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Maravilla-Herrera P, Merino M, Alfonso Zamora S, Balea Filgueiras J, Carrascosa Carrillo JM, Delgado Sánchez O, Dolz Sinisterra F, García-Ruiz A, Herranz Pinto P, Manfredi A, Martínez Olmos J, Morales de los Ríos Luna P, Puig L, Ros S, Hidalgo-Vega Á. The social value of a PASI 90 or PASI 100 response in patients with moderate-to-severe plaque psoriasis in Spain. Front Public Health 2023; 11:1000776. [PMID: 36778548 PMCID: PMC9909187 DOI: 10.3389/fpubh.2023.1000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction Psoriasis is a chronic disease involving the skin, which significantly impacts the quality of life. Disease severity and treatment efficacy (i.e., response) are assessed through the Psoriasis Area and Severity Index (PASI). A PASI 75 response, i.e., an improvement of at least 75% with respect to the baseline PASI score, has traditionally been used as a therapeutic benchmark in clinical trials. Therapeutic advances have made PASI 90 or PASI 100 responses possible in most patients treated with some biologics. A greater response may generate social value beyond clinical outcomes that would benefit both patients and society. Methods A 1-year economic model was applied to estimate the impact of having a PASI 75, PASI 90, or PASI 100 response in four areas of analysis (quality of life, activities of daily living, work productivity, and out-of-pocket expenditures) and the social value of having a PASI 90 or PASI 100 response in comparison with a PASI 75 response. A mixed-methods approach based on the scientific literature, a focus group with patient, and an advisory committee with psoriasis stakeholders was used. The model included three different scenarios: having a PASI 90 vs a PASI 75 response; a PASI 100 vs a PASI 90 response; and a PASI 100 vs a PASI 75 response. A sensitivity analysis was included. Results The annual economic impact per patient with moderate-to-severe plaque psoriasis having a PASI 75 response was estimated at Ł 6,139, mainly related to labour productivity losses and quality of life reductions. Having a PASI 90 or a PASI 100 response would reduce this impact to €3,956 or €1,353, respectively. Accordingly, the social value of having a PASI 90 instead of a PASI 75 response was estimated at €2,183, and €4,786 with a PASI 100 response. Discussion A PASI 90 or PASI 100 response would have a lower economic impact and a greater social value than a PASI 75 response for patients with moderate-to-severe plaque psoriasis.
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Affiliation(s)
| | - María Merino
- Department of Health Outcomes Research, Weber, Madrid, Spain,*Correspondence: María Merino ✉
| | - Santiago Alfonso Zamora
- Department of Management, Psoriasis and Psoriatic Arthritis Patient and Family Association (Acción Psoriasis), Barcelona, Spain
| | | | | | - Olga Delgado Sánchez
- Department of Management, Spanish Society of Hospital Pharmacy (SEFH), Madrid, Spain,Department of Pharmacy, Son Espases University Hospital, Illes Balears, Spain
| | | | - Antonio García-Ruiz
- Health Economics and Rational Use of Medicines, Department of Pharmacology and Clinical Therapeutics, Biomedical Research Institute of Malaga (IBIMA), University of Malaga, Malaga, Spain
| | | | - Antonio Manfredi
- Department of Management, Psoriasis and Psoriatic Arthritis Patient and Family Association (Acción Psoriasis), Barcelona, Spain
| | | | | | - Lluís Puig
- Department of Dermatology, Santa Creu i Sant Pau Hospital, Barcelona, Spain,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sandra Ros
- Psychologist, Departments of Dermatology and Rheumatology, and Cardiac Transplant Unit, Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Álvaro Hidalgo-Vega
- Department of Economic Analysis and Finances, University of Castilla-La Mancha, Toledo, Spain,Fundación Weber, Madrid, Spain
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Merino M, Ivanova Y, Maravilla-Herrera P, Barragán B, Sierra J, Peñuelas-Saiz Á, Hidalgo-Vega Á. Optimising the management of patients with multiple myeloma in Spain: A measurement of the social return on investment. Eur J Cancer Care (Engl) 2022; 31:e13706. [PMID: 36177961 DOI: 10.1111/ecc.13706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to reach a consensus on a set of proposals to optimise the disease management of Multiple myeloma (MM) within the Spanish National Health System (SNHS) and to apply the Social Return on Investment (SROI) method to estimate their social impact. METHODS A Multidisciplinary Working Team (MWT) including MM main stakeholders was organised. A survey was administered to gather information from patients regarding the impact of MM on different life domains. A forecast-type SROI analysis, with a 1-year timeframe, was applied. RESULTS Fifteen proposals were selected, to optimise MM management, including actions for early diagnosis, psychological support, improvement of information for patients and quick access to palliative care, among others. The implementation of these proposals would benefit patients, their informal caregivers and the SNHS. The investment required would amount to 10.32 million euros with a social return of 43.31 million euros: 4.2 euros for each euro invested. According to the sensitivity analysis, this ratio could range from 3.38 to 5.20 euros from the worst to the best-case scenario. CONCLUSIONS The current management of MM could be optimised by implementing a set of proposals that would most likely result in an overall positive social return.
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Affiliation(s)
| | | | | | - Begoña Barragán
- AEAL, Asociación Española de Afectados por Linfoma, Mieloma y Leucemia, Madrid, Spain
| | - Jordi Sierra
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ángeles Peñuelas-Saiz
- Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Álvaro Hidalgo-Vega
- Fundación Weber, Madrid, Spain.,Universidad de Castilla-La Mancha, Toledo, Spain
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Merino M, Martín Lorenzo T, Maravilla-Herrera P, Ancochea J, Gómez Sáenz JT, Hass N, Molina J, Peces-Barba G, Trapero-Bertran M, Trigueros Carrero JA, Hidalgo-Vega Á. A Social Return on Investment Analysis of Improving the Management of Chronic Obstructive Pulmonary Disease Within the Spanish National Healthcare System. Int J Chron Obstruct Pulmon Dis 2022; 17:1431-1442. [PMID: 35761956 PMCID: PMC9233487 DOI: 10.2147/copd.s361700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To define a set of proposals that would improve the current management of chronic obstructive pulmonary disease (COPD) within the Spanish National Healthcare System (SNHS) from a comprehensive multidisciplinary perspective and to assess the impact of its implementation from clinical, healthcare, economic, and social perspectives. Patients and Methods A group of 20 stakeholders related to COPD (healthcare professionals, patients, and informal caregivers, among others) participated in an online Delphi process to agree on a set of 15 proposals that would improve the current management of COPD within the SNHS in four areas: diagnosis, risk stratification, management of exacerbations, and management of stable COPD. A one-year forecast-type social return on investment (SROI) analysis was used to estimate the impact that implementing the set of proposals would have in relation to the investment required. A sensitivity analysis was used to test the strength of the model when varying assumption-based data-points. Results The hypothetical implementation of the complete set of 15 proposals would require a €668 million investment and would generate a €2079 million social impact concerning savings for the SNHS and quality of life improvements for patients and their informal caregivers, among others. Accordingly, for every euro invested in the set of proposals, a social return of €3.11 would be generated (€2.71 in the worst-case scenario and €3.62 in the best-case scenario) of both tangible (32.56%) and intangible nature (67.44%). Conclusion Altogether, implementing this set of 15 proposals would generate a positive social impact, threefold the required investment. The results may inform decisions relative to healthcare policy and practice regarding COPD management within the SNHS, further contributing to reduce the large burden of COPD.
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Affiliation(s)
| | | | | | - Julio Ancochea
- Pulmonology Service, La Princesa University Hospital - IIS-Princesa, Madrid, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Respiratory Diseases Networking Biomedical Research Centre - CIBERES, Carlos III Institute of Health - ISCIII, Madrid, Spain
| | | | - Nicole Hass
- Chronic Obstructive Pulmonary Disease Patient and Family Association - APEPOC, Pontevedra, Spain
| | - Jesús Molina
- Francia Health Centre, Fuenlabrada, Madrid, Spain
| | - Germán Peces-Barba
- Pulmonology Service, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Marta Trapero-Bertran
- Basic Sciences Department, University Institute for Patient Care, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Álvaro Hidalgo-Vega
- Department of Economic Analysis and Finances, Universidad de Castilla-La Mancha, Toledo, Spain
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Zozaya N, Villoro R, Abdalla F, Alfonso Zamora S, Balea Filgueiras J, Carrascosa Carrillo JM, Delgado Sánchez O, Dolz Sinisterra F, García-Ruiz A, Herranz Pinto P, Manfredi A, Martínez Olmos J, Morales de los Ríos Luna P, Puig Sanz L, Ros S, Hildago-Vega Á. Unmet Needs in the Management of Moderate-to-Severe Psoriasis in Spain: A Multidimensional Evaluation. Acta Derm Venereol 2022; 102:adv00678. [DOI: 10.2340/actadv.v102.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is a chronic, systemic inflammatory disease that affects the skin, with a high impact on patients’ quality of life. The aim of this study was to identify and determine the relative importance of unmet needs in the management of moderate-to-severe psoriasis in Spain, from a multi-stakeholder perspective. A mixed method-approach was used to collect information, design a questionnaire and a discrete-choice exercise, and elicit the unmet needs through a multidisciplinary committee composed of 12 experts. A total of 65 unmet needs were identified and categorized into 4 areas: clinical, patient-related, decision-making process, and social. Decision-making process unmet needs were perceived as the most pressing ones, followed by social, clinical and patient-related. Individually, the need to incorporate outcomes that are important to the patients and to have treatments that achieve total clearance with a rapid onset of action and long-term persistence were the most important unmet needs.
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Soto I, Mateo J, García-Diego DA, Gil B, Ruiz-Beato E, Ivanova Y, Martín Lorenzo T, Maravilla-Herrera P, Hidalgo-Vega Á, Merino M. The impact of improving haemophilia A management within the Spanish National Healthcare System: a social return on investment analysis. BMC Health Serv Res 2022; 22:115. [PMID: 35081958 PMCID: PMC8793183 DOI: 10.1186/s12913-021-07447-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 12/22/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Haemophilia A (HA) has been associated with poor health-related quality of life and a large economic burden, accentuated by severity, arthropathy, and inhibitors. To meet global standards of care, the management of HA should align with the principles of care outlined by the World Federation of Haemophilia. The aims of the present study were to establish a set of proposals to improve HA management within the Spanish National Health System (SNHS) and to estimate the impact its hypothetical implementation would generate from a clinical, healthcare, economic, and social perspective. METHODS A multidisciplinary group of experts agreed on a set of 15 proposals to improve HA management within the SNHS. Thereafter, a forecast-type Social Return on Investment analysis was carried out to estimate the impact of implementing this set of proposals within the SNHS over a one-year timeframe, in relation to the required investment. RESULTS This study estimated that the implementation of the complete set of 15 proposals would require a total investment of 2.34 M€ and have a total impact of 14.60 M€. Accordingly, every euro invested in the complete set of 15 proposals would yield a social return of €6.23 (€3.37 in the worst-case scenario and €9.69 in the best-case scenario) of both tangible and intangible nature in similar proportions (45.71 and 54.29%, respectively). CONCLUSIONS These results can be used to inform policy and practice such that interventions that may potentially improve current public health challenges associated with the management of HA may be implemented.
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Affiliation(s)
| | - José Mateo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | - Yoana Ivanova
- Weber, Calle Moreto, 17, 5 Dcha, 28014 Madrid, Spain
| | | | | | | | - María Merino
- Weber, Calle Moreto, 17, 5 Dcha, 28014 Madrid, Spain
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