Cost-Effectiveness of Endovascular Aneurysm Repair Versus Open Surgical Repair for Ruptured Abdominal Aortic Aneurysms: A Systematic Review

Context: If the diameter of an aneurysm increases by more than 6 cm, the risk of aortic rupture increases by 50 within 10 years. Therefore, rupture of aneurysm, which is usually asymptomatic, can lead to severe complications and increase the risk of mortality. The current study aimed to systematically review studies comparing the cost-effective endovascular aneurysm repair (EVAR) and open surgical repair (OSR) as the primary treatment options for patients with ruptured abdominal aortic aneurysms (AAAs). Methods: An electronic search was conducted in PubMed, EMBASE, Science Direct, Scopus, and other scientific economic databases. Relevant articles were searched from 1999 to 2020 using keywords, such as "abdominal aortic aneurysm", "endovascular", "open surgery", "rupture", "economic evaluation", and "cost-effectiveness". The quality of articles was assessed using the Quality of Health Economic studies (QHES) checklist; finally, five articles were included in this review. Results: The results of the QHES checklist showed that most studies had a good quality. A third-party payer's perspective was the dominant perspective in all selected studies, comparing EVAR with OSR. All studies considered the direct medical costs and did not disclose any discount rates, except for one study, reporting a 3.5 discount rate. Almost all included studies found EVAR to be a costeffective intervention; only one study concluded that EVAR, with a cost-effectiveness ratio of 424,542, was not the best treatment option. Conclusion: In patients with ruptured AAAs, the EVAR intervention improved the quality of life, decreased the mortality rate, and shortened the hospital stay as compared to OSR

Economic evaluation of ivabradine in treatment of patients with heart failure: a systematic review

BACKGROUND: Chronic heart failure (CHF) is a clinical status and a progressive health disorder extremely related to increased morbidity and mortality worldwide. Accordingly, this study aimed to assess systematic review of literature on cost-effectiveness done in patients with heart failure receiving Ivabradine plus standard treatment compared with standard treatment alone. AREAS COVERED: This study is a systematic review in which all published articles related to the study topic were assessed in time range of 2014-2020. In order to find articles, internet search in foreign databases of PubMed, Embase, ISI/Web of Science (WoS), SCOPUS, Global Health databases, through keywords related to the objective was performed. Six articles out of 1524 article related to final topic were assessed. In addition, quality of studies was evaluated using CHEERS checklist. In six countries investigated (Iran, Thailand, Australia, United States of America, United Kingdom, and Greece), willingness-to-pay (WTP) thresholds higher cost per QALY, and highest ICER for Ivabradine was in USA (55,600 /QALY) and the lowest was in Thailand (10,616/QALY). Most items of CHEERS were estimated in the studies and studies had good quality. EXPERT OPINION: Regarding our investigation, ivabradine combined with standard care was more cost-effective than standard care alone in most of the evaluated studies, although the cost of this intervention was higher than its effectiveness. However, the threshold chosen by each country can have a significant impact on these results. And to have a more accurate result, it is required to pay more attention to the income level in different countries

Economic evaluation of ivabradine in treatment of patients with heart failure: a systematic review

Background: Chronic heart failure (CHF) is a clinical status and a progressive health disorder extremely related to increased morbidity and mortality worldwide. Accordingly, this study aimed to assess systematic review of literature on cost-effectiveness done in patients with heart failure receiving Ivabradine plus standard treatment compared with standard treatment alone. Areas covered: This study is a systematic review in which all published articles related to the study topic were assessed in time range of 2014�2020. In order to find articles, internet search in foreign databases of PubMed, Embase, ISI/Web of Science (WoS), SCOPUS, Global Health databases, through keywords related to the objective was performed. Six articles out of 1524 article related to final topic were assessed. In addition, quality of studies was evaluated using CHEERS checklist. In six countries investigated (Iran, Thailand, Australia, United States of America, United Kingdom, and Greece), willingness-to-pay (WTP) thresholds higher cost per QALY, and highest ICER for Ivabradine was in USA (55,600 /QALY) and the lowest was in Thailand (10,616/QALY). Most items of CHEERS were estimated in the studies and studies had good quality. Expert opinion: Regarding our investigation, ivabradine combined with standard care was more cost-effective than standard care alone in most of the evaluated studies, although the cost of this intervention was higher than its effectiveness. However, the threshold chosen by each country can have a significant impact on these results. And to have a more accurate result, it is required to pay more attention to the income level in different countries. © 2021 Informa UK Limited, trading as Taylor & Francis Group

Blood Coagulation Disorders Among the Iranian Population: a Systematic Review

Background: Blood coagulation disorders are one of the causes of mortality. Therefore, the study of coagulation disorders is also important. This systematic review was conducted to investigate blood coagulation disorders in the Iranian population. Methods: Searches in electronic databases such as Web of Science, PubMed, Scopus, SID, ProQuest, and Magiran from May 10, 1990 to May 10, 2019 were performed according to PRISMA guidelines. Cross-sectional, cohort, experimental, and case-control studies were included according to the inclusion criteria without gender and language restrictions. Results: After screening and selection, 14 studies were selected for data extraction. Accordingly, the most common blood coagulation disorder in the south of Iran was a defect in FXIII (599 of 1,165). C.559T>C (27 of 189) and c.562T>C (20 of 189) mutations had the highest frequency. The most common FXIII polymorphism among the Iranian Azerbaijanis was Val34Leu (203 of 410). The second most common coagulation disorder was FV Leiden (396 of 1,165). Then, c.1691G>A (151 of 396) was the most common mutation. Conclusions: This study shows that the most critical coagulation disorder among the Iranian population is FXIII deficiency and the most common mutation is c.562T>C. © 2023 Verlag Klinisches Labor GmbH. All rights reserved

The economic burden of cancer in iran during 1995-2019: A systematic review

Background: Cancer is the third cause of death following cardiovascular disease and accidents, in Iran. The purpose of this study was to systematically review the economic burden of cancer studies in Iran. Methods: This systematic review examined the types of direct medical and non-medical costs and indirect costs in cancer patients and includes studies in English and Persian that were reviewed in Scopus, Web of science, SID, Iranmedex, Magiran and databases of Medline, etc., from 1995-2019. Results: Twenty-one articles were included. Most studies have examined the direct costs of all types of cancers. The articles reviewed different types of cancer, such as prostate cancer (n=2), colorectal cancer (n=2), breast cancer (n=4), gastric cancer (n=2), oral and pharyngeal cancer (n=1), lung cancer (n=3), and blood cancer (n=4). The great number of studies were related to the gastrointestinal, breast and blood cancers. The gastrointestinal (gastric and colorectal) and breast cancer had the major economic burden than others. Conclusion: It is necessary that special attention to patients, supportive measures to reduce the share of costs, and more budget allocation for prevention, screening and early detection being at priorities in the health system planning. © 2021, Iranian Journal of Public Health. All rights reserved

Economic evaluation of laboratory diagnostic test types in Covid-19 epidemic: A systematic review

BACKGROUND: Corona 2 virus (SARS-CoV-2) is known as the causative agent of COVID-19 disease; the World Health Organization (WHO) declared it an epidemic on March 11, 2020. The Joint Guidelines of the Centers for Disease Control and Prevention (CDC) and the WHO including social distancing, the use of face masks, emphasis on hand washing, quarantine, and using diagnosis tests have been used widely, but the value of diagnostic interventions to prevent the transmission of SARS-CoV-2 is unclear. We compared the economic evaluation of different laboratory diagnostic interventions with each other and also with implementing the conservative CDC & WHO guidelines. MATERIAL AND METHODS: Electronic searches were conducted on PubMed, Embase, Science Direct, Scopus, Cochrane Library, Web of Knowledge, NHSEED, NHS Health Technology assessment (CRD), and Cost-Effectiveness Analysis Registry databases. Related articles were reviewed from January 2020 to the end of November 2021. RESULTS: Out of 1791 initial studies, 13 articles had the inclusion criteria. According to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, ten studies were of excellent quality, and the remaining two studies were of very good quality. Most studies were cost-effectiveness analysis studies. The entered studies had different time horizons. Diagnostic tests reviewed in the studies included real-time polymerase chain reaction (RT-PCR) test, immunoglobulin G (IgG) & Antigen, point of care tests. Although polymerase chain reaction (PCR) testing improves the quality of life and survival for patients with infected Covid-19 based on its greater effectiveness compared to standard protection protocols, due to the high cost of this intervention, it has been considered a cost-effective method in some countries. CONCLUSION: Since most studies have been conducted in developed countries, it unquestionably does not make sense to extend these results to low-income and developing countries. Therefore further studies are required in low-income and developing countries to evaluate the cost-effectiveness of laboratory-based diagnostic methods (RT-PCR) of covid-19 in variable prevalence of infectious cases