost per QALY gained was £47,861, with the additional cost arising from increased time on disease-modifying therapies (DMTs). Cost-effectiveness of anti-drug antibody testing was sensitive to anti-drug antibody development risk, their impact on drug efficacy, and costs of disease-modifying therapies (DMTs). Anti-drug antibody testing to inform MS treatment switching could improve clinical outcomes, but its cost-effectiveness depends on anti-drug antibody risk, its impact on drug efficacy, and costs of DMTs.

Next generation sequencing (NGS) can decrease the diagnostic odyssey for patients with rare diseases. However, valuing the combination of health and non-health outcomes associated with NGS is challenging. While stated preference methods can be used for monetary valuation of outcomes, frameworks that jointly account for both costs and benefits to determine cost-acceptability are limited. Insights into cost-acceptability can help inform pricing and access decisions where competition among NGS alternatives is imperfect or diagnostics are provided as a public good.

Time preference is increasingly considered in health state valuation. As its inclusion impacts the produced value sets, it is important to account for it using the correct specification. Various discounting functions have been used, and both directions of time preference have been identified. I aimed to extend the composite time-trade off task (composite TTO, cTTO) by follow-up questions (TTOFUs) to identify the discounting function and direction for individual respondents.

Despite its increasing prevalence, the economic impact of eosinophilic esophagitis (EoE) in Europe is understudied and direct economic costs remain unknown.

This study explores the educational inequality in a workplace in Japan in relation to the physiological risk factors. It investigates the difference in the prevalence rates of being overweight, hypertensive, dyslipidemic or diabetic between male employees who have undergone university education and those who have not. Combining the mandatory annual health check-up data, annual stress check survey data and personnel data (total sample size=7,428), this study conducts a decomposition analysis to identify the major contributing factors to the inequality and it measures the extent to which the observed between-group disparity is associated with the differences in observable characteristics. For all four conditions, significant disparities are observed between the groups. Between-group differences pertaining to alcohol consumption, smoking behaviours, job positions, psychological stress and family structure are the major significant contributing factors behind the between-group disparities in health. The results indicate that, along with a universal health-promoting approach, additional efforts to support less educated employees should be initiated to mitigate the health inequality.

Interstitial lung disease (ILD) consists of many subtypes, with idiopathic pulmonary fibrosis (IPF) and subtypes that manifest as progressive pulmonary fibrosis (PPF) exhibit faster progression and poorer prognosis. Recent updates in the definition of PPF and expanded approval of antifibrotic treatments warrant a comprehensive review to understand the economic impact and key cost drivers.

Over the past decades, most European countries switched emergency contraceptive availability from prescription to over-the-counter (OTC) status. However, the effect of OTC switches on emergency and regular contraceptive use, on demographic indicators (birth rate, abortion rate) and health outcomes (sexually transmitted diseases) varies depending on the study setting. Only Poland switched emergency contraceptives back to prescription (Rx) status after previously loosening restrictions and causal analyses of an Rx switch are lacking entirely. We employ multiple (staggered/synthetic) difference-in-differences models to evaluate the effect of (a) an OTC switch, exploiting variation in the timing of the OTC switch among several European countries and (b) a Rx switch at the example of Poland. We find that the use of emergency contraceptives increased (decreased) after OTC (Rx) switches. The use of regular hormonal contraceptives, the rate of births and abortions and the incidence of various sexually transmitted diseases remained essentially unaffected or - if found - effects did not withstand robustness checks. Our results suggest that increased use of emergency contraceptives due to liberalized over-the-counter access may be reversed by a return to prescription bound access.

Alternative payment models (APMs) aim to improve efficiency and fairness in healthcare by shifting financial responsibility from payers to providers. Given their prospective nature, APMs require effective risk adjustment (RA) to prevent risk-selection incentives. RA design comes with complex trade-offs between risk selection, cost control and gaming. In the light of these trade-offs, thorough ex-ante evaluation of RA models is crucial. Traditionally, RA-model evaluation in the context of APMs has heavily relied on statistical metrics like R-squared. While useful for assessing model fit, these metrics often fail to capture the full spectrum of relevant incentives. This study therefore addresses the question: "What do meaningful incentive metrics for ex-ante evaluation of RA models look like in the context of prospective APMs for healthcare providers?" We conducted a literature review and consulted experts to synthesize existing work on RA evaluation. This informed the development of a conceptual framework for defining incentive metrics, distinguishing among risk-selection, cost-control, and gaming incentives. We applied our framework in a simulation of prospective payments to primary care practices (PCPs) in the Netherlands, using 2019 claims data from 346 PCPs (N = 1.4 M patients). The analysis focused on selection incentives, comparing traditional statistical metrics with metrics derived from our framework. Results show that statistical metrics like R-squared fall short in assessing selection incentives compared to our incentive metrics. This highlights the need for tailored incentive metrics for the ex-ante evaluation of RA models that are grounded in a thorough understanding of relevant provider behaviors in the light of APM goals.

This study used electronic health records from The Ohio State University Healthcare System to estimate hospital costs (payrolls, supplies, utilities) for foodborne diseases (FBD) across a range of clinical diagnoses. We considered the relationship between FBD and comorbidities since comorbidities may increase the risk of FBD or FBD sequelae. Our regression analysis advances prior work by estimating incremental FBD costs while adjusting for chronic conditions, comorbidities, and other confounders (e.g., demographics, payor and patient types) using large-scale EHR data, filling a critical gap in FBD cost estimation. We analyzed 8,147,264 encounter episodes from 2017 to 2021, totaling 697,732 patient years, with 930 being FBD-associated. Poisson regression yielded baseline annual FBD hospital costs of $8,258 per patient (cost-to-charge adjusted). When adjusting and comparing different types of comorbidities, the Clogg Z-test showed that cost estimates without comorbidity controls were $3,735 higher than baseline costs per patient-year (p = 0.098). However, there was little difference between the baseline and the estimates that took comorbidities into account. Instead of using foodborne pathogen-specific codes, costs were marginally lower by $1,492 (p = 0.058) when using gastroenteritis codes (such as infectious diarrhea). In contrast, gastrointestinal symptom codes such as diarrhea and others were associated with $3,440 (p < 0.001) higher costs than codes specific to foodborne pathogens. We discussed the implications of FBD cost variations through sensitivity analyses of comorbidity adjustments and diagnostic coding in methodology, and how these variations mimic liability assessments in the consumer and food industry.

Treatment landscape in metastatic lung cancer has progressed quickly over the last decade, mainly due to immunotherapies and targeted therapies. This study aimed to describe changes in costs associated with metastatic lung cancer in France.

The objective of this study was to create a mapping algorithm by utilizing traditional regression analyses and a machine learning approach to estimate EQ-5D-5 L values based on EORTC QLQ-LC43 data in the absence of direct EQ-5D-5 L measurements.

To assess the cost-effectiveness of enzyme replacement therapy (ERT) compared with best supportive care (BSC) for late-onset Pompe disease (LOPD) in a UK NHS setting.

This study aimed to develop a value set for the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Utility-Core 10 Dimensions (QLU-C10D) based on the preferences of Chinese cancer patients, and to compare results with the Chinese general population value set.

The EQ-TIPS (v2.0) is an experimental instrument to measure and value the HRQoL in children aged 0-3 years. This study consulted experts and caregivers to (a) review the instrument's wording and content for global relevance; (b) assess the need for additional dimensions; (c) identify potential challenges in measuring HRQoL in young children.

The spread of the COVID-19 pandemic, along with government interventions, significantly reshaped economic activity, leading to abrupt shifts in household consumption behavior. This paper offers an empirical analysis of how the rollout of COVID-19 vaccines influenced consumer spending, using high-frequency debit and credit card transaction data from three European countries. The findings indicate that vaccinations, in conjunction with other policy measures, helped mitigate the pandemic's severe economic impact and supported a recovery in consumer spending. First, the deployment of vaccines had a statistically and economically significant positive effect on private consumption. Second, additional policy responses-aimed at containing the virus and providing financial support to households and businesses-also had notable effects on both the volume and composition of card-based transactions. Third, the stimulative impact of vaccinations on consumer spending was more pronounced in contact-intensive sectors, such as services, compared to goods.

Transthyretin amyloid cardiomyopathy (ATTR-CA) is a progressive, fatal disease that often presents as heart failure with preserved ejection fraction (HFpEF). To date, scarce evidence about the economic burden of ATTR-CA has been published. This study compared the economic impact of HFpEF in patients with and without ATTR-CA in Spain.