Heterogeneity in cost-effectiveness analysis of vaccination for mild and moderate alzheimer’s disease

Chung Hsien Lin, Jean Ching Yuan Fann, Sam Li Sheng Chen, Hsiu Hsi Chen, Kuen Cheh Yang

研究成果: 雜誌貢獻文章

摘要

Background: Immunotherapy for Alzheimer’s disease(AD) has gained momentum in recent years. One of the concerns over its application pertains to Cost-Effectiveness Analysis (CEA) from population average and specific subgroup differences, as such a therapy is imperative for health decisionmakers to allocate limited resources. However, this sort of CEA model considering heterogeneous population with risk factors adjustment has been rarely addressed. Methods: We aimed to show the heterogeneity of CEA in immunotherapy for AD in comparison with the comparator without intervention. Economic evaluation was performed via incremental CostEffectiveness Ratio (ICER) and Cost-Effectiveness Acceptability Curve (CEAC) in terms of the QualityAdjusted Life Years (QALY). First, population-average CEA was performed with and without adjustment for age and gender. Secondly, sub-group CEA was performed with the stratification of gender and age based on Markov process. Results: Given the threshold of $20,000 of willingness to pay, the results of ICER without and with adjustment for age and gender revealed similar results ($14,691/QALY and $17,604/QALY). The subgroup ICER results by different age groups and gender showed substantial differences. The CEAC showed that the probability of being cost-effective was only 48.8%-53.3% in terms of QALY at population level but varied from 83.5% in women aged 50-64 years, following women aged 65-74 years and decreased to 0.2% in men≥ 75 years. Conclusion: There were considerable heterogeneities observed in the CEA of vaccination for AD. As with the development of personalized medicine, the CEA results assessed by health decision-maker should not only be considered by population-average level but also specific sub-group levels.
原文英語
頁(從 - 到)495-504
頁數10
期刊Current Alzheimer Research
16
發行號6
DOIs
出版狀態已發佈 - 一月 1 2019

指紋

Cost-Benefit Analysis
Alzheimer Disease
Vaccination
Population
Immunotherapy
Risk Adjustment
Markov Chains
Precision Medicine
Health
Age Groups
Costs and Cost Analysis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

引用此文

Heterogeneity in cost-effectiveness analysis of vaccination for mild and moderate alzheimer’s disease. / Lin, Chung Hsien; Fann, Jean Ching Yuan; Chen, Sam Li Sheng; Chen, Hsiu Hsi; Yang, Kuen Cheh.

於: Current Alzheimer Research, 卷 16, 編號 6, 01.01.2019, p. 495-504.

研究成果: 雜誌貢獻文章

Lin, Chung Hsien ; Fann, Jean Ching Yuan ; Chen, Sam Li Sheng ; Chen, Hsiu Hsi ; Yang, Kuen Cheh. / Heterogeneity in cost-effectiveness analysis of vaccination for mild and moderate alzheimer’s disease. 於: Current Alzheimer Research. 2019 ; 卷 16, 編號 6. 頁 495-504.
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abstract = "Background: Immunotherapy for Alzheimer’s disease(AD) has gained momentum in recent years. One of the concerns over its application pertains to Cost-Effectiveness Analysis (CEA) from population average and specific subgroup differences, as such a therapy is imperative for health decisionmakers to allocate limited resources. However, this sort of CEA model considering heterogeneous population with risk factors adjustment has been rarely addressed. Methods: We aimed to show the heterogeneity of CEA in immunotherapy for AD in comparison with the comparator without intervention. Economic evaluation was performed via incremental CostEffectiveness Ratio (ICER) and Cost-Effectiveness Acceptability Curve (CEAC) in terms of the QualityAdjusted Life Years (QALY). First, population-average CEA was performed with and without adjustment for age and gender. Secondly, sub-group CEA was performed with the stratification of gender and age based on Markov process. Results: Given the threshold of $20,000 of willingness to pay, the results of ICER without and with adjustment for age and gender revealed similar results ($14,691/QALY and $17,604/QALY). The subgroup ICER results by different age groups and gender showed substantial differences. The CEAC showed that the probability of being cost-effective was only 48.8{\%}-53.3{\%} in terms of QALY at population level but varied from 83.5{\%} in women aged 50-64 years, following women aged 65-74 years and decreased to 0.2{\%} in men≥ 75 years. Conclusion: There were considerable heterogeneities observed in the CEA of vaccination for AD. As with the development of personalized medicine, the CEA results assessed by health decision-maker should not only be considered by population-average level but also specific sub-group levels.",
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AU - Lin, Chung Hsien

AU - Fann, Jean Ching Yuan

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AU - Yang, Kuen Cheh

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AB - Background: Immunotherapy for Alzheimer’s disease(AD) has gained momentum in recent years. One of the concerns over its application pertains to Cost-Effectiveness Analysis (CEA) from population average and specific subgroup differences, as such a therapy is imperative for health decisionmakers to allocate limited resources. However, this sort of CEA model considering heterogeneous population with risk factors adjustment has been rarely addressed. Methods: We aimed to show the heterogeneity of CEA in immunotherapy for AD in comparison with the comparator without intervention. Economic evaluation was performed via incremental CostEffectiveness Ratio (ICER) and Cost-Effectiveness Acceptability Curve (CEAC) in terms of the QualityAdjusted Life Years (QALY). First, population-average CEA was performed with and without adjustment for age and gender. Secondly, sub-group CEA was performed with the stratification of gender and age based on Markov process. Results: Given the threshold of $20,000 of willingness to pay, the results of ICER without and with adjustment for age and gender revealed similar results ($14,691/QALY and $17,604/QALY). The subgroup ICER results by different age groups and gender showed substantial differences. The CEAC showed that the probability of being cost-effective was only 48.8%-53.3% in terms of QALY at population level but varied from 83.5% in women aged 50-64 years, following women aged 65-74 years and decreased to 0.2% in men≥ 75 years. Conclusion: There were considerable heterogeneities observed in the CEA of vaccination for AD. As with the development of personalized medicine, the CEA results assessed by health decision-maker should not only be considered by population-average level but also specific sub-group levels.

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