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Article ; Online: Economic Evaluation of Targeted Therapies for Anaplastic Lymphoma Kinase- and ROS1 Fusion-Positive Non-Small Cell Lung Cancer in India.

Gupta, Dharna / Gupta, Nidhi / Singh, Navneet / Prinja, Shankar

JCO global oncology

2024 Volume 10, Page(s) e2300260

Abstract: Purpose: Targeted therapies, such as crizotinib and ceritinib, have shown promising results in treating non-small cell lung cancer (NSCLC) with specific oncogenic drivers like anaplastic lymphoma kinase (: Methods: The Markov model consisted of three ...

Abstract	Purpose: Targeted therapies, such as crizotinib and ceritinib, have shown promising results in treating non-small cell lung cancer (NSCLC) with specific oncogenic drivers like anaplastic lymphoma kinase ( Methods: The Markov model consisted of three health states: progression-free survival, progressive disease, and death. Lifetime costs and consequences were estimated for three treatment arms: crizotinib, ceritinib, and chemotherapy for patients with Results: The total lifetime cost per patient for Conclusion: Our study findings suggest that the prices of ceritinib and crizotinib need to be reduced significantly to justify their value for inclusion in India's publicly financed health insurance scheme for treatment of patients with locally advanced/metastatic
MeSH term(s)	Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/pathology ; Anaplastic Lymphoma Kinase ; Crizotinib/therapeutic use ; Cost-Benefit Analysis ; Protein-Tyrosine Kinases/therapeutic use ; Lung Neoplasms/drug therapy ; Lung Neoplasms/pathology ; Proto-Oncogene Proteins/therapeutic use ; Pyrimidines ; Sulfones
Chemical Substances	Anaplastic Lymphoma Kinase (EC 2.7.10.1) ; ceritinib (K418KG2GET) ; Crizotinib (53AH36668S) ; Protein-Tyrosine Kinases (EC 2.7.10.1) ; Proto-Oncogene Proteins ; ROS1 protein, human (EC 2.7.10.1) ; Pyrimidines ; Sulfones
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Journal Article
ISSN	2687-8941
ISSN (online)	2687-8941
DOI	10.1200/GO.23.00260
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: India's publicly financed insurance scheme: scope for revision - authors' reply.

Prinja, Shankar / Singh, Maninder Pal / Bahuguna, Pankaj

The Lancet regional health. Southeast Asia

2023 Volume 14, Page(s) 100236

Language	English
Publishing date	2023-06-14
Publishing country	England
Document type	Journal Article
ISSN	2772-3682
ISSN (online)	2772-3682
DOI	10.1016/j.lansea.2023.100236
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: National hospital costing systems matter for universal healthcare: the India PM-JAY experience.

Prinja, Shankar / Chugh, Yashika / Garg, Basant / Guinness, Lorna

BMJ global health

2023 Volume 8, Issue 11

Abstract: India envisions achieving universal health coverage to provide its people with access to affordable quality health services. A breakthrough effort in this direction has been the launch of the world's largest health assurance ... ...

Abstract	India envisions achieving universal health coverage to provide its people with access to affordable quality health services. A breakthrough effort in this direction has been the launch of the world's largest health assurance scheme
MeSH term(s)	Humans ; Universal Health Care ; Health Care Costs ; Hospitals ; India
Language	English
Publishing date	2023-11-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2023-012987
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Article: Costing of services under National Tuberculosis Elimination Program at public health facilities of northern India.

Kumar, Dinesh / Prinja, Shankar

The Indian journal of tuberculosis

2022 Volume 70, Issue 2, Page(s) 232–238

Abstract: Background: Costing of resources helps to measure financial implications and effective utilization of resources of national programs. As there is limited evidence about cost per service, current study was done to assess the cost of services under ... ...

Abstract	Background: Costing of resources helps to measure financial implications and effective utilization of resources of national programs. As there is limited evidence about cost per service, current study was done to assess the cost of services under National Tuberculosis Elimination Program (NTEP) at Community Health Centres (CHCs) and Primary Health Centres (PHCs) of northern state of India. Material and methods: Cross-sectional study carried out in two districts and from each district eight CHCs and PHCs were randomly selected. Results: Mean annual cost of providing NTEP services at CHCs and PHCs were US$5243.1 (95%CI: 3008.0-7225.4) and US$1031.9 (95%CI: 669.1-1447.1) respectively. Across both centres human resource contributes to the most (CHC: 72.9%; PHC: 85.9%). One way sensitivity analysis was carried out for all health facilities and observed that human resource cost influences most cost per treated case by providing services under NTEP. Although relatively very less but cost of drugs also influences cost per treatment. Conclusion: Cost of delivering services was high for CHCs as compared to PHCs. At both types of health facilities, human resource contributes the most to cost of delivering services under the program.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Health Facilities ; Community Health Centers ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control ; India/epidemiology
Language	English
Publishing date	2022-05-27
Publishing country	India
Document type	Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2022.05.009
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Article ; Online: Cost-Effectiveness Analysis of Systemic Therapy for Intensification of Treatment in Metastatic Hormone-Sensitive Prostate Cancer in India.

Gupta, Nidhi / Gupta, Dharna / Vaska, Kiran Gopal / Prinja, Shankar

Applied health economics and health policy

2024 Volume 22, Issue 3, Page(s) 415–426

Abstract: Background and objective: Androgen-deprivation therapy is the mainstay of treatment for patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC). However, the intensification of treatment with either docetaxel or novel anti- ... ...

Abstract	Background and objective: Androgen-deprivation therapy is the mainstay of treatment for patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC). However, the intensification of treatment with either docetaxel or novel anti-androgens (abiraterone-acetate plus prednisone [AAP], enzalutamide, and apalutamide) is being recommended based on the improved clinical outcomes and quality of life among patients. This study aimed to determine the most cost-effective drug for treatment intensification for patients with mHSPC in India. Methods: A Markov model was developed with four health states: progression-free survival, progressive disease, best supportive care, and death. Lifetime costs and consequences were estimated for four treatment sequences: AAP-first, enzalutamide-first, apalutamide-first, and docetaxel-first. Incremental cost per quality-adjusted life-year (QALY) gained with a given treatment option was compared against the next best alternative and assessed for cost effectiveness using a willingness to pay threshold of 1 × per capita gross domestic product in India. Results: We estimated that the total lifetime cost per patient was ₹1,367,454 (US$17,487), ₹2,168,885 (US$27,735), ₹7,678,501 (US$98,190), and ₹1,358,746 (US$17,375) in the AAP-first, enzalutamide-first, apalutamide-first, and docetaxel-first treatment sequence, respectively. The mean quality-adjusted life-years lived per patient were 4.78, 5.03, 3.22, and 2.61, respectively. The AAP-first sequence incurs an incremental cost of ₹4014 (US$51) per quality-adjusted life-year gained as compared with the docetaxel-first sequence, with a 87% probability of being cost effective at the willingness-to-pay threshold of 1 × per-capita gross domestic product of India. The use of AAP-first also incurs an incremental net monetary benefit of ₹396,491 (US$5070) as compared with the docetaxel-first treatment sequence. Nearly a 48% reduction in the price of enzalutamide is required to make it a cost-effective treatment sequence as compared with AAP-first in India. Conclusions: We concur with the inclusion of standard-dose AAP in India's publicly financed health insurance scheme for the intensification of treatment in mHSPC as it is the only cost-effective sequence among the various novel anti-androgens when compared with the docetaxel-first treatment sequence. Furthermore, a systematic reduction in the price of enzalutamide would further help to improve clinical outcomes among patients with mHSPC.
MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/drug therapy ; Docetaxel/therapeutic use ; Cost-Effectiveness Analysis ; Androgen Antagonists/therapeutic use ; Quality of Life ; Cost-Benefit Analysis ; Prednisone/therapeutic use ; Hormones/therapeutic use ; Benzamides ; Nitriles ; Phenylthiohydantoin
Chemical Substances	Docetaxel (15H5577CQD) ; enzalutamide (93T0T9GKNU) ; Androgen Antagonists ; Prednisone (VB0R961HZT) ; Hormones ; Benzamides ; Nitriles ; Phenylthiohydantoin (2010-15-3)
Language	English
Publishing date	2024-01-10
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2171420-4
ISSN	1179-1896 ; 1175-5652
ISSN (online)	1179-1896
ISSN	1175-5652
DOI	10.1007/s40258-023-00866-w
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Article ; Online: Congenital Heart Disease: Would It Be the Key Driver of Infant Survival During Amrit Kaal (2022-2047)?

Baranwal, Arun K / Prinja, Shankar / Kaur, Navpreet

Indian pediatrics

2023 Volume 60, Issue 1, Page(s) 98–102

Abstract: Post-independence, we made significant strides in childhood survival. However, there is an abysmal improvement in survival due to birth defects. Globally, India contributes the largest proportion of under-5 deaths, overall as well as due to birth defects. ...

Abstract	Post-independence, we made significant strides in childhood survival. However, there is an abysmal improvement in survival due to birth defects. Globally, India contributes the largest proportion of under-5 deaths, overall as well as due to birth defects. Congenital heart disease (CHD) is the single most common cause of birth-defect related deaths, and is the 7th most common cause of infant deaths. Scarcity of pediatric cardiac care professionals and pediatric cardiac centers has led to a huge demand-supply gap. Understanding the burden of CHD and taking imperative steps at primary, secondary and tertiary levels are essential during Amrit Kaal (2022-2047). Coverage of management of CHD under Janani Shishu Suraksha Karyakram, Rashtriya Bal Suraksha Karyakram and Ayushman Bharat programs offers a huge promise, as shown by the experience from Hridayam program in Kerala.
MeSH term(s)	Humans ; Child ; Infant ; Heart Defects, Congenital/therapy ; India/epidemiology
Language	English
Publishing date	2023-02-13
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Zs.A 859: Show issues

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Article: Effect of tobacco taxation on smoking prevalence and smoking-attributable deaths in India.

Rana, Kirtan / Goel, Sonu / Prinja, Shankar

Indian journal of public health

2023 Volume 67, Issue 2, Page(s) 278–283

Abstract: Background: Higher taxes are the single most effective way to encourage tobacco users to quit tobacco use and prevent youth from initiation.: Objectives: The present study aims to estimate the effect of raising the tax on smoked tobacco products on ... ...

Abstract	Background: Higher taxes are the single most effective way to encourage tobacco users to quit tobacco use and prevent youth from initiation. Objectives: The present study aims to estimate the effect of raising the tax on smoked tobacco products on its consumption and smoking-attributable deaths in India. Materials and methods: A mathematical model was developed which used the projected population of India, taxation rates on smoked tobacco products, smoking prevalence, and price elasticity of demand of cigarette and bidi from 2017 to 2025. Four scenarios of tax increment (0%, 25%, 50%, and 100%) on smoked tobacco products were created which were modeled to calculate smoking prevalence and smoking-attributable deaths due to respiratory diseases, heart diseases, stroke tuberculosis, and cancer in country till 2025. Results: A relative decrease of 6.2% in the prevalence of smoking was observed between the existing tax rates and its increment to 100% over the last increment of 6%. Similarly, smoking-attributable deaths (SAD) decreased by 6.04% on increasing the tax rates to 100% of the existing taxation rates. There has been a steady increase in SAD in scenario 1 which decreases effectively in scenario 4, which in turn leads to the saving of around 33,000 lives due to tobacco-related diseases by 2025. Conclusion: The consumption of cigarettes and bidis can be reduced by raising the price of these products. The model will help policymakers in deciding to fix the tax and ultimately the price of cigarettes and bidi to reduce its consumption and smoking-attributable mortality.
MeSH term(s)	Humans ; Adolescent ; Prevalence ; India/epidemiology ; Smoking/epidemiology ; Taxes ; Commerce
Language	English
Publishing date	2023-07-18
Publishing country	India
Document type	Journal Article
ZDB-ID	800737-8
ISSN	2229-7693 ; 0019-557X
ISSN (online)	2229-7693
ISSN	0019-557X
DOI	10.4103/ijph.ijph_93_22
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Article ; Online: India’s publicly financed insurance scheme

Shankar Prinja / Maninder Pal Singh / Pankaj Bahuguna

The Lancet Regional Health - Southeast Asia, Vol 14, Iss , Pp 100236- (2023)

scope for revision – Authors’ reply

2023

Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health technology assessment in India in the next decade: reflections on a vision for its path to maturity and impact.

Gheorghe, Adrian / Mehndiratta, Abha / Baker, Peter / Culyer, Anthony / Prinja, Shankar / Kar, Sitanshu Sekhar / Guzman, Javier

BMJ evidence-based medicine

2024

Language	English
Publishing date	2024-01-30
Publishing country	England
Document type	Journal Article
ISSN	2515-4478
ISSN (online)	2515-4478
DOI	10.1136/bmjebm-2023-112491
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Article ; Online: Cost-Effectiveness Analysis of Denosumab in the Prevention of Skeletal-Related Events Among Patients With Breast Cancer With Bone Metastasis in India.

Wadhwa, Raina / Gupta, Nidhi / Dixit, Jyoti / Malhotra, Pankaj / Lakshmi, Pvm / Prinja, Shankar

JCO global oncology

2024 Volume 10, Page(s) e2300396

Abstract: Purpose: Denosumab is clinically superior to zoledronic acid (ZA) for preventing and delaying time to first and subsequent skeletal-related events (SREs) among patients with breast cancer (BC) with bone metastases. We evaluated the cost and health ... ...

Abstract	Purpose: Denosumab is clinically superior to zoledronic acid (ZA) for preventing and delaying time to first and subsequent skeletal-related events (SREs) among patients with breast cancer (BC) with bone metastases. We evaluated the cost and health benefits of denosumab and ZA (once every 4 weeks and once every 12 weeks) among four different molecular subtypes of BC with bone metastases in India. Materials and methods: A Markov model was developed in Microsoft Excel to estimate lifetime health consequences and resulting costs among cohort of 1,000 patients with BC with bone metastasis, for three intervention scenarios, namely denosumab (once every 4 weeks), ZA (once every 4 weeks), and ZA (once every 12 weeks). The health outcomes were measured in terms of SREs averted and quality-adjusted life-years (QALYs) gained. The cost of each intervention scenario was measured using both the health system and the patient's perspectives. Indirect costs because of lost productivity were not included. The future costs and outcomes were discounted at the standard rate of 3%. Results: Over a lifetime, the incremental number of SREs averted with use of denosumab once every 4 weeks (compared with ZA once every 4 weeks and once every 12 weeks) among patients with luminal A, luminal B, human epidermal growth factor receptor 2-enriched, and triple negative breast cancer were estimated as 0.39, 0.26, 0.25, and 0.19, respectively. The number of QALYs lived were slightly higher in the denosumab arm (1.45-2.80) compared with ZA once every 4 weeks and once every 12 weeks arms (1.44-2.78). However, denosumab once every 4 weeks was not found to be a cost-effective alternative for either of the four molecular subtypes of breast cancer. ZA once every 12 weeks was found to be a cost-effective option with an average cost-effectiveness ratio ranging between ₹68,254 and ₹73,636. Conclusion: ZA once every 12 weeks is the cost-effective treatment option for BC with bone metastases in India. The present study findings hold significance for standard treatment guidelines under India's government-funded health insurance program.
MeSH term(s)	Humans ; Female ; Denosumab/therapeutic use ; Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology ; Diphosphonates/therapeutic use ; Bone Density Conservation Agents/therapeutic use ; Cost-Effectiveness Analysis ; Imidazoles/therapeutic use ; Cost-Benefit Analysis ; Bone Neoplasms/drug therapy ; Bone Neoplasms/metabolism ; Zoledronic Acid/therapeutic use
Chemical Substances	Denosumab (4EQZ6YO2HI) ; Diphosphonates ; Bone Density Conservation Agents ; Imidazoles ; Zoledronic Acid (6XC1PAD3KF)
Language	English
Publishing date	2024-03-07
Publishing country	United States
Document type	Journal Article
ISSN	2687-8941
ISSN (online)	2687-8941
DOI	10.1200/GO.23.00396
Database	MEDical Literature Analysis and Retrieval System OnLINE

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