Expert review of pharmacoeconomics & outcomes research
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Expert Rev Pharmacoecon Outcomes Res · Aug 2021
Artificial intelligence in outcomes research: a systematic scoping review.
Introduction: Despite the number of systematic reviews of how artificial intelligence is being used in different areas of medicine, there is no study on the scope of artificial intelligence methods used in outcomes research, the cornerstone of health technology assessment (HTA). This systematic scoping review aims to systematically capture the scope of artificial intelligence methods used in outcomes research to enhance decision-makers' knowledge and broaden perspectives for health technology assessment and adoption. Areas covered: The review identified 370 studies, consisted of artificial intelligence methods applied to adult patients who underwent any health/medical intervention and reported therapeutic, preventive, or prognostic outcomes. ⋯ The predictive analysis was common in neoplastic disorders. Neural networks algorithm was predominantly found in surgical method studies, but a mixture of artificial intelligence algorithms was applied to the studies with the rest of the interventions. Expert opinion: There are certain gaps in artificial intelligence applications used in outcomes research across therapeutic areas and further considerations are needed by decision-makers before incorporating artificial intelligence usage into HTA decision-making processes.
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Expert Rev Pharmacoecon Outcomes Res · Aug 2021
Comparative StudyCost-effectiveness analyses comparing cemented, cementless, hybrid and reverse hybrid fixation in total hip arthroplasty: a systematic overview and critical appraisal of the current evidence.
Background: This study aims to present an overview and critical appraisal of all previous studies comparing costs and outcomes of the different modes of fixation in total hip arthroplasty (THA). A secondary aim is to provide conclusions regarding the most cost-effective mode of implant fixation per gender and age-specific population in THA, based on high quality studies. Methods: A systematic search was conducted to identify cost-effectiveness analyses (CEAs) comparing different modes of implant fixation in THA. ⋯ Conclusion: Currently available well performed CEAs generally support the use of cemented and hybrid fixation for all age-groups relevant for THA and both genders. However, these findings were mainly based on a single database and depended on assumptions made in the studies' methodology. Issues discussed in this paper have to be considered and future work is needed.
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Expert Rev Pharmacoecon Outcomes Res · Jun 2021
Cost-effectiveness analyses of targeted therapy and immunotherapy for advanced non-small cell lung cancer in the United States: a systematic review.
Introduction: Mutation-targeting and immuno-oncology drugs are revolutionizing the treatment of advanced non-small cell lung cancer (NSCLC). Cost-effectiveness analyses (CEA) of these drugs have been conducted using various analytical methods and cost-effectiveness thresholds. This systematic review provides a comprehensive summary of the available evidence. ⋯ Expert commentary: Medications of interest have changed and are individualized to particular mutations. The cost-effectiveness thresholds varied among sponsors but generally trended to increase over time. This review provides an overview of the available cost-effectiveness findings for stakeholders and contributes to evidence-based practice.
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Expert Rev Pharmacoecon Outcomes Res · Jun 2021
Comparative StudyCost-effectiveness of osimertinib versus standard EGFR-TKI as first-line treatment for locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia.
Objectives: To assess the cost-effectiveness of osimertinib versus standard epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), gefitinib or erlotinib, as first-line treatment for patients with locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia from a healthcare system perspective. Methods: A partitioned survival model comprising three mutually exclusive health states with a five-year time horizon was developed. Model inputs were sourced from the pivotal trial (FLAURA) and published literature. ⋯ The base-case ICER was most sensitive to changes in cost of first-line osimertinib, time horizon, and choice of overall survival data (interim versus final analysis). Conclusions: At a willingness-to-pay threshold of A$50,000/QALY, first-line osimertinib is not cost-effective compared with standard EGFR-TKIs in Australia based on the current published price. To achieve acceptable cost-effectiveness, the cost of first-line osimertinib needs to be reduced by at least 68.4%.
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Expert Rev Pharmacoecon Outcomes Res · Apr 2021
Comparative StudyCost of fremanezumab, erenumab, galcanezumab and onabotulinumtoxinA associated adverse events, for migraine prophylaxis in Spain.
Objective: To compare the cost of adverse events (AEs) associated with preventive treatment of migraine with fremanezumab, versus erenumab, galcanezumab, and onabotulinumtoxinA. Methods: A probabilistic modeling analysis was performed, using second-order Monte Carlo simulations, with 1,000 simulations, in patients with at least 4 days of migraine per month, from the perspective of the National Health System and a time horizon of 12 weeks. ⋯ Results: Fremanezumab would generate average savings of -€469 (95% CI -€303; -€674) versus erenumab, -€268 (95% CI -€171; -€391) versus galcanezumab, -€1,100 (95% CI -€704; -€1,608) or -€1,295 (95% CI -€835; -€1,893) versus onabotulinumtoxinA using real-life or clinical trial data, respectively. Conclusions: The different safety profile of treatment with fremanezumab, compared to erenumab, galcanezumab, and onabotulinumtoxinA, would generate savings in health-care resources in all the scenarios considered.