SUMMARYThe aim of the study is to estimate the pension costs incurred for patients with musculoskeletal disorders (MDs) and specifi cally with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in Italy between 2009 and 2012. We analyzed the database of the Italian National Social Security Institute (Istituto Nazionale Previdenza Sociale i.e. INPS) to estimate the total costs of three types of social security benefi ts granted to patients with MDs, RA and AS: disability benefi ts (for people with reduced working ability), disability pensions (for people who cannot qualify as workers) and incapacity pensions (for people without working ability). We developed a probabilistic model with a Monte Carlo simulation to estimate the total costs for each type of benefi t associated with MDs, RA and AS. We also estimated the productivity loss resulting from RA in 2013. From 2009 to 2012 about 393 thousand treatments were paid for a total of approximately €2.7 billion. The annual number of treatments was on average 98 thousand and cost in total €674 million per year. In particular, the total pension burden was about €99 million for RA and €26 million for AS. The productivity loss for AR in 2013 was equal to €707,425,191 due to 9,174,221 working days lost. Our study is the fi rst to estimate the burden of social security pensions for MDs based on data of both approved claims and benefi ts paid by the national security system. From 2009 to 2012, in Italy, the highest indirect costs were associated with disability pensions (54% of the total indirect cost), followed by disability benefi ts (44.1% of cost) and incapacity pensions (1.8% of cost). In conclusion, MDs are chronic and highly debilitating diseases with a strong female predominance and very signifi cant economic and social costs that are set to increase due to the aging of the population.
A377235 U (108)/200 U (100-440) was injected. Based on a BoNT-A injection interval of 12 weeks, the annual cost per patient in the UK would be 1,068 GBP for abobotulinum-toxinA, 1,198 GBP for onabotulinumtoxinA and 1,399 GBP for incobotulinumtox-inA. ConClusions: Considering the real life practice of BoNT-A injections and the comparison of treatment groups treated for the same limb segment, this analysis suggests that the use of abobotulinumtoxinA would result potentially in a reduction in the health care cost for the treatment of spasticity and that more patients could be treated with abobotulinumtoxinA with a given budget.
Outpatients with CLBP who received at least one acupuncture session in a Korean Medicine clinic during the study period were included and followed up for 3 months. All patients received regular acupuncture treatments in accordance with the doctors' discretion. The clinical effects were measured by condition-specific outcomes and preference-based outcome. In terms of cost analysis, the cumulative resource use for direct medical costs at each research clinic during the study period and direct patient data using the self-reported health care utilization questionnaires were used. Results: A total of 105 patients were finally analyzed. Significant improvements in condition-specific and preference-based measures were observed after acupuncture treatment. An average of approximately $134 per patient was reported for direct medical costs in each clinic for one month (8.5 sessions) and $213 for three months (13.5 sessions). Other medical expenses related to CLBP were reduced during this period. ConClusions: Acupuncture to manage CLBP in general clinical practice in Korea, inexpensively improved pain, functional disability, and quality of life. The study results are meaningful and consistent with the results of previous randomized controlled trials performed in other European countries. A large-scale prospective cohort or registry based on practice may be helpful to strengthen the evidence of the cost-effectiveness of acupuncture.
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