Publications by authors named "Werner Brouwer"

Background: The outbreak of COVID-19 was followed by an unprecedented package of measures to protect public health. Over 150 countries mandated school closures to reduce the risk of transmission. Decisions on whether to close schools involve trade-offs between important effects on public health, learning outcomes, well-being of children, productivity of parents.

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Adopting a societal perspective in cost-effectiveness analysis (CEA) requires including all societal costs and benefits even if they fall outside of the realm of health and healthcare. While some benefits are not explicitly included, they might be implicitly included when people value quality-adjusted life-years (QALYs) in monetary terms. An example is utility of consumption (UoC) which has played a crucial role in discussions regarding the welfare economic underpinnings of CEA.

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Objectives: The Epilepsy Support Dog Evaluation study was commissioned by the Dutch Ministry of Health, Welfare and Sports to inform a reimbursement decision on seizure dogs. The randomized trial found that seizure dogs reduce seizure frequency and improve health-related quality of life of persons with severe refractory epilepsy (PSREs). This article examined the cost-effectiveness (CE) of adding seizure dogs to usual care for PSREs in The Netherlands.

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Article Synopsis
  • The study examines the impact of public disagreement on negative reimbursement decisions for new health technologies in publicly financed healthcare systems, particularly when individual patients are depicted in the media.
  • By conducting a discrete choice experiment with a representative sample in the Netherlands, researchers found that presenting a patient’s image increased public disagreement with reimbursement denials.
  • Results showed that disagreement was also influenced by factors such as the patient's age, health-related quality of life, life expectancy before treatment, and potential gains from treatment.
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Objectives: Economic evaluations using broader measures to capture benefits beyond improved health can inform policy making, but only if the monetary value of gains measured using these instruments is understood. This study explored contingent valuation as a method to estimate the monetary value of a well-being-adjusted life-year (WALY) as measured by ICEpop Capability Measure for Adults (ICECAP-A).

Methods: In a large online survey of representative samples from 7 European countries, participants valued a change in the ICECAP-A from their current health state to a randomly assigned hypothetical state.

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Objectives: Economic evaluations of interventions in health and social care require outcome measures that capture their full benefits, including those beyond health. This study aimed to assess construct validity, test-retest reliability, and responsiveness of the newly developed 10-item Well-being instrument (WiX).

Methods: Data were gathered via an online survey in a representative sample of the adult general population in The Netherlands (N = 1045).

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Background And Objectives: The aim of this study was to evaluate whether people living with severe medically refractory epilepsy (PSRE) benefit from a seizure dog.

Methods: An individual-level stepped-wedge randomized controlled trial was conducted. The study was conducted in the Netherlands among adults with daily to weekly seizures.

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Health authorities using cost-effectiveness analysis (CEA) for informing reimbursement decisions on health technologies increasingly require economic evaluations encompassing both CEA and budget impact analysis (BIA). Good Research Practices advocate that the economic and clinical assumptions underlying these analyses are aligned and consistently applied. Nonetheless, CEAs and BIAs often are stand-alone analyses used in different stages of the decision-making process.

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An important issue in economic evaluations is determining whether all relevant impacts are considered, given the perspective chosen for the analysis. Acknowledging that patients are not isolated individuals has important implications in this context. Increasingly, the term "spillovers" is used to label consequences of health interventions on others.

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Background: Omission of family and caregiver health spillovers from the economic evaluation of healthcare interventions remains common practice. When reported, a high degree of methodological inconsistency in incorporating spillovers has been observed.

Aim: To promote emerging good practice, this paper from the Spillovers in Health Economic Evaluation and Research (SHEER) task force aims to provide guidance on the incorporation of family and caregiver health spillovers in cost-effectiveness and cost-utility analysis.

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Article Synopsis
  • - The study aimed to create a Dutch value set for the Mental Health Quality of Life questionnaire (MHQoL) to improve the evaluation of mental health care benefits in health economics.
  • - A discrete choice experiment (DCE) involving 1,308 participants was conducted to gather data, focusing on key dimensions such as "physical health," "mood," and "relationships" that are valued by people with mental health issues.
  • - The resulting value set enables the generation of index values for various MHQoL states, facilitating cost-utility analyses for mental healthcare interventions in the Netherlands.
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Background: Systemic family interventions for adolescents with problems of substance use and/or delinquency are increasingly focused subject of economic evaluations. Treatment effects go beyond improvements in commonly measured health-related quality of life (HRQOL). The Teen-Addiction Severity Index (T-ASI) was identified as capable of capturing these broad outcomes.

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Background: Compensation mechanisms and multiplier effects may affect productivity losses due to illness, disability, or premature death of individuals. Hence, they are important in estimating productivity losses and productivity costs in the context of economic evaluations of health interventions. This paper presents a systematic literature review of papers focusing on compensation mechanisms and multiplier effects, as well as whether and how they are included in health economic evaluations.

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Aim: This paper investigates the prevalence and determinants of three main states of people's willingness to be vaccinated (WTBV) against COVID-19 - willing, unwilling and hesitant - and the occurrence and predictors of shifts between these states over time. Understanding the dynamics of vaccine intentions is crucial for developing targeted campaigns to increase uptake and emergency response preparedness.

Study Design: A panel survey consisting of 9 quarterly waves of data collected between April 2020 and January 2022.

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The COVID-19 pandemic considerably impacted the lives of European citizens. This study aims to provide a nuanced picture of well-being patterns during the pandemic across Europe with a special focus on relevant socio-economic sub-groups. This observational study uses data from a repeated, cross-sectional, representative population survey with nine waves of data from seven European countries from April 2020 to January 2022.

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Introduction: Given the initial shortage of vaccines to protect against coronavirus disease 2019 (COVID-19), many countries set up priority lists, implying that large parts of the population had to wait. We therefore elicited the willingness to pay (WTP) for access to two hypothetical COVID-19 vaccines.

Methods: Respondents were asked how much they would be willing to pay to get an immediate COVID-19 vaccination rather than waiting for one through the public system.

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Experiencing deteriorating health has implications for your quality of life. The theory of adaptation suggests that with time spend living in a health state individuals can adapt, resulting in observed quality of life levels to revert or stagnate despite persistently decreased health. Adaptation has implications for the use of subjective quality of life indicators when quantifying the impact of health changes or the benefits from new medical technologies.

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A cost-effectiveness analysis has become an important method to inform allocation decisions and reimbursement of new technologies in healthcare. A cost-effectiveness analysis requires a threshold to which the cost effectiveness of a new intervention can be compared. In principle, the threshold ought to reflect opportunity costs of reimbursing a new technology.

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Article Synopsis
  • The new EU Regulations aim to enhance the quality of clinical evidence for medical devices and streamline market access processes across EU countries.
  • Recommendations suggest that the assessment of medical devices and health technology should be better coordinated, especially for innovative, high-risk devices, and an accelerated approval program could be beneficial.
  • The article reviews past global accelerated approval programs, highlighting issues like uncertainty in clinical evidence and calls for an Accelerated Access Pathway in the EU to improve timely access for patients and encourage collaboration among member states on coverage decisions.
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Background: Productivity costs can form a large and influential component of total costs in an economic evaluation taking a societal perspective. In calculating productivity costs, estimating productivity losses is a central element. Compensation mechanisms and multiplier effects may influence these losses but remain understudied.

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Background: A small group of people with epilepsy suffers from frequent seizures despite the available pharmacological and non-pharmacological interventions. The impact of epilepsy on these people extends beyond health-related quality of life (HRQoL), impacting a person's broader well-being and ability to participate in society. This study describes the burden of medically refractory epilepsy in people who suffer from daily to weekly seizures, in terms of HRQoL, well-being, and societal costs.

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Recently, due to the corona virus outbreak, pandemics and their effects have been at the forefront of the research agenda. However, estimates of the perceived value of early warning systems (EWSs) for identifying, containing, and mitigating outbreaks remain scarce. This paper aims to show how potential health gains due to an international EWS might be valued.

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People do not only care about maximizing health gains but also about their distribution. For example, they give more weight to younger patients than older patients. This pilot study aims to investigate if age weighting is reinforced by loss aversion if young people are falling behind one's perceived 'normal' quality of life (QoL), while older people do not.

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