Immunization is an important component of preventive healthcare services aiming to prevent and eventually eradicate infectious diseases by immunizing people before they become infected. Although immunization is an integral part of children's healthcare, this fact is underrated, even ignored in adults. In Turkey, adult immunization is available only for certain high risk groups such as health care professionals and populations aged > 65 y and under certain conditions including pregnancy, military service, travel-pilgrimage, and employment procedures. The fact that diseases such as pneumococcal pneumonia, influenza, rubeola, varicella, hepatitis A, and tetanus, which could be associated with severe complications in adults, are vaccine-preventable indicates the importance of adult immunization. In addition to the healthcare providers' knowledge about immunization, effective policies of related professional associations and the management of this issue by regulatory authorities, people's awareness in protecting their own health is of utmost importance in achieving the targeted level of adult immunization. This article focuses on the characteristics of the individuals as one of the 3 main cornerstones (individual, healthcare providers, regulatory authorities and supporting organizations) of immunization practices and discusses barriers to adult immunization and recommends solutions.
This study aimed to determine the economic burden and affecting factors in adult community-acquired pneumonia (CAP) patients (≥ 18 years) by retrospectively evaluating the data of 2 centers in Istanbul province, Turkey. Data of outpatients and inpatients with CAP from January 2013 through June 2014 were evaluated. The numbers of laboratory analyses, imaging, hospitalization days, and specialist visits were multiplied by the relevant unit costs and the costs of the relevant items per patient were obtained. Total medication costs were calculated according to the duration of use and dosage. The mean age was 61.56 ± 17.87 y for the inpatients (n = 211; 48.6% female) and 53.78 ± 17.46 y for the outpatients (n = 208; 46.4% male). The total mean cost was €556.09 ± 1,004.77 for the inpatients and €51.16 ± 40.92 for the outpatients. In the inpatients, laboratory, medication, and hospitalization costs and total cost were significantly higher in those ≥ 65 y than in those <65 y. Besides the hospitalization duration, specialist visit, imaging, laboratory, medication, and hospitalization costs and total cost were significantly higher in those hospitalized more than once than in those hospitalized once. While the specialist visit cost was higher in the inpatients with comorbidities, the imaging cost was higher in the outpatients with comorbidities. CAP poses a higher cost in inpatients, elders, and individuals with comorbidities. Costs can be decreased by rational decisions about hospitalization and antibiotic use according to the recommendations of guidelines and authorities. Vaccination may decrease medical burden and contribute to economy by preventing the disease, especially in risk groups.
Pneumococcal disease is responsible for significant morbidity and mortality. All over the world, 1.6 million people die of pneumococcal disease every year; this estimate includes the deaths of 1 million children aged less than 5 years and the deaths of 600.000- 800.000 adults. The burden of pneumococcal disease is high in adults. Increasing age and the presence of comorbidity has a significant affected of the risk of developing the disease. During mass gatherings, such as pilgrimage individuals, is exposed to severe community-acquired pneumococcal infections. Individuals who has Streptococcus pneumoniae in nasopharynx, have the potential to infection and leave exposed to the risk of pneumococcal disease the other Individuals with sneezing, coughing or out of breath, given breath through droplets of these microorganisms. In the present review, the relationship of pneumococcal disease in adults and pilgrimage, vaccination strategies will be considered and then during a visit to Pilgrimate and Umrah pilgrims against the current vaccine recommendations will be summarised.
A497 explore the cost implications of prescribing Ellipta portfolio in appropriate patients versus alternative therapies, in line with clinical guidelines. Methods: a one-year BIM was constructed to explore financial implications of prescribing Ellipta medicines as alternative treatment options to currently prescribed therapies. The BIM is based on UK prescription analysis, epidemiological and resource data. The BIM uses prescription data to generate patient cohorts and progresses them to more intensive therapy based on estimates of symptoms of exacerbation or breathlessness. It also considers medicines optimsation for patients that could benefit from simplified regimens and estimates the budget impact of moving patients using non-licensed ICS/ LABA to licensed therapies. The model allows definition of treatment progressions, using appropriate Ellipta devices to target bronchodilator or steroid based regimens. Costs are calculated using market share of current treatments vs. a scenario in which Ellipta medicines are used. Differences in patient outcomes, efficacy or safety are not explored. Results: It is estimated that the average health economy in the UK has 5,518 COPD patients of whom 1,320 are eligible to be progressed in their medication. In year 1, compared to a base case of utilising the most routinely used existing COPD therapies (100% implementation rate for new incident patients and 50% for all others) would increase spend by £247,830 compared with a reduced budget impact of -£131,920 if these eligible patients were moved to Ellipta medicines. ConClusions:The introduction of Ellipta portfolio in COPD could potentially reduce the budget impact and total spend on COPD therapies by £379,750 in the average UK health economy compared to current prescribing patterns. Funded by GSK PRS21 Budget ImPact analySIS Of fORmOteROl eaSyhaleR In the tReatment Of aSthma In chIldRen In the RuSSIan fedeRatIOnKulikov A, Kilimanova E objeCtives: To conduct the budget impact analysis of Formoterol Easyhaler, which allowed to determine the net economic effect of the budget impact in regards of replacement of one medicine to another. Methods: Information search was conducted in the public domain. Pharmacoeconomic analysis method -budget impact and direct cost analysis were performed. Results: In this study, given the pharmacoeconomic evaluation of drugs Formoterol Easyhaler, Oxis Turbuhaler, Foradil Aerolizer and Atimos. The study had a time horizon of one year. The daily dose of formoterol was 24 mcg. Cost analysis was conducted on the cost of basic pharmacotherapy, compensation costs for treatment of exacerbations, compensation costs for side effects and adverse reactions. The total direct cost per patient with asthma amounted to 1 262, 17$ to the Easyhaler group, 1 581, 83$ to the Turbuhaler group, 1 498,95 and 1 499,99 to the Foradil (30 and 60 doses), and 1 705, 06$ to the Atimos. The selection of budget impact method of pharmacoeconomic analysis was determined by the advantages of Formoterol Easyhaler in terms of its eff...
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