The objective of this study was to evaluate the clinical effectiveness and cost-effectiveness of oral-health promotion programs (OHPPs) aiming to improve children’s knowledge of favorable oral health behavior to lower decayed/-missing/-filled teeth (DMFT) while reducing the financial cost on health institutions. An electronic search was performed in seven databases. Studies were restricted to human interventions published in English. The search study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the risk of bias was assessed based on the Drummonds Checklist. A total of 1072 references were found. Among these, 19 full texts were included. Most studies had a strong quality. The overall pooled impact of OHPPs estimates children suffering from DMFT/S to have 81% lower odds of participating in OHPP (95% CI 61–90%, I2: 98.3%, p = 0). Furthermore, the program was shown to be effective at lowering the cost in 97 out of 100 OHPPs (95% CI 89–99%, I2: 99%, p = 0). Three subgroups analyses (age groups, study countries, studies of the last five years) were performed to evaluate the influence modification on the pooled effect. A comprehensive analysis of the OHPPs confirmed a reduction effect on child DMFT, hence, lowering the financial burden of dental-care treatment on health institutions.

No abstract

Background Smoking cessation pharmacotherapies (SCPs) have been established as cost-effective for the treatment of tobacco use disorder across a variety of settings. In Jordan, a resource-constrained country where smoking rates rank at one of the highest globally, the cost-effectiveness of SCPs has not yet been quantified. The lack of information about the value of SCPs has contributed to low demand for them (from public and private payers) and consequently low availability of these medications. The aim of this study was to simulate—in a hypothetical cohort of Jordanian smokers—the clinical and economic impact of using two smoking cessation regimens and to generate cost-effectiveness values that can support policy changes to avail smoking cessation medication in a country burdened with heavy tobacco use. Methods We employed a similar approach to a widely used economic model, the Benefits of Smoking Cessation on Outcomes (BENESCO) model. A hypothetical cohort of Jordanian male smokers aged 30 to 70 years and making a quit attempt using either a varenicline regimen or a nicotine replacement therapy (NRT) regimen were followed over time (until reaching 70 years of age). Markov simulations were run for the cohort, and life years gained were computed for each arm (compared to no intervention). Drug costs, prevalence of smoking, and population life expectancies were based on Jordanian data. Efficacy data were obtained from the literature. Incremental cost-effectiveness ratios as well as the potential budgetary impact of employing these regimens were generated. Several parameters were modified in sensitivity analyses to capture potential challenges unique to Jordan and that could impact the results. Results For a treatment cohort of 527,118 Jordanian male smokers who intended to quit, 103,970 life years were gained using the varenicline regimen, while 64,030 life years were gained using the NRT regimen (compared to the no-intervention arm of life years). The cost per life year gained was JD1204 ($1696 USD) and JD1342 ($1890 USD) for varenicline and NRT, respectively.

This paper compares a homogeneous group of countries in terms of capacity and technology, where we picked income as indicator for capacity and technology. We study the case of the Hashemite Kingdom of Jordan. We apply radical data envelopment analysis to 36 middle income countries where we calculate constant returns to scale technical efficiency and variable returns to scale technical efficiency to show the health care sector efficiency in Jordan. Using different factors for input first we studied healthcare expenditure per capita then as percent of GDP and public expenditure as percent of GDP and private as percent of GDP, and last was the number of beds per 1000 population and physicians per 1000 population all to the same output life expectancy. The results show that there is inefficiency in health care expenditure. The inefficiency mainly is shown by two major findings, first the lack of utilization of resources. Secondly, the public-sector inefficiency. The output is justifiable for many challenges faced the health sector in the year of the study one of which is the Syrian refuges crisis. We shed light on factors causing the inefficiency where modifications could yield substantial efficiency gains. As for the mix between public and private sectors and the quality and utilization and distribution of the real resources, nevertheless adding health economists to the management staff for there is a managerial inefficiency.

Background: Rate of nonadherence to antiepileptic drugs (AEDs) in children is about 33%. Engaging clinical pharmacists in the management of patients has proved to increase adherence to medications which will improve the outcomes of treatment. Objectives: To investigate the effect of a clinical pharmacist-led education on the adherence to AEDs in pediatric patients with epilepsy. Secondary outcomes include effectiveness and safety of AEDs, satisfaction with information about AEDs provided to the caregivers, and patients quality of life (QoL). Methods: This was an interventional study where pediatric patients were randomly assigned to the intervention (n = 41) or the control (n = 40) group. A 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the first group as add-on to standard medical care received by latter. Outcomes were measured at baseline and after 8-week follow-up. Results: The intervention group had an increase in mean adherence score from 6 ± 1.09 at baseline to 7.6 ± 0.9 at follow-up ( P value < 0.001), while the control group had no significant change ( P value > 0.05), the difference between the 2 groups at follow-up was significant ( P value < 0.0001). No significant difference was observed between groups at follow-up with regard to effectiveness ( P value > 0.05), and safety ( P value = 0.08). While higher satisfaction with information ( P value < 0.0001), and higher QoL ( P value < 0.05) was observed in the intervention group. Conclusion and relevance: Clinical pharmacist-led education had a positive outcome on pediatric patients with epilepsy with regard to adherence, effectiveness, safety, satisfaction with information about AEDs, and QoL.

Background: Smoking is a major cause globally of morbidity and mortality hence life years lost, this issue manifested in 399 Million Jordanian dinars (JD)($562.3 million USD) lost yearly due to productivity lost as a consequence of smoking in Jordan1. It is no surprise that quitting smoking will reduce the loss in life years and hence productivity. In this study, using cohort simulation, we want to quantify the gains in productivity from smoking cessation aids usage for one course of smoking cessation aid varenicline or nicotine replacement therapy in comparison to physician counseling only without pharmacological therapy, in the population that intends to quit at a point of time, through campaigns nationwide, among the working-age population followed up until retirement. Methodology: We present a transparent, generic model based on accepted analytic methods that allow users to assess the present value of lifetime earnings gained (PVLE) in smokers who intend to quit. It is shown in previous studies that smoking cessation aids are cost-effective in Jordan (Madae’en et al. 2020), yet the benefit of using smoking cessation aids goes further to reduce productivity loss by reducing life years lost. Our model incorporates life-years gained from the Markov Model in Madae’en et al. (2020), simulation of Jordanian male smokers’ cohort in three scenarios of either using varenicline or nicotine replacement therapy or only physician consultation, to estimate life-years gained and hence reduction in lost productivity costs. Results: We found productivity loss was reduced in males who attempted to quit in their productive years. Using Varenicline, the researchers calculated the expected future payments (wages) count for years gained due to varenicline use for a wage average of 507 JDs ($714.5 USD) per month discounted by 8% for the rest of their productive life. As well as for the other two scenarios, the gained productivity from one course of varenicline to the male adults over 30 who intend to quit will reduce loss by more than 72 billion JDs ($101.42 billion USD) among the working-age population followed up until retirement. Conclusion: policy change must be approached to reimbursement of smoking cessation aid in the Jordanian formulary.