Determinants of Cost-Effectiveness results of Biological Therapies for Severe Asthma: a systematic methodological assessment.
Autor: | Torre-Pérez L; Methodology of Biomedical Research and Public Health PhD Program, Universitat Autónoma de Barcelona, Spain; Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain; Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain. Electronic address: lr.delatorre.prz@gmail.com., Santero M; Methodology of Biomedical Research and Public Health PhD Program, Universitat Autónoma de Barcelona, Spain; Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain; Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain., Nieto-Gutierrez W; Methodology of Biomedical Research and Public Health PhD Program, Universitat Autónoma de Barcelona, Spain; Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain; Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain; Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Perú., Giesen C; Centro de Salud Internacional Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain., Nardin A; Department of Diagnostics and Public Health, University of Verona, Via San Francesco 22 - 37129 Verona, IT; Ecohealth Unit, Environment and Health Department, Italian National Institute of Health, Viale Regina Elena 299 - 00161, Rome, IT., Cosma C; School of Specialization in Hygiene and Preventive Medicine, Department of Health Sciences, University of Florence, 50134 Florence, Italy., Pires PS; Hospital S. Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal., Guida A; School of Specialization in Hygiene and Preventive Medicine, Department of Health Sciences, University of Florence, 50134 Florence, Italy., Simonini M; Department of Diagnostics and Public Health, University of Verona, Via San Francesco 22 - 37129 Verona, IT., Lazo CQ; Methodology of Biomedical Research and Public Health PhD Program, Universitat Autónoma de Barcelona, Spain., Xie F; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Centre for Health Economics and Policy Analysis (CHEPA), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada., Alonso-Coello P; Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain; Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP), Spain. |
---|---|
Jazyk: | angličtina |
Zdroj: | Journal of clinical epidemiology [J Clin Epidemiol] 2024 Dec 03, pp. 111621. Date of Electronic Publication: 2024 Dec 03. |
DOI: | 10.1016/j.jclinepi.2024.111621 |
Abstrakt: | Objective: to assess the associations between cost-effectiveness analysis' (CEA) methodological characteristics and Incremental Cost-Effectiveness Ratio (ICER) outcomes and conclusions, in biological treatments for asthma. Study Design and Setting: We included CEAs comparing biological treatments to standard care, in adults with severe asthma. We performed a search in MEDLINE, EMBASE, and Web of Science (Sep 2022). We extracted and summarised CEA's characteristics and critically appraised the studies using the extended Consensus Health Economic Criteria (e-CHEC). In those reporting benefits as quality-adjusted life years (QALY), we conducted bivariate and regression analyses. Results: We identified 33 CEAs that showed overall good quality (above 66.6% of compliance) with variable results across e-CHEC sections. We included 28 cost-utility analysis (CUA) on biological treatments in asthma in our analysis. Only industry sponsorship showed significant differences in the bivariate analysis (p=0.021 for the difference in ICER medians, and p=0.027 for the different percentage in reported cost-effectiveness). In the regression adopting a non-lifetime horizon and non-use of a model (β = 4.25 and β = 0.16, p<0.05), significantly associated in the multivariate ananlysis. Only non industry sponsorship showed a significant association with the drug being reported as not cost-effective, both in the bivariate and multivariate analysis (OR = 13.2, and OR = 20.15 p<0.05). Conclusion: Our study identified significant limitations, including poor reporting practices and the impact of industry sponsorship on outcomes, with notable effects on cost-effectiveness conclusions.These findings highlight the need for policymakers and healthcare decision-makers to meticulously consider methodological rigour and potential biases in economic evaluations. (Copyright © 2024. Published by Elsevier Inc.) |
Databáze: | MEDLINE |
Externí odkaz: |