Pharmacoeconomics and Health Outcomes Research Iberia (Spain)

Chronic kidney disease (CKD) is a major global cause of morbidity and mortality. Recent nephroprotective therapies have improved CKD management, yet their cost effectiveness across settings remains uncertain. This review systematically identified and compared cost-effectiveness studies of novel CKD treatments for both broad CKD populations and disease-specific subgroups. A systematic search was conducted in PubMed and the Cochrane Library using terms related to "chronic kidney disease," "cost-effectiveness," "cost-utility," "health technology assessment," "SGLT2 inhibitor," and commercial and generic names of nephroprotective drugs approved since 2013. Eligible studies were full-length articles in English published between January 2015 and September 2025. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios were extracted. All monetary values were standardized to 2025 US dollars. The search yielded 172 records, of which 26 met inclusion criteria. A supplementary search identified ten additional studies, resulting in 36 evaluations. Most studies assessed sodium-glucose cotransporter 2 inhibitors or finerenone. Across evaluations, these therapies consistently improved outcomes, with QALY gains reported in all studies (0.012-1.44 QALYs gained). Most concluded that the interventions were cost effective compared with standard of care, and 13 reported cost-saving results. Only three studies reported an incremental cost-efffectiveness ratio above $100,000 per QALY threshold. Cost effectiveness was observed in both general CKD and CKD with diabetes mellitus, although estimates varied by country, time horizon, and analytic perspective. Current evidence indicates that novel nephroprotective therapies for CKD are generally cost effective, and in some settings cost saving. These findings support their value in both general CKD and diabetic populations and highlight the importance of early treatment adoption to delay disease progression and reduce long-term healthcare costs.

Controlling low-density lipoprotein cholesterol (LDL-C) levels reduces atherosclerotic risk in patients with atherosclerotic cardiovascular disease. However, not all available therapies provide the same efficacy or safety outcomes, influencing treatment preferences. Our study aimed to identify patients’ and healthcare professionals’ (HCP) preferences for the attributes related to lipid-lowering therapies (LLT). A literature review and 2 focus groups (patients = 4; HCP = 8), were conducted to identify LLT attributes and levels. A total of 5 attributes with 2 or 3 levels each resulted in 36 scenarios. The relative importance given to each attribute was estimated using a conditional logit model. A total of 50 patients and 89 HCP participated. The estimated relative importance was: prevention of cardiovascular problems (HCP: 37.7%; patients: 26.8%); LDL-C reduction (HCP: 31.6%; patients: 26.8%); route and frequency of administration (HCP: 10.9; patients: 10.3%) safety (HCP: 10.2%; patients: 24.0%); and medication collection location (HCP: 9.5%; patients: 12.1%). The preferred route and frequency of administration for HCP was a subcutaneous injection administered by an HCP once every 6 months, while patients equally preferred subcutaneous injection administered by an HCP once every 6 months and oral administration ( r = 0.01; P = .95) over a self-administered injection twice per month ( r = −0.36; P = .01). HCP and patients considered treatment efficacy preventing cardiovascular events and reducing LDL-C levels the most important attributes, followed by route and frequency of administration for HCP and safety for patients. Regarding route and frequency of administration, HCP preferred low frequency subcutaneous injection administered by an HCP and patients, are less prompt to accept a self-administered injection twice per month over the other options. El control de los niveles de colesterol unido a lipoproteínas de baja densidad (cLDL) reduce el riesgo ateroesclerótico en pacientes con enfermedad cardiovascular ateroesclerótica. Sin embargo, no todos los tratamientos disponibles ofrecen la misma eficacia o seguridad, lo que influye en las preferencias de tratamiento. Nuestro estudio tuvo como objetivo identificar las preferencias de pacientes y profesionales sanitarios (PS) respecto a los atributos relacionados con los tratamientos hipolipemiantes (THL). Se realizó una revisión de la literatura y 2 grupos focales (pacientes = 4; PS = 8) para identificar los atributos y niveles de las THL. Un total de 5 atributos con 2 o 3 niveles cada uno dieron lugar a 36 escenarios. La importancia relativa asignada a cada atributo se estimó mediante un modelo logit condicional. Participaron un total de 50 pacientes y 89 PS. La importancia relativa estimada fue: prevención de problemas cardiovasculares (PS: 37,7%; pacientes: 26,8%); reducción de cLDL (PS: 31,6%; pacientes: 26,8%); vía y frecuencia de administración (PS: 10,9%; pacientes: 10,3%); seguridad (PS: 10,2%; pacientes: 24,0%); y lugar de recogida de la medicación (PS: 9,5%; pacientes: 12,1%). La vía y frecuencia de administración preferida por los PS fue la inyección subcutánea administrada por un profesional sanitario una vez cada 6 meses, mientras que los pacientes mostraron igual preferencia por la inyección subcutánea administrada por un profesional sanitario una vez cada 6 meses y la administración oral (r = 0,01; p = 0,95) frente a la inyección autoadministrada 2 veces al mes (r = −0,36; p = 0,01). Los PS y los pacientes consideraron que la eficacia del tratamiento en la prevención de eventos cardiovasculares y la reducción de los niveles de cLDL eran los atributos más importantes, seguidos por la vía y frecuencia de administración en el caso de los PS, y la seguridad en el caso de los pacientes. Con respecto a la vía y frecuencia de administración, los PS prefirieron la inyección subcutánea de baja frecuencia administrada por un profesional sanitario, mientras que los pacientes mostraron menor disposición a aceptar la inyección autoadministrada 2 veces al mes en comparación con las otras opciones.

ABSTRACT Background This study evaluated the efficiency CE-latanoprost unidose (cationic emulsion of latanoprost) versus latanoprost unidose (non-emulsion formulation) in open-angle glaucoma and ocular hypertension (OAG/OHT) with concomitant ocular surface disease (OSD) patients’ treatment in Spain. Methods A cost–utility analysis was performed using a Markov model simulating the progression of OAG/OHT. From a Spanish National Health System perspective over a 5-year time horizon, quality-adjusted life years (QALYs) and the total cost of each therapy were estimated (annual discount rate: 3%). Therapy efficacy included adherence, disease progression, and OSD reduction. Utility values for OAG/OHT and OSD-related disutility values were obtained from literature. Five ophthalmologists validated all included parameters. Total costs (€, 2023) included CE-latanoprost or latanoprost drug acquisition (€10/30 single-dose), glaucoma diagnosis, patient follow-up, and OAG management costs. Results The base case results showed that CE-latanoprost unidose increased health outcomes (2.69 vs. 2.49 QALYs) and lowered costs (€5,292.12 vs. €5,441.55) being a dominant option (0.21 QALYs gained and €149.43 less) compared to latanoprost unidose. Conclusions CE-latanoprost unidose was a cost-effective option for the treatment of patients with OAG/OHT and OSD in comparison to latanoprost unidose (non-emulsion formulation). In addition to its clinical benefits, the economic analysis supports using CE-latanoprost in terms of efficiency.

ObjectivesTo assess the economic burden of premature mortality due to liver cancer in Spain over 10 years (2013–2022) using a retrospective economic analysis.DesignA population-based retrospective study using the Human Capital approach.SettingWe analysed national registry data from the Spanish National Institute of Statistics on mortality, employment and wage structure. Sensitivity analyses were conducted using discount rates of 0%, 3% and 6%.ParticipantsAll individuals who died from liver cancer between 2013 and 2022, with a focus on the working-age population under 65 years of age.Primary and secondary outcome measuresPrimary outcomes included years of potential life lost (YPLL), years of potential labour productive life lost (YPLPLL) and associated productivity losses due to premature liver cancer mortality. Secondary outcomes involved trend analyses of productivity loss and YPLL over time, and assessment of sex-specific and age-specific differences in productivity losses.ResultsBetween 2013 and 2022, 36 635 individuals died from liver cancer, including 6622 individuals of working age. This led to 9924–12 068 YPLL annually. The cumulative productivity loss was €12.88 billion (range: €12.52–€13.26 billion).ConclusionsThese findings highlight the substantial economic impact of liver cancer mortality in Spain and underscore the importance of targeted prevention and screening programmes for high-risk populations.

The goal of this study is to determine the medical costs, comorbidity profile, and health care resources use of patients diagnosed with prostate cancer who have been treated in Spanish hospitals. The admission records of the patients diagnosed with prostate cancer used in the study were registered between January 2016 and December 2020. These records have been collected from a Spanish hospital discharge database and have been evaluated in a retrospective multicenter analysis. 8218 patients from the database met the criteria and were thus analyzed. The median aged of the diagnosed patients was 71.68 years. The median Charlson comorbidity index (CCI) score was 4, and the updated median CCI was 3. Hypertension was diagnosed in the 49.76% of the individuals, 37.03% had chronic obstructive pulmonary disease and 34.51% had hyperlipidaemia. The mortality rate was 9.30%. The most common medical procedure was prostate resection with percutaneous endoscopic approach (31.18%). The mean annual cost per admission was 5212.98€ €. Technologies, such as the prostate-specific antigen (PSA) testing for screening has helped in the diagnosis in the past decades, enhancing a decrease in the mortality rate of the patients throughout the years.

Objective: To estimate the efficiency of a nurse-led telephone program for nonadherent to treatment Type 2 diabetics with comorbid depression (TELE-DD program). Design: Secondary analysis of cost-consequence and budget impact, utilizing data from a randomized clinical trial conducted in the primary healthcare setting. The target population consisted of Type 2 diabetic patients with comorbid depression who were nonadherent to their pharmacological treatment. Method: The average cost per controlled patient (glycated hemoglobin < 7%) and the incremental cost-effectiveness ratio were calculated. Similarly, the budgetary impact over 1 year of implementing this program in the region of reference of the randomized clinical trial was assessed. Results: The number of controlled patients is higher in the TELE-DD group at 6, 12, and 18 months. The average cost per controlled patient was higher in the TELE-DD group than in the control group at 6 months (€160.31 vs. €49.79), but lower at 12 (€150.09 vs. €179.59) and 18 months (€209.22 vs. €376.88). The incremental cost-effectiveness ratio at 6, 12, and 18 months was €254.47, €143.65, and €177.46, respectively. The budget impact analysis revealed that implementing the TELE-DD program would result in a reduction of €721,940.68 in expenditure for the funder in the first year of application. Conclusions: A nurse-led telephone program for nonadherent Type 2 diabetics with comorbid depression is an efficient option in the management of healthcare resources. These results highlight the role of nursing in chronic patient management and the efficient use of healthcare resources. Trial Registration: ClinicalTrials.gov Identifier: NCT04097483.