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- Geale, Kirk, et al.
(författare)
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Estimating the Value of A New Antibiotic : A Novel Approach Using Esbl As A Case Study
- 2016
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Ingår i: Value in Health. - : Elsevier. - 1098-3015 .- 1524-4733. ; 19:7, s. A422-A423
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Develop a model capable of estimating the value of a new antibiotic for use in treating last-line patients not eligible for, or having failed on, all currently available antibiotic treatments.Methods: Ten annual cohorts of incident last-line patients (total of 314) infected with extended spectrum beta-lactamase (ESBL) -producing bacteria were modelled from the onset of the last-line infection over the course of their remaining life, in a scenario where a new antibiotic was available and one where it was not. Efficacy was measured by mortality, where 5% (95%) of patients died due to the infection in the scenario with(out) a new antibiotic. In the scenario with a new antibiotic, the mortality rate increased by 0.5% annually. Costs including lab tests, hospital stays, and productivity loss were calculated in both scenarios. Quality-adjusted life-years gained (QALYs) were estimated using weights for patients with an infection (0.61) and after recovery (0.84), in addition to disutility incurred by one caregiver per patient (-0.14). Differences in costs, QALYs, deaths, and days off work were calculated between the two arms; costs and QALYs were discounted to the present year. The value of a new antibiotic is reflected in the incremental results.Results: In the last-line ESBL population of 314 patients over 10 years, the availability of a new antibiotic resulted in SEK 20.4 million in cost saving, 2795 QALYs gained, 273 fewer infection-caused deaths, and 2198 fewer days off work.Conclusions: Valuation of a new antibiotic is a high public health priority due to increasing antibiotic resistance and decreasing rates of development of new antibiotics. Access to a new antibiotic for last-line patients provides a large benefit to society, using ESBL as case-study. The results are conservative as they exclude factors that are relatively difficult to estimate such as the risk of an outbreak.
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- Lindberg, I., et al.
(författare)
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Direct healthcare cost of atopic dermatitis in the Swedish population
- 2021
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Ingår i: Journal of Investigative Dermatology. - : Elsevier. - 0022-202X .- 1523-1747. ; 141:5 Suppl., s. S45-S45
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Data quantifying population-based direct healthcare costs (DHCC) for atopic dermatitis (AD) by severity are limited. This study was designed to provide estimates for these costs. Patients were identified at first AD diagnosis in the National Patient Registry (secondary care) or in primary care (national coverage: 31%) (International Classification of Diseases-10 L20) or first dispensation of topical calcineurin inhibitor or topical corticosteroid (Anatomical Therapeutic Chemical code D11AH01/02 once; D07 twice in a year) in the Prescribed Drug Registry in 2007-17 (index) and followed until death, emigration, 31 Dec 2018 or adulthood. Patients without AD diagnosis with a record of diagnoses/treatment for other non-AD skin conditions were excluded. Patients were matched 1:1 on age, gender and region to controls. 1-year DHCC for secondary and primary care visits and filled prescriptions were compared with controls (2020€). Disease severity (mild-to-moderate [M2M] vs severe) using AD treatment and visits as proxies was assessed between index to 30 days after. 187,338 M2M (48% female; mean age 4) and 46,754 severe children (51%; 8), while 445,317 M2M (55%; 55) and 11,640 severe adults (57%; 53) were included. In children vs. controls, 1-year DHCC for secondary care, primary care and medications were respectively €72, €23, €33 million (mn) higher in M2M and €26, €4, €13 mn higher in severe; in adults vs. controls, €353, €68, €182 mn higher in M2M and €21, €2, €17 mn higher in severe (all comparisons significant, p<0.05). On population level, AD is associated with substantial economic burden, which is higher in M2M vs severe AD partially due to higher prevalence of M2M.
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