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10.1007/s12325-021-01654-5

http://scihub22266oqcxt.onion/10.1007/s12325-021-01654-5
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suck abstract from ncbi


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pmid33650025      Adv+Ther 2021 ; 38 (4): 1811-1831
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  • A Cost-Effectiveness Framework for COVID-19 Treatments for Hospitalized Patients in the United States #MMPMID33650025
  • Sheinson D; Dang J; Shah A; Meng Y; Elsea D; Kowal S
  • Adv Ther 2021[Apr]; 38 (4): 1811-1831 PMID33650025show ga
  • INTRODUCTION: The COVID-19 pandemic is a global crisis impacting population health and the economy. We describe a cost-effectiveness framework for evaluating acute treatments for hospitalized patients with COVID-19, considering a broad spectrum of potential treatment profiles and perspectives within the US healthcare system to ensure incorporation of the most relevant clinical parameters, given evidence currently available. METHODS: A lifetime model, with a short-term acute care decision tree followed by a post-discharge three-state Markov cohort model, was developed to estimate the impact of a potential treatment relative to best supportive care (BSC) for patients hospitalized with COVID-19. The model included information on costs and resources across inpatient levels of care, use of mechanical ventilation, post-discharge morbidity from ventilation, and lifetime healthcare and societal costs. Published literature informed clinical and treatment inputs, healthcare resource use, unit costs, and utilities. The potential health impacts and cost-effectiveness outcomes were assessed from US health payer, societal, and fee-for-service (FFS) payment model perspectives. RESULTS: Viewing results in aggregate, treatments that conferred at least a mortality benefit were likely to be cost-effective, as all deterministic and sensitivity analyses results fell far below willingness-to-pay thresholds using both a US health payer and FFS payment perspective, with and without societal costs included. In the base case, incremental cost-effectiveness ratios (ICER) ranged from $22,933 from a health payer perspective using bundled payments to $8028 from a societal perspective using a FFS payment model. Even with conservative assumptions on societal impact, inclusion of societal costs consistently produced ICERs 40-60% lower than ICERs for the payer perspective. CONCLUSION: Effective COVID-19 treatments for hospitalized patients may not only reduce disease burden but also represent good value for the health system and society. Though data limitations remain, this cost-effectiveness framework expands beyond current models to include societal costs and post-discharge ventilation morbidity effects of potential COVID-19 treatments.
  • |*COVID-19 Drug Treatment[MESH]
  • |Aftercare[MESH]
  • |Cost-Benefit Analysis[MESH]
  • |Humans[MESH]
  • |Pandemics[MESH]
  • |Patient Discharge[MESH]
  • |Quality-Adjusted Life Years[MESH]
  • |SARS-CoV-2[MESH]


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