Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
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In an effort to sustainably strengthen orthopaedic trauma care in Haiti, a 2-year Orthopaedic Trauma Care Specialist (OTCS) program for Haitian physicians has been developed. The program will provide focused training in orthopaedic trauma surgery and fracture care utilizing a train-the-trainer approach. The purpose of this analysis was to calculate the cost-effectiveness of the program relative to its potential to decrease disability in the Haitian population. ⋯ The current economic analysis suggests the OTCS program to be a highly cost-effective intervention. Probabilistic sensitivity analysis demonstrates that the conclusions remain stable even when considering the joint uncertainty of the cost and DALY estimates.
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The Child Health Utility-9D (CHU-9D) and the Assessment of Quality of Life-6D (AQOL-6D) presently represent the only two generic preference-based instruments developed for application with young people with both adult- and adolescent-specific scoring algorithms. The main objective of this study was to compare and contrast the application of adult and adolescent scoring algorithms for the CHU-9D and AQOL-6D in valuing the health of a community-based sample of adolescents. ⋯ The differences in adolescent and adult values for identical health states are more profound for the CHU-9D and ultimately may be significant enough to have an impact on health care policy. It is important to note that there are important differences between the CHU-9D instrument and the AQOL-6D instrument that may also have a significant impact on the valuations obtained.
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To quantify patients' preferences for new pharmacist independent prescribing services in general practice for managing common existing long-term conditions compared with usual medical prescribing. ⋯ The pharmacist service is valued by patients as an alternative to doctor prescribing in primary care and therefore represents an acceptable form of service delivery when informing policy.
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Given the importance of health insurance for financing medicines and recent policy changes designed to reduce health-related out-of-pocket expenditure (OOPE) in Mexico, our study examined and analyzed the effect of health insurance on the probability and amount of OOPE for medicines and the proportion spent from household available expenditure (AE) funds. ⋯ Medicines were the most prevalent component of health expenditures in Mexico. We recommend improving access to health services and strengthening access to medicines to reduce high OOPE.
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Comparative Study
Cost-effectiveness analysis of the bivalent compared with the quadrivalent human papillomavirus vaccines in Taiwan.
To compare the epidemiological and economic impact of additional cross-protection against oncogenic human papillomavirus (HPV) types beyond 16/18 of the bivalent vaccine (BV) versus protection against nononcogenic HPV types 6/11 of the quadrivalent vaccine (QV) in Taiwan. ⋯ Both vaccines have a different epidemiological impact with an increased number of CC-related lesions potentially prevented for the BV because of additional cross-protection. In the Taiwanese setting, HPV mass vaccination using the BV was estimated to dominate vaccination using the QV.