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Gozlan G, Lecardeur L, Monfort AS, Doz M, Ortiz I, Larroumets P, Lafuma A. [Cost-effectiveness analysis of aripiprazole once-monthly versus paliperidone palmitate once-monthly in the treatment of schizophrenia in France]. Encephale 2018; 44:496-503. [PMID: 30482480 DOI: 10.1016/j.encep.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the cost-effectiveness ratio of aripiprazole once-monthly compared to once-monthly injectable paliperidone palmitate in the treatment of schizophrenia in France on the basis of results and data from the QUALIFY study. METHODS Consumed resources data measured with a dedicated questionnaire and results on the quality of life scales from the QUALIFY study were combined with French standard unit costs of each collected consumed resources during QUALIFY to estimate the cost-effectiveness ratios of the two products. Multivariate sensitivity analyses were performed to test the combined impact of the different assumptions. RESULTS Findings of the study showed greater efficacy on the quality of life (QLS) and psychiatric evaluation scales (CGI-S and CGI-I) observed in QUALIFY of aripiprazole compared with paliperidone palmitate. Findings also suggest a trend (P=0.0733) in the reduction of total costs linked to a statistical decrease (P<0,0001) in drug costs in the aripiprazole group. These findings are reinforced by the probabilistic sensitivity analyses. CONCLUSION Aripiprazole appeared to be more cost-effective than paliperidone palmitate in the French context. Limits of this study are mainly related with the duration of the clinical trial and to assumptions on the transposability of measured consumed resources in the international clinical trial to the French healthcare system.
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Affiliation(s)
- G Gozlan
- 32, boulevard de Courcelles, 75017 Paris, France
| | - L Lecardeur
- UMR 6232 CNRS, centre Esquirol, centre hospitalier universitaire de Caen, avenue Côte de Nacre, 14033 Caen cedex, France
| | - A-S Monfort
- GHT Paris psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75674 Paris cedex 14, France
| | - M Doz
- Cemka-Eval, 43, boulevard Maréchal Joffre, 92340 Bourg-la-Reine, France
| | - I Ortiz
- Lundbeck SAS, Tour W, 102 terrasse Boieldieu, La Défense, 92085 Paris cedex, France
| | - P Larroumets
- Otsuka pharmaceutical France, 1 avenue Edouard-Belin 92566 CS, 40066 Rueil-Malmaison cedex, France
| | - A Lafuma
- Cemka-Eval, 43, boulevard Maréchal Joffre, 92340 Bourg-la-Reine, France.
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Benhamou D, Piriou V, De Vaumas C, Albaladejo P, Malinovsky JM, Doz M, Lafuma A, Bouaziz H. Ready-to-use pre-filled syringes of atropine for anaesthesia care in French hospitals – a budget impact analysis. Anaesth Crit Care Pain Med 2017; 36:115-121. [DOI: 10.1016/j.accpm.2016.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/30/2016] [Indexed: 11/15/2022]
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Epinette JA, Lafuma A, Robert J, Doz M. Cost-effectiveness model comparing dual-mobility to fixed-bearing designs for total hip replacement in France. Orthop Traumatol Surg Res 2016; 102:143-8. [PMID: 26803224 DOI: 10.1016/j.otsr.2015.12.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/23/2015] [Accepted: 12/03/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Instability is among the main causes of total hip arthroplasty (THA) failure. In clinical studies, THA with a dual-mobility cup (THA-DM) decreased the risk of instability after primary THA compared to THA with a fixed-bearing design (THA-FB). However, whether THA-DM is more cost-effective than THA-FB has not been established using Markov modelling with determination of the incremental cost-effectiveness ratio (ICER). The objectives of this work were to: (1) measure the efficiency of these two options, (2) use the nationwide hospital electronic database (PMSI) to estimate direct costs of dislocations and revisions for instability, and (3) conduct deterministic and probabilistic sensitivity analyses to estimate potential mean annual cost-savings in France. HYPOTHESIS We hypothesised that primary THA-DM was cost-saving compared to primary THA-FB. MATERIAL AND METHODS In the database, we identified 80,405 patients who had THA in 2009 and we collected their outcomes over 4 years (2009-2012). Cost-effectiveness was assessed based on the costs of resources used for all consequences of prosthetic dislocation and paid for by the statutory health insurance system or other sources. RESULTS THA-DM was associated with a relative risk of dislocation of 0.4 versus THA-FB. This risk difference translated into 3283 fewer dislocations per 100,000 patients with THA-DM. The corresponding cost-savings for the 140,000 primary THA procedures done in France annually was 39.62 million Euros. A relative risk of 0.2 would yield annual cost-savings of 56.28 million Euros. In the probabilistic sensitivity analysis, THA-DM was the less costly option under all hypotheses, with potential maximum cost-savings of more than 100 million Euros per year in France. DISCUSSION This comparative cost-effectiveness analysis suggests that THA-DM may induce substantial cost-savings compared to THA-FB. This possibility should be assessed by long-term clinical studies of new-generation DM prostheses.
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Affiliation(s)
- J-A Epinette
- Centre de recherche et documentation des arthroplasties, clinique médico-chirurgicale, 200, rue d'Auvergne, 62700 Bruay-Labuissière, France.
| | - A Lafuma
- CEMKA-EVAL-économie de la santé-modélisations, 43, boulevard du Maréchal-Joffre, 92340 Bourg-La-Reine, France
| | - J Robert
- CEMKA-EVAL-économie de la santé-modélisations, 43, boulevard du Maréchal-Joffre, 92340 Bourg-La-Reine, France
| | - M Doz
- CEMKA-EVAL-économie de la santé-modélisations, 43, boulevard du Maréchal-Joffre, 92340 Bourg-La-Reine, France
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Barragán-Campos HM, Le Faou AL, Rose M, Livartowski A, Doz M, Astagneau P, Cormier E, Chiras J. Percutaneous vertebroplasty in vertebral metastases from breast cancer: interest in terms of pain relief and quality of life. Interv Neuroradiol 2014; 20:591-602. [PMID: 25363262 DOI: 10.15274/inr-2014-10084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 12/31/2022] Open
Abstract
Percutaneous vertebroplasty (PV) is a therapeutic option in patients with vertebral metastases (VM). However its efficacy in pain relief, improvement in quality of life and safety in patients with VM from breast cancer has not been reported. We present a longitudinal retrospective study of 31 consecutively treated female patients with VM from breast cancer where 88 vertebrae were treated in 44 sessions of PV, in which osteolytic, osteoblastic and mixed lesions were recorded. The visual analogue pain scale (VAS) was used to evaluate pain pre-PV, at one, three, six and 12 months post-PV. The Eastern Cooperative Group (ECOG) performance status scale was used at the same time intervals to measure quality of life: 90.3% pain relief was identified with a VAS reduction from 5.7 ± 2.0 pre-PV to 2.9 ± 2.2 post-PV at one-month follow-up (p<0.001) and 0.6 ± 1.0 at 12-month follow-up (p<0.001). In our series 48.4% of patients were classified as having an ECOG grade 0 and 1 pre-PV, which increased to 80.8% at the 12-month follow-up. While 22.6% of the patients were classified at ECOG grades 3 and 4 pre-PV, this improved to 0% at 12 months follow-up. The morbidity rate for this procedure was 12.9% immediately and only 3.2% at 30 days post-PV with all complications being resolved medically or with CT-guided infiltration. PV is a safe procedure with a high efficacy in pain relief, and improvement of quality of life in patients with diverse types of VM from breast cancer.
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Affiliation(s)
| | - Anne-Laurence Le Faou
- Research Unit 4069, MGEN Public Health Foundation, René Descartes University; Paris, France
| | - Michèle Rose
- Department of Anesthesiology, Pitié-Salpêtrière Hospital; Paris, France
| | | | - Marianne Doz
- Institute Curie Medical Information Service; Paris, France
| | - Pascal Astagneau
- Department of Public Health Pitié-Salpêtrière, Pitié-Salpêtrière Hospital; Paris, France
| | - Evelyne Cormier
- Department of Diagnostic and Interventional Neuroradiology, Pitié-Salpêtrière Hospital; Paris, France
| | - Jacques Chiras
- Department of Diagnostic and Interventional Neuroradiology, Pitié-Salpêtrière Hospital; Paris, France
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Villanueva V, Girón J, Martín J, Hernández-Pastor L, Lahuerta J, Doz M, Cuesta M, Lévy-Bachelot L. Quality of life and economic impact of refractory epilepsy in Spain: The ESPERA study. Neurología (English Edition) 2013. [DOI: 10.1016/j.nrleng.2012.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Villanueva V, Girón J, Martín J, Hernández-Pastor L, Lahuerta J, Doz M, Cuesta M, Lévy-Bachelot L. Impacto económico y en calidad de vida de la epilepsia resistente en España: estudio ESPERA. Neurologia 2013; 28:195-204. [DOI: 10.1016/j.nrl.2012.04.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 04/21/2012] [Indexed: 11/25/2022] Open
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Doz M, Chouaid C, Com-Ruelle L, Calvo E, Brosa M, Robert J, Decuypère L, Pribil C, Huerta A, Detournay B. The association between asthma control, health care costs, and quality of life in France and Spain. BMC Pulm Med 2013; 13:15. [PMID: 23517484 PMCID: PMC3610114 DOI: 10.1186/1471-2466-13-15] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 02/19/2013] [Indexed: 11/23/2022] Open
Abstract
Background Current asthma management guidelines are based on the level of asthma control. The impact of asthma control on health care resources and quality of life (QoL) is insufficiently studied. EUCOAST study was designed to describe costs and QoL in adult patients according to level of asthma control in France and Spain. Methods An observational cost of illness study was conducted simultaneously in both countries among patients age greater or equal to 18 with a diagnosis of asthma for at least 12 months. Patients were recruited prospectively by GPs in 2010 in four waves to avoid a seasonal bias. Health care resources utilization of the three months before the inclusion was collected through physician questionnaires. Asthma control was evaluated using 2009 GINA criteria over a 3-month period. QoL was assessed using EQ-5D-3L®. Results 2,671 patients (France: 1,154; Spain: 1,517) were enrolled. Asthma was controlled in 40.6% [95% CI: 37.7% - 43.4%] and 29.9% [95% CI: 27.6% - 32.3%] of French and Spanish patients respectively. For all types of costs, the percentage of patients using health care resources varied significantly according to the level of asthma control. The average cost (euros/3-months/patient) of controlled asthma was €85.4 (SD: 153.5) in France compared with €314.0 (SD: 2,160.4) for partially controlled asthma and €537.9 (SD: 2,355.7) for uncontrolled asthma (p<0.0001). In Spain, the corresponding figures were €152.6 (SD: 162.1), €241.2 (SD: 266.8), and €556.8 (SD: 762.4). EQ-5D-3L® score was higher (p<0.0001) in patients with controlled asthma compared to partially controlled and uncontrolled asthma in both countries (respectively 0.88; 0.78; 0.63 in France and 0.89; 0.82; 0.69 in Spain). Conclusions In both countries, patients presenting with uncontrolled asthma had a significantly higher asthma costs and lower scores of Qol compared to the others.
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Affiliation(s)
- Marianne Doz
- Cemka-Eval, 43 Boulevard du Maréchal Joffre, Bourg-la-Reine, F-92340, France
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Michel M, Doz M, Leclerc-Teffahi S, Detournay B, Lévy-Bachelot L. Prise en charge du purpura thrombopénique immunologique en France avant la mise à disposition des agonistes du récepteur à la thrombopoïétine. Rev Med Interne 2012; 33:305-10. [DOI: 10.1016/j.revmed.2012.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 01/12/2012] [Accepted: 02/13/2012] [Indexed: 12/29/2022]
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Doz M, Berdeaux G, Lafuma A. Economic analysis of cataract surgery in Europe: An analysis of hospital databases available in 11 countries. Rev Epidemiol Sante Publique 2011. [DOI: 10.1016/j.respe.2011.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Michel M, Denjean F, Doz M, Detournay B, Levy-Bachelot L. Impact de la maladie et modalités de prise en charge du PTI chronique de l’adulte en France entre 2004 et 2006. Etude observationnelle rétrospective multicentrique portant sur 122 patients. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Buron C, Doz M, Salomon AV, Couturier J, Beuzeboc P, Livartowski A. [Reflexion on innovation diffusion factors: the case of Herceptin]. Bull Cancer 2007; 94:297-306. [PMID: 17371772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Accepted: 11/30/2006] [Indexed: 05/14/2023]
Abstract
New innovating cancer therapies are becoming available on the market. Because medical innovations put a serious financial burden on healthcare system, it is important to understand their diffusion. To analyze this process of diffusion, the molecule trastuzumab (Herceptin) provided by Roche Laboratories was chosen. Because Herceptin is commercialized since 1999 few data are available for this analysis. The objective of this study is to identify factors and brakes associated with the diffusion of the innovation Herceptin. By identifying these factors and brakes, one can notice that Herceptin is the perfect case to illustrate a successful diffusion. All factors mentioned in E. M. Rogers theory are verified with Herceptin: benefit, simplicity, triability, observability and compatibility. The tolerance is excellent and side effects minimized except for cardiac toxicity for patients previously treated with anthracyclines. The weakness concerning financing has been overcome since France changed the payment system to a prospective payment based on the hospital activity. The only problem left is that the fluorescence in situ hybridisation (FISH) test is still not reimbursed by the social security.
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Affiliation(s)
- Catherine Buron
- Service d'information médicale, Institut Curie, 25 rue d'Ulm, 75005 Paris
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Doz M, Assaf N, Trystram D, Godon-Hardy S, Boquet L, Chomette E, Reyes L, Fredy D, Meder J. P-12 L’embolisation des anévrismes intracrâniens rompus : étude de cout. J Neuroradiol 2004. [DOI: 10.1016/s0150-9861(04)96941-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gerbaud L, Lejeune ML, Abou-Samra T, Doz M, Mathey MF, D'Incan M, Déchelotte P, Souteyrand P, Glanddier PY. Epidemiological survey of melanoma in the Auvergne region (France): is there an increased incidence in Auvergne? Eur J Epidemiol 2003; 18:331-5. [PMID: 12803373 DOI: 10.1023/a:1023643219686] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To assess the efficiency of melanoma screening and prevention campaigns in the Auvergne region (France), cases of melanoma have been recorded since 1st June 1998. The epidemiological follow-up of melanoma was carried out using two sentinel networks; one involving the pathologists, and the other, the dermatologists of the region. Incidence was calculated using the capture-recapture method, by cross-matching the data supplied by both dermatologists and pathologists. Between June 1st 1998 and December 31st 2000, 363 cases of melanoma were recorded. The crude incidence rate of melanoma per 100,000 person-years was 17.1 for all melanomas and 14.6 for invasive melanomas. These rates of incidence were higher than the estimated national rate of France, and were close to incidences found in countries of Northern Europe. This might be explained by an increase in screening for melanoma, by more precise estimation of the incidence due to the capture-recapture method, or by geographic factors (mountainous area). An answer may be provided by following the variation in time of incidence and thickness of melanomas; the increase in the number of thin (low Breslow index) melanomas corresponding with increased screening.
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Affiliation(s)
- L Gerbaud
- Epidémiologie, Economie de la Santé et Prévention, CHU de Clermont-Ferrand, France.
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Gerbaud L, Chiambaretta F, Desrumeaux H, Privat C, Doz M, Menerath JM, Guichard C, Garcier JM, Boyer L. [Cost efficiency study of lacrimal canal obstruction treatment]. J Radiol 2003; 84:41-6. [PMID: 12637886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To compare three methods used to clear the lacrimal canal. PATIENTS AND METHODS A total of 32 files (20 for the dacryocysto-rhinostomy by endoscopic way, 5 for the dacryocysto-rhinostomy by external way and 7 cases of percutaneous stenting) were reviewed. For each, costs of performed interventions were reviewed. An average of the total cost per patient was calculated for all three methods and was then correlated to the initial efficiency of the method. RESULTS Results show that the average cost for stenting is up to 1,366.80 EUR, for the endoscopic way is up to 2 001.53 EUR and for the external way is up to 2,220.46 EUR. ANOVA (Analysis of Variance) gives significant results when comparing stent to endoscopic way (p=0.000007) and to the external way (p =0.02). The analysis of sensitivity concerning the success rate of various treatments shows that the stent was potentially the most cost-effective and that a failure rate of 35.1% is rather acceptable by comparison to the endoscopic method. If the stent is considered as an outpatient intervention, then, a failure rate of 50% is acceptable. CONCLUSION If the failure rate stays under 35.1%, the stent may be considered as a short-term cost-effective method.
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Affiliation(s)
- L Gerbaud
- Services d'Epidémiologie, d'Economie de la Santé de Prévention, CHU de Clermont-Ferrand
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Ruivard M, Gerbaud L, Doz M, Philippe P. Ferritin is more cost-effective than transferrin receptor-ferritin index for the diagnosis of iron deficiency. Arch Intern Med 2002; 162:1783. [PMID: 12153390 DOI: 10.1001/archinte.162.15.1783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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