Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal.
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615 |
Resumo: | Oral anticoagulant therapy with vitamin K blockers has been increasing in the last few years and its effectiveness is directly related to maintaining INR values within the target range. The objective of this study is to evaluate the cost-effectiveness of INR auto-monitoring versus monitoring in a laboratory or a health care centre, in Portugal.The study was conducted from a social perspective and considered only the direct costs. A Markov model was developed that considered the evolution of a hypothetical patient cohort, in annual cycles, with a time horizon of 5 years. For each patient, prothrombin time monitoring was predicted in three different ways: auto-monitoring, laboratory monitoring, and monitoring in a health care centre. The parameters analyzed were life-years gained and QALYs.The auto-monitoring option had a cost-effectiveness per QALY of 542euro/QALY (4.71 QALYs and 4.74 life-years). Health centre monitoring showed a costeffectiveness of 526euro/QALY (4.66 QALYs and 4.70 life-years) and the laboratory option had a cost-effectiveness of 704euro/QALY (4.64 QALYs and 4.68 life-years).Results showed that auto-monitoring is the option that presents more benefits. Results for both auto-monitoring and monitoring in a health care centre are better than monitoring in a laboratory. |
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Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal.Estudo de avaliação do custo incremental da auto-monitorização de INR versus controlo laboratorial ou monitorização no centro de saúde, em Portugal.Oral anticoagulant therapy with vitamin K blockers has been increasing in the last few years and its effectiveness is directly related to maintaining INR values within the target range. The objective of this study is to evaluate the cost-effectiveness of INR auto-monitoring versus monitoring in a laboratory or a health care centre, in Portugal.The study was conducted from a social perspective and considered only the direct costs. A Markov model was developed that considered the evolution of a hypothetical patient cohort, in annual cycles, with a time horizon of 5 years. For each patient, prothrombin time monitoring was predicted in three different ways: auto-monitoring, laboratory monitoring, and monitoring in a health care centre. The parameters analyzed were life-years gained and QALYs.The auto-monitoring option had a cost-effectiveness per QALY of 542euro/QALY (4.71 QALYs and 4.74 life-years). Health centre monitoring showed a costeffectiveness of 526euro/QALY (4.66 QALYs and 4.70 life-years) and the laboratory option had a cost-effectiveness of 704euro/QALY (4.64 QALYs and 4.68 life-years).Results showed that auto-monitoring is the option that presents more benefits. Results for both auto-monitoring and monitoring in a health care centre are better than monitoring in a laboratory.Oral anticoagulant therapy with vitamin K blockers has been increasing in the last few years and its effectiveness is directly related to maintaining INR values within the target range. The objective of this study is to evaluate the cost-effectiveness of INR auto-monitoring versus monitoring in a laboratory or a health care centre, in Portugal.The study was conducted from a social perspective and considered only the direct costs. A Markov model was developed that considered the evolution of a hypothetical patient cohort, in annual cycles, with a time horizon of 5 years. For each patient, prothrombin time monitoring was predicted in three different ways: auto-monitoring, laboratory monitoring, and monitoring in a health care centre. The parameters analyzed were life-years gained and QALYs.The auto-monitoring option had a cost-effectiveness per QALY of 542euro/QALY (4.71 QALYs and 4.74 life-years). Health centre monitoring showed a costeffectiveness of 526euro/QALY (4.66 QALYs and 4.70 life-years) and the laboratory option had a cost-effectiveness of 704euro/QALY (4.64 QALYs and 4.68 life-years).Results showed that auto-monitoring is the option that presents more benefits. Results for both auto-monitoring and monitoring in a health care centre are better than monitoring in a laboratory.Ordem dos Médicos2010-04-14info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615oai:ojs.www.actamedicaportuguesa.com:article/615Acta Médica Portuguesa; Vol. 23 No. 2 (2010): March-April; 203-12Acta Médica Portuguesa; Vol. 23 N.º 2 (2010): Março-Abril; 203-121646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615/299Macedo, AnaCarrasco, JoãoAndrade, SofiaMoital, Inêsinfo:eu-repo/semantics/openAccess2022-12-20T10:56:36Zoai:ojs.www.actamedicaportuguesa.com:article/615Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:37.681047Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. Estudo de avaliação do custo incremental da auto-monitorização de INR versus controlo laboratorial ou monitorização no centro de saúde, em Portugal. |
title |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. |
spellingShingle |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. Macedo, Ana |
title_short |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. |
title_full |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. |
title_fullStr |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. |
title_full_unstemmed |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. |
title_sort |
Incremental cost evaluation study of INR self-monitoring versus laboratorial control or monitoring in health care centres, in Portugal. |
author |
Macedo, Ana |
author_facet |
Macedo, Ana Carrasco, João Andrade, Sofia Moital, Inês |
author_role |
author |
author2 |
Carrasco, João Andrade, Sofia Moital, Inês |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Macedo, Ana Carrasco, João Andrade, Sofia Moital, Inês |
description |
Oral anticoagulant therapy with vitamin K blockers has been increasing in the last few years and its effectiveness is directly related to maintaining INR values within the target range. The objective of this study is to evaluate the cost-effectiveness of INR auto-monitoring versus monitoring in a laboratory or a health care centre, in Portugal.The study was conducted from a social perspective and considered only the direct costs. A Markov model was developed that considered the evolution of a hypothetical patient cohort, in annual cycles, with a time horizon of 5 years. For each patient, prothrombin time monitoring was predicted in three different ways: auto-monitoring, laboratory monitoring, and monitoring in a health care centre. The parameters analyzed were life-years gained and QALYs.The auto-monitoring option had a cost-effectiveness per QALY of 542euro/QALY (4.71 QALYs and 4.74 life-years). Health centre monitoring showed a costeffectiveness of 526euro/QALY (4.66 QALYs and 4.70 life-years) and the laboratory option had a cost-effectiveness of 704euro/QALY (4.64 QALYs and 4.68 life-years).Results showed that auto-monitoring is the option that presents more benefits. Results for both auto-monitoring and monitoring in a health care centre are better than monitoring in a laboratory. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-04-14 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615 oai:ojs.www.actamedicaportuguesa.com:article/615 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/615 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/615/299 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 23 No. 2 (2010): March-April; 203-12 Acta Médica Portuguesa; Vol. 23 N.º 2 (2010): Março-Abril; 203-12 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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