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News
Cedar Associates officially opens its doors.
On December 15, 2006, we moved into new headquarters in
Menlo Park, CA. Building on more than 20 years of
experience in academia, practicing medicine, and working
with partners in the private and public sector, we are
well-positioned to meet the increasing challenges that
many stakeholders (healthcare providers, patients,
manufacturers, government agency) face in striving to
reliably assess the value and costs of new services and
interventions.
Pivotal paper published on the cost-effectiveness of
herpes zoster vaccine
Dr. Hornberger (Principal, Cedar Associates LLC)
published a widely quoted paper on the results of a
cost-effectiveness analyses of the recently approved
herpes zoster vaccine (Hornberger J & Robertus K. Ann
Intern Med 2006;145:317-325, 386-387). Here is what
people have said:
A new study looks at the cost-effectiveness of a
vaccine to prevent herpes zoster and the most severe
outcome of zoster infection, postherpetic neuralgia, and
suggests that although it does increase quality-adjusted
life-years (QALYs), the vaccine may be within the range
considered cost-effective only under certain conditions.
From: Medscape Medical New, Sept 27, 2006
Assuming a vaccine cost of $200 and 12-year duration
of vaccine efficacy, the cost per
quality-adjusted life year (QALY) was
$159,375. The editorialist suggests that the
cost-effectiveness of the vaccine remains to
be definitively estimated and that coverage decisions
will for now be based on "willingness to
pay." From: Journal Watch Neurology October 24,
2006.
The VZV vaccine improves quality-adjusted survival by
only 0.6 days compared with no vaccination. Vaccination
is unlikely to cost less than $100,000 per
quality-adjusted life year gained, unless it is used in
adults younger than 70, costs less than $200 per unit,
and the duration of efficacy is more than 30 years. The
cost is still greater than what is commonly accepted as
cost-effective, and the duration of efficacy is unknown.
From Patient Care. The Journal of Best Clinical
Practices for Today’s Physician.
Coming Soon:
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Hornberger J,
Holodniy M, Robertus K, et al. A systematic
review of cost-utility analyses in HIV/AIDS. Med
Decis Making (forthcoming).
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Lyman GH, Cosler LE,
Kuderer NM, Hornberger J. Impact of a 21-gene
RT-PCR assay on treatment decisions in early-stage
breast cancer: an economic analysis based on
prognostic and predictive validation studies. Cancer
(forthcoming).
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Holodniy M,
Hornberger J, Rapoport D. et al.
Relationship between antiretroviral prescribing
patterns and treatment guidelines in
treatment-Naïve, HIV-1 infected U.S. veterans:
1992-2004. JAIDS (forthcoming).
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