Expert review of pharmacoeconomics & outcomes research
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Expert Rev Pharmacoecon Outcomes Res · Aug 2021
Artificial intelligence in outcomes research: a systematic scoping review.
Introduction: Despite the number of systematic reviews of how artificial intelligence is being used in different areas of medicine, there is no study on the scope of artificial intelligence methods used in outcomes research, the cornerstone of health technology assessment (HTA). This systematic scoping review aims to systematically capture the scope of artificial intelligence methods used in outcomes research to enhance decision-makers' knowledge and broaden perspectives for health technology assessment and adoption. Areas covered: The review identified 370 studies, consisted of artificial intelligence methods applied to adult patients who underwent any health/medical intervention and reported therapeutic, preventive, or prognostic outcomes. ⋯ The predictive analysis was common in neoplastic disorders. Neural networks algorithm was predominantly found in surgical method studies, but a mixture of artificial intelligence algorithms was applied to the studies with the rest of the interventions. Expert opinion: There are certain gaps in artificial intelligence applications used in outcomes research across therapeutic areas and further considerations are needed by decision-makers before incorporating artificial intelligence usage into HTA decision-making processes.
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Expert Rev Pharmacoecon Outcomes Res · Aug 2021
Comparative StudyCost-effectiveness analyses comparing cemented, cementless, hybrid and reverse hybrid fixation in total hip arthroplasty: a systematic overview and critical appraisal of the current evidence.
Background: This study aims to present an overview and critical appraisal of all previous studies comparing costs and outcomes of the different modes of fixation in total hip arthroplasty (THA). A secondary aim is to provide conclusions regarding the most cost-effective mode of implant fixation per gender and age-specific population in THA, based on high quality studies. Methods: A systematic search was conducted to identify cost-effectiveness analyses (CEAs) comparing different modes of implant fixation in THA. ⋯ Conclusion: Currently available well performed CEAs generally support the use of cemented and hybrid fixation for all age-groups relevant for THA and both genders. However, these findings were mainly based on a single database and depended on assumptions made in the studies' methodology. Issues discussed in this paper have to be considered and future work is needed.
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Expert Rev Pharmacoecon Outcomes Res · Jun 2021
Cost-effectiveness analyses of targeted therapy and immunotherapy for advanced non-small cell lung cancer in the United States: a systematic review.
Introduction: Mutation-targeting and immuno-oncology drugs are revolutionizing the treatment of advanced non-small cell lung cancer (NSCLC). Cost-effectiveness analyses (CEA) of these drugs have been conducted using various analytical methods and cost-effectiveness thresholds. This systematic review provides a comprehensive summary of the available evidence. ⋯ Expert commentary: Medications of interest have changed and are individualized to particular mutations. The cost-effectiveness thresholds varied among sponsors but generally trended to increase over time. This review provides an overview of the available cost-effectiveness findings for stakeholders and contributes to evidence-based practice.
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Expert Rev Pharmacoecon Outcomes Res · Feb 2021
Review Comparative StudyCost-effectiveness of nivolumab in advanced melanoma: a drug review.
Introduction: The immune checkpoint inhibitors, including nivolumab, and targeted agents have dramatically improved the outcome for patients with unresectable advanced melanoma. Areas covered: This is a narrative review of the published evidence on nivolumab in metastatic melanoma. Expert opinion: In ipilimumab pre-treated patients (CheckMate 037), nivolumab was associated with a higher response rate and a longer duration of response when compared to chemotherapy. ⋯ In patients with previously untreated metastatic melanoma, the anti-PD-1 monoclonal antibodies nivolumab and pembrolizumab improve survival when compared to ipilimumab. Nivolumab is equally active in BRAF mutated and BRAF wild type melanoma. The optimal sequence of checkpoint inhibitors and BRAF/MEK inhibitors in BRAF mutated patients has not been established.
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Expert Rev Pharmacoecon Outcomes Res · Dec 2019
ReviewLearning from our mistakes: using key opportunities to remove the perverse incentives that help drive antibiotic resistance.
Introduction: Governments need to do far more to help curb the emergence and transmission of antibiotic resistance and help protect the efficacy of any new antibiotics that come to the market. Industry is an important stakeholder that must be brought on-board such efforts given its influence on the direction and scale of antibiotic sales. Financial incentives supporting industry R&D of novel antibiotics should structurally remove the drivers of superfluous sales and encourage access to newer antibiotics where infections are otherwise resistant to treatment. ⋯ Expert opinion: Pharmaceutical companies need to be rewarded generously for their efforts to develop new, badly needed antibiotics. But the current marketplace does not provide a sustained financial lure and its reliance on unit-sales for profitability jeopardizes the efficacy of antibiotics both new and old. Fully delinked models can make antibiotic R&D more financially appealing and create a market environment that is far less threatening to public health.