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Cost-effectiveness analysis of routine rotavirus vaccination in Brazil

Soárez, Patrícia Coelho de; VALENTIM, Joice; SARTORI, Ana Marli Christovam; NOVAES, Hillegonda Maria Dutilh
Fonte: PAN AMER HEALTH ORGANIZATION Publicador: PAN AMER HEALTH ORGANIZATION
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
95.95%
Objective. The objective of this study was to conduct a cost-effectiveness analysis of a universal rotavirus vaccination program among children : 5 years of age in Brazil. Methods. Considering a hypothetical annual cohort of approximately 3 300 000 newborns followed over 5 years, a decision-tree model was constructed to examine the possible clinical and economic effects of rotavirus infection with and without routine vaccination of children. Probabilities and unit costs were derived from published research and national administrative data. The impact of different estimates for key parameters was studied using sensitivity analysis. The analysis was conducted from both healthcare system and societal perspectives. Results. The vaccination program was estimated to prevent approximately 1735 351 (54%) of the 3 210 361 cases of rotavirus gastroenteritis and 703 (75%) of 933 rotavirus-associated deaths during the 5-year period. At a vaccine price of 18.6 Brazilian reais (R$) per dose, this program would cost R$121 673 966 and would save R$38 536 514 in direct costs to the public healthcare system and R$71 778 377 in direct and indirect costs to society. The program was estimated to cost R$1 028 and R$1 713 per life-years saved (LYS)from the societal and healthcare system perspectives...

Cost-effectiveness analysis of universal childhood hepatitis A vaccination in Brazil: Regional analyses according to the endemic context

Sartori, Ana Marli C.; de Soarez, Patricia Coelho; Dutilh Novaes, Hillegonda Maria; Amaku, Marcos; de Azevedo, Raymundo Soares; Moreira, Regina Celia; Moreira Beltrao Pereira, Leila Maria; de Alencar Ximenes, Ricardo Arraes; Turchi Martelli, Celina Maria
Fonte: ELSEVIER SCI LTD; OXFORD Publicador: ELSEVIER SCI LTD; OXFORD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
85.97%
Objective: To To conduct a cost-effectiveness analysis of a universal childhood hepatitis A vaccination program in Brazil. Methods: An age and time-dependent dynamic model was developed to estimate the incidence of hepatitis A for 24 years. The analysis was run separately according to the pattern of regional endemicity, one for South + Southeast (low endemicity) and one for the North + Northeast + Midwest (intermediate endemicity). The decision analysis model compared universal childhood vaccination with current program of vaccinating high risk individuals. Epidemiologic and cost estimates were based on data from a nationwide seroprevalence survey of viral hepatitis, primary data collection, National Health Information Systems and literature. The analysis was conducted from both the health system and societal perspectives. Costs are expressed in 2008 Brazilian currency (Real). Results: A universal immunization program would have a significant impact on disease epidemiology in all regions, resulting in 64% reduction in the number of cases of icteric hepatitis, 59% reduction in deaths for the disease and a 62% decrease of life years lost, in a national perspective. With a vaccine price of R$16.89 (US$7.23) per dose, vaccination against hepatitis A was a cost-saving strategy in the low and intermediate endemicity regions and in Brazil as a whole from both health system and society perspective. Results were most sensitive to the frequency of icteric hepatitis...

Análise da relação custo-efetividade do tratamento com DCI - Desfibrilador Cardioversor Implantável; Cost-effectiveness analysis of implantable cardioverter defibrillator therapy (ICD)

Matos, Afonso José de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 23/03/2007 PT
Relevância na Pesquisa
86.05%
Objetivo: Análise da relação custo-efetividade do tratamento com o uso do DCI - Desfibrilador Cardioversor Implantável comparado com o tratamento clínico alternativo através de medicamentos. Revisão de literatura: O estudo contemplou a revisão da conceituação das técnicas de avaliação econômica e de apropriação de custos de procedimentos hospitalares, bem como experiências sobre a análise da relação custo-efetividade aplicadas às intervenções médicas consideradas na pesquisa. Métodos: O estudo utilizou a unidade de Custo por AVG - Ano de Vida Ganho, como expressão do indicador de custo-efetividade. A metodologia compreendeu a definição da perspectiva da pesquisa (Sistema Único de Saúde na qualidade de principal financiador do implante de DCIs, no Brasil), elaboração dos protocolos padrões de tratamento, cálculo dos custos totais dos tratamentos baseados em indicadores praticados por hospitais de referência, os quais encontram-se estimados para o período de dez anos e ajustados para valor presente à taxa de desconto de 6% ao ano. No âmbito da efetividade, foram utilizados parâmetros da literatura, os quais encontram-se baseados nos anos de vida ganhos do tratamento com o uso do DCI, em relação ao tratamento clínico. Resultados: O custo por AVG alcançado pelo estudo foi de R$ 20.530...

Análise de custo-efetividade do tratamento supervisionado e autoadministrado da tuberculose; Cost-effectiveness analysis of supervised and self-administered treatment of tuberculosis.

Gomes, Michela Prestes
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 27/03/2013 PT
Relevância na Pesquisa
85.97%
A tuberculose (TB) é uma doença infecto contagiosa causada pelo Bacilo de Koch (Mycobacterium tuberculosis), sua forma mais frequente é a tuberculose pulmonar, e tem cura quando o tratamento é realizado corretamente. É uma das importantes causas de mortalidade no mundo, e apresenta alta prevalência e incidência no Brasil, o qual se encontra entre os países com maiores números de casos da doença. O objetivo desse trabalho foi efetuar um estudo sobre custo-efetividade do tratamento para tuberculose (abordando as estratégias de tratamento supervisionado e autoadministrado), buscando evidencias para estimar custos diretos (no distrito oeste de Ribeirão Preto-SP) e custos indiretos (para algumas regiões deste município). Por ser uma doença associada às condições sociais e econômicas (nelas incluídas o Brasil), buscou-se observar as deficiências das organizações e gestão do sistema de saúde, através da análise dos custos gerados pela TB. Foi efetuado um estudo epidemiológico, descritivo, pesquisa avaliativa, visando coletar dados sócio-demográficos, e características sobre acompanhamento e evolução do tratamento através dos prontuários dos doentes de TB para estimativa de custos diretos, e também estimar os custos indiretos através de entrevista com os pacientes. A fim de efetuarmos a análise de custo-efetividade do tratamento diretamente observado (TDO) e autoadministrado (TAA) da TB. Foram amplamente discutidos a qualidade dos dados...

Cost-effectiveness analysis for sustainable wastewater engineering : a case study at Minho-Lima’s rivers basins (Portugal)

Costa, Sérgio; Coutinho, L.; Nogueira, R.; Brito, A. G.; Salas, J. J.; Póvoa, C.
Fonte: Universidade do Minho Publicador: Universidade do Minho
Tipo: Conferência ou Objeto de Conferência
Publicado em 11/11/2007 ENG
Relevância na Pesquisa
96%
The present work was focused on a methodological assessment for defining cost-effective measures regarding to wastewater sanitation in rural areas and was carried out within the project AQUA Project – Preliminary Studies for the Water Framework Directive Implementation at the Minho and Lima’s Rivers Basins. In order to assure a good ecological and chemical status in water bodies according to Water Framework Directive, a set of priority and complementary actions combined with a cost-effectiveness analysis was used to select a wastewater treatment strategy to increase public attendance. Using geoprocessing methodologies and geographic information multicriteria analysis (e.g.: soil, land use, topography), locations with high potential for implementation of low-energy wastewater treatment systems were identified and worked out with cost-functions. The results show that a combination of centralized and decentralized plants allow a cost-effectiveness attendance of 1,51 k¤/equivalent inhabitant in Minho and Lima’s river basins. The approach indicates that low-energy wastewater treatment plants are interesting options with a promising cost-effectiveness potential in rural areas.

Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system

Bahia,Luciana Ribeiro; Araujo,Denizar Vianna; Pepe,Camila; Trindade,Michelle; Camargo,Caroline Mendonça; Javaroni,Valter
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2012 EN
Relevância na Pesquisa
95.99%
OBJECTIVE: To perform a cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia (BPH) under Brazilian public health system perspective (Unified Health System - "Sistema Único de Saúde (SUS)"). MATERIAL AND METHODS: A revision of the literature of the medical treatment of BPH using alpha-blockers, 5-alpha-reductase inhibitors and combinations was carried out. A panel of specialists defined the use of public health resources during episodes of acute urinary retention (AUR), the treatment and the evolution of these patients in public hospitals. A model of economic analysis(Markov) predicted the number of episodes of AUR and surgeries (open prostatectomy and transurethral resection of the prostate) related to BPH according to stages of evolution of the disease. Brazilian currency was converted to American dollars according to the theory of Purchasing Power Parity (PPP 2010: US$ 1 = R$ 1.70). RESULTS: The use of finasteride reduced 59.6% of AUR episodes and 57.9% the need of surgery compared to placebo, in a period of six years and taking into account a treatment discontinuity rate of 34%. The mean cost of treatment was R$ 764.11 (US$449.78) and R$ 579.57 (US$ 340.92) per patient in the finasteride and placebo groups...

Chronic Hepatitis C treatment for genotype 2 or 3 in Brazil: cost effectiveness analysis of peginterferon plus ribavirin as first choice treatment

Blatt,Carine Raquel; Storb,Bernd; Mühlberger,Nikolai; Farias,Mareni Rocha; Siebert,Uwe
Fonte: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
85.96%
Brazilian Guidelines to HCV treatment (2007) recommended that the first choice treatment for patients with chronic hepatitis C (CHC) and genotype 2 or 3 is interferon alpha (IFN) plus ribavirin (RBV) for 24 weeks. The aim of this study is compare the cost and effectiveness to Hepatitis C treatment in patients with genotype 2 or 3 of peginterferon alpha (PEG) as the first choice of treatment within PEG for those that do not respond to IFN. The target population is CHC patients with genotype 2 or 3 in Brazil. The interventions are: PEG-SEC (first IFN plus RBV for 24 weeks, after, for non-responders and relapsers subsequently PEG plus RBV for 48 weeks); PEG-FIRST24 (PEG+RBV for 24 weeks). The type of the study is cost-effectiveness analysis. The data sources are: Effectiveness data from meta-analysis conducted on the Brazilian population. Treatment cost from Brazilian micro costing study is converted into USD (2010). The perspective is the Public Health System. The outcome measurements are Sustained Viral Response (SVR) and costs. PEG-FIRST24 (SVR: 87.8%, costs: USD 8,338.27) was more effective and more costly than PEG-SEC (SVR: 79.2%, costs: USD 5,852.99). The sensitivity analyses are: When SVR rates with IFN was less than 30% PEG-FIRST is dominant. On the other hand...

Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis

Norheim, Ole F; Baltussen, Rob; Johri, Mira; Chisholm, Dan; Nord, Erik; Brock, DanW; Carlsson, Per; Cookson, Richard; Daniels, Norman; Danis, Marion; Fleurbaey, Marc; Johansson, Kjell A; Kapiriri, Lydia; Littlejohns, Peter; Mbeeli, Thomas; Rao, Krishna D;
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
85.97%
This Guidance for Priority Setting in Health Care (GPS-Health), initiated by the World Health Organization, offers a comprehensive map of equity criteria that are relevant to health care priority setting and should be considered in addition to cost-effectiveness analysis. The guidance, in the form of a checklist, is especially targeted at decision makers who set priorities at national and sub-national levels, and those who interpret findings from cost-effectiveness analysis. It is also targeted at researchers conducting cost-effectiveness analysis to improve reporting of their results in the light of these other criteria. The guidance was develop through a series of expert consultation meetings and involved three steps: i) methods and normative concepts were identified through a systematic review; ii) the review findings were critically assessed in the expert consultation meetings which resulted in a draft checklist of normative criteria; iii) the checklist was validated though an extensive hearing process with input from a range of relevant stakeholders. The GPS-Health incorporates criteria related to the disease an intervention targets (severity of disease, capacity to benefit, and past health loss); characteristics of social groups an intervention targets (socioeconomic status...

Buprenorphine versus methadone maintenance: a cost-effectiveness analysis

Doran, C.; Shanahan, M.; Mattick, R.; Ali, R.; White, J.; Bell, J.
Fonte: Elsevier Sci Ireland Ltd Publicador: Elsevier Sci Ireland Ltd
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
85.99%
This article presents the cost-effectiveness results of a randomised controlled trial conducted in two Australian cities. The trial was designed to assess the safety, efficacy and cost-effectiveness of buprenorphine versus methadone in the management of opioid dependence. The trial utilised a flexible dosing regime that was tailored to the clinical need of the patients, with high maximum doses, using the marketed formulation, under double-blind conditions. A total of 405 subjects were randomised to a treatment at one of three specialist outpatient drug treatment centres in Adelaide and Sydney, Australia. The perspective of the cost-effectiveness analysis was that of the service provider and included costs relevant to the provision of treatment. The primary outcome measure used in the economic analysis was change in heroin-free days from baseline to the sixth month of treatment. Treatment with methadone was found to be both less expensive and more effective than treatment with buprenorphine, which suggests methadone dominates buprenorphine. However, statistical testing found that the observed difference between the cost-effectiveness of methadone and buprenorphine treatments was not statistically significant. The results of this study provide useful policy information on the costs and outcomes associated with the use of methadone and buprenorphine and indicate that buprenorphine provides a viable alternative to methadone in the treatment of opioid dependence.; Christopher M. Doran...

A cost-effectiveness analysis of heroin detoxification methods in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD)

Shanahan, M.; Doran, C.; Digiusto, E.; Bell, J.; Lintzeris, N.; White, J.; Ali, R.; Saunders, J.; Mattick, R.; Gilmour, S.
Fonte: Pergamon-Elsevier Science Ltd Publicador: Pergamon-Elsevier Science Ltd
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
95.95%
Abstract This economic evaluation was part of the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) project. Data from four trials of heroin detoxification methods, involving 365 participants, were pooled to enable a comprehensive comparison of the cost-effectiveness of five inpatient and outpatient detoxification methods. This study took the perspective of the treatment provider in assessing resource use and costs. Two short-term outcome measures were used—achievement of an initial 7-day period of abstinence, and entry into ongoing post-detoxification treatment. The mean costs of the various detoxification methods ranged widely, from AUD $491 (buprenorphine-based outpatient); to AUD $605 for conventional outpatient; AUD $1404 for conventional inpatient; AUD $1990 for rapid detoxification under sedation; and to AUD $2689 for anaesthesia per episode. An incremental cost-effectiveness analysis was carried out using conventional outpatient detoxification as the base comparator. The buprenorphine-based outpatient detoxification method was found to be the most cost-effective method overall, and rapid opioid detoxification under sedation was the most cost-effective inpatient method; http://www.elsevier.com/wps/find/journaldescription.cws_home/471/description#description; M.D. Shanahan...

Cost-effectiveness analysis of adjuvant therapy for operable breast cancer from a Chinese perspective: Doxorubicin plus Cyclophosphamide versus Docetaxel plus Cyclophosphamide

Liubao, P.; Xiaomin, W.; Chongqing, T.; Karnon, J.; Gannong, C.; Jianhe, L.; Wei, C.; Xia, L.; Junhua, C.
Fonte: Adis International Ltd Publicador: Adis International Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
86%
Background: An oncology trial compared four cycles of doxorubicin/ cyclophosphamide (AC) with four cycles of docetaxel/cyclophosphamide (TC) in operable breast cancer patients (71% were diagnosed with hormone receptor positive and 48% with node-negative breast cancer). The objective of this study was to estimate the lifetime cost effectiveness of AC versus TC, from a Chinese healthcare provider perspective, based on a clinical trial. Methods: A lifetime cost-effectiveness analysis was performed using a Markov model. Events rates and utilities in the Markov model were derived from published papers. Data on cost of breast cancer care were obtained from the Second Xiangya Hospital of Central South University, Changsha, PR China. One-way sensitivity analysis and probabilistic sensitivity analysis were undertaken. Cost estimates were valued in Chinese yuan (Y), year 2008 values. All costs and outcomes were discounted at 3% per annum. Results: Patients receiving TC gained 14.45 QALYs, 0.41 QALYs more than patients receiving AC. The lifetime costs of patients receiving TC were Y93 511, Y10 116 more than that of AC patients. The incremental cost-effectiveness ratios were Y26742 per life-year gained (2719.8 [pounds sterling] per year) and Y24305 per QALY gained (2471.9 [pounds sterling] per QALY). The most sensitive parameter in the model was the cost of primary cancer treatments in the TC arm. At a threshold willingness to pay of Y86 514 per QALY...

Function after spinal treatment, exercise, and rehabilitation: Cost-effectiveness analysis based on a randomized controlled trial

Morris, Stephen; Morris, Tim P.; McGregor, Alison H.; Dore, Caroline J.; Jamrozik, Konrad
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
86.01%
Study Design. Cost-effectiveness analysis alongside a factorial randomized controlled trial. Objective. To assess the cost-effectiveness of a rehabilitation program and/or an education booklet each compared with usual care for the postoperative management of patients undergoing discectomy or lateral nerve root decompression surgery. Summary of Background Data. There is little knowledge about the cost-effectiveness of postoperative management of patients after spinal surgery. Methods. A total of 338 patients were recruited into the study between June 2005 and March 2009. Patients were randomized to rehabilitation only, booklet only, rehabilitation plus booklet, or usual care only. Interactions between booklet and rehabilitation were nonsignificant; hence, we compare booklet versus no booklet and rehabilitation versus no rehabilitation. We adopt an English National Health Service and personal social services perspective. Data on outcomes and costs are based on patient level data from the trial. A 1-year time horizon was used. Outcomes were measured in terms of quality-adjusted life years. Health-related quality of life was reported by patients using the EuroQol-5D (EQ-5D). A comprehensive range of health service contacts were included in the cost analysis. Results. There were no significant differences in costs or outcomes associated with either intervention. Mean incremental costs and mean quality-adjusted life years gained per patient of booklet versus no booklet were -£87 (95% CI: -£1221 to £1047) and -0.023 (95% CI: -0.068 to 0.023)...

Análise de custo-efetividade do tratamento da hepatite C crônica genótipo 1: comparação da adição do boceprevir a terapia padrão (interferon-α peguilado e ribavirina); Cost-effectiveness analysis of treatment of genotype 1 chronic hepatitis C: comparison of boceprevir addition to standard of care (pegylated interferon alfa plus ribavirin).

Maia, Sarah Cristina Oliveira Machado
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 30/03/2015 PT
Relevância na Pesquisa
85.96%
A hepatite C afeta cerca de 150 milhões de pessoas no mundo e é a razão mais comum de transplantes de fígado. A erradicação viral, por meio de tratamento medicamentoso, é a única intervenção que pode deter a progressão da doença, reduzir a mortalidade e melhorar a qualidade de vida dos pacientes. Em 2011, foi aprovado o boceprevir, um inibidor de protease, que passou a ser adicionado à terapia padrão dupla (interferon peguilado e ribavirina) pelo Protocolo Clínico brasileiro para tratamento de Hepatite C genótipo 1 em pacientes com grau de fibrose maior que F2. Devido ao alto custo de aquisição deste medicamento e à produção cada vez maior de novas tecnologias para essa área terapêutica, foi proposta essa pesquisa que tem como objetivo analisar o custo-efetividade da terapia tripla em relação à terapia dupla, no tratamento da hepatite C crônica genótipo 1 em pacientes virgens de tratamento para todos os graus de fibrose. Para tanto, foi construído um modelo de Markov com 15 estados de saúde representando a história natural da Hepatite C crônica. O modelo seguiu uma coorte hipotética pela vida toda, em que os custos foram expressos em Reais e os desfechos em anos de vida ganhos. A perspectiva adotada foi a do SUS. A RCEI calculada...

Cost-Effectiveness Analysis of Results-Based Financing Programs; A Toolkit

Shepard, Donald; Zeng, Wu; Nguyen, Ha Thi Hong
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Working Paper; Publications & Research; Publications & Research :: Working Paper
ENGLISH; EN_US
Relevância na Pesquisa
85.98%
Results-based financing (RBF), which rewards providers, users, or administrators of services upon achieving a set of verified results, has been gaining attraction in global health as a prominent approach to gain value for money. With a large number of countries adopting RBF in the recent years, evidence starts to emerge which points to the effectiveness of RBF in improving coverage and quality of important services, such as maternal and child health and reproductive health. The current toolkit aims to support country programs to assess the cost-effectiveness of RBF interventions and to facilitate cross-country comparisons of RBF programs. The toolkit is specifically tailored to supply-side RBF but its general principles apply to most health systems interventions directed at the health-related millennium development goals (MDGs). The development of the toolkit was based on actual experience of conducting a cost effectiveness analysis of Zambia’s RBF program and an extensive review of RBF programs features across the health results innovation trust fund (HRITF) portfolio. Given that RBF programs in the HRITF portfolio are typically complex health system interventions...

Cost-effectiveness analysis of aerial platforms and suitable communication payloads

Everly, Randall E.; Limmer, David C.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado
Relevância na Pesquisa
85.98%
Approved for public release; distribution is unlimited.; The goal of this research is to perform a cost-effectiveness analysis of selected aerial platforms and suitable communication payloads for use as communication relays in support of distributed military operations. Aerial platforms, for the purpose of this study, include UAVs, towers and aerostats. A multi-objective analysis is utilized to compare dissimilar attributes together among the alternatives. Cost data for each system considered is presented. To analyze the cost-effectiveness of alternatives for different mission sets, three hypothetical scenarios are used including disaster relief, long-range relay, and the tactical user. This research identifies the most cost-effective aerial platforms and communication payloads for each scenario based on the authors' preferences. Future decision makers can utilize this study as a decision tool to match their own preferences.; Lieutenant Commander, United States Navy;Lieutenant, United States Navy

A user's manual for the Cost Effectiveness Analysis Spreadsheet Model for aircraft engines (CEAMOD Version 2.0)

Reeves, Ross R.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 353 p.
EN_US
Relevância na Pesquisa
95.91%
Approved for public release; distribution is unlimited.; This thesis provides a comprehensive procedures manual and user's guide which will enable both current users and beginners to understand and employ Version 2.0 of the Cost Effectiveness Analysis model (CEAMOD), which is written in EXCEL spreadsheet software, in their service's aircraft engine Component Improvement Programs (CIP). The purpose of the CEAMOD is to project the possible savings which would be achieved from an Engineering Change Proposal's (ECP) implementation. The thesis begins by describing the model's background, basic assumptions, and format. Next, a detailed description of each page and the cell formulas used in each column of the spreadsheet are provided. A 'getting started' user's guide was also created to provide the user with the basic information necessary to actually use the CEA Deck/EXCEL spreadsheet software. An example of each page of the CEA model is provided as well as the Standard History File fleet input pages.; Lieutenant, United States Navy

The Clinical and Economic Impact of Point-of-Care CD4 Testing in Mozambique and Other Resource-Limited Settings: A Cost-Effectiveness Analysis

Hyle, Emily P.; Jani, Ilesh V.; Lehe, Jonathan; Su, Amanda E.; Wood, Robin; Quevedo, Jorge; Losina, Elena; Bassett, Ingrid V.; Pei, Pamela P.; Paltiel, A. David; Resch, Stephen; Freedberg, Kenneth A.; Peter, Trevor; Walensky, Rochelle P.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
85.97%
Background: Point-of-care CD4 tests at HIV diagnosis could improve linkage to care in resource-limited settings. Our objective is to evaluate the clinical and economic impact of point-of-care CD4 tests compared to laboratory-based tests in Mozambique. Methods and Findings: We use a validated model of HIV testing, linkage, and treatment (CEPAC-International) to examine two strategies of immunological staging in Mozambique: (1) laboratory-based CD4 testing (LAB-CD4) and (2) point-of-care CD4 testing (POC-CD4). Model outcomes include 5-y survival, life expectancy, lifetime costs, and incremental cost-effectiveness ratios (ICERs). Input parameters include linkage to care (LAB-CD4, 34%; POC-CD4, 61%), probability of correctly detecting antiretroviral therapy (ART) eligibility (sensitivity: LAB-CD4, 100%; POC-CD4, 90%) or ART ineligibility (specificity: LAB-CD4, 100%; POC-CD4, 85%), and test cost (LAB-CD4, US$10; POC-CD4, US$24). In sensitivity analyses, we vary POC-CD4-specific parameters, as well as cohort and setting parameters to reflect a range of scenarios in sub-Saharan Africa. We consider ICERs less than three times the per capita gross domestic product in Mozambique (US$570) to be cost-effective, and ICERs less than one times the per capita gross domestic product in Mozambique to be very cost-effective. Projected 5-y survival in HIV-infected persons with LAB-CD4 is 60.9% (95% CI...

The cost-effectiveness of providing antenatal lifestyle advice for women who are overweight or obese: the LIMIT randomised trial

Dodd, J.M.; Ahmed, S.; Karnon, J.; Umberger, W.; Deussen, A.R.; Tran, T.; Grivell, R.M.; Crowther, C.A.; Turnbull, D.; McPhee, A.J.; Wittert, G.; Owens, J.A.; Robinson, J.S.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
85.98%
BACKGROUND: Overweight and obesity during pregnancy is common, although robust evidence about the economic implications of providing an antenatal dietary and lifestyle intervention for women who are overweight or obese is lacking. We conducted a health economic evaluation in parallel with the LIMIT randomised trial. Women with a singleton pregnancy, between 10(+0)-20(+0) weeks, and BMI ≥25 kg/m(2) were randomised to Lifestyle Advice (a comprehensive antenatal dietary and lifestyle intervention) or Standard Care. The economic evaluation took the perspective of the health care system and its patients, and compared costs encountered from the additional use of resources from time of randomisation until six weeks postpartum. Increments in health outcomes for both the woman and infant were considered in the cost-effectiveness analysis. Mean costs and effects in the treatment groups allocated at randomisation were compared, and incremental cost effectiveness ratios (ICERs) and confidence intervals (95%) calculated. Bootstrapping was used to confirm the estimated confidence intervals, and to generate acceptability curves representing the probability of the intervention being cost-effective at alternative monetary equivalent values for the outcomes avoiding high infant birth weight...

Análise custo-efetividade e índice de qualidade da refeição aplicados à Estratégia Global da OMS; Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy

Machado, Flávia Mori Sarti; Simões, Arlete Naresse
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/02/2008 POR
Relevância na Pesquisa
86.06%
OBJETIVO: Testar o uso da metodologia de análise custo-efetividade como instrumento de decisão na produção de refeições para inclusão das recomendações proferidas na Estratégia Global da Organização Mundial da Saúde. MÉTODOS: Cinco opções alternativas de cardápio de café da manhã foram analisadas previamente à implementação da refeição em unidade de alimentação e nutrição de uma universidade do estado de São Paulo, no ano de 2006. O custo de cada opção baseou-se em preços de mercado dos componentes de custo direto. Os benefícios em saúde foram calculados com base em adaptação do Índice de Qualidade da Refeição (IQR). Foram calculadas a razão custo-efetividade dos cardápios pela divisão dos benefícios pelos custos e a razão custo-efetividade incremental pelo diferencial de custo por unidade de benefício adicional. A escolha considerou unidades de benefício à saúde em relação ao custo direto de produção, assim como a efetividade incremental por unidade de custo diferencial. RESULTADOS: A análise resultou na opção mais simples com adição de uma fruta (IQR=64 e custo=R$1,58) como melhor alternativa. Observou-se maior efetividade das alternativas com uma porção de fruta (IQR1=64 / IQR3=58 / IQR5=72) sobre as demais (IQR2=48 / IQR4=58). CONCLUSÕES: O cálculo da razão custo-efetividade permitiu identificar a melhor opção de café da manhã com base na análise custo-efetividade e Índice de Qualidade da Refeição. Tais instrumentos agregam características de facilidade de aplicação e objetividade de avaliação...

Cost-effectiveness analysis of routine rotavirus vaccination in Brazil

Soárez,Patrícia Coelho de; Valentim,Joice; Sartori,Ana Marli Christovam; Novaes,Hillegonda Maria Dutilh
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2008 EN
Relevância na Pesquisa
95.95%
OBJECTIVE: The objective of this study was to conduct a cost-effectiveness analysis of a universal rotavirus vaccination program among children < 5 years of age in Brazil. METHODS: Considering a hypothetical annual cohort of approximately 3 300 000 newborns followed over 5 years, a decision-tree model was constructed to examine the possible clinical and economic effects of rotavirus infection with and without routine vaccination of children. Probabilities and unit costs were derived from published research and national administrative data. The impact of different estimates for key parameters was studied using sensitivity analysis. The analysis was conducted from both healthcare system and societal perspectives. RESULTS: The vaccination program was estimated to prevent approximately 1 735 351 (54%) of the 3 210 361 cases of rotavirus gastroenteritis and 703 (75%) of 933 rotavirus-associated deaths during the 5-year period. At a vaccine price of 18.6 Brazilian reais (R$) per dose, this program would cost R$121 673 966 and would save R$38 536 514 in direct costs to the public healthcare system and R$71 778 377 in direct and indirect costs to society. The program was estimated to cost R$1 028 and R$1 713 per life-years saved (LYS) from the societal and healthcare system perspectives...