BackgroundCurrent asthma management guidelines are based on the level of asthma control. The impact of asthma control on health care resources and quality of life (QoL) is insufficiently studied. EUCOAST study was designed to describe costs and QoL in adult patients according to level of asthma control in France and Spain.MethodsAn observational cost of illness study was conducted simultaneously in both countries among patients age greater or equal to 18 with a diagnosis of asthma for at least 12 months. Patients were recruited prospectively by GPs in 2010 in four waves to avoid a seasonal bias. Health care resources utilization of the three months before the inclusion was collected through physician questionnaires. Asthma control was evaluated using 2009 GINA criteria over a 3-month period. QoL was assessed using EQ-5D-3L®.Results2,671 patients (France: 1,154; Spain: 1,517) were enrolled. Asthma was controlled in 40.6% [95% CI: 37.7% - 43.4%] and 29.9% [95% CI: 27.6% - 32.3%] of French and Spanish patients respectively.For all types of costs, the percentage of patients using health care resources varied significantly according to the level of asthma control. The average cost (euros/3-months/patient) of controlled asthma was €85.4 (SD: 153.5) in France compared with €314.0 (SD: 2,160.4) for partially controlled asthma and €537.9 (SD: 2,355.7) for uncontrolled asthma (p<0.0001). In Spain, the corresponding figures were €152.6 (SD: 162.1), €241.2 (SD: 266.8), and €556.8 (SD: 762.4). EQ-5D-3L® score was higher (p<0.0001) in patients with controlled asthma compared to partially controlled and uncontrolled asthma in both countries (respectively 0.88; 0.78; 0.63 in France and 0.89; 0.82; 0.69 in Spain).ConclusionsIn both countries, patients presenting with uncontrolled asthma had a significantly higher asthma costs and lower scores of Qol compared to the others.

The total cost of AR for society is considerable. Greater frequency of symptoms and more severe AR are associated with higher costs. Indirect costs are almost threefold direct costs, especially in presenteeism. A reduction in presenteeism would generate considerable savings for society.

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This paper estimates medical resource use, direct costs, and productivity losses and costs (indirect costs) during episodes of acute otitis media (AOM) in young children. A 24-item Internet questionnaire was developed for parents in Belgium (Flanders), France, Germany, Italy, The Netherlands, Spain, and the United Kingdom (UK) to report health care resource use and productivity losses during the most recent episode of AOM in their child, younger than 5 years. The percentage who did not seek medical help for AOM was considerable inThe Netherlands (28.3%) and the UK (19.7%). Antibiotic use was high, ranging from 60.8%(Germany) to 87.1% (Italy). Total costs per AOM episode ranged from €332.00 (The Netherlands) to €752.49 (UK). Losses in productivity accounted for 61% (France) to 83% (Germany) of the total costs. AOM poses a significant medical and economic burden to society. Keywords: acute otitis media, direct costs, indirect costsAbbreviated Article Title: Burden of acute otitis media in seven EU countries 3 INTRODUCTIONOtitis media is one of the most common diseases in early infancy and childhood. A diagnosis of acute otitis media (AOM) requires a history of acute onset of signs and symptoms of middle-ear inflammation. [1, 2] Otitis media with effusion (OME) is defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection; OME frequently follows AOM.[2, 3] AOM does not usually lead to any measurable long-term consequences.In about 90% of cases in children older than 2 years, the worst symptoms subside within 3 days (range 27 days) [2,4]; in about 40% to 60% of cases in children younger than 2 years, the worst symptoms subside within 3 days.[5] However, long-term consequences of AOM can occur; OME is the most common cause of acquired hearing loss in childhood. OME also has been associated with delayed language development and behavioral problems.[6]The incidence of AOM peaks between the ages of 6 and 11 months.[2] In Europe, Germany and The Netherlands have reported a cumulative prevalence of 35% by the age of 2 years, [7] based on prospective birth cohorts. By the age of 3 years, 50% to 85% of children will have had at least one episode of AOM.[2] In Spain, 60% of 4-year-olds will have had AOM, based on a retrospective cohort study among pediatricians.[8] Recurrent AOM (≥ 4 episodes per year) is common, affecting up to 20% of children younger than 1 year; up to 40% of older children eventually have six or more episodes in total.[2]Although guidelines on the treatment of AOM differ between countries, the current consensus is that in most patients aged 2 years and older, symptomatic treatment (e.g., analgesics) is sufficient, [9, 10] For most countries, data are lacking on the use of medical resources for AOM, including the proportion of cases not seeking medical care. In addition, data are not available to estimate the impact of AOM on other direct and indirect costs. It is highly likely that parents of children with AOM, both those who do and those who do not seek...

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As a treatment option for refractory idiopathic OAB, at 10 years, SNM provides a considerable possibility of symptom and quality-of-life improvement and is cost-effective compared to BoNT-A or continued OMT.

According to the efficiency thresholds for oncology patients in developed countries, sunitinib is considered cost-effective vs. BSC with acceptable costs per LY and QALY gained.