PP613 The Cost Analysis Of Subcutaneous And Intravenous Dosage Forms For Systemic Juvenile Idiopathic Arthritis Treatment In Ukraine

2020 ◽  
Vol 36 (S1) ◽  
pp. 44-44
Author(s):  
Alona Masheiko ◽  
Oresta Piniazhko ◽  
Iryna Romanenko ◽  
Mariya Leleka ◽  
Valeriia Serediuk
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cost Analysis ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Medical Costs ◽  
Dosage Forms ◽  
The State ◽  
Ministry Of Health ◽  
Direct Medical Costs ◽  
Costs Of Treatment ◽  
The Cost

IntroductionThe Health Technology Assessment (HTA) Department of the “State Expert Center of the Ministry of Health (MoH) of Ukraine” was established in 2019 for conducting assessments and development of recommendations for informing decisions for the Ministry of Health of Ukraine (MoH) regarding the financing of health technologies based on HTA. The study aimed to conduct cost analysis and compare the treatment costs of two available dosage forms of tocilizumab for subcutaneous and intravenous administration for systemic juvenile idiopathic arthritis in Ukraine. Currently there is a central procurement program financed by the state budget with pharmaceuticals provided to patients with juvenile idiopathic arthritis approved by the Cabinet of Ministers Decree of Ukraine №255 dated 13.03.2019.MethodsThe cost analysis was carried out for tocilizumab over a 1-year horizon per one patient. The analysis included drug manufacturers' prices from the registry of the MoH dated 19.09.2019. The annual number of tocilizumab vials for intravenous infusion for each weight category of patients is approved by the order MoH №334 from 14 February 2019. The direct medical costs were included in the analysis omitting cost of administration.ResultsThe direct medical costs of treatment with intravenous tocilizumab per one patient for one budgetary year ranged from between USD7,563.83 and USD30,255.30 depending on patient's weight that was in the range of 10–80 kg. The direct medical costs of treatment per one patient for one year with subcutaneous tocilizumab was USD7,782.40 for patients < 30 kg and USD15,564.80 for patients ≥ 30 kg.ConclusionsThe introduction of subcutaneous tocilizumab can potentially lead to cost savings on average USD 4,041.97 (34.2%) for patients < 30 kg and USD 5,245.82 (25.2%) for patients ≥ 30 kg per one patient for 1-year treatment compared to the intravenous route. Intravenous tocilizumab has an economic advantage over the subcutaneous route solely for the pediatric population of certain weight categories. The cost of intravenous tocilizumab was USD 218.58 lower (2.9%) for patients ≤ 13 kg and USD 2,320.25 lower (17.5%) for patients with weight 31–35 kg, compared to the cost of subcutaneous tocilizumab.

The Direct and Indirect Costs of Treating the Victims of the 2016 Nice Terror Attacks in a Single Pediatric Hospital

2021 ◽  
pp. 1-4
Author(s):  
Federico Solla ◽  
Eytan Ellenberg ◽  
Virginie Rampal ◽  
Julien Margaine ◽  
Charles Musoff ◽  
...  
Keyword(s):  
Indirect Costs ◽  
Medical Costs ◽  
Pediatric Hospital ◽  
Terror Attack ◽  
Direct And Indirect Costs ◽  
Terror Attacks ◽  
Direct Medical Costs ◽  
Annual Budget ◽  
The Difference ◽  
The Cost

Abstract Objective: To analyze the cost of the terror attack in Nice in a single pediatric institution. Methods: We carried out descriptive analyses of the data coming from the Lenval University Children’s Hospital of Nice database after the July 14, 2016 terror attack. The medical cost for each patient was estimated from the invoice that the hospital sent to public insurance. The indirect costs were calculated from the hospital’s accounting, as the items that were previously absent or the difference between costs in 2016 versus the previous year. Results: The costs total 1.56 million USD, corresponding to 2% of Lenval Hospital’s 2016 annual budget. Direct medical costs represented 9% of the total cost. The indirect costs were related to human resources (overtime, sick leave), revenue shortfall, and security and psychiatric reinforcement. Conclusion: Indirect costs had a greater impact than did direct medical costs. Examining the level and variety of direct and indirect costs will lead to a better understanding of the consequences of terror acts and to improved preparation for future attacks.

scholarly journals The trend of direct medical costs and associated factors in patients with chronic hepatitis B in Guangzhou, China: an eight-year retrospective cohort study

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Shuo Yang ◽  
Ge Chen ◽  
Yueping Li ◽  
Guanhai Li ◽  
Yingfang Liang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Medical Insurance ◽  
Medical Costs ◽  
Direct Medical Costs ◽  
B Virus ◽  
The Cost

Abstract Background Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the medical costs associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the problem, we investigated the trend of direct medical costs and associated factors in patients with chronic HBV infection. Methods A retrospective cohort study of 65,175 outpatients and 12,649 inpatients was conducted using a hospital information system database for the period from 2008 to 2015. Generalized estimating equations (GEE) were applied to explore associations between annual direct medical costs and corresponding factors, meanwhile quantile regression models were used to evaluate the effect of treatment modes on different quantiles of annual direct medical costs stratified by medical insurances. Results The direct medical costs increased with time, but the proportion of antiviral costs decreased with CHB progression. Antiviral costs accounted 54.61% of total direct medical costs for outpatients, but only 6.17% for inpatients. Non-antiviral medicine costs (46.06%) and lab tests costs (23.63%) accounted for the majority of the cost for inpatients. The direct medical costs were positively associated with CHB progression and hospitalization days in inpatients. The direct medical costs were the highest in outpatients with medical insurance and in inpatients with free medical service, and treatment modes had different effects on the direct medical costs in patients with and without medical insurance. Conclusions CHB patients had a heavy economic burden in Guangzhou, China, which increased over time, which were influenced by payment mode and treatment mode.

Direct medical costs of treatment in newly-diagnosed high-grade glioma among commercially insured US patients

2017 ◽  
Vol 20 (12) ◽  
pp. 1237-1243 ◽  
Author(s):  
Shan Jiang ◽  
Kala Hill ◽  
Dipen Patel ◽  
A. Reginald Waldeck ◽  
Marc Botteman ◽  
...  
Keyword(s):  
High Grade Glioma ◽  
Medical Costs ◽  
High Grade ◽  
Newly Diagnosed ◽  
Direct Medical Costs ◽  
Costs Of Treatment

Abstract 19839: Clinical and Economic Burden of Rheumatic Heart Disease in Low-Income Nations: Estimating the Cost-of-Illness in India and Uganda

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Alexander T Sandhu ◽  
Kathikeyan G ◽  
Ann Bolger ◽  
Emmy Okello ◽  
Dhruv S Kazi
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Cost Of Illness ◽  
Economic Burden ◽  
Indirect Costs ◽  
Medical Costs ◽  
Discrete State ◽  
Direct Medical Costs ◽  
The Cost ◽  
Rheumatic Heart

Introduction: Rheumatic heart disease (RHD) strikes young adults at their peak economic productivity. Defining the global economic burden of RHD may motivate investments in research and prevention, yet prior approaches considering only medical costs may have underestimated the cost of illness. Objectives: To estimate the clinical and economic burden of RHD in India and Uganda. Outcomes were disability-adjusted life years (DALYs), direct medical costs, and indirect costs due to disability and premature mortality (2012 USD). Methods: We used a discrete-state Markov model to simulate the natural history of RHD using country-, age-, and gender-specific estimates from the literature and census data. We estimated direct medical costs from WHO-CHOICE and Disease Control and Prevention 3 publications. We conservatively estimated indirect costs (lost earnings and imputed caregiver costs) from World Bank data using novel economic methods. Results: In 2012, RHD generated 6.1 million DALYs in India and cost USD 10.7 billion (Table 1), including 1.8 billion in direct medical costs and 8.9 billion in indirect costs. During the same period, RHD produced 216,000 DALYs in Uganda, and cost USD 414 million, and, as in India, indirect costs represented the majority (88%) of the cost of illness. In both countries, women accounted for the majority (71-80%) of the DALYs; in Uganda, women bore 75% of the total cost. In sensitivity analyses, higher progression rates for subclinical disease doubled direct costs and DALYs. Conclusion: RHD exacts an enormous toll on the populations of India and Uganda, and its economic burden may be grossly underestimated if indirect costs are not systematically included. Women bear a disproportionate clinical burden from pregnancy-related complications. These results suggest that effective prevention and screening of RHD may represent a sound public health investment, particularly if targeted at high-risk subgroups such as young women.

scholarly journals Economic Burden of Public Health Care Was Higher Than That of Hospitalization and Treatment Associated With COVID-19 in China

2020 ◽  
Author(s):  
Xiaohua Liang ◽  
Lun Xiao ◽  
Xue-Li Yang ◽  
Xue-Fei Zhong ◽  
Peng Zhang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
National Level ◽  
Emerging Infectious Diseases ◽  
Medical Costs ◽  
Public Health Care ◽  
Chinese Government ◽  
Direct Medical Costs ◽  
Epidemiological Surveys ◽  
The Cost

Abstract Background: During the coronavirus disease 2019 (COVID-19) pandemic, it is essential to evaluate the socioeconomic burden imposed on the Chinese health care system.Methods: We prospectively collected information from the Center for Disease Control and Prevention and the designated hospitals to determine the cost of public health care and hospitalization due to COVID-19. We estimated the resource use and direct medical costs per confirmed case and the costs associated with public health care per thousand people at the national level.Results: The average costs per case for specimen collection and nucleic acid testing (NAT) were $29.49 and $53.44, respectively, while the average cost of NAT for high-risk populations was $297.94 per capita. The average costs per thousand people for epidemiological surveys, disinfectant, health education and centralized isolation were $49.54, $247.01, $90.22 and $543.72, respectively. A single hospitalization for COVID-19 in China cost an average of $3,792.69 ($2,754.82-$5,393.76) in direct medical costs incurred only during hospitalization, while the total costs associated with hospitalization were estimated to have reached nearly $31,229.39 million in China as of 20 May 2020. The cost of public health care ($6.81 billion) was 20 times that of hospitalization.Conclusions: This study highlights the magnitude of resources needed to control the COVID-19 pandemic and treat COVID-19 cases. Public health measures implemented by the Chinese government have been valuable with regard to reducing the infection rate and may be cost-effective ways to control emerging infectious diseases.

Cost of lung cancer in East Azerbaijan province, in Iran, in 2017

2020 ◽  
Vol 14 (3) ◽  
pp. 461-470
Author(s):  
Habibeh Mir ◽  
Farshad Seyednejad ◽  
Habib Jalilian ◽  
Shirin Nosratnejad ◽  
Mahmood Yousefi
Keyword(s):  
Lung Cancer ◽  
Length Of Hospital Stay ◽  
Indirect Costs ◽  
Medical Costs ◽  
Content Type ◽  
Direct Medical Costs ◽  
Hospitalization Costs ◽  
Illness Study ◽  
East Azerbaijan ◽  
The Cost

Purpose Costs estimation is essential and important to resource allocation and prioritizing different interventions in the health system. The purpose of this paper is to estimate the costs of lung cancer in Iran, in 2017. Design/methodology/approach This was a prevalence-based cost of illness study with a bottom-up approach costing conducted from October 2016 to April 2017. The sample included 645 patients who referred to Imam Reza hospital, Tabriz, Iran, in 2017. Follow-up interviews were every two months. Hospitalization costs extracted from the patient’s record and outpatient costs, nondirect medical costs and indirect costs collected using questionnaire. SPSS software version 22 was used for the data analysis. Findings Mean direct medical costs, nondirect medical costs and indirect costs amounted to 36,637.02 ± 23,515.13 PPP (2016) (251,313,217.83 Rials), 2,025.25 ± 3,303.72 PPP (2016) (16,613,202.53 Rials) and 48,348.55 ± 34,371.84 PPP (2016) (396,599,494.56 Rials), respectively. There was a significant and negative correlation between direct medical costs, direct nonmedical costs, indirect costs and age at diagnosis, and there was a significant and positive correlation between the length of hospital stay and direct medical cost. Originality/value As the cost of lung cancer is substantial and there have been little studies in this area, the objective of this study is to investigate the cost of lung cancer and present ways to tackle this.

scholarly journals Cost–utility and budget impact analysis of tocilizumab for the treatment of refractory systemic juvenile idiopathic arthritis in Thailand

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037588
Author(s):  
Nitichen Kittiratchakool ◽  
Disorn Kulpokin ◽  
Chonticha Chanjam ◽  
Soamarat Vilaiyuk ◽  
Sirirat Charuvanij ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Standard Treatment ◽  
Budget Impact ◽  
Disease Onset ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Cost Effective ◽  
Medical Costs ◽  
Cost Utility ◽  
Base Case ◽  
Health State

ObjectivesThis study aimed to analyse the cost–utility and budget impact of adding tocilizumab to the standard treatment for patients with refractory systemic juvenile idiopathic arthritis (sJIA) in Thailand.DesignEconomic evaluation using a decision-analytical model.SettingThailand.ParticipantsPatients with refractory sJIA who were ≥2 years old.MethodsThe use of tocilizumab as an add-on therapy to standard treatment was compared with standard treatment alone. A simulated health state transition model was used to estimate the lifetime costs and health outcomes from a societal perspective. Direct medical costs were collected from tertiary hospital databases while direct non-medical costs were derived from interviews. Health-related quality of life (QoL) was measured using the proxy version of three-level EuroQol five-dimensional questionnaire (EQ-5D-3L). Future costs and outcomes were discounted at an annual rate of 3%. The base case population was patients aged 9.41 years old at refractory disease onset. The results were reported as incremental cost-effectiveness ratios (ICER) in US dollar (USD). One-way and probabilistic sensitivity analysis were conducted to investigate parameter uncertainty. The 5-year budget impact was estimated from a governmental perspective.ResultsThe ICER of standard treatment plus tocilizumab was US$35 799 per quality-adjusted life-year (QALY) gained compared with standard treatment alone, which was not cost-effective at the threshold of US$5128 per QALY gained. The estimated 5 years budget impact was approximately US$4.8 million.ConclusionsThe use of standard treatment plus tocilizumab was not cost-effective in the Thai context, which has limited data. However, there is currently no second-line treatment for refractory sJIA in the Thai National List of Essential Medicines; thus, patients must receive higher doses of standard treatment which can cause many side effects. In contrast, tocilizumab showed obvious efficacy in clinical trials in improving treatment response and QoL. Therefore, the price of tocilizumab should be negotiated to reduce the financial impact on the healthcare system.

scholarly journals Cost-analysis of Treatment of Patients with Acute Myeloid Leukemia

2021 ◽  
Vol 14 (8) ◽  
Author(s):  
Vahid Alipour ◽  
Soroush Rad ◽  
Fateme Mezginejad ◽  
Reza Jahangiri ◽  
Rafat Bagherzadeh ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Cost Analysis ◽  
Myeloid Leukemia ◽  
Descriptive Analysis ◽  
Medical Costs ◽  
Nonparametric Tests ◽  
Nursing Visit ◽  
Payer Perspective ◽  
The Cost ◽  
Acute Myeloid

Background: Acute myeloid leukemia (AML) is the second common leukemia (5.18%) and the third deadliest leukemia in Iran. Moreover, it is the fifth prevalent cancer in the world, which involves 8% of all cancers. Objectives: The aim of this study was to calculate direct medical and non-medical costs of AML in 2019. Methods: The present retrospective-descriptive analysis was conducted on 192 patients with AML aged 19 to 70 years from 2016 to 2018. The data were collected from hospital records and interviews with experts. The bottom-up micro-costing approach and payer perspective was considered for cost analysis status. The relationship of affective variables was investigated, using nonparametric tests, including Mann–Whitney and Kruskal–Wallis tests. Costs were divided into costs of diagnosis, hospitalization, medication, nursing, visit and consultation, operating room, and medical supplies. The data were described by mean ± standard deviation and reported by percentage and also analyzed by SPSS 11 software. Results: According to the findings, the average age of all patients was 43.91 years and 55.7% of the patients were male. The highest and the lowest diagnostic costs were associated with laboratory tests at $1656459.48 and ultrasound charges $4229.46, respectively. The total direct medical costs per patient were $1056624.78 with an average of $4846.90 and the cost of medication included 36% of the total costs. The direct medical and non-medical costs were $10485488.48 and $487522.87, respectively Conclusions: Costs of AML treatment were estimated to be $1056624.78. Finally, it can be concluded that the cost of AML in Iran is much cheaper than that compared to other countries and also due to hidden subsidies from the public sector, the payment from the patient's pocket is very small.

Cost effectiveness of whole breast IMRT for reduction of moist desquamation

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17004-17004 ◽  
Author(s):  
J. B. Strauss ◽  
S. S. Chen ◽  
A. T. Dickler ◽  
K. L. Griem
Keyword(s):  
Radiation Therapy ◽  
Cost Effectiveness ◽  
Marginal Cost ◽  
Cost Minimization ◽  
Medical Costs ◽  
Breast Size ◽  
Direct Medical Costs ◽  
Moist Desquamation ◽  
Breast Imrt ◽  
The Cost

17004 Background: Cost minimization studies have compared conventional whole breast radiation therapy (C-WBRT) to whole breast intensity modulated radiation therapy (IMRT). Consistently, IMRT has proved to be far more expensive. The weakness of cost minimization studies is that they assume the outcomes and toxicities of the treatment modalities in question are identical. Data from a case- control trial and a recent randomized controlled trial show that IMRT reduces the incidence of moist desquamation. We performed an analysis to estimate the cost effectiveness of breast IMRT to prevent moist desquamation. Methods: The direct medical costs of C-WBRT and IMRT were estimated using the 2006 Medicare Fee Schedule. We assumed rates of moist desquamation of 48 to 31% in accordance with Pignol, et al., ASTRO 2006. The cost effectiveness ratio (additional dollars spent per case of desquamation avoided) was calculated under two circumstances: 1) every patient received IMRT, or 2) only those patients destined to desquamate were treated with IMRT. Results: The direct medical costs of C-WBRT are $7,948 vs. $29,790 for IMRT. Thus, the marginal cost of IMRT is $22,142. In circumstance 1, the marginal cost to avoid one case of desquamation is $130,247. In circumstance 2, this cost is $62,518. Conclusions: The two circumstances described above are extremes that bound the range of cost estimates. Patient risk factors for desquamation, such as large breast size, can be used to identify high risk patients, obviating the need to treat all patients with IMRT. However, perfect prospective identification of all patients destined to desquamate is unlikely. Instead, the true marginal cost to avoid one case of moist desquamation will lie between $62,518 and $130,247. This cost may be too high to justify the benefit of reduced acute skin toxicity, but it is likely that the benefits of IMRT have been underestimated. IMRT may shorten the duration of moist desquamation. Late effects such as breast fibrosis and color variegation of the skin caused by desquamation as well as dose to the heart and lungs may be decreased by IMRT. If new data support these benefits, then IMRT may become a more cost effective option. No significant financial relationships to disclose.

scholarly journals The cost of systemic therapy for metastatic colorectal carcinoma in Slovenia: discrepancy analysis between cost and reimbursement

2015 ◽  
Vol 49 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Tanja Mesti ◽  
Biljana Mileva Boshkoska ◽  
Mitja Kos ◽  
Metka Tekavčič ◽  
Janja Ocvirk
Keyword(s):  
Health Insurance ◽  
Side Effects ◽  
Systemic Therapy ◽  
Medical Costs ◽  
Hospital Treatment ◽  
Cost Assessment ◽  
Actual Cost ◽  
Direct Medical Costs ◽  
The Difference ◽  
The Cost

AbstractBackground. The aim of the study was to estimate the direct medical costs of metastatic colorectal cancer (mCRC) treated at the Institute of Oncology Ljubljana and to question the healthcare payment system in Slovenia.Methods. Using an internal patient database, the costs of mCRC patients were estimated in 2009 by examining (1) mCRC direct medical related costs, and (2) the cost difference between payment received by Slovenian health insurance and actual mCRC costs. Costs were analysed in the treatment phase of the disease by assessing the direct medical costs of hospital treatment with systemic therapy together with hospital treatment of side effects, without assessing radiotherapy or surgical treatment. Follow-up costs, indirect medical costs, and nonmedical costs were not included.Results. A total of 209 mCRC patients met all eligibility criteria. The direct medical costs of mCRC hospitalization with systemic therapy in Slovenia for 2009 were estimated as the cost of medications (cost of systemic therapy + cost of drugs for premedication) + labor cost (the cost of carrying out systemic treatment) + cost of lab tests + cost of imaging tests + KRAS testing cost + cost of hospital treatment due to side effects of mCRC treatment, and amounted to €3,914,697. The difference between the cost paid by health insurance and actual costs, estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009, was €1,900,757.80.Conclusions. The costs paid to the Institute of Oncology Ljubljana by health insurance for treating mCRC with systemic therapy do not match the actual cost of treatment. In fact, the difference between the payment and the actual cost estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009 was €1,900,757.80. The model Australian Refined Diagnosis Related Groups (AR-DRG) for cost assessment in oncology being currently used is probably one of the reasons for the discrepancy between pay-outs and actual costs. We propose new method for more precise cost assessment in oncology.

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