A195in a hypothetical ten-million member health plan over a 3-year horizon. Estimates of plan cancer rates and utilization of HEC and MEC therapies were derived from epidemiological and market data. Treatment costs were computed using standard prescribing dosages, U.S. drug cost listings and simple reimbursement and dispensing assumptions. Uptake of NEPA was calculated at 5% a year for 3 years, and competing antiemetic therapies were reduced proportionately based on initial share assumptions. RESULTS: A total of 54,000 patients with cancer were identified in the model scenario. Of these, 9,882 (18.3%) would receive HEC and 3,949 (7.3%) would receive MEC requiring combination therapy, for a total of 13,830 eligible for NEPA. Cost of CINV prevention prior to the adoption of NEPA was estimated at $40.96 million. Following adoption of NEPA, cumulative costs were reduced by nearly $652K by the end of year 3. Calculations using PMPM estimates showed cumulative savings of $0.002 in year 1, $0.004 in year 2, and $0.005 in year 3. CONCLUSIONS: Results of the model indicate that adoption of NEPA for the prevention of CINV may have a relatively neutral impact on a U.S. health plan budget. Additionally, these estimates do not include savings from a potential reduction in the overall rate of CINV.
(2020): Costeffectiveness analysis of replacing the 10-valent pneumococcal conjugate vaccine (PCV10) with the 13-valent pneumococcal conjugate vaccine (PCV13) in Brazil infants, Human Vaccines & Immunotherapeutics,
Our findings indicate that local ASCs protected the bronchial stump after pneumonectomy and induced local changes in gene expression related to their protective action. These results could lead to a potential new therapeutic modality for the prevention of BPF.
It is estimated that the prevalence of moderate-to-severe SA (apnoeahypopnoea index > 15/h) is 10%. Approximately 11% of SA patients have comorbid COPD, which worsens sleep quality and desaturations. This study investigated the effects of PAP therapy on all-cause mortality and cost of illness (COI) in patients with SA and COPD in Germany. A statutory health insurance (SHI) perspective was taken. Methods: A total of > 4 million individuals covered by the SHI database were analysed (≈5% of the German SHI population). PAP therapy was initiated in 4,068 patients with SA (PAP group). Propensity score matching was used to define a control group (CG) of 4,068 SA patients matched for age, sex, risk factors/aetiology, region and medication who received usual care (no PAP). Of these, 1,300 patients in the PAP group and 1,192 patients in the CG had comorbid COPD. This subgroup of patients was followed for 3 years after initiation of PAP therapy. Results: Total COI was higher in the PAP group versus CG in the first year of follow-up (€ 8,697 vs € 6,999, p< 0.0001). However, during the second and third year the difference in COI between the PAP and CG was smaller (year 2: € 7,340 vs € 7,316, p< 0.0048; year 3: € 6,847 vs € 6,714, p< 0.001). PAP recipients had a significantly lower 3-year mortality rate compared with CG (8.2% vs 11.7%, p< 0.001; relative risk reduction 30.1%). ConClusions: SA patients with COPD treated with PAP showed significantly reduced mortality and morbidity. Total COI was higher in PAP recipients versus CG over the first 3 years of follow-up, but the difference between groups decreased over time. A follow-up period of ≥ 5 years may be required to show beneficial economic outcomes in SA patients receiving PAP therapy.
A407patients received medical services to the value of 927 million Euro or 14.2% of total reimbursed lump-sums (6.53 billion Euros) in Austria. 224 million Euros fall upon medical tumour therapy. With regard to monoclonal antibody therapies, 56 million Euros was refunded. ConClusions: The current development in modern cancer therapies leads to efficient treatment pathways expressed in higher survival rates, reduced hospital days and an improved quality-of-life.
direct and indirect costs of patients with AF-related stroke in China, producing an average cost per patient per year and the economic burden of the whole AFrelated stroke Chinese population. METHODS: A cost-of-illness analyses was performed. Prevalence data on AF-related stroke for the Chinese population was collected from literatures. An observational retrospective study was conducted to collect the economic data. We recruited 156 patients diagnosed with AF and stroke in Beijing, Shanghai and Guangzhou between October 2012 and December 2012. Patients or their carers were interviewed about resource utilization and absenteeism from work in the past year. Direct medical costs included outpatient visit, hospitalization, ambulatory, drug, diagnostic tests, and physiotherapy costs. Indirect costs were estimated using a human capital approach. All costs referred to 2011. RESULTS: Among 156 patients with AFrelated stroke, 59.35% were male and the mean age was 67.9±30.2 years. 98.0% patients have at least one kind of health insurance. From the societal perspective, total costs per patient over 1 year amounted to Chinese Yuan (CNY) 25538 (median: CNY13342, IQR: CNY7662-CNY 38714), with direct costs accounting for 94.2% and indirect costs for 5.8% of the total. And for the direct costs, the informal care costs were CNY9162. The drug costs were CNY6293. Based on the prevalence of AF and AF-related stroke in China from literatures, there was about 0.968 million patients of AF-related stroke. Costs for the nation are estimated at CNY24.7 billion per year. CONCLUSIONS: The economic burden of AF-related stroke in China is considerable. The primary burden on patients was due to informal care and drugs.
RESUMOO câncer de pulmão é considerado uma das principais causas de morte por câncer no Brasil e no mundo. Entre os principais tipos de câncer de pulmão, o tipo não-pequenas células corresponde a aproximadamente 85% dos casos da doença. Sua alta mortalidade pode ser atribuída ao diagnós-tico tardio, sendo a maioria dos pacientes diagnosticada com a doença em estádios avançados. O manejo do câncer de pulmão não-pequenas células exige a utilização intensiva de cuidados, além da abordagem multidisciplinar no diagnóstico, tratamento e reabilitação, que em um cenário de recursos finitos, gera importante custo de oportunidade para o sistema de saúde brasileiro em relação à oferta de recursos na assistência oncológica. Assim, o objetivo do presente estudo foi descrever o impacto que o câncer de pulmão não-pequenas células promove na sociedade brasileira, por meio de uma busca na literatura. ABSTRACTLung cancer is considered the major cause of death due to cancer in Brazil and worldwide. Among the main types of lung cancer, non-small cell lung cancer corresponds to approximately 85% of cases of the disease. The high mortality can be attributed to the late diagnosis once most of the patients are diagnosed when the disease is at an advanced stage. Non-small cell lung cancer management requires an intensive use of cares, besides multidisciplinary approach at diagnoses, treatment and rehabilitation, what in a finite resources set, bring relevant opportunity cost to health system about resource offer in oncologic assistance. Therefore, the aim of this study was to describe the impact that non-small cell lung cancer promotes in Brazilian society, through literature search.
OBJECTIVES: Depression is a major health problem. Previous studies on the cost of depression have mainly taken a primary care perspective. Such studies do not include all patients with depression, and should be completed by cost estimates from psychiatric care. The objectives of this study were to estimate the annual societal cost of depression per patient in psychiatric care in Sweden, and to relate costs to disease severity, depressive episodes, hospitalization, and patient functioning. METHODS: Retrospective resource use data in inpatient and outpatient care for 2006-2008, as well as ICD-10 diagnoses and Global Assessment of Functioning (GAF), were obtained from Northern Stockholm psychiatric clinic with a catchment area including 47% of the adult inhabitants in Stockholm city. This data set was combined with national register data on prescription pharmaceuticals and sick leave to estimate the societal cost of depression. RESULTS: The study included 10,593 patients (63% women). The average annual societal cost per patient was around USD 21,000 in 2006-2008. The largest cost item was indirect costs due to productivity losses (89%), and the second largest was outpatient care (6%). Patients with mild, moderate or severe depression had an average cost of approximately USD 18,000, USD 21,000, and USD 29,000, respectively. Total costs were significantly higher during depressive episodes, for patients with co-morbid psychosis or anxiety, for hospitalized patients, and for patients with low GAF scores. CONCLUSIONS:The largest share of societal costs for patients with depression in psychiatric care is indirect. The total costs were higher than previously reported from a primary care setting, and strongly related to hospitalization, episodes of active depression, and global functioning. This suggests that effective treatment and rehabilitation that avoid depressive episodes and hospitalization may not only improve patient health, but also reduce the societal cost of depression.
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