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The researchers found that although there were important exceptions, most studies found that drug exclusion policies reduced costs and did not negatively impact patients.

An info-graphic based on this study can be found here– Dr.

In future research we plan to examine the consistency between the payer coverage determination and the evidence they report reviewing when adjudicating the decision.

In a recent study published in the American Journal of Managed Care, researchers from the Center for the Evaluation of Value and Risk in Health analyzed findings from 26 empirical studies to examine how drug exclusion policies affect patients and healthcare costs.

We also found variation in the types of intervention for which payers issued coverage determinations for: 89% of payers issued the largest proportion of their coverage policies for medical devices; 11% issued the largest proportion for drugs.

Additionally, for a subset of interventions – the seven medical devices, pharmaceuticals, surgeries, and diagnostic tests/imaging procedures for which the payers most often issued coverage policies – we examined the payers’ coverage determinations and the evidence that the payers reported reviewing in their policy.

(2016) A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted. See below for a full list of all cost-utility studies and selected reviews and editorials published December 12-16, 2016. See below for a full list of all cost-utility studies and selected reviews and editorials published December 5-9, 2016. PMID: 27935333.10: Kearns B, Chilcott J, Whyte S, Preston L, Sadler S. PMID: 27919292.11: Kingsley J, Karanth S, Revere FL, Agrawal D. PMID: 12: Kolu P, Raitanen J, Puhkala J, Tuominen P, Husu P, Luoto R. PMID: 27936083.13: Lai K, Zhang C, Ke W, Gao Y, Zhou S, Liu L, Yang Y. PMID: 27928739.14: Luttjeboer J, Setiawan D, Cao Q, Cahh Daemen T, Postma MJ. PMID: 27816370.15: Maurer KA, Chen HF, Wagner AL, Hegde ST, Patel T, Boulton ML, Hutton DW. PMID: 27810315.17: Salazar J, Saxena V, Kahn JG, Roberts JP, Mehta N, Volk M, Lai JC. PMID:27926593.18: Shiffman D, Arellano AR, Caulfield MP, Louie JZ, Bare LA, Devlin JJ, Melander O. PMID: 27927162.19: Sørensen SS, Pedersen KM, Weinreich UM, Ehlers L. PMID: 27928660.• Pneumococcal vaccine found to be cost-saving among infants: The newest pneumococcal vaccine (PHi D-CV) introduced in the UK national vaccination program was found to produce greater cost-savings and more health benefits compared to the PCV-13 pneumococcal vaccine. PMID: 27841726.22: Murphy J, Gray A, Cooper C, Cooper D, Ramsay C, Carr A. PMID: 27909127.23: Neumann A, Lindholm L, Norberg M, Schoffer O, Klug SJ, Norström F. PMID: 27913943.24: Pinyol C, Cepeda JM, Roldan I, Roldan V, Jimenez S, Gonzalez P, Soto J. PMID: 27457613.25: Rafia R, Scope A, Harnan S, Stevens JW, Stevenson M, Lobo A. PMID: 27480631.26: Salisbury AC, Li H, Vilain KR, Jaff MR, Schneider PA, Laird JR, Cohen DJ. Laparoscopic Versus Open Cholecystectomy: A Cost-Effectiveness Analysis at Rwanda Military Hospital. Cost-effectiveness of direct-acting antiviral regimen ombitasvir/paritaprevir/ritonavir in treatment-naïve and treatment-experienced patients infected with chronic hepatitis C virus genotype 1b in Japan. Mirabegron for the treatment of overactive bladder: cost-effectiveness from US commercial health-plan and Medicare Advantage perspectives. Cost Effectiveness of Apixaban and Enoxaparin for the Prevention of Venous Thromboembolism After Total Knee Replacement in China. Cost-Effectiveness of the 'One4All' HIV Linkage Intervention in Guangxi Zhuang Autonomous Region, China. 2016 Nov PMID: 27893864.33: Zhang P, Yang Y, Wen F, Wheeler J, Fu P, Li Q. PMID: 27118432.• Apixaban regarded as cost-effective treatment option for stroke prevention in Greece: Apixaban was found to be a cost-effective treatment option versus warfarin and aspirin for the prevention of stroke in patients with atrial fibrillation from a Greek healthcare payer perspective (2).• Future prevalence and cost burden of Chronic Lymphocytic Leukemia (CLL) estimated to have large financial impact: The increased benefit of oral targeted therapies is projected to enhance CLL survivorship but higher costs can impose a substantial financial burden on both patients and payers in the U. (4).• Cognitive screening tests for detecting dementia and mild cognitive impairment found to be cost-effective: Cognitive screening tests for use by General Practitioners considered a cost-effective strategy compared to standard of care in England (18). PMID: 27865653.6: Li N, Yang X, Fan L, Totev T, Guerin A, Chen L, Bhattacharyya S, Joseph G. PMID: 27841717.7: Maru S, Byrnes JM, Carrington MJ, Stewart S, Scuffham PA. Cost-effectiveness of Wait Time Reduction for Intensive Behavioral Intervention Services in Ontario, Canada. If you are interested in becoming a sponsor, please contact Julie Lannon for more information.

To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry. VF, Jin L, Karumanchi SM, Guan C, Vuong Q, Rivera N, Mc Cleod-Omawale J, He M. PMID: 27978578.7: Olfert JA, Penz ED, Manns BJ, Mishra EK, Davies HE, Miller RF, Luengo-Fernandez R, Gao S, Rahman NM. PMID: 27983774.10: Turner HC, Bettis AA, Chu BK, Mc Farland DA, Hooper PJ, Mante SD, Fitzpatrick C, Bradley MH. PMID: 27956460.11: Wang Z, Chen Z, Wang X, Hao G, Ma L, Zhao X, Li Y, Zhang L, Zhu M. To discover more CEA articles or to dive in-depth on some of these topics, please visit the Tufts CEA Registry. Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery. Cost-effectiveness of screening for ovarian cancer amongst postmenopausal women: a model-based economic evaluation. Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates - A Modeling Study. Effectiveness and Cost-Effectiveness of a Cluster-Randomized Prenatal Lifestyle Counseling Trial: A Seven-Year Follow-Up. Cost-Effectiveness Comparison Between the Response-Guided Therapies and Monotherapies of Nucleos(t)ide Analogues for Chronic Hepatitis B Patients in China. Threshold cost-effectiveness analysis for a therapeutic vaccine against HPV-16/18-positive cervical intraepithelial neoplasia in the Netherlands. Cost-effectiveness analysis of pneumococcal vaccination for infants in China. Cost-Effectiveness of Direct-Acting Anti-viral Treatment in Hepatitis C-infected Liver Transplant Candidates with Compensated Cirrhosis and Hepatocellular Carcinoma. Use of low density lipoprotein particle number levels as an aid in statin treatment decisions for intermediate risk patients: a cost-effectiveness analysis. Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease. (2)• Introduction of a new flu vaccine found to be beneficial: The Quadrivalent influenza vaccine (QIV) was projected to have greater health gains and cost-savings compared to the Trivalent influenza vaccine (TIV) in Germany. PMID: 26750641.13: Hager J, Henriksson M, Carlsson P, Länne T, Lundgren F. PMID: 27905693.14: Jalal H, O'Dell JR, Bridges SL Jr, Cofield S, Curtis JR, Mikuls TR, Moreland LW, Michaud K. PMID:27015606.16: Kisiel JB, Konijeti GG, Piscitello AJ, Chandra T, Goss TF, Ahlquist DA, Farraye FA, Ananthakrishnan AN. PMID: 27464589.17: Lester-Coll NH, Dosoretz AP, Magnuson WJ, Laurans MS, Chiang VL, Yu JB. PMID: 27903191.18: Li N, Yang X, Fan L, Totev T, Guerin A, Chen L, Bhattacharyya S, Joseph G. PMID: 27841717.19: Luca NJ, Burnett HF, Ungar WJ, Moretti ME, Beukelman T, Feldman BM, Schwartz G, Bayoumi AM. PMID:27059807.21: Maru S, Byrnes JM, Carrington MJ, Stewart S, Scuffham PA. Costs, quality of life and cost-effectiveness of arthroscopic and open repair for rotator cuff tears: an economic evaluation alongside the UKUFF trial. The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program. A Systematic Literature Review on the Cost-Effectiveness of Apixaban for Stroke Prevention in Non-valvular Atrial Fibrillation. Vedolizumab for Treating Moderately to Severely Active Crohn's Disease After Prior Therapy: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Cost-Effectiveness of Endovascular Femoropopliteal Intervention Using Drug-Coated Balloons Versus Standard Percutaneous Transluminal Angioplasty: Results From the IN. Cost-effectiveness analysis of antiviral therapy in patients with advanced hepatitis B virus-related hepatocellular carcinoma treated with sorafenib. See below for a full list of all cost-utility studies and selected reviews and editorials published November 21-25, 2016. Pub Med PMID: 27887672.16: Shao H, Zhai S, Zou D, Mir MU, Zawadzki NK, Shi Q, Liu S, Shi L. PMID: 27817216.17: Sutherland CS, Stone CM, Steinmann P, Tanner M, Tediosi F. PMID: 27884709.18: Tong T, Thokala P, Mc Millan B, Ghosh R, Brazier J. PMID: 27874210.20: Winters D, Casten R, Rovner B, Murchison A, Leiby BE, Haller JA, Hark L, Weiss DM, Pizzi LT. PMID: 27884979.21: Yue WW, Li XL, Xu HX, Lu F, Sun LP, Guo LH, He YP, Wang D, Yin ZQ. PMID: 27883069.• Therapy presents reasonable value in reducing cardiovascular outcomes: in patients with heart failure (NYHA class II to IV), sacubitril-valsartan therapy reduced cardiovascular mortality and morbidity for reasonable value (11)See below for a full list of all cost-utility studies and selected reviews and editorials published November 14-18, 2016. PMID: 27865561.4: Goranitis I, Coast J, Day E, Copello A, Freemantle N, Frew E. Nilotinib versus dasatinib as second-line therapy in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase who are resistant or intolerant to imatinib: a cost-effectiveness analysis based on real-world data. Long-term cost-effectiveness of home versus clinic-based management of chronic heart failure: The WHICH? Stay up-to-date on all the news from the CEA Registry by following us on Twitter @Tufts CEVR or Like Us on Facebook.The data is accessible to the public on the GHCEA Registry website. Pub Med PMID: 27838068.5: Zanocco KA, Wu JX, Yeh MW. Cost-effectiveness analysis of the temporary percutaneous ileostomy for faecal diversion after colorectal resection in elderly. A clinician's guide to the cost and health benefits of hepatitis C cure assessed from the individual patient perspective. Cost-effectiveness of professional pharmacy services in community pharmacy: a systematic review. Cost effectiveness of letrozole and purified urinary FSH in treating women with clomiphene citrate-resistant polycystic ovarian syndrome: a randomized controlled trial. Cost-effectiveness Analysis of Fluorouracil, Leucovorin, and Irinotecan versus Epirubicin, Cisplatin, and Capecitabine in Patients with Advanced Gastric Adenocarcinoma. The cost-effectiveness of disease-modifying therapies for the treatment of relapsing-remitting multiple sclerosis. Cost effectiveness of case-finding strategies for primary prevention of cardiovascular disease: a modelling study. CEAs not selected for full review will still be included in the CEA Registry, but with limited, descriptive information. This change follows the rapidly growing publication rate of CEAs, with over 600 cost-utility analyses (CUAs) published in 2014 alone.Our study systematically reviews the cost-per-DALY studies from 2000-2015, summarizing: a) descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, b) methodological and reporting practices over time, c) types of costs included in analyses, d) the correlation between diseases researched and the burden of disease in different world regions The number of published cost-per-DALY studies increased markedly after 2007. • Postpartum depression screening and treatment is cost-effective: After new recommendations issued from the U. Preventive Services Task Force promoting screening for postpartum depression, a new study finds screening for and treating postpartum depression to be cost-effective and recommends this practice be considered as part of usual postnatal care (8)• Nutrition intervention effective at reducing childhood obesity: One study has determined a school-based nutrition education intervention to be extremely cost-effective in reducing childhood obesity among elementary school students (1)• Patient-Centered Care is good value: Incorporating patient preferences within practice-based guidelines has been found to have good value and is recommended as a priority for developing new guidelines (16)See below for a full list all cost-utility studies and selected reviews and editorials published November 7-11, 2016. Pub Med PMID: 27839930.4: Zhao D, Gai Tobe R, Cui M, He J, Wu B. Parathyroidectomy for asymptomatic primary hyperparathyroidism: A revised cost-effectiveness analysis incorporating fracture risk reduction. The new process allows the CEA Registry to provide valuable ratio and preference weight information for a select group of important studies to our users while continuing to provide a comprehensive list of cost-effectiveness studies published annually across different disease areas and interventions.Chambers, the study’s lead author, participated on a podcast to discuss this...published in the American Journal of Managed Care we report on our research that sought to map the private health care payer coverage and reimbursement landscape.One reason for this variation could be that payers use different evidence and/or different criteria to make decisions.

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