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OP95 A Systematic Review Of The Cost And Cost Effectiveness Of Immunoglobulin Treatment In Patients With Hematological Malignancies
- Sara Carrillo De Albornoz, Khai Li Chai, Alisa M. Higgins, Dennis Petrie, Erica M. Wood, Zoe K. McQuilten
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 39 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 14 December 2023, pp. S26-S27
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Introduction
Patients with hematological malignancies are likely to develop hypogammaglobulinemia (HGG) and subsequent infections. Immunoglobulin (Ig) replacement is commonly given to prevent infections, but the total costs and cost effectiveness of its use are unknown.
MethodsA systematic review was conducted following PRISMA guidelines to assess evidence on the costs and cost effectiveness of Ig replacement, administered intravenously (IVIg) or subcutaneously (SCIg), in adult patients with hematological malignancies. This review was registered with PROSPERO (CRD42022321908).
ResultsSix studies were included out of a total of 3,612 citations. A narrative synthesis was conducted because of the high level of heterogeneity across the included studies. Two economic evaluations were identified: one cost-utility analysis (CUA) of IVIg versus no Ig and one comparing IVIg with SCIg. The quality of the evidence was low, with most studies having small patient numbers and a high risk of bias. Compared with no treatment, Ig replacement reduced the hospitalization rate in patients with hematological malignancies.
One study reported no change in hospitalization rates following a program to reduce IVIg use, and an observational study comparing IVIg with SCIg found more hospitalizations with SCIg but lower total costs per patient. The CUA comparing IVIg with no IVIg suggested that IVIg treatment was not cost effective, but this study was published in 1991 and had significant limitations. The other CUA found that home-based SCIg was more cost effective than IVIg, but model inputs were derived from unpublished data in a very small patient cohort with HGG and different malignancies.
ConclusionsOur review highlights key gaps in the literature. The cost effectiveness of Ig replacement in patients with hematological malignancies is still very uncertain. Despite the increasing use of Ig replacement there are limited data regarding its direct and indirect costs, and its optimal use and implications for healthcare resources remain unclear. Given the paucity of data on the cost and cost effectiveness of Ig treatment in this population, further health economic research is warranted.
The Qualitative Transparency Deliberations: Insights and Implications
- Alan M. Jacobs, Tim Büthe, Ana Arjona, Leonardo R. Arriola, Eva Bellin, Andrew Bennett, Lisa Björkman, Erik Bleich, Zachary Elkins, Tasha Fairfield, Nikhar Gaikwad, Sheena Chestnut Greitens, Mary Hawkesworth, Veronica Herrera, Yoshiko M. Herrera, Kimberley S. Johnson, Ekrem Karakoç, Kendra Koivu, Marcus Kreuzer, Milli Lake, Timothy W. Luke, Lauren M. MacLean, Samantha Majic, Rahsaan Maxwell, Zachariah Mampilly, Robert Mickey, Kimberly J. Morgan, Sarah E. Parkinson, Craig Parsons, Wendy Pearlman, Mark A. Pollack, Elliot Posner, Rachel Beatty Riedl, Edward Schatz, Carsten Q. Schneider, Jillian Schwedler, Anastasia Shesterinina, Erica S. Simmons, Diane Singerman, Hillel David Soifer, Nicholas Rush Smith, Scott Spitzer, Jonas Tallberg, Susan Thomson, Antonio Y. Vázquez-Arroyo, Barbara Vis, Lisa Wedeen, Juliet A. Williams, Elisabeth Jean Wood, Deborah J. Yashar
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- Journal:
- Perspectives on Politics / Volume 19 / Issue 1 / March 2021
- Published online by Cambridge University Press:
- 06 January 2021, pp. 171-208
- Print publication:
- March 2021
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In recent years, a variety of efforts have been made in political science to enable, encourage, or require scholars to be more open and explicit about the bases of their empirical claims and, in turn, make those claims more readily evaluable by others. While qualitative scholars have long taken an interest in making their research open, reflexive, and systematic, the recent push for overarching transparency norms and requirements has provoked serious concern within qualitative research communities and raised fundamental questions about the meaning, value, costs, and intellectual relevance of transparency for qualitative inquiry. In this Perspectives Reflection, we crystallize the central findings of a three-year deliberative process—the Qualitative Transparency Deliberations (QTD)—involving hundreds of political scientists in a broad discussion of these issues. Following an overview of the process and the key insights that emerged, we present summaries of the QTD Working Groups’ final reports. Drawing on a series of public, online conversations that unfolded at www.qualtd.net, the reports unpack transparency’s promise, practicalities, risks, and limitations in relation to different qualitative methodologies, forms of evidence, and research contexts. Taken as a whole, these reports—the full versions of which can be found in the Supplementary Materials—offer practical guidance to scholars designing and implementing qualitative research, and to editors, reviewers, and funders seeking to develop criteria of evaluation that are appropriate—as understood by relevant research communities—to the forms of inquiry being assessed. We dedicate this Reflection to the memory of our coauthor and QTD working group leader Kendra Koivu.1