Willingness to Pay for Down Syndrome Screening: A systematics Review.

Background:Financial ability to pay has a unique role in the accessibility of health care services, which indicates the necessity of raising enough funds by governments. However, how much households are willing to pay (WTP) for receiving a particular service? And what factors influence their WTP? The current systematic review aimed to, firstly, review studies on the WTP for Down syndrome (DS) screening, and, secondly, to identify factors that affect WTP for DS screening. Methods:We systematically searched the Scopus, PubMed, Web of Sciences (ISI), and Embase databases to identify relevant studies from their inception to June 2020; the search strategy was updated on December 2021. Initially, 157 articles were identified, and 5 were found eligible for full-text review. In event of any disagreement, a third reviewer was used. Extracted WTPs were converted to US dollars in 2018 using exchange rate parity and the present value formula to make a comparison. The quality assessment of the selected studies was done using the "Lancsar and Louvier" and Smith checklist; also, vote counting was used to assess the influence of factors. Results:Five eligible studies, published from 2005 to 2020, were fully reviewed. All final studies were scored as good quality. The extracted WTPs varied from $169 to $1118 in UK and Canada, respectively. Income and information/knowledge about screening tests were the most frequently investigated factors. Education level, detection rate, women's age, cost, and family history were significantly associated with higher levels of WTP for DS screening. Conclusion:This study demonstrated a significant gap in WTP for DS screening in various countries. Women are WTP higher costs for tests with higher screenings. Also, a unique role was identified for income, occupation, information, and family history of DS in WTP for DS screening. In addition, a positive association was found for the variable of age.

Economic Evaluation of Palliative Care for Patients with Cancer Disease: A Systematic Review.

Background: With the increase in the population of cancer patients and the importance of reducing the economic burden of disease, it is very important to offer solutions that can provide the services needed by this group of patients in the most appropriate way. In recent years, palliative care services have been provided in a wide range of countries for this purpose, and many studies have been conducted to assess its economic and clinical aspects. The current study aimed to systematically review economic evaluation studies that investigate the costs of end-of-life care for cancer patients. Methods: Electronic search was performed in multiple databases and different resources between 2000-2021 based on inclusion and exclusion criteria. Inclusion criteria were Studies consisting of a complete EE, including CEA, CUA, and CBA regarding the EE of palliative care for patients with cancer disease, EE studies carried out by decision analysis models following the EE approach, full-text articles in the English language, and published during 2000 and 2021 and According to our search strategy, the following articles were removed: studies conducted as a partial EE (like those intended to evaluate the effectiveness, cost evaluation, QoL evaluation), articles with poor methodological quality based on the CHEERS checklist, non-English studies, study protocols, articles presented to a conference, and letters to the editor. The quality of the articles was evaluated using a CHEERS checklist. Results: 29 studies were included based on inclusion criteria. Most articles were published during the past decade. All studies were performed in high-income countries (UK= 6 studies, Canada= 5 studies). Most studies (n=7) focused on the health sector. Results of quality evaluation showed that 10 articles had excellent quality (score higher than 85%). Most studies (27 out of 29 studies) concluded that palliative medicine interventions were cost-effective and yielded positive cost-effectiveness results. 20 studies confidently concluded about the costs and benefits of providing palliative care services on cost-effectiveness and cost savings, and 2 studies made such a conclusion with uncertainty. Therefore, palliative care for cancer patients is cost-effective or cost-saving in 85% of studies. Conclusion: Although there are a wide variety of studies, characteristics, and quality of the final studies included in the present study, there are relatively favorable and stable patterns regarding the results. Palliative care is usually less expensive than comparator groups, and the cost difference is statistically significant in most cases, and this treatment is a relatively cost-effective option. However, making the right relevant decision and applying it as a dominant therapy approach in different countries requires further study in larger populations and over a longer period.

Economic evaluation of the utilization of telemedicine for patients with cardiovascular disease: a systematic review.

Cardiovascular disease is one of the major causes of mortality in the world, with high human and financial burdens on communities. Telemedicine is a tool for providing services for patients that are difficult to access or in need of immediate care. The aim of this study was to systematically review economic evaluation studies that compared telemedicine with usual care for cardiovascular patients. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and related articles published up to December 2018 were searched in different databases (PubMed, Embase, SCOPUS, Global Health, Google Scholar, Magiran, SID). The articles were selected based on inclusion and exclusion criteria. Consolidated health economic evaluation reporting standards statement checklist was used to qualitatively evaluate the papers. Overall, 20 articles were included in the study. The studies used quality-adjusted life years to measure outcomes. The highest and lowest values of Incremental Cost-effectiveness Ratio were $515,082 and $2099 that had been reported in the UK and New Zealand, respectively. Most of the items of the checklist were reported and the quality of most of the studies was excellent and very good. According to the results, telemedicine improves the clinical outcomes and results in considerable saving in costs. Utilizing telemedicine concurrent with the usual care for service delivery is more cost-effective. The reviewed studies had been conducted in high-income countries, hence, it is essential to be cautious when generalizing the results and applying them in health systems policymaking.

Economic burden of osteoporosis in the world: A systematic review.

Background: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures and deterioration of bone tissue. It is also associated with an increased risk of fracture that is the most important complication of osteoporosis. The knowledge about costs and economic aspects of osteoporosis plays an important role in making policies and planning measures for the prevention and management of this disease; hence, this study systematically investigated the available evidence on the costs associated with osteoporosis worldwide. Methods: In this systematic review, electronic searches were performed on various online databases, including PubMed, Embase, Scopus, web of science, ProQuest, and Cochrane. The timeframe selected for searching articles was from 1980 to 2018. Results: Of a total of 1989 papers, 28 papers were included in the study on the basis of inclusion criteria. Based on the data extracted from the mentioned studies, the mean age of people with osteoporotic fractures was 50 years, with the highest costs associated with hip fractures. Conclusion: Our review indicated that the cost of osteoporosis carries a significant economic burden on countries in the world. The main cost drivers in this study were Fracture-related costs. The direct annual cost of treating osteoporotic fractures of people on average is reported to be between 5000 and 6500 billion USD in Canada, Europe and the USA alone, not taking into account indirect costs such as disability and loss of productivity. Prevention of this disease can significantly reduce the costs incurred by the health system.