Cost Effectiveness of Elidel in the Management of Patients with Atopic Dermatitis in Canada
Bibliographic record
Abstract
With increasing pressure on health care resources, it is necessary to demonstrate that new treatments are both effective and cost effective. The purpose of this study was to assess the cost effectiveness of pimecrolimus (Elidel) compared to usual therapy in the treatment of both adults and children with atopic eczema in Canada. Analysis was performed using a decision model which estimated the incremental cost per quality adjusted life year (QALY) gained from both a societal and health care perspective. For children, Elidel leads an incremental cost per QALY of $38,000 from a societal perspective. For adults, the incremental cost per QALY was $35,000. Elidel will lead to an overall increase in costs but with an improvement in clinical outcomes. The cost effectiveness ratios for Elidel were consistently below $50,000 per QALY gained. Given previous funding decisions in Canada, Elidel may be considered a cost-effective use of health care resources. Avec la demande accrue pour les ressources en soins de santé, il devient essentiel de prouver aussi bien l'efficacité que la rentabilité de tout nouveau traitement. Évaluer la rentabilité de pimecrolimus (Elidel) par rapport au traitement traditionnel de l'eczéma atopique chez les adultes et les enfants au Canada. Des analyses ont été faites au moyen d'un modèle décisionnel qui estime le coût par année-personne sans invalidité des points de vue sociétal et de santé. Dans le cas des enfants, le coût par année-personne sans invalidité du point de vue sociétal est de 38 000 $. Pour les adultes, le coût est de 35 000 $. Elidel mènera à une augmentation générale des coûts mais sera accompagné d'une amélioration des résultats cliniques. Les taux de rentabilité de l'Elidel étaient toujours inférieurs à 50 000 $ pour chaque année-personne additionnelle. En effectuant une comparaison avec les décisions de financement antérieures au Canada, le recours à l'Elidel pourrait être considéré comme usage rentable des ressources en soins de santé.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".