OBJECTIVES To systematically evaluate the long-term effectiveness and cost-effectiveness of HPV-based primary cervical cancer screening in the German health care context using a decision-analysis approach. METHODS A Markov-model for HPV-infection and cervical cancer was developed for the German health care context, and applied to evaluate various screening strategies that differ by screening ...

BACKGROUND Many patients visit the accident and emergency department (AED) on their own initiative, although their medical problem can be adequately treated by a general practitioner (GP). Objective To evaluate the cost-effectiveness of addition of a GP to the AED (new care method) in comparison with usual care (usual care method). METHODS This study followed a before/after design. Patients a...

OBJECTIVE Acute HIV infection often causes influenza-like illness (ILI) and is associated with high infectivity. We estimated the effectiveness and cost-effectiveness of strategies to identify and treat acute HIV infection in men who have sex with men (MSM) in the USA. DESIGN Dynamic model of HIV transmission and progression. INTERVENTIONS We evaluated three testing approaches: viral load t...

OBJECTIVES This study sought to assess the cost-effectiveness of captopril therapy for survivors of myocardial infarction. BACKGROUND The recent randomized, controlled Survival and Ventricular Enlargement (SAVE) trial showed that captopril therapy improves survival in survivors of myocardial infarction with an ejection fraction < or = 40%. The present ancillary study was designed to determine...

An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a theoretical perspective, the cost-effectiveness threshold model is not inconsistent with these two arguments. The ob...

OBJECTIVES To investigate, using a Dutch model, whether and under what variables framed for other European countries screening for human papillomavirus (HPV) is preferred over cytology screening for cervical cancer, and to calculate the preferred number of examinations over a woman's lifetime. DESIGN Cost effectiveness analysis based on a Dutch simulation model. Base case analyses investigate...

OBJECTIVE To assess the health and economic outcomes of various screening and vaccination strategies for cervical cancer prevention. DESIGN Cost-effectiveness analysis from a societal perspective. SETTING Thailand. POPULATION Females aged 9 years and older. METHODS Using a mathematical model of human papillomavirus (HPV) infection and cervical cancer, calibrated to epidemiological data ...

BACKGROUND Patient registry data serves an increasing role in drug safety and comparative effectiveness research, but registry databases often do not contain confounder information measured at the same time that treatments begin. This study evaluated a set of approaches for estimating confounder values at treatment initiation using actual data from a rheumatoid arthritis (RA) registry to examin...

BACKGROUND The objective of this study was to evaluate the cost-effectiveness of women undergoing IVF treatment with recombinant FSH (rFSH) in comparison with highly purified urinary FSH (uFSH-HP) and human menopausal gonadotrophins (HMG). METHODS A decision-analytic model was used to estimate cost-effectiveness ratios for 'the average cost per ongoing pregnancy' and 'incremental cost per add...

We could reasonably expect society to give at least the same weight to the marginal utility of the poor as to the rich, and to the marginal utility of the ill as compared to the healthy. Whilst Hansen et al. [Journal of Health Economics (2004)], may be said to link CEA and CBA within a welfarist framework, the assumptions they require are inconsistent with these types of ethical preferences. Th...