Predicted clinical and economic burden associated with reduction in access to acute coronary interventional care during the COVID-19 lockdown in two European countries.

Aims: As a consequence of untimely or missed revascularization of ST-elevation myocardial infarction (STEMI) patients during the COVID-19 pandemic, many patients died at home or survived with serious sequelae, resulting in potential long-term worse prognosis and related health-economic implications.This analysis sought to predict long-term health outcomes [survival and quality-adjusted life-years (QALYs)] and cost of reduced treatment of STEMIs occurring during the first COVID-19 lockdown.

Methods And Results: Using a Markov decision-analytic model, we incorporated probability of hospitalization, timeliness of PCI, and projected long-term survival and cost (including societal costs) of mortality and morbidity, for STEMI occurring during the first UK and Spanish lockdowns, comparing them with expected pre-lockdown outcomes for an equivalent patient group.

Heterogeneity in the systems of pediatric diabetes care across the European Union.

Background: It is known that the systems of pediatric diabetes care differ across the member states of the European Union (EU). The aim of this project was to characterize some of the main differences among the national systems.

Methods: Data were collected using two questionnaires.

An overview and commentary on retrospective, continuous glucose monitoring for the optimisation of care for people with diabetes.

Introduction: Normoglycaemia in people with diabetes results in improved outcome. Continuous glucose monitoring provides detailed diagnostic information used to optimise therapy with the goal of achieving normoglycaemia. The objective of this study was to review the published literature evaluating the single device available for blinded, professional clinical use of continuous glucose monitoring; in particular all randomised controlled trials (RCTs) and relevant observational studies.

Valuing condition-specific health states using simulation contact lenses.

Objective: This article reports on a study that used contact lenses to simulate the effects of a visual impairment caused by age-related macular degeneration (ARMD). The primary objective was to examine the feasibility of using this method of simulation. A secondary objective was to compare the results from this experiment with those obtained from ARMD patients (n = 209) using generic preference-based measures (Health Utilities Index 3 (HUI3) and EUROQOL 5 Dimensions (EQ-5D) and patient time trade-off (TTO).

An economic evaluation of valsartan for post-MI patients in the UK who are not suitable for treatment with ACE inhibitors.

Objectives: The overall objective of this study was to estimate the costs and outcomes associated with treatment with valsartan for post-myocardial infarction (post-MI) patients with left ventricular systolic dysfunction, heart failure, or both, who are not suitable for treatment with angiotensin-converting enzyme (ACE) inhibitors, compared to placebo.

Methods: A Markov model, using data drawn from the Valsartan in Acute Myocardial Infarction (VALIANT) trial and other trials, was developed to predict the future health pathways, resource use, and costs for patients who have recently experienced an MI. Patients received either valsartan (mean dose 247 mg) or placebo.

Cost-effectiveness of letrozole versus tamoxifen as initial adjuvant therapy in hormone receptor-positive postmenopausal women with early-stage breast cancer.

Background: In Breast International Group (BIG) 1-98, a randomized, double-blind trial comparing 5 years of initial adjuvant therapy with letrozole versus tamoxifen in postmenopausal women with hormone receptor-positive early breast cancer, letrozole significantly improved disease-free survival by 19% and reduced risk of breast cancer recurrence by 28% and distant recurrence by 27%.

Patients And Methods: A Markov model was used to estimate the incremental cost per quality-adjusted life year (QALY) gained with 5 years of initial adjuvant therapy with letrozole versus tamoxifen from a US health care system perspective. Probabilities and costs of breast cancer recurrence and treatment-related adverse events and health-state utilities were based on published results of BIG 1-98 and other published studies.