المؤلفون: Rattanavipapong W; Health Intervention and Technology Assessment Programme, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Rd., Muang, Nonthaburi, Thailand., Poonsiri C; Health Intervention and Technology Assessment Programme, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Rd., Muang, Nonthaburi, Thailand. chittawan.p@hitap.net., Isaranuwatchai W; Health Intervention and Technology Assessment Programme, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Rd., Muang, Nonthaburi, Thailand.; Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Iamsirithaworn S; Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand., Apakupakul J; Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand., Sonthichai C; Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand., Kitphati R; Health Technical Office, Ministry of Public Health, Nonthaburi, Thailand., Teerawattananon Y; Health Intervention and Technology Assessment Programme, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Rd., Muang, Nonthaburi, Thailand.; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

المصدر: Applied health economics and health policy [Appl Health Econ Health Policy] 2023 May; Vol. 21 (3), pp. 511-522. Date of Electronic Publication: 2023 Mar 16.

نوع المنشور: Review; Journal Article

بيانات الدورية: Publisher: Open Mind Journals Ltd Country of Publication: New Zealand NLM ID: 101150314 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1179-1896 (Electronic) Linking ISSN: 11755652 NLM ISO Abbreviation: Appl Health Econ Health Policy Subsets: MEDLINE

مواضيع طبية MeSH: COVID-19 Vaccines* , COVID-19*/prevention & control, Humans ; Cost-Benefit Analysis ; Thailand ; Retrospective Studies ; Quality-Adjusted Life Years

مستخلص: Background and Aims: The introduction of Coronavirus disease 2019 (COVID-19) vaccines urged all Thais to seek prevention of serious illness and death from COVID-19. However, immunocompromised individuals might not be able to achieve an efficient immune response from these vaccines. This study aimed to evaluate the cost-effectiveness and budget impact of introducing Evusheld (tixagevimab plus cilgavimab) for three patient groups-organ transplant, autoimmune disease, and dialysis patients, from the Thai government perspective.
Methods: A Markov decision model was developed to compare the use of Evusheld plus COVID-19 vaccines versus COVID-19 vaccines alone. The methodology followed the National HTA Guidelines of Thailand. Model input parameters were collected locally from retrospective data and from a literature review.
Results: Evusheld helped prevent COVID-19 infection, severe infection, and death in all three patient groups. Using the Thai threshold of 160,000 Thai Baht (THB) per quality-adjusted life year (QALY) gained, the only scenario found to be cost-effective was that of dialysis patients with inadequate immune response, with an incremental cost-effectiveness ratio (ICER) of 54,700 THB per QALY gained. To make a policy of Evusheld provision cost-effective in other groups, the price of Evusheld had to be lower (a reduction of 44-88% of its current price). The results of one-way sensitivity analysis indicated that the cost-effectiveness of Evusheld was sensitive to changes in the rate of infection, cost and efficacy of Evusheld, proportion of inadequate immune responses, and the probability of moving from a 'recovered' to 'susceptible' status.
Conclusion: Among three COVID-19-vaccinated immunocompromised patient populations, this study concluded that Evusheld was cost-effective for dialysis patients with inadequate immune response to the COVID-19 vaccine.
(© 2023. The Author(s).)

المؤلفون: Thiboonboon K; Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Muang, Nonthaburi, 11000, Thailand. kittiphong10@gmail.com., Santatiwongchai B; Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Muang, Nonthaburi, 11000, Thailand., Chantarastapornchit V; Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Muang, Nonthaburi, 11000, Thailand., Rattanavipapong W; Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Muang, Nonthaburi, 11000, Thailand., Teerawattananon Y; Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Muang, Nonthaburi, 11000, Thailand.

المصدر: Applied health economics and health policy [Appl Health Econ Health Policy] 2016 Dec; Vol. 14 (6), pp. 659-672.

نوع المنشور: Journal Article; Review; Systematic Review

بيانات الدورية: Publisher: Open Mind Journals Ltd Country of Publication: New Zealand NLM ID: 101150314 Publication Model: Print Cited Medium: Internet ISSN: 1179-1896 (Electronic) Linking ISSN: 11755652 NLM ISO Abbreviation: Appl Health Econ Health Policy Subsets: MEDLINE

مواضيع طبية MeSH: Cost-Benefit Analysis*, Biomedical Research/*economics , Developed Countries/*economics , Developing Countries/*economics , Evidence-Based Practice/*economics , Rotavirus Vaccines/*economics, Biomedical Research/standards ; Capacity Building/economics ; Capacity Building/methods ; Evidence-Based Practice/standards ; Humans ; Rotavirus Vaccines/standards

مستخلص: Background: For more than three decades, the number and influence of economic evaluations of healthcare interventions have been increasing and gaining attention from a policy level. However, concerns about the credibility of these studies exist, particularly in studies from low- and middle- income countries (LMICs). This analysis was performed to explore economic evaluations conducted in LMICs in terms of methodological variations, quality of reporting and evidence used for the analyses. These results were compared with those studies conducted in high-income countries (HICs).
Methods: Rotavirus vaccine was selected as a case study, as it is one of the interventions that many studies in both settings have explored. The search to identify individual studies on rotavirus vaccines was performed in March 2014 using MEDLINE and the National Health Service Economic Evaluation Database. Only full economic evaluations, comparing cost and outcomes of at least two alternatives, were included for review. Selected criteria were applied to assess methodological variation, quality of reporting and quality of evidence used.
Results: Eighty-five studies were included, consisting of 45 studies in HICs and 40 studies in LMICs. Seventy-five percent of the studies in LMICs were published by researchers from HICs. Compared with studies in HICs, the LMIC studies showed less methodological variety. In terms of the quality of reporting, LMICs had a high adherence to technical criteria, but HICs ultimately proved to be better. The same trend applied for the quality of evidence used.
Conclusion: Although the quality of economic evaluations in LMICs was not as high as those from HICs, it is of an acceptable level given several limitations that exist in these settings. However, the results of this study may not reflect the fact that LMICs have developed a better research capacity in the domain of health economics, given that most of the studies were in theory led by researchers from HICs. Putting more effort into fostering the development of both research infrastructure and capacity building as well as encouraging local engagement in LMICs is thus necessary.