Rita Faria’s journal round-up for 14th September 2020

Every Monday our authors provide a round-up of the latest peer-reviewed journal publications. We cover all issues of major health economics journals as well as some other notable releases. Visit our Resources page for links to more journals or follow the HealthEconBot. If you’d like to write one of our weekly journal round-ups, get in touch.

PharmacoEconomics

Volume 38, Issue 9

A couple of the papers caught my eye in the September issue of PharmacoEconomics. The first is by Paul Catchpole and Victoria Barrett, from the APBI, who suggest three topics for the ongoing review of the NICE Methods Guide for technology appraisal: value frameworks, uncertainty, and discounting, in an article that was discussed by Chris a few months ago. I read this with interest given that a lot of my work is for NICE, both as a researcher and as a committee member. Relating to the value framework, Paul and Victoria suggest including benefits beyond QALYs and to replace the end of life criteria with a “severity-based modifier”.  It’s not completely clear from the paper, but I suppose that this would be a way to adjust QALY gains upwards (or downwards) depending on disease severity. Of course, the crux of the matter is that any adjustments to the benefits side of the cost-effectiveness equation should be matched in the opportunity cost side. With respect to uncertainty, they call for improvements in the way that uncertainty is presented to NICE Committees, with which I completely agree, and pragmatism in how to approach it. Lastly, they ask for the discount rate to be lowered to 1.5% for health effects in line with the HM Treasury Green Book.

The other paper that I’d like to highlight is a meta-analysis of unit costs of immunisation delivery in LMICs. It’s rare to see a meta-analysis of costs, and even more so in LMICs! This remarkable study by Allison Portnoy and colleagues calculated that the cost per dose for routine delivery of childhood vaccines, excluding the price of the vaccine, was $1.87 (95% uncertainty interval $0.64–4.38) across all LMICs. This study is sure to be very useful to analysts and policymakers working on immunisation programmes.

Among the other papers, three are on cost-effectiveness analysis: of cannabinoid oil for the treatment of Dravet syndrome in children, of ravulizumab compared to eculizumab for paroxysmal nocturnal hemoglobinuria, and of inclisiran for the secondary prevention of cardiovascular events. Remaining within the field of cost-effectiveness, a study compared a cohort model to a micro-simulation model for the simulation of costs and health outcomes in type 2 diabetes. With the goal of informing a cost-effectiveness model, Luiza Grazziotin and colleagues reviewed the literature for health state utility values in juvenile idiopathic arthritis. For costing, we have a review of cost-of-illness studies in hepatitis C, and a budget impact analysis of venetoclax + obinutuzumab for chronic lymphocytic leukaemia. Lastly, there is a paper look at the financing of drug innovation in the US.

PharmacoEconomics – Open

Volume 4, Issue 3

This month’s issue of PharmacoEconomics – Open is mostly on economic evaluations and related topics. The editorial sets the theme with a comment on how cost-effectiveness can inform pandemic preparedness plans.

I found a cost-benefit analysis of a public health campaign to prevent excessive UV exposure in Denmark to be quite interesting. The authors linked information on the Danish population’s UV exposure, the incidence of skin cancers, the effect of UV exposure on skin cancer, the avoided costs if skin cancer incidence reduced, and the costs of the campaign.

If you enjoy reading cost-effectiveness analyses, there’s plenty to choose from in this issue. There are cost-effectiveness analyses in depression, in idiopathic pulmonary fibrosis, in preventing complications from invasive angiographic procedures, in stroke prevention in patients with atrial fibrillation, in the prevention of gestational diabetes and hypertensive disease in pregnancy, in the self-care of blood pressure, and on testing for a biomarker prior to bevacizumab treatment for breast cancer

Still on the topic of cost-effectiveness, there are two systematic reviews of cost-effectiveness studies, on heart failure and on chronic hepatitis B, as well as a comment on a previously published review in glaucoma together with the authors’ reply.

The remaining papers include a cost study on advanced prostate cancer, a burden-of-illness study on cardiovascular disease in patients with type 1 diabetes, a study on the satisfaction with and burden of treatment for patients with multiple myeloma and their caregivers, and a study on the predictors and the consequences of metabolic acidosis in preterm infants on hospital length of stay and costs.

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