Comparison Of Treatment Costs Research Articles

Comparative Cost Analysis of Hypercholesterolemia Treatment: Allopathic Medicine and Ayurveda Medicine

The cost of treatment is very high for CVD and the prevalence of hypercholesterolemia is also very high in developing countries. Many Indian people do not have basic amenities and medical facilities are also not accessible. So alternative medicine can play an important role in the treatment of high cholesterol. Arjuna and Kutki are effective medicines in treating high cholesterol. Methodology: Comparative cross sectional study was planned to determine the socio-economic, and demographic status and comparison of treatment costs of high cholesterol patients in SS Hospital, IMS, BHU, Varanasi. Result: The overall expenditure for Group B is significantly high (3670.06) compared to Group A (1341.10). Medicine costs form the largest portion of expenses in Group B (1:4.8), while laboratory costs are the largest in Group A. Discussion: The economic burden poses a significant challenge in the treatment of any illness. Elevated cholesterol levels pose a significant problem in the current state of affairs in India. Developing countries face significant challenges in managing their financial issues.

Technical–Economic Feasibility of a New Method of Adsorbent Materials and Advanced Oxidation Techniques to Remove Emerging Pollutants in Treated Wastewater

The focus on emerging contaminants (ECs) in wastewater has intensified due to the considerable risks they present to human health and wildlife. This paper presents the results of the technical–economic assessment of the Clean Up solution, carried out in the framework of the project entitled “Validation of Adsorbent Materials and Advanced Oxidation Techniques to Remove Emerging Pollutants in Treated Wastewater”. The viability of the Clean Up system is evaluated by being applied as an advanced treatment system for treated urban wastewater, that is, for the elimination of pathogens and emerging pollutants (EPs), while considering the established quality criteria by current regulations. In this sense, it is a technology that has been successfully validated at an experimental level, and that offers similar removal performance compared to that of the most efficient alternatives available on the market. The technical–economic assessment has been conducted through a systematic process. Initially, the estimation involved the calculation of treatment costs for the Clean Up system when applied at an industrial scale. Subsequently, the treatment costs were estimated for the most favorable technological alternative to the Clean Up system from a technical–economic standpoint, also applied at an industrial scale, within identical scenarios and conditions as those assumed for the Clean Up system. The final step involved a comprehensive comparison of treatment costs between both alternatives, implemented uniformly under analogous conditions and assumed similar performance across all cases.

Comparison of treatment costs for primary localized prostate cancer in Austria and Vienna: an economic analysis.

Prostate cancer is the most common cancer in men. Several efficient treatments are available for primary prostate cancer, but an economic comparison of these modalities has not been done in Austria. The current study provides an economic comparison of radiotherapy and surgery for prostate cancer in Vienna and Austria. We analyzed the catalog of medical services of the Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection and present the treatment costs for the public health sector with an LKF-point value and monetary value in 2022. External beam radiotherapy, especially ultrahypofractionated, is the least costly treatment modality for low-risk prostate cancer, with costs of 2,492 € per treatment. For intermediate-risk prostate cancer, differences between moderate hypofractionation and brachytherapy are small, with costs of 4,638-5,140 €. In a high-risk setting, differences between radical prostatectomy and radiotherapy with androgen deprivation therapy are small (7,087 € vs. 7474.06 €). From a purely financial point of view, treatment of low- and intermediate-risk prostate cancer in Vienna and Austria should consist of radiotherapy as long as the current catalog of services is up to date. For high-risk prostate cancer, no major difference was found.

Comparison of treatment costs of plasma knife tonsillectomy with conventional tonsillectomy at Ho Chi Minh City Otolaryngology Hospital, 2020

Objective: Tonsillitis is one of the common diseases in children and adults. Tonsillectomy is one of the most popular surgeries performed by ear-nose-throat doctors in the world as well as in Vietnam. Currently, in Vietnam, there is no scientific study evaluating the costs (include treatment cost, non-medical cost and direct cost) of 2 methods of tonsillectomy with Plasma knife and conventional tonsillectomy. Compare the treatment costs of Plasma knife tonsillectomy with conventional tonsillectomy at Ho Chi Minh City Otolaryngology Hospital in 2020 by descriptive cross-sectional method. Methods: Crossectional study with 100 patients with plasma knife tonsillectomy and 36 patients with conventional tonsillectomy Result: The results show that the average cost of a tonsillectomy with a Plasma knife is 17,695,000 ± 6,690,000 VND, the average cost of a conventional method is 21,413,000 ± 7,901,000 VND. The plasma knife tonsillectomy method has a lower total cost than the conventional method and is statistically significant with p < 0.05. The average cost saved when choosing the plasma cutting method instead of the convention is 3,178,000 VND. Although the direct cost of treatment in the Plasma group is higher than that of the conventional group, the direct costs not for treatment such as travel and meals, indirect costs of lost income of patients and caregivers lower. Because the number of days off due to surgery of the Plasma group is 6.54 ± 3.51, lower than the conventional group 8.14 ± 2.32 days Conclusion: The hospital needs to advise patients on issues of expenses through seminars, scientific reports and on the hospital's media: website, facebook, Fanpage. Keywords: Cost, tonsillectomy, plasma knife, conventional tonsillectomy, Ho Chi Minh City Otolaryngology Hospital.

The management of posterior epistaxis in the United Kingdom, a national survey

Background: Posterior bleeds account for 5% of epistaxis. The patient cohort is often elderly and has significant co-morbidities. Such cases have been managed historically with urinary catheters, held in place with umbilical clips. Recently bespoke, double balloon, posterior packs have been utilised. The treatments remain in clinical equipoise with no gold standard or clear national guideline. Methodology: A ten question survey was sent out through www.surveymonkey.com. Attempts were made to contact all Trusts in the United Kingdom via the ENT on call service. A comparison of treatment costs was made. Results: 112 responses have been received. 54% of respondents reported a preference for bespoke posterior pack insertion, only 12% preferred catheters. Twice as many respondents have seen complications from urinary catheters: 14% vs 29%. The availability of posterior packs is inconsistent: 30% of respondents were not aware of the packs or reported them unavailable in their hospital. Conclusions: This survey provides the first comparison of the techniques in the United Kingdom. Bespoke packs have a lower complication rate and are preferred by ENT clinicians on the front line of patient care. We recommend that all UK trusts should stock posterior packs which should be used as first line treatment for cases of posterior epistaxis.

Comparison of treatment costs of pembrolizumab versus nivolumab in head and neck squamous cell carcinoma.

e19368 Background: Pembrolizumab and Nivolumab are PD-1 inhibiting immunotherapy agents approved for the treatment of metastatic or recurrent head and neck squamous cell carcinoma in patients previously treated with platinum-based chemotherapy. Both therapies have demonstrated similar survival benefits and adverse event profiles, but there is no published comparison of treatment cost and survival between the two agents. This study aims to analyze the cost-effectiveness of pembrolizumab compared to nivolumab through network meta-analysis techniques. Methods: Data published from the KEYNOTE-040 (pembrolizumab) and CheckMate 141 (nivolumab) studies were used to generate a model incorporating the cost of each drug in both the arms. The cost of treatment of side effects was extracted from previously published data and used for cost estimation in the model. Data from the standard of care arms (cetuximab, methotrexate, or docetaxel) in each study were adjusted to provide a common reference between the two studies. The number of years added in terms of overall survival was calculated for the entire experimental arm and the cost of each such year was calculated. All costs were adjusted for inflation. Results: Using published data from the KENOTE-040 trial, the average cost per patient adjusted for inflation over time, over 24 months in the pembrolizumab arm was $159,302, and similarly using data from the Checkmate 141 trial, the average cost per patient over 18 months in the nivolumab arm was $118,790. The cost of management of adverse effects was $18,728 vs $16,685 (pembrolizumab vs. nivolumab) during these time periods. Our model suggests that the adjusted total cost per month for patients on these drugs is very similar: $7417.91 vs. $7526.38. Assuming that the quality of life was similar in both groups and using an average OS for the standard of care arms, our model predicts that ICER for pembrolizumab is higher than nivolumab ($203,085 vs. 132,644). Conclusions: Both pembrolizumab and nivolumab improve survival benefit compared to their respective standard of care arms. However, the ICER for both medications is higher than the threshold set by many payers and health provider organizations. The model makes several assumptions which may render it less accurate to compare between trials but the cost of treatment for both drugs is not in the cost-effective range. To utilize these drugs in a cost-conscious practice, further research is needed to investigate lower doses at a slower frequency along with reduction of the price for each medication.

Comparison of treatment costs for pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma based on KEYNOTE-040 clinical trial.

e18524 Background: Pembrolizumab has been approved by the FDA for the treatment of recurrent and refractory squamous cell cancer of the Head and Neck. This approval was based on the favorable results noted in the pembrolizumab arm of the KEYNOTE-040 clinical trial which compared pembrolizumab with the standard of care (methotrexate/cetuximab/docetaxel). This study aims to compare the financial aspects of these treatment arms in the setting of their relative clinical advantages in terms of increased overall survival by applying current pricing of the drugs and treatment for side effects. Methods: Data published from the KEYNOTE-040 study was used to generate a model incorporating the cost of each drug in both arms. The incidence of side effects was also extracted from the published data. The cost of treatment of side effects was extracted from previously published data and used for cost estimation in the model. The number of years added in terms of overall survival was calculated for the entire experimental arm and the cost of each such year was calculated. This model assumes that all drugs were supplied at the cost indicated at the retail price advertised by their producers. The cost was adjusted for inflation to the current year. Results: Based on current pricing, 248 patients in the control arm which involved methotrexate /cetuximab /docetaxel incurred an estimated total cost of $2,918,185 over 24 months. The total cost for the pembrolizumab arm based on current pricing was $36,744,819 for 247 patients over 24 months. The cost of management of adverse effects was $383,910 vs. $18,728 (Std. of care vs. Pembrolizumab). The total cost averaged over all patients in both arms was $13,314 vs. $ 148,840. There is an inverse relationship between drug cost and management of adverse side effects in both arms. Conclusions: Treatment with pembrolizumab confers an increase in overall survival but the cost of the incremental gain appears to be high. The model makes several assumptions including the distribution of cost over the patient population in both arms and extrapolates it to the cost in US dollars. It is very likely that the quality of life was superior in the pembrolizumab arm but it was not incorporated into our model. Justification of the continued use of pembrolizumab must be weighed against the long term survival benefits accrued by its usage in the context of a different and possibly better quality of life.

Development of an MCDA framework for evaluation and positioning of oncological treatments in clinical practice.

95 Background: Ensuring that effective innovations are accessible in a timely and affordable manner to all cancer patients is a challenge that stakeholders face today. Several oncology frameworks (ASCO, ESMO, ICER, NCCN) have been developed to define and quantify the value of oncological therapies to support clinicians and patients at the time of selection and as a basis for decision-making. However, current frameworks only define treatment value in terms of clinical benefit, creating a need for one that allows holistic evaluation of treatments and supports decision-making in clinical practice. The ECO Foundation led this study to develop a reflective multi-criteria decision analysis (MCDA) based framework for evaluation and positioning of new oncological drugs from the clinical oncology perspective. Methods: The framework was developed following EVIDEM methodology. Systematic literature review was performed to identify most relevant criteria used for evaluation of innovative treatments to complement the EVIDEM V4.0 framework. The criteria compendium was presented to a group of clinical oncologists from ECO. The Expert Group assessed each criterion for its inclusion in the framework and suggested modifications in their definition and/or response scale. This framework was then tested with two case studies (Abemaciclib for metastatic HER-/HR+ breast cancer and TAS for metastatic colorectal cancer). The objective was to validate the criteria selected alongside their definitions and response scale with practical examples. A reflective discussion based on the score assigned to each criterion was also carried out. Results: Out of 15 criteria presented to the Expert Group, 8 were included in the final framework, and definition and/or response scale of 7 of these criteria were modified: Disease severity, Unmet needs, Efficacy comparison, Safety/tolerability comparison, Treatment intention, Treatment cost comparison, Comparison of other medical costs and Quality of evidence. Conclusions: A reflective MCDA framework has been developed and validated, based on the value of the treatment, for assessment and positioning of oncological therapies in the context of clinical practice in Spain.

Economic Comparison Between Endovascular Coiling vs Neurosurgical Clipping for Ruptured and Unruptured Intracranial Aneurysms in Austria

Abstract INTRODUCTION Subarachnoid hemorrhage from a ruptured intracranial aneurysm poses a significant health hazard due to its high rates of mortality and disability. The 2 most commonly used treatment modalities of intracranial aneurysms are neurosurgical clipping and endovascular coiling. Through the decision on which treatment option should be chosen in every case is made based on medical indication, nevertheless, due to high socioeconomic burden of subarachnoid hemorrhage, it is also important to compare the healthcare expenditures, caused by clipping and coiling. METHODS A comparison of treatment costs of clipping, coiling and stent-assisted coiling (SAC) of ruptured and unruptured aneurysms in Austria was performed. We considered costs of surgery, diagnostic imaging, postoperative in-hospital care, treatment of the complications and initial rehabilitation. Cost-related data was provided by Vienna General Hospital. The length of hospital stay, complications and mortality rates were obtained from previous studies. Based on this information, a decision tree was built. RESULTS Surgery costs of coiling were significantly higher compared to clipping (13.303 98 Euro for Coiling and 24.847 63 Euro for SAC vs 6.835 23 Euro for Clipping). The main cost-driving factors were implants costs. However, clipping caused higher costs of in-hospital stay and initial rehabilitation. Altogether, when considering all in-hospital costs and the cost of rehabilitation treatment, the difference in costs of aneurysm clipping vs coiling was less pronounced. CONCLUSION This study is the first attempt to calculate the costs of aneurysm treatment in Austria. However, the economic comparison is partially based on estimations.

Comparison of treatment costs at the Psychiatric Ward in Gryfice between 2016 and 2017, after the introduction of olanzapine long-acting injectable in hospital treatment

Objectives. The aim of this study was to compare the costs of treatment at the Psychiatric Ward in Gryfice between 2016 and 2017, after the introduction of olanzapine long-acting injectable in hospital treatment. Material and methods. Analysis of numerical data of the costs of treatment at the Psychiatric Ward in Gryfice (60 inpatient beds) between 2016 and 2017, data from the central hospital pharmacy – internal expenditure of medicines (OLAI, clozapine and zuclopentixol – acetate and decanoate). In 2016, two patients were treated with olanzapine long-acting injectable; in 2017, it was 25 patients, who met the diagnosis criteria for schizophrenia according to ICD-10 and the indications for the refund of the drug (recurrence of psychotic symptoms as a result of documented persistent lack of cooperation). Results. Compared with 2016, in 2017, there were 104 fewer patients hospitalised (–7%); the number of patient-days decreased by 254 (–1.1%) and the number of patients diagnosed as schizophrenia lowered by 32 (–18.5%). The cost of pharmacological treatment decreased both per patient (reduction by 6.7%) and per patient-day (reduction by 12, 2%). The use of other drugs also decreased. Conclusions. Introduction of olanzapine long-acting injectable in hospital treatment is economically beneficial in the short term. In 2017, as compared to 2016, a reduction in the cost of pharmacological treatment was achieved at the Psychiatric Ward in Gryfice (both per patient and per patient-day). The consumption of other neuroleptic drugs, such as clozapine and zuclopenthixol (acetate and decanoate), decreased, too.

The Cost Analysis of Pressure Ulcer Treatment; The Treatment Cost Comparison of Conventional and Modern Wound Care

The Cost Analysis of Pressure Ulcer Treatment; The Treatment Cost Comparison of Conventional and Modern Wound Care

Economic evaluation and cost of interventions for cerebral palsy: a systematic review.

Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications.

PSY21 - Treatment Cost Comparison of Pirfenidone Versus Nintedanib on The Treatment of Idiopathic Pulmonary Fibrosis

PSY21 - Treatment Cost Comparison of Pirfenidone Versus Nintedanib on The Treatment of Idiopathic Pulmonary Fibrosis

Treatment Cost Comparison and Development of Sustainability Indices for Microwave Soil Remediation of TPHs(Total Petroleum Hydrocarbons)

The three processes of 1) high- & low-temperature microwave heatings, 2) the soil washing, and 3) the thermal desorption processes in soil remediation are analysed on the treatment cost data for 2003-2012 years. The cost of microwave heating method with at temperature 500-700℃, for 30 minutes, and at 4-6 kW is approximately 10 $/ton (13,000 ₩) due to the deep through heating of micro-wave, the soil washing with chemicals is about 80 $/ton (85,000 ₩) due to the chemicals & duration, and the thermal desorption process is around 40 $/ton (41,000 ₩) from the less efficiency. Furthermore the sustainability has been assessed, and suggestions are made. 1) Green; the minimal environmental footprint, 2) Growth; the least cost, 3) Shared; the social & environmental justice, 4) Smart; the microwave characteristics of deep through irradiation & heating, and 5) Mutuality; the flexibility of the technology. More additives including water, the government support, and public relation are suggested realizing the microwave in this condition is not harmful to human beings.

PCN93 - A Cost Comparison of Treatment with Abiraterone Acetate Plus Prednisone in the Pre Chemotherapy Setting Followed By Enzalutamide in the Post-Chemotherapy Setting Versus the Opposite Treatment Sequence in Metastatic Castration Resistant Prostate Cancer Patients With non-Visceral Metastases

PCN93 - A Cost Comparison of Treatment with Abiraterone Acetate Plus Prednisone in the Pre Chemotherapy Setting Followed By Enzalutamide in the Post-Chemotherapy Setting Versus the Opposite Treatment Sequence in Metastatic Castration Resistant Prostate Cancer Patients With non-Visceral Metastases

Comparison of treatment costs of laparoscopic and open surgery.

IntroductionLaparoscopy has been a standard procedure in most medical centres providing surgical services for many years. Both the range and number of laparoscopic procedures performed are constantly increasing. Over the last decade, laparoscopic procedures have been successfully applied both in emergency and oncological surgery. However, treatment costs have become a more important factor in choosing between open or laparoscopic procedures.AimTo present the total real costs of open and laparoscopic cholecystectomy, appendectomy and sigmoidectomy.Material and methodsBetween 1 May 2010 and 30 March 2015 in the Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Lodz, and in the Department of General Surgery of the Saint John of God Hospital, Lodz, doctors performed 1404 cholecystectomies, 392 appendectomies and 88 sigmoidectomies. A total of 97% of the cholecystectomy procedures were laparoscopic and 3% were open. Similarly, 22% of total appendectomies were laparoscopic and 78% were open, while 9% of sigmoidectomies were laparoscopic and 91% open.ResultsThe requirement for single-use equipment in laparoscopic procedures increases the expense. However, after adding up all other costs, surprisingly, differences between the costs of laparoscopic and open procedures ranged from 451 PLN/€ 114 for laparoscopic operations to 611 PLN/€ 153 for open operations.ConclusionsLaparoscopic cholecystectomy, considered the standard surgery for treating gallbladder diseases, is cheaper than open cholecystectomy. Laparoscopic appendectomy and sigmoidectomy are safe methods of minimally invasive surgery, slightly more expensive than open operations. Of all the analyzed procedures, one-day laparoscopic cholecystectomy is the most profitable. The costs of both laparoscopic and open sigmoidectomy are greatly underestimated in Poland.

Treatment Cost Comparison for Radical Prostatectomy, Volumetric Arc Therapy (VMAT) With High-Dose-Rate Brachytherapy (HDR) Boost, HDR Monotherapy Single Fraction and I-125 Implant for Localized Prostate Cancer in a Spanish Private Practice

Treatment Cost Comparison for Radical Prostatectomy, Volumetric Arc Therapy (VMAT) With High-Dose-Rate Brachytherapy (HDR) Boost, HDR Monotherapy Single Fraction and I-125 Implant for Localized Prostate Cancer in a Spanish Private Practice

Potential Budgetary Impact of Large Scale Screening of Small Fiber Neuropathy in the Follow-Up of Patients with Type 2 Diabetes in France

Aims: The burden of diabetes-related complications is important and increasing in France. Early screening of microvascular complications could avoid the occurrence of more severe consequences. An economic model using a 5-year time horizon was developed to estimate the potential impact in France of large screening of diabetic autonomic neuropathy using Sudoscan, a quick, non-invasive and quantitative method developed for screening of small fiber neuropathy. Methods: A disease progression model was first developed to describe the long-term evolution of patients with type 2 diabetes regarding microvascular complications over successive time periods and patients were classified in 4 groups according to the severity. Complication-related costs were then calculated for a cohort of patients treated according to the current pattern of care and compared with the costs incurred by the same cohort assuming the introduction and widespread use of a large screening of small fiber neuropathy using the Sudoscan method. Comparison of treatment costs between the two situations was used to evaluate the potential budget impact of such a prevention policy in France. Results: According to this general screening of early complications more than 25,000 patients could avoid more severe complications. The gross benefit of such a new prevention strategy would be around € 280 million at 5th year. After 5 years of follow-up, the cumulated gross benefit would be € 837 million and in the worst case scenario (decrease of 20% for each uncertain parameter, namely the distribution of patients among severity groups, the death rates in each severity group, and the distribution of newly diagnosed patients in each severity group) gross benefit would remain at more than € 50 million for the first year and more than € 255 million at the 5th year (using 6% as global efficacy of screening method as basal value). Conclusion: Large screening of small fiber neuropathy could avoid more severe peripheral neuropathy and consequently decrease the burden related to such complications for a limited investment.

Treatment Cost Comparison: Paliperidone Palmitate Versus Risperidone Long Acting in Brazil.

Treatment Cost Comparison: Paliperidone Palmitate Versus Risperidone Long Acting in Brazil.

PRM31 - Performance comparison of different types of propensity score matching algorithms in a study of rare disease treatment cost comparison using real world evidence

It is well-accepted that data pre-processing and the creation of matching cohorts may provide a more balanced assessment in real world evidence analysis. The objective of this study is to show that proper selection of a propensity score matching (PSM) algorithm can significantly enhance the sensitivity of treatment cost comparison for rare diseases using claims databases. Five years of retrospective inpatient commercial insurance claims data from Truven MarketScan™ were used to compare the six-month drug cost of ‘Drug X’ to ‘Drug Y’ for a rare disease, with Drug Y being the market leader. Within this study, three different types of PSM techniques were used (naïve matching, logit and recursive partitioning) to determine the impact of matching algorithms on the sensitivity of final comparison. A 2:1 matching ratio was used to take advantage of much larger patient pool for Drug Y. Without PSM, the difference in cost of the two treatments was not statistically significant, although these results show that the spending for Drug X patients is approximately $220 less than Drug Y users over a 6 month period. In the naïve matching method, the drug cost of treatment X was $234 lower than treatment Y, although the observed difference was not statistically significant. Using the logit regression algorithm, it was found that the mean cost of Drug X was approximately $368 lower than Drug Y (p=0.028). Lastly, with non-linear recursive partitioning PSM, the treatment cost of Drug X was $351 lower than Drug Y (p=0.045). The use of PSM in studies can help to remove potential confounders and produce unbiased results. Model-based PSM outperforms naïve matching in terms of enhancing analysis sensitivity. The careful selection of a matching algorithm can play a pivotal role in economic investigations for rare diseases using real world evidence.