Incremental Costs, Revenues and Outcomes with PCSK9 (Per Patient. Health System’s and Payer’s Perspective) ^1/.

<p>Incremental Costs, Revenues and Outcomes with PCSK9 (Per Patient. Health System’s and Payer’s Perspective) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0169761#t002fn001" target="_blank">^1/</a>.</p

Decision-analytic model describing treatment and CVD events.

<p>Treatment could be PCSK9 inhibitor or standard-therapy. MI: Myocardial Infarction. Other: Other CVD event including unstable angina, transient ischemic attack, congestive heart failure, etc.</p

Model Parameters.

<p>Model Parameters.</p

Acceptability curve from health system perspective.

<p>Acceptability curve from health system perspective.</p

CEA and ROI analysis at Different Prices of PCSK9 (Health System’s and Payer’s Perspective) ^1/.

<p>CEA and ROI analysis at Different Prices of PCSK9 (Health System’s and Payer’s Perspective) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0169761#t003fn001" target="_blank">^1/</a>.</p

Acceptability from private and health system perspective.

<p>Acceptability from private and health system perspective.</p

Effects of trail and greenspace exposure on hospitalisations in a highly populated urban area: retrospective cohort study of the Houston Bayou Greenways program

Exposure to urban greenspaces has been linked to improved health outcomes for prevalent conditions. Studies have observed traditional block greenspaces, whereas linear trail systems could maximise health impacts by reaching greater population percentages. We assessed the temporal effects of linear greenspace exposure on health by examining the impact of the Bayou Greenways (BGs) linear trail implementation on health conditions and hospitalisations. We retrospectively analysed inpatient hospitalisation records for Harris County, Texas, from 2015–2019. Thirteen health conditions were explored with hospital admission rates per zip code as the primary outcome. Primary exposure variables were attributes of the BGs interconnected trail system: access duration, ten-minute walk proximity, and access point density. Models were evaluated to assess associations between admission rates in zip codes with and without BGs. Unadjusted analyses for zip codes with high access to trails had reduced odds of admission for obesity (OR, 95%CI: 0.18, 0.10–0.30), ischaemic heart disease (IHD; OR, 95%CI: 0.56, 0.34–0.93), and acute myocardial infarction (AMI; OR, 95%CI: 0.59, 0.37–0.94). Zip codes with >30% of the population within a ten-minute walk showed significant reduction in odds of hospital admission for obesity, (OR, 95%CI: 0.07, 0.03-0.17), IHD (OR, 95%CI: 0.23, 0.12–0.44), and AMI (OR, 95%CI: 0.29, 0.14–0.62). Analysis of socio-economic status (SES) demonstrated that low income and less densely populated areas showed increased admissions for obesity, IHD, AMI, and all-cause hospitalisations. Access to trails may be important in lower SES areas. These findings can inform public policy to integrate greenspace to support healthier communities.</p

Cost-Effectiveness Acceptability Curves.

<p>Panel (a): 10-Year CVD Events, Treat CAC ≥ 1. Panel (b): 10-Year CVD Events, Treat CAC ≥ 100. Note: The cost-effectiveness acceptability curves show the proportion of simulations (vertical axis) that are cost-effective at a given willingness-to-pay threshold (horizontal axis). A mean CAC scanning cost of $100 and a mean statin cost of$180 is assumed in both plots (indirect costs and costs associated with incidentalomas are not included). The vertical intercept of each cost-effectiveness acceptability curve includes simulations that are cost saving and which result in a loss of fewer QALYs compared to the alternative scenarios. The intercept can be interpreted as the probability that a strategy would be accepted at a willingness-to-pay threshold of $0/QALY. For example, approximately 75$0/QALY threshold.</p

Averted CHD and CVD Events Per 1,000 Persons, Base-Case MESA Event Rates.

<p>Note: Simulated events per 1,000 persons, by risk assessment and treatment strategy. The results displayed in this table value outcomes in terms of averted events, but <i>not</i> QALYs. Results reflect all base-case model assumptions and 1x MESA event rates.</p><p>* Column displays results for the scenario where patients with CAC≥1 are advised to initiate statins (intensive therapy for CAC≥100, and standard therapy for 1≤CAC<100).</p><p>Averted CHD and CVD Events Per 1,000 Persons, Base-Case MESA Event Rates.</p

Sensitivity Analysis on Event Rate Parameters—2x MESA Event Rates.

<p>Note: A risk assessment and treatment strategy is said to dominate if it is less costly and more effective than both of the alternative strategies to which it is compared. Otherwise, the favored strategy may be incrementally more costly and more effective than ATP III, which was the standard of risk assessment when this study was conducted. If the incremental cost per unit of effect is less than or equal to $50,000, the alternative intervention is assumed to be favored, and an incremental cost-effectiveness ratio (ICER) is reported. If the ICER exceeds$50,000, but is positive, then ATP III is preferred. Mean costs and effects for each scenario, which are the basis for the decisions summarized in the table, are presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0116377#pone.0116377.s004" target="_blank">S3 Table</a>. Scenarios are identified by the scenario number on each row of the table.</p><p>Sensitivity Analysis on Event Rate Parameters—2x MESA Event Rates.</p