The CEA Registry Blog

By CEA Registry Team on 1/18/2017 12:56 PM
This week we highlighted findings from recently published cost-effectiveness studies
  • PCSK9 inhibitors to reduce cardiovascular risk found to not add value to U.S. health system and is not profitable for private payers: The current price of PCSK9 inhibitors must be reduced by more than 70% in order to be considered a cost-effective drug to fight cardiovascular disease (1)
  • Diabetes risk-targeted prevention interventions likely cost-effective: A Type II diabetes prevention program targeted towards different at-risk groups in the UK was shown to be cost-effective,  particularly for certain high-risk groups (2)
  • Education program for preventing progression to Type II diabetes likely cost-effective: Compared to standard of care, the structured education program (Let's Prevent) demonstrated higher costs, but also had higher quality of life making it cost-effective at a threshold of £20 000/QALY in the UK (17)
  • Government policy to reduce dietary sodium intake estimated to be highly cost-effective worldwide: A regulation strategy coalescing industry contracts, government monitoring, and public education to reduce dietary sodium is thought to be highly cost effective worldwide (25)
See below for a full list of all cost-utility studies and selected reviews and editorials published January 9-13, 2017.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Arrieta A, Page TF, Veledar E, Nasir K. Economic Evaluation of PCSK9 Inhibitors in Reducing Cardiovascular Risk from Health System and Private Payer Perspectives. PLoS One. 2017 Jan 12;12(1):e0169761. PMID: 28081164.
2: Breeze PR, Thomas C, Squires H, Brennan A, Greaves C, Diggle PJ, Brunner E, Tabak A, Preston L, Chilcott J. The impact of Type 2 diabetes prevention programmes based on risk-identification and lifestyle intervention intensity strategies: a cost-effectiveness analysis. Diabet Med. 2017 Jan 11. PMID: 28075544.
3: Chen Q, Jain N, Ayer T, Wierda WG, Flowers CR, O'Brien SM, Keating MJ, Kantarjian HM, Chhatwal J. Economic Burden of Chronic Lymphocytic Leukemia in the Era of Oral Targeted Therapies in the United States. J Clin Oncol. 2017 Jan 10;35(2):166-174. PMID: 27870563.
4: Dilla T, Alexiou D, Chatzitheofilou I, Ayyub R, Lowin J, Norrbacka K. The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m(2). J Med Econ. 2017 Jan 13:1-10. PMID: 28008768.
5: Ferket BS, Hunink MG, Khanji M, Agarwal I, Fleischmann KE, Petersen SE. Cost-effectiveness of the polypill versus risk assessment for prevention of cardiovascular disease. Heart. 2017 Jan 11. PMID: 28077465.
6: Ferrándiz L, et al. Internet-based skin cancer screening using clinical images alone or in conjunction with dermoscopic images: A randomized teledermoscopy trial. J Am Acad Dermatol. 2017 Jan 12. PMID: 28089728.
7: Fust K, Parthan A, Maschio M, Gu Q, Li X, Lyman GH, Tzivelekis S, Villa G, Weinstein MC. Granulocyte colony-stimulating factors in the prevention of febrile neutropenia: review of cost-effectiveness models. Expert Rev Pharmacoecon Outcomes Res. 2017 Jan 9. PMID: 28064553.
8: Gargano LM, Hajjeh R, Cookson ST. Pneumonia prevention: Cost-effectiveness analyses of two vaccines among refugee children aged under two years, Haemophilus influenzae type b-containing and pneumococcal conjugate vaccines, during a humanitarian emergency, Yida camp, South Sudan. Vaccine. 2017 Jan 11;35(3):435-442. PMID: 27989625.
9: Germar MJ, Purugganan C, Bernardino MS, Cuenca B, Chen YC, Li X, Van Kriekinge G, Lee IH. Cost-effectiveness analysis of AS04-adjuvanted human papillomavirus 16/18 vaccine compared with human papillomavirus 6/11/16/18 vaccine in the Philippines, with the new 2-dose schedule. Hum Vaccin Immunother. 2017 Jan 11:0. PMID: 28075249.
10: Gissel C, Götz G, Repp H. Reply to: Need for improvements in reported cost-effectiveness of adalimumab in rheumatoid arthritis. Z Rheumatol. 2017 Jan 13. PMID: 28084541.
11: Gonzalez L. A Focus on the Program of All-Inclusive Care for the Elderly (PACE). J Aging Soc Policy. 2017 Jan 13. PMID: 28085633.
12: Ivanidze J, et al. Effects of Radiation Exposure on the Cost-Effectiveness of CT Angiography and Perfusion Imaging in Aneurysmal Subarachnoid Hemorrhage. AJNR Am J Neuroradiol. 2017 Jan 12. PMID: 28082263.
13: Javanbakht M, et al. Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial. BMJ Open. 2017 Jan 13;7(1):e013254. PMID: 28087548.
14: Kearns BC, Thomas SM. Cost-effectiveness of superficial femoral artery endovascular interventions in the UK and Germany: a modelling study. BMJ Open. 2017 Jan 13;7(1):e013460. PMID:28087551.
15: Lahr MM, van der Zee DJ, Luijckx GJ, Vroomen PC, Buskens E. Centralising and optimising decentralised stroke care systems: a simulation study on short-term costs and effects. BMC Med Res Methodol. 2017 Jan 10;17(1):5. PMID: 28073360.
16: Lapointe-Shaw L, Voruganti T, Kohler P, Thein HH, Sander B, McGeer A. Cost-effectiveness analysis of universal screening for carbapenemase-producing Enterobacteriaceae in hospital inpatients. Eur J Clin Microbiol Infect Dis. 2017 Jan 11. PMID: 28078557.
17: Leal J, Ahrabian D, Davies MJ, Gray LJ, Khunti K, Yates T, Gray AM. Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial. BMJ Open. 2017 Jan 9;7(1):e013592. PMID: 28069625.

18: Lee JT, Lawson KD, Wan Y, Majeed A, Morris S, Soljak M, Millett C. Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence. Prev Med. 2017 Jan 10. PMID: 28087465.

19: Newhall K, Albright B, Tosteson A, Ozanne E, Trus T, Goodney PP. Cost-effectiveness of prophylactic appendectomy: a Markov model. Surg Endosc. 2017 Jan 11. PMID: 28078461.
20: Petracchi F, Paez C, Igarzabal L. Cost-effectiveness of cytogenetic evaluation of products of conception by chorionic villous sampling in recurrent miscarriage. Prenat Diagn. 2017 Jan 9. PMID: 28067420.
21: Rogers BL, Wilner LB, Maganga G, Walton SM, Suri DJ, Langlois BK, Chui KK, Boiteau JM, Vosti SA, Webb P. Program changes are effective and cost-effective in increasing the amount of oil used in preparing corn soy blend porridge for treatment of moderate acute malnutrition in Malawi. Matern Child Nutr. 2017 Jan 12. PMID: 28083927.
22: Sheng G, Chen S, Dong C, Zhang R, Miao M, Wu D, Tan SC, Liu C, Xiong T. Societal implications of medical insurance coverage for imatinib as first-line treatment of chronic myeloid leukemia in China: a cost-effectiveness analysis. J Med Econ. 2017 Jan 12:1-11. PMID:27936995.
23: van Werkhoven CH, Postma DF, Mangen MJ, Oosterheert JJ, Bonten MJ; CAP-START study group.. Cost-effectiveness of antibiotic treatment strategies for community-acquired pneumonia: results from a cluster randomized cross-over trial. BMC Infect Dis. 2017 Jan 10;17(1):52. PMID: 28068956.
24: Walker KF, Dritsaki M, Bugg G, Macpherson M, McCormick C, Grace N, Wildsmith C, Bradshaw L, Smith GC, Thornton JG. Labour induction near term for women aged 35 or over: an economic evaluation. BJOG. 2017 Jan 11. PMID: 28075507.
25: Webb M, Fahimi S, Singh GM, Khatibzadeh S, Micha R, Powles J, Mozaffarian D. Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations. BMJ. 2017 Jan 10;356:i6699. PMID: 28073749.
26: Weber S, Pongratz G, Schneider M, Brinks R. Need for improvements in reported cost effectiveness of adalimumab in rheumatoid arthritis. Z Rheumatol. 2017 Jan 13. PMID: 28084542.
By CEA Registry Team on 1/9/2017 2:03 PM
This week we highlighted findings from recently published cost-effectiveness studies:
  • Canadian health system yields relatively good value for money: After applying separate adjustments to match total health spending, costs per QALY gained in Canada for the period from 1980-2012 were generally lower than those found for the US, but not for the UK (1)
  •  Alzheimer’s disease health-economic models face methodological and data challenges: A targeted review of the literature reveals a lack of current long-term large-scale data accurately representing the continuous, multifaceted, and heterogeneous disease process of Alzheimer’s.  These data gaps limit researchers’ ability to accurately estimate the cost-effectiveness of emerging treatments (10)
See below for a full list of all cost-utility studies and selected reviews and editorials published January 2-6, 2017.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Ariste R, Di Matteo L. Value for money: an evaluation of health spending in Canada. Int J Health Econ Manag. 2017 Jan 3. PMID: 28050679.
2: Broekema AE, et al; FACET study group investigators. Study protocol for a randomised controlled multicentre study: the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) in patients with cervical radiculopathy. BMJ Open. 2017 Jan 5;7(1):e012829. PMID: 28057652.
3: Buntrock C, Berking M, Smit F, Lehr D, Nobis S, Riper H, Cuijpers P, Ebert D. Preventing Depression in Adults With Subthreshold Depression: Health-Economic Evaluation Alongside a Pragmatic Randomized Controlled Trial of a Web-Based Intervention. J Med Internet Res. 2017 Jan 4;19(1):e5. PMID: 28052841.
4: Catalá-López F, Ridao M. Improving transparency of methods and results in cost-effectiveness analyses for cancer prevention, treatment and control. Med Clin (Barc). 2017 Jan 6;148(1):43-45. PMID: 27567331.
5: Christensen H, Trotter CL. Modelling the cost-effectiveness of catch-up 'MenB'
(Bexsero) vaccination in England. Vaccine. 2017 Jan 5;35(2):208-211. PMID: 27923519.
6: Dritsaki M, Achana F, Mason J, Petrou S. Methodological Issues Surrounding the Use of Baseline Health-Related Quality of Life Data to Inform Trial-Based Economic Evaluations of Interventions Within Emergency and Critical Care Settings: A Systematic Literature Review. Pharmacoeconomics. 2017 Jan 6. PMID: 28063084.
7: Ericsson Å, Lundqvist A. Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden. Appl Health Econ Health Policy. 2017 Jan 6. PMID: 28063135.
8: Galactionova K, Tediosi F, Camponovo F, Smith TA, Gething PW, Penny MA. Country specific predictions of the cost-effectiveness of malaria vaccine RTS,S/AS01 in endemic Africa. Vaccine. 2017 Jan 3;35(1):53-60. PMID: 27890400.
9: Groen H, Neelis EG, Poley MJ, Olieman JF, Scheenstra R, Krabbe PF, Dijkstra G, Rings EH. Intestinal rehabilitation for children with intestinal failure is cost-effective: a simulation study. Am J Clin Nutr. 2017 Jan 4. PubMed PMID: 28052886.
10: Gustavsson A, et al. Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer's disease. Alzheimers Dement. 2017 Jan 4. PubMed PMID: 28063281.
11: Hunt B, Ye Q, Valentine WJ, Ashley D. Evaluating the Long-Term Cost-Effectiveness of Daily Administered GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes in the United Kingdom. Diabetes Ther. 2017 Jan 5. PMID: 28058656.
12: Jacob V, et al; Community Preventive Services Task Force.. Cost and economic benefit of clinical decision support systems for cardiovascular disease prevention: a community guide systematic review. J Am Med Inform Assoc. 2017 Jan 3. pii: ocw160. PMID: 28049635.
13: Jan S, Wiseman V. Updated Recommendations for Cost-effectiveness Studies. JAMA. 2017 Jan 3;317(1):89-90. PMID: 28030693.
14: Jeemon P, et al. A PROgramme of Lifestyle Intervention in Families for Cardiovascular risk reduction (PROLIFIC Study): design and rationale of a family based randomized controlled trial in individuals with family history of premature coronary heart disease. BMC Public Health. 2017 Jan 5;17(1):10. PMID: 28056897.
15: Kim DY, Han KH, Jun B, Kim TH, Park S, Ward T, Webster S, McEwan P. Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea. PLoS One. 2017 Jan 6;12(1):e0167770. PMID: 28060834.
16: Kim ES, Kim JA, Lee EK. National reimbursement listing determinants of new cancer drugs: a retrospective analysis of 58 cancer treatment appraisals in 2007-2016 in South Korea. Expert Rev Pharmacoecon Outcomes Res. 2017 Jan 3:1-9. PMID: 28010146.
17: Kripke K, et al. Correction: Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20-29 in Zimbabwe. PLoS One. 2017 Jan 3;12(1):e0169696. PMID: 28046126.
18: Kwon SH, Park SK, Byun JH, Lee EK. Eliciting societal preferences of reimbursement decision criteria for anti cancer drugs in South Korea. Expert Rev Pharmacoecon Outcomes Res. 2017 Jan 3:1-9 PMID: 28019130.
19: Longcroft-Wheaton G, Bhandari P. Management of early colonic neoplasia: where are we now and where are we heading? Expert Rev Gastroenterol Hepatol. 2017 Jan 4. PMID: 28052695.
20: Maw AM, Shen NT, Fletcher DR. Updated Recommendations for Cost-effectiveness Studies. JAMA. 2017 Jan 3;317(1):89. PMID:28030694.
21: Nurmatov U, et al. Allergen immunotherapy for IgE-mediated food allergy: a systematic review and meta-analysis. Allergy. 2017 Jan 6. PMID: 28058751.
22: Pollom EL, et al. Cost-effectiveness of Stereotactic Body Radiation Therapy versus Radiofrequency Ablation for Hepatocellular Carcinoma: A Markov Modeling Study. Radiology. 2017 Jan 3:161509. PMID: 28045603.
23: Reyes JF, et al. Beyond expectations: Post-implementation data shows rotavirus vaccination is likely cost-saving in Australia. Vaccine. 2017 Jan 5;35(2):345-352. PubMed PMID: 27916411.
24: Rojas A, Ganesh T, Walker A, Dingledine R. Ethylatropine Bromide as a Peripherally Restricted Muscarinic Antagonist. ACS Chem Neurosci. 2017 Jan 6. PubMed PMID: 28044440.
25: Sanders GD, Neumann PJ, Russell LB. Updated Recommendations for Cost-effectiveness Studies-Reply. JAMA. 2017 Jan 3;317(1):90. PMID: 28030697.
26: Stahmeyer JT, Rossol S, Liersch S, Guerra I, Krauth C. Cost-Effectiveness of Treating Hepatitis C with Sofosbuvir/Ledipasvir in Germany. PLoS One. 2017 Jan 3;12(1):e0169401. PMID: 28046099.
27: Steinke S, et alCost-effectiveness of an 8% Capsaicin Patch in the Treatment of Brachioradial Pruritus and Notalgia Paraesthetica, Two Forms of Neuropathic Pruritus. Acta Derm Venereol. 2017 Jan 4;96(7):71-76. PMID: 27241458.
28: Wilkinson D, Savulescu J. Cost-equivalence and Pluralism in Publicly-funded Health-care Systems. Health Care Anal. 2017 Jan 6. PubMed PMID: 28062971.
29: Yang MC, Chen YP, Tan EC, Leteneux C, Chang E, Chu CH, Lai CC. Epidemiology,
treatment pattern and health care utilization of myopic choroidal neovascularization: a population based study. Jpn J Ophthalmol. 2017 Jan 6. doi: 10.1007/s10384-016-0496-3. PMID: 28062929.
30: Zhou Y, et al. Enrichment of total steroidal saponins from the extracts of Trillium  tschonoskii Maxim by macroporous resin and the simultaneous determination of eight steroidal saponins in final the product by HPLC. J Sep Sci. 2017 Jan 3. PubMed PMID: 28044421.
31: Zylla D, et al. Establishment of Personalized Pain Goals in Oncology Patients to Improve Care and Decrease Costs. J Oncol Pract. 2017 Jan 3:JOP2016017616. PMID: 28045611.
By CEA Registry Team on 1/4/2017 5:26 PM
Elle Pope, MPH and Peter J Neumann, ScD
A newly published article in Health Research Policy and Systems reveals several impediments in using cost-effectiveness evidence to inform policy setting in low- and middle-income countries (LMICs) [1]. Staff members from the Health Intervention and Technology Assessment Program (HITAP) surveyed key health policy experts in Vietnam, India and Bangladesh on barriers to the use of cost-effectiveness data to better inform the development of the Tufts Medical Center Global Health Cost-Effectiveness Analysis (GHCEA) Registry. This new database contains studies reporting cost-per-disability adjusted life year (DALY) averted information published in English language peer-reviewed journals [1].
Thirty-two participants from Health Ministries, universities, and non-governmental organizations were interviewed in-depth on existing barriers to using cost-effectiveness evidence to inform policy. The results revealed that, in the chosen settings of Bangladesh, India and Vietnam, the use of cost-effectiveness information is lacking due to limited knowledge among policymakers, inadequate human resources, and a lack of communication with health authorities in government sectors. All participants agreed that a cost-per-DALY registry would be useful for LMICs in expanding their access to otherwise limited economic data. Consensus on how the registry should be built included the following:
  1. Information broken down by diseases or cohorts to easily address specific policy questions
  2. Inclusion of both cost-per-DALY and cost-per-quality adjusted life year (QALY) information to encompass all available data
  3. Endorsements from reputable global health authorities to establish legitimacy
  4. Provision of basic information on research methods so that transferability of an intervention across different settings can be undertaken
As a greater number of LMICs move towards universal health coverage plans, the demand for economic evidence to inform coverage decisions will increase. The development of the cost-per-DALY database will aid technical advisors and health economic researchers in implementing appropriate health interventions in low-resources settings.
[1] Neumann PJ, Thorat T, Zhong Y, Anderson J, Farquhar M, Salem M, et al. (2016) A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted. PLoS ONE 11(12) 2016.
By CEA Registry Team on 1/4/2017 2:34 PM
 This week we highlighted findings from recently published cost-effectiveness studies:
  • HPV vaccination of men who have sex with men has promising cost-effective results: A substantial decline in HPV-disease burden among men who have sex with men (MSM) was projected to occur after offering HPV vaccination in England, with cost-effective results likely even among HIV-positive MSM (12).
  • Development of the Global Health Cost-Effectiveness Analysis (GHCEA) Registry highlights strengths and limitations of literature: Despite the growing abundance of cost-per-DALY averted studies, adherence to good practices for conducting and reporting vary greatly (17). Read more here.
  • The use of hepatitis C virus (HCV) treatment is likely to be cost-effective for HCV infected cirrhotic patients in Italy:  The cost-effectiveness of daclatasvir (DCV) + sofosbuvir (SOF) + ribavirin (RBV) for 12 and 16 weeks vs SOF + RBV for 16 and 24 weeks was found to be mostly cost-effective for the treatment of genotype 3 HCV infected cirrhotic patients(18).
See below for a full list of all cost-utility studies and selected reviews and editorials published December 19-30, 2016.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Aljabri A, Huckleberry Y, Karnes JH, Gharaibeh M, Kutbi HI, Raz Y, Yun S, Abraham I, Erstad B. Cost-effectiveness of anticoagulants for suspected heparin-induced thrombocytopenia in the United States. Blood. 2016 Dec 29;128(26):3043-3051. PMID: 27793877.
2: Berm EJ, Gout-Zwart JJ, Luttjeboer J, Wilffert B, Postma MJ. A Model Based Cost-Effectiveness Analysis of Routine Genotyping for CYP2D6 among Older, Depressed Inpatients Starting Nortriptyline Pharmacotherapy. PLoS One. 2016 Dec 29;11(12):e0169065. PMID: 28033366.
3: de Graaff B, Neil A, Si L, Yee KC, Sanderson K, Gurrin L, Palmer AJ. Cost-Effectiveness of Different Population Screening Strategies for Hereditary Haemochromatosis in Australia. Appl Health Econ Health Policy. 2016 Dec 29. PMID: 28035629.
4: De Wals P, Zhou Z. Cost-Effectiveness Comparison of Monovalent C Versus Quadrivalent ACWY Meningococcal Conjugate Vaccination in Canada. Pediatr Infect Dis J. 2016 Dec 23. PMID: 28027288.
5: Dilla T, Alexiou D, Chatzitheofilou I, Ayyub R, Lowin J, Norrbacka K. The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2  diabetes mellitus in Spain in patients with BMI≥30 kg/m(2). J Med Econ. 2016 Dec 23:1-26. PMID: 28008768.
6: Dobbs RW, Magnan BP, Abhyankar N, Hemal AK, Challacombe B, Hu J, Dasgupta P, Porpiglia F, Crivellaro S. Cost effectiveness and robot-assisted urologic surgery: does it make dollars and sense? Minerva Urol Nefrol. 2016 Dec 22. PMID: 28008756.
7: Feldhaus I, LeFevre AE, Rai C, Bhattarai J, Russo D, Rawlins B, Chaudhary P, Thapa K. Optimizing treatment for the prevention of pre-eclampsia/eclampsia in Nepal: is calcium supplementation during pregnancy cost-effective? Cost Eff Resour Alloc. 2016 Dec 28;14:13. PMID:28035193.
8: Gharaibeh M, McBride A, Bootman JL, Patel H, Abraham I. Economic evaluation
for the US of nab-paclitaxel plus gemcitabine versus FOLFIRINOX versus gemcitabine in the treatment of metastatic pancreas cancer. J Med Econ. 2016 Dec 21:1-8. PMID: 27919186.
9: Gordon J, McEwan P, Evans M, Puelles J, Sinclair A. Managing glycaemia in older people with type 2 diabetes: a retrospective, primary care based cohort study, with economic assessment of patient outcomes. Diabetes Obes Metab. 2016 Dec 27. PMID: 28026911.
10: Landstedt-Hallin L, Gundgaard J, Ericsson Å, Ellfors-Zetterlund S. Cost-effectiveness of switching to insulin degludec from other basal insulins: Evidence from Swedish real-world data. Curr Med Res Opin. 2016 Dec 30:1-29. PMID: 28035840.
11: Li J, Wen Z, Cai A, Tian F, Zhang L, Luo Y, Deng L, He J, Yang Y, Chen W. Real-world cost-effectiveness of infliximab for moderate-to-severe rheumatoid arthritis in a medium-sized city of China. J Comp Eff Res. 2016 Dec 20. PMID: 27997219.
12: Lin A, Ong KJ, Hobbelen P, King E, Mesher D, Edmunds WJ, Sonnenberg P, Gilson R, Bains I, Choi YH, Tanton C, Soldan K, Jit M. Impact and cost-effectiveness of selective human papillomavirus vaccination of men who have sex with men. Clin Infect Dis. 2016 Dec 23. PMID: 28011615.
13: Lu S, Ye M, Ding L, Tan F, Fu J, Wu B. Cost-effectiveness of gefitinib, icotinib, and pemetrexed-based chemotherapy as first-line treatments for advanced non-small cell lung cancer in China. Oncotarget. 2016 Dec 27. PMID: 28036283.
14: Martinez JM, Anene A, Bentley TG, Cangelosi MJ, Meckley LM, Ortendahl JD, Montero AJ. Cost Effectiveness of Metal Stents in Relieving Obstructive Jaundice in Patients with Pancreatic Cancer. J Gastrointest Cancer. 2016 Dec 27. PMID: 28025817.
15: Mohiuddin S, Reeves B, Pufulete M, Maishman R, Dayer M, Macleod J, McDonagh T, Purdy S, Rogers C, Hollingworth W. Model-based cost-effectiveness analysis of B-type natriuretic peptide-guided care in patients with heart failure. BMJ Open. 2016 Dec 28;6(12):e014010. PMID:28031211.
16: Mohr NM, Stoltze A, Ahmed A, Kiscaden E, Shane D. Using continuous quantitative capnography for emergency department procedural sedation: a systematic review and cost-effectiveness analysis. Intern Emerg Med. 2016 Dec 28.PMID: 28032265.
17: Neumann PJ, Thorat T, Zhong Y, Anderson J, Farquhar M, Salem M, Sandberg E, Saret CJ, Wilkinson C, Cohen JT. A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted. PLoS One. 2016 Dec 22;11(12):e0168512. PMID: 28005986.
18: Restelli U, Alberti A, Lazzarin A, Bonfanti M, Nappi C, Croce D. Cost-effectiveness analysis of the use of daclatasvir + sofosbuvir + ribavirin (16 weeks and 12 weeks) vs sofosbuvir + ribavirin (16 weeks and 24 weeks) for the treatment of cirrhotic patients affected with hepatitis C virus genotype 3 in Italy. Eur J Health Econ. 2016 Dec 22. PMID: 28008546.
19: Sharma M, Seoud M, Kim JJ. Cost-effectiveness of increasing cervical cancer screening coverage in the Middle East: An example from Lebanon. Vaccine. 2016 Dec 22. PMID: 28017434.
20: Shireman TI, et al. Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke). Stroke. 2016 Dec 27. PMID: 28028150.
21: Smith KJ, Zimmerman RK, Nowalk MP, Lin CJ. Cost-Effectiveness of the 4 Pillars Practice Transformation Program to Improve Vaccination of Adults Aged 65 and Older. J Am Geriatr Soc. 2016 Dec 26. PMID: 28024090.
22: Tufail A, et al. Automated Diabetic Retinopathy Image Assessment Software: Diagnostic
Accuracy and Cost-Effectiveness Compared with Human Graders. Ophthalmology. 2016
Dec 23. PMID: 28024825.
23: van de Graaf VA, et al. Cost-effectiveness of Early Surgery versus Conservative Treatment with Optional Delayed Meniscectomy for Patients over 45 years with non-obstructive meniscal tears (ESCAPE study): protocol of a randomised controlled trial. BMJ Open. 2016 Dec 21;6(12):e014381. PMID: 28003302.
24: Veenstra DL, Guzauskas GF, Villa KF, Boudreau DM. The budget impact and cost-effectiveness of defibrotide for treatment of veno-occlusive disease with multi-organ dysfunction in patients post-hematopoietic stem cell transplant. J Med Econ. 2016 Dec 23:1-27. PMID: 28008770.
25: White MT, Yeung S, Patouillard E, Cibulskis R. Costs and Cost-Effectiveness of Plasmodium vivax Control. Am J Trop Med Hyg. 2016 Dec 28;95(6 Suppl):52-61.PMID: 28025283.
26: Wong C, Jiang M, You JH. Potential Cost-Effectiveness of an Influenza Vaccination Program Offering Micro-needle Patch for Vaccine Delivery in Children. PLoS One. 2016 Dec 22;11(12):e0169030. PMID: 28006012.
27: Yan X, Gu X, Xu Z, Lin H, Wu B. Cost-Effectiveness of Different Strategies for the Prevention of Venous Thromboembolism After Total Hip Replacement in China. Adv Ther. 2016 Dec 20. PMID: 28000167.
By CEA Registry Team on 12/23/2016 10:28 AM

Peter J. Neumann Sc.D., and Teja Thorat, MPH.

In our just published paper in PLOS ONE, we introduce a new online database of cost-per-DALY averted studies, and also review the studies included and trends in publication [1].

The Global Health Cost-Effectiveness Analysis (GHCEA) Registry contains cost-per-DALY averted studies published in English language peer-reviewed journals. The GHCEA Registry currently includes 479 studies from 2000 through 2015. In our new study, we highlight the data collection process for the Registry. The data is accessible to the public on the GHCEA Registry website.

Our study systematically reviews the cost-per-DALY studies from 2000-2015, summarizing:

a) descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective,
b) methodological and reporting practices over time,
c) types of costs included in analyses,
d) the correlation between diseases researched and the burden of disease in different world regions

The number of published cost-per-DALY studies increased markedly after 2007.  Notably, 85 studies were published in 2015, compared with 46 in 2014.

Cost-per-DALY studies from Sub-Saharan Africa comprised the largest portion of published studies and the disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%), followed by non-communicable diseases (28%).  We also found that adherence to good practices for conducting and reporting cost-effectiveness analysis varied considerably. Studies mainly included formal healthcare sector costs but varied considerably in their inclusion of other cost components.  A large number of the studies in Sub-Saharan Africa addressed high-burden conditions such as HIV/AIDS, tuberculosis, neglected tropical diseases and malaria, and diarrhea, lower respiratory infections, meningitis, and other common infectious diseases.

[1] Neumann PJ, Thorat T, Zhong Y, Anderson J, Farquhar M, Salem M, et al. (2016) A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted. PLoS ONE 11(12) 2016.

By CEA Registry Team on 12/21/2016 8:58 AM
Once each week we highlight findings from recently published cost-effectiveness studies:
  • Universal approach to antenatal HIV testing is cost-effective: A study on the cost-effectiveness of HIV testing strategies for pregnant woman from both high and low HIV prevalence settings found that a universal instead of focused approach achieved better health outcomes and was cost-saving or cost-effective across a range of settings. (3)
  • CT scans for all anticoagulated patients with head injuries is not cost-effective: Selective use of CT scanning for those with evidence of traumatic brain injury is recommended in the UK and more cost-effective than providing CT scans for all anticoagulated patients with head injuries. (5)
  • Potential ART adherence monitoring interventions in Sub-Saharan Africa is potentially cost-effective: In situations where viral load monitoring may or may not be available, adherence monitoring-based interventions provide health benefits and are potentially cost-effective, depending on the intervention cost. (8)
  • The next generation nonavalent HPV vaccine may change the number of recommended cervical cancer screenings in developed countries: Cervical cancer screenings were still found to be cost-effective among women who receive the new human papillomavirus (HPV) vaccine, however the number of optical screening tests will vary across developed countries. (9)
See below for a full list of all cost-utility studies and selected reviews and editorials published December 12-16, 2016.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Cichosz SL, Ehlers LH, Hejlesen O. Health effectiveness and cost-effectiveness of telehealthcare for heart failure: study protocol for a randomized controlled trial. Trials. 2016 Dec 12;17(1):590. PMID: 27955682.
2: Elbasha E, Greaves W, Roth D, Nwankwo C. Cost-effectiveness of elbasvir/grazoprevir use in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and chronic kidney disease in the United States. J Viral Hepat. 2016 Dec 13. PMID: 27966249.

3: Ishikawa N, Dalal S, Johnson C, Hogan DR, Shimbo T, Shaffer N, Pendse RN, Lo YR, Ghidinelli MN, Baggaley R. Should HIV testing for all pregnant women continue? Cost-effectiveness of

universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings. J Int AIDS Soc. 2016  Dec 14;19(1):21212. PMID: 27978939.
4: Kornelsen JA, Barclay L, Grzybowski S, Gao Y. Rural health service planning: the need for a comprehensive approach to costing. Rural Remote Health. 2016 Oct-Dec;16(4):3604. PMID: 27978763.
5: Kuczawski M, Stevenson M, Goodacre S, Teare MD, Ramlakhan S, Morris F, Mason S. Should all anticoagulated patients with head injury receive a CT scan? Decision-analysis modelling of an observational cohort. BMJ Open. 2016 Dec 13;6(12):e013742. PMID: 27974370.
6: Meltzer ME, Congdon N, Kymes SM, Yan X, Lansingh VC, Sisay A, Müller A, Chan
VF, Jin L, Karumanchi SM, Guan C, Vuong Q, Rivera N, McCleod-Omawale J, He M. Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery: Prospective Review of Early Cataract Outcomes and Grading (PRECOG) Study. JAMA Ophthalmol. 2016 Dec 15. PMID: 27978578.
7: Olfert JA, Penz ED, Manns BJ, Mishra EK, Davies HE, Miller RF, Luengo-Fernandez R, Gao S, Rahman NM. Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion. Respirology. 2016 Dec 16. PMID: 27983774.
8: Phillips AN, Cambiano V, Nakagawa F, Bansi-Matharu L, Sow PS, Ehrenkranz P, Ford D, Mugurungi O, Apollo T, Murungu J, Bangsberg DR, Revill P. Cost Effectiveness of Potential ART Adherence Monitoring Interventions in Sub-Saharan  Africa. PLoS One. 2016 Dec 15;11(12):e0167654. PMID: 27977702.

9: Simms KT, Smith MA, Lew JB, Kitchener HC, Castle PE, Canfell K. Will cervical screeni

ng remain cost-effective in women offered the next generation nonavalent HPV vaccine? Results for four developed countries. Int J Cancer. 2016 Dec 15;139(12):2771-2780. PMID: 27541596.
10: Turner HC, Bettis AA, Chu BK, McFarland DA, Hooper PJ, Mante SD, Fitzpatrick C, Bradley MH. Investment success in public health: An analysis of the cost-effectiveness and cost-benefit of the Global Programme to Eliminate Lymphatic Filariasis. Clin Infect Dis. 2016 Dec 12. PMID: 27956460.
11: Wang Z, Chen Z, Wang X, Hao G, Ma L, Zhao X, Li Y, Zhang L, Zhu M. Cost-effectiveness of nitrendipine and hydrochlorothiazide or metoprolol to treat hypertension in rural community health centers in China. J Hypertens. 2016 Dec 12. PMID: 27977472.
By CEA Registry Team on 12/12/2016 1:52 PM
 Once each week we highlight findings from recently published cost-effectiveness studies:
  • Primary prophylaxis among patients with early-stage breast cancer or non-Hodgkin lymphoma (NHL) found to be cost-effective strategy: Primary prophylaxis with pegfilgrastim was found to be more cost-effective compared to other prophylaxis approaches in patients with stage II breast cancer or NHL in Belgium. (6)
  • Screening for ovarian cancer is both more effective and more expensive than not screening: Lifetime outcomes and cost-effectiveness of screening for ovarian cancer with multimodal screening in the UK was found to be worthwhile. (10)
  • Direct-acting anti-viral treatment in liver transplant candidates with Hepatitis C found to be cost-effective strategy: Deferring treatment for Hepatitis C until after liver transplant and maintaining access to the expanded pool of HCV(+) donors appears to be the most cost-effective strategy for well-compensated HCV-infected cirrhotics listed for liver transplantation. (17)
  •  Community-based care management for patients with chronic obstructive pulmonary disease (COPD) in Denmark more costly, but more effective: A new analysis revealed that while case management for patients with COPD was more expensive than usual care, a greater gain in health benefits was observed. The cost-effectiveness ratio observed exceeds thresholds set by NICE, but no formal CEA threshold values exist in Denmark. (19)
See below for a full list of all cost-utility studies and selected reviews and editorials published December 5-9, 2016.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Cost-effectiveness of repairing versus replacing composite or amalgam restorations. Br Dent J. 2016 Dec 9;221(11):716. PMID: 27932813.
2: Ademi Z, Gloy V, Glinz D, Raatz H, Van Stiphout J, Bucher HC, Schwenkglenks M. Cost-effectiveness of primarily surgical versus primarily conservative treatment of acute and subacute radiculopathies due to intervertebral disc herniation from the Swiss perspective. Swiss Med Wkly. 2016 Dec 5;146:w14382.
PMID: 27922167.
3: Boccalini S, Bechini A, Gasparini R, Panatto D, Amicizia D, Bonanni P. Economic studies applied to vaccines against invasive diseases: an updated budget impact analysis of age-based pneumococcal vaccination strategies in the elderly in Italy. Hum Vaccin Immunother. 2016 Dec 7:0. PMID:27925845.
4: Elser JL, Bigler LL, Anderson AM, Maki JL, Lein DH, Shwiff SA. The Economics of a Successful Raccoon Rabies Elimination Program on Long Island, New York. PLoS Negl Trop Dis. 2016 Dec 9;10(12):e0005062. PMID: 27935946.
5: Endo IC, Ziegelmann PK, Patel A. The economic promise of developing and implementing dengue vaccines: Evidence from a systematic review. Vaccine. 2016 Dec 7;34(50):6133-6147. PMID: 27810313.
6: Fust K, Li X, Maschio M, Villa G, Parthan A, Barron R, Weinstein MC, Somers L, Hoefkens C, Lyman GH. Cost-Effectiveness Analysis of Prophylaxis Treatment Strategies to Reduce the Incidence of Febrile Neutropenia in Patients with Early-Stage Breast Cancer or Non-Hodgkin Lymphoma. Pharmacoeconomics. 2016 Dec 7. PMID: 27928760.
7: Giordano A, Bonometti GP, Vanoglio F, Paneroni M, Bernocchi P, Comini L, Giordano A. Feasibility and cost-effectiveness of a multidisciplinary home-telehealth intervention programme to reduce falls among elderly discharged from hospital: study protocol for a randomized controlled trial. BMC Geriatr. 2016 Dec 7;16(1):209. PMID: 27923343.
8: Jenks M, Taylor M, Shore J. Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery. Expert Rev Pharmacoecon Outcomes Res. 2016 Dec 9. PMID: 27935333.
9: Jiang M, You JH. CYP2C19 LOF and GOF-Guided Antiplatelet Therapy in Patients with Acute Coronary Syndrome: A Cost-Effectiveness Analysis. Cardiovasc Drugs Ther. 2016 Dec 7. PMID: 27924429.
10: Kearns B, Chilcott J, Whyte S, Preston L, Sadler S. Cost-effectiveness of screening for ovarian cancer amongst postmenopausal women: a model-based economic evaluation. BMC Med. 2016 Dec 6;14(1):200. PMID: 27919292.
11: Kingsley J, Karanth S, Revere FL, Agrawal D. Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates - A Modeling Study. PLoS One. 2016 Dec 9;11(12):e0167452. PMID:
12: Kolu P, Raitanen J, Puhkala J, Tuominen P, Husu P, Luoto R. Effectiveness and Cost-Effectiveness of a Cluster-Randomized Prenatal Lifestyle Counseling Trial: A Seven-Year Follow-Up. PLoS One. 2016 Dec 9;11(12):e0167759. PMID: 27936083.
13: Lai K, Zhang C, Ke W, Gao Y, Zhou S, Liu L, Yang Y. Cost-Effectiveness Comparison Between the Response-Guided Therapies and Monotherapies of Nucleos(t)ide Analogues for Chronic Hepatitis B Patients in China. Clin Drug Investig. 2016 Dec 7. PMID: 27928739.
14: Luttjeboer J, Setiawan D, Cao Q, Cahh Daemen T, Postma MJ. Threshold cost-effectiveness analysis for a therapeutic vaccine against HPV-16/18-positive cervical intraepithelial neoplasia in the Netherlands. Vaccine. 2016 Dec 7;34(50):6381-6387. PMID: 27816370.
15: Maurer KA, Chen HF, Wagner AL, Hegde ST, Patel T, Boulton ML, Hutton DW. Cost-effectiveness analysis of pneumococcal vaccination for infants in China. Vaccine. 2016 Dec 7;34(50):6343-6349.PMID: 27810315.
16: Misra UK, Mani VE, Kalita J. A Cost-Effective Approach to the Diagnosis and Management of Acute Infectious Encephalitis. Eur Neurol. 2016 Dec 8;77(1-2):66-74. PMID: 27924792.
17: Salazar J, Saxena V, Kahn JG, Roberts JP, Mehta N, Volk M, Lai JC. Cost-Effectiveness of Direct-Acting Anti-viral Treatment in Hepatitis C-infected Liver Transplant Candidates with Compensated Cirrhosis and Hepatocellular Carcinoma. Transplantation. 2016 Dec 6. PMID:27926593.
18: Shiffman D, Arellano AR, Caulfield MP, Louie JZ, Bare LA, Devlin JJ, Melander O. Use of low density lipoprotein particle number levels as an aid in statin treatment decisions for intermediate risk patients: a cost-effectiveness analysis. BMC Cardiovasc Disord. 2016 Dec 7;16(1):251. PMID: 27927162.
19: Sørensen SS, Pedersen KM, Weinreich UM, Ehlers L. Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease. Appl Health Econ Health Policy. 2016 Dec 7. PMID: 27928660.

20: Xu S, Immaneni S, Hazen GB, Silverberg JI, Paller AS, Lio PA. Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis. JAMA Pediatr. 2016 Dec 5:e163909. PMID: 27918774.

21: Zhao D, Gai Tobe R, Cui M, He J, Wu B. Cost-effectiveness of a 23-valent pneumococcal polysaccharide vaccine immunization programme for the elderly in Shanghai, China. Vaccine. 2016 Dec 7;34(50):6158-6165. PMID: 27838068.
By CEA Registry Team on 12/5/2016 4:12 PM

Once each week we highlight findings from recently published cost-effectiveness studies:

• Pneumococcal vaccine found to be cost-saving among infants: The newest pneumococcal vaccine (PHiD-CV) introduced in the UK national vaccination program was found to produce greater cost-savings and more health benefits compared to the PCV-13 pneumococcal vaccine. (2)
• Introduction of a new flu vaccine found to be beneficial: The Quadrivalent influenza vaccine (QIV) was projected to have greater health gains and cost-savings compared to the Trivalent influenza vaccine (TIV) in Germany. (3)
• HIV prevention strategies offer cost-effective alternative: Among HIV prevention strategies for men who have sex with men, preexposure prophylaxis (PrEP) and test-and-treat methods were found to be highly cost-effective relative to currently practiced methods. (4)
• Targeted lifestyle intervention valuable in preventing type 2 diabetes: An intervention focused on nutrition and physical activity was found to very cost-effective in preventing or delaying type 2 diabetes compared to no intervention in a Swedish community. (23)
See below for a full list of all cost-utility studies and selected reviews and editorials published November 28 to December 2, 2016.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Chuang LH, Verheggen BG, Charokopou M, Gibson D, Grandy S, Kartman B. Cost-effectiveness analysis of exenatide once-weekly versus dulaglutide, liraglutide, and lixisenatide for the treatment of type 2 diabetes mellitus: an analysis from the UK NHS perspective. J Med Econ. 2016 Dec;19(12):1127-1134.
PMID: 27310712.
2: Delgleize E, Leeuwenkamp O, Theodorou E, Van de Velde N. Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model. BMJ Open. 2016 Nov 30;6(11):e010776. PMID: 27903558.
3: Dolk C, Eichner M, Welte R, Anastassopoulou A, Van Bellinghen LA, Poulsen Nautrup B, Van Vlaenderen I, Schmidt-Ott R, Schwehm M, Postma M. Cost-Utility of Quadrivalent Versus Trivalent Influenza Vaccine in Germany, Using an Individual-Based Dynamic Transmission Model. Pharmacoeconomics. 2016 Dec;34(12):1299-1308. PMID: 27647004.
4: Drabo EF, Hay JW, Vardavas R, Wagner ZR, Sood N. A Cost-effectiveness Analysis of Preexposure Prophylaxis for the Prevention of HIV Among Los Angeles County Men Who Have Sex With Men. Clin Infect Dis. 2016 Dec 1;63(11):1495-1504. PMID:27558571.
5: Elbasha EH, Robertson MN, Nwankwo C. The cost-effectiveness of testing for NS5a resistance-associated polymorphisms at baseline in genotype 1a-infected (treatment-naïve and treatment-experienced) subjects treated with all-oral elbasvir/grazoprevir regimens in the United States. Aliment Pharmacol Ther. 2016 Dec 1. PMID: 27910116.
6: Eljamel MS, Mahboob SO. The effectiveness and cost-effectiveness of intraoperative imaging in high-grade glioma resection; a comparative review of intraoperative ALA, fluorescein, ultrasound and MRI. Photodiagnosis Photodyn Ther. 2016 Dec;16:35-43. PMID:27491856.
7: Evans M, Gundgaard J, Hansen BB. Cost-Effectiveness of Insulin Degludec/Insulin Aspart Versus Biphasic Insulin Aspart in Patients with Type 2 Diabetes from a Danish Health-Care Perspective. Diabetes Ther. 2016 Dec;7(4):809-823. PMID: 27553066.
8: Fisher M, Walker A, Falqués M, Moya M, Rance M, Taylor D, Lindner L. Cost-effectiveness of linaclotide compared to antidepressants in the treatment of irritable bowel syndrome with constipation in Scotland. Eur J Health Econ. 2016 Dec;17(9):1091-1100. PMID: 26728984.
9: Gao LL, Basta M, Kanchwala SK, Serletti JM, Low DW, Wu LC. Cost-effectiveness  of microsurgical reconstruction for head and neck defects after oncologic resection. Head Neck. 2016 Nov 29. PMID: 27898195.
10: Gordon J, McEwan P, Hurst M, Puelles J. The Cost-Effectiveness of Alogliptin Versus Sulfonylurea as Add-on Therapy to Metformin in Patients with Uncontrolled Type 2 Diabetes Mellitus. Diabetes Ther. 2016 Dec;7(4):825-845. PMID:27787778.
11: Gordon J, McEwan P, Sabale U, Kartman B, Wolffenbuttel BH. The cost-effectiveness of exenatide twice daily (BID) vs insulin lispro three times daily (TID) as add-on therapy to titrated insulin glargine in patients with type 2 diabetes. J Med Econ. 2016 Dec;19(12):1167-1174. PMID: 27356188.
12: Gras A, Broughton J. A cost-effectiveness model for the use of a cannabis-derived oromucosal spray for the treatment of spasticity in multiple sclerosis. Expert Rev Pharmacoecon Outcomes Res. 2016 Dec;16(6):771-779. PMID: 26750641.
13: Hager J, Henriksson M, Carlsson P, Länne T, Lundgren F. Revisiting the cost-effectiveness of screening 65-year-old men for abdominal aortic aneurysm based on data from an implemented screening programme. Int Angiol. 2016 Dec 1. PMID: 27905693.
14: Jalal H, O'Dell JR, Bridges SL Jr, Cofield S, Curtis JR, Mikuls TR, Moreland  LW, Michaud K. Cost-Effectiveness of Triple Therapy Versus Etanercept Plus Methotrexate in Early Aggressive Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2016 Dec;68(12):1751-1757. PMID:27015606.
15: Jeong K, Cairns J. Systematic review of health state utility values for economic evaluation of colorectal cancer. Health Econ Rev. 2016 Dec;6(1):36. PMID: 27541298; 
16: Kisiel JB, Konijeti GG, Piscitello AJ, Chandra T, Goss TF, Ahlquist DA, Farraye FA, Ananthakrishnan AN. Stool DNA Analysis is Cost-Effective for Colorectal Cancer Surveillance in Patients With Ulcerative Colitis. Clin Gastroenterol Hepatol. 2016 Dec;14(12):1778-1787.e8. PMID: 27464589.
17: Lester-Coll NH, Dosoretz AP, Magnuson WJ, Laurans MS, Chiang VL, Yu JB. Cost-effectiveness of stereotactic radiosurgery versus whole-brain radiation therapy for up to 10 brain metastases. J Neurosurg. 2016 Dec;125(Suppl 1):18-25.  PMID: 27903191.
18: Li N, Yang X, Fan L, Totev T, Guerin A, Chen L, Bhattacharyya S, Joseph G. Nilotinib versus dasatinib as second-line therapy in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase who are resistant or intolerant to imatinib: a cost-effectiveness analysis based on real-world data. J Med Econ. 2016 Dec 2:1-9. PMID: 27841717.
19: Luca NJ, Burnett HF, Ungar WJ, Moretti ME, Beukelman T, Feldman BM, Schwartz G, Bayoumi AM. Cost-Effectiveness Analysis of First-Line Treatment With Biologic Agents in Polyarticular Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken). 2016 Dec;68(12):1803-1811. PMID:27059807.
20: Mahon J, Claxton L, Wood H. Modelling the cost-effectiveness of human milk and breastfeeding in preterm infants in the United Kingdom. Health Econ Rev. 2016 Dec;6(1):54. PMID: 27909996.
21: Maru S, Byrnes JM, Carrington MJ, Stewart S, Scuffham PA. Long-term cost-effectiveness of home versus clinic-based management of chronic heart failure: the WHICH? study. J Med Econ. 2016 Dec 1:1-10. PMID: 27841726.
22: Murphy J, Gray A, Cooper C, Cooper D, Ramsay C, Carr A. Costs, quality of life and cost-effectiveness of arthroscopic and open repair for rotator cuff tears: an economic evaluation alongside the UKUFF trial. Bone Joint J. 2016 Dec;98-B(12):1648-1655. PMID: 27909127.
23: Neumann A, Lindholm L, Norberg M, Schoffer O, Klug SJ, Norström F. The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program. Eur J Health Econ. 2016 Dec 2. PMID: 27913943.
24: Pinyol C, Cepeda JM, Roldan I, Roldan V, Jimenez S, Gonzalez P, Soto J. A Systematic Literature Review on the Cost-Effectiveness of Apixaban for Stroke Prevention in Non-valvular Atrial Fibrillation. Cardiol Ther. 2016 Dec;5(2):171-186. PMID: 27457613.
25: Rafia R, Scope A, Harnan S, Stevens JW, Stevenson M, Lobo A. Vedolizumab for Treating Moderately to Severely Active Crohn's Disease After Prior Therapy: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Pharmacoeconomics. 2016 Dec;34(12):1241-1253. PMID: 27480631.
26: Salisbury AC, Li H, Vilain KR, Jaff MR, Schneider PA, Laird JR, Cohen DJ. Cost-Effectiveness of Endovascular Femoropopliteal Intervention Using Drug-Coated Balloons Versus Standard Percutaneous Transluminal Angioplasty: Results From the IN.PACT SFA II Trial. JACC Cardiovasc Interv. 2016 Nov 28;9(22):2343-2352. PMID: 27884360.
27: Silverstein A, Costas-Chavarri A, Gakwaya MR, Lule J, Mukhopadhyay S, Meara JG, Shrime MG. Laparoscopic Versus Open Cholecystectomy: A Cost-Effectiveness Analysis at Rwanda Military Hospital. World J Surg. 2016 Nov 30. PMID: 27905020.
28: Tinelli M, Ryan M, Bond C. What, who and when? Incorporating a discrete choice experiment into an economic evaluation. Health Econ Rev. 2016 Dec;6(1):31.PubMed PMID: 27472943; 
29: Virabhak S, Yasui K, Yamazaki K, Johnson S, Mitchell D, Yuen C, Samp JC, Igarashi A. Cost-effectiveness of direct-acting antiviral regimen ombitasvir/paritaprevir/ritonavir in treatment-naïve and treatment-experienced patients infected with chronic hepatitis C virus genotype 1b in Japan. J Med Econ. 2016 Dec;19(12):1144-1156. PMID: 27348464.
30: Wielage RC, Perk S, Campbell NL, Klein TM, Posta LM, Yuran T, Klein RW, Ng DB. Mirabegron for the treatment of overactive bladder: cost-effectiveness from US commercial health-plan and Medicare Advantage perspectives. J Med Econ. 2016 Dec;19(12):1135-1143. PMID: 27326725.
31: Yan X, Gu X, Zhou L, Lin H, Wu B. Cost Effectiveness of Apixaban and Enoxaparin for the Prevention of Venous Thromboembolism After Total Knee Replacement in China. Clin Drug Investig. 2016 Dec; 36(12):1001-1010. PMID:27581246.
32: Zang X, Tang H, Min JE, Gu D, Montaner JS, Wu Z, Nosyk B. Cost-Effectiveness of the 'One4All' HIV Linkage Intervention in Guangxi Zhuang Autonomous Region, China. PLoS One. 2016 Nov PMID: 27893864.
33: Zhang P, Yang Y, Wen F, Wheeler J, Fu P, Li Q. Cost-effectiveness analysis of antiviral therapy in patients with advanced hepatitis B virus-related hepatocellular carcinoma treated with sorafenib. J Gastroenterol Hepatol. 2016 Dec;31(12):1978-1985. PMID: 27118432.
By CEA Registry Team on 11/28/2016 4:26 PM

 Once each week we highlight findings from recently published cost-effectiveness studies:

Apixaban regarded as cost-effective treatment option for stroke prevention in Greece: Apixaban was found to be a cost-effective treatment option versus warfarin and aspirin for the prevention of stroke in patients with atrial fibrillation from a Greek healthcare payer perspective (2).
• Future prevalence and cost burden of Chronic Lymphocytic Leukemia (CLL) estimated to have large financial impact: The increased benefit of oral targeted therapies is projected to enhance CLL survivorship but higher costs can impose a substantial financial burden on both patients and payers in the U.S. (4).
• Cognitive screening tests for detecting dementia and mild cognitive impairment found to be cost-effective: Cognitive screening tests for use by General Practitioners considered a cost-effective strategy compared to standard of care in England (18).
See below for a full list of all cost-utility studies and selected reviews and editorials published November 21-25, 2016.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Arefian H, Heublein S, Scherag A, Brunkhorst FM, Younis MZ, Moerer O, Fischer D, Hartmann M. Hospital-related cost of sepsis: A systematic review. J Infect. 2016 Nov 21. pii: S0163-4453(16)30288-2. PMID: 27884733.
2: Athanasakis K, Boubouchairopoulou N, Karampli E, Tarantilis F, Savvari P, Bilitou A, Kyriopoulos J. Cost Effectiveness of Apixaban versus Warfarin or Aspirin for Stroke Prevention in Patients with Atrial Fibrillation: A Greek Perspective. Am J Cardiovasc Drugs. 2016 Nov 23. PMID: 27882517.
3: Bozkaya D, Livingston T, Migliaccio-Walle K, Odom T. The cost-effectiveness of disease-modifying therapies for the treatment of relapsing-remitting multiple sclerosis. J Med Econ. 2016 Nov 21:1-6. PMID:27822961.
4: Chen Q, Jain N, Ayer T, Wierda WG, Flowers CR, O'Brien SM, Keating MJ, Kantarjian HM, Chhatwal J. Economic Burden of Chronic Lymphocytic Leukemia in the Era of Oral Targeted Therapies in the United States. J Clin Oncol. 2016 Nov 21:JCO2016682856. PMID: 27870563.
5: Chotai S, Parker SL, Sielatycki JA, Sivaganesan A, Kay HL, Wick JB, McGirt MJ, Devin CJ. Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease. Eur Spine J. 2016 Nov 24. PMID: 27885477.
6: Gama E, Were V, Ouma P, Desai M, Niessen L, Buff AM, Kariuki S. Large-scale implementation of disease control programmes: a cost-effectiveness analysis of long-lasting insecticide-treated bed net distribution channels in a malaria-endemic area of western Kenya-a study protocol. BMJ Open. 2016 Nov 21;6(11):e012776. PMID: 27872120.
7: Gu S, Zeng Y, Yu D, Hu X, Dong H. Cost-Effectiveness of Saxagliptin versus Acarbose as Second-Line Therapy in Type 2 Diabetes in China. PLoS One. 2016 Nov 22;11(11):e0167190. PMID: 27875596.
8: Hellard M, Pedrana A, Scott N. Targeted direct-acting antiviral treatment for chronic hepatitis C: a financial reality or an obstacle to elimination? J Hepatol. 2016 Nov 21. PMID: 27884764.
9: Klebanoff MJ, Corey KE, Chhatwal J, Kaplan LM, Chung RT, Hur C. Bariatric Surgery for Nonalcoholic Steatohepatitis: A Clinical and Cost-Effectiveness Analysis. Hepatology. 2016 Nov 23. PMID: 27880977.
10: Lam SW, Wai M, Lau JE, McNamara M, Earl M, Udeh B. Cost-Effectiveness Analysis of Second-Line Chemotherapy Agents for Advanced Gastric Cancer. Pharmacotherapy. 2016 Nov 21. PMID: 27870079.
11: Malet-Larrea A, García-Cárdenas V, Sáez-Benito L, Benrimoj SI, Calvo B, Goyenechea E. Cost-effectiveness of professional pharmacy services in community pharmacy: a systematic review. Expert Rev Pharmacoecon Outcomes Res. 2016 Dec;16(6):747-758. PMID: 27828725.
12: Maulsby C, Jain KM, Weir BW, Enobun B, Riordan M, Charles VE; RiC Intervention Team., Holtgrave DR. The Cost and Threshold Analysis of Retention in Care (RiC): A Multi-Site National HIV Care Program. AIDS Behav. 2016 Nov 21. PMID: 27873083.
13: Ong AA, Carroll WW, Nguyen SA, Gillespie MB. Cost-effectiveness of transfacial gland-preserving removal of parotid sialoliths. Laryngoscope. 2016 Nov 22. PMID: 27873327.
14: Patterson PD, Smith KJ, Hostler D. Cost-effectiveness of workplace wellness to prevent cardiovascular events among U.S. firefighters. BMC Cardiovasc Disord. 2016 Nov 21;16(1):229. PMID: 27871247.
15: Serra-Arbeloa P, Rabines-Juárez ÁO, Álvarez-Ruiz MS, Guillén-Grima F. Cost of cutaneous melanoma by tumor stage: A descriptive analysis. Actas Dermosifiliogr. 2016 Nov 22. pii: S0001-7310(16)30329-5.PubMed PMID: 27887672.
16: Shao H, Zhai S, Zou D, Mir MU, Zawadzki NK, Shi Q, Liu S, Shi L. Cost-effectiveness analysis of dapagliflozin versus glimepiride as monotherapy in a Chinese population with type 2 diabetes mellitus. Curr Med Res Opin. 2016 Nov 23:1-11. PMID: 27817216.
17: Sutherland CS, Stone CM, Steinmann P, Tanner M, Tediosi F. Seeing beyond 2020: an economic evaluation of contemporary and emerging strategies for elimination of Trypanosoma brucei gambiense. Lancet Glob Health. 2016 Nov 21. PMID: 27884709.
18: Tong T, Thokala P, McMillan B, Ghosh R, Brazier J. Cost effectiveness of using cognitive screening tests for detecting dementia and mild cognitive impairment in primary care. Int J Geriatr Psychiatry. 2016 Nov 22. PMID: 27874210.
19: Wera E, Mourits MC, Siko MM, Hogeveen H. Cost-Effectiveness of Mass Dog Vaccination Campaigns against Rabies in Flores Island, Indonesia. Transbound Emerg Dis. 2016 Nov 23. PMID: 27878980.
20: Winters D, Casten R, Rovner B, Murchison A, Leiby BE, Haller JA, Hark L, Weiss DM, Pizzi LT. Cost-Effectiveness of Behavior Activation Versus Supportive Therapy on Adherence to Eye Exams in Older African Americans With Diabetes. Am J  Med Qual. 2016 Nov 23. PMID: 27884979.
21: Yue WW, Li XL, Xu HX, Lu F, Sun LP, Guo LH, He YP, Wang D, Yin ZQ. Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study. Sci Rep. 2016 Nov 24;6:37838. PMID: 27883069.
By CEA Registry Team on 11/22/2016 9:03 AM
Once each week we highlight findings from recently published cost-effectiveness studies
• Wait time reduction for behavioral intervention for autism spectrum disorder is cost-effective: A new study out of Canada projects that providing early access to behavior interventions for children with severe autism spectrum disorder is associated with improved outcomes and reduced costs (8)
• Therapy presents reasonable value in reducing cardiovascular outcomes: in patients with heart failure (NYHA class II to IV), sacubitril-valsartan therapy reduced cardiovascular mortality and morbidity for reasonable value (11)
See below for a full list of all cost-utility studies and selected reviews and editorials published November 14-18, 2016. To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry. Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Banerjee S, Jeon-Slaughter H, Tsai S, Mohammad A, Foteh M, Abu-Fadel M, Gigliotti OS, Cawich I, Rodriguez G, Kumbhani D, Addo T, Luna M, Das TS, Prasad A, Armstrong EJ, Shammas NW, Brilakis ES. Comparative Assessment of Procedure Cost and Outcomes Between Guidewire and Crossing Device Strategies to Cross Peripheral Artery Chronic Total Occlusions. JACC Cardiovasc Interv. 2016 Nov 14;9(21):2243-2252. PMID: 27832850.
2: Cui S, Tobe RG, Mo X, Liu X, Xu L, Li S. Cost-effectiveness analysis of rotavirus vaccination in China: Projected possibility of scale-up from the current domestic option. BMC Infect Dis. 2016 Nov 15;16(1):677. PMID: 27846803.
3: Fernández-García P, Marco-Doménech SF, Lizán-Tudela L, Ibáñez-Gual MV, Navarro-Ballester A, Casanovas-Feliu E. The cost effectiveness of vacuum-assisted versus core-needle versus surgical biopsy of breast lesions. Radiologia. 2016 Nov 16. pii: S0033-8338(16)30143-6. doi: 10.1016/j.rx.2016.09.006. PMID: 27865561.
4: Goranitis I, Coast J, Day E, Copello A, Freemantle N, Frew E. Maximizing Health or Sufficient Capability in Economic Evaluation? A Methodological Experiment of Treatment for Drug Addiction. Med Decis Making. 2016 Nov 17.  PubMed PMID: 27856827.
5: Griffin SO, Naavaal S, Scherrer C, Patel M, Chattopadhyay S; Community Preventive Services Task Force. Evaluation of School-Based Dental Sealant Programs: An Updated Community Guide Systematic Economic Review. Am J Prev Med. 2016 Nov 16. pii: S0749-3797(16)30510-4. doi: 10.1016/j.amepre.2016.10.004. PMID: 27865653.
6: Li N, Yang X, Fan L, Totev T, Guerin A, Chen L, Bhattacharyya S, Joseph G. Nilotinib versus dasatinib as second-line therapy in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase who are resistant or intolerant to imatinib: a cost-effectiveness analysis based on real-world data. J Med Econ. 2016 Nov 14:1-24. PMID: 27841717.
7: Maru S, Byrnes JM, Carrington MJ, Stewart S, Scuffham PA. Long-term cost-effectiveness of home versus clinic-based management of chronic heart failure: The WHICH? study. J Med Econ. 2016 Nov 14:1-25. PMID: 27841726.
8: Piccininni C, Bisnaire L, Penner M. Cost-effectiveness of Wait Time Reduction for Intensive Behavioral Intervention Services in Ontario, Canada. JAMA Pediatr. 2016 Nov 14. doi: 10.1001/jamapediatrics.2016.2695. PMID: 27842183.
9: Ride J, Lorgelly P, Tran T, Wynter K, Rowe H, Fisher J. Preventing postnatal maternal mental health problems using a psychoeducational intervention: the cost-effectiveness of What Were We Thinking. BMJ Open. 2016 Nov 18;6(11):e012086. doi: 10.1136/bmjopen-2016-012086. PMID: 27864246.
10: Rykov K, Reininga IH, Knobben BA, Sietsma MS, Ten Have BL. The design of a randomised controlled trial to evaluate the (cost-) effectiveness of the posterolateral versus the direct anterior approach for THA (POLADA - trial). BMC Musculoskelet Disord. 2016 Nov 15;17(1):476. PMID: 27846875.
11: Sandhu AT, Ollendorf DA, Chapman RH, Pearson SD, Heidenreich PA. Cost-Effectiveness of Sacubitril-Valsartan in Patients With Heart Failure With Reduced Ejection Fraction. Ann Intern Med. 2016 Nov 15;165(10):681-689. PubMed PMID: 27571284.
12: Thommes EW, Kruse M, Kohli M, Sharma R, Noorduyn SG. Review of seasonal influenza in Canada: Burden of disease and the cost-effectiveness of quadrivalent inactivated influenza vaccines. Hum Vaccin Immunother. 2016 Nov 18:0. PMID: 27858509.
13: Tonmukayakul U, Arrow P. Cost-effectiveness analysis of the atraumatic restorative treatment-based approach to managing early childhood caries. Community Dent Oral Epidemiol. 2016 Nov 14. doi: 10.1111/cdoe.12265. PMID: 27859533.
By CEA Registry Team on 11/17/2016 1:25 PM

By Elle Pope

Once each week we highlight findings from recently published cost-effectiveness studies:
 • Postpartum depression screening and treatment is cost-effective: After new recommendations issued from the U.S. Preventive Services Task Force promoting screening for postpartum depression, a new study finds screening for and treating postpartum depression to be cost-effective and recommends this practice be considered as part of usual postnatal care (8)
Nutrition intervention effective at reducing childhood obesity: One study has determined a school-based nutrition education intervention to be extremely cost-effective in reducing childhood obesity among elementary school students (1)
Patient-Centered Care is good value: Incorporating patient preferences within practice-based guidelines has been found to have good value and is recommended as a priority for developing new guidelines (16)
See below for a full list all cost-utility studies and selected reviews and editorials published November 7-11, 2016.  To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry.  Follow us on Twitter (@TuftsCEVR) and Facebook.
1: Graziose MM, Koch PA, Wang YC, Lee Gray H, Contento IR. Cost-effectiveness of a Nutrition Education Curriculum Intervention in Elementary Schools. J Nutr Educ Behav. 2016 Nov 11. pii: S14994046(16)30853-3. PubMed PMID: 27843129.
2: Venkatesh S, Pasternak JD, Beninato T, Drake FT, Kluijfhout WP, Liu C, Gosnell JE, Shen WT, Clark OH, Duh QY, Suh I. Cost-effectiveness of active surveillance versus hemithyroidectomy for micropapillary thyroid cancer. Surgery. 2016 Nov 10. pii: S0039-6060(16)30570-0. PubMed PMID: 27839930.
3: Ruder JA, Turvey B, Hsu JR, Scannell BP. Effectiveness of a Low-Cost Drilling Module in Orthopaedic Surgical Simulation. J Surg Educ. 2016 Nov 7. pii:S1931-7204(16)30229-X. PubMed PMID: 27839695.
4: Zhao D, Gai Tobe R, Cui M, He J, Wu B. Cost-effectiveness of a 23-valent pneumococcal polysaccharide vaccine immunization programme for the elderly in Shanghai, China. Vaccine. 2016 Nov 9. pii: S0264-410X(16)31025-8. PubMed PMID: 27838068.
5: Zanocco KA, Wu JX, Yeh MW. Parathyroidectomy for asymptomatic primary hyperparathyroidism: A revised cost-effectiveness analysis incorporating fracture risk reduction. Surgery. 2016 Nov 8. pii: S0039-6060(16)30493-7. PubMed PMID: 27836213.
6: Dowell JD, Shah SH, Cooper KJ, Yıldız V, Pan X. Cost-benefit analysis of establishing an inferior vena cava filter clinic. Diagn Interv Radiol. 2016 Nov 11. PubMed PMID: 27833068.
7: Bugiantella W, Rondelli F, Mariani L, Polistena A, Sanguinetti A, Avenia N, Mariani E. Cost-effectiveness analysis of the temporary percutaneous ileostomy for faecal diversion after colorectal resection in elderly. Aging Clin Exp Res. 2016 Nov 10. PubMed PMID: 27832466.
8: Wilkinson A, Anderson S, Wheeler SB. Screening for and Treating Postpartum Depression and Psychosis: A Cost-Effectiveness Analysis. Matern Child Health J. 2016 Nov 10. PubMed PMID: 27832444.
9: McEwan P, Selvapatt N, Brown A, Thursz M, Bennett H, Webster S, Kalsekar A, Yuan Y, Brenner M, Gordon J. A clinician's guide to the cost and health benefits  of hepatitis C cure assessed from the individual patient perspective. Eur J Gastroenterol Hepatol. 2016 Nov 9. PubMed PMID: 27832039.
10: Malet-Larrea A, García-Cárdenas V, Sáez-Benito L, Benrimoj SI, Calvo B, Goyenechea E. Cost-effectiveness of professional pharmacy services in community pharmacy: a systematic review. Expert Rev Pharmacoecon Outcomes Res. 2016 Nov 9. PubMed PMID: 27828725.
11: Hassan A, Shehata N, Wahba A. Cost effectiveness of letrozole and purified urinary FSH in treating women with clomiphene citrate-resistant polycystic ovarian syndrome: a randomized controlled trial. Hum Fertil (Camb). 2016 Nov 8:1-6. PubMed PMID: 27825272.
12: Wen F, Zheng H, Wu Y, Wheeler J, Zeng X, Fu P, Li Q. Cost-effectiveness Analysis of Fluorouracil, Leucovorin, and Irinotecan versus Epirubicin, Cisplatin, and Capecitabine in Patients with Advanced Gastric Adenocarcinoma. Sci Rep. 2016 Nov 8;6:36060. PubMed PMID: 27824060.
13: Bozkaya D, Livingston T, Migliaccio-Walle K, Odom T. The cost-effectiveness of disease-modifying therapies for the treatment of relapsing-remitting multiple sclerosis. J Med Econ. 2016 Nov 8:1-16. PubMed PMID:27822961.
14: Crossan C, Lord J, Ryan R, Nherera L, Marshall T. Cost effectiveness of case-finding strategies for primary prevention of cardiovascular disease: a modelling study. Br J Gen Pract. 2016 Nov 7. pii: bjgpjan-2017-67-654-marshall-fl-p. PubMed PMID: 27821671.
15: Reynolds MR, Baron SJ, Cohen DJ. Economic Implications of Transcatheter Aortic Valve Replacement in Patients at Intermediate Surgical Risk. Circulation. 2016 Nov 8;134(19):1416-1418. PubMed PMID: 27821418.
16: Padula WV, Millis MA, Worku AD, Pronovost PJ, Bridges JF, Meltzer DO. Individualized cost-effectiveness analysis of patient-centered care: a case series of hospitalized patient preferences departing from practice-based guidelines. J Med Econ. 2016 Nov 10:1-9. PubMed PMID: 27786569.
17: Carter MJ, Gilligan AM, Waycaster CR, Schaum K, Fife CE. Cost effectiveness of adding clostridial collagenase ointment to selective debridement in individuals with stage IV pressure ulcers. J Med Econ. 2016 Nov 9:1-13. PubMed PMID: 27774840.
By CEA Registry Team on 11/4/2016 9:16 AM

The Tufts Medical Center Cost-Effectiveness Analysis Registry ( has been updated to include published cost-effectiveness analyses (CEAs) from 2015.  

New data collection process
Starting with studies published in 2015, the CEA Registry will continue to display detailed information only for select studies that undergo full article review. Detailed description for the selection process is provided here. CEAs not selected for full review will still be included in the CEA Registry, but with limited, descriptive information.

Why the change?
This change follows the rapidly growing publication rate of CEAs, with over 600 cost-utility analyses (CUAs) published in 2014 alone. The new process allows the CEA Registry to provide valuable ratio and preference weight information for a select group of important studies to our users while continuing to provide a comprehensive list of cost-effectiveness studies published annually across different disease areas and interventions.  

CEA Registry contents
For years 1976-2015, we catalogue all cost-effectiveness analyses publishing CUAs. For 2015, we will include limited information on CEAs exclusively reporting cost per life-year (LY) results.

The current upload adds the following to the database:
- 701 cost-effectiveness analyses articles published in 2015, including:
    > 654 CUAs (398 full review and 257 partial review)
    > 47 cost-per-LY studies (29 full review and 18 partial review)
- Among 397 full review $/QALY articles:
    > 1,108 cost-effectiveness ratios
    > 1,971 utility weights

The full Registry now includes:
- 5,702 cost-effectiveness analyses articles published from 1976 through 2015
    > 5,655 CUAs
    > 47 cost-per-LY studies
    > 14,570 cost-effectiveness ratios
    > 21,927 utility weights

Figure. Article Review Process for CEA Registry along with number of cost-effectiveness analyses reviewed


The CEA data dictionary provides a list of variables used for data extraction for cost-per-QALY and cost-per-LY studies. It also provides information on changes in the variables over time. [Click here]


CEA Registry website

Online search capabilities allow for public access to a select set of data from the registry, including utility weights and ratios.  CEVR’s premium access subscribers can access and download both the entire CEA Registry and the Tufts National Coverage Determination database, which provides detailed information on each national coverage decision.  Premium access subscribers can conduct advanced searches of the Registry data. 

If you are interested in becoming a sponsor, please contact Julie Lannon for more information.

Stay up-to-date on all the news from the CEA Registry by following us on Twitter @TuftsCEVR or Like Us on Facebook.

By CEA Registry Team on 10/27/2016 1:46 PM

Research suggests that private health care payers cover medical interventions inconsistently.  In a study published in the Journal of Managed Care and Specialty Pharmacy we examined the consistency of the largest private payers’ coverage decisions for rheumatoid arthritis drugs.3  We examined coverage policies for rheumatoid arthritis drugs issued by the largest 10 payers in terms of covered lives in three ways.


First, we compared how the payers covered the rheumatoid arthritis drugs relative to each drug’s corresponding FDA approval.  We found that 69% of the payers’ coverage determinations were more restrictive than the corresponding FDA approval, 15% were consistent; 3% were less restrictive; and 13% were mixed, i.e., were more restrictive than the label in one way but less restrictive in another.  


Second, we compared the coverage policies with the American College of Rheumatology (ACR) treatment recommendations.  We found that 34% of the payers’ coverage determinations were consistent with the ACR recommendations, 33% were more restrictive; 17% were less restrictive; and 17% were mixed.


Third, we reviewed the coverage policies to determine the evidence that the payers reported reviewing when making their determination.  We found that payers reported reviewing a different evidence base in their coverage determinations.  For instance, we found that only Aetna reported reviewing evidence from each considered evidence category.  This finding is consistent with other research that has examined the evidence base that payers report reviewing in their coverage policies.


While we expected some differences among the included payers, the identified variation across the payers’ was notable.  One reason for this variation could be that payers use different evidence and/or different criteria to make decisions.  Indeed, we found that the included payers reported reviewing a different evidence base in their decisions.  In future research we plan to examine the consistency between the payer coverage determination and the evidence they report reviewing when adjudicating the decision. 

By CEA Registry Team on 10/19/2016 11:23 AM
In a recent study published in the American Journal of Managed Care, researchers from the Center for the Evaluation of Value and Risk in Health analyzed findings from 26 empirical studies to examine how drug exclusion policies affect patients and healthcare costs.  The researchers found that although there were important exceptions, most studies found that drug exclusion policies reduced costs and did not negatively impact patients.    

An info-graphic based on this study can be found here–   

Dr. Chambers, the study’s lead author, participated on a podcast to discuss this...
By CEA Registry Team on 10/14/2016 8:19 AM

 By James D. Chambers, Ph.D.


In a study published in the American Journal of Managed Care we report on our research that sought to map the private health care payer coverage and reimbursement landscape.  We considered all publicly available coverage policies for medical interventions issued by the largest 20 private health care payers.  Two payers do not make their coverage determinations publicly available and were excluded from this research.  In total, we considered more than 7,000 coverage policies.


We found that the number of policies payers issued varied, ranging from 146 by UnitedHealthcare to 698 by Aetna.  We also found variation in the types of intervention for which payers issued coverage determinations for: 89% of payers issued the largest proportion of their coverage policies for medical devices; 11% issued the largest proportion for drugs.


Additionally, for a subset of interventions – the seven medical devices, pharmaceuticals, surgeries, and diagnostic tests/imaging procedures for which the payers most often issued coverage policies – we examined the payers’ coverage determinations and the evidence that the payers reported reviewing in their policy.


We found that how payers covered the interventions varied: for 9 of the 28 interventions some payers covered the intervention and others did not.  We also found variation with respect to the evidence that the payers reported reviewing in their coverage policies, some highlights are presented here:


  • Overall, payers reported reviewing clinical studies in 87% of policies.
  • Two payers did not report reviewing systematic reviews or meta-analyses in any policies; nine payers reported reviewing systematic reviews or meta-analyses in at least half of their policies.
  • Fourteen payers reported reviewing cost-effectiveness analyses at least some of the time
  • No payer reported receiving direct input from patients or patient advocates.


In summary, our research highlights variation in how US private payers cover medical interventions and in the evidence that payers report reviewing in their coverage policies.  This variation across private payers’ coverage policies may lead to unequal access to medical technology for patients and presents a challenge for manufacturers developing evidence for new technologies.

By CEA Registry Team on 9/27/2016 12:01 PM


The American Journal of Public Health has published our paper highlighting the paucity of recently published cost-utility analyses that address the leading health concerns in the US Department of Health and Human Services Healthy People 2020 report. 

Using the Tufts Medical Center Cost-Effectiveness Analysis Registry (, a database containing 5000 published cost-utility analyses published in the MEDLINE literature through 2014, two researchers at the Center for the Evaluation of Value and Risk in Health (CEVR) reviewed abstracts for articles published 2011 to 2014 (n=687) and subsequently categorized cost-utility analyses that addressed the specific priorities listed in the 12 Healthy People 2020 areas (n = 120). 

Key findings include:  7.3% of recently published cost-utility analyses addressed key clinical preventative services and only 2% of recently published cost-utility analyses covered each of the following Healthy People 2020 topics: reproductive and sexual health, nutrition/physical activity/obesity, maternal and infant health, and tobacco.  Fewer than 1% addressed priority interventions for injuries and violence, mental health, or substance abuse.  No recent cost-utility analyses addressed specific Healthy People 2020 priorities on oral health, environmental quality, or social determinants of health.  

The scarcity of cost-utility analyses on the government’s own priorities, including interventions addressing areas with substantial burdens of morbidity and mortality, is troubling.  The lack of evaluation of interventions that mitigate risks in these areas keeps the United States on the path of solving health problems largely through medical care rather than through changes in the built and social environment.  

By CEA Registry Team on 9/13/2016 11:00 AM

By Peter J. Neumann, Sc.D.

The Journal of the American Medical Association today published a special communications from the Second Panel on Cost Effectiveness in Health and Medicine.  The Panel updates 20-year-old guidelines and recommendations for evaluating cost-effectiveness in health and medicine.1

The field of cost-effectiveness analysis has advanced in important ways over the years and the need to deliver health care efficiently has only grown.  Updating the guidelines provides an opportunity to reflect on the evolution of cost-effectiveness analysis and to provide guidance for the next generation of practitioners and consumers.

Building on the original work of the 1996 Panel on Cost-Effectiveness in Health and Medicine, originally convened by the U.S. Public Health Service, the recommendations are intended to guide decision makers in using new methods for analyzing evidence, reporting standardized results, incorporating both healthcare system and societal perspectives, and weighing ethical issues in the use of cost-effectiveness analysis.

Primarily funded by grants from the Robert Wood Johnson Foundation and the Bill & Melinda Gates Foundation, the panel recommends several key changes to the guidelines, including:

•    Broadening the scope of the Reference Case, a standard set of methodology that should be followed to ensure quality analysis by creating comparable measurements.

•    Measuring health effects in terms of quality adjusted life years, a measure that includes both the quality and quantity of life lived.

•    Including both costs reimbursed by third-party payers and those paid for out-of-pocket by patients in healthcare sector analyses.

•    Using an “Impact Inventory” that lists the health and non-health effects of a healthcare intervention to ensure that all consequences are considered, including those to patients, caregivers, social services and others outside the healthcare sector.  This tool also allows analysts to look at categories of impacts that may be most important to stakeholders.

•    A reporting checklist and guidelines for transparency that include assumptions in any analysis and the disclosure of potential conflicts of interest.
The panel was co-chaired by Gillian D. Sanders, professor in the Department of Medicine and a member of both the Duke Clinical Research Institute and the Duke-Margolis Center for Health Policy, and Peter J. Neumann, ScD, Director, Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center and Professor of Medicine at Tufts University.  The panel also included Anirban Basu (University of Washington), Dan W. Brock (Harvard Medical School), David Feeny (McMaster University), Murray Krahn (University of Toronto), Karen M. Kuntz (University of Minnesota), David O. Meltzer (University of Chicago), Douglas K. Owens (VA Palo Alto Health Care System and Stanford University), Lisa A. Prosser (University of Michigan), Joshua A. Salomon (Harvard T.H. Chan School of Public Health), Mark J. Sculpher (University of York, UK), Thomas A. Trikalinos (Brown University), Louise B. Russell (Rutgers University), Joanna E. Siegel, and Theodore G. Ganiats (University of California – San Diego School of Medicine).

1Sanders GD, Neumann PJ, Basu A, Brock DW, Feeny D, Krahn M, Kuntz KM, Meltzer DO, Owens DK, Prosser LA, Salomon JA, Sculpher MJ, Trikalinos TA, Russell LB, Siegel JE, Ganiats TG. Recommendations for Conduct, Methodological Practices, and Reporting of Cost-Effectiveness Analyses: Second Panel on Cost Effectiveness in Health and Medicine. JAMA. 2016;316(10):1093-1103

By CEA Registry Team on 8/15/2016 8:31 AM

By Pei-Jung Lin, PhD

People with multiple sclerosis (MS) may experience problems with the use of the arms and hands, walking, tiredness, eyesight, attention, and memory.  Our recent study in PharmacoEconomics suggests that not all symptoms are equally troubling to patients, however:  MS patients may value potential improvement in one symptom (e.g., improved arm and hand coordination) over another (e.g., less fatigue) [1].

Further, MS patients may rank the importance of treating various symptoms differently from the way neurologists rank them.  For example, our survey found that MS patients would be willing to pay $410-$520/month to improve their mobility alone—higher than neurologists believe their patients would pay ($216-$249/month, depending on the scenario).  For paired symptoms, our results showed that MS patients would pay the most to treat both mobility and upper limb function (US$525/month) and the least to treat mobility and fatigue (US$371/month) (Figure 1).  In contrast, neurologists believed MS patients would pay the most to treat both mobility and fatigue (US$263/month) and the least to treat mobility and upper limb function (US$177/month) (Figure 2).

Our findings may suggest a mismatch between what MS patients want and what neurologists assume their patients want.  Given this discrepancy, it is important for MS patients and their clinicians to discuss treatment priorities that take into account patient preferences.  As numerous studies have pointed out, understanding these preferences is crucial for effective patient-physician communication and improved patient outcomes and treatment adherence.  Additionally, a better understanding of patient-centered outcomes can guide the development of MS treatments.

In prior work, we have investigated patient preferences and patient-centered communications.  Through a population-based survey, we document that the way a doctor frames survival statistics can make a big difference in how the patient perceives the value of cancer therapy [2].  As patients are asked to shoulder more costs and make difficult decisions about their care, understanding when and why framing matters is essential for uncovering how patients evaluate the value of medical interventions.

Figure 1: Estimated mean monthly willingness-to-pay values among MS patient respondents

Figure 2: Estimated mean monthly patient willingness-to-pay values among neurologist respondents

This study was supported by research funding from Biogen to Tufts Medical Center.

[1] Lin PJ, Saret CJ, Neumann PJ, Sandberg EA, Cohen JT. Assessing the Value of Treatment to Address Various Symptoms Associated with Multiple Sclerosis: Results from a Contingent Valuation Study. Pharmacoeconomics. 2016 Jul 26. [Epub ahead of print] PubMed PMID: 27461538.

[2] Lin PJ, Concannon TW, Greenberg D, Cohen JT, Rossi G, Hille J, Auerbach HR, Fang CH, Nadler ES, Neumann PJ. Does framing of cancer survival affect perceived value of care? A willingness-to-pay survey of US residents. Expert Rev Pharmacoecon Outcomes Res. 2013 Aug;13(4):513-22. PubMed PMID: 23977977.

By CEA Registry Team on 6/15/2016 4:20 PM
 By Pei-Jung Lin, PhD.

Alzheimer’s disease and related dementias (ADRD) is a slow, progressive disease.  Many people with ADRD may live for years with the disease left unrecognized or untreated, in part because the early symptoms are mild and often mistaken as part of normal aging.  Our recent study1 in the Journal of the American Geriatrics Society (JAGS) found that ADRD patients may already use more health care services than those without dementia before they receive a formal diagnosis. Our findings suggest that ADRD patients’ Medicare expenditures may start to increase at least 12 months preceding their first diagnosis date (Figure 1).  We found that total Medicare expenditures are 42% higher among ADRD patients than matched controls during the year prior to diagnosis ($15,091 vs. $10,622), and 192% higher during the first year immediately following diagnosis ($27,126 vs. $9,274).  Our study also showed that ADRD patients’ Medicare expenditures increase substantially during the period...
By CEA Registry Team on 5/16/2016 8:41 AM

By CEA Registry Team

The Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry (, will begin to display detailed information only for selected studies considered to be high impact economic evaluations. Starting with studies published in 2015, all CEA abstracts will be reviewed by two Tufts reviewers, who will make a determination by consensus on whether the study qualifies for an extended review based on: the study’s population, the medical intervention(s) being studied, novelty of treatment, as well as the generalizability of the study’s results, as inferred from the abstract. The selected studies will then be reviewed in full so the Registry team can collect detailed information on cost-effectiveness ratios, utility weights, and study methodology. The cost-utility studies not deemed to be high impact will continue to be included in the CEA Registry, but with limited information extracted only from the abstract, including country of study, intervention type, target population and interventions evaluated, without providing ratios, weights, or disaggregate cost and QALY data. Limited information on cost per life year studies will also be included in the Registry starting with studies published in 2015.

This change follows the rapidly growing publication rate of CUAs, with over 600 studies published in 2014 alone. The newer process allows the CEA Registry to provide valuable ratio and preference weight information for a select group of important studies to our users while continuing to provide a comprehensive list of cost per QALY and cost per life year studies published annually across different disease areas and interventions.  The Registry is currently updated through 2014 and contains 5,000 cost-utility studies with over 13,000 standardized cost-effectiveness ratios and 19,000 utility weights.

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