National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Ambulatory Care and Surgery (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedSun D, Heimall JR, Greenhawt MJ
Cost utility of lifelong immunoglobulin replacement therapy vs hematopoietic stem cell transplant to treat agammaglobulinemia.
This study evaluated the cost utility of lifelong immunoglobulin replacement therapy (IRT) versus hematopoietic stem cell transplant (HSCT) to treat agammaglobulinemia. This economic evaluation used Markov analysis to model the base-case scenario of a patient aged 12 months to receive lifelong IRT vs matched sibling donor (MSD) or matched unrelated donor (MUD) HSCT. In this evaluation, lifelong IRT cost more than HSCT ($1,512,946 compared with $563,776 [MSD] and $637,036 [MUD]) and generated similar quality-adjusted life-years (QALYs) (20.61 vs 17.25 [MSD] and 17.18 [MUD]). While choosing IRT over HSCT generated higher incremental cost-effectiveness ratios (ICERs), it exceeded US willing-to-pay threshold of $100,000/QALY. However, IRT prevented at least 2488 premature deaths per 10,000 microsimulations compared with HSCT treatment. But when the annual IRT price was reduced from $60,145 to below $29,469, IRT became the cost-effective strategy.
AHRQ-funded; HS024599.
Citation: Sun D, Heimall JR, Greenhawt MJ .
Cost utility of lifelong immunoglobulin replacement therapy vs hematopoietic stem cell transplant to treat agammaglobulinemia.
JAMA Pediatr 2022 Feb; 176(2):176-84. doi: 10.1001/jamapediatrics.2021.4583..
Keywords: Medication, Healthcare Costs, Treatments, Evidence-Based Practice
Nguyen JT, Cole AL, Leech AA
Cost-effectiveness of first-line tyrosine kinase inhibitor therapy initiation strategies for chronic myeloid leukemia.
AHRQ-funded; HS000032.
Citation: Nguyen JT, Cole AL, Leech AA .
Cost-effectiveness of first-line tyrosine kinase inhibitor therapy initiation strategies for chronic myeloid leukemia.
Value Health 2020 Oct;23(10):1292-99. doi: 10.1016/j.jval.2020.05.019..
Keywords: Chronic Conditions, Medication, Healthcare Costs, Treatments
Shaker M, Greenhawt M
Estimation of health and economic benefits of commercial peanut immunotherapy products: a cost-effectiveness analysis.
The goal of this study was to evaluate critical inputs associated with the cost-effectiveness of epicutaneous peanut immunotherapy (EPIT) and peanut oral immunotherapy (POIT) from a societal perspective. In microsimulations with Markov modeling, virtual children aged 4 years over received EPIT, POIT, or no immunotherapy treatment. The main outcomes and measures were rates of therapy-associated adverse reactions; quality-of-life improvements associated with changes in tolerated peanut doses were modeled along with quality-adjusted life-years (QALY), anaphylaxis, therapy-associated anaphylaxis, and fatalities. The findings of this simulated analysis indicate that EPIT and POIT may be cost-effective, but the authors note that further research is needed.
AHRQ-funded; HS024599.
Citation: Shaker M, Greenhawt M .
Estimation of health and economic benefits of commercial peanut immunotherapy products: a cost-effectiveness analysis.
JAMA Netw Open 2019 May 3;2(5):e193242. doi: 10.1001/jamanetworkopen.2019.3242..
Keywords: Healthcare Costs, Outcomes, Respiratory Conditions, Treatments
Yin LX, Padula WV, Gadkaree S
Health care costs and cost-effectiveness in laryngotracheal stenosis.
The goal of this study was to conduct a cost-effectiveness analysis comparing open reconstruction surgery versus endoscopic dilation in the treatment of laryngotracheal stenosis (LTS). Cricotracheal/tracheal resection (CTR/TR) and endoscopic dilation were compared at a willingness-to-pay threshold of $50,000 per quality-adjusted life year (QALY) over 5 and 10 years. Annual treatment costs were derived from the Department of Otolaryngology-Head and Neck Surgery at Johns Hopkins University. The results indicate that patients with intubation-related stenosis have higher annual costs than idiopathic patients. The major risk factor for increased cost was etiology of stenosis. Although CTR/TR contributes significantly to cost in LTS, it is more cost-effective than endoscopic dilations for appropriately selected patients over the 5- and 10-year periods.
AHRQ-funded; HS000029.
Citation: Yin LX, Padula WV, Gadkaree S .
Health care costs and cost-effectiveness in laryngotracheal stenosis.
Otolaryngol Head Neck Surg 2019 Apr;160(4):679-86. doi: 10.1177/0194599818815068..
Keywords: Healthcare Costs, Surgery, Treatments
Dinan MA, Wilson LE, Reed SD
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
This study examined whether associations between 21-gene recurrence score (RS) genomic testing and lower costs among patients with early-stage, estrogen receptor-positive breast cancer were observable in real-world data from the Medicare population. The investigators found that RS testing was associated with lower overall and chemotherapy-related costs in patients with high-risk disease, consistent with lower chemotherapy use among these patients. Higher overall costs for patients with intermediate-risk and low-risk disease were driven largely by non-treatment-related costs.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
J Natl Compr Canc Netw 2019 Mar;17(3):245-54. doi: 10.6004/jnccn.2018.7097..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Healthcare Costs, Medicare, Women
Shen NT, Schneider Y, Congly SE
Cost effectiveness of early insertion of transjugular intrahepatic portosystemic shunts for recurrent ascites.
Treatment options for recurrent ascites resulting from decompensated cirrhosis include serial large-volume paracentesis and albumin infusion (LVP+A) or insertion of a transjugular intrahepatic portosystemic shunt (TIPS). In this study, the investigators examined whether TIPS insertion was cost effective. The investigators concluded that based on Markov model analysis, early placement of TIPSs appeared to be a cost-effective strategy for management of specific patients with cirrhosis and recurrent ascites.
AHRQ-funded; HS000066.
Citation: Shen NT, Schneider Y, Congly SE .
Cost effectiveness of early insertion of transjugular intrahepatic portosystemic shunts for recurrent ascites.
Clin Gastroenterol Hepatol 2018 Sep;16(9):1503-10.e3. doi: 10.1016/j.cgh.2018.03.027..
Keywords: Healthcare Costs, Surgery, Patient-Centered Outcomes Research, Treatments
Linas BP, Morgan JR, Pho MT
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
This study used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of treatment policies for interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 and to identify strategies that balance access with cost control. It found that among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes.
AHRQ-funded; HS022433.
Citation: Linas BP, Morgan JR, Pho MT .
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
Open Forum Infect Dis 2017 Winter;4(1):ofw266. doi: 10.1093/ofid/ofw266.
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Keywords: Hepatitis, Healthcare Costs, Healthcare Costs, Treatments
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
Lairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Poonawalla IB, Parikh RC, Du XL
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
The authors evaluated the cost-effectiveness of various chemotherapeutic and targeted therapy alternatives for ovarian cancer. They found that standard platinum-taxane combination chemotherapy for first-line treatment was most cost-effective.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Parikh RC, Du XL .
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
Pharmacoeconomics 2015 Nov;33(11):1155-85. doi: 10.1007/s40273-015-0304-9.
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Keywords: Treatments, Healthcare Costs, Medication, Cancer: Ovarian Cancer
Dalton VK, Liang A, Hutton DW
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
The objective of this study was to estimate the economic consequences of expanding options for early pregnancy loss treatment beyond expectant management and operating room surgical evacuation (usual care). It found that the cost per case was $241.29 lower for women undergoing treatment in the expanded care model as compared with the usual care model.
AHRQ-funded; HS015491.
Citation: Dalton VK, Liang A, Hutton DW .
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
Am J Obstet Gynecol 2015 Feb;212(2):177.e1-6. doi: 10.1016/j.ajog.2014.08.031..
Keywords: Healthcare Costs, Pregnancy, Treatments, Ambulatory Care and Surgery
Jackson H, Mandell K, Johnson K
Cost-effectiveness of injectable extended-release naltrexone compared with methadone maintenance and buprenorphine maintenance treatment for opioid dependence.
The authors estimated the cost-effectiveness of injectable extended-release naltrexone (XR-NTX) compared with methadone maintenance and buprenorphine maintenance treatment for adult males enrolled in treatment for opioid dependence in the United States from the perspective of state-level addiction treatment payers. They found that XR-NTX is a cost-effective medication for treating opioid dependence if state addiction treatment payers are willing to pay at least $72 per opioid-free day.
AHRQ-funded; HS000083.
Citation: Jackson H, Mandell K, Johnson K .
Cost-effectiveness of injectable extended-release naltrexone compared with methadone maintenance and buprenorphine maintenance treatment for opioid dependence.
Subst Abus 2015;36(2):226-31. doi: 10.1080/08897077.2015.1010031.
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Keywords: Healthcare Costs, Medication, Opioids, Substance Abuse, Treatments
Pershing S, Enns EA, Matesic B
Cost-effectiveness of treatment of diabetic macular edema.
The researchers sought to determine the cost-effectiveness of different treatments of diabetic macular edema (DME). They found that vascular endothelial growth factor (VEGF) inhibitors with or without laser treatment provide important health benefits with favorable cost-effectiveness, costing less per QALY gained than many accepted therapies.
AHRQ-funded; HS000028.
Citation: Pershing S, Enns EA, Matesic B .
Cost-effectiveness of treatment of diabetic macular edema.
Ann Intern Med 2014 Jan 7;160(1):18-29. doi: 10.7326/m13-0768..
Keywords: Diabetes, Eye Disease and Health, Healthcare Costs, Quality of Life, Treatments