Published: 03-08-2020

We update the heoro.com database every day with new studies relevant to health economics and outcomes research. In this blog we summarise some of the key studies added throughout August 2020.

Studies reporting utilities

• Patients with active graft-versus-host disease after haematopoietic stem call transplant in Japan had significantly worse SF-36 scores than those with resolved GVHD. Kurosawa 2019 Go to paper on PubMed
• SF-6D utility values were lower and QALY losses higher in adults in the US with atopic dermatitis than controls with autoimmune disorders, diabetes, heart disease and food allergy. Silverberg 2019 Go to paper on PubMed
• The EQ-5D-5L has a higher resolution than the EQ-5D-3L in assessing change in quality of life after total hip arthroplasty in Sweden; the corresponding EQ-VAS scores correlated well. Eneqvist 2020 Go to paper on PubMed
• Mean SF-36 scores fell from 82.2 before to 64.2 4 weeks after the introduction of social distancing for COVID-19  in uninfected reproductive-age Italian women living with a sexual partner. Schiavi 2020 Go to paper on PubMed
• SF-36 scores were significantly improved for up to 6.5 years after an intensive CBT program for chronic low back pain in the Netherlands; healthcare resource use was significantly lower for 5 years. Groot 2019 Go to paper on PubMed
• A systematic review found that EQ-5D values  and HAQ-DI scores were significantly increased after autologous haematopoietic stem cell transplant in patients with systemic sclerosis; SF-36 scores did not consistently improve.  Puyade 2020 Go to paper on PubMed
• Preference-based utilities were 0.61 for monocular blindness, 0.18 for binocular blindness, 0.96 for mild dysphonia, 0.58 for  moderate dysphonia and 0.33 for severe dysphonia in patients with voice disorders in the UK. Naunheim 2020 Go to paper on PubMed
• EQ-5D and WHOQOL-Bref utility values were significantly higher after 3-6 months or longer in patients with lung cancer treated with targeted therapy than standard chemotherapy in Taiwan. Yang 2019 Go to paper on PubMed
• SF-36 scores were significantly improved from 1 month after septoplasty in patients with nasal septal deviation in Turkey. Erdivanli 2020 Go to paper on PubMed

Studies validating a PRO instrument

• The iPCQ-VR and TiCP-VR questionnaires were validated as measures of productivity loss and healthcare utilisation in sick workers with chronic musculoskeletal pain the the Netherlands. Beemster 2019 Go to paper on PubMed
• Predictive models were developed based on individual responses to the Scoliosis Research Society-22R (SRS-22R) in adults with spinal deformity undergoing spinal surgery. Ames 2019 Go to paper on PubMed
• The Kessler-6 scale was validated as a measure of psychological distress in hospital nurses in Vietnam. Kawakami 2020 Go to paper on PubMed
• A systematic review found the ICEpop CAPability measure for Adults (ICECAP-A) correlated well with the Assessment of Quality of Life-Eight Dimension but inconsistently with the EQ-5D. Afentou 2020 Go to paper on PubMed

Other PRO studies

• EORTC QLQ-C30 scores were significantly higher after a self-care and education intervention, showing greater quality of life and reduced fatigue in patients having chemotherapy for gastrointestinal cancers in China. Xie 2020 Go to paper on PubMed
• Equine therapy significantly improved pain and range of movement in the back, hips and shoulders but not the knees in 20 adults and older adults with arthritis in the USA after 6 weeks compared with control; some aspects of quality of life also improved. White-Lewis 2019 Go to paper on PubMed

Studies reporting costs and resource use

• A systematic review found limited evidence on indirect costs associated with stroke and bleeding in patients with atrial fibrillation; costs were highest in patients with haemorrhagic stroke and intracranial haemorrhage and account for 30 to 50% of total costs by 2 years after bleeding events. Martin 2019 Go to paper on PubMed
• Lifetime societal costs associated with abusive head trauma in 64 children aged 0 to 2 years in Canada was $354million; investment of $5 per newborn in the PURPLE program saved $273.52 per child in societal costs. Beaulieu 2019 Go to paper on PubMed
• A systematic review of the economic impact of workplace interventions on productivity found inconsistencies in the way absenteeism is valued and presenteeism is measured and valued across the 21 studies identified. Jones 2019 Go to paper on PubMed
• Screening college students for COVID-19 with a test of 70% sensitivity every 2 days with Rt of 2.5, 1 day with Rt of 3.5 or 7 days with Rt of 1.5 would keep new infections at a manageable number and cost $470, $910 or $120 per student per semester in the USA. Paltiel 2020 Go to paper on PubMed
• Costs of managing eosinophilic oesophagitis in the USA were significantly higher than costs of Crohn's disease or coeliac disease in children and men. Anderson 2020 Go to paper on PubMed 
• Having uncontrolled diabetes did not have a significant effect on health care use in Spain; patients transitioned across classes of disease control over time. Gil 2019 Go to paper on PubMed
• Orthopaedic admissions for trauma fell by 32% during COVID-19 isolation in Belgium compared with 2018; 2.6% of patients had COVID-19 compared with 0.3% of the general population. Hernigou 2020 Go to paper on PubMed
• The direct costs of dengue for the mean 274 cases per year in Japan in 2011-2015 was $1,365 per patient and indirect costs were $151. Kajimoto 2020 Go to paper on PubMed 
• 38% of 61,024 admissions for varicella in England in 2004-2017 had complications, which increased length of stay by 3.1 times and costs by 72%. Bernal 2019 Go to paper on PubMed
• Hospitalisation rates for Herpes zoster and mean treatment costs are higher in immunocompromised than non-immunocompromised adults in the UK, and are highest in adults aged >80 years. Curran 2019 Go to paper on PubMed
• Emergency care and hospitalisation costs were significantly lower in patients with migraine in Taiwan who used acupuncture in the first year after diagnosis than those without acupuncture. Tsai 2020 Go to paper on PubMed
• Demand for dental services during COVID-19 fell in Germany by up to 80%, with fall in annual revenue of 30 to 31%; 12% to 29% of practices would have negative net profit for the year. Schwendicke 2020 Go to paper on PubMed

Economic evaluations

• Tacrolimus induction and maintenance was more cost-effective than mycophenolate mofetil or azathioprine in patients with lupus nephritis in China. Kim 2019 Go to paper on PubMed
• Using 3 instead of 2 PCR tests to diagnose COVID-19 and inform patient discharge would lead to 850.1 QALYs gained (749.4 due to years of life saved) at a cost of 49.1 million Yuan in China. Jiang 2020 Go to paper on PubMed
• Adding atezolizumab to nab-paclitaxel is not cost-effective first-line therapy for advanced triple-negative breast cancer  in the US or China, with an ICER of $331,997/QALY overall in the US and $106,339/QALY in China, and $229,360/QALY (US) and $72,972/QALY (China) in the PD-L1-positive population. Weng 2020 Go to paper on PubMed
• Rotavirus vaccination of children aged 0 to 5 years is cost-effective in Nigeria: reducing rotavirus mortality by 6% to 35% in different regions, with an ICER of US$33 to $88/DALY averted. Anderson 2020 Go to paper on PubMed
• Insulin degludec was cost-effective compared with glargine in patients with type 2 diabetes at high risk of cardiovascular disease in the UK, with an ICER of £14,956/QALY. Pollock  2019 Go to paper on PubMed 
• Universal screening of pregnant women in labour for COVID-19 is more cost-effective than providing universal full personal protective equipment to prevent infection transmission to healthcare staff  in the USA if COVID-19 prevalence is less than 29.5%. Savitsky 2020 Go to paper on PubMed
• In women with alcohol use disorder in the USA, group CBT is likely to be cost-effective compared with individual CBT when the value to decision-makers of 1 additional day free of drinking is <$141 or day of heavy drinking avoided is <$258. Olmstead 2019 Go to paper on PubMed
• Differences in drug sequences in moderate-severe rheumatoid arthritis lead to small changes in QALYs but large differences in costs; starting with etanercept biosimilars is the most cost-effective in France. Ghabri 2020 Go to paper on PubMed
• One-time or biannual pharmacy distribution of intranasal naloxone is cost-effective at preventing overdose in high-risk opioid users in the USA, with an ICER of $56,600/QALY and $84,799/QALY respectively. Acharya 2020 Go to paper on PubMed
• Tenofovir prophylaxis in women with high viral loads is cost-effective at preventing mother-to-child hepatitis B transmission in China with an ICER of US$9087/QALY gained compared with standard care. Yin 2020 Go to paper on PubMed
• A systematic review found that stem cell transplant is the most cost-effective first-line treatment for multiple myeloma in eligible patients; bortezomib, lenalidomide + dexamethasone and pomalidomide + dexamethasone are more cost-effective than dexamethasone alone. Fu 2019 Go to paper on PubMed

Studies reporting mortality rates and trends

• Mortality from COVID-19 was significantly higher in the North of Brazil than other regions, possibly reflecting more comorbidities due to lower socioeconomic development, and in Pardo and Black populations than White Brazilians. Baqui 2020 Go to paper on PubMed
• Mortality incidence rate ratio for COVID-19 was 13.1 in adults in long-term care facilities in Canada compared with community-living adults aged >69 years; infection in staff was associated with death among residents after 6-day lag. Fisman 2020 Go to paper on PubMed
• Mortality was 33% at 30 days in 69 patients aged 80 to 98 years in Italy with COVID-19; severe dementia, low oxygen saturation and high lactate dehydrogenase predicted death. Covino 2020 Go to paper on PubMed
• Of 154 patients hospitalised with COVID-19 in China, 33.8% died; APACHE II scores >17 predicted hospital mortality more accurately than SOFA or CURB65 scores. Zou 2020 Go to paper on PubMed
• Mortallity in patients with hip fractures in the USA was 35.3% in those testing positive for COVID-19, 7.1% in those suspected of having COVID-19 and 0.9% in those not infected; length of stay, complications and need for ventilation were increased with COVID-19 infection. Egol 2020 Go to paper on PubMed
• Socioeconomic inequalities in premature mortality in the UK in 2003 to 2018 were mainly due to tuberculosis, opioid use, HIV, psychoactive drugs use, viral hepatitis, and obesity; 14.4 months of life were lost on average before age 75 years due to inequality. Lewer 2020 Go to paper on PubMed
• In-hospital mortality from COVID-19 was significantly higher in patients aged >60 years, with diabetes or COPD in the USA. Smith 2020 Go to paper on PubMed
• In 210 patients with COVID-19 aged 18-45 years in the USA, 9% died, 17% required ventilation, 45% were admitted; obesity increased risk of mortality 6-fold. Steinberg 2020 Go to paper on PubMed
• In 50-year-old adults in the UK in 2002-2013, healthy working life expectancy was 9.42 years in men and 8.25 years in women, life expectancy was 31.76 years in men and 33.49 years in women. Parker 2020 Go to paper on PubMed
• Age-standardised mortality from alcohol-related liver disease is estimated to increase from 8.23/100,000 person-years in 2019 to 15.2/100,000 person-years in 2040 in the USA if alcohol consumption remains constant, equating to 1,128,400 DALYs by 2040. Julien 2020 Go to paper on PubMed
• Delaying cancer surgery due to COVID-19 in the UK would decrease life-years gained per patient by 0.97 for 3-month delay, 2.19 for 6-month delay, equivalent of 19% and 43% of LYGs incurred from hospitalising patients with COVID-19. Sud 2020 Go to paper on PubMed
• Among 27,347 postmenopausal women in the USA, conjugated oestrogen HRT was associated with a significantly lower risk of breast cancer incidence and mortality after 20 years compared with placebo, oestrogen plus progesterones significantly increased incidence but not mortality from breast cancer. Chlebowski 2020 Go to paper on PubMed
• A 12-factor risk score including age, sex, ethnicity, diabetes, hypertension and chronic lung disease predicted need for ICU admission and mortality in patients with COVID-19 in the UK. Galloway 2020 Go to paper on PubMed
• Mortality in patients with stomach cancer was strongly correlated with both anatomical site of affected lymph nodes and with number of positive nodes. Duchon 2020 Go to paper on PubMed
• Mortality from COVID-19 was significantly higher in men than women from an international database after propensity score matching, 8.13% in men versus 4.6% in women. Alkhouli 2020 Go to paper on PubMed
• Age >70 years, Alzheimer's dementia and chronic lung disease were the only independent predictors of mortality in 103 adults with COVID-19 in Korea. Hwang 2020 Go to paper on PubMed
• Mortality in patients with bone fractures in China was 0.46% during the COVID-19 pandemic and 0.43% in 2019; fractures were half as common during COVID and were more likely to be in older people. Lv 2020 Go to paper on PubMed
• 10% of 3711 patients admitted with COVID-19 in Spain had rheumatic or musculoskeletal disease, with mortality of 26%; only rheumatic disease activity, dyslipidaemia, cardiovascular disease and interstitial lung disease independently predicted mortality. Santos 2020 Go to paper on PubMed
• Out-of-hospital cardiac arrests increased from 13.42/million in March-April 2012-2019 to 26.64/million during COVID-19 pandemic in France; the proportion surviving to hospital admission fell from 22.8% to 12.8%. Marijon 2020 Go to paper on PubMed
• ICU capacity-dependent deaths can be reduced by 75% in a UK hospital during COVID-19 by increasing ICU capacity from 45 to 100 beds, reducing length of stay by 25% and flattening peak demand to 26 admissions per day; total deaths would be reduced by 30%. Wood 2020 Go to paper on PubMed
• Mortality from COVID-19 was significantly higher in patients with pulmonary hypertension but not in those with right ventricular dysfunction in Italy. Pagnesi 2020 Go to paper on PubMed