Latest news with #costeffectiveness
Medscape
12 hours ago
- Health
- Medscape
Trimodal Therapy Costs Offset QOL Benefit in Bladder Cancer
TOPLINE: In patients with muscle-invasive bladder cancer, trimodal therapy modestly improved quality of life compared with radical cystectomy but was not cost-effective at either 5 or 10 years. The high costs associated with trimodal therapy exceeded commonly accepted 'willingness-to-pay' thresholds, a new analysis found. METHODOLOGY: Trimodal therapy, which includes maximal transurethral resection followed by chemotherapy and radiation, is an alternative for patients who are unable or unwilling to undergo radical cystectomy. However, there are no randomized trials comparing the two approaches, and data on cost and utility trade-offs are limited. Researchers compared the cost-effectiveness of trimodal therapy and radical cystectomy using a simulation model that incorporates health economics. The index patient reflected patients in a large 2023 retrospective study: aged 71 years with clinical stage T2-4aN0M0 muscle-invasive bladder cancer, solitary tumor < 7 cm in size, adequate bladder function, and no multifocal or extensive carcinoma in situ. The model simulated outcomes over 5 and 10 years, using cost data from a Medicare payer perspective (adjusted to 2021 US dollars) and assumed the two treatment approach es had equivalent oncologic efficacy. Primary outcomes included costs, effectiveness measured in quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Cost-effectiveness was assessed using a willingness-to-pay threshold of $100,000 per QALY. TAKEAWAY: The average cost of trimodal therapy was more than $30,000 higher than the cost of radical cystectomy at 5 years ($71,014 vs $40,489) and 10 years ($85,137 vs $49,570). Trimodal therapy demonstrated a small advantage over radical cystectomy in terms of quality of life, due to fewer acute and long-term toxic effects: 3.94 vs 3.87 QALYs at 5 years and 6.61 vs 6.49 QALYs at 10 years. Compared to radical cystectomy, trimodal therapy was not cost-effective overall at either timepoint, with ICERs of $464,291 per QALY at 5 years and $308,636 per QALY at 10 years. However, trimodal therapy was considered cost-effective for 21% of patients at 10 years — supporting its use for some 'appropriately counseled' patients. Sensitivity analysis revealed that trimodal therapy would become broadly cost-effective if the initial cost dropped by more than half (to $17,605), or if it achieved an 11.6% improvement in metastasis-free survival. IN PRACTICE: The results underscore two ongoing needs: a better understanding of patients' long-term outcomes with trimodal therapy vs radical cystectomy and measures to rein in the high cost of bladder cancer care. 'These findings highlight the importance of developing policy initiatives that help reduce [trimodal therapy] costs and of providing patients with accurate expectations of long-term toxic effects to help guide preference-sensitive care,' the study authors wrote. SOURCE: The study, led by Daniel Joyce, MD, MS, Vanderbilt University Medical Center, Nashville, Tennessee, was published online in JAMA Network Open. LIMITATIONS: The findings were limited by model assumptions and potential selection bias from the retrospective studies used. The model inputs were based on the best available evidence. All nonmuscle-invasive recurrences after trimodal therapy were assumed to be treated with Bacillus Calmette-Guérin, possibly overestimating costs by excluding intravesical chemotherapy options. DISCLOSURES: The authors did not disclose any funding information. Several authors declared receiving consulting fees or grants or having other ties with various sources. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
South China Morning Post
14-05-2025
- Business
- South China Morning Post
Surprise lay-offs hit Hong Kong's Hang Seng Bank amid HSBC's sweeping revamp
Hong Kong retail lender Hang Seng Bank is laying off staff as part of its parent company HSBC Holdings' aggressive restructuring aimed at enhancing cost-effectiveness and growth. Advertisement The lender, 62.14 per cent owned by HSBC , informed staff in various departments over the past few weeks that they would lose their jobs as part of the restructuring plan, two separate sources told the Post. The affected units were mainly supporting departments such as information technology and corporate communications, as well as index compiler Hang Seng Indexes and some units that were being consolidated in the restructuring, the sources said. The total number of people affected was not disclosed. Some departments lost up to 20 per cent of their staff, while the hardest-hit team was cut in half, the sources said. Wealth management and other key growth areas would not be affected and were instead the focus of expansion, the sources said. The bank is currently recruiting for about 100 vacancies. 'Hang Seng's lay-off plan is a surprise to the market, because the domestic lenders in Hong Kong tend not to have massive lay-offs and tend to keep a stable headcount even during the previous financial crises,' said Kenny Ng Lai-yin, a strategist at Everbright Securities International. Advertisement 'The surprise lay-offs may reflect the challenging operating environment and weak local economy in Hong Kong, as both the retail and property sectors have performed badly. Hang Seng has no choice but to cut down staff headcount to reduce costs.' The lay-offs were expected to continue in the coming two months, the sources said. Remaining employees must apply for their positions again, competing with new external applicants.
South China Morning Post
14-05-2025
- Business
- South China Morning Post
HSBC's Hong Kong unit Hang Seng Bank lays off staff as part of sweeping revamp
Hong Kong retail lender Hang Seng Bank is carrying out lay-offs as part of its parent company HSBC Holdings' aggressive restructuring aimed at enhancing cost-effectiveness and growth. The lender, 62.14 per cent owned by HSBC , informed staff in various departments over the past few weeks that they would lose their jobs as part of the restructuring plan, two separate sources told the Post. The affected units were mainly supporting departments such as information technology and corporate communications, as well as index compiler Hang Seng Indexes and some units that are being consolidated in the restructuring, the sources said. The total number of people affected was not disclosed. Some departments lost up to 20 per cent of their staff, while the hardest-hit team was cut in half, the sources said. Wealth management and other key growth areas would not be affected and were instead the focus of expansion, the sources said. The bank is currently recruiting for about 100 vacancies. The lay-offs were expected to continue in the coming two months, the sources said. Remaining employees must apply for their positions again, competing with new external applicants. Hang Seng Bank did not directly comment, but said it commonly reviewed and made adjustments to its organisation and departments to meet customers' needs. 'This includes creating new roles, restructuring the organisation [and] upgrading staff's technical skills so as to offer a better quality of service for customers,' the bank said in a statement in Chinese.
Associated Press
13-05-2025
- Health
- Associated Press
New Studies Recommend Inclusion of Dynamic Inputs in Cost-Effectiveness Analyses to Better Reflect Drug Value Over Time
Cost-effectiveness models that exclude dynamic pricing likely underestimate a treatment's benefits versus its costs to society WASHINGTON, DC, UNITED STATES, May 13, 2025 / / -- Two new studies published in Value in Health underscore the importance of incorporating dynamic pricing and other evolving inputs into cost-effectiveness analyses (CEAs) to more accurately represent the value of prescription drugs across their lifecycles. 'CEAs are comprised of both science and judgment – which is why they are a tool, not a rule,' said NPC Chief Science Officer Jon Campbell, PhD, who was an author on both studies. 'This research supports more useful tools that better reflect market realities.' The first paper, ' U.S. Drug Pricing Patterns Before Loss of Exclusivity, ' characterizes changes in drug prices following launch and prior to loss of market exclusivity to enable the inclusion of dynamic pricing assumptions in CEAs. The paper is authored by Ching-Hsuan Lin, MD, MPH, and Joshua Cohen, PhD, of the Center for the Evaluation of Value and Risk in Health (CEVR) at Tufts Medical Center; and James Motyka, PharmD, and Jon Campbell, PhD, of the National Pharmaceutical Council (NPC). 'The assumption that drug prices stay the same after launch distort a cost-effectiveness projection,' Dr. Campbell explained. 'The failure to accurately represent the cost to society of a drug or its comparator can have ripple effects on market competition and the ability to bring future innovations to market.' In their analysis of inflation-adjusted pricing data for 32 brand-name drugs that are most likely to be selected within the Drug Price Negotiation Program, the authors identified several insights to inform CEAs: -The average inflation-adjusted mean annual drug price change for commonly prescribed and large-market drugs was -4.7%. -Mean annual price changes for 25 (78%) of the studied drugs were negative, suggesting most had lower net prices at the end of the observed period once adjusted for inflation. -Modeling indicates that price change rates tend to moderate with more time since a drug's launch. The study also includes an interactive tool to help researchers incorporate these empirical models into CEAs alongside other evidence on price drops after the loss of exclusivity. The second study, " Identifying the Influential Dynamic Inputs in Cost-Effectiveness Analyses, " is the first work of its kind investigating the influence of specific dynamic inputs on cost-effectiveness findings. Informed by an advisory panel of economic modeling experts, this study calculated cost-effectiveness estimates for four stylized examples to explore how omitting dynamic inputs could misrepresent a treatment's cost-effectiveness. The paper is authored by Melanie D. Whittington, PhD, Joshua T. Cohen, PhD, and Peter J. Neumann, ScD, affiliated with CEVR at Tufts Medical Center and Tyler D. Wagner, PhD, and Jonathan D. Campbell, PhD, of NPC. 'Omitting key drug pricing dynamics risks misrepresenting a medicine's benefits versus costs over the lifecycle,' said Dr. Wagner. 'It is a disservice to patients if these analyses use the same inaccurate assumptions and inputs to assess all drugs.' Key findings from the modeling include: -For chronically administered drugs, the static (i.e. conventional) cost-effectiveness estimate was less favorable than the dynamic estimate by over 60%. Drug price changes after loss of exclusivity had the most impact on this difference. -For one-time administration drugs, the static estimate was less favorable by over 30%. In this case, impact on the difference in cost-effectiveness findings included price changes as well as the age at baseline and discount rate. -The inclusion of dynamic inputs had a greater impact in CEAs for chronically administered treatments than for one-time treatments, indicating that static models do not have the same level of CEA finding bias across all treatment types. 'Moving from static to dynamic inputs for CEAs is not a cure-all but will help prevent CEAs from misrepresenting certain cost dynamics that are a component of the comprehensive value of medicines,' added Dr. Campbell. About the National Pharmaceutical Council NPC serves patients and society with policy-relevant research on the value of patient access to innovative medicines and the importance of scientific advancement. We envision a world where advances in medicine are accessible to patients, valued by society, and sustainably reimbursed by payers to ensure continued innovation. For more information, visit and follow NPC on LinkedIn. Michael Pratt National Pharmaceutical Council (NPC) +1 202-695-5776 email us here Visit us on social media: LinkedIn YouTube X Legal Disclaimer: EIN Presswire provides this news content 'as is' without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.
