Burden Of Illness Studies Research Articles

Index hospital cost of adverse events following thoracic surgery: a systematic review of economic literature

ObjectivesAdverse events (AEs) following thoracic surgery place considerable strain on healthcare systems. A rigorous evaluation of the economic impact of thoracic surgical AEs remains lacking and is required to understand...

Healthcare costs and utilization associated with pain among breast cancer survivors: a propensity score matched cohort study using SEER-Medicare data.

To assess healthcare costs and utilization of treatment-related pain among breast cancer survivors. A retrospective matched cohort study using Surveillance Epidemiology and End Results SEER-Medicare linked data was conducted. The study population included older breast cancer survivors continuously enrolled in Medicare parts A, B, and D in the baseline and 1-year follow-up periods. Survivors with pain were matched to survivors without pain using PSM. Incremental all-cause healthcare costs associated with pain were calculated using a two-part model. Incremental healthcare utilization of inpatient hospitalizations, ER, outpatient, and physician services were estimated using the negative binomial model. The study included 101,120 non-metastatic breast cancer patients between July 2007 and September 2013. The final analytical cohort after matching included 5891 survivors in both groups. The incremental annual all-cause total healthcare costs per patient were higher in survivors with pain as compared to survivors without pain (Δ = 4379.00 (95% CI: 4308.00-4448.80). The main cost drivers were hospitalizations at 71%, followed by ER at 16% and physician services at 9% for survivors diagnosed with pain. Annual all-cause healthcare resource utilization was also found to be higher in survivors with pain as compared to survivors without pain across all categories of use. Similar trends were observed when stratified by surgery type and subgrouped by pain type and pain-related costs. This study provided baseline data that can be used for future cost-effectiveness analysis studies and burden of illness studies. Treatment-related costs have a substantial burden on healthcare costs andthe utilization of Medicare.

Estimating the burden of acute gastrointestinal illness: a pilot study of the prevalence and underreporting in Saint Lucia, Eastern Caribbean.

Saint Lucia was the first country to conduct a burden of illness study in the Caribbean to determine the community prevalence and underreporting of acute gastroenteritis (AGE). A retrospective cross-sectional population survey on AGE-related illness was administered to a random sample of residents of Saint Lucia in 20 April-16 May 2008 and 6-13 December 2009 to capture the high- and low-AGE season respectively. Of the selected 1,150 individuals, 1,006 were administered the survey through face-to-face interviews (response rate 87.4%). The overall monthly prevalence of AGE was 3.9%. The yearly incidence rate was 0.52 episodes/person-year. The age-adjusted monthly prevalence was 4.6%. The highest monthly prevalence of AGE was among children aged < 5 years (7.5%) and the lowest in persons aged 45-64 years (2.6%). The average number of days an individual suffered from diarrhoea was 3.8 days [range 1-21 day(s)]. Of the reported AGE cases, only seven (18%) sought medical care; however, 83% stayed at home due to the illness [(range 1-16 day(s), mean 2.5]; and 26% required other individuals to take care of them. The estimated underreporting of syndromic AGE and laboratory-confirmed foodborne disease pathogens was 81% and 99% respectively during the study period. The economic cost for treating syndromic AGE was estimated at US$ 3,892.837 per annum. This was a pilot study on the burden of illness (BOI) in the Caribbean. The results of the study should be interpreted within the limitations and challenges of this study. Lessons learnt were used for improving the implementation procedures of other BOI studies in the Caribbean.

Health Economics of Chronic Obstructive Pulmonary Disease

Studies describing the economic impact of chronic obstructive pulmonary disease (COPD) are used for several purposes. There can, however, be limitations as costs based on results of a clinical trial are likely to be significantly different from real world practice. Sometimes, it may be more useful to capture the costs of the important components accurately rather than the often unachievable aim of capturing every cost however small. Burden of illness studies can help identify clinical targets or patterns of care-for example, hospitalization-that are major health care cost drivers. In the United Kingdom, burden of COPD studies suggest an annual cost of 781 pounds sterlings- 1,154 pounds sterlings per patient. Cost analyses can be divided into four types: cost minimization, cost-effectiveness, cost benefit, and cost utility. Utilities such as quality-adjusted life year (QALY) measure the effectiveness of different therapies, and can be obtained in various ways and in different populations, potentially leading to significant differences in the results. Payers often apply cost per QALY thresholds when assessing whether a new therapy should be used or not. In the United Kingdom, it is accepted that there is a sigmoid relationship between the cost per QALY and the likelihood of a therapy being recommended, with a lower inflection between 5,000 pounds sterlings and 15,000 sterlings, below which rejection is unlikely and an upper inflection between 25,000 pounds sterlings and 35,000, above which acceptance is unlikely, but not impossible. On this basis, pulmonary rehabilitation and inhaled steroids are unlikely to be rejected but lung volume reduction surgery may be.

An update on the health economics of asthma and allergy.

Health economics is receiving more attention as decision-makers--whether purchaser, physician, or patient--are looking for a more comprehensive understanding of the impact of adopting new healthcare strategies. In this article we review the recent advances in the health economics of asthma and allergy. In burden of illness studies, estimates of the economic burden of asthma and allergy were reported from countries and regions not previously detailing these costs. There were economic evaluations comparing medications and those that evaluated disease management programs. The recent studies of pharmaceuticals have focused on evaluating the cost-effectiveness of various controller medications for the treatment of asthma. Although mostly observational, such studies increase the evidence that these medications are relatively cost-effective. A few recent economic evaluations have been published examining disease management and education programs. These studies are generally long-term evaluations and have not shown consistent health economic impact. The field of health economics in asthma and allergy continues to evolve and aims to provide information to aid in decision making.

WW7: BEYOND COST-EFFECTIVENESS: THE STRATEGIC VALUE OF PRODUCTIVITY-RELATED OUTCOMES IN CLINICAL TRIALS, BURDEN OF ILLNESS STUDIES, AND POST-MARKETING RESEARCH

OBJECTIVES: This workshop will describe the strategic value of including productivity measures as outcomes of concern in clinical trials, burden of illness studies, and post-marketing research. PARTICIPANTS WHO WOULD BENEFIT: Sponsors of clinical trials, burden of illness studies, and post-marketing research; Employers who offer medical care benefits and other benefit programs; Outcomes researchers; Drug formulary developers; Regulators. Until recent years, productivity has been overlooked as a measure of value in clinical trials, burden of illness studies, and post-marketing research. However, recent advances in data development capabilities and market pressures to differentiate the plethora of drugs either under development or on the market have motivated a concern for a broader set of relevant outcome measures. In addition, concerns over the ability to document the total impact of drug therapy have emerged as important issues, as pharmaceutical developers, health care providers, employers, formulary developers, and policy-makers strive to fully understand their own or society's return on investment in drug therapy. Recent evidence suggests that, among leading employers in the U.S., productivity-related metrics account for more than half (53%) of the cost of employer benefit programs. In Europe, rigorously developed and supportable claims about the impact of drugs under development or already marketed can influence the drug approval process. In the U.S. and elsewhere, such evidence may influence initial and subsequent formulary decisions, and the appropriate use of alternative drug therapies. This workshop will illustrate how to 1) identify productivity-related metrics, 2) collect and process data on these metrics, and 3) use these data in sophisticated research studies designed for clinical trials, to document the full burden of illness, or to legitimately support post-marketing claims of the effectiveness of drug therapy. It will be shown that metrics related to morbidity, mortality and quality of life that are typical in many research studies are incomplete, and that better decisions can be made by incorporating a more complete set of relevant outcome measures.

What's in a Name? The Economics of Burden of Illness Studies

What's in a Name? The Economics of Burden of Illness Studies