Cost-effectiveness of apixaban and warfarin in the prevention of thromboembolic complications among atrial fibrillation patients.

Background: To reduce the risk of thromboembolic complications, clinical guidelines recommend anticoagulation treatment for almost all atrial fibrillation (AF) patients. Although warfarin has long been the primary treatment alternative, now newer alternatives such as apixaban have proven effective in prevention of the thromboembolic complications of non-valvular AF. The aim of this study is to assess the cost-effectiveness of apixaban when compared with warfarin in the prevention of AF-associated thromboembolic complications in Finland.

Cost-utility of first-line actinic keratosis treatments in Finland.

Introduction: Cost-utility assessment of first-line actinic keratosis (AK) treatments for max 25 cm2 AK field.

Methods: A probabilistic, 2-year decision tree model was used to assess costs, quality-adjusted life-years (QALY), incremental cost-effectiveness ratio (ICER), cost-effectiveness efficiency frontier, cost-effectiveness acceptability frontier (CEAF), and expected value of perfect information (EVPI) of AK treatments from the Finnish health care payer perspective with 3% discounting per annum. In the model, the first-line AK treatment resulted in complete clearance (CC) or non-CC with or without local skin responses (LSR), or AK recurrence.

Economic impact of 13-valent pneumococcal conjugate vaccine in Finnish adults ≥50 years with underlying chronic medical conditions.

Rationale, Aims And Objectives: Invasive pneumococcal diseases (IPD) are associated with substantial burden in adults (≥50 years). Moreover, adults with vascular, metabolic or respiratory diseases have been shown to have a 3-6 times higher risk of IPD when compared with their healthy controls. These persons at higher risk are likely to benefit most from pneumococcal vaccinations.

Warfarin treatment among Finnish patients with atrial fibrillation: retrospective registry study based on primary healthcare data.

Objective: To assess the frequency of warfarin use, the achieved international normalised ratio (INR) balance among warfarin users and the primary healthcare outpatient costs of patients with atrial fibrillation (AF).

Design: Retrospective, non-interventional registry study.

Setting: Primary healthcare.

Administration costs of intravenous biologic drugs for rheumatoid arthritis.

Background: Cost-effectiveness studies explicitly reporting infusion times, drug-specific administration costs for infusions or real-payer intravenous drug cost are few in number. Yet, administration costs for infusions are needed in the health economic evaluations assessing intravenously-administered drugs.

Objectives: To estimate the drug-specific administration and total cost of biologic intravenous rheumatoid arthritis (RA) drugs in the adult population and to compare the obtained costs with published cost estimates.

Bayesian predictors of very poor health related quality of life and mortality in patients with COPD.

Background: Chronic obstructive pulmonary disease (COPD) is associated with increased mortality and poor health-related quality of life (HRQoL) compared with the general population. The objective of this study was to identify clinical characteristics which predict mortality and very poor HRQoL among the COPD population and to develop a Bayesian prediction model.

Methods: The data consisted of 738 patients with COPD who had visited the Pulmonary Clinic of the Helsinki and Turku University Hospitals during 1995-2006.

Differential use of extended and immediate release quetiapine: a retrospective registry study of Finnish inpatients with schizophrenia spectrum and bipolar disorders.

Objective: Extended release (XR) and immediate release (IR) quetiapine have differing dosing, titration and plasma concentration profiles. The authors assessed whether the use of quetiapine XR and IR in schizophrenia spectrum disorders (SCZ) and bipolar disorder (BD) differ.

Design: Retrospective non-interventional registry study.

The association between anxiety and the degree of illness in mild obstructive sleep apnoea.

Introduction: Obstructive sleep apnoea (OSA) has been reported to associate with anxiety, but earlier observations are scarce and the role of the persistence of anxiety in this connection is unclear.

Objectives: To examine the associations between OSA and anxiety, and in particular clarify the observations regarding the role of the persistence of anxiety in this connection.

Methods: A total of 61 overweight patients with mild OSA participated in a 12-month lifestyle modification study and reported the presence of anxiety both at baseline and on 12-month follow up.

Economic evaluation of sequential treatments for follicular non-hodgkin lymphoma.

Background: The cost-effectiveness analyses of follicular lymphoma (FL) treatments have focused on the second-line rituximab maintenance in patients with relapsed FL. The assessment of full FL treatment chain has been lacking.

Objective: The aim of this study was to assess the cost-effectiveness of FL treatment sequences.

Risk factors for persistent frequent use of the primary health care services among frequent attenders: a Bayesian approach.

Objectives: The aim of this study was to examine risk factors that predict persistent healthcare frequent attendance among a frequent attender (FA) population.

Design: Prospective cohort study without intervention.

Setting: Primary healthcare centre in Tampere, Finland.

Cost-utility of different treatment strategies after the failure of tumour necrosis factor inhibitor in rheumatoid arthritis in the Finnish setting.

Objective: To evaluate the cost-utility of different treatment strategies in severe RA after TNF-inhibitor failure.

Methods: The cost-effectiveness of treatment strategies was compared in a group of hypothetical Finnish RA patients. Initially, the patients received either best supportive care (BSC) or one of the following treatments before BSC: adalimumab (ADAL), abatacept (ABAT), etanercept (ETAN), infliximab (INFL) or rituximab (RTX).

Population-based health-economic evaluation of the secondary prevention of coronary heart disease in Finland.

Objective: To evaluate the cost-effectiveness of generic atorvastatin 20 mg (A20), branded rosuvastatin 10 mg (R10), generic simvastatin 40 mg (S40) and the combination of generic S40 + branded ezetimibe 10 mg (S40 + EZ10) for the secondary prevention of coronary heart disease (CHD) in Finnish patients not meeting the target goal of low-density lipoprotein cholesterol (LDL-C) with S40.

Research Design And Methods: A probabilistic Markov model was employed to evaluate the costs and health outcomes of the different therapies based on the cardiovascular events avoided. The model included Framingham risk equations, Finnish population characteristics, event rates, quality of life estimates, resource use and unit costs.

Costs and quality of life effects of the first year of renal replacement therapy in one Finnish treatment centre.

Objective: The main objective of the study was to assess the cost and quality of life (QoL) effects of elective dialysis patients during the first year of end-stage renal disease (ESRD) treatment in one Finnish treatment centre.

Methods: A prospective case-series study was performed involving all elective dialysis patients (n=29) in a Finnish dialysis unit during 2003-2004. Direct costs of ESRD treatment were obtained from the hospital database and the Social Insurance Institution.

Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea.

Rationale: Obesity is the most important risk factor for obstructive sleep apnea (OSA). However, although included in clinical guidelines, no randomized controlled studies have been performed on the effects of weight reduction on mild OSA.

Objectives: The aim of this prospective, randomized controlled parallel-group 1-year follow-up study was to determine whether a very low calorie diet (VLCD) with supervised lifestyle counseling could be an effective treatment for adults with mild OSA.

Economic evaluation of sunitinib malate in second-line treatment of metastatic renal cell carcinoma in Finland.

Background: Cytokine therapy is currently used as first-line treatment of metastatic renal cell carcinoma (mRCC). Until recently, treatments with proven efficacy after the failure of first-line cytokine therapy were not available. In recent clinical trials, sunitinib has been associated with good response rates in patients with mRCC.