Ms Sopany Saing is a Research Fellow at CHERE and has completed a Master in Public Health (health economics and health policy) at the University of Sydney. Sopany has completed a Bachelor of Commerce (Business Economics) and a Bachelor of Science (Honours Class I Medical Microbiology and Immunology) from the University of New South Wales. Since joining CHERE she has reviewed and conducted evaluations for Pharmaceutical Benefits Advisory Committee and the Medical Services Advisory Committee. She has received a Faculty of Business grant looking at the cost-effectiveness of infant sleep programs. She has also completed a number of commissioned projects for FSANZ and NSW Health. Prior to joining CHERE, Sopany worked in health economic consulting at the CIE (Centre for International Economics) and in medical research at the Garvan Institute of Medical Research. She has extensive experience in the systematic review of scientific literature, health economics, evidence-based research methodologies, and medical science research.
Prichard, R, Kershaw, L, Goodall, S, Davidson, P, Newton, PJ, Saing, S & Hayward, C 2020, 'Costs before and after left ventricular assist device implant and preceding heart transplant: a cohort study', Heart, Lung and Circulation.View/Download from: Publisher's site
Hewitt, J, Saing, S, Goodall, S, Henwood, T, Clemson, L & Refshauge, K 2019, 'An economic evaluation of the SUNBEAM program. A falls prevention randomised controlled trial in residential aged care', Clinical Rehabilitation, vol. 33, no. 3, pp. 524-534.View/Download from: Publisher's site
To estimate the cost-effectiveness of a strength and balance exercise programme (SUNBEAM) which has been shown to be clinically effective in reducing the rate of falls in residents of aged care facilities.
An economic evaluation was conducted alongside a pragmatic cluster randomized controlled trial that included 16 residential care facilities and 221 participants. Mean participant age was 86 years, 65% were female and 78% relied on a mobility aide. A cost-effectiveness analysis examined the costs of providing the exercise programme and costs of health service use arising from falls in each arm (intervention and usual care) over 12 months.
Incremental cost-effectiveness ratios were calculated for the cost per fall avoided. Costs were bootstrapped to obtain adjusted confidence intervals for the incremental cost-effectiveness ratios.
Of 63 facilities contacted, 16 met the eligibility criteria and were randomized to the intervention or usual care (1:1). There were 142 falls in the intervention group and 277 in the usual care group. 72 injurious falls occurred in the intervention group versus 157 with usual care. Delivery of the SUNBEAM programme cost $463 per participant. The mean total cost of each fall (regardless of group) was $400.09 and the mean cost of each injurious fall was $708.27. The incremental cost-effectiveness ratio was $22 per fall per person avoided with the mean bootstrapped incremental cost-effectiveness ratio $18 per fall avoided (95% CI: −$380.34 to $417.85).
The SUNBEAM programme can be considered cost-effective, relative to other fall-prevention interventions in older adults.
Saing, S, Haywood, P, van der Linden, N, Manipis, K, Goodall, S & Meshcheriakova, O 2019, 'Real-World Cost Effectiveness of Mandatory Folic Acid Fortification of Bread-Making Flour in Australia.', Applied health economics and health policy, vol. 17, no. 2, pp. 243-254.View/Download from: Publisher's site
BACKGROUND:In 2009, mandatory folic acid fortification of bread-making flour was introduced in Australia to reduce the birth prevalence of preventable neural tube defects (NTDs) such as spina bifida. Before the introduction of the policy, modelling predicted a reduction of 14-49 NTDs each year. OBJECTIVE:Using real-world data, this study provides the first ex-post evaluation of the cost effectiveness of mandatory folic acid fortification of bread-making flour in Australia. METHODS:We developed a decision tree model to compare different fortification strategies and used registry data to quantify the change in NTD rates due to the policy. We adopted a societal perspective that included costs to industry and government as well as healthcare and broader societal costs. RESULTS:We found 32 fewer NTDs per year in the post-mandatory folic acid fortification period. Mandatory folic acid fortification improved health outcomes and was highly cost effective because of the low intervention cost. The policy demonstrated improved equity in outcomes, particularly in birth prevalence of NTDs in births from teenage and indigenous mothers. CONCLUSIONS:This study calculated the value of mandatory folic acid fortification using real-world registry data and demonstrated that the attained benefit was comparable to the modelled expected benefits. Mandatory folic acid fortification (in addition to policies including advice on supplementation and education) improved equity in certain populations and was effective and highly cost effective for the Australian population.
Saing, S, van der Linden, N, Hayward, C & Goodall, S 2019, 'Why is There Discordance between the Reimbursement of High-Cost 'Life-Extending' Pharmaceuticals and Medical Devices? The Funding of Ventricular Assist Devices in Australia.', Applied health economics and health policy, vol. 17, no. 4, pp. 421-431.View/Download from: Publisher's site
New health technologies often yield health benefits, but often at a high cost. In Australia, the processes for public reimbursement of high-cost pharmaceuticals and medical devices are different, potentially resulting in inequity in support for new therapies. We explore how reimbursement is different for medical devices compared with pharmaceuticals, including whether higher cost-effectiveness thresholds are accepted for pharmaceuticals. A literature review identified the challenges of economic evaluations for medical devices compared with pharmaceuticals. We used the ventricular assist device as a case study to highlight specific features of medical device funding in Australia. We used existing guidelines to evaluate whether ventricular assist devices would fulfil the requirements for the "Life-Saving Drugs Program", which is usually reserved for expensive life-extending pharmaceutical treatments of serious and rare medical conditions. The challenges in conducting economic evaluations of medical devices include limited data to support effectiveness, device-operator interaction (surgical experience) and incremental innovations (miniaturisation). However, whilst high-cost pharmaceuticals may be funded by a single source (federal government), the funding of high-cost devices is complex and may be funded via a combination of federal, state and private health insurance. Based on the Life-Saving Drugs Program criteria, we found that ventricular assist devices could be funded by a similar mechanism to that which funds high-cost life-extending pharmaceuticals. This article highlights the complexities of medical device reimbursement. Whilst differences in available evidence affect the evaluation process, differences in funding methods contribute to inequitable reimbursement decisions between medical devices and pharmaceuticals.
Saing, S, Haywood, P, Duncan, J, Ma, N, Cameron, A & Goodall, S 2018, 'Cost-effective imaging for resectability of liver lesions in colorectal cancer: An economic decision model', ANZ Journal of Surgery, vol. 88, no. 6, pp. E507-E511.View/Download from: Publisher's site
Saing, S, Parkinson, B, Church, J & Goodall, S 2018, 'Cost effectiveness of a community delivered consultation to improve infant sleep problems and maternal well-being', vol. Value in Health Regional Issues, no. 15, pp. 91-98.View/Download from: Publisher's site
Bagg, MK, Hübscher, M, Rabey, M, Wand, BM, O’Hagan, E, Moseley, L, Stanton, TR, Maher, CG, Goodall, S, Saing, S, O’Connell, NE, Luomajoki, H & McAuley, JH 2017, 'The RESOLVE Trial for people with Chronic Low Back Pain: Protocol for a randomised clinical trial', Journal of Physiotherapy, vol. 63, no. 1, pp. 47-48.
Nerich, V, Saing, S, Gamper, E-M, Holzner, B, Pivot, X, Viney, R & Kemmler, G 2017, 'Critical appraisal of health-state utility values used in breast cancer-related cost-utility analyses', BREAST CANCER RESEARCH AND TREATMENT, vol. 164, no. 3, pp. 527-536.View/Download from: Publisher's site
Nerich, V, Saing, S, Gamper, EM, Kemmler, G, Daval, F, Pivot, X & Holzer, B 2016, 'Cost-utility analyses of drug therapies in breast cancer: a systematic review', Breast Cancer Research and Treatment, vol. 159, no. 3, pp. 407-424.View/Download from: Publisher's site
The economic evaluation (EE) of health care products has become a necessity. Their quality must be high in order to trust the results and make informed decisions. While cost–utility analyses (CUAs) should be preferred to cost–effectiveness analyses in the oncology area, the quality of breast cancer (BC)-related CUA has been given little attention so far. Thus, firstly, a systematic review of published CUA related to drug therapies for BC, gene expression profiling, and HER2 status testing was performed. Secondly, the quality of selected CUA was assessed and the factors associated with a high-quality CUA identified. The systematic literature search was conducted in PubMed, MEDLINE/EMBASE, and Cochrane to identify published CUA between 2000 and 2014. After screening and data extraction, the quality of each selected CUA was assessed by two independent reviewers, using the checklist proposed by Drummond et al. The analysis of factors associated with a high-quality CUA (defined as a Drummond score ≥7) was performed using a two-step approach. Our systematic review was based on 140 CUAs and showed a wide variety of methodological approaches, including differences in the perspective adopted, the time horizon, measurement of cost and effectiveness, and more specially health-state utility values (HSUVs). The median Drummond score was 7 [range 3–10]. Only one in two of the CUA (n = 74) had a Drummond score ≥7, synonymous of “high quality.” The statistically significant predictors of a high-quality CUA were article with “gene expression profiling” topic (p = 0.001), consulting or pharmaceutical company as main location of first author (p = 0.004), and articles with both incremental cost–utility ratio and incremental cost–effectiveness ratio as outcomes of EE (p = 0.02). Our systematic review identified only 140 CUAs published over the past 15 years with one in two of high quality. It showed a wide variety of methodological approaches, especially focused on HSUVs. A critical ...
Saing, S, Haywood, P, Van Der Linden, N, Manipis, K, Meshcheriakova, O & Goodall, S 2019, 'Real world cost-effectiveness of mandatory folic acid fortification of bread making flour in Australia', 11th Health Services and Policy Research Conference, Auckland, New Zealand.
Saing, S, Van Der Linden, N, Hayward, C & Goodall, S 2019, 'Cost-effectiveness analysis of ventricular assist devices used as a bridge to transplant in patients with end-stage heart failure', 11th Health Services and Policy Research Conference, Auckland, New Zealand.
Mulhern, B, Norman, R, Street, D, Lancsar, E, Ratcliffe, J, Shah, K, Devlin, N, Meshcheriakova, O, Saing, S, Manipis, K, Addo, R, Nolasco, V, Brazier, J & Viney, R 2019, 'Valuing EQ-5D-5L: comparing the time trade off and discrete choice experiment valuation methods', 11th Meeting of the International Academy of Health Presference Research, Auckland, New Zealand.
Saing, S, van der Linden, N, Hayward, CS & Goodall, S 2018, 'COST-EFFECTIVENESS OF LEFT VENTRICULAR ASSIST DEVICES IN END STAGE HEART FAILURE USING STATE TRANSITION MODELLING BASED ON REGISTRY DATA', VALUE IN HEALTH, ELSEVIER SCIENCE INC, pp. S261-S261.View/Download from: Publisher's site
Flattery, M, Mulhern, B, Norman, R, Viney, R, Street, D, Feng, Y, Addo, R, Manipis, K, Meshcheriakova, O & Saing, S 2017, 'Valuing EQ-5D-5L in Australia using an adapted EQ-VT: Informing the further development of a revised valuation protocol', 34th EuroQol Plenary Meeting, Barcelona.
Saing, S 2017, 'Modelling the cost-effectiveness of strategies to treat end-stage heart failure using discrete event simulation [Conference presentation]', 10th Health Services and Policy Research Conference, Surfers Paradise.
Saing, S, Haywood, P & Goodall, S 2016, 'Cost effectiveness of contrast-enhanced liver MRI in the characterisation of suspected liver lesions in patients with colorectal cancer', ISPOR Asia-Pacific Conference, Singapore.
Saing, S, Haywood, P & Goodall, S 2016, 'Economic evaluation of contrast-enhanced liver MRI in the characterisation of suspected liver lesions', ISPOR Australia Chapter, Contemporary Economic Modelling: State of the Art, Sydney.
Saing, S, Kemmler, G, Gamper, EM, Daval, F, Holzner, B, Pivot, X, Viney, R & Nerich, V 2016, 'Cost-utility analyses of drug therapies in breast cancer: a systematic review and critical appraisal of health-state utility values', 38th Annual Australian Health Economics Society Conference, Australian Health Economics Society Conference, Perth.