Cost-consequence Analysis Research Articles

P0690 Purposeful design and integration of a pilot Inflammatory Bowel Disease (IBD) diet clinic into a multi-disciplinary IBD service demonstrates exemplar service utility and is of high value to patients

Abstract Background International guidelines recommend people with inflammatory bowel disease (IBD) have access to a dietitian who can undertake a comprehensive nutrition assessment and provide personalised dietary counselling. Few Australian tertiary IBD services offer dedicated and co-located IBD diet clinics (IBDDCs) to enable point of care, integrated dietary management. The value of IBDDCs to patients and IBD services is unknown. This study aimed to examine the utility and patient-reported value of an integrated IBDDC. Methods A 24-month prospective clinical service audit of a pilot IBDDC at The Queen Elizabeth Hospital, Adelaide, South Australia was conducted. Adults with IBD and nutrition-related issues identified during gastroenterology consultation were referred for specialist IBD dietetic consultation. IBD-diet referral criteria and clinic templates that included direct access appointments for patients requiring point of care dietary management were established. IBDDC service activity audit captured referral rates, wait times, mode of consult delivery, attendance and appointment outcomes. A subgroup of patients completed service evaluation questionnaires. Descriptive data is presented. Results Between February 2021–February 2023, 182 new referrals to IBDDC resulted in 133 new appointments accounting for closures during COVID lockdowns. Of these, 108/133 (81%) attended first consultation and 86/108 (64%) were point of care appointments. The ratio of new to review appointment utilisation was 1:2. Of 382 scheduled reviews, 329/382 (86%) attended and 34/329 (9%) utilised point of care consults. Overall, 19/515 (3.7%) failed to attend (FTA) IBDDC appointments over 24-months. In a subgroup of 55 patients, 89.1% reported future access to integrated IBDDCs as highly valuable. Conclusion A dedicated IBDDC demonstrates high service utility and exceptionally low FTA rates over 24-months. Direct access appointments are novel and were well utilised for patients requiring point of care dietary assessment and care planning. This is exemplar of how to purposely integrate dietetic services into high acuity multi-disciplinary IBD models of care and maximise patient attendance. The next steps are to complete a health economic cost consequence analysis of IBDDC to inform integration of dietetic services into Australian IBD models of care.

Cost-Effectiveness Analyses of Bone Morphogenetic Protein 2 (rhBMP-2) in Spinal Fusion: A Systematic Review.

Systematic Review Study. The objective of this study is to assess the cost-effectiveness and cost-utility of rhBMP-2 in spine surgeries. PubMed, MEDLINE, OVID and CENTRAL (Cochrane Central Register of Controlled Trials) databases were systematically searched for studies reporting the use of rhBMP-2 for spinal procedures in comparison to autograft and/or allograft and alternative graft materials under consideration of cost-effectiveness, cost-benefit, cost minimization, and/or cost-utility analysis. Relevant data points were extracted and compiled. The standardization of the selected studies was graded using the CHEERS criteria. Of the 88 eligible publications, 17 met the inclusion criteria. Overall, 8 studies showed a favorable cost-analysis profile. Three studies performed cost-consequence analyses, none of which reported positive findings. Among 7 cost-utility analyses and 7 cost-effectiveness analyses, 3 and 5, respectively, reported a likely benefit to the usage of rhBMP-2. The CHEERS scores for the included studies ranged from 15 to 23 out of 24 points, with a median score of 19. There is no consensus regarding the cost-effectiveness or cost-utility of rhBMP-2 in spinal fusion. rhBMP-2 may function as a cost-effective adjunct in spinal fusion surgeries in select cases.

The Cost of Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Type 1 Diabetes Pregnancies in the United States: A Cost-Consequences Analysis Using Real-World Evidence.

Data on the cost implications of continuous glucose monitoring (CGM) use in type 1 diabetes (T1D) pregnancies in the United States are sparse. Drawing on associations identified in real-world evidence from a retrospective chart review at the Barbara Davis Center for Diabetes, we conducted a cost-consequences analysis of CGM use versus self-monitoring of blood glucose (SMBG), inclusive of neonatal intensive care unit (NICU) spending. In the base-case analysis assuming per-label CGM use and per-guideline finger-stick frequency, the per-person cost was $16,254 for CGM versus $15,182 for SMBG. In a real-world scenario analysis, the per-person cost was $13,708 for CGM versus $14,524 for SMBG. In both analyses, there was a cost savings for NICU admissions of $2,903 with CGM use. In the probabilistic sensitivity analysis, CGM was cost saving in 25% of base-case model iterations and 46% of real-world model iterations. This study adds to the growing evidence base that the increased costs of CGM use versus SMBG to manage T1D pregnancies are likely offset by better neonatal health outcomes.

The economic burden of asthma in Italy: evaluating the potential impact of different treatments in adult patients with severe eosinophilic asthma.

Asthma is a prevalent chronic respiratory condition that significantly impacts public health, with severe asthma subtypes, such as severe eosinophilic asthma, imposing substantial socioeconomic burdens. Real-world data from the Italian Health Information System were analyzed to evaluate the economic consequences of asthma in Italy. An in-depth comparative analysis was conducted to investigate the economic implications of various asthma subtypes, focusing on severe eosinophilic asthma. Additionally, the study projected the potential cost-effectiveness of novel treatments aimed at reducing hospitalization rates, specialist visits, and oral corticosteroid use for patients with severe eosinophilic asthma in Italy. The analysis revealed that severe asthma, and notably severe eosinophilic asthma, places a substantial economic burden on the Italian National Health System. Estimates demonstrated that implementing innovative treatments to mitigate the risks of hospitalization and specialist visits, as well as reducing oral corticosteroid usage in severe eosinophilic asthma patients, could lead to significant cost savings. The cost-consequence analysis indicated potential yearly reductions of €50.0 million (27%) for the treatment of severe asthma and €31.7 million (26%) for severe eosinophilic asthma. This study presents a comprehensive evaluation of the economic repercussions of severe asthma in Italy. The findings emphasize the necessity of identifying and developing effective therapeutic strategies to improve the management of severe asthma while simultaneously reducing the economic burden on the healthcare system. These results offer valuable insights for healthcare policymakers and practitioners, facilitating evidence-based decisions in asthma management and healthcare policy in Italy.

An economic evaluation of the Virtual Rural Generalist Service versus usual care in Western NSW Local Health District.

Evaluate the cost-effectiveness of the Virtual Rural Generalist Service (VRGS) model of care. A cost-consequence analysis of the VRGS model of care compared with usual care (treatment by local or locum [non-VRGS] doctors) from the perspective of the health care funder in 2022 prices. Twenty-nine rural and remote hospitals in the Western NSW Local Health District where the VRGS has been in operation (VRGS sites). Patients of any age who presented to an emergency department (ED) or were admitted to hospital at VRGS sites over the pre-VRGS period (1 February 2019 to 31 January 2020) or the post-VRGS period (1 July 2021 to 30 June 2022). The VRGS model of care, which provides 24-hour 7-days-a-week rural generalist doctors, both virtually and in person, to small rural and remote hospitals, predominantly for lower acuity ED presentations, daily ward rounds for inpatients admitted by a VRGS medical officer, and ad hoc inpatient medical reviews when local doctors need support or are unavailable. Incremental cost per incremental quality-of-care outcome, maintenance of health service activity levels, workforce sustainability (measured by changes in locum shifts), and service acceptability (as determined by thematic analysis of interviews). The cost per standard unit of health care (national weighted activity unit) was lower for the VRGS ($1047) than for usual care ($1753). VRGS doctors dealt with ED presentations of similar complexity to non-VRGS doctors, and admissions of significantly lower (40%) complexity. Health service activity remained stable from the pre-VRGS period to the post-VRGS period, only declining by 4% in the post-VRGS period, which was during the coronavirus disease 2019 pandemic. Locum shifts decreased from 1456 days in the pre-VRGS period to 609 days in the post-VRGS period, improving the sustainability of the workforce. Local doctors and managers found the VRGS to be acceptable, but thought it could be enhanced with additional investment in nursing and technical staff. Our economic evaluation of the VRGS showed that it provided lower cost care and equivalent quality-of-care outcomes when compared with usual care for ED presentations of the same complexity, and supported local clinical staff to maintain activity levels despite a pandemic. With additional investment in data capture and in nursing and technical staff to support the service, the VRGS has promise as a flexible service that can help sustain access to quality medical care in rural and remote communities.

Cost consequences analysis of early vocational rehabilitation compared with usual care for stroke survivors.

To compare costs and consequences of Early Stroke Specialist Vocational Rehabilitation (ESSVR) with usual care in working age, stroke survivors over 12 months. An economic evaluation nested within the pragmatic, multi-centre, randomised, controlled RETurn to work After stroKE (RETAKE) study. Twenty-one English and Welsh National Health Service (NHS) hospital-based stroke units. A UK NHS and Personal Social Services perspective was taken in the base-case and a wider perspective (participant, family, employer and other public services) in a secondary analysis. A total of 583 stroke survivors age ≥18 years (mean 54.0 years, 69% male). Participants were randomised to ESSVR, an early, individually tailored (in content, dose, intensity and duration) intervention, plus usual care or usual care alone. Disease-specific resource-use data and EQ-5D-5L (health-related quality of life) collected at baseline, 3, 6 and 12 months. Resource-use items were valued using unit costs in UK£ 2021/22. EQ-5D-5L was used to estimate Quality-adjusted life-years (QALYs). If ESSVR was found effective, an incremental cost-utility analysis was planned, otherwise a cost-consequence analysis. The clinical study found no evidence of a between-group difference in the proportion of participants returning to work at 12 months. This, and the level of missing data, means a cost-consequence analysis is reported. Using imputed data, ESSVR plus usual care is estimated to be more expensive with slightly higher QALYs compared with usual care. Early Stroke Specialist Vocational Rehabilitation is unlikely to be considered cost-effective over 12 months, which fits with the clinical finding of no between-group difference in return-to-work rates post-stroke. The ISRCTN registry: ISRCTN12464275 https://doi.org/10.1186/ISRCTN12464275.

Psychological safety in the perioperative environment: a cost-consequence analysis

IntroductionPsychologically unsafe healthcare environments can lead to high levels of staff turnover, and unwanted financial burden. In this study, we investigate the hypothesis that lower levels of psychological safety are...

EE777 Diagnostic Pathways for Prostate Cancer in Italy: A Cost-Consequences Analysis

EE777 Diagnostic Pathways for Prostate Cancer in Italy: A Cost-Consequences Analysis

EE718 The Burden of Hepatitis Delta in Italy: Potential Impacts of Bulevirtide Through a Cost of Illness and Cost-Consequence Analyses

EE718 The Burden of Hepatitis Delta in Italy: Potential Impacts of Bulevirtide Through a Cost of Illness and Cost-Consequence Analyses

HSD100 Economics of a Virtual Care Model for Diagnosis and Treatment of Sleep Apnea in Germany: Results From a Cost-Consequence Analysis

HSD100 Economics of a Virtual Care Model for Diagnosis and Treatment of Sleep Apnea in Germany: Results From a Cost-Consequence Analysis

MT8 Cost-Consequences Analysis (CCA) of Echocardiography Digital Artificial Intelligence (AI) Monitoring Application Developed at Hosmartai (Horizon 2020 Funded)

MT8 Cost-Consequences Analysis (CCA) of Echocardiography Digital Artificial Intelligence (AI) Monitoring Application Developed at Hosmartai (Horizon 2020 Funded)

MT50 Cost-Consequences Analysis (CCA) of the Hosmartai Virtual Coach for Continuity of Care Among Older Adults

MT50 Cost-Consequences Analysis (CCA) of the Hosmartai Virtual Coach for Continuity of Care Among Older Adults

MT65 Cost-Consequences Analysis (CCA) of Artificially Intelligent Clinician-Friendly Interpretable Computer-Aided Diagnosis (ICADX) Tool for Coronary Artery Disease (CAD) Developed at Hosmartai (Horizon 2020 Funded)

MT65 Cost-Consequences Analysis (CCA) of Artificially Intelligent Clinician-Friendly Interpretable Computer-Aided Diagnosis (ICADX) Tool for Coronary Artery Disease (CAD) Developed at Hosmartai (Horizon 2020 Funded)

MT36 Cost-Consequences Analysis (CCA) of Artificially Intelligent Clinician-Friendly Interpretable Computer-Aided Diagnosis (ICADX) Tool for the Detection of Preterm Births (OB-GYN) Developed at Hosmartai (Horizon 2020 Funded)

MT36 Cost-Consequences Analysis (CCA) of Artificially Intelligent Clinician-Friendly Interpretable Computer-Aided Diagnosis (ICADX) Tool for the Detection of Preterm Births (OB-GYN) Developed at Hosmartai (Horizon 2020 Funded)

MT51 Cost-Consequences Analysis (CCA) of Small Bowel Video Capsule Endoscopy (VCE) Digital Artificial Intelligence (AI) Monitoring Application Developed at Hosmartai (Horizon 2020 Funded)

MT51 Cost-Consequences Analysis (CCA) of Small Bowel Video Capsule Endoscopy (VCE) Digital Artificial Intelligence (AI) Monitoring Application Developed at Hosmartai (Horizon 2020 Funded)

EE729 Clinical and Economic Impact of a Tri-Layer Hybrid Biomaterial vs Synthetic Mesh for Ventral Hernia Repair in Australia: A Cost-Consequence and Budget Impact Analysis

EE729 Clinical and Economic Impact of a Tri-Layer Hybrid Biomaterial vs Synthetic Mesh for Ventral Hernia Repair in Australia: A Cost-Consequence and Budget Impact Analysis

EE162 Cost Consequence Analysis of Using the Elecsys Anti-Müllerian Hormone Plus Immunoassay as Part of Polycystic Ovary Syndrome Assessment in the United Kingdom

EE162 Cost Consequence Analysis of Using the Elecsys Anti-Müllerian Hormone Plus Immunoassay as Part of Polycystic Ovary Syndrome Assessment in the United Kingdom

EE574 Cost-Consequences Analysis of the Use of TyrxTM Antibacterial Envelope in Patients Undergoing Device Replacement Procedures in Türkiye

EE574 Cost-Consequences Analysis of the Use of TyrxTM Antibacterial Envelope in Patients Undergoing Device Replacement Procedures in Türkiye

EE262 Cost-Consequence Analysis of Cabozantinib in Combination With Nivolumab in Treatment of First-Line Advanced Renal Cell Carcinoma in Germany: A Payer Perspective

EE262 Cost-Consequence Analysis of Cabozantinib in Combination With Nivolumab in Treatment of First-Line Advanced Renal Cell Carcinoma in Germany: A Payer Perspective

EE778 Early Cost-Consequence Analysis of Comprehensive Genomic Profiling in a Metastasized Tumor-Agnostic Population

EE778 Early Cost-Consequence Analysis of Comprehensive Genomic Profiling in a Metastasized Tumor-Agnostic Population