2022
Societal Cost of Opioid Use in Symptomatic Knee Osteoarthritis Patients in the United States
Huizinga JL, Stanley EE, Sullivan JK, Song S, Hunter DJ, Paltiel AD, Neogi T, Edwards RR, Katz JN, Losina E. Societal Cost of Opioid Use in Symptomatic Knee Osteoarthritis Patients in the United States. Arthritis Care & Research 2022, 74: 1349-1358. PMID: 33629485, PMCID: PMC8382774, DOI: 10.1002/acr.24581.Peer-Reviewed Original ResearchConceptsSymptomatic knee osteoarthritisOpioid use disorderOpioid useMcMaster Universities Osteoarthritis Index (WOMAC) pain scoreSymptomatic knee osteoarthritis patientsLong-term pain managementProlonged opioid usePublic health causeStrong opioid useSocietal costsKnee osteoarthritis patientsSocietal economic burdenDirect medical costsMedicare Current Beneficiary SurveyOsteoarthritis Policy ModelCriminal justice costsOUD prevalencePain scoresSD ageOpioid regimensPain managementKnee osteoarthritisOsteoarthritis patientsWestern OntarioMedical costs
2019
Rapid, point-of-care diagnosis of tuberculosis with novel Truenat assay: Cost-effectiveness analysis for India’s public sector
Lee DJ, Kumarasamy N, Resch SC, Sivaramakrishnan GN, Mayer KH, Tripathy S, Paltiel AD, Freedberg KA, Reddy KP. Rapid, point-of-care diagnosis of tuberculosis with novel Truenat assay: Cost-effectiveness analysis for India’s public sector. PLOS ONE 2019, 14: e0218890. PMID: 31265470, PMCID: PMC6605662, DOI: 10.1371/journal.pone.0218890.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioLife expectancySmear microscopyXpert MTB/RIFHIV-negative adultsPeripheral healthcare settingsMTB/RIFPrimary healthcare facilitiesSputum smear microscopyCost-effectiveness ratioCost-effectiveness analysisPresumptive tuberculosisTB diagnosisTB prevalenceTruenatMicroscopy centresXpertBudget impactRifampicin resistanceDiagnostic strategiesTuberculosisTB detectionHealthcare settingsDiagnostic sensitivityNovel molecular assayCost‐Effectiveness of Diet and Exercise for Overweight and Obese Patients With Knee Osteoarthritis
Losina E, Smith KC, Paltiel AD, Collins JE, Suter LG, Hunter DJ, Katz JN, Messier SP. Cost‐Effectiveness of Diet and Exercise for Overweight and Obese Patients With Knee Osteoarthritis. Arthritis Care & Research 2019, 71: 855-864. PMID: 30055077, PMCID: PMC6349519, DOI: 10.1002/acr.23716.Peer-Reviewed Original ResearchMeSH KeywordsAgedCaloric RestrictionComparative Effectiveness ResearchComputer SimulationCost-Benefit AnalysisExerciseFemaleHealth Care CostsHealthy LifestyleHumansMaleMiddle AgedModels, EconomicMonte Carlo MethodObesityOsteoarthritis, KneeQuality of LifeQuality-Adjusted Life YearsRisk Reduction BehaviorTime FactorsTreatment OutcomeWeight LossConceptsIncremental cost-effectiveness ratioProbabilistic sensitivity analysesKnee osteoarthritisObese patientsIntensive dietSocietal perspectiveHealth care sector perspectiveLifetime costsOsteoarthritis Policy ModelCost-effectiveness ratioIDEA trialPain reductionUsual careExercise programArthritis trialsTreatment strategiesLifetime horizonClinical practicePatientsOsteoarthritisOverweightQALYHealth care sectorWeight reductionDiet
2018
The cost‐effectiveness of HIV pre‐exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil
Luz PM, Osher B, Grinsztejn B, Maclean RL, Losina E, Stern ME, Struchiner CJ, Parker RA, Freedberg KA, Mesquita F, Walensky RP, Veloso VG, Paltiel AD. The cost‐effectiveness of HIV pre‐exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil. Journal Of The International AIDS Society 2018, 21: e25096. PMID: 29603888, PMCID: PMC5878414, DOI: 10.1002/jia2.25096.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioHIV infectionTransgender womenPrEP effectivenessHigh riskMedical costsPre-exposure prophylaxis programHIV pre-exposure prophylaxisAnnual HIV incidenceUniversal ART accessPre-exposure prophylaxisHIV testing frequencyDirect medical costsHigh-risk MSMLife expectancyHIV infection riskUndiscounted life expectancyCost-effectiveness ratioYears of lifeUnited States dollarsHIV careHIV incidenceMean ageProphylaxis programART access
2017
Do Less Harm: Evaluating HIV Programmatic Alternatives in Response to Cutbacks in Foreign Aid.
Walensky RP, Borre ED, Bekker LG, Hyle EP, Gonsalves GS, Wood R, Eholié SP, Weinstein MC, Anglaret X, Freedberg KA, Paltiel AD. Do Less Harm: Evaluating HIV Programmatic Alternatives in Response to Cutbacks in Foreign Aid. Annals Of Internal Medicine 2017, 167: 618-629. PMID: 28847013, PMCID: PMC5675810, DOI: 10.7326/m17-1358.Peer-Reviewed Original ResearchConceptsYears of lifeHIV transmissionHIV programsFuture incident casesSecond-line ARTHIV care continuumViral load monitoringAdverse clinical consequencesResource-limited nationsBase-case analysisCurrent standardHIV deathsIncident casesCôte d'IvoireCare continuumART efficacyClinical consequencesHIV detectionLess HarmHIVSocietal perspectiveProductivity costsNational InstituteDeathYears
2016
The Anticipated Clinical and Economic Effects of 90-90-90 in South Africa.
Walensky RP, Borre ED, Bekker LG, Resch SC, Hyle EP, Wood R, Weinstein MC, Ciaranello AL, Freedberg KA, Paltiel AD. The Anticipated Clinical and Economic Effects of 90-90-90 in South Africa. Annals Of Internal Medicine 2016, 165: 325-33. PMID: 27240120, PMCID: PMC5012932, DOI: 10.7326/m16-0799.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsChild, OrphanedCost-Benefit AnalysisHealth Care CostsHIV InfectionsHumansMass ScreeningModels, BiologicalSouth AfricaConceptsOverall virologic suppressionVirologic suppressionHIV transmissionYears of lifeMaternal orphansTarget strategyHIV/AIDS 90HIV case detectionIncremental cost-effectiveness ratioJoint United Nations ProgrammeHIV transmission ratesSouth African HIVCost of careCost-effectiveness ratioBase-case analysisAIDS 90Incident infectionsAfrican HIVUnited Nations ProgrammeCase detectionHIV detectionTreatment targetsSouth African survey dataRapid treatmentSocietal perspective
2015
Model-based evaluation of cost-effectiveness of nerve growth factor inhibitors in knee osteoarthritis: impact of drug cost, toxicity, and means of administration
Losina E, Michl G, Collins JE, Hunter DJ, Jordan JM, Yelin E, Paltiel AD, Katz JN. Model-based evaluation of cost-effectiveness of nerve growth factor inhibitors in knee osteoarthritis: impact of drug cost, toxicity, and means of administration. Osteoarthritis And Cartilage 2015, 24: 776-785. PMID: 26746146, PMCID: PMC4838505, DOI: 10.1016/j.joca.2015.12.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedAnti-Inflammatory Agents, Non-SteroidalCost-Benefit AnalysisDisease ProgressionDrug CostsFemaleHealth Care CostsHealth Services ResearchHumansInfusions, IntravenousInjections, SubcutaneousMaleMiddle AgedModels, EconometricNerve Growth FactorOsteoarthritis, KneePain MeasurementQuality-Adjusted Life YearsSelf AdministrationUnited StatesConceptsNerve growth factor inhibitorsQuality-adjusted life yearsStandard of careTotal knee replacement surgeryIncremental cost-effectiveness ratioGrowth factor inhibitorsKnee osteoarthritisFactor inhibitorsOA progressionSelf-administered subcutaneous injectionsSevere knee osteoarthritisDirect medical costsKnee replacement surgeryQuality-adjusted life expectancyOsteoarthritis Policy ModelCost-effectiveness ratioMeans of administrationBase-case analysisCost-effective treatmentHospital deliveryIntravenous infusionDisease progressionLifetime riskReplacement surgerySubcutaneous injectionDefining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis
Losina E, Dervan EE, Paltiel AD, Dong Y, Wright RJ, Spindler KP, Mandl LA, Jones MH, Marx RG, Safran-Norton CE, Katz JN. Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis. PLOS ONE 2015, 10: e0130256. PMID: 26086246, PMCID: PMC4472814, DOI: 10.1371/journal.pone.0130256.Peer-Reviewed Original ResearchThe Lifetime Medical Cost Savings From Preventing HIV in the United States
Schackman BR, Fleishman JA, Su AE, Berkowitz BK, Moore RD, Walensky RP, Becker JE, Voss C, Paltiel AD, Weinstein MC, Freedberg KA, Gebo KA, Losina E. The Lifetime Medical Cost Savings From Preventing HIV in the United States. Medical Care 2015, 53: 293-301. PMID: 25710311, PMCID: PMC4359630, DOI: 10.1097/mlr.0000000000000308.Peer-Reviewed Original ResearchConceptsHIV infectionLifetime medical costsMedical costsUS health system perspectiveAntiretroviral treatment statusHIV disease treatmentHIV Research NetworkTransmission risk groupsCD4 cell countHigh-risk individualsHealth system perspectiveHIV prevention interventionsMedical cost savingsMedical Expenditure Panel SurveyLifetime cost estimatesRace/ethnicityPreexposure prophylaxisHIV diseaseHIV preventionRisk groupsPrevention interventionsAge 35High riskSecondary infectionTreatment statusLifetime Medical Costs of Knee Osteoarthritis Management in the United States: Impact of Extending Indications for Total Knee Arthroplasty
Losina E, Paltiel AD, Weinstein AM, Yelin E, Hunter DJ, Chen SP, Klara K, Suter LG, Solomon DH, Burbine SA, Walensky RP, Katz JN. Lifetime Medical Costs of Knee Osteoarthritis Management in the United States: Impact of Extending Indications for Total Knee Arthroplasty. Arthritis Care & Research 2015, 67: 203-215. PMID: 25048053, PMCID: PMC4422214, DOI: 10.1002/acr.22412.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyDirect medical costsOA patientsKnee osteoarthritisMedical costsKnee arthroplastyTKA utilizationEligibility criteriaEffective nonoperative therapiesKellgren/LawrenceKnee osteoarthritis managementKnee OA patientsSymptomatic knee osteoarthritisMulticenter Osteoarthritis StudyLifetime costsUtilization Project dataOsteoarthritis Policy ModelLifetime direct medical costsLifetime medical costsHealth care costsMedicare reimbursement schedulesTotal lifetime costsNonoperative therapySymptomatic osteoarthritisOsteoarthritis managementCost-Effectiveness of Genotype Testing for Primary Resistance in Brazil
Luz PM, Morris BL, Grinsztejn B, Freedberg KA, Veloso VG, Walensky RP, Losina E, Nakamura YM, Girouard MP, Sax PE, Struchiner CJ, Paltiel AD. Cost-Effectiveness of Genotype Testing for Primary Resistance in Brazil. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 68: 152-161. PMID: 25415289, PMCID: PMC4294967, DOI: 10.1097/qai.0000000000000426.Peer-Reviewed Original ResearchConceptsGenotype resistance testingART initiationAntiretroviral treatmentART costsGenotype testingEvandro Chagas Clinical Research InstituteResistance prevalenceFirst-line ART initiationHIV Clinical CohortHIV treatment guidelinesIncremental cost-effectiveness ratioBaseline patient characteristicsEffective antiretroviral treatmentART-naive individualsLife expectancyClinical Research InstituteCost-effectiveness ratioImmune recoveryCD4 countViral suppressionHIV diseasePatient characteristicsTreatment guidelinesMean agePrimary resistance
2014
The Clinical and Economic Impact of Point-of-Care CD4 Testing in Mozambique and Other Resource-Limited Settings: A Cost-Effectiveness Analysis
Hyle EP, Jani IV, Lehe J, Su AE, Wood R, Quevedo J, Losina E, Bassett IV, Pei PP, Paltiel AD, Resch S, Freedberg KA, Peter T, Walensky RP. The Clinical and Economic Impact of Point-of-Care CD4 Testing in Mozambique and Other Resource-Limited Settings: A Cost-Effectiveness Analysis. PLOS Medicine 2014, 11: e1001725. PMID: 25225800, PMCID: PMC4165752, DOI: 10.1371/journal.pmed.1001725.Peer-Reviewed Original ResearchConceptsCare CD4 testIncremental cost-effectiveness ratioCare CD4 testingPOC CD4CD4 testCD4 testingResource-limited settingsHIV diagnosisHIV testingClinical outcomesAntiretroviral therapy (ART) eligibilityPerson lifetime costsLife expectancyLifetime costsCost-effectiveness ratioResource limited settingsCost-effectiveness analysisSensitivity/specificityImmunological stagingLow sensitivity/specificityCost-effective thresholdLaboratory-based testsSurvivalEditors' SummaryOutcomesMobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness
Bassett IV, Govindasamy D, Erlwanger AS, Hyle EP, Kranzer K, van Schaik N, Noubary F, Paltiel AD, Wood R, Walensky RP, Losina E, Bekker LG, Freedberg KA. Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness. PLOS ONE 2014, 9: e85197. PMID: 24465503, PMCID: PMC3898963, DOI: 10.1371/journal.pone.0085197.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioFacility-based testingHIV screeningHIV diagnosisFacility-based HIV testingFrequency of HIVUndiagnosed HIV prevalenceEarly HIV diagnosisLife expectancyMobile screening unitCost-effectiveness ratioResource-limited settingsCD4 countUndiagnosed HIVHIV testingHIV prevalenceCape TownClinical impactPopulation life expectancyMedical costsHIVScreening unitIntervention costsDiagnosisMedical facilities
2013
Cost-Effectiveness of HIV Treatment as Prevention in Serodiscordant Couples
Walensky RP, Ross EL, Kumarasamy N, Wood R, Noubary F, Paltiel AD, Nakamura YM, Godbole SV, Panchia R, Sanne I, Weinstein MC, Losina E, Mayer KH, Chen YQ, Wang L, McCauley M, Gamble T, Seage GR, Cohen MS, Freedberg KA. Cost-Effectiveness of HIV Treatment as Prevention in Serodiscordant Couples. New England Journal Of Medicine 2013, 369: 1715-1725. PMID: 24171517, PMCID: PMC3913536, DOI: 10.1056/nejmsa1214720.Peer-Reviewed Original ResearchConceptsEarly antiretroviral therapyHuman immunodeficiency virusAntiretroviral therapySerodiscordant couplesHIV transmissionHIV Prevention Trials Network 052 studyIncremental cost-effectiveness ratioCost-effectiveness ratioResource-limited settingsHIV infectionClinical benefitImmunodeficiency virusHIV treatmentLonger survivalOpportunistic diseasesEarly initiationFive yearsLifetime outcomesPublic healthSuch personsPatientsPeriodTherapyInfectionDiseaseDisease-modifying drugs for knee osteoarthritis: can they be cost-effective?
Losina E, Daigle ME, Suter LG, Hunter DJ, Solomon DH, Walensky RP, Jordan JM, Burbine SA, Paltiel AD, Katz JN. Disease-modifying drugs for knee osteoarthritis: can they be cost-effective? Osteoarthritis And Cartilage 2013, 21: 655-667. PMID: 23380251, PMCID: PMC3670115, DOI: 10.1016/j.joca.2013.01.016.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioQuality-adjusted life yearsTotal knee replacementPain reliefMajor toxicityRevision total knee replacementCare sequenceConservative pain managementGuideline-concordant careKnee OA treatmentQuality-adjusted life expectancyOsteoarthritis Policy ModelCost-effectiveness ratioCorticosteroid injectionKnee OAKnee osteoarthritisPain managementOsteoarthritis drugsKnee replacementDMOADsOA treatmentLife yearsProgressionLife expectancyRelief
2012
The cost-effectiveness of rapid HIV testing in substance abuse treatment: Results of a randomized trial
Schackman BR, Metsch LR, Colfax GN, Leff JA, Wong A, Scott CA, Feaster DJ, Gooden L, Matheson T, Haynes LF, Paltiel AD, Walensky RP. The cost-effectiveness of rapid HIV testing in substance abuse treatment: Results of a randomized trial. Drug And Alcohol Dependence 2012, 128: 90-97. PMID: 22971593, PMCID: PMC3546145, DOI: 10.1016/j.drugalcdep.2012.08.009.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsSubstance abuse treatment programsNational HIV/AIDS StrategyCost-effectiveness ratioCommunity-based substance abuse treatment programsUndiagnosed HIV prevalenceRisk reduction counselingRapid HIV testingTreatment programHIV testingHIV prevalenceSite rapid testingSite rapid HIV testingHIV risk reduction counselingHIV/AIDS StrategyIncremental cost-effectiveness ratioHIV testing strategiesLife expectancyHIV testing offerPrior testing historyReceipt of resultsSubstance abuse treatmentRapid testingHIV screeningPatient demographicsNewer drugs and earlier treatment
Sloan CE, Champenois K, Choisy P, Losina E, Walensky RP, Schackman BR, Ajana F, Melliez H, Paltiel AD, Freedberg KA, Yazdanpanah Y. Newer drugs and earlier treatment. AIDS 2012, 26: 45-56. PMID: 22008655, PMCID: PMC3237010, DOI: 10.1097/qad.0b013e32834dce6e.Peer-Reviewed Original ResearchConceptsCD4 cell countAntiretroviral therapyHIV RNACD4 cellsHIV diseaseCells/Life expectancyCell countMean CD4 cell countMean age 38 yearsAge 38 yearsMedical resource utilizationLifetime costsUndiscounted life expectancyCost of careAIDS Complications (CEPAC) modelART initiationHIV CostRegimen costsAntiretroviral drugsART costsEarly treatmentCopies/High-income countriesEfficacious drugs
2010
Expanded HIV Screening in the United States: What Will It Cost Government Discretionary and Entitlement Programs? A Budget Impact Analysis
Martin EG, Paltiel AD, Walensky RP, Schackman BR. Expanded HIV Screening in the United States: What Will It Cost Government Discretionary and Entitlement Programs? A Budget Impact Analysis. Value In Health 2010, 13: 893-902. PMID: 20950323, PMCID: PMC2999642, DOI: 10.1111/j.1524-4733.2010.00763.x.Peer-Reviewed Original ResearchMeSH KeywordsAIDS SerodiagnosisForecastingHealth Care CostsHumansMass ScreeningMedical AssistanceProspective Payment SystemUnited StatesConceptsHIV screeningEarly treatment goalsNew HIV casesFrequency of screeningBudget impact analysisTotal budget increasesHIV careAnnual incidenceHIV casesHIV prevalenceCDC estimatesUS CentersTreatment goalsBudget impactTreatment programDisease controlHIVTest characteristicsTreatment costsFinancial burdenCareScreeningSmall proportionProgram savingsFund care
2009
Cost-Effectiveness of Preventing Loss to Follow-up in HIV Treatment Programs: A Côte d'Ivoire Appraisal
Losina E, Touré H, Uhler LM, Anglaret X, Paltiel AD, Balestre E, Walensky RP, Messou E, Weinstein MC, Dabis F, Freedberg KA, AIDS F, investigators A. Cost-Effectiveness of Preventing Loss to Follow-up in HIV Treatment Programs: A Côte d'Ivoire Appraisal. PLOS Medicine 2009, 6: e1000173. PMID: 19859538, PMCID: PMC2762030, DOI: 10.1371/journal.pmed.1000173.Peer-Reviewed Original ResearchConceptsHIV treatment programsResource-limited settingsPerson/yearART initiationAIDS Complications-International modelTreatment programWorld Health Organization criteriaAntiretroviral therapy initiationLTFU ratesHIV careTherapy initiationCumulative incidenceClinical benefitOrganization criteriaClinical impactLTFUPayer perspectiveCost of interventionInternational criteriaLife expectancyEfficacyInterventionPreventing LossCareSurvival lossWhen to start antiretroviral therapy in resource-limited settings.
Walensky RP, Wolf LL, Wood R, Fofana MO, Freedberg KA, Martinson NA, Paltiel AD, Anglaret X, Weinstein MC, Losina E. When to start antiretroviral therapy in resource-limited settings. Annals Of Internal Medicine 2009, 151: 157-66. PMID: 19620143, PMCID: PMC3092478, DOI: 10.7326/0003-4819-151-3-200908040-00138.Peer-Reviewed Original ResearchMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsAnti-HIV AgentsAnti-Infective AgentsCD4 Lymphocyte CountCohort StudiesComputer SimulationCost-Benefit AnalysisDecision TreesDisease ProgressionDrug Administration ScheduleHealth Care CostsHIV InfectionsHumansLife ExpectancySensitivity and SpecificitySouth AfricaTrimethoprim, Sulfamethoxazole Drug CombinationConceptsAntiretroviral therapyCD4 countLong-term survivalCells/LART initiationCells/L.ART initiation strategiesIncremental cost-effectiveness ratioSevere opportunistic diseaseDoris Duke Charitable FoundationLife expectancyCD4 count thresholdHIV treatment decisionsCost-effectiveness ratioInternational clinical trialsBase-case analysisResource-limited settingsYears of lifeCost-effectiveness analysisPerson's life expectancyObservational cohortCD4 thresholdHIV diseaseTreatment guidelinesEarly therapy