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  1. Su TT, Flessa S
    Eur J Health Econ, 2013 Feb;14(1):75-84.
    PMID: 21953320 DOI: 10.1007/s10198-011-0354-7
    The objective of the study is to identify the determinants of household direct and indirect costs in the Nouna District, Burkina Faso. The data used were from a household survey conducted during 2000-2001. The multinominal logit models were applied to investigate the determinants of direct and indirect costs. The respondents who were sick in the rainy season and severity of illness significantly increased the probability of having high direct and indirect household costs. Acute illness occured in an adult was positively associated with magnitude of household indirect costs. Household economic status and utilization of western medical care played an important role in magnitude of direct cost. The information on determinants of household direct and indirect costs is necessary in order to get a complete picture of household costs for seeking health care and identification of vulnerable social groups and households.
  2. Rajsic S, Gothe H, Borba HH, Sroczynski G, Vujicic J, Toell T, et al.
    Eur J Health Econ, 2019 Feb;20(1):107-134.
    PMID: 29909569 DOI: 10.1007/s10198-018-0984-0
    OBJECTIVES: Stroke is a leading cause for disability and morbidity associated with increased economic burden due to treatment and post-stroke care (PSC). The aim of our study is to provide information on resource consumption for PSC, to identify relevant cost drivers, and to discuss potential information gaps.

    METHODS: A systematic literature review on economic studies reporting PSC-associated data was performed in PubMed/MEDLINE, Scopus/Elsevier and Cochrane databases, Google Scholar and gray literature ranging from January 2000 to August 2016. Results for post-stroke interventions (treatment and care) were systematically extracted and summarized in evidence tables reporting study characteristics and economic outcomes. Economic results were converted to 2015 US Dollars, and the total cost of PSC per patient month (PM) was calculated.

    RESULTS: We included 42 studies. Overall PSC costs (inpatient/outpatient) were highest in the USA ($4850/PM) and lowest in Australia ($752/PM). Studies assessing only outpatient care reported the highest cost in the United Kingdom ($883/PM), and the lowest in Malaysia ($192/PM). Fifteen different segments of specific services utilization were described, in which rehabilitation and nursing care were identified as the major contributors.

    CONCLUSION: The highest PSC costs were observed in the USA, with rehabilitation services being the main cost driver. Due to diversity in reporting, it was not possible to conduct a detailed cost analysis addressing different segments of services. Further approaches should benefit from the advantages of administrative and claims data, focusing on inpatient/outpatient PSC cost and its predictors, assuring appropriate resource allocation.

  3. Rehman AU, Hassali MAA, Muhammad SA, Harun SN, Shah S, Abbas S
    Eur J Health Econ, 2020 Mar;21(2):181-194.
    PMID: 31564007 DOI: 10.1007/s10198-019-01119-1
    OBJECTIVES: To find the economic burden of COPD and to identify the key cost drivers in the management of COPD patients across different European countries.

    BACKGROUND: COPD is a major cause of mortality and morbidity and is associated with considerable economic burden on the individual and society. It limits the daily activities and working ability of the patients.

    METHODOLOGY: We conducted a systematic search of PUBMED, SCIENCE DIRECT, Cochrane CENTRAL, SCOPUS, Google Scholar and SAGE Premier Databases to find scientific research articles evaluating the cost of COPD management from patient and societal perspective.

    RESULTS: Estimated per patient per year direct cost in Norway, Denmark, Germany, Italy, Sweden, Greece, Belgium, and Serbia was €10,701, €9580, €7847, €7448, €7045, €2896, €1963, and €2047, respectively. Annual per patient cost of work productivity loss was highest in Germany as €5735 and lowest in Greece as €998. It was estimated as €4824, €2033 and €1298 in Bulgaria, Denmark and Sweden, respectively. Several factors found associated with increasing cost of COPD management that include but not limited to late diagnosis, severity of disease, frequency of exacerbation, hospital readmissions, non-adherence to the therapy and exposure to COPD risk factors.

    CONCLUSION: Minimizing the COPD exacerbations and controlling the worsening of symptoms may potentially reduce the cost of COPD management at any stage.

  4. Shafie AA, Vasan Thakumar A
    Eur J Health Econ, 2020 Dec;21(9):1411-1420.
    PMID: 32892230 DOI: 10.1007/s10198-020-01233-5
    OBJECTIVE: This study aimed to test multiplicative modelling with EQ-5D-3L time-trade-off (TTO) and visual analogue scale (VAS) values.

    METHODS: A multi-stage sampling design was adopted for the study and data collection took place in three phases in 2010, 2011, and 2012 in the Northern region of Malaysia. Face-to-face interviews involved respondents answering both 13 TTO and 15 VAS valuation tasks were carried out. Both additive and multiplicative model specifications were explored using the valuation data. Model performance was evaluated using out-of-sample predictive accuracy by applying the cross-validation technique. The distribution of the model values was also graphically compared on Bland-Altman plots and kernel density distribution curves.

    RESULTS: Data from 630 and 611 respondents were included for analyses using TTO and VAS models, respectively. In terms of main-effects specifications, cross-validation results revealed a slight superiority of multiplicative models over its additive counterpart in modelling TTO values. However, both main-effects models had roughly equal predictive accuracy for VAS models. The non-linear multiplicative model with I32 term, MULT7_TTO, performed best for TTO models; while, the linear additive model with N3 term, ADD11_VAS, outperformed the other VAS models. Multiplicative modelling neither altered the dimensional rankings of importance nor did it change the distribution of values of the health states.

    CONCLUSION: Using EQ-5D-3L valuation data, multiplicative modelling was shown to improve out-of-sample predictive accuracy of TTO models but not of VAS models.

  5. Shafie AA, Chhabra IK, Wong JHY, Mohammed NS
    Eur J Health Econ, 2021 Jul;22(5):735-747.
    PMID: 33860379 DOI: 10.1007/s10198-021-01287-z
    PURPOSE: To develop a mapping algorithm for generating EQ-5D-3L utility scores from the PedsQL Generic Core Scales (PedsQL GCS) in patients with transfusion-dependent thalassemia (TDT).

    METHODS: The algorithm was developed using data from 345 TDT patients. Spearman's rank correlation was used to evaluate the conceptual overlap between the instruments. Model specifications were chosen using a stepwise regression. Both direct and response mapping methods were attempted. Six mapping estimation methods ordinary least squares (OLS), a log-transformed response using OLS, generalized linear model (GLM), two-part model (TPM), Tobit and multinomial logistic regression (MLOGIT) were tested to determine the root mean squared error (RMSE) and mean absolute error (MAE). Other criterion used were accuracy of the predicted utility score, proportions of absolute differences that was less than 0.03 and intraclass correlation coefficient. An in-sample, leave-one-out cross validation was conducted to test the generalizability of each model.

    RESULTS: The best performing model was specified with three out of the four PedsQL GCS scales-the physical, emotional and social functioning score. The best performing estimation method for direct mapping was a GLM with a RMSE of 0.1273 and MAE of 0.1016, while the best estimation method for response mapping was the MLOGIT with a RMSE of 0.1597 and MAE of 0.0826.

    CONCLUSION: The mapping algorithm developed using the GLM would facilitate the calculation of utility scores to inform economic evaluations for TDT patients when EQ-5D data is not available. However, caution should be exercised when using this algorithm in patients who have poor quality of life.

  6. Yong ASJ, Lim YH, Cheong MWL, Hamzah E, Teoh SL
    Eur J Health Econ, 2021 Dec 02.
    PMID: 34853930 DOI: 10.1007/s10198-021-01407-9
    BACKGROUND: Understanding patient preferences in cancer management is essential for shared decision-making. Patient or societal willingness-to-pay (WTP) for desired outcomes in cancer management represents their preferences and values of these outcomes.

    OBJECTIVE: The aim of this systematic review is to critically evaluate how current literature has addressed WTP in relation to cancer treatment and achievement of outcomes.

    METHODS: Seven databases were searched from inception until 2 March 2021 to include studies with primary data of WTP values for cancer treatments or achievement of outcomes that were elicited using stated preference methods.

    RESULTS: Fifty-four studies were included in this review. All studies were published after year 2000 and more than 90% of the studies were conducted in high-income countries. Sample size of the studies ranged from 35 to 2040, with patient being the most studied population. There was a near even distribution between studies using contingent valuation and discrete choice experiment. Based on the included studies, the highest WTP values were for a quality-adjusted life year (QALY) ($11,498-$589,822), followed by 1-year survival ($3-$198,576), quality of life (QoL) improvement ($5531-$139,499), and pain reduction ($79-$94,662). Current empirical evidence suggested that improvement in QoL and pain reduction had comparable weights to survival in cancer management.

    CONCLUSION: This systematic review provides a summary on stated preference studies that elicited patient preferences via WTP and summarised their respective values. Respondents in this review had comparable WTP for 1-year survival and QoL, suggesting that improvement in QoL should be emphasised together with survival in cancer management.

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