Cheryl McDade

Cost-Utility of Aspirin and Proton Pump Inhibitors for Primary Prevention

BACKGROUNDnAspirin reduces myocardial infarction but increases gastrointestinal tract (GI) bleeding. Proton pump inhibitors (PPIs) may reduce upper GI bleeding. We estimate the cost-utility of aspirin treatment with or without a PPI for coronary heart disease (CHD) prevention among men at different risks for CHD and GI bleeding.nnnMETHODSnWe updated a Markov model to compare costs and outcomes of low-dose aspirin plus PPI (omeprazole, 20 mg/d), low-dose aspirin alone, or no treatment for CHD prevention. We performed lifetime analyses in men with different risks for cardiovascular events and GI bleeding. Aspirin reduced nonfatal myocardial infarction by 30%, increased total stroke by 6%, and increased GI bleeding risk 2-fold. Adding a PPI reduced upper GI bleeding by 80%. Annual aspirin cost was

Cost-effectiveness of 2 + 1 dosing of 13-valent and 10-valent pneumococcal conjugate vaccines in Canada

13.99; the generic PPI cost was

Cost Effectiveness of 5-Alpha Reductase Inhibitors for the Prevention of Prostate Cancer in Multiple Patient Populations

200.00.nnnRESULTSnIn 45-year-old men with a 10-year CHD risk of 10% and 0.8 per 1000 annual GI bleeding risk, aspirin (

Cost effectiveness of chemoprevention for prostate cancer with dutasteride in a high-risk population based on results from the REDUCE Clinical trial

17,571 and 18.67 quality-adjusted life-years [QALYs]) was more effective and less costly than no treatment (

Model-Based Cost-Effectiveness Analyses for Prostate Cancer Chemoprevention

18,483 and 18.44 QALYs). Compared with aspirin alone, aspirin plus PPI (

Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model

21,037 and 18.68 QALYs) had an incremental cost per QALY of

Economic analysis: Randomized, placebo-controlled clinical trial of dutasteride in men at high risk for prostate cancer:

447,077. Results were similar in 55- and 65-year-old men. The incremental cost per QALY of adding a PPI was less than

Pneumococcal Vaccination Provides Substantial Value for Money for Canadians

50,000 per QALY at annual GI bleeding probabilities greater than 4 to 6 per 1000.nnnCONCLUSIONSnTreatment with aspirin for CHD prevention is less costly and more effective than no treatment in men older than 45 years with greater than 10-year, 10% CHD risks. Adding a PPI is not cost-effective for men with average GI bleeding risk but may be cost-effective for selected men at increased risk for GI bleeding.

Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People’s Republic of China

BackgroundThirteen-valent pneumococcal conjugate vaccine (PCV13) and 10-valent pneumococcal conjugate vaccine (PCV10) are two recently approved vaccines for the active immunization against Streptococcus pneumoniae causing invasive pneumococcal disease in infants and children. PCV13 offers broader protection against Streptococcus pneumoniae; however, PCV10 offers potential protection against non-typeable Haemophilus influenza (NTHi). We examined public health and economic impacts of a PCV10 and PCV13 pediatric national immunization programs (NIPs) in Canada.MethodsA decision-analytic model was developed to examine the costs and outcomes associated with PCV10 and PCV13 pediatric NIPs. The model followed individuals over the remainder of their lifetime. Recent disease incidence, serotype coverage, population data, percent vaccinated, costs, and utilities were obtained from the published literature. Direct and indirect effects were derived from 7-valent pneumococcal vaccine. Additional direct effect of 4% was attributed to PCV10 for moderate to severe acute otitis media to account for potential NTHi benefit. Annual number of disease cases and costs (2010 Canadian dollars) were presented.ResultsIn Canada, PCV13 was estimated to prevent more cases of disease (49,340 when considering both direct and indirect effects and 7,466 when considering direct effects only) than PCV10. This translated to population gains of 258 to 13,828 more quality-adjusted life-years when vaccinating with PCV13 versus PCV10. Annual direct medical costs (including the cost of vaccination) were estimated to be reduced by

Budgetary impact on a U.S. health plan after adopting umeclidinium/vilanterol (UMEC/VI) for the management of moderate-to-severe COPD

5.7 million to