bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP59 Do Digital Health Terms Provide Sufficient Information To Allow For Health Technology Assessment?
Authors: Zrubka Zsombor , Annette Champion , Di Bidino Rossella , Holtorf Anke-Peggy , Earla Jagadeswara R , Boltyenkov Artem , Tabata-Kelly Masami , Asche Carl Victor , Burrell Anita 
Published: December 2023

IntroductionUmbrella digital health term (DHT) (digital health, eHealth, mHealth, telehealth, and telemedicine) definitions contain insufficient information about patient value for health economics and outcomes research and health technology assessment (HTA) purposes. Qualitative content analysis of secondary DHT (e.g., telesurgery and teleradiology) definitions was performed by the ISPOR Digital Health Special Interest Group to determine if they were more useful for health economics and outcomes research purposes.MethodsSecondary DHT definitions were extracted from a previous scoping review and consolidated by reviewer pairs using uniform rules. Definitions were analyzed for explicit (directly stated) or implicit (inferred) information on 24 categories: Patient, Intervention, Comparator, Outcome, Timing, Setting (PICOTS); the Shannon-Weaver communication model (SWE) (sender, message, encoder, channel, decoder, and receiver, extended with mode of information exchange); the quality domains of Agency for Healthcare Research and Quality (AHRQ) (safe, effective, patient-centered, timely, efficient, and equitable); information related to applied technology or geographic scope; and the World Health Organization (WHO) classification of digital health interventions v1.0 (digital health interventions category, health system challenges, and system categories).ResultsAcross 107 unique definitions of 73 secondary DHTs, the number of explicitly or implicitly addressed categories across the frameworks ranged from zero to 15, with references to elements of PICOTS (79.4%), SWE (90.7%), AHRQ (30.8%), applied technology (52.3%), geographic scope (0%), and WHO frameworks (86.9%). PICOTS information was found for Patients in 35 percent of definitions, Intervention in 59 percent, Comparator in 20 percent, and Outcomes in 18 percent.ConclusionsSecondary DHT definitions do not adequately specify PICOTS or other characteristics of interest for HTA. An online Delphi survey has been launched among a wider group of ISPOR members to identify the minimum information set to define patient facing DHTs for evidence summaries and value assessments. The results of this research should be shared for discussion with other digital health stakeholder groups.
OP71 Road To Public Funding Of Cancer Codependent Technologies In Australia In The Last Ten Years
Authors: Gao Yuan , Laka Mah , Merlin Tracy 
Published: December 2023

IntroductionIn Australia, cancer codependent technologies (cCDTs) mostly comprise a biomarker targeting medicine and a companion diagnostic test (CDx). Health technology assessment (HTA) of cCDTs is carried out to inform funding deliberations on CDxs by the Medical Services Advisory Committee (MSAC) and on personalized medicine by the Pharmaceutical Benefits Advisory Committee (PBAC). To understand the strengths and weaknesses of this dual assessment mechanism, we studied the journey of cCDTs in getting funding support from the two committees since the introduction of the codependent technology evaluation framework.MethodsPublic summary documents summarizing deliberations by each committee were reviewed from 2012 to 2022. Information was retrieved on the patient indication, date, biomarkers related to the tests, and PBAC or MSAC funding outcomes. The alignment of HTA decisions, time taken until dual funding approval (if approved), and the reasons for discrepant and negative decision-making were determined.ResultsFrom 2012 to 2022, a total of 26 cCDT applications were submitted to PBAC and MSAC, corresponding with 43 paired PBAC/MSAC considerations and 11 single committee considerations. Non-small cell lung cancer and programmed cell death ligand 1 were the most frequently nominated cancer and biomarker test, respectively. When a cCDT was submitted in the same decision round to both committees, 60 percent of funding decisions were aligned, reaching 73 percent when the considerations were made separately (resubmissions). Only 9 percent of considerations received polarized, where one committee supported and the other committee rejected funding. After multiple resubmissions, 73 percent of cCDTs obtained dual funding support after an average of 34.8 weeks, with considerations by PBAC and MSAC occurring an average of 2.3 and 1.9 times, respectively.ConclusionsMost cCDTs obtain funding support, but only after multiple resubmissions to PBAC and MSAC. Polarized decisions are rare. Reasons for rejection primarily relate to uncertain clinical benefit and an unacceptably high incremental cost-effectiveness ratio.
OP78 Cost-effectiveness Of A 20-valent Pneumococcal Conjugate Vaccine To Directly Protect Adults Against Pneumococcal Disease In England
Authors: Mendes Diana , Averin Ahuva , Atwood Mark , Sato Reiko , Vyse Andrew , Campling James , Weycker Derek , Slack Mary , Ellsbury Gillian , Mugwagwa Tendai 
Published: December 2023

IntroductionAdult vaccination with 13-valent pneumococcal conjugate vaccine is currently recommended in the UK only for very high-risk individuals, with 23-valent pneumococcal polysaccharide vaccine (PPV23) being recommended to all adults 65 years or older and those 18 years or older with specified risk conditions. A 20-valent pneumococcal conjugate vaccine (PCV20) has recently become available for use in adults with potential to address a substantial proportion of the current adult pneumococcal disease burden in the UK. We evaluated the cost-effectiveness of PCV20 vaccination compared with PPV23 in adults in England currently eligible for pneumococcal vaccination.MethodsA probabilistic model with a Markov-type process was used to depict lifetime risks and costs of pneumococcal disease among a cohort of English adults. Epidemiologic parameters, serotype coverage, costs, vaccine effectiveness and coverage were based on published literature or publicly available data. The National Health Service perspective was adopted, health effects were expressed in quality-adjusted life years (QALYs), and future costs and QALYs were discounted at 3.5 percent.ResultsResults suggest that under reasonable assumptions concerning disease burden, vaccine, effectiveness, and vaccine cost, PCV20 implementation of an age-and risk-based strategy targeting all adults aged 65 years or older and younger risk group adults aged 18 to 64 years would reduce a large number of pneumococcal disease hospitalizations and pneumococcal-related deaths compared to currently recommended PPV23.The incremental cost-effectiveness ratio was well below the current willingness-to-pay range of GBP20,000-GBP30,000 per QALY gained, with PCV20 being cost saving compared with PPV23 in base case and most sensitivity analyses. Probabilistic sensitivity analysis suggests high certainty in recommending PCV20 for vaccination of adults aged 18 to 64 years in risk groups and all aged 65 years or older instead of PPV23.ConclusionsOur findings support replacing PPV23 with PCV20 to directly protect adults against pneumococcal disease, reducing hospitalizations and saving lives in the UK.
OP81 Cost Effectiveness Of Human Papillomavirus Extended Genotyping For Cervical Cancer Screening In Singapore
Authors: Chua Brandon , Lim Li Min , Ng Joseph , Ma Viva , Jaime Caro J. , Wee Hwee Lin 
Published: December 2023

IntroductionThe World Health Organization recommends the human papillomavirus (HPV) test for cervical cancer screening. HPV partial genotyping (PGT) identifies HPV16 and HPV18 individually and the 12 other high-risk HPV genotypes (hrHPV) collectively. In contrast, HPV extended genotyping (XGT) identifies six hrHPV individually (HPV16,18,31,45,51, and 52) and the other eight in three groups (HPV33/58, HPV56/59/66, and HPV35/39/68). XGT allows better risk stratification for patient management and monitoring of persistent same-genotype infections (PSGI), which convey a higher risk for cervical cancer. This study compared the cost, quality-adjusted life-years (QALYs), and resource use of XGT with PGT when used as the primary cervical cancer screening method in Singapore.MethodsA discretely integrated condition event simulation was developed for screening 500,122 women aged 30 to 69 years over five years from the health system perspective, using a three percent annual discount. For XGT, women with HPV35/39/51/56/59/66/68 and reflex cytology of atypical squamous cells of undetermined significance were recalled for a repeat screening in one year, instead of the immediate colposcopy referral that occurs with PGT. At repeat screening, colposcopy was only provided for women with PSGI on XGT. Published data from Singapore were used for inputs and supplemented with data from international literature. Deterministic and probabilistic uncertainty analyses were conducted. Scenario analysis was conducted to simulate various HPV burdens among women. XGT was cost effective when the incremental cost-effectiveness ratio (ICER) relative to PGT was below SGD100,000 (USD118,906) (gross domestic product per capita in 2021).ResultsXGT was cost effective relative to PGT (ICER SGD16,370 [USD19,465]), with fewer colposcopies (n=7,130; 19%), liquid-based cytology tests (n=6,027; 7%), and clinic consultations (n=9,787; 2%) but more HPV tests (n=2,446; 0.5%). The ICER was most sensitive to the relative cost of XGT and the cost of PGT. XGT remained cost effective in one-way sensitivity analysis in all 1,000 probabilistic uncertainty simulations and in scenario analysis with various HPV burdens.ConclusionsXGT can provide a cost effective, risk-based approach to primary cervical cancer screening, with lower resource utilization than PGT.
OP122 Economic Evidence To Support Expanding Use Of Existing Positron Emission Tomography Technology As A Diagnostic Tool For High-Risk Cancer Patients
Authors: Tew Michelle , Douglas Abby , Szer Jeff , Bajel Ashish , Harrison Simon , Tio Shio Yen , Worth Leon , Hicks Rodney , Ritchie David , Slavin Monica , Thursky Karin , Dalziel Kim 
Published: December 2023

IntroductionIn Australia, 18F-fluorodeoxyglucose positron emission tomography with low-dose computed tomography (FDG-PET/CT) is currently only funded for cancer staging-related indications. A recent multicenter randomized trial demonstrated that FDG-PET/CT, compared with standard of care computed tomography (CT) imaging, improved antimicrobial management and the outcomes of patients with persistent and recurrent neutropenic fever. There is potential value in expanding the use of FDG-PET/CT as a diagnostic tool for this high-risk population. We conducted an economic evaluation from a healthcare perspective alongside the randomized trial and compared FDG-PET/CT with standard CT up to 6 months after the scans.MethodsCase report forms were used to collect resource utilization data and length of hospitalization. Effectiveness was measured as the number of patients with antimicrobial rationalization and quality-adjusted life-years (QALYs) derived from patient-reported trial-based health-related quality of life. Generalized linear models (GLM) were used to analyze costs and outcomes. Incremental cost-effectiveness ratios (ICERs) for each of the outcomes were calculated and interpreted as the cost per patient with antimicrobial rationalization and cost per QALY gained. To account for sampling, we performed bootstrapping with 1,000 replications using the recycled predictions method.ResultsThe adjusted healthcare costs were lower in the FDG-PET/CT group (mean AUD49,563, 95% confidence interval [CI]: 36,867, 65,133; equivalent to USD34,268, 95% CI: 25,490, 45,033) compared with the standard CT group (mean AUD57,574, 95% CI: 44,837, 73,347; equivalent to USD39,807, 95% CI: 31,000, 50,712). The magnitude of differences in QALYs between the two groups was small (0.001; 95% CI: -0.001, -0.001). When simulated 1,000 times, our analysis showed that across both outcomes FDG-PET/CT was the dominant strategy as it was cheaper and had better outcomes than standard CT in 74 percent of simulations.ConclusionsFDG-PET/CT is cost effective when compared with standard CT for investigating persistent or recurrent neutropenic fever in high-risk patients. Aligning economic evaluations with clinical studies is key to an integrated evidence generation approach for supporting funding for FDG-PET/CT in this patient group.
OP124 Cost Effectiveness Of End-Stage Renal Disease Treatment Methods In Türkiye
Authors: Kılıç Mustafa , Yigit Vahit 
Published: December 2023

IntroductionChronic kidney disease is an important public health problem and is a leading cause of morbidity and mortality worldwide. Hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (Tx) are the main treatments for this disease. The aim of this research was to determine the cost effectiveness of treatments for end-stage renal disease from the perspective of a reimbursement institution in Türkiye.MethodsA Markov model was developed to measure costs and health outcomes in terms of quality-adjusted life-years (QALYs). The model parameters were based on a six percent discount rate, lifetime time horizon, and a reimbursement agency perspective. The main outcome measures were the incremental cost-effectiveness ratio (ICER) and the cost per QALY. One-way and probabilistic sensitivity analyses were performed to determine parameter uncertainty.ResultsThe lifetime costs of HD, PD, and Tx were USD26,883, USD37,672, and USD31,227, respectively. The lifetime QALYs gained with HD, PD, and Tx were 5.21, 6.77, and 9.73, respectively. The cost per QALY of HD, PD, and Tx were USD5,161, USD5,567, and USD3,211, respectively. Compared with Tx, the ICERs for HD and PD were USD961 and USD2,178, respectively.ConclusionsCost differences have occurred between the treatment options for end-stage renal disease due to the increase in drug costs in Türkiye in recent years. As seen in the Markov model in this research, HD, PD, and Tx are complementary rather than rival treatments. This study found that the cost effectiveness of Tx is higher than HD or PD. However, the rate of Tx, which has a higher quality of life compared with HD, is around 22 percent in Türkiye; the rate for PD is four percent. It is therefore recommended that a health policy be developed to encourage kidney donation and promote PD as a superior alternative to HD for eligible patients.
OP138 Navigating High-Cost Medicines: Promoting Consistent, Evidence-based Use Of High-Cost Medicines In A Fiscally And Equitable Responsible Manner
Authors: Pulver Lisa , Barclay Peter , Bennett Dr Sasha , Burgess Naomi , Dartnell Jonathan , Drake Catherine , Laba Tracey-Lea , Liew David , Mason Kylie , Melocco Terry , O’Reilly Mary , Sheahan Linda , Subramaniam Kavitha , Hill Catherine 
Published: December 2023

IntroductionHospitals play a significant and important role in funding high-cost medicines so patients can access treatments they need. High-cost medicines are often specialty medicines, which contribute to a significant and increasing portion of the hospital budget. It is imperative that these expensive medicines are governed and managed with a fair, standardized evidence-based process. We aim to provide a framework for Drugs and Therapeutics Committees (DTCs).MethodsDuring 2021, Guiding Principles were developed following a literature review and survey of current practices by DTCs in Australia. An Expert Advisory Group (EAG) was convened, comprising individuals with expertise in quality use of medicines, evidence-based medicine and medicines governance. The guiding principles were drafted by the EAG, in consultation with a range of stakeholders and relevant external organizations. All feedback was collated, reviewed and discussed to refine the content of the final Guiding Principles released in January 2022.ResultsSeven overarching principles provide key recommendations for the governance of high-cost medicines:(i)A definition of high‑cost medicines should be determined and clearly articulated for use by each medicines governance committee.(ii)Review of high-cost medicines requires members with relevant expertize to facilitate good and effective decision-making.(iii)The committee should engage directly with the applicant prior to review to ensure a full understanding of the rationale for the request.(iv)consistent, robust and transparent procedure for the assessment of high-cost medicine applications should be defined and implemented for use by each medicines governance committee to ensure fair process.(v)Ethical considerations fundamentally underpin deliberations around high-cost medicines.(vi)The decisions and outcomes of the decision making should be transparent and appropriately communicated to the various audiences.(vii)The high-quality assessment of high-cost medicines requires appropriate training and resourcing.ConclusionsThese national Guiding Principles promote consistent, evidence-based use of high-cost medicines and provide a framework for DTCs to assess and achieve effective governance for the quality use of high‑cost medicines.
OP148 Influence Of The Hospital-Based Health Technology Assessment Unit On New Technologies Transfer At The National Level In Kazakhstan
Authors: Avdeyev Andrey , Saduakassova Aigul , Tleulessova Indira , Akhmedullin Ruslan , Lyugay Ekaterina , Fet Maхim , Albayev Rustam , Benberin Valeriy , Shanazarov Nasrulla , Okesh Makhabbat , Aimanova Tansolpan , Akhmetova Makpal , Bariyeva Gulzada , Turar Olzhas 
Published: December 2023

IntroductionThe hospital-based Health Technology Assessment (HB-HTA) Unit in the Hospital of the President’s Affairs Administration has been operating since 2015 and is the first example of the implementation of the HB-HTA system in Kazakhstani hospitals. In addition to assessing the feasibility of implementing new health technologies (HTs) into the hospital’s practice, the Unit also interacts with the National Regulatory Authority (NRA) to transfer new technologies into the National Reimbursement System (NRS). We report on the transformation of the HB-HTA Unit from a stand-alone entity to an integrated, specialized agency.MethodsData were drawn from reports of the HB-HTA Unit and internal NRA documents. Inclusion of new HTs into the NRS consists of the following sequential stages: (i) implementing the technology in at least one hospital; (ii) filing an application with the Ministry of Health Care (MoH) in the field of HTA to resolve the issue of reimbursement at the national level; (iii) in case of a positive decision, approval at the national level of the clinical protocol for using the medical intervention; (iv) agreement on the reimbursement price of the technology.ResultsBased on positive recommendations from the HB-HTA report in 2015, the hospital implemented 19 new nuclear medicine technologies. In 2016, the hospital initiated an application to the MoH to include these technologies in the NRS (previously, these technologies were carried out only for a fee or with private insurance). From 2016 to 2020, a positive decision from the MoH was received, protocols for medical interventions were published at the national level, and cost estimates were formulated. In 2021, 19 new medical services in nuclear imaging and scintigraphy were included in the NRS.ConclusionsDespite the long and bureaucratic process of including new HTs in the NRS, the HB-HTA Unit managed to speed up this process. One of the main priorities of the integrated HB-HTA Unit is to promote the transfer of HTs into the health system at the national level.
OP157 Evaluating The Clinical And Economic Impact Of Adopting A Closed Peripheral Intravenous Catheter System In A Japanese Hospital
Authors: Xian Tan Kristin Hui , Tomaru Takeshi , Gala Smeet , Ma Yan 
Published: December 2023

IntroductionUp to 90 percent of inpatients require an intravenous catheter during their hospitalization. A closed, integrated peripheral intravenous catheter (PIVC) system has been shown to protect veins for longer and reduce the risk of complications and unnecessary restarts when compared with an open system. This study evaluated the annual clinical and economic outcomes of adopting a closed, integrated PIVC system, instead of an open system, for inpatients in a Japanese hospital.MethodsA budget impact analysis was developed to estimate the clinical and economic impact for a 500-bed hospital with an 85 percent occupancy rate and a 96-hour catheter replacement protocol. For the analysis, the average length of stay for patients was 12 days and 90 percent of inpatients required a PIVC. Inputs such as catheter failure rate, complication rate, consumables costs, and complication management costs were informed by global and local data sources. The outcomes evaluated included consumables utilization, complication events, nurse time, and overall cost impact.ResultsThe analysis estimated that 12,604 patients required PIVCs. Moving from an open to a closed, integrated PIVC system resulted in a 68 percent reduction in consumables (3,786 fewer catheters and 36,315 fewer connecting accessories). Complications (occlusion, extravasation, phlebitis, and bending) were reduced by 62 percent (3,682 fewer episodes). Blood exposure was reduced by 98 percent (3,565 fewer episodes), and nurse time decreased by 17 percent (786 fewer hours). This resulted in a potential overall cost saving of JPY3,955,140 (USD28,756) annually, after offsetting the acquisition cost of JPY888,247 (USD6,458) associated with the closed system.ConclusionsPIVC is the most common vascular access device used in hospitals, and insertion and maintenance are often performed by nurses. Fewer complications can be expected with a closed system, leading to better patient outcomes. In addition, nurses spend less time managing complications and replacing PIVCs, and consumables utilization is reduced. This results in improved operational efficiency and potential cost savings for hospitals.