| 1. |
- Andrén, Daniela, 1968
(författare)
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Long-term absenteeism due to sickness in Sweden. How long does it take and what happens after?
- 2007
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Ingår i: European Journal of Health Economics. - : Springer. ; 8:1, s. 41-50
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we analyze exits from long-term sickness spells in Sweden. Using data for more than 2,500 people, the aim is to analyze the transition to different states: return to work, full disability pension, partial disability pension, and other exits from the labor force. Given the complexity of the exit decision, which encompasses both the individual’s choice, the medical evaluation and the decision of the insurance adjudicator, we consider the outcome as being the result of two aspects of the exit process: one that governs the duration of a spell prior to the decision to exit, and another that governs the type of exit. Therefore, the analysis is done in two steps: first, we analyze the duration of the sickness spells, and then we analyze the process that governs the type of exit. The results indicate that both individual characteristics and push factors, such as regional unemployment, are important for both components of the decision process.
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| 2. |
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| 3. |
- Anxo, Dominique, 1953-, et al.
(författare)
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Impact of late and prolonged working life on subjective health : the Swedish experience
- 2019
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 20:3, s. 389-405
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores the relationship between the prolongation of working life and subjective health. Drawing on a unique combination of longitudinal data and the results of a postal survey in Sweden, we investigate the health consequences of extending working life beyond the normal retirement age of 65. To do this, we compare the health status of two groups of retired people: one group who left the labour market completely at the age of 65, and a second group who remained in employment after the age of 65. Using a standard linear probability model and controlling for a range of socio-economic variables as well as previous labour market experiences, perceived life expectancy, pre-retirement income and health, our estimations show that those continuing to work after 65 on average display a 6.8% higher probability of reporting better health during retirement than those leaving at the age of 65. However, we find that this positive correlation between the extension of working life and health is only transitory. After 6 years of retirement, the health advantage of working after the normal retirement age disappears. Furthermore, we did not find any evidence that working after the age of 65 is positively correlated with physical fitness, self-reported depressive symptoms or well-being.
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| 4. |
- Aregbeshola, BS, et al.
(författare)
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Determinants of catastrophic health expenditure in Nigeria
- 2018
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7601. ; 19:4, s. 521-532
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Tidskriftsartikel (refereegranskat)
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| 5. |
- Banefelt, J., et al.
(författare)
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Work productivity loss and indirect costs associated with new cardiovascular events in high-risk patients with hyperlipidemia: estimates from population-based register data in Sweden
- 2016
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Ingår i: European Journal of Health Economics. - : SPRINGER. - 1618-7598 .- 1618-7601. ; 17:9, s. 1117-1124
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To estimate productivity loss and associated indirect costs in high-risk patients treated for hyperlipidemia who experience cardiovascular (CV) events. Methods Retrospective population-based cohort study conducted using Swedish medical records linked to national registers. Patients were included based on prescriptions of lipid-lowering therapy between 1 January 2006 and 31 December 2011 and followed until 31 December 2012 for identification of CV events and estimation of work productivity loss (sick leave and disability pension) and indirect costs. Patients were stratified into two cohorts based on CV risk level: history of major cardiovascular disease (CVD) and coronary heart disease (CHD) risk equivalent. Propensity score matching was applied to compare patients with new events (cases) to patients without new events (controls). The incremental effect of CV events was estimated using a difference-in-differences design, comparing productivity loss among cases and controls during the year before and the year after the cases event. Results The incremental effect on indirect costs was largest in the CHD risk equivalent cohort (n = 2946) at (sic)3119 (P value amp;lt;0.01). The corresponding figure in the major CVD history cohort (n = 4508) was (sic)2210 (P value amp;lt;0.01). There was substantial variation in productivity loss depending on the type of event. Transient ischemic attack and revascularization had no significant effect on indirect costs. Myocardial infarction ((sic)), unstable angina ((sic)) and, most notably, ischemic stroke ((sic)) yielded substantial incremental cost estimates (P values amp;lt;0.01). Conclusions Indirect costs related to work productivity losses of CV events are substantial in Swedish high-risk patients treated for hyperlipidemia and vary considerably by type of event.
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| 6. |
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| 7. |
- Belger, Mark, et al.
(författare)
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Determinants of time to institutionalisation and related healthcare and societal costs in a community-based cohort of patients with Alzheimer's disease dementia
- 2019
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 20:3, s. 343-355
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine the costs of caring for community-dwelling patients with Alzheimer’s disease (AD) dementia in relation to the time to institutionalisation.Methods: GERAS was a prospective, non-interventional cohort study in community-dwelling patients with AD dementia and their caregivers in three European countries. Using identified factors associated with time to institutionalisation, models were developed to estimate the time to institutionalisation for all patients. Estimates of monthly total societal costs, patient healthcare costs and total patient costs (healthcare and social care together) prior to institutionalisation were developed as a function of the time to institutionalisation.Results: Of the 1495 patients assessed at baseline, 307 (20.5%) were institutionalised over 36 months. Disease severity at baseline [based on Mini-Mental State Examination (MMSE) scores] was associated with risk of being institutionalised during follow up (p < 0.001). Having a non-spousal informal caregiver was associated with a faster time to institutionalisation (944 fewer days versus having a spousal caregiver), as was each one-point worsening in baseline score of MMSE, instrumental activities of daily living and behavioural disturbance (67, 50 and 30 fewer days, respectively). Total societal costs, total patient costs and, to a lesser extent, patient healthcare-only costs were associated with time to institutionalisation. In the 5 years pre-institutionalisation, monthly total societal costs increased by more than £1000 (€1166 equivalent for 2010) from £1900 to £3160 and monthly total patient costs almost doubled from £770 to £1529.Conclusions: Total societal costs and total patient costs rise steeply as community-dwelling patients with AD dementia approach institutionalisation.
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| 8. |
- Berg, J, et al.
(författare)
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Costs and quality of life of multiple sclerosis in Sweden
- 2006
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7598. ; 7 Suppl 2, s. S75-85
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Tidskriftsartikel (refereegranskat)
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| 9. |
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| 10. |
- Bolin, Kristian, et al.
(författare)
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Epilepsy in Sweden: health care costs and loss of productivity-a register-based approach.
- 2012
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 13:6, s. 819-826
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The objective was to estimate health care costs and productivity losses due to epilepsy in Sweden and to compare these estimates to previously published estimates. METHODS: Register data on health care utilisation, pharmaceutical sales, permanent disability and mortality were used to calculate health care costs and costs that accrue due to productivity losses. By linkage of register information, we were able to distinguish pharmaceuticals prescribed against epilepsy from prescriptions that were prompted by other indications. RESULTS: The estimated total cost of epilepsy in Sweden in 2009 was 441 million, which corresponds to an annual per-patient cost of 8,275. Health care accounted for about 16% of the estimated total cost, and drug costs accounted for about 7% of the total cost. The estimated health care cost corresponded to about 0.2% of the total health care cost in Sweden in 2009. Indirect costs were estimated at 370 million, 84% of which was due to sickness absenteeism. Costs resulting from epilepsy-attributable premature deaths or permanent disability to work accounted for about 1% of the total indirect cost in Sweden in 2009. DISCUSSION: The per-patient cost of epilepsy is substantial. Thus, even though the prevalence of the illness is relatively small, the aggregated cost that epilepsy incurs on society is significant.
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| 11. |
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| 12. |
- Chevreul, Karine, et al.
(författare)
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Social/economic costs and health-related quality of life in patients with cystic fibrosis in Europe
- 2016
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 17, s. 7-18
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Our goal was to provide data on the economic burden and health-related quality of life (HRQOL) of patients with cystic fibrosis (CF) and their caregivers in Europe. Methods: A cross-sectional study was carried out on adults and children with CF in eight European countries. Patients completed an anonymous questionnaire regarding their socio-demographic characteristics, use of healthcare services and presence of a caregiver. Costs were calculated with a bottom-up approach using unit costs from each participating country, and HRQOL was assessed using EQ-5D. The principal caregiver also answered a questionnaire on their characteristics, HRQOL and burden. Results: A total of 905 patients with CF was included (399 adults and 506 children). The total average annual cost per patient varied from €21,144 in Bulgaria to €53,256 in Germany. Adults had higher direct healthcare costs than children, but children had much higher informal care costs (P
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| 13. |
- Dackehag, Margareta, et al.
(författare)
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Productivity or discrimination? An economic analysis of excess-weight penalty in the Swedish labor market.
- 2015
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 16:6, s. 589-601
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Tidskriftsartikel (refereegranskat)abstract
- This article investigates the excess-weight penalty in income for men and women in the Swedish labor market, using longitudinal data. It compares two identification strategies, OLS and individual fixed effects, and distinguishes between two main sources of excess-weight penalties, lower productivity because of bad health and discrimination. For men, the analysis finds a significant obesity penalty related to discrimination when applying individual fixed effects. We do not find any significant excess-weight penalty for women.
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| 14. |
- Dahlgren, Cecilia, et al.
(författare)
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Short- and intermediate-term impact of DTC telemedicine consultations on subsequent healthcare consumption
- 2024
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The use of direct-to-consumer (DTC) telemedicine consultations in primary healthcare has increased rapidly, in Sweden and internationally. Such consultations may be a low-cost alternative to face-to-face visits, but there is limited evidence on their effects on overall healthcare consumption. The aim of this study was to assess the short- and intermediate-term impact of DTC telemedicine consultations on subsequent primary healthcare consumption, by comparing DTC telemedicine users to matched controls in a Swedish setting. Methods: We constructed a database with individual-level data on healthcare consumption, for all residents of Region Stockholm in 2018, by linking national and regional registries. The study population included all individuals who had ≥ 1 physician consultation (telemedicine or face-to-face) during the first half of 2018. DTC telemedicine users were matched 1:2 to controls who were non-users of DTC telemedicine but who had a traditional face-to-face consultation during the study period. The matching criteria were diagnosis and demographic and socioeconomic variables. An interrupted time series analysis was performed to compare the healthcare consumption of DTC telemedicine users to that of the control group. Results: DTC telemedicine users increased their healthcare consumption more than controls. The effect seemed to be mostly short term (within a month), but was also present at the intermediate term (2–6 months after the initial consultation). The results were robust across age and disease groups. Conclusion: The results indicate that DTC telemedicine consultations increase the total number of physician consultations in primary healthcare. From a policy perspective, it is therefore important to further investigate for which diagnoses and treatments DTC telemedicine is suitable so that its use can be encouraged when it is most cost-efficient and limited when it is not. Given the fundamentally different models for reimbursement, there are reasons to review and possibly harmonise the incentive structures for DTC telemedicine and traditional primary healthcare.
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| 15. |
- Davidson, Thomas, et al.
(författare)
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In pursuit of QALY weights for relatives : Empirical estimates in relatives caring for older people
- 2008
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Ingår i: European Journal of Health Economics. - : SpringerLink. - 1618-7598 .- 1618-7601. ; 9:3, s. 285-292
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Tidskriftsartikel (refereegranskat)abstract
- This study estimates quality-adjusted life-year (QALY) weights for relatives caring for an older person. The data used are from the Swedish part of the EUROFAMCARE study. A new measure is introduced called the R-QALY weight, defined as the effect on a relative’s QALY weight due to being a relative of a disabled or sick individual. R-QALY weights were created by comparing relatives’ QALY weights with population-based QALY weights. They were also created by comparing with QALY weights reassessed for a hypothetical situation in which the older person needed no care. The results indicate that R-QALY weights are small when compared with population-based weights, but large when compared with QALY weights reassessed for the hypothetical situation. Moreover, R-QALY weights were affected by relatives’ age, sex, and subjective perception of positive and negative aspects of the caregiving situation. These aspects should therefore be taken into account in health economics evaluations using a societal approach.
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| 16. |
- Ericson, Lisa, et al.
(författare)
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Atrial fibrillation : the cost of illness in Sweden
- 2011
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 12:5, s. 479-87
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To provide an estimate of the annual cost of atrial fibrillation (AF) in Sweden.METHODS: Prevalence-based cost analysis of AF in Sweden for 2007. Direct medical (hospitalizations, hospital outpatient care, primary health care, non-pharmacological interventions, pharmaceuticals, and anticoagulation monitoring) and non-medical (transportation associated with health care visits) costs of AF, direct costs of AF complications (stroke and heart failure), and indirect costs (production loss), were included. Data were based on Swedish registries, reports and databases, published literature, and an expert panel.RESULTS: There were 100,557 individuals with AF as primary or secondary diagnosis that were either hospitalized or treated in hospital outpatient care in 2007. The total cost of AF was estimated at 708 million. The major cost driver was the direct cost of complications (54%), followed by hospitalization due to AF including AF as secondary diagnosis (18%), and production loss (12%).CONCLUSION: This is a comprehensive, nation-based cost analysis of AF where relevant data were derived from national registries covering the entire Swedish population. The results showed that the annual cost of AF was high in comparison with other diseases, but likely to be underestimated as a conservative approach was applied in the analysis.
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| 17. |
- Ericson, Lisa, et al.
(författare)
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Societal costs of fetal alcohol syndrome in Sweden
- 2017
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 18:5, s. 575-585
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate the annual societal cost of fetal alcohol syndrome (FAS) in Sweden, focusing on the secondary disabilities thought feasible to limit via early interventions.METHODS: Prevalence-based cost-of-illness analysis of FAS in Sweden for 2014. Direct costs (societal support, special education, psychiatric disorders and alcohol/drug abuse) and indirect costs (reduced working capacity and informal caring), were included. The calculations were based on published Swedish studies, including a register-based follow-up study of adults with FAS, reports and databases, and experts.RESULTS: The annual total societal cost of FAS was estimated at €76,000 per child (0-17 years) and €110,000 per adult (18-74 years), corresponding to €1.6 billion per year in the Swedish population using a prevalence of FAS of 0.2 %. The annual additional cost of FAS (difference between the FAS group and a comparison group) was estimated at €1.4 billion using a prevalence of 0.2 %. The major cost driver was the cost of societal support.CONCLUSIONS: The cost burden of FAS on the society is extensive, but likely to be underestimated. A reduction in the societal costs of FAS, both preventive and targeted interventions to children with FAS, should be prioritized. That is, the cost of early interventions such as placement in family homes or other forms of housing, and special education, represent unavoidable costs. However, these types of interventions are highly relevant to improve the individual's quality of life and future prospects, and also, within a long-term perspective, to limit the societal costs and personal suffering.
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| 18. |
- Forslid, Rikard, et al.
(författare)
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Assessing the consequences of quarantines during a pandemic
- 2021
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 22:7, s. 1115-1128
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Tidskriftsartikel (refereegranskat)abstract
- This paper analyzes the epidemiological and economic effects of quarantines. We use a basic epidemiological model, a SEIR-model, that is calibrated to roughly resemble the COVID-19 pandemic, and we assume that individuals that become infected or are isolated on average lose a share of their productivity. An early quarantine postpones but does not alter the course of the pandemic at a cost that increases in the duration and the extent of the quarantine. For quarantines at later stages of the pandemic there is a trade-off between lowering the peak level of infectious people on the one hand and minimizing fatalities and economic losses on the other hand. A longer quarantine dampens the peak level of infectious people and also reduces the total number of infected persons but increases economic losses. Both the peak level of infectious individuals and the total share of the population that will have been infected are U-shaped in relation to the share of the population in quarantine, while economic costs increase in this share. In particular, a quarantine covering a moderate share of the population leads to a lower peak, fewer deaths and lower economic costs, but it implies that the peak of the pandemic occurs earlier.
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| 19. |
- Gamba, Simona, et al.
(författare)
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The impact of cost-sharing on prescription drug demand : evidence from a double-difference regression kink design
- 2022
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 23, s. 1591-1599
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Tidskriftsartikel (refereegranskat)abstract
- Pharmaceuticals represent the third-largest expenditure item in health care spending in the OECD countries, and cost growth is around 5% per year in many OECD countries. One possible way to contain the rise in pharmaceutical spending is the use of cost-sharing schemes that makes insured individuals directly bear parts of the cost of a drug. This study estimates the price sensitivity of demand for prescription drugs using data on all prescription drug purchases from a random sample of 400,000 Swedes followed from 2010 to 2013. We use a regression kink design (RKD) by exploiting the kinked Swedish cost-sharing scheme to assess the price elasticity. Further, since the cost-sharing scheme has changed over time, we also use a double-difference RKD to account for potential confounding nonlinearities around the kink. Our results indicate that the standard RKD results are biased and exaggerate the price sensitivity. Our preferred double-difference RKD specifications show no or minor price sensitivity (95% CI price elasticity from - 0.12 to 0.02). The results are similar in several sub-group analyses across age groups, sexes, and income quartiles.
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| 20. |
- Gerdtham, Ulf, et al.
(författare)
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Factors affecting chronic obstructive pulmonary disease (COPD)-related costs: a multivariate analysis of a Swedish COPD cohort.
- 2009
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 10:2, s. 217-26
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Tidskriftsartikel (refereegranskat)abstract
- Chronic obstructive pulmonary disease (COPD) is an increasing public health problem, generating considerable costs. The objective of this study was to identify factors affecting COPD-related costs. A cohort of 179 subjects with COPD was interviewed over the telephone on four occasions about their annual use of COPD-related resources. The data set and explanatory variables were analysed by means of multivariate regression techniques for six different types of cost: societal (or total), direct (health care) and indirect (productivity), and three subcomponents of direct costs-hospitalisation, outpatient and medication. Poor lung function, dyspnoea and asthma were independently associated with higher costs. Poor lung function (severity of COPD) significantly increased all six examined cost types. Dyspnoea (breathing problems) also increased costs, though to a varying extent. The presence of reported asthma increased total, direct, outpatient and medication costs. Poor lung function and, to a lesser extent, extent of dyspnoea and concomitant asthma, were all strongly associated with higher COPD-related costs. Strong efforts should be made to prevent the progression of COPD and its symptoms.
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| 21. |
- Granlund, David, 1979-, et al.
(författare)
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Fixed budgets as a cost containment measure for pharmaceuticals
- 2006
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 7:1, s. 37-45
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In Västerbotten County, Sweden, there are two health centers which (in contrast to all other health centers in the region) bear strict responsibility over their pharmaceutical budget. This study examined whether the prices and quantities of pharmaceuticals prescribed by physicians working at these health centers differ significantly from those prescribed by physicians at health centers with open-ended budgets. Estimation results using matching methods, which allows us to compare similar patients at the different health centers, show that the introduction of fixed pharmaceutical budgets did not affect physicians' prescription behavior, indicating that fixed budgets may not be an efficient measure to reduce costs. Another explanation is that the health centers under study already had taken measures to contain costs, making it hard to further reduce costs.
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| 22. |
- Granlund, David, et al.
(författare)
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Parallel Imports and Mandatory Substitution Reform : a kick or a muff for price competition in pharmaceuticals?
- 2015
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 16:9, s. 969-983
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Tidskriftsartikel (refereegranskat)abstract
- What has been the effect of competition from parallel imports on prices of locally-sourced on-patent drugs? Did the 2002 Swedish mandatory substitution reform increase this competition? To answer these questions, we carried out difference-in-differences estimation on monthly data for a panel of all on-patent prescription drugs sold in Sweden during the 40 months from January 2001 through April 2004. On average, facing competition from parallel imports caused a 15-17% fall in price. While the reform increased the effect of competition from parallel imports, it was only by 0.9%. The reform, however, did increase the effect of therapeutic competition by 1.6%.
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| 23. |
- Granlund, David, 1979-
(författare)
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The effect of health care expenditure on sickness absence
- 2010
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 11:6, s. 555-568
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Tidskriftsartikel (refereegranskat)abstract
- Increased health care expenditure could be used to improve quality of care or reduce waiting time and could therefore be expected to affect the health and sickness absence of a population. Still, based on data from a panel of Swedish municipalities, public health care expenditure was found to have no, or only a negligible effect on absence due to sickness or disability. The same result was obtained when separate estimates were done for men and women and for absence due to sickness and disability.
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| 24. |
- Gustavsson, Anders, et al.
(författare)
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Disease progression and costs of care in Alzheimer's disease patients treated with donepezil: a longitudinal naturalistic cohort.
- 2012
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 13:5, s. 561-568
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Improved data and methods are needed for modeling disease progression in Alzheimer's disease (AD) for economic evaluation of treatments. The aim is to estimate prediction models for long-term AD progression and subsequently economic outcomes. METHODS: Three-year follow-up data on 435 patients treated with the cholinesterase inhibitor donepezil in clinical practise were analyzed. Regression models were estimated for long-term prediction of decline in cognitive function (ADAS-cog) and activities in daily living (ADL) ability, risk of institutionalization and costs of care. RESULTS: The cognitive deterioration was estimated at between 1.6 and 4 ADAS-cog points per every 6 months, increasing with disease severity. Cognitive function was an important predictor of ADL-ability, which itself was the most important predictor of the risk of institutionalization and costs of care. Combining all models in a cross-validation process generated accurate predictions of costs of care at each 6 months follow-up. CONCLUSION: The proposed methods for representing AD progression and economic outcomes can be used in micro-simulation models for the economic evaluation of new treatments.
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| 25. |
- Gyllensten, Hanna, 1979, et al.
(författare)
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Costs of illness of multiple sclerosis in Sweden : a population-based register study of people of working age
- 2018
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 19:3, s. 435-446
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Multiple sclerosis (MS) causes work disability and healthcare resource use, but little is known about the distribution of the associated costs to society.OBJECTIVES: We estimated the cost of illness (COI) of working-aged individuals with MS, from the societal perspective, overall and in different groups.METHODS: A population-based study was conducted, using data linked from several nationwide registers, on 14,077 individuals with MS, aged 20-64 years and living in Sweden. Prevalence-based direct and indirect costs in 2010 were calculated, including costs for prescription drug use, specialized healthcare, sick leave, and disability pension.RESULTS: The estimated COI of all the MS patients were SEK 3950 million, of which 75% were indirect costs. MS was the main diagnosis for resource use, causing 38% of healthcare costs and 67% of indirect costs. The distribution of costs was skewed, in which less than 25% of the patients accounted for half the total COI.CONCLUSIONS: Indirect costs contributed to approximately 75% of the estimated overall COI of MS patients of working age in Sweden. MS was the main diagnosis for more than half of the estimated COI in this patient group. Further studies are needed to gain knowledge on development of costs over time during the MS disease course.
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| 26. |
- Hallberg, S., et al.
(författare)
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Healthcare costs associated with cardiovascular events in patients with hyperlipidemia or prior cardiovascular events : estimates from Swedish population-based register data
- 2016
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 17:5, s. 591-601
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Tidskriftsartikel (refereegranskat)abstract
- To estimate healthcare costs of new cardiovascular (CV) events (myocardial infarction, unstable angina, revascularization, ischemic stroke, transient ischemic attack, heart failure) in patients with hyperlipidemia or prior CV events. A retrospective population-based cohort study was conducted using Swedish national registers and electronic medical records. Patients with hyperlipidemia or prior CV events were stratified into three cohorts based on CV risk level: history of major cardiovascular disease (CVD), coronary heart disease (CHD) risk-equivalent, and low/unknown risk. Propensity score matching was applied to compare patients with new events to patients without new events for estimation of incremental costs of any event and by event type. A CV event resulted in increased costs over 3 years of follow-up, with the majority of costs occurring in the 1st year following the event. The mean incremental cost of patients with a history of major CVD (n = 6881) was a,not sign8588 during the 1st year following the event. This was similar to that of CHD risk-equivalent patients (n = 3226; a,not sign6663) and patients at low/unknown risk (n = 2497; a,not sign8346). Ischemic stroke resulted in the highest 1st-year cost for patients with a history of major CVD and CHD risk-equivalent patients (a,not sign10,194 and a,not sign9823, respectively); transient ischemic attack in the lowest (a,not sign3917 and a,not sign4140). Incremental costs remained elevated in all cohorts during all three follow-up years, with costs being highest in the major CVD history cohort. Healthcare costs of CV events are substantial and vary considerably by event type. Incremental costs remain elevated for several years after an event.
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| 27. |
- Heckley, Gawain, et al.
(författare)
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Frequency and intensity of alcohol consumption : New Evidence from Sweden
- 2016
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 18:4, s. 495-517
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Tidskriftsartikel (refereegranskat)abstract
- There is an increasing body of evidence that the intensity in which alcohol is drunk is of greater concern than the frequency or overall quantity consumed. This paper provides an extensive analysis of the demand for alcohol as measured by total quantity, frequency, and intensity. A unique large sample of cross-sectional data from Sweden 2004–2011 allows reduced-form alcohol demand equations to be estimated for beer, wine, and spirits, split by alcohol drinking pattern (average vs. binge drinkers) and gender. Results find a negative beer excise rate effect for participation and frequency, and positive effect for intensity. The effect was stronger for binge drinkers. Generally, the results also show a positive socioeconomic (income and education) gradient in frequency demand and a negative gradient in the intensity demand. Female wine drinkers show a positive socioeconomic gradient in both frequency and intensity. The findings highlight the complexity of this policy space. Tax increases appear to reduce frequency but raise intensity consumed. The more educated and higher earners drink more in total, but less intensely when they do and this is likely to explain in part why poor health is concentrated amongst lower socioeconomic status individuals.
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| 28. |
- Holmerova, I, et al.
(författare)
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Costs of dementia in the Czech Republic
- 2017
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7601. ; 18:8, s. 979-986
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Tidskriftsartikel (refereegranskat)
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| 29. |
- Hultkrantz, Lars, 1952-
(författare)
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Discounting in economic evaluation of healthcare interventions : what about the risk term?
- 2021
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 22:3, s. 357-363
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Forskningsöversikt (refereegranskat)abstract
- Results from economic evaluations of long-term outcomes are strongly dependent on the chosen discount rate. A recent review of national guidelines for evaluation of healthcare interventions finds that "the level of currently used discount rates seems relatively high in many countries". However, this conclusion comes from a comparison to rates derived or observed for investments in safe assets, while rate of return requirements are typically considerably higher when investment involves risk. This paper reviews recent literature on how to account for project-specific risk in determination of the social rate of discount and discusses implications for economic evaluation of healthcare interventions. It concludes that the available empirical evidence strongly suggests that the demand for and consumer value of health and healthcare is co-variant with income, which therefore implies that there is a non-diversifiable risk component of health-related investment.
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| 30. |
- Jarl, Johan, et al.
(författare)
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The Danish effect on Swedish alcohol costs An analysis based on hospitalization data from southern Sweden.
- 2006
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 7:1, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated: (a) the cost and change in hospitalizations related to alcohol misuse for the healthcare sector and (b) the effect of distance to the border on alcohol-related hospitalization costs. The first objective was analyzed using descriptive statistics and the second using ordinary least squares regression on aggregated municipality data. The total cost decreased marginally during the study period while the number of patient-cases decreased substantially, presenting evidence of a substitution towards outpatient care. The increase in average treatment cost and the almost constant total cost provide evidence for a societal increase in the burden of alcohol-related diseases. We found a negative effect for distance to Denmark on alcohol-related hospitalization cost for the year 2003. The effect was smaller for 1998, suggesting that the increase in private import quotas during the study period has affected individuals’ consumption level and/or consumption pattern. We also found indications that the increase in import quotas lead to a higher cost increase for heavy consumers than for low consumers.
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| 31. |
- Jarl, Johan, et al.
(författare)
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The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002
- 2008
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 9:4, s. 351-360
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Tidskriftsartikel (refereegranskat)abstract
- This article estimates the societal cost of alcohol consumption in Sweden in 2002, as well as the effects on health and quality of life. The estimation includes direct costs, indirect costs and intangible costs. Relevant cost-of-illness methods are applied using the human capital method and prevalence-based estimates, as suggested in existing international guidelines, allowing cautious comparison with prior studies. The results show that the net cost (i.e. including protective effects of alcohol consumption) is 20.3 billion Swedish kronor (SEK) and the gross cost (counting only detrimental effects) is 29.4 billon (0.9 and 1.3% of GDP). Alcohol consumption is estimated to cause a net loss of 121,800 QALYs. The results are within the range found in prior studies, although at the low end. A large number of sensitivity analyses are performed, indicating a sensitivity range of 50%.
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| 32. |
- Jedrzejczak, J, et al.
(författare)
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Economic and social cost of epilepsy in Poland: 5-year analysis
- 2021
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7601. ; 22:3, s. 485-497
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Tidskriftsartikel (refereegranskat)
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| 33. |
- Johansson, Naimi, 1988, et al.
(författare)
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Effects of primary care cost-sharing among young adults : Varying impact across income groups and gender
- 2019
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 20:8, s. 1271-1280
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Tidskriftsartikel (refereegranskat)abstract
- We estimate the price sensitivity in health care among adolescents and young adults, and assess how it varies across income groups and gender, using a regression discontinuity design. We use the age differential cost-sharing in Swedish primary care as our identification strategy. At the 20th birthday, the copayment increases from €0 to approx. €10 per primary care physician visit and close to this threshold the copayment faced by each person is distributed almost as good as if randomized. The analysis is performed using high-quality health care and economic register data of 73,000 individuals aged 18–22. Our results show that the copayment decreases the average number of visits by 7%. Among women visits are reduced by 9%, for low-income individuals by 11%, and for low-income women by 14%. In conclusion, modest copayments have significant utilization effects, and even in a policy context with relatively low income inequalities, the effect is substantially larger in low-income groups and among women.
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| 34. |
- Jönsson, Bengt, et al.
(författare)
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Advanced therapy medicinal products and health technology assessment principles and practices for value-based and sustainable healthcare
- 2019
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Ingår i: European Journal of Health Economics. - : Springer Verlag (Germany). - 1439-6637 .- 1618-7598 .- 1618-7601. ; 20:3, s. 427-438
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Tidskriftsartikel (refereegranskat)abstract
- Background: Advanced therapy medicinal products (ATMPs) are beginning to reach European markets, and questions are being asked about their value for patients and how healthcare systems should pay for them. Objectives: To identify and discuss potential challenges of ATMPs in view of current health technology assessment (HTA) methodology—specifically economic evaluation methods—in Europe as it relates to ATMPs, and to suggest potential solutions to these challenges. Methods: An Expert Panel reviewed current HTA principles and practices in relation to the specific characteristics of ATMPs. Results: Three key topics were identified and prioritised for discussion—uncertainty, discounting, and health outcomes and value. The panel discussed that evidence challenges linked to increased uncertainty may be mitigated by collection of follow-on data, use of value of information analysis, and/or outcomes-based contracts. For discount rates, an international, multi-disciplinary forum should be established to consider the economic, social and ethical implications of the choice of rate. Finally, consideration of the feasibility of assessing the value of ATMPs beyond health gain may also be key for decision-making. Conclusions: ATMPs face a challenge in demonstrating their value within current HTA frameworks. Consideration of current HTA principles and practices with regards to the specific characteristics of ATMPs and continued dialogue will be key to ensuring appropriate market access.
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| 35. |
- Jönsson, Bengt
(författare)
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Disruptive innovation and EU health policy
- 2017
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Ingår i: European Journal of Health Economics. - : Springer Verlag (Germany). - 1439-6637 .- 1618-7598 .- 1618-7601. ; 18:3, s. 269-272
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Tidskriftsartikel (refereegranskat)
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| 36. |
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| 37. |
- Jönsson, Bengt, et al.
(författare)
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Patient access to rheumatoid arthritis treatments
- 2008
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 8:Suppl. 2, s. 33-34
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 38. |
- Jönsson, B, et al.
(författare)
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The burden of rheumatoid arthritis and access to treatment: uptake of new therapies
- 2008
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 8:Suppl. 2, s. 61-86
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents data on international differences in use of TNF inhibitors. It is part of a study on burden and cost of RA, access to new therapies and the role of HTA in determining access and cost-effectiveness. United States has the fastest most extensive use of the new drugs, about three times the average in the western European countries and Canada. Eastern and central European countries as well as Australia, South Africa and Turkey lag far behind. However, some smaller European countries, most notably Norway and Sweden have use of the new drugs not far behind the United States. While the income level of the country, and thus the health care expenditures per capita is a major factor for determining use in low and middle income countries, there are still considerable differences among countries with similar high total health care expenditures. Differences in prices are considerable between the US and Europe due to the changes in exchange rates between the US dollar and the Euro, but high and low use is not systematically related to differences in price.
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| 39. |
- Jönsson, Bengt, et al.
(författare)
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The Cost-Effectiveness of Dual Oral Antiplatelet Therapy following Percutaneous Coronary Intervention : A Swedish Analysis of the CREDO Trial
- 2005
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Ingår i: The European Journal of Health Economics. - : Springer-Verlag. - 1618-7601 .- 1618-7598. ; 6:4, s. 354-362
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Tidskriftsartikel (refereegranskat)abstract
- The CREDO trial demonstrated the clinical efficacy of 12-month antiplatelet therapy with clopidogrel compared to standard 28-day treatment with a 27% relative reduction in the combined risk of death, myocardial infarction, or stroke in patients undergoing percutaneous coronary intervention (PCI) and being treated with aspirin. This study evaluated the long-term cost-effectiveness of 12-month vs. 28-day therapy with clopidogrel in Sweden. A Markov model was developed which assumed a hypothetical cohort of patients in a post-PCI state to have certain risks of suffering one of the endpoints of the CREDO trial: stroke, myocardial infarction, or death. The model predicted a mean survival of 12.098 years in the 12-month arm vs. 12.026 in the 28-day arm, an incremental gain of 0.072 life-years. The gain in survival came at a predicted incremental cost of €217, resulting in an incremental cost-effectiveness ratio of €3,022. Thus the predicted cost-effectiveness ratio of long-term treatment with clopidogrel in patients undergoing PCI is well below the threshold values currently considered cost-effective.
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| 40. |
- Jönsson, Bengt
(författare)
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The cost of multiple sclerosis in Europe
- 2006
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Ingår i: The European Journal of Health Economics. - : Zentralbibliothek der Wirtschaftswissenschaften in der Bundesrepublik Deutschland. - 1618-7601 .- 1618-7598. ; 7:2, s. 3-4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Multiple sclerosis (MS) is an autoimmune disease of the central nervous system with onset in the early thirties. The disease is characterized by inflammation, destruction of the myelin coating of nerve fibres and axonal loss that lead to symptoms such as visual and sensory disturbances, limb weakness, gait problems and neurogenic bladder and bowel symptoms, all of which become increasingly disabling over time. Irreversible functional disability occurs early, making MS the second most common cause of neurological disability in young adults.
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| 41. |
- Jönsson, Bengt, et al.
(författare)
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Time for a change in drug licensing requirements?
- 2002
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Ingår i: The European journal of health economics. - : Springer Science and Business Media LLC. - 1618-7601 .- 1618-7598. ; 3:2, s. 137-138
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Tidskriftsartikel (refereegranskat)
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| 42. |
|
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| 43. |
- Jönsson, L
(författare)
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Economic evidence in dementia: a review
- 2004
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7598. ; 5 Suppl 1, s. S30-5
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Tidskriftsartikel (refereegranskat)
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| 44. |
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| 45. |
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| 46. |
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| 47. |
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| 48. |
- Kobelt, G, et al.
(författare)
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Costs and quality of life of multiple sclerosis in Austria
- 2006
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7598. ; 7 Suppl 2, s. S14-23
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Tidskriftsartikel (refereegranskat)
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| 49. |
- Kobelt, G, et al.
(författare)
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Costs and quality of life of multiple sclerosis in Germany
- 2006
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7598. ; 7 Suppl 2, s. S34-44
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Tidskriftsartikel (refereegranskat)
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| 50. |
- Kobelt, G, et al.
(författare)
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Costs and quality of life of multiple sclerosis in Italy
- 2006
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Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - : Springer Science and Business Media LLC. - 1618-7598. ; 7 Suppl 2, s. S45-54
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Tidskriftsartikel (refereegranskat)
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