Economic Evaluations Of Preventive Interventions Research Articles

A systematic review of economic evaluations for opioid misuse, cannabis and illicit drug use prevention.

Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear. This review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use. Literature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist. Eleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost-benefit studies reported cost-savings. One cost-effectiveness and two cost-utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds. There are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics ('the Network System to Prevent Doctor-Shopping for Narcotics') show promising cost-effectiveness and warrant consideration.

PRS27 Incorporating Heterogeneity in Risk for Infection and Disease in Cost-Effectiveness of Preventative Strategies in Older Adults

Older adults are often evaluated as one homogeneous group. As currently illustrated with the COVID-19 pandemic, older adults are however heterogeneous in risk factors for infection and disease, including, for example, frailty, immunity, and clustering. This research aims to assess the use and the importance of including such heterogeneity in older adults in health economic evaluations of preventive interventions, such as vaccinations.

Quality of life and time to death: have the health gains of preventive interventions been underestimated?

This article explores the implications of the relation between quality of life (QoL) and time to death (TTD) for economic evaluations of preventive interventions. By using health survey data on QoL for the general Dutch population linked to the mortality registry, we quantify the magnitude of this relationship. For addressing specific features of the nonstandard QoL distribution such as boundness, skewness, and heteroscedasticity, we modeled QoL using a generalized additive model for location, scale, and shape (GAMLSS) with a β inflated outcome distribution. Our empirical results indicate that QoL decreases when approaching death, suggesting that there is a strong relationship between TTD and QoL. Predictions of different regression models revealed that ignoring this relationship results in an underestimation of the quality-adjusted life year (QALY) gains for preventive interventions. The underestimation ranged between 3% and 7% and depended on age, the number of years gained from the intervention, and the discount rate used.

Economic evaluations of interventions designed to prevent mental disorders: a systematic review.

The prevention of mental disorders is a growing field and there are interventions that have been demonstrated to prevent some disorders, particularly depression, from developing. The aim of the current study is to update two existing reviews of the cost-effectiveness studies of preventive interventions for mental disorders in order to determine whether such interventions are good value-for-money. A search was undertaken in Medline, PsycInfo and Econlit. The search was limited to articles published in English covering the period from 2010 to September 2013. Inclusion criteria for the review comprised comparative economic evaluations of interventions designed to prevent mental disorders. Ten new economic evaluations have been published since 2010, more than doubling the numbers of economic evaluations of preventive interventions for mental disorders published prior to 2010. Using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, the majority of studies were of a good standard and used cost-utility frameworks. Indicated types of interventions for the prevention of depression and anxiety appeared to be particularly good value-for-money and most of these studies were modelled evaluations. Unfortunately, many such interventions are still not routinely provided. Future trials of preventive interventions for mental disorders need to include robust economic evaluations so that the economic impact of such interventions from the individual study participant perspective can be determined.

The Economic Analysis of Prevention in Mental Health Programs

This article introduces the role economics can play in deciding whether programs designed to prevent mental disorders, which carry large disease and economic burdens, are a worthwhile use of limited healthcare resources. Fortunately, preventive interventions for mental disorders exist; however, which interventions should be financed is a common issue facing decision makers, and economic evaluation can provide answers. Unfortunately, existing economic evaluations of preventive interventions have limited applicability to local healthcare contexts. An approach to priority setting largely based on economic techniques-Assessing Cost-Effectiveness (ACE)-has been developed and used in Australia to answer questions regarding the economic credentials of competing interventions. Eleven preventive interventions for mental disorders and suicide, mostly psychological in nature, have been evaluated using this approach, with many meeting the criteria of good value for money. Interventions targeting the prevention of suicide, adult and childhood depression, childhood anxiety, and early psychosis have particular merit.

Cost-effectiveness research on preventive interventions: a survey of the publications in 2008

In recent years the literature regarding the cost-effectiveness of disease prevention and health promotion has grown exponentially. Aim of this study is to investigate: (i) how many and what type of economic evaluations have been published in 2008, (ii) the diseases or health problems World Health Organization International Classification of Diseases 10 chapters the economic evaluations of preventive interventions focus on, in relation to the global burden of disease and (iii) the cost-effectiveness of these interventions. Literature study of economic evaluations on preventive interventions in PubMed and Scopus. In 2008, 232 economic evaluations of preventive interventions have been published. Of these studies, 75% (n = 175) used costs per (Quality Adjusted) Life Year [(QA)LY] gained as outcome measure. Most economic evaluations focus on the prevention of infectious diseases (31.5%, n = 73) and cancers (21%, n = 49) Infectious diseases are responsible for the highest global burden of disease (19.8%), followed by mental and behavioural disorders (11.7%). Of the included economic evaluations, 80% remained below a threshold of €50 000 and 60% below €20 000 per (QA)LY. This study shows that many economic evaluations of preventive interventions use a generic outcome measure. This adds to the comparability of different studies on the cost-effectiveness of prevention. Although the focus of published economic evaluations in general corresponds well with those diseases that cause a large share of the world's burden of disease, mental and behavioural diseases and diseases of the respiratory system remain underrepresented. Finally, it appears that the vast majority of published economic evaluations of preventive measures show favourable cost-effectiveness levels.

Cost Effectiveness of Preventive Interventions in Type 2 Diabetes Mellitus

A systematic review of the literature was conducted to give an overview of economic evaluations of preventive interventions in type 2 diabetes mellitus. The interventions were sorted by type of preventive intervention (primary, secondary or tertiary) and by category (e.g. education, medication for hypertension). Several databases were searched for studies published between January 1990 and May 2004 on the three types of preventive intervention. For each study selected, inclusion of specific components from a standardised list of items, including quality, was recorded in a database. Summary tables were generated based on the database.A number of conclusions were drawn from this review. The most important was that strict blood pressure control was a more cost-effective intervention than less strict control, as shown by six studies reporting cost savings to very low costs per life-year gained. Primary and secondary prevention of type 2 diabetes were also highly cost effective, but these results were based on very few studies. Medications to reduce weight and hyperglycaemia together were cost effective compared with conventional interventions. Finally, the separate results regarding medications to reduce weight, hyperglycaemia and hypercholesterolaemia varied enormously, thus no conclusion could be drawn and further economic analysis is required.