Melissa L.D. Christopher

Cost‐utility analysis of bevacizumab versus ranibizumab in neovascular age‐related macular degeneration using a Markov model

OBJECTIVE To evaluate the cost-effectiveness of intravitreal bevacizumab to ranibizumab in patients with neovascular age-related macular degeneration (AMD). METHODS A cost-utility analysis using a Markov model was performed to evaluate incremental cost-effectiveness ratio [ICER,

Cost Utility of Tumour Necrosis Factor-α Inhibitors for Rheumatoid Arthritis

US per quality-adjusted life year (QALY) gained] between bevacizumab and ranibizumab from a US payer perspective. Transition probabilities for ranibizumab and bevacizumab were extrapolated from published studies and local institutional data. Utility values, likewise, were obtained from another published study. Mortality rates were determined from the Centers for Disease Control 2003 Life Tables. Resource utilization and total direct costs were estimated using the Centers for Medicare and Medicaid Services and the Veterans Affairs Decision Support System. A hypothetical cohort of 1000 patients was simulated through the model for 20 years. Sensitivity analyses were performed using univariate and probabilistic sensitivity analysis (PSA) on all costs, transition probabilities and utility values. An acceptability curve was generated to illustrate the cost-effectiveness probability of bevacizumab to ranibizumab with increasing willingness-to-pay (WTP). RESULTS The cost-effectiveness ratios (CER) for bevacizumab and ranibizumab were

Cost Utility of Tumour Necrosis Factor-α Inhibitors for Rheumatoid Arthritis: An Application of Bayesian Methods for Evidence Synthesis in a Markov Model

1405 per QALY and

Measuring patient satisfaction in the Pharmacy Specialty Immunization Clinic: a pharmacist-run immunization clinic at the Veterans Affairs San Diego Healthcare System.

12,177 per QALY, respectively. The ICER for bevacizumab was dominant compared to ranibizumab. The base-case CER was sensitive to drug costs of the study medications with a breakeven point of

The Authorsʼ Reply

44 for ranibizumab and

Trends in naloxone prescriptions prescribed after implementation of a National Academic Detailing Service in the Veterans Health Administration: A preliminary analysis

2666 for bevacizumab. PSA revealed a 95% probability of bevacizumab being more cost-effective than ranibizumab at a WTP of

Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration’s national program

50,000 per QALY gained. CONCLUSION Based on a WTP defined at

Underutilization of the current clinical capacity to provide buprenorphine treatment for opioid use disorders within the Veterans Health Administration

50,000 per QALY gained, bevacizumab was cost-effective versus ranibizumab 95% of the time because of lower acquisition costs and increased efficacy.

Academic Detailing to Improve Opioid Safety: Implementation Lessons from a Qualitative Evaluation

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease that affects approximately 1.5 million people in the US. Tumour necrosis factor (TNF)-α inhibitors have been shown to effectively treat and maintain remission in patients with moderately to severely active RA compared with conventional agents. The high acquisition cost of TNF-α inhibitors prohibits access, which mandates economic investigations into their affordability. The lack of head-to-head comparisons between these agents makes it difficult to determine which agent is the most cost effective.ObjectiveThis study aimed to determine which TNF-α inhibitor was the most cost-effective agent for the treatment of moderately to severely active RA from the US healthcare payer’s perspective.MethodsA Markov model was constructed to analyse the cost utility of five TNF-α inhibitors (in combination with methotrexate [+MTX]) versus MTX monotherapy using Bayesian methods for evidence synthesis. The model had a cycle length of 3 months and an overall time horizon of 5 years. Transition probabilities and utility scores were based on published studies. Total direct costs were adjusted to year 2009

Iconography : Variability in opioid prescribing in veterans affairs emergency departments and urgent cares

US using the medical component of the Consumer Price Index. All costs and QALYs were discounted at a rate of 3% per year. Patient response to the different strategies was determined by the American College of Rheumatology (ACR)50 criteria. One-way and probabilistic sensitivity analyses (PSAs) were performed to test the robustness of the base-case scenario. The base-case scenario was changed to ACR20 criteria (scenario 1) and ACR70 criteria (scenario 2) to determine the model’s robustness. Cost-effectiveness acceptability curves and cost-effectiveness frontiers were used to estimate the cost-effectiveness probability of each treatment strategy. A willingness-to-pay (WTP) threshold was defined as three times the US GDP per capita (