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Cost-effectiveness analysis of budesonide/formoterol maintenance and reliever therapy versus fixed combination treatments for asthma in Finland*.

https://arctichealth.org/en/permalink/ahliterature154066
Source
Curr Med Res Opin. 2008 Dec;24(12):3453-61
Publication Type
Article
Date
Dec-2008
Author
Klaus Tamminen
Juha Laine
Erkki Soini
Janne Martikainen
Hannu Kankaanranta
Author Affiliation
AstraZeneca, Espoo, Finland.
Source
Curr Med Res Opin. 2008 Dec;24(12):3453-61
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Asthma - drug therapy - economics
Bronchodilator Agents - administration & dosage - economics
Budesonide - administration & dosage - economics
Child
Costs and Cost Analysis
Double-Blind Method
Drug Combinations
Drug Therapy, Combination
Ethanolamines - administration & dosage - economics
Finland
Humans
Male
Middle Aged
Abstract
Budesonide/formoterol maintenance and reliever therapy has shown its effectiveness as a treatment for moderate-to-severe asthma.
To explore the cost-effectiveness of budesonide/formoterol maintenance and reliever therapy as compared to fixed combination therapies (budesonide/formoterol and salmeterol/fluticasone) with terbutaline as needed in the treatment of asthma in Finland.
Patients without asthma exacerbations during a 6-month period were used as the effectiveness variable in the within-trial economic analysis. Finnish unit costs were applied to pooled resource use data, and multinomial cost-effectiveness plane and acceptability curves were formed based on bootstrapping.
Use of budesonide/formoterol maintenance and reliever therapy significantly reduced the rate of severe asthma exacerbations as compared with a fixed dose of budesonide/formoterol or salmeterol/fluticasone and terbutaline as needed. Total costs over 6 months were 496 euros per patient for those who used the budesonide/formoterol maintenance and reliever therapy treatment model, which was 78-101 euros lower than the cost of fixed combinations of salmeterol/fluticasone or budesonide/formoterol with terbutaline as needed. The results indicate that the budesonide/formoterol maintenance and reliever therapy achieves a high probability (> 93%) of cost effectiveness irrespective of willingness to pay level.
Budesonide/formoterol maintenance and reliever therapy may be considered in the treatment of moderate-to-severe asthma instead of conventional treatment with combination products in view of its good clinical efficacy and a high probability of cost-effectiveness in the Finnish setting. However, a cost-effectiveness analysis with a longer time horizon, more Finnish-specific data, and ICS + short/long-acting inhaled beta(2)-agonist as an additional comparator is still warranted.
PubMed ID
19032127 View in PubMed
Less detail

Cost-effectiveness of single agent, uptitration and switching statin treatment strategies for lipid lowering in Sweden.

https://arctichealth.org/en/permalink/ahliterature146775
Source
Curr Med Res Opin. 2010 Feb;26(2):389-96
Publication Type
Article
Date
Feb-2010
Author
Janne A Martikainen
Erkki Soini
Thomas Paulsson
Author Affiliation
ESiOR Oy, P.O. Box 1188, 70211 Kuopio, Finland. janne.martikainen@esior.fi
Source
Curr Med Res Opin. 2010 Feb;26(2):389-96
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Algorithms
Cardiovascular Diseases - economics - prevention & control
Computer simulation
Cost-Benefit Analysis
Dose-Response Relationship, Drug
Health Planning Guidelines
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage - economics
Hyperlipidemias - drug therapy - economics
Hypolipidemic Agents - administration & dosage - economics
Models, Econometric
Retrospective Studies
Sweden
Treatment Outcome
Withholding Treatment
Abstract
To assess which alternative treatment strategies are optimum in terms of cost-effectiveness (EUR/patient treated to target, EUR/PTT) in lowering cholesterol in high-risk patients with elevated LDL-cholesterol (LDL-C) in Sweden.
A probabilistic cost-effectiveness model was developed to estimate the mean expected costs and proportion of patients reaching goal attainment (defined as LDL-C Simva20 --> Simva40, Rosu10, Simva20 --> Rosu10 --> Rosu20 --> Rosu40, or Simva20 --> Simva40 --> Rosu20 --> Rosu40). An important finding was that when LDL-C level exceed 4.0 mmol/L (154mg/dL) and when willingness to pay is less than 500 EUR per additional PTT, the optimal treatment strategy would be to initiate cholesterol-lowering treatment directly with rosuvastatin 10 mg.
The results of this study indicate that the optimal approach to initiate lipid-lowering therapy would be to treat patients with the lower baseline LDL-C levels with the least costly treatment strategies, while initiating lipid-lowering treatment with a high-potency statin (rosuvastatin) in patients with moderately high or high baseline LDL-C levels. This recommendation can be assumed to be relevant particularly when the fact that after treatment initiation the majority of Swedish patients will not have any changes in their lipid-lowering medication or dose is taken into account. Finally, since only the short-term results are presented here, it would be valuable to conduct further studies of the long-term cost-effectiveness of different statin treatment strategies that focus on treatment persistence and LDL-C goal attainment in real practice.
PubMed ID
20001451 View in PubMed
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Cost-effectiveness of statins in the prevention of coronary heart disease events in middle-aged Finnish men.

https://arctichealth.org/en/permalink/ahliterature157163
Source
Curr Med Res Opin. 2008 Jun;24(6):1823-32
Publication Type
Article
Date
Jun-2008
Author
Piia Peura
Janne Martikainen
Erkki Soini
Taru Hallinen
Leo Niskanen
Author Affiliation
Department of Social Pharmacy, Center for Pharmaceutical Policy and Economics (CEPPE), University of Kuopio, Kuopio, Finland. Piia.Peura@uku.fi
Source
Curr Med Res Opin. 2008 Jun;24(6):1823-32
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Cohort Studies
Coronary Disease - prevention & control
Cost-Benefit Analysis
Finland
Fluorobenzenes - economics - therapeutic use
Heptanoic Acids - economics - therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - economics - therapeutic use
Life expectancy
Male
Markov Chains
Middle Aged
Pyrimidines - economics - therapeutic use
Pyrroles - economics - therapeutic use
Quality-Adjusted Life Years
Simvastatin - economics - therapeutic use
Sulfonamides - economics - therapeutic use
Abstract
This study evaluated the long-term cost-effectiveness of atorvastatin 20 mg, rosuvastatin 10 mg and simvastatin 40 mg in primary and secondary prevention of CHD in Finland.
The effect of statin therapy on the incidence of CHD and the expected total costs of the disease were described using a Markov state transition model. Due to the limited amount of evidence concerning mortality and morbidity for rosuvastatin, the model was used to transmute the efficiency data of all statins (decrease in total cholesterol) into long-term endpoints (myocardial infarction, death) using risk functions of the FINRISK and 4S studies. The study followed a characterized cohort of 55-year-old Finnish men with an average 3.3-6.6% baseline risk of dying from cardiovascular disease within a 10-year period.
Incremental cost-effectiveness ratios (ICERs) for atorvastatin and rosuvastatin, compared with simvastatin, measured as cost of life years gained (euro/LYG) and cost of quality adjusted life years gained (euro/QALY).
The use of rosuvastatin increased the life expectancy by 0.27 years on average (LYG) compared with simvastatin, producing additional 0.08 quality-adjusted life-years (QALYs). Compared with simvastatin, the cost of one LYG with rosuvastatin was euro10 834 and the cost of one QALY gained was euro36 548 (discount rate 5% per annum). Corresponding figures for atorvastatin were euro31 286/LYG and euro105 599/QALY.
If the decision makers' willingness to pay for a QALY gained is around euro40 000 there is a high probability (>50%) that rosuvastatin represents a cost-effective form of therapy in the prevention of CHD in middle-aged men with an average 3.3-6.6% risk of dying within 10 years from cardiovascular disease. However, the true clinical impact of these results needs confirmation from on-going clinical trials, as the role of rosuvastatin in reducing clinical events is pending, but for simvastatin and atorvastatin established.
PubMed ID
18485270 View in PubMed
Less detail

Costs of administration, travelling, and productivity losses associated with hospital administration of multiple myeloma drugs in Finland.

https://arctichealth.org/en/permalink/ahliterature302154
Source
J Med Econ. 2019 Apr; 22(4):328-335
Publication Type
Journal Article
Date
Apr-2019
Author
Petri Mankinen
Ville Vihervaara
Saku Torvinen
Janne Martikainen
Erkki Soini
Author Affiliation
a ESiOR Oy , Kuopio , Finland.
Source
J Med Econ. 2019 Apr; 22(4):328-335
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Antineoplastic Agents - administration & dosage - economics - therapeutic use
Bortezomib - administration & dosage - economics - therapeutic use
Costs and Cost Analysis
Efficiency, Organizational - economics
Finland
Humans
Injections, Intravenous
Injections, Subcutaneous
Multiple Myeloma - drug therapy
Oligopeptides - administration & dosage - economics - therapeutic use
Travel - economics
Abstract
To estimate the drug administration, travelling, and productivity costs associated with infusion or subcutaneous proteasome inhibitor (PI) treatments (specifically carfilzomib and bortezomib) for multiple myeloma (MM) patients in Finland.
Price tariffs of Finnish hospital districts are used as the basis of invoicing sent to healthcare service payers. A review of these price tariff lists was conducted and obtained data analysed to estimate the mean unit cost of PI administration visit. Travelling costs stratified by areas with different population densities were assessed, based on the national travelling reimbursement register data maintained by the Social Insurance Institution of Finland. Productivity costs due to time spent on administration visits and travelling were estimated based on an expert interview and a spatial healthcare accessibility analysis.
Nineteen (95%) of the Finnish hospital districts were included in the review. Relevant unit cost information was found for 15 (75%) of the districts. The mean PI administration cost alone was 270€ (95% CI?=?189€-351€) per administration and increased to 371€ when travelling costs were included. Productivity costs added, the mean PI administration costs totalled 405€ for bortezomib and 437€ for carfilzomib.
The costing rationale of price tariffs may vary between hospital districts. Productivity costs were estimated conservatively, due to lack of data.
The administration of intravenous or subcutaneous PIs to treat MM in healthcare facilities causes significant and potentially avoidable healthcare, travelling, and indirect costs, and they should be included in all health economic evaluations (HEEs). As the cost estimates utilized in this study represent most of central hospitals in the country, they provide useful information for future HEEs. A broader conclusion is that novel oral medications, such as the first oral PI, have a significant potential for reducing administration-related costs of subcutaneous or intravenous PIs.
PubMed ID
30644325 View in PubMed
Less detail

Cost-utility analysis of vortioxetine versus agomelatine, bupropion SR, sertraline and venlafaxine XR after treatment switch in major depressive disorder in Finland.

https://arctichealth.org/en/permalink/ahliterature284758
Source
Expert Rev Pharmacoecon Outcomes Res. 2017 Jun;17(3):293-302
Publication Type
Article
Date
Jun-2017
Author
Erkki Soini
Taru Hallinen
Mélanie Brignone
Rosanne Campbell
Françoise Diamand
Sandrine Cure
Maria Aalto-Setälä
Natalya Danchenko
Hannu Koponen
Katarzyna Kolasa
Source
Expert Rev Pharmacoecon Outcomes Res. 2017 Jun;17(3):293-302
Date
Jun-2017
Language
English
Publication Type
Article
Keywords
Acetamides - administration & dosage - economics
Antidepressive Agents - administration & dosage - economics
Bupropion - administration & dosage - economics
Cost-Benefit Analysis
Decision Trees
Depressive Disorder, Major - drug therapy - economics
Finland
Humans
Markov Chains
Models, Theoretical
Piperazines - administration & dosage - economics
Recurrence
Sertraline - administration & dosage - economics
Sulfides - administration & dosage - economics
Treatment Outcome
Venlafaxine Hydrochloride - administration & dosage - economics
Abstract
To assess the cost-utility of vortioxetine versus relevant comparators (agomelatine, bupropion SR, sertraline, and venlafaxine XR) in the finnish setting in major depressive disorder (MDD) patients with inadequate response to selective serotonin- /serotonin-norepinephrine reuptake inhibitors.
A one-year analysis was conducted using a decision tree with a Markov state transition component. The health states were remission, relapse and recovery. A Finnish healthcare payer perspective was adopted.
Vortioxetine was less costly and more effective versus all comparators in both direct and societal perspectives. Vortioxetine reduced the average annual direct costs by 4% versus venlafaxine XR and 8% versus sertraline. The greater efficacy associated with vortioxetine was translated into a higher percentage of patients in remission and recovery. The model was most sensitive to changes in remission rates at 8 weeks.
This cost-utility analysis showed vortioxetine to be a good alternative for MDD patients switching therapy in Finland.
PubMed ID
27680105 View in PubMed
Less detail

Modeled Health Economic Impact of a Hypothetical Certolizumab Pegol Risk-Sharing Scheme for Patients with Moderate-to-Severe Rheumatoid Arthritis in Finland.

https://arctichealth.org/en/permalink/ahliterature291293
Source
Adv Ther. 2017 Oct; 34(10):2316-2332
Publication Type
Comparative Study
Journal Article
Meta-Analysis
Date
Oct-2017
Author
Erkki Soini
Christian Asseburg
Maarit Taiha
Kari Puolakka
Oana Purcaru
Riitta Luosujärvi
Author Affiliation
ESiOR Oy, Kuopio, Finland. erkki.soini@esior.fi.
Source
Adv Ther. 2017 Oct; 34(10):2316-2332
Date
Oct-2017
Language
English
Publication Type
Comparative Study
Journal Article
Meta-Analysis
Keywords
Adult
Aged
Aged, 80 and over
Antirheumatic Agents - economics - therapeutic use
Arthritis, Rheumatoid - drug therapy - economics
Certolizumab Pegol - economics - therapeutic use
Cost-Benefit Analysis - statistics & numerical data
Female
Finland
Humans
Male
Middle Aged
Polyethylene Glycols - economics - therapeutic use
Quality-Adjusted Life Years
Risk Assessment - economics
Treatment Outcome
Abstract
To model the American College of Rheumatology (ACR) outcomes, cost-effectiveness, and budget impact of certolizumab pegol (CZP) (with and without a hypothetical risk-sharing scheme at treatment initiation for biologic-naïve patients) versus the current mix of reimbursed biologics for treatment of moderate-to-severe rheumatoid arthritis (RA) in Finland.
A probabilistic model with 12-week cycles and a societal approach was developed for the years 2015-2019, accounting for differences in ACR responses (meta-analysis), mortality, and persistence. The risk-sharing scheme included a treatment switch and refund of the costs associated with CZP acquisition if patients failed to achieve ACR20 response at week 12. For the current treatment mix, ACR20 at week 24 determined treatment continuation. Quality-adjusted life years were derived on the basis of the Health Utilities Index.
In the Finnish target population, CZP treatment with a risk-sharing scheme led to a estimated annual net expenditure decrease ranging from 1.7% in 2015 to 5.6% in 2019 compared with the current treatment mix. Per patient over the 5 years, CZP risk sharing was estimated to decrease the time without ACR response by 5%-units, decrease work absenteeism by 24 days, and increase the time with ACR20, ACR50, and ACR70 responses by 5%-, 6%-, and 1%-units, respectively, with a gain of 0.03 quality-adjusted life years. The modeled risk-sharing scheme showed reduced costs of €7866 per patient, with a more than 95% probability of cost-effectiveness when compared with the current treatment mix.
The present analysis estimated that CZP, with or without the risk-sharing scheme, is a cost-effective alternative treatment for RA patients in Finland. The surplus provided by the CZP risk-sharing scheme could fund treatment for 6% more Finnish RA patients.
UCB Pharma.
Notes
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PubMed ID
28975568 View in PubMed
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6 records – page 1 of 1.