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- Ekman, Björn
(author)
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Cost Analysis of a Digital Health Care Model in Sweden
- 2018
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In: PharmacoEconomics Open. - : Springer Science and Business Media LLC. - 2509-4254 .- 2509-4262. ; 2:3, s. 347-354
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Journal article (peer-reviewed)abstract
- Digital technologies in health care areexpected to increase in scope and to affect ever more partsof the health care system. It is important to enhance theknowledge of whether new digital methods and innovationsprovide value for money compared with traditional modelsof care.Objective The objective of the study was to evaluatewhether a digital health care model for primary care is aless costly alternative compared with traditional in-officeprimary care in Sweden.Methods Cost data for the two care models were collectedand analyzed to obtain a measure in local currency per carecontact.Results The comparison showed that the total economiccost of a digital consultation is 1960 Swedish krona (SEK)(SEK100 = US$11.29; February 2017) compared withSEK3348 for a traditional consultation at a health careclinic. Cost differences arose on both the provider side andon the user side.Conclusion The digital health care model may be a lesscostly alternative to the traditional health care model.Depending on the rate of digital substitution, gross economiccost savings of between SEK1 billion and SEK10billion per year could be realized if more digital consultationswere made. Further studies are needed to validatethe findings, assess the types of care most suitable fordigital care, and also to obtain various quality-adjustedoutcome measures.
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- Eliasson, Björn, 1959, et al.
(author)
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Long-Term Cost Effectiveness of Oral Semaglutide Versus Empagliflozin and Sitagliptin for the Treatment of Type 2 Diabetes in the Swedish Setting
- 2022
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In: Pharmacoeconomics-Open. - : Springer Science and Business Media LLC. - 2509-4262 .- 2509-4254. ; 6:3, s. 343-354
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Journal article (peer-reviewed)abstract
- Objective The aim of this study was to assess the cost effectiveness of oral semaglutide versus other oral glucose-lowering drugs for the management of type 2 diabetes (T2D) in Sweden. Methods The Swedish Institute for Health Economics Diabetes Cohort Model was used to assess the cost effectiveness of oral semaglutide 14 mg versus empagliflozin 25 mg and oral semaglutide 14 mg versus sitagliptin 100 mg, using data from the head-to-head PIONEER 2 and 3 trials, respectively, in which these treatments were added to metformin (+/- sulphonylurea). Base-case and scenario analyses were conducted. Robustness was evaluated with deterministic and probabilistic sensitivity analyses. Results In the base-case analyses, greater initial lowering of glycated haemoglobin levels with oral semaglutide versus empagliflozin and oral semaglutide versus sitagliptin, respectively, resulted in reduced incidences of micro- and macrovascular complications and was associated with lower costs of complications and indirect costs. Treatment costs were higher for oral semaglutide, resulting in higher total lifetime costs than with empagliflozin (Swedish Krona [SEK] 1,245,570 vs. 1,210,172) and sitagliptin (SEK1,405,789 vs. 1,377,381). Oral semaglutide was shown to be cost effective, with an incremental cost-effectiveness ratio (ICER) of SEK239,001 per quality-adjusted life-year (QALY) compared with empagliflozin and SEK120,848 per QALY compared with sitagliptin, from a payer perspective. ICERs were lower at SEK191,721 per QALY compared with empagliflozin and SEK95,234 per QALY compared with sitagliptin from a societal perspective. Results were similar in scenario analyses that incorporated cardiovascular effects, and also in sensitivity analyses. Conclusions In a Swedish setting, oral semaglutide was cost effective compared with empagliflozin and sitagliptin for patients with T2D inadequately controlled on oral glucose-lowering drugs.
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- Fridhammar, Adam, et al.
(author)
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The Value of a New Diagnostic Test for Prostate Cancer : A Cost-Utility Analysis in Early Stage of Development
- 2021
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In: PharmacoEconomics - Open. - : Springer Science and Business Media LLC. - 2509-4262 .- 2509-4254. ; 5:1, s. 77-88
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Journal article (peer-reviewed)abstract
- Background: Standard biopsy for prostate cancer diagnosis is an unpleasant and sometimes painful procedure with a detection rate as low as around 50%. Consequently, an accurate blood-based test would be highly desirable to improve the predictive accuracy. However, the clinical value of a new blood test for diagnosing prostate cancer depends on its sensitivity and specificity, in relation to the selected target population. Objective: The aim of this analysis was to investigate the health-economic value of introducing a new and more accurate diagnostic blood-based test to identify men in need of a biopsy to diagnose prostate cancer. Method: We developed a Discrete Event Simulation Model with outputs including number of biopsies, cancer diagnosis, treatments and prostate cancer deaths. The analysis was performed from a health care perspective. It used epidemiologic data, treatment patterns, and health care costs from the Swedish region Skåne (population of 1.3 million). A 90% sensitivity and specificity of the new test was assumed. Results: Among 31,250 men, age 50–69 years, 16.4% had a PSA between 3.0 and 9.9 µg/L and 28.9% a PSA of 2.0–9.9 µg/L. Testing men with PSA 3.0–9.9 µg/L, as in current clinical practice, decreased the number of biopsies by 3595, detected 61 more cancers, resulting in and two more fatalities and subsequently a loss of 14 QALYs. Cost offsets could justify a test value of SEK 4996. Testing a larger population, PSA 2.0–9.9 µg/L prevented 6 deaths, added 50 QALYs, and could justify a value of the test of SEK 5165, given a value of health of SEK 500,000 per QALY. Conclusion: A new blood-based test for prostate cancer has a significant potential to reduce the number of biopsies needed, resulting in reduced health care costs and improve patient care.
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- Granlund, David, 1979-, et al.
(author)
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Can Private Provision of Primary Care Contribute to the Spread of Antibiotic Resistance? : A Study of Antibiotic Prescription in Sweden
- 2021
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In: PharmacoEconomics - Open. - : Springer. - 2509-4262 .- 2509-4254. ; 5:2, s. 187-195
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Journal article (peer-reviewed)abstract
- Background: Growing rates of antibiotic resistance, caused by increasing antibiotic use, pose a threat by making antibiotics less effective in treating infections.Objective: We aimed to study whether physicians working at privately and publicly owned health centres differed in the likelihood of prescribing antibiotics and choosing broad-spectrum over narrow-spectrum antibiotics.Methods: To estimate the effect of ownership on the probability of a prescribed drug being an antibiotic, we analysed all 4.5 million prescriptions issued from 2011 to 2015 at primary health centres in Västerbotten, Sweden. We controlled for patient age, sex, number of prescriptions per patient, and month of prescription, and used a maximum likelihood logit estimator. We then analysed how ownership affected the likelihood of a prescribed antibiotic being broad spectrum. We also used aggregated data to estimate the impact of the number of private health centres on the number of antibiotic prescriptions per inhabitant and the proportion of broad-spectrum antibiotics.Results: Holding other factors constant, private physicians were 6% more likely to prescribe antibiotics and 9% more likely to choose broad-spectrum antibiotics. An increase by one additional private health centre was positively associated with an increase in the number of antibiotic prescriptions per inhabitant and a higher proportion, although not significant, of broad-spectrum antibiotic prescriptions.Conclusion: Our findings suggest that private physicians prescribe more antibiotics, especially broad-spectrum antibiotics, than public physicians. Therefore, it is crucial to provide health centres with incentives to follow guidelines for antibiotic prescription, especially when the level of private provision of primary healthcare is high.
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- Karampampa, Korinna, et al.
(author)
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Healthcare, Sickness Absence, and Disability Pension Cost Trajectories in the First 5 Years After Diagnosis with Multiple Sclerosis: A Prospective Register-Based Cohort Study in Sweden.
- 2020
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In: PharmacoEconomics - open. - : Springer Science and Business Media LLC. - 2509-4254 .- 2509-4262. ; 4, s. 91-103
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Journal article (peer-reviewed)abstract
- The aim was to longitudinally explore the healthcare, sickness absence (SA), and disability pension (DP) cost trajectories among newly diagnosed people with multiple sclerosis (MS), and investigate whether trajectories differ by year of MS diagnosis, sociodemographics, and multi-morbidity.People with MS in Sweden, aged 25-60years and with a new MS diagnosis in the years 2006, 2007, 2008, or 2009 (four different cohorts) were identified in nationwide registers and followed prospectively for 5years, determining the annual, per patient, direct (inpatient and specialised outpatient healthcare, co-payments, and dispensed drugs) and indirect (SA and DP) costs. Descriptive statistics and group-based trajectories were computed.In total, 3272 people with new MS were identified. In all cohorts, direct costs increased the year after diagnosis and thereafter declined (e.g. from €8261 to €9128, and to €7953, 5years after diagnosis, for the 2006 cohort). SA costs continuously decreased over 5years, while DP costs increased (e.g. from €9795 to €2778 vs. from €7277 to €15,989, respectively, for the 2006 cohort). When pooling all cohorts, four trajectories of direct and indirect costs were identified. A total of 32.1% of people with MS had high direct and indirect costs, which first increased and then decreased; the contrary was seen for trajectories with low direct and indirect costs.There is heterogeneity in the development of MS costs over time after diagnosis; decreasing cost trajectories could be associated with the use of innovative MS therapies, slowing disease progression over time.
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