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  1. Article: Investing in the Prevention of Communicable Disease Outbreaks: Fiscal Health Modelling-The Tool of Choice for Assessing Public Finance Sustainability.

    van der Schans, Simon / Schöttler, Marcel H / van der Schans, Jurjen / Connolly, Mark P / Postma, Maarten J / Boersma, Cornelis

    Vaccines

    2023  Volume 11, Issue 4

    Abstract: National strategies for preparedness for future outbreaks of COVID-19 often include timely preparedness with vaccines. Fiscal health modelling (FHM) has recently been brought forward as an additional analysis by defining the public economic impact from a ...

    Abstract National strategies for preparedness for future outbreaks of COVID-19 often include timely preparedness with vaccines. Fiscal health modelling (FHM) has recently been brought forward as an additional analysis by defining the public economic impact from a governmental perspective. As governments are the main decision-makers concerning pandemic preparedness, this study aimed to develop an FHM framework for infectious diseases in the Netherlands. Based on the Dutch COVID-19 outbreak of 2020 and 2021 and publicly available data on tax income and gross domestic product (GDP), the fiscal impact of COVID-19 was assessed using two approaches. Approach I: Prospective modelling of future fiscal impact based on publicly available laboratory-confirmed COVID-19 cases; and Approach II: Retrospective assessment of the extrapolated tax and benefit income and GDP. Approach I estimated the consequences that can be causally linked to the population counts reducing income taxes by EUR 266 million. The total fiscal loss amounted to EUR 164 million over 2 years (excluding pension payments averted). The total losses in terms of tax income (2020 and 2021) and GDP (2020) (Approach II), were estimated at, respectively, EUR 13.58 billion and EUR 96.3 billion. This study analysed different aspects of a communicable disease outbreak and its influence on government public accounts. The choice of the two presented approaches depends on the perspective of the analysis, the time horizon of the analysis and the availability of data.
    Language English
    Publishing date 2023-04-10
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2703319-3
    ISSN 2076-393X
    ISSN 2076-393X
    DOI 10.3390/vaccines11040823
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Monitoring physical impact and recovery of pancreatic cancer treatment using consumer wearable health data: A case report.

    van der Schans, Cees P / van der Schans, Simon / van der Schans, Jurjen / Mylius, Caspar / Klaase, Joost

    Digital health

    2023  Volume 9, Page(s) 20552076231177127

    Abstract: Consumer wearables health data may reflect the impact of pancreatic cancer and its treatment on cardiorespiratory fitness and the subsequent recovery after treatment. The patient is a 65-year-old male treated for borderline resectable pancreatic cancer. ... ...

    Abstract Consumer wearables health data may reflect the impact of pancreatic cancer and its treatment on cardiorespiratory fitness and the subsequent recovery after treatment. The patient is a 65-year-old male treated for borderline resectable pancreatic cancer. Treatment consisted of four courses of FOLFIRINOX neoadjuvant chemotherapy, a Whipple procedure with a right hemicolectomy and venous segment resection, and eight courses of adjuvant FOLFIRINOX chemotherapy. Physical activity and moderate to vigorous physical activity declined after the onset of symptoms, increased in the weeks before surgery, declined after surgery and then gradually recovered during and after adjuvant chemotherapy. Estimated VO
    Language English
    Publishing date 2023-05-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2819396-9
    ISSN 2055-2076
    ISSN 2055-2076
    DOI 10.1177/20552076231177127
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  3. Article ; Online: A novel perspective on pharmaceutical R&D costs: opportunities for reductions.

    van der Schans, Simon / De Loos, Frans / Boersma, Cornelis / Postma, Maarten J / Büller, Hans

    Expert review of pharmacoeconomics & outcomes research

    2021  Volume 22, Issue 2, Page(s) 167–175

    Abstract: Introduction: R&D costs as an element of medicines' pricing play a prominent role in the discussions regarding the affordability of medicine. This paper investigates the details of R&D costs and the potential for reductions.: Areas covered: The ... ...

    Abstract Introduction: R&D costs as an element of medicines' pricing play a prominent role in the discussions regarding the affordability of medicine. This paper investigates the details of R&D costs and the potential for reductions.
    Areas covered: The manuscript focuses on the constitution of R&D costs in relation to medicines' pricing and its potential developments. This manuscript builds on a cost-of-opportunity approach to explore the results of potential changes in drug development and its possible economic, political, and societal impacts.
    Expert opinion: The cost of capital is the largest cost category that could be affected by authorities. Public institutions can affect these costs by increasing public investments in R&D and reducing the amount of development time that is associated with a high capital need. In order to affect the cost of failure, it is key to understand its drivers. A government taking risks as the funder of early innovation yields an opportunity to introduce an alternative model for medicine development. Next, to control pricing, it is important to adequately reward innovation in order to ensure improved quality of care, access, and affordability of systems. Innovation, high-quality care, access, and affordability require entrepreneurial and changing positions of governments, authorities, public institutions, and the pharmaceutical industry.
    MeSH term(s) Costs and Cost Analysis ; Drug Costs ; Drug Development ; Drug Industry ; Humans ; Pharmaceutical Preparations
    Chemical Substances Pharmaceutical Preparations
    Language English
    Publishing date 2021-10-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2208481-2
    ISSN 1744-8379 ; 1473-7167
    ISSN (online) 1744-8379
    ISSN 1473-7167
    DOI 10.1080/14737167.2022.1987219
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6194: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Cost-Effectiveness of Newborn Screening for Spinal Muscular Atrophy in The Netherlands.

    Velikanova, Rimma / van der Schans, Simon / Bischof, Matthias / van Olden, Rudolf Walther / Postma, Maarten / Boersma, Cornelis

    Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

    2022  Volume 25, Issue 10, Page(s) 1696–1704

    Abstract: Objectives: Spinal muscular atrophy (SMA) is a rare genetic disorder that causes progressive muscle weakness and paralysis. In its most common and severe form, the majority of untreated infants die before 2 years of age. Early detection and treatment, ... ...

    Abstract Objectives: Spinal muscular atrophy (SMA) is a rare genetic disorder that causes progressive muscle weakness and paralysis. In its most common and severe form, the majority of untreated infants die before 2 years of age. Early detection and treatment, ideally before symptom onset, maximize survival and achievement of age-appropriate motor milestones, with potentially substantial impact on health-related quality of life. Therefore, SMA is an ideal candidate for inclusion in newborn screening (NBS) programs. We evaluated the cost-effectiveness of including SMA in the NBS program in The Netherlands.
    Methods: We developed a cost-utility model to estimate lifetime health effects and costs of NBS for SMA and subsequent treatment versus a treatment pathway without NBS (ie, diagnosis and treatment after presentation with overt symptoms). Model inputs were based on literature, local data, and expert opinion. Sensitivity and scenario analyses were conducted to assess model robustness and validity of results.
    Results: After detection of SMA by NBS in 17 patients, the number of quality-adjusted life-years gained per annual birth cohort was estimated at 320 with NBS followed by treatment compared with treatment after clinical SMA diagnosis. Total healthcare costs, including screening, diagnostics, treatment, and other healthcare resource use, were estimated to be €12 014 949 lower for patients identified by NBS.
    Conclusions: NBS for early identification and treatment of SMA versus later symptomatic treatment after clinical diagnosis improves health outcomes and is less costly and, therefore, is a cost-effective use of resources. Results were robust in sensitivity and scenario analyses.
    MeSH term(s) Cost-Benefit Analysis ; Humans ; Infant ; Infant, Newborn ; Muscular Atrophy, Spinal/diagnosis ; Muscular Atrophy, Spinal/genetics ; Muscular Atrophy, Spinal/therapy ; Neonatal Screening/methods ; Netherlands ; Quality of Life
    Language English
    Publishing date 2022-08-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1471745-1
    ISSN 1524-4733 ; 1098-3015
    ISSN (online) 1524-4733
    ISSN 1098-3015
    DOI 10.1016/j.jval.2022.06.010
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5904: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Economic evaluation of orphan drug Lutetium-Octreotate vs. Octreotide long-acting release for patients with an advanced midgut neuroendocrine tumour in the Netherlands.

    Hagendijk, Marije E / van der Schans, Simon / Boersma, Cornelis / Postma, Maarten J / van der Pol, Simon

    The European journal of health economics : HEPAC : health economics in prevention and care

    2021  Volume 22, Issue 6, Page(s) 991–999

    Abstract: Objectives: Multiple studies showed positive effects of Lutetium-Octreotate (LO) treatment in neuroendocrine tumours. LO has been used in the Netherlands since the 1980s and recently received the orphan status shortly after the acquisition by Novartis. ... ...

    Abstract Objectives: Multiple studies showed positive effects of Lutetium-Octreotate (LO) treatment in neuroendocrine tumours. LO has been used in the Netherlands since the 1980s and recently received the orphan status shortly after the acquisition by Novartis. Since then, the official list price has increased sixfold. From a value-based pricing perspective, we analysed the impact of the increase in price on the incremental cost-effectiveness ratio (ICER) of LO treatment compared to optimal best supportive care, a high dose of Octreotide long-acting release (O-LAR), using the clinical data of the NETTER-1 trial.
    Methods: A Markov model was developed to evaluate the costs per quality-adjusted life-year (QALY) for LO treatment compared to O-LAR from the healthcare perspective. A scenario analysis was conducted to compare the cost-effectiveness with the initial and increased price level of the LO-treatment.
    Results: At the increased price level, the cost-effectiveness analysis rendered a deterministic ICER of €53,500 per QALY, while at the initial pricing, the ICER was €19,000 per QALY. The probabilistic sensitivity analysis (PSA) showed that LO had a high probability of being cost-effective at both the increased and initial price level, considering a cost-effectiveness threshold of €80,000.
    Conclusions: Even at the increased price level, LO treatment can still be considered cost-effective using the applicable Dutch willingness-to-pay threshold of 80,000 euro per QALY. Considering the public scrutiny in relation to this price increase, these outcomes raise the question whether traditional cost-effectiveness methods are sufficient in fully capturing the societal acceptance of prices of new medicines.
    MeSH term(s) Cost-Benefit Analysis ; Humans ; Lutetium ; Netherlands ; Neuroendocrine Tumors/drug therapy ; Octreotide/therapeutic use ; Orphan Drug Production ; Quality-Adjusted Life Years
    Chemical Substances Lutetium (5H0DOZ21UJ) ; Octreotide (RWM8CCW8GP)
    Language English
    Publishing date 2021-04-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2045253-6
    ISSN 1618-7601 ; 1618-7598
    ISSN (online) 1618-7601
    ISSN 1618-7598
    DOI 10.1007/s10198-021-01303-2
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5475: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: The impact of patent expiry on drug prices: insights from the Dutch market.

    van der Schans, Simon / Vondeling, Gert T / Cao, Qi / van der Pol, Simon / Visser, Sipke / Postma, Maarten J / Rozenbaum, Mark H

    Journal of market access & health policy

    2020  Volume 9, Issue 1, Page(s) 1849984

    Abstract: ... ...

    Abstract Background
    Language English
    Publishing date 2020-12-01
    Publishing country United States
    Document type Journal Article
    ISSN 2001-6689
    ISSN 2001-6689
    DOI 10.1080/20016689.2020.1849984
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  7. Article ; Online: Systematic Review and Quality Appraisal of Cost-Effectiveness Analyses of Pharmacologic Maintenance Treatment for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Recommendations.

    van der Schans, Simon / Goossens, Lucas M A / Boland, Melinde R S / Kocks, Janwillem W H / Postma, Maarten J / van Boven, Job F M / Rutten-van Mölken, Maureen P M H

    PharmacoEconomics

    2016  Volume 35, Issue 1, Page(s) 43–63

    Abstract: Background: Worldwide, chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic lung disease with considerable clinical and socioeconomic impact. Pharmacologic maintenance drugs (such as bronchodilators and inhaled corticosteroids) ... ...

    Abstract Background: Worldwide, chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic lung disease with considerable clinical and socioeconomic impact. Pharmacologic maintenance drugs (such as bronchodilators and inhaled corticosteroids) play an important role in the treatment of COPD. The cost effectiveness of these treatments has been frequently assessed, but studies to date have largely neglected the impact of treatment sequence and the exact stage of disease in which the drugs are used in real life.
    Objective: We aimed to systematically review recently published articles that reported the cost effectiveness of COPD maintenance treatments, with a focus on key findings, quality and methodological issues.
    Methods: We performed a systematic literature search in Embase, PubMed, the UK NHS Economic Evaluation Database (NHS-EED) and EURONHEED (European Network of Health Economics Evaluation Databases) and included all relevant articles published between 2011 and 2015 in either Dutch, English or German. Main study characteristics, methods and outcomes were extracted and critically assessed. The Quality of Health Economic Studies (QHES) instrument was used as basis for quality assessment, but additional items were also addressed.
    Results: The search identified 18 recent pharmacoeconomic analyses of COPD maintenance treatments. Papers reported the cost effectiveness of long-acting muscarinic antagonist (LAMA) monotherapy (n = 6), phosphodiesterase (PDE)-4 inhibitors (n = 4), long-acting beta agonist/inhaled corticosteroid (LABA/ICS) combinations (n = 4), LABA monotherapy (n = 2) and LABA/LAMA combinations (n = 2). All but two studies were funded by the manufacturer, and all studies indicated favourable cost effectiveness; however, the number of quality-adjusted life-years (QALYs) gained was small. Less than half of the studies reported a COPD-specific outcome in addition to a generic outcome (mostly QALYs). Exacerbation and mortality rates were found to be the main drivers of cost effectiveness. According to the QHES, the quality of the studies was generally sufficient, but additional assessment revealed that most studies poorly represented the cost effectiveness of real-life medication use.
    Conclusions: The majority of studies showed that pharmacologic COPD maintenance treatment is cost effective, but most studies poorly reflected real-life drug use. Consistent and COPD-specific methodology is recommended.
    MeSH term(s) Administration, Inhalation ; Adrenal Cortex Hormones/administration & dosage ; Adrenal Cortex Hormones/economics ; Bronchodilator Agents/administration & dosage ; Bronchodilator Agents/economics ; Cost-Benefit Analysis ; Drug Therapy, Combination ; Economics, Pharmaceutical ; Humans ; Muscarinic Antagonists/administration & dosage ; Muscarinic Antagonists/economics ; Phosphodiesterase 4 Inhibitors/administration & dosage ; Phosphodiesterase 4 Inhibitors/economics ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/economics ; Quality-Adjusted Life Years
    Chemical Substances Adrenal Cortex Hormones ; Bronchodilator Agents ; Muscarinic Antagonists ; Phosphodiesterase 4 Inhibitors
    Language English
    Publishing date 2016-10-12
    Publishing country New Zealand
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-016-0448-2
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3579: Show issues Location:
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