OBJECTIVE The purpose of this study was to determine whether routine hepatitis C virus screening in pregnancy is cost-effective. STUDY DESIGN A decision tree with Markov analysis was developed to compare 3 approaches to asymptomatic hepatitis C virus infection in low-risk pregnant women: (1) no hepatitis C virus screening, (2) hepatitis C virus screening and subsequent treatment for progressi...

OBJECTIVES We estimated the costs associated with reducing class sizes in kindergarten through grade 3 as well as the effects of small class sizes on selected outcomes such as quality-adjusted life-years and future earnings. METHODS We used multiple data sets to predict changes in the outcomes assessed according to level of educational attainment. We then used a Markov model to estimate futur...

BACKGROUND The appropriate time to initiate antiretroviral therapy is controversial for human immunodeficiency virus (HIV)-infected patients with CD4 cell counts between 200/microL and 350/microL and low levels of HIV RNA, potentially leading to barriers to treatment access. OBJECTIVE To examine the effect of cholesterol changes and fat redistribution symptoms on the clinical benefits and cos...

OBJECTIVE To analyze the cost-utility of using extracorporeal oxygenation for patients with severe acute respiratory distress syndrome in Brazil. METHODS A decision tree was constructed using databases from previously published studies. Costs were taken from the average price paid by the Brazilian Unified Health System (Sistema Único de Saúde; SUS) over three months in 2011. Using the data of...

BACKGROUND The quality-adjusted life year (QALY) is an attractive outcome measure because it captures both health-related quality of life (HRQL) and life expectancy in a single metric. We present a method for calculating QALYs that is simple, utilizes data that are free of charge, and may improve consistency in burden-of-disease investigations. METHODS For purposes of illustration, we calcula...

OBJECTIVES To investigate the long-term clinical and economic outcomes associated with exenatide versus insulin glargine as "add-on" treatments to oral therapy in individuals with Type 2 diabetes inadequately controlled with combination oral agents in the Swiss setting. METHODS A computer simulation model of diabetes was used to project complications, life expectancy, quality-adjusted life ex...

OBJECTIVES To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea. METHODS A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAs...

BACKGROUND Ethnic health inequalities for males and females among the elderly have not yet been verified in multicultural societies in developing countries. The aim of this study was to assess the extent of disparities in health expectancy among the elderly from different ethnic groups using quality-adjusted life expectancy. DESIGN A cross-sectional community-based survey was conducted. A tot...