113 results on '"Rutten, Frans F."'
Search Results
102. Health care costs out of control: the experience of Switzerland
- Author
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Jonsson, Bengt, Abel-Smith, Brian, Blanpain, Jan E., Gilliand, Pierre, Rutten, Frans F. H., Schwefel, Detlef, and Sommer, Jurg H.
- Subjects
- *
MEDICAL care - Published
- 1985
103. Equity in Ghanaian breast cancer treatment outcomes-a modeling study in Komfo Anokye Teaching Hospital.
- Author
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Niëns LM, Nyarko KM, Zelle SG, Jehu-Appiah C, and Rutten FF
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- Developing Countries, Female, Ghana, Hospitals, Teaching, Humans, Income, Insurance Coverage, Treatment Outcome, Breast Neoplasms diagnosis, Breast Neoplasms economics, Breast Neoplasms therapy, Socioeconomic Factors
- Published
- 2014
- Full Text
- View/download PDF
104. Inquiry into the relationship between equity weights and the value of the QALY.
- Author
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Bobinac A, van Exel NJ, Rutten FF, and Brouwer WB
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- Cost-Benefit Analysis, Health Care Rationing economics, Health Care Rationing methods, Humans, Models, Economic, Patient Acceptance of Health Care, Social Values, Quality-Adjusted Life Years
- Abstract
Background: A commonly held view of the decision rule in economic evaluations in health care is that the final incremental cost-effectiveness ratio needs to be judged against some threshold, which is equal for all quality-adjusted life-year (QALY) gains. This reflects the assumption that "a QALY is a QALY" no matter who receives it, or the equity notion that all QALY gains are equally valuable, regardless of the context in which they are realized. If such an assumption does not adequately reflect the distributional concerns in society, however, different thresholds could be used for different QALY gains, whose relative values can be seen as "equity weights.", Aim: Our aim was to explore the relationship between equity or distributional concerns and the social value of QALYs within the health economics literature. In light of the empirical interest in equity-related concerns as well as the nature and height of the incremental cost-effectiveness ratio threshold, this study investigates the "common ground" between the two streams of literature and considers how the empirical literature estimating the incremental cost-effectiveness ratio threshold treats existing distributional considerations., (Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
105. GET MORE, PAY MORE? An elaborate test of construct validity of willingness to pay per QALY estimates obtained through contingent valuation.
- Author
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Bobinac A, van Exel NJ, Rutten FF, and Brouwer WB
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- Adult, Female, Humans, Male, Middle Aged, Models, Econometric, Netherlands, Reproducibility of Results, Financing, Personal, Health Services Needs and Demand economics, Quality-Adjusted Life Years
- Abstract
Estimates of WTP per QALY can be taken as an indication of the monetary value of health gains, which may carry information regarding the appropriate height of the cost-effectiveness threshold. Given the far-reaching consequences choosing a particular threshold, and thus the potential relevance of WTP per QALY estimates, it is important to address the validity of these estimates. This study addresses this issue. Our findings offer little support to the validity of WTP per QALY estimates obtained in this study. Implications for general WTP per QALY estimates and further research are discussed., (Copyright © 2011 Elsevier B.V. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
106. [New drugs: money-back guarantee?].
- Author
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Steenhoek A, Koopmanschap MA, Franken MG, and Rutten FF
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- Humans, Reimbursement, Incentive, Risk Sharing, Financial, Drug Costs, Drug Industry economics, Product Surveillance, Postmarketing
- Abstract
When a new medical technology, for example a new drug, is introduced onto the market there should be a discussion of the balance between "uncertainty versus value to society and demand". The new technology is sometimes given the benefit of the doubt due to a lack of information. Follow-up investigation is actually essential but is seldom mandatory and hardly ever spontaneously initiated. Specific measures, based on stimulation or penalization, could reduce the degree of uncertainty concerning the efficacy, safety and efficiency of a new technology. A serious option when a new drug produces disappointing results is to pay the manufacturer less.
- Published
- 2011
107. Lifestyle intervention: from cost savings to value for money.
- Author
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Rappange DR, Brouwer WB, Rutten FF, and van Baal PH
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- Health Policy, Humans, Public Health, United Kingdom, Cost Savings, Primary Prevention economics, Risk Reduction Behavior
- Abstract
Prevention of unhealthy lifestyles has sometimes been promoted as simultaneously reducing costs and improving public health but this will unlikely prove to be true. Additional medical costs in life years gained due to treatment of unrelated diseases may offset possible savings in related diseases, but are often ignored both in health promotion policies and in economic evaluations of life-prolonging interventions. Many national guidelines explicitly recommend excluding these costs from economic evaluations or leave inclusion up to the discretion of the analyst. This may result in too favorable estimations of cost-effectiveness, feeding the unjustified optimism among policymakers regarding lifestyle interventions as a cost-saving option. However, prevention may still be a cost-effective way to improve public health, even when it does not result in cost savings, but this should be judged taking all future costs into account and be based on the true value for money provided by lifestyle interventions.
- Published
- 2010
- Full Text
- View/download PDF
108. Caring for and caring about: disentangling the caregiver effect and the family effect.
- Author
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Bobinac A, van Exel NJ, Rutten FF, and Brouwer WB
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- Adolescent, Adult, Aged, Aged, 80 and over, Caregivers statistics & numerical data, Female, Home Nursing psychology, Humans, Male, Middle Aged, Models, Economic, Stress, Psychological, Young Adult, Caregivers psychology, Cost of Illness, Family Health
- Abstract
Besides patients' health and well-being, healthcare interventions may affect the well-being of significant others. Such 'spill over effects' in significant others may be distinguished in two distinct effects: (i) the caregiving effect and (ii) the family effect. The first refers to the welfare effects of providing informal care, i.e., the effects of caring for someone who is ill. The second refers to a direct influence of the health of a patient on others' well-being, i.e., the effects of caring about other people. Using a sample of Dutch informal caregivers we found that both effects exist and may be comparable in size. Our results, while explorative, indicate that economic evaluations adopting a societal perspective should include both the family and the caregiving effects measured in the relevant individuals.
- Published
- 2010
- Full Text
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109. Cost-effectiveness of collaborative care for the treatment of major depressive disorder in primary care. A systematic review.
- Author
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van Steenbergen-Weijenburg KM, van der Feltz-Cornelis CM, Horn EK, van Marwijk HW, Beekman AT, Rutten FF, and Hakkaart-van Roijen L
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- Adult, Aged, Cost-Benefit Analysis, Humans, Middle Aged, Primary Health Care organization & administration, Quality-Adjusted Life Years, Cooperative Behavior, Depressive Disorder, Major therapy, Health Care Costs, Primary Health Care economics
- Abstract
Background: The effectiveness of collaborative care for patients with major depressive disorder in primary care has been established. Assessing its cost-effectiveness is important for deciding on implementation. This review therefore evaluates the cost-effectiveness of collaborative care for major depressive disorder in primary care., Methods: A systematic search on economic evaluations of collaborative care was conducted in Pubmed and PsychInfo. Quality of the studies was measured with the Cochrane checklist and the CHEC-list for economic evaluations. Cost-effectiveness and costs per depression-free days were reported., Results: 8 studies were found, involving 4868 patients. The quality of the cost effectiveness studies, according to the CHEC-list, could be improved. Generally, the studies did not include all relevant costs and did not perform sensitivity analysis. Only 4 out of 8 studies reported cost per QALY, 6 out of 8 reported costs per depression-free days. The highest costs per QALY reported were $49,500, the highest costs per depression-free day were $24., Conclusions: Although studies did not fulfil all criteria of the CHEC-list, collaborative care is a promising intervention and it may be cost-effective. However, to conclude on the cost-effectiveness, depression research should follow economic guidelines to improve the quality of the economic evaluations.
- Published
- 2010
- Full Text
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110. Self-reported healthcare decision-makers' attitudes towards economic evaluations of medical technologies.
- Author
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Galani C and Rutten FF
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- Health Care Rationing economics, Health Care Rationing legislation & jurisprudence, Health Care Rationing statistics & numerical data, Health Policy, Health Resources statistics & numerical data, Humans, Medical Laboratory Science legislation & jurisprudence, Self Report, Attitude to Health, Decision Making physiology, Health Care Costs, Health Resources economics, Medical Laboratory Science economics
- Abstract
Background: Increasing costs have generated concern among governments and healthcare providers who have realized the need for cost containment measures and more efficient resource utilization. Health economics is one potential source of information that can make healthcare more efficient., Scope: This review article summarizes the published literature on self-reported attitudes of healthcare decision-makers towards economic evaluations of medical technologies and examines the extent to which economic evaluations are used in health policy decisions., Methods: A systematic literature review of published English language studies was conducted using MEDLINE, EMBASE, and HEED from January 1995 to December 2007., Findings: Fifty-five articles investigated the use of economic evaluations on three levels of decision-making: central, local, and physician level. Results indicate the use of economic evaluation information increased from limited/minor to moderate use. The influence of economic evaluations increased with the level of centralization of healthcare system. Barriers to use health economics research varied across levels and included health economics research-related barriers such as timely availability, lack of credibility, insufficient methodological quality and decision-context-related barriers including limited decision makers' knowledge, inflexibility in healthcare budgets and variability among healthcare organizations., Conclusions: For consistent policy-making it is important that similar recommendations for cost-effective interventions and programs are developed at all levels and that implementation is promoted by incorporating the appropriate incentives in healthcare provision.
- Published
- 2008
- Full Text
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111. Need for differential discounting of costs and health effects in cost effectiveness analyses.
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Brouwer WB, Niessen LW, Postma MJ, and Rutten FF
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- Cost-Benefit Analysis methods, Forecasting, Health Expenditures, Humans, Preventive Health Services trends, Quality-Adjusted Life Years, State Medicine economics, United Kingdom, Preventive Health Services economics
- Published
- 2005
- Full Text
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112. The missing link: on the line between C and E.
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Brouwer WB and Rutten FF
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- Absenteeism, Cost of Illness, Efficiency, Health Services Research methods, Humans, Leisure Activities economics, Workload economics, Workload statistics & numerical data, Attitude to Health, Cost-Benefit Analysis methods, Health Status Indicators, Quality-Adjusted Life Years
- Abstract
In this paper it is argued that the separation of elements associated with the time spent by the patient is not conducted in a consistent way. This is the case for income (for which there at least has been some attention) and for other time elements like lost unpaid work, leisure and role-functioning. The use of general rather than specific preferences in health state assessments makes the separation of time-elements into costs and effects difficult. While costs are calculated specifically for the patient group under study, effects are normally derived from preferences in the general public. The characteristics of these two groups in terms of (the opportunity of) spending time on activities need not coincide. The use of specific time-group valuations of health states may be a good alternative to using general health state valuations., (Copyright 2002 John Wiley & Sons, Ltd.)
- Published
- 2003
- Full Text
- View/download PDF
113. The drug budget silo mentality: the Dutch case.
- Author
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Koopmanschap MA and Rutten FF
- Subjects
- Clinical Pharmacy Information Systems, Cost Control methods, Drug Costs statistics & numerical data, Drug Prescriptions economics, Health Care Rationing, Humans, National Health Programs organization & administration, Netherlands, Treatment Outcome, Budgets, Drug Utilization economics, Economics, Pharmaceutical, Health Care Reform, National Health Programs economics
- Abstract
This article provides a broad outline of developments in the Dutch health-care policy related to the costs, budgeting, and reimbursement of pharmaceuticals. In-hospital drugs costs are part of hospital budgets, whereas for the main part of costs, nonhospital drugs, no strict budget exists. The government sets a goal for the annual cost increase of nonhospital drugs, but has only limited means to enforce that goal. Two measures were implemented to reduce drug prices: a reference price system and a price law. Both measures had a modest and temporary impact on drug prices during the 1990s. In limiting the utilization of drugs, the package of reimbursed drugs has been restricted. This led to a shift from public to private costs and possible substitution of cheaper not reimbursed drugs by more expensive reimbursed drugs. An electronic prescription system was implemented to encourage rational prescription. Although 70% of the Dutch general practitioners reported to use the system, the estimated savings on drug costs appear to be modest and far less than expected. The use of economic evaluation for reimbursement decisions will increase. From 2005 onward a pharmacoeconomic study and budget impact analysis is formally required for new nonclustered drugs seeking a premium price. Furthermore, in the future the health-care insurers will get a more prominent role in limiting the costs of drugs and enhancing the efficient use of drugs within their overall budgets. Health-care insurers may choose which drugs to purchase and reimburse and they can negotiate drug prices with the pharmaceutical industry, wholesalers, and local pharmacists.
- Published
- 2003
- Full Text
- View/download PDF
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