Cost Effectiveness Analysis

An economic analysis comparing the relative cost and impact of different medical treatments with the aim of directing health care spending more efficiently.

Cost-effectiveness of two opioid use disorder treatments

Dec. 18, 2018

[reposted from the CHERISH blog]

One key strategy in reducing deaths from the opioid epidemic is to improve access to existing evidence-based treatments. Two new economic studies by CHERISH Investigators Drs. Sean Murphy, Kathryn McCollister, and Bruce Schackman can help providers, patients, and payers sort through alternative pharmacotherapies to prevent opioid relapse.

Cost-effective Screening and Treatment of Hepatitis C

Issue Brief
Sep. 17, 2018

In just five years, hepatitis C has changed from a difficult-to-treat chronic condition to one that is readily cured by a short course of medication. Medical breakthroughs have now created the possibility of eliminating the transmission of HCV, but also bring a new challenge for the health system—how to identify individuals carrying the hepatitis C virus (HCV), and how to pay for life-saving treatments. This Issue Brief reviews recent evidence on the cost-effectiveness of screening and treatment strategies, and makes the case for universal, one-time HCV screening for all US adults.

Cost-effectiveness of maternal GBS immunization in low-income sub-Saharan Africa

Dec. 14, 2017

Louise B.Russell, Sun-Young Kim, Ben Cosgriff, Sri Ram Pentakota, Stephanie J.Schrag, Ajoke Sobanjo-ter Meulen, Jennifer R.Verani, Anushua Sinha

Abstract [from journal] 

Background: A maternal group B streptococcal (GBS) vaccine could prevent neonatal sepsis and meningitis. Its cost-effectiveness in low-income sub-Saharan Africa, a high burden region, is unknown.

Methods: We used a decision tree model, with Markov nodes to project infants’ lifetimes, to compare maternal immunization delivered through routine antenatal care with no immunization. 37 countries were clustered on the basis of economic and health resources and past

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Cost-effectiveness of a potential group B streptococcal vaccine for pregnant women in the United States

Oct. 27, 2017

Sun-Young Kim, Chi Nguyen, Louise B.Russell, Sara Tomczyk, Fatimah Abdul-Hakeem, Stephanie J.Schrag, Jennifer R.Verani, Anushua Sinha

Abstract [from journal]

Background: In the U.S., intrapartum antibiotic prophylaxis (IAP) for pregnant women colonized with group B streptococcus (GBS) has reduced GBS disease in the first week of life (early-onset/EOGBS). Nonetheless, GBS remains a leading cause of neonatal sepsis, including 1000 late-onset (LOGBS) cases annually. A maternal vaccine under development could prevent EOGBS and LOGBS.

Methods: Using a decision-analytic model, we compared the public health impact, costs, and

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The Value of Value Frameworks

Oct. 26, 2017

“Value” is more than a buzzword. In response to rising costs, payers, physicians, and patients have turned to value assessment frameworks to inform treatment plans and design sustainable budgets. However, the usefulness and potential of these tools remain murky. LDI’s 50th anniversary symposium convened a panel to elucidate key questions for the future of value frameworks—what does value mean to different stakeholders in the health care system? How should payers, doctors, and patients appraise the value of the care they receive?

Cost Offset Associated With Early Start Denver Model for Children With Autism

Jul. 19, 2017

Zuleyha Cidav, Jeff Munson, Annette Estes, Geraldine Dawson, Sally Rogers, David Mandell

In Child and Adolescent Psychiatry, Zuleyha Cidav and colleagues, including David Mandell, examine the effect of the Early Start Denver Model (ESDM) for treatment of young children with autism on health care service use and costs. ESDM is a comprehensive behavioral intervention for young children with autism that utilizes teaching strategies based on applied behavior analysis. Such early interventions have previously been associated with significant behavioral outcome improvements and long-term cost savings.

The authors find that, while ESDM is more expensive than community...

Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

Jul. 10, 2017

Linda H. Aiken, Douglas Sloane, Peter Griffiths, Anne Marie Rafferty, Luk Bruyneel, Matthew McHugh, Claudia B. Maier, Teresa Moreno-Casbas, Jane E. Ball, Dietmar Ausserhofer, Walter Sermeus

In BMJ Quality & Safety, Linda Aiken and colleagues, including Matthew McHugh examine the association of hospital nursing skill mix with patient mortality, patient ratings of care, and indicators of quality care among European hospitals. As policymakers around the world seek to reduce health spending, a popular target in Europe has been to transition from more professional nurses to fewer high-cost nurses supported by more lower-wage assistants. The authors analyzed how nursing skill mix affects indicators of quality patient care. The authors utilized cross-sectional patient...

Association Between Hospital Participation in a Medicare Bundled Payment Initiative and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes

Jun. 29, 2017

Laura A. Dummit, Daver Kahvecioglu, Grecia Marrufo, Rahul Rajkumar, Jaclyn Marshall, Eleonora Tan, Matthew J. Press, Shannon Flood, L. Daniel Muldoon, Qian Gu, Andrea Hassol, David M. Bott, Amy Bassano, Patrick H. Conway

In JAMA, Laura Dummit and colleagues, including Matthew Press, evaluate whether a Centers for Medicare and Medicaid Services (CMS) bundled payment pilot program is associated with a reduction in Medicare payments. Specifically, the authors assess if Bundled Payments for Care Improvement (BPCI) reduced Medicare payments and maintained quality in lower extremity joint replacement. This CMS program was launched in 2013 to test whether linking payments for services provided during an episode of care can reduce Medicare payments and maintain quality. The authors used a difference-in-...

Economic evaluation of a behavioral intervention versus brief advice for substance use treatment in pregnant women: results from a randomized controlled trial

Jun. 22, 2017

Xiao Xu, Kimberly A. Yonkers, and Jennifer Prah Ruger

In BMC Pregnancy and Childbirth, Xiao Xu and colleagues, including Jennifer Ruger, assess the economic impact of motivational enhancement therapy and cognitive behavioral therapy (MET-CBT) among substance-using pregnant women. The study was performed alongside a clinical trial that compared the intervention to brief advice about the risks of substance use and found no significant differences in the outcomes such as drug and alcohol use. As such, the authors conducted a cost minimization analysis, from the perspective of the health system. They found that, while the intervention...

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