# Indence Health > Indence Health: Crossing Barriers to Market Access Together! ## Posts - [Transarterial Chemoembolization Versus Transarterial Radioembolization in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Real-World and Clinical Trial Evidence](https://indencehealth.com/transarterial-chemoembolization-versus-transarterial-radioembolization-in-hepatocellular-carcinoma-a-systematic-review-and-meta-analysis-of-real-world-and-clinical-trial-evidence/): Transarterial chemoembolization and transarterial radioembolization are both established locoregional options for hepatocellular carcinoma, yet direct comparative evidence is complicated by variation in disease stage, patient selection, procedural technique, and research design. Individual randomized and observational publications can therefore produce estimates that are difficult to interpret in isolation. Bringing randomized clinical trial and real-world evidence together offers a way to assess whether the overall comparative assessment is consistent across a broader clinical evidence base. The systematic review identified 25 comparative publications for meta-analysis, comprising 8,146 patients. Fourteen publications contributed overall-survival data, with a pooled hazard ratio of 0.99 and a 95% confidence... - [Depression, Anxiety and Sleep Disorders Among Patients with Interstitial Lung Disease in the United States: A Systematic Literature Review](https://indencehealth.com/depression-anxiety-and-sleep-disorders-among-patients-with-interstitial-lung-disease-in-the-united-states-a-systematic-literature-review/): Depression, anxiety, and sleep disorders can add substantially to the burden of interstitial lung disease, but prevalence estimates in the United States have been difficult to interpret because publications differ in sample size, data source, and measurement instrument. In this setting, variability is not simply statistical noise. It can reveal how strongly prevalence estimates depend on the way comorbidity is identified and measured. The systematic literature review examined United States evidence through December 2024 and considered idiopathic pulmonary fibrosis separately from other forms of interstitial lung disease. The weighted average prevalence reported for depression was 12.3% in idiopathic pulmonary fibrosis and... - [A Systematic Assessment of Diffuse Large B-Cell Lymphoma Cell-of-Origin Classification Performance Evaluating Non-Inferiority of the Hans Immunohistochemistry Algorithm to Gene Expression Profiling](https://indencehealth.com/a-systematic-assessment-of-diffuse-large-b-cell-lymphoma-cell-of-origin-classification-performance-evaluating-non-inferiority-of-the-hans-immunohistochemistry-algorithm-to-gene-expression-profiling/): Cell-of-origin classification is an established component of diffuse large B-cell lymphoma characterization, but the optimal testing approach remains debated. Gene expression profiling is often treated as the reference method, while the Hans immunohistochemistry algorithm is widely accessible and can be performed on routine formalin-fixed tissue. Conventional accuracy comparisons are difficult, however, because gene expression platforms themselves vary and there is no perfect gold standard against which every test can be judged. The analysis assembled 19 publications comprising 2,247 tumors, including evidence comparing Hans immunohistochemistry with gene expression profiling and evidence comparing different gene expression profiling platforms. A Bayesian latent-class model was... - [Inflation Reduction Act Negotiations: Qualitative Insights from 25 Medicare Part D Drug Price Negotiations](https://indencehealth.com/inflation-reduction-act-negotiations-qualitative-insights-from-25-medicare-part-d-drug-price-negotiations/): Publicly reported negotiated prices under the Medicare Drug Price Negotiation Program provide drug-level information, but viewing each product in isolation makes it difficult to see broader patterns across negotiation cycles and therapeutic areas. A cross-product assessment can add a different layer of value by comparing the scale of negotiated reductions, the size of the exposed Medicare population, and how these features differ between oncology and non-oncology medicines. The analysis examined 25 Medicare Part D drugs across the 2026 and 2027 negotiation cycles. Ten drugs were included in the first cycle and 15 in the second. Twenty were non-oncology medicines and five... - [Real-World Diagnostic Delay, Treatment Access, and Health System Burden in Primary Immunodeficiency/Inborn Errors of Immunity: Evidence from the United States and ex-US Settings](https://indencehealth.com/real-world-diagnostic-delay-treatment-access-and-health-system-burden-in-primary-immunodeficiency-inborn-errors-of-immunity-evidence-from-the-united-states-and-ex-us-settings/): For primary immunodeficiency and inborn errors of immunity, recurrent infections are only one part of the burden. Delayed recognition, repeated healthcare use before diagnosis, access to genetic testing and immunoglobulin replacement, travel requirements, and psychosocial consequences can accumulate across the patient journey. These effects are often reported in separate real-world publications, making it difficult to see how diagnostic delay, inequity, treatment logistics, and economic burden interact at a health-system level. The review synthesized 11 real-world publications. Six were from the United States and five were from European settings. Diagnostic delay was the most frequently represented evidence theme, followed by healthcare-resource-use reduction... - [Unit-Consistent Translation of Treatment Effects into Number Needed to Treat and Cost per Event Avoided in Health Economic Evaluations](https://indencehealth.com/unit-consistent-translation-of-treatment-effects-into-number-needed-to-treat-and-cost-per-event-avoided-in-health-economic-evaluations/): Number needed to treat is frequently used to translate treatment effects into an intuitive decision metric, but the calculation is only meaningful when it matches the structure of the endpoint. Binary outcomes, time-to-event outcomes, and recurrent events quantify treatment benefit in different units. Applying the same formula across all three can create estimates that appear simple while mixing patient-level and event-level interpretations and answering fundamentally different clinical and economic questions. This methodological assessment compared three endpoint structures and the corresponding treatment-effect translations, with each mapped to its appropriate estimand, time horizon, and reporting unit. Fixed-time binary outcomes were expressed as patient-level... - [Implementation of Managed-Entry Agreements in HTA Submissions: Types, Use-Cases, and Operational Considerations](https://indencehealth.com/implementation-of-managed-entry-agreements-in-hta-submissions-types-use-cases-and-operational-considerations/): Managed-entry agreements are used when a promising health technology reaches reimbursement decision-making with unresolved financial, clinical, or implementation uncertainty. Across jurisdictions, however, these arrangements are described and implemented in different ways. A list of agreement names is therefore less useful to decision-makers than an understanding of which uncertainty or risk each agreement is intended to manage, the circumstances in which it may be appropriate, and the infrastructure required to make it work. This cross-jurisdictional review examined publicly available health technology assessment submissions, and payer materials and organized managed-entry agreements according to their primary risk-management function and operational design. Four recurring archetypes... - [Confidence Intervals for Event-Based Number Needed to Treat: A Practical Approach for Health Economic Evaluation Outputs](https://indencehealth.com/confidence-intervals-for-event-based-number-needed-to-treat-a-practical-approach-for-health-economic-evaluation-outputs/): Number needed to treat is intuitive when the outcome is binary. It expresses how many patients must be treated to prevent one additional event. Recurrent outcomes such as exacerbation, relapses, or hospitalizations are different because one patient may experience multiple events. Event-based number needed to treat can represent this repeated-event burden, but the reciprocal transformation used to calculate it creates asymmetric and potentially unstable uncertainty intervals, particularly when the treatment-related rate difference approaches zero. A simulation analysis compared delta-method and non-parametric bootstrap confidence intervals across 36 recurrent-event scenarios, combining three baseline event rates, four treatment rate ratios, and three time horizons... - [Evaluating the Performance of a Supervised Artificial Intelligence Model in Screening Abstracts for Oncology-Focused Targeted Literature Reviews](https://indencehealth.com/evaluating-the-performance-of-a-supervised-artificial-intelligence-model-in-screening-abstracts-for-oncology-focused-targeted-literature-reviews/): Artificial intelligence can reduce the manual burden of literature screening, but evidence reviews in oncology pose a difficult test. Eligibility criteria often combine disease sub-types, line of therapy, biomarker status, demographics, geography, and research design. Performance measured in a simple review may therefore give little indication of how the same model behaves when the population, intervention – comparator, outcomes, and research-design criteria become more granular. The analysis evaluated a supervised machine-learning model across 28 oncology-focused literature reviews, with individual searches yielding between 587 and 3,653 records. Performance varied substantially. Decision match rates ranged from 52% to 87%, recall from 17% to... - [Measures for Integrating Carbon Footprints into Economic Evaluations: A Targeted Review of Environmental and Economic Metrics](https://indencehealth.com/measures-for-integrating-carbon-footprints-into-economic-evaluations-a-targeted-review-of-environmental-and-economic-metrics/): Healthcare decisions increasingly need to account for environmental consequences as well as clinical outcomes and costs. Yet carbon emissions do not fit automatically into conventional cost-effectiveness or budget impact frameworks. The central methodological problem is therefore not whether emissions can be measured, but how environmental measures should be incorporated without obscuring the economic and health outcomes that decision-makers already use. Different approaches to integration may also be more appropriate for different decision contexts, making the choice of metric itself an important methodological consideration. This targeted review screened 1,007 records and included 21 publications. Across the evidence base, environmental measures such as... - [An Interactive R-Shiny Application for Budget Impact Modeling of Cell and Gene Therapies Under Multiple Innovative Payment Scenarios](https://indencehealth.com/an-interactive-r-shiny-application-for-budget-impact-modeling-of-cell-and-gene-therapies-under-multiple-innovative-payment-scenarios/): Cell and gene therapies can create a distinctive financing problem. Costs may be concentrated at treatment initiation while clinical benefits extend over several years. Conventional budget impact models can describe expenditure, but a single fixed payment assumption may obscure how financing design itself changes the timing of affordability pressures. This work addressed that problem by making alternative payment structures an explicit, testable part of the model. An interactive R-Shiny-based budget impact model was developed to compare a reference market containing standard of care with a new market in which a cell or gene therapy is introduced. Users can vary epidemiology, uptake,... - [A Systematic Literature Review to Identify Risk Factors and Symptoms of Long COVID-19 in Adult Indian Patients](https://indencehealth.com/a-systematic-literature-review-to-identify-risk-factors-and-symptoms-of-long-covid-19-in-adult-indian-patients/): Long COVID-19 is not a single, uniform clinical state. Risk factors and symptom patterns can differ according to how long symptoms have persisted after the initial infection, making a single undifferentiated summary difficult to interpret. In India, where the published evidence was spread across relatively small and methodologically varied publications, a stage-specific synthesis was needed to understand how the profile changes over time. Fifteen publications, comprising 3,533 subjects with Long COVID-19 disease, were included. Seven publications represented the ongoing symptomatic phase and eight the post-COVID-19 disease phase. In the ongoing symptomatic phase, severity of the initial infection and severe symptom burden... - [A Systematic Literature Review to Identify Potential Risk Factors and Causative Organisms for Neonatal Sepsis in Indian Neonates](https://indencehealth.com/a-systematic-literature-review-to-identify-potential-risk-factors-and-causative-organisms-for-neonatal-sepsis-in-indian-neonates/): A Systematic Literature Review to Identify Potential Risk Factors and Causative Organisms for Neonatal Sepsis in Indian Neonates Neonatal sepsis remains a major clinical and health-system challenge in India, but the evidence describing who is most at risk and which organisms are most frequently implicated is dispersed across populations, hospitals, and research designs. While individual publications can identify local risk factors or microbiological patterns, a systematic synthesis can determine which signals recur across settings and which appear only sporadically. The review identified 5,842 records and included 64 publications at full-text review. Twenty-four publications met the pre-specified prioritization criterion of reporting at... - [A Systematic Literature Review to Assess Variability in Conducting and Reporting of Matching-Adjusted Indirect Comparisons in Chronic Lymphocytic Leukemia: Findings and Implications for European Union Health Technology Assessment](https://indencehealth.com/a-systematic-literature-review-to-assess-variability-in-conducting-and-reporting-of-matching-adjusted-indirect-comparisons-in-chronic-lymphocytic-leukemia-findings-and-implications-for-european-union/): A Systematic Literature Review to Assess Variability in Conducting and Reporting of Matching-Adjusted Indirect Comparisons in Chronic Lymphocytic Leukemia: Findings and Implications for European Union Health Technology Assessment When direct head-to-head evidence is unavailable, matching-adjusted indirect comparisons can help address comparative evidence gaps. Their usefulness, however, depends heavily on analytical choices – which prognostic factors and treatment-effect modifiers are selected, how much of the original sample remains represented after adjustment, which outcomes are evaluated, and whether sensitivity analyses test the robustness of the result. In chronic lymphocytic leukemia, published matching-adjusted indirect comparisons therefore provide an opportunity to examine not only treatment... - [An introduction to Financial toxicity](https://indencehealth.com/an-introduction-to-financial-toxicity/): Indence Publication An introduction to Financial toxicity Published: September 14, 2023Category: Forensic   The term ‘Financial toxicity’ refers to the impacts of increasing healthcare costs and financial burden on patients, after they are diagnosed with a threatening disease. Financial toxicity was initially coined in the context of cancer patients, where not only it was used to indicate the financial hardship experienced by the patients during the treatment, but also to indicate the emotional strain and unhealthy coping mechanisms. Under financial stress, every household adjusts differently. Majority of families sell off their assets to meet the out-of-pocket expenses (OOPE), others may skip... - [Rare Diseases: Emerging HEOR Research Landscape in SAARC Nations](https://indencehealth.com/rare-diseases-emerging-heor-research-landscape-in-saarc-nations/): Indence Publication Rare Diseases: Emerging HEOR Research Landscape in SAARC Nations Published: September 8, 2023Category: Medical It is estimated that 300 million people in the world live with a rare disease and over 45 million people belong from the South Asia. The South Asian Association for Regional Cooperation (SAARC) aims to integrate the economics and improve the quality of life of the peoples of its eight member countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka). Only 4 out of 8 member countries have HTA bodies, and there some of the member countries are aiming to implement universal health... ## Pages - [Terms and Conditions](https://indencehealth.com/terms-and-conditions/) - [Privacy Policy](https://indencehealth.com/privacy-policy/) - [footer-new](https://indencehealth.com/footer-new/) - [Advisors](https://indencehealth.com/advisors/) - [Cookie Policy (EU)](https://indencehealth.com/cookie-policy-eu/) - [About](https://indencehealth.com/about/) - [Careers](https://indencehealth.com/careers/) - [Contact](https://indencehealth.com/contact/) - [About Team](https://indencehealth.com/about-team/) - [Footer](https://indencehealth.com/home/footer/) - [Home](https://indencehealth.com/) - [Services](https://indencehealth.com/services/) - [Publications](https://indencehealth.com/publications/): Indence Health publications and research insights on HEOR, real-world evidence, disease burden and market access. ## Optional - [Agent (MCP protocol)](websites-agents.hostinger.com/indencehealth.com/mcp) [comment]: # (Generated by Hostinger Tools Plugin)