This study discusses two main questions: the direct medical costs and the clinical effectiveness of the hospital treatment with insulin of pregnant women with gestational diabetes (GD). A prospective study that includes 50 women with GD is performed. The pregnant women are divided into 2 groups: Group I (n=30) - pregnant women treated only with a diet; and Group II (n=20) - pregnant women treated with diet and insulin. We found that the metabolite compensation degree is improved after the applied treatment with insulin. The coefficient cost/effectiveness is 6954 lv./100 women. The analysis decision tree confirms in a very convenient way the fact that insulin treatment is a clinically more effective and financially more profitable strategy.
Introduction: The concept "Pharmaceutical care" is a new philosophy for Bulgarian community pharmacy practice. Beginning in 2000, a new course in pharmaceutical care was introduced in the curriculum of the Faculty of Pharmacy, Sofia, Bulgaria. Later its status changed from free to compulsory and was included in the National Education regulation for higher pharmaceutical education. The newly graduated pharmacists are making their first attempts to introduce this knowledge into practice.Aim: This study was designed to evaluate two criteria; the applicability of pharmaceutical care standards to Bulgarian pharmacies and their importance for the patient.Results: The results from two questionnaires show that practicing pharmacists appraise the pharmaceutical care standards for pharmacy practice as applicable and are interested in applying these standards if a legal regulation is introduced.Conclusion: Pharmacists are better prepared to implement pharmaceutical care practice and standards in Bulgarian community pharmacy.
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Endovascular coil treatment is used as an alternative to clipping in cerebral aneurysms. The aim of this study was to compare endovascular treatment versus surgical clipping by cost-effectiveness аnd cost-utility analyses on the basis of the decision-tree modeling. The study included patients with cerebral aneurysms and was conducted from November 2010 to November 2011. Of 124 patients 90 underwent surgical clipping, whereas 34 were treated via coiling. The clinical outcome at 6 months according to Glasgow Outcome Scale (GOS) and cost of treatment were evaluated in both groups. Health conditioned quality of life for the first year was assessed in 106 patients using EuroQoL 5D5L. 91.2% of coiled patients and 81.1% of surgical treated patients were in GOS 4 and 5. The average cost for the patients undergoing endovascular treatment of aneurysms was 19856 BGL, while the average cost of surgical clipping was 11480 BGL. QALY was 0.844 for 27 coiled patients, and it was 0.737 for 79 surgical treated patients. There was no significant difference in clinical outcome at 6 months and in QALY for the first year after treatment. Patients with coiled cerebral aneurysms had higher procedure prices and costs of consumables than patients treated by clipping. В.Георгієва -хірург відділення нейрохірургії Університетської клініки «Софіамед» (м. Софія, Болгарія) Зл.Димитрова -доктор фарм. наук, професор факультету хімії та фармації Софійського університету ім. Св. Климента Охридського К.Петкова -канд. фарм. наук, доцент Пловдивського медичного університету
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