Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
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Comparative Study
The cost-effectiveness of influenza vaccination for people aged 50 to 64 years: an international model.
Routine influenza vaccination is currently recommended in several countries for people aged more than 60 or 65 years or with high risk of complications. A lower age threshold of 50 years has been recommended in the United States since 1999. To help policymakers consider whether such a policy should be adopted more widely, we conducted an economic evaluation of lowering the age limit for routine influenza vaccination to 50 years in Brazil, France, Germany, and Italy. ⋯ Extending routine influenza vaccination to people more than 50 years of age is likely to be cost-effective in all four countries studied.
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Quality-controlled mammography screening programs (MSP) have led to a reduction in breast cancer mortality. The purpose of this economic analysis was to assess the cost-effectiveness of MSP compared with an established opportunistic screening strategy (OS) in Switzerland, to identify the major factors influencing the economic outcome. ⋯ This analysis, performed under conservative assumptions, supports that MSP in Switzerland enables a relevant reduction of breast cancer mortality, at moderate additional cost, compared with OS.
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Comparative Study
Too much ado about propensity score models? Comparing methods of propensity score matching.
A large number of possible techniques are available when conducting matching procedures, yet coherent guidelines for selecting the most appropriate application do not yet exist. In this article we evaluate several matching techniques and provide a suggested guideline for selecting the best technique. ⋯ Sensitivity analysis of the matching techniques is especially important because none of the proposed methods in the literature is a priori superior to the others. The suggested joint consideration of propensity score matching and multivariate analysis offers an approach to assessing the robustness of the estimates.
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It is normally stated that an economic evaluation should take the societal perspective and that this implies the incorporation of all costs and effects, regardless of where these occur. Nevertheless, this broad perspective may be in conflict with the narrower perspective of the health-care decision-makers we are usually trying to aid. In this article, it is argued that not all costs have to be considered equally important for health-care decision-making and that there is a discrepancy between the economically preferred societal perspective and the aim of aiding health-care decision-makers. ⋯ We suggest that it may be useful to adopt a two-perspective approach as a standard, presenting one cost-effectiveness ratio following a strict health-care perspective and one following the common societal perspective. The health-care perspective may assist the health-care policymaker better in achieving health-care goals, while the societal perspective indicates whether the local rationality of the narrow health-care perspective is also in line with societal optimality. More research on actual decisions should provide more insight into the relative weights attached to different types of costs.