Parkinson’s disease (PD) is a complex progressive movement disorder leading to motor and non-motor symptoms that become increasingly debilitating as the disease advances, considerably reducing quality of life. Advanced treatment options include deep brain stimulation (DBS). While clinical effectiveness of DBS has been demonstrated in a number of randomised controlled trials (RCT), evidence on cost-effectiveness is limited. The cost-effectiveness of DBS combined with BMT, versus BMT alone, was evaluated from a UK payer perspective. Individual patient-level data on the effect of DBS on PD symptom progression from a large 6-month RCT were used to develop a Markov model representing clinical progression and capture treatment effect and costs. A 5-year time horizon was used, and an incremental cost-effectiveness ratio (ICER) was calculated in terms of cost per quality-adjusted life-years (QALY) and uncertainty assessed in deterministic sensitivity analyses. Total discounted costs in the DBS and BMT groups over 5 years were £68,970 and £48,243, respectively, with QALYs of 2.21 and 1.21, giving an incremental cost-effectiveness ratio of £20,678 per QALY gained. Utility weights in each health state and costs of on-going medication appear to be the key drivers of uncertainty in the model. The results suggest that DBS is a cost-effective intervention in patients with advanced PD who are eligible for surgery, providing good value for money to health care payers.

The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.

Different inhaled corticosteroids can be used to treat asthma but their relative efficacy on quality of life and relative economic impact are mostly unknown. A decision model compared the cost-utility of beclomethasone, beclomethasone-extrafine, fluticasone and budesonide in adult patients with either moderate or severe persistent asthma. The patients' health state was described by the Asthma Symptom Utility Index. Patients' consumption of healthcare resources, according to the health state, was elicited by a Delphi Panel. Within 2 months, beclomethasone-extrafine prolonged quality-adjusted life by 0.5-2.3 days, as compared with the other inhaled corticosteroids, and reduced asthma-related per patient costs by euro12-67.

Costs of ISS and subsequent reoperations have a significant impact on health insurances budgets. The annual cost of reoperations exceeds the direct cost of the primary surgery driven by the need for further inpatient and outpatient care.

The aim of this research is to assess the humanistic and economic burden of focal drug-refractory epilepsy in Europe. MethOds: A PubMed literature review was performed to identify publications from January 2004 to December 2014 on prevalence and incidence, impact on quality of life and associated costs of epilepsy. Results: In Europe around 6 million people have epilepsy, with 30-45% of patients being drug-refractory and 70% of those having focal drug-refractory epilepsy. The prevalence and incidence rate of epilepsy is 457 and 43.87 per 100.000 persons, respectively. Epilepsy is associated with psychiatric comorbidities, chronic somatic conditions, significantly lower quality of life and 2-11 times higher all-cause mortality than the general population. In 2004 health care expenditures for the treatment of epilepsy accounted for 0.2% of the total European national income and the annual cost per patient varied from € 2.000 to € 11.500. In 2010, the yearly cost of epilepsy ranged from € 13.8 to € 20 billion. The cost of epilepsy depends on the severity and frequency of seizures and if patients are drug-refractory (20% to 40% of drug-refractory patients account for 80% of the costs). The main cost drivers of epilepsy treatment are hospitalizations, antiepileptic drug costs and indirect costs (due to high unemployment rate; 46% compared with 19% for the matched control population). Standard therapy for drug-refractory focal epilepsy is open surgery which is highly effective but also highly invasive and requires strict screening criteria. Minimally invasive surgical techniques are an alternative to open surgery and have shown promising clinical benefits with lower neurological impairment and less hospital stays compared with open surgery. cOnclusiOns: This data highlights the high humanistic and economic burden of focal drug-refractory epilepsy in Europe, and the need for new procedures to improve health outcomes and reduce health care resource utilization.