Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye.

OBJECTIVES: The most cost-effective option for replacing lost teeth is not evident because there is a dearth of evidence-based information on implant-supported single crowns versus tooth-supported fixed dental prostheses. This study conducted the analysis of cost-effectiveness of implant-supported single crown and tooth-supported fixed dental prostheses from a social perspective in Türkiye. METHODS: Costs were calculated in the analysis from a social perspective for 2021. Costs and quality-adjusted prosthesis year (QAPY) values were computed over a 20-year period in the study using the Markov model. The computed values were discounted by 5%. The results are presented as the incremental cost-effectiveness ratio. To assess the impact of uncertainty on cost-effectiveness analyses, a tornado diagram and Monte Carlo simulations were created. RESULTS: Throughout the 20-year time horizon, tooth-supported fixed dental prostheses cost $985.58 cumulatively, whereas implant-supported single crown cost $2161.64 (US $1 = 9.22 ₺ as of 15 October 2021). The calculated incremental cost-effectiveness ratio is 1.333 per QAPY. Compared with the implant-supported single crown tooth-supported fixed dental prostheses, it offers a QAPY of 0.882 over a 20-year period, while costing an additional $1176.06. CONCLUSIONS: These results suggest that the implant-supported single crown provided higher QAPY value but was costlier. When the research's findings are compared with the literature, it becomes clear that Türkiye has lower dental care expenses than most other nations.

Is Aducanumab treatment developed to prevent progression of Alzheimer's disease cost-effective in Turkey?

BACKGROUND: Alzheimer's Disease (AD), the most common type of dementia, is a chronic, progressive, and neurodegenerative brain discomfort that causes the be damage to brain cells. Although there is no definitive treatment for AD, various drug treatments are used to reduce and control the symptoms of the disease. Developed for the treatment of mild-stage Alzheimer's patients, Aducanumab is the only drug approved by the Food and Drug Administration (FDA) in the past two decades. However, the cost is very high and, in many countries, Aducanumab has not been approved due to insufficient clinical efficacy and lack of evidence yet. This study aims to analyze the cost-effectiveness of Aducanumab, which was developed for the treatment of mild-stage AD, from the patient's perspective. METHODS: In the study, the Markov model was developed to determine the cost-effectiveness of Aducanumab compared to Standard of Care (SoC) therapy over a 5-year horizon. Cost and effectiveness data were taken from the literature. In the study, the discount rate was determined as 6%. The results were presented as the incremental cost-effectiveness ratio (ICER), which represents the cost per quality-adjusted life years (QALY). The results were retested with a one-way and probabilistic sensitivity analysis (PSA) due to possible uncertainties in the research parameters. The results were presented with the tornado diagram and the scatter plots. RESULTS: With the Markov model, the total costs of Aducanumab and SoC treatments over a 5-year horizon were found to be 98.068 $ and 21.292 $, respectively. Aducanumab treatment had an incremental gain of 0.64 QALY and an incremental cost of 76.776 $ compared to the SoC treatment. The ICER value, which shows the additional cost per QALY of Aducanumab, was 119.408 $/QALY. As a result of the study, it was determined that Aducanumab was not cost-effective when compared to SoC treatment. Sensitivity analysis results showed stability against uncertainties. Aducanumab was confirmed not to be cost-effective with its current price and potential clinical benefit. CONCLUSION: The result of the research is considered important in terms of providing evidence-based information on the cost-effectiveness of Aducanumab in Turkey. However, further, research is needed to evaluate Aducanumab's clinical efficacy and cost-effectiveness.

Outsourcing and its implications for hospital organizations in Turkey.

To thrive in this era of global competition, all organizations must explore new managerial approaches to get an edge in the marketplace. One increasingly appealing approach is outsourcing. Hospitals are particularly fertile environments for outsourcing, given their role as providers of a broad and complex array of services, many of which may be bought from other institutions. The purpose of this study is to determine the types of services that hospitals in Turkey buy from other organizations. The study sample included 14 university hospitals, 20 Ministry of Health Hospitals, 15 Social Insurance Organization Hospitals and 31 private hospitals in Istanbul, Ankara, Izmir, Antalya, and Eskisehir, which are the biggest cities in Turkey. The following services were found to be outsourced: hospital management information systems (83.8%), cleaning services (81.3%), maintenance services (72.5%), leased medical devices (75.0%), food services (60.0%), patient direction services (63.8%), magnetic imaging services (60.0%), other imaging services (48.8%), laboratory services (42.5%), security services (38.8%), laundry services (36.3%), patient transportation services (33.8%), accounting services (26.3%), ambulance services (22.5%), patient satisfaction measurement services (13.8%), consultancy services (12.5%), and financial and investment services (9.5%). Private hospitals bought more services than public facilities did. The sampled hospitals chose to outsource services in order to decrease costs (78.8%), increase the quality of services rendered (65.5%), increase flexibility and share risk (36.6%), and increase profits (11.2%). The results of this study suggest that outsourcing, when applied judiciously through cost and risk analysis, is a cost-effective approach that can be used by most hospitals.