Analysis of the management and costs of headache disorders in Spain during the period 2011–2016: a retrospective multicentre observational study

ObjectivesTo investigate the number and characteristics of the Spanish population affected by headache disorders and the direct medical cost that these patients represent for the healthcare system.DesignA retrospective multicentre observational study.SettingRecords from all patients admitted with headache in primary and secondary care centres in Spain between 2011 and 2016 that were registered in a Spanish claims database were included in the analysis. Direct medical costs were calculated using the standardised average expenses of medical procedures determined by the Spanish Ministry of Health.ResultsData extraction claimed primary care records from 636 722 patients and secondary care records from 30 077 patients. Women represented 63% and 65% of all patients with headache in primary and secondary care respectively, with the exception of cluster headaches, a group with 60% of male patients. No large shifts were observed over time in patients’ profile; contrarily, the number of cases per 10 000 patients attended in primary care increased 2-folds between 2011 and 2016 for migraine and 1.85-folds for other headaches. Migraine was the cause for 28% of primary care consultations and 50% of secondary care admissions, and it was responsible for the largest portion of healthcare costs in 2016, a total amount of € 7 302 718. The estimated annual direct medical cost of headache disorders was € 10 716 086.ConclusionsMigraine was responsible for half of the secondary care admissions linked to headache disorders. The raise detected in the number of cases registered in primary care is likely to impact the direct medical costs associated to these disorders causing an increase in the total burden they represent for the Spanish National Healthcare System.

Download Full-text

Economic Burden of Tuberculosis Diabetes Co-Morbidity in Tuberculosis Patients Attending Two Chest Clinics in Lagos State

Nigerian Journal of Pharmaceutical Research ◽

10.4314/njpr.v16i2.11s ◽

2021 ◽

Vol 16 (2) ◽

pp. 91-100

Author(s):

F.A. Ayeni ◽

O.O. Oyetunde ◽

B.A. Aina ◽

H.O. Yarah

Keyword(s):

Direct Medical Cost ◽

Medical Cost ◽

Indirect Costs ◽

Medical Costs ◽

Female Patients ◽

Direct Medical Costs ◽

Tb Treatment ◽

Co Morbidity ◽

Lagos State ◽

Significant Burden

Background: Diabetes mellitus (DM) increases the risk of developing tuberculosis (TB) three-fold. The cost of accessing care for TB-DM co-morbidity poses a significant burden on patients, as they bear both direct and indirect costs of treatment, mostly of out-of-pocket.Objective: To estimate the direct medical cost of illness in patients with TB-DM co-morbidity in two chest clinics in Lagos State.Materials and Methods: An observational study, carried out in two chest clinics in Lagos State to evaluate direct medical costs associated with TBDM co-morbidity during TB treatment. A semi structured questionnaire, pharmacy price list of drugs and an online transportation service lara.ng was employed to document and quantify prescribed medications, laboratory investigations, number of clinic attendance and attendant transportation costs.Results: Among the participants, 53.8% were females. The mean age was 50.7±9.7 years. The total direct medical and non-medical costs for TBDM management was NGN8,604,819 (USD24,585.20) for the duration of TB treatment. Average cost per patient (CPP) was NGN179,384.85 (USD512.53). This was equivalent to 49.8% of the current national minimum wage. Male patients incurred more mean direct medical cost than female patients (NGN26, 647.90 vs NGN24, 020.40), while female patients incurred more mean direct non-medical costs than the males (NGN22, 314.30 versus NGN13, 041.70). Patients aged 60 years and above incurred the highest mean direct costs compared to other age groups.Conclusion: Direct medical costs are substantial in TBDM co-morbidity and increase with age.

Download Full-text

Estimating the Direct Medical Cost of Syphilis in China

10.21203/rs.3.rs-845735/v1 ◽

2021 ◽

Author(s):

Hui Zi Gong ◽

Kui Ru Hu ◽

Jun Li ◽

Xia Wan ◽

He Yi Zheng

Keyword(s):

Direct Medical Cost ◽

Medical Cost ◽

Economic Burden ◽

Medical Costs ◽

Effective Control ◽

Western Region ◽

Eastern Region ◽

Relative Cost ◽

Direct Medical Costs ◽

The Absolute

Abstract Background Few studies investigating the direct medical cost of syphilis was conducted in developing countries, including China. Methods The main tasks of our study were to estimate the direct medical costs of syphilis in China at subnational level, and to characterize the distribution of the direct medical cost of syphilis in 31 Chinese provincial districts in relation to GDP. Data on medical expenses for syphilis patients diagnosed at Peking Union Medical College Hospital (PUMCH) was used to estimate direct medical cost per case, which was then multiplied by the number of newly reported cases of syphilis in China to yield the absolute medical cost for syphilis. Relative costs, defined as the absolute costs in per million of gross domestic product (GDP), was also calculated. Comparisons of direct medical cost represented as absolute cost and relative cost respectively, in different years and different provincial districts were conducted. Gini index was used to characterize the distribution of syphilis cases and direct medical cost of syphilis at provincial level. Results Average cost of patients with follow-up more than 36 month was regarded as the most reasonable estimate of direct medical cost per case, and was obtained as US $ 134.43 in primary syphilis, US $ 119.24 in secondary syphilis, US $ 503.76 in tertiary syphilis and US $ 97.59 in latent syphilis. Absolute medical cost of syphilis in China increased from US $ 11.15 million to US $46.89 million from 2004 to 2016. Relative cost in China increased from 2.85 to 5.26 per million of GDP from 2004 to 2010, and decreased from 5.26 to 3.99 per million of GDP from 2010 to 2016. The largest relative cost was always observed in western region. Between 2009 and 2016, a large relative medical cost was observed in 7 to 9 provinces in western region, 3 to 5 provinces in eastern region, 1 to 4 provinces in central region, 1 to 2 provinces in northeastern region. The level of inequality decreased from 2010 to 2016, and kept a continuously moderate equality from 2012 to 2016. Conclusion This study provided a rough estimate of the direct medical costs of syphilis in China and its distribution pattern in 31 Chinese provincial districts. The results highlight that syphilis caused a huge economic burden in China, which distributed disproportionally within provinces. Western region bore a huge and increasing economic burden, while the economic burden in eastern region had once been huge, but tending to decline. Thus, more active and effective control are needed, and strategies on the prevention and control of syphilis be managed according to local conditions.

Download Full-text

Treatment pattern and direct medical costs of pediatric outpatients with actuate respiratory infection at X hospital in Jambi

Jurnal Ilmiah Farmasi ◽

10.20885/jif.vol16.iss2.art10 ◽

2020 ◽

Vol 16 (2) ◽

pp. 196-203

Author(s):

Hendri Pranata ◽

Rasmaladewi Rasmaladewi ◽

Mukhlis Sanuddin

Keyword(s):

Direct Medical Cost ◽

Respiratory Infection ◽

Medical Cost ◽

Pediatric Patients ◽

Supportive Therapy ◽

Medical Costs ◽

Total Direct Medical Cost ◽

Direct Medical Costs ◽

Retrospective Data Collection ◽

Pediatric Outpatients

Introduction: Acute respiratory infection is common among the general public. Such disease and its associated symptoms encourage higher consumption of medicine. Varied medications for ARI patients incur different costs of each patient, which eventually lead to higher healthcare costs. Objectives: To identify the treatment patterns and direct medical costs among ARI pediatric patients at X Hospital in Jambi. Methods: This research was an observational study with retrospective data collection. The samples were collected in 2018. Results: The results showed that the most-frequently administered antibiotic for ARI pediatric patients was cefixime (29.17%), while the most-commonly used supportive therapy for ARI pediatric patients was the combination of antihistamines, antipyretics-analgesics, decongestant, and corticosteroid (16.67%). The total direct medical cost to ARI pediatric patients was IDR 191,097. Conclusion: The mean direct medical cost for ARI therapy was IDR 191,097. More administered therapy resulted in higher medical costs. Keywords: ARI, child, antibiotics, direct medical costs

Download Full-text

Health care resources utilization and costs associated with different clinical stages of chronic hepatitis B in Egypt

Egyptian Liver Journal ◽

10.1186/s43066-021-00162-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jackleen Azer Abd El-Halim ◽

Gihan Ismael Gewaifel ◽

Eman Ahmed Fawzy Darwish ◽

Ahmed Maher Ramadan ◽

Gihan Hamdy ElSisi

Keyword(s):

Health Care ◽

Chronic Hepatitis ◽

Direct Medical Cost ◽

Medical Cost ◽

Medical Costs ◽

Age Group ◽

High Quality ◽

Health Care Resources ◽

Direct Medical Costs ◽

And Control

Abstract Introduction Chronic hepatitis B (CHB) is associated with many serious clinical and social consequences. Despite Egypt being classified as a country of low endemicity, the infection is associated with a 15–25% risk of premature death from liver cancer or end-stage liver disease. The national committee of treatment and control of viral hepatitis has already offered a high-quality service for the diagnosis and treatment of CHB on a free basis. The current study aims to estimate the health care resources utilization and the annual direct medical cost associated with different clinical stages of CHB-related disease in Egypt. Methodology The data was retrieved through record review for three months in the General Administration of Hepatitis Viruses Control, Egypt. Then, the data was extrapolated to the population level by multiplying the prevalence in Egypt with a focus on the productive age groups (25–59 years). Results The cost and utilization of different health care resources increase with disease progression. The total annual direct medical costs due to CHB in Egypt is 21.3 L.E. Billion (4.7 Int$ billion/year) for the management of estimated 1,420,700 CHB patients. The direct medical costs among the productive age group (25–59 years) constitute more than half of the total cost (57%). The highest disease burden is encountered among (25–29 years) age group; 2.695 L.E. billion (0.59 Int$ billion/year). Despite liver transplantation phase being associated with the highest annual cost/patient, the number of patients in this stage is the lowest. Then, it only constitutes 0.04% of the disease direct medical cost in the country. The chronic hepatitis clinical stage constitutes 57.26% of the disease direct medical cost in Egypt’s working age group. Conclusion Strengthening the preventive and control measures is mandatory to alleviate the disease’s direct medical costs. Close monitoring of the chronic hepatitis stage is mandatory to prevent disease progression. Enhancement of vaccination efforts will lower the disease prevalence and its cost. The universal health insurance system which is gradually implemented in Egypt nowadays will be a cornerstone in relieving the economic stresses by allowing more access to high-quality health care services.

Download Full-text

The epidemiology and direct medical costs of diseases associated with human papillomavirus infection among men in Manitoba, Canada

10.1101/2020.12.02.20242891 ◽

2020 ◽

Author(s):

Christiaan H. Righolt ◽

Gurpreet Pabla ◽

Salaheddin M. Mahmud

Keyword(s):

Human Papillomavirus ◽

Direct Medical Cost ◽

Prescription Drugs ◽

Medical Cost ◽

Economic Burden ◽

Medical Costs ◽

Hpv Infection ◽

Invasive Cancer ◽

Male Resident ◽

Direct Medical Costs

AbstractBackgroundThere is little information on the economic burden of human papillomavirus-related diseases (HPV-RDs) among men. We used province-wide clinical, administrative and accounting databases to measure the direct medical costs of HPV infections in men in Manitoba (Canada).MethodsWe included all males aged 9 years and older with health insurance coverage in Manitoba between January 1997 and December 2016. We identified HPV-RD patient cohorts and matched each patient to HPV-RD-free men. We estimated the net direct medical cost (excess cost of hospitalizations, outpatient visits, and prescription drugs) of patients compared to their matches for anogenital warts (AGWs) and HPV-caused cancers. We adjusted costs to 2017 Canadian dollars. For each condition, we attributed costs to HPV based on the etiological fraction caused by HPV infection.ResultsWe found that the median net direct medical cost was about $250 for AGW patients and $16,000 for invasive cancer patients. The total cost was about $49 million or $2.6 million per year. Overall, 54%-67% ($26-$33 million) was attributable to HPV infection according different estimates of the attributable fraction. The net annual attributable cost was $2.37-$2.95 per male resident and $161-$200 per male newborn. The estimated potential savings was 30% for the bivalent vaccine and 56%-60% for the quadrivalent and nonavalent vaccines.ConclusionsOverall, HPV’s economic burden on males remains significant, the average cost of treating all conditions attributable to HPV was about $180 per male newborn. Invasive cancer accounted for the majority of these costs.

Download Full-text

Developing National Estimates of the Out-of-Pocket Costs of Cancer: The Importance of Including Patients with Lymphoma.

Blood ◽

10.1182/blood.v104.11.3138.3138 ◽

2004 ◽

Vol 104 (11) ◽

pp. 3138-3138

Author(s):

Kathryn R. McCaffrey ◽

Kenneth R. Carson ◽

Lucie Kutikova ◽

Matt Fisher ◽

Simon Pickard ◽

...

Keyword(s):

Breast Cancer ◽

Medical Care ◽

Direct Medical Cost ◽

Cancer Patients ◽

Medical Cost ◽

Medical Costs ◽

Breast Cancer Patients ◽

Direct Medical Costs ◽

12Th Grade ◽

Out Of Pocket Costs

Abstract Background: While Congress has mandated that the NIH provide a national estimate of the cost of cancer, almost all cancer cost studies have focused exclusively on breast cancer. No study has reported comparison data for persons with Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL). These illnesses have a high cure rate, and affected persons are likely to experience significant economic hardships. Many participate in the workforce during treatment and long after the treatment is complete. Herein, we report preliminary results from an ongoing study on the out-of-pocket direct medical and non-medical costs for a cohort of patients with lymphoma and provide contextual comparison with a cohort of breast cancer patients who received care at the same cancer center (Arozullah, Supportive Oncology, 2004). Methods: 178 breast cancer and lymphoma patients provided information on out-of-pocket costs for the preceding 3-month period; 12% had a diagnosis of HD or NHL. In total, 120 lymphoma patients will be interviewed for this study. Direct medical costs are costs related to medical care such as medications, procedures, and doctor visits. Direct non-medical costs are costs related to cancer, but not medical care, such as costs for meals, transportation, parking, and phone calls. Results: The majority of both lymphoma and breast cancer patients were < 65 years old, married, and employed. All patients had healthcare insurance coverage, with the majority insured with private plans. In comparison to women with breast cancer, persons with HD/NHL had similar mean monthly out-of-pocket cost expenditures, $635 versus $728. For lymphoma patients, factors associated with high direct medical costs included ≤ 12th grade education ($1,585/month) and HD ($1,133/month). Conclusion: Mean monthly out-of-pocket expenditures are similar for HD/NHL and breast cancer. Direct medical out-of-pocket expenditures for lymphoma vary. Direct medical expenditures are greatest for HD ($1,130), intermediate for aggressive NHL and breast cancer ($512–$597), and lowest for indolent NHL ($180). Comprehensive economic analyses of cancer should include a range of malignancies. Average Monthly Out-of-Pocket Costs for Lymphoma and Breast Cancer Patients. Direct Medical Cost Direct Medical Cost Direct Non-Medical Cost Direct Non-Medical Cost Lymphoma Breast Lymphoma Breast Household Income < $60,000 $381 $664 $40 $111 ≥ $60,000 $599 $553 $159 $161 Education ≤ 12th grade $1,585 $610 $72 $118 > 12th grade $437 $653 $141 $122 Diagnosis < 6 Months $577 $487 $114 $135 ≥ 6 Months $333 $660 $128 $130 Total Lymphoma $516 .. $119 .. HD $1,133 .. $155 .. AggressiveNHL $512 .. $167 .. Indolent NHL $180 .. $166 .. Total Breast Cancer .. $597 .. $131

Download Full-text

Association between National Early Warning Scores in primary care and clinical outcomes: an observational study in UK primary and secondary care

British Journal of General Practice ◽

10.3399/bjgp20x709337 ◽

2020 ◽

Vol 70 (695) ◽

pp. e374-e380 ◽

Cited By ~ 11

Author(s):

Lauren J Scott ◽

Niamh M Redmond ◽

Alison Tavaré ◽

Hannah Little ◽

Seema Srivastava ◽

...

Keyword(s):

Primary Care ◽

Observational Study ◽

Clinical Outcomes ◽

Early Warning ◽

Secondary Care ◽

Early Warning Score ◽

Medical Review ◽

News Values ◽

Process Measures ◽

Sepsis Diagnosis

BackgroundNHS England has mandated use of the National Early Warning Score (NEWS), more recently NEWS2, in acute settings, and suggested its use in primary care. However, there is reluctance from GPs to adopt NEWS/NEWS2.AimTo assess whether NEWS calculated at the point of GP referral into hospital is associated with outcomes in secondary care.Design and settingAn observational study using routinely collected data from primary and secondary care.MethodNEWS values were prospectively collected for 13 047 GP referrals into acute care between July 2017 and December 2018. NEWS values were examined and multivariate linear and logistic regression used to assess associations with process measures and clinical outcomes.ResultsHigher NEWS values were associated with faster conveyance for patients travelling by ambulance, for example, median 94 minutes (interquartile range [IQR] 69–139) for NEWS ≥7; median 132 minutes, (IQR 84–236) for NEWS = 0 to 2); faster time from hospital arrival to medical review (54 minutes [IQR 25–114] for NEWS ≥7; 78 minutes [IQR 34–158] for NEWS = 0 to 2); as well as increased length of stay (5 days [IQR 2–11] versus 1 day [IQR 0–5]); intensive care unit admissions (2.0% versus 0.5%); sepsis diagnosis (11.7% versus 2.5%); and mortality, for example, 30-day mortality 12.0% versus 4.1% for NEWS ≥7 versus NEWS = 0 to 2, respectively. On average, for patients referred without a NEWS value (NEWS = NR), most clinical outcomes were comparable with patients with NEWS = 3 to 4, but ambulance conveyance time and time to medical review were comparable with patients with NEWS = 0 to 2.ConclusionThis study has demonstrated that higher NEWS values calculated at GP referral into hospital are associated with a faster medical review and poorer clinical outcomes.

Download Full-text

The National Economic Burden of Rare Disease in United States in 2019

10.21203/rs.3.rs-1046815/v1 ◽

2021 ◽

Author(s):

Grace Yang ◽

Inna Cintina ◽

Anne Pariser ◽

Elisabeth Oehrlein ◽

Jamie Sullivan ◽

...

Keyword(s):

Rare Disease ◽

Direct Medical Cost ◽

Medical Cost ◽

Economic Burden ◽

Claims Data ◽

Indirect Costs ◽

Medical Costs ◽

Hospital Inpatient ◽

Care Providers ◽

National Economic

Abstract Background: To provide a comprehensive assessment of the total economic burden of rare diseases (RD) in the U.S. in 2019.We followed a prevalence-based approach that combined the prevalence of 379 RDs with the per-capita direct medical and indirect costs, to derive the national economic burden by patient age and type of RD. To estimate prevalence and the direct medical cost of RD, we used claims data from three sources: Medicare 5% Standard Analytical File, Transformed Medicaid Statistical Information System, and Optum claims data for the privately insured. To estimate indirect and non-medical cost components, we worked with the rare disease community to design and implement a primary survey.Results: There were an estimated 15.5 million U.S. children (N=1,322,886) and adults (N=14,222,299) with any of the 379 RDs in 2019 with a total economic burden of $997 billion, including a direct medical cost of $449 billion (45%), $437 billion (44%) in indirect costs, and $111 billion (11%) in non-medical costs. The top drivers for excess medical costs associated with RD are hospital inpatient care and prescription medication; the top indirect cost categories are labor market productivity losses due to absenteeism, presenteeism, and forced early retirement.Conclusions: Our findings highlight the scale of the RD economic burden and call for immediate attention from the scientific communities, policy leaders, and other key stakeholders such as health care providers and employers, to think innovatively and collectively, to identify new ways to help improve the care, management, and treatment of these often-devastating diseases.

Download Full-text

COST OF ILLNESS PADA PASIEN PENYAKIT KANKER PAYUDARA DI RSUD ULIN BANJARMASIN

Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan ◽

10.36387/jiis.v5i2.573 ◽

2020 ◽

Vol 5 (2) ◽

pp. 407-415

Author(s):

Noor Aisyah ◽

◽

Shela Puji Dina

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Cost Of Illness ◽

Medical Cost ◽

Indirect Costs ◽

Medical Costs ◽

Patient Treatment ◽

Breast Cancer Patients ◽

Economic Burden Of Disease ◽

Direct Medical Costs

The cost of illness is an important element in disease decision making because it can evaluate the economic burden of disease. One of them is breast cancer because breast cancer is a catastrophic disease. This study aims to determine direct medical costs, direct non-medical costs, indirect costs, and total costs based on a societal perspective in breast cancer patients at Ulin Hospital, Banjarmasin. This study is an observational analytic study with a prevalence-based cost of illness approach. Data was taken retrospectively for direct medical costs collected from patient medical records that met the inclusion and exclusion criteria, patient treatment data, and details of direct medical costs for the period January-July 2020. Direct non-medical costs and indirect costs were taken from the results of filling out a questionnaire to Breast cancer patients who have undergone treatment in the inpatient room of RSUD Ulin Banjarmasin. Data analysis used descriptive statistics to identify patient characteristics and the costs of breast cancer. The results of the study, the average direct medical cost of breast cancer patients at Ulin Banjarmasin Hospital was Rp. 6,281,700. The average direct non-medical cost was Rp. 416,780 and the average indirect cost was Rp. 229,820. Meanwhile, the average overall cost per episode of inpatient was Rp. 6,928,300

Download Full-text

Abstract WP50: Cost-Effectiveness of Mechanical Thrombectomy for Acute Ischemic Stroke: An Analysis From RESILIENT Trial

Stroke ◽

10.1161/str.51.suppl_1.wp50 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Ana Claudia de Souza ◽

Sheila Martins ◽

Carisi Polanczyk ◽

Denizar Vianna ◽

Leonardo Carbonera ◽

...

Keyword(s):

Cost Effectiveness ◽

Incremental Cost ◽

Healthcare System ◽

Standard Care ◽

Mechanical Thrombectomy ◽

Medical Costs ◽

Incremental Cost Effectiveness Ratio ◽

Mortality Data ◽

Cost Effectiveness Ratio ◽

Direct Medical Costs

Background and purpose: RESILIENT Trial was the first study in a developing country to demonstrate the benefit of mechanical thrombectomy (MT) in acute stroke patients. This economic evaluation aimed to access the cost-utility of MT under the perspective of the Brazilian Public Healthcare System. Methods: Analysis was based on a subset sample of the original study (151 of 221 patients) from 4 hospitals. We compared costs and utilities between MT plus standard care (n=78) vs. standard care alone (n=73). Direct medical costs were considered, and utilities were inputted according to each patient’s Utility-Weighted modified Rankin Score (UW-mRS). First-year survival was obtained from trial follow-up and modelled for a life-time horizon adjusted by National Mortality Data. Direct medical costs were converted to I$ using Purchasing Power Parity (PPP). A discount rate of 5% was used. Incremental cost-effectiveness ratio (ICER) is expressed in cost (I$) per Quality-Adjusted Life Year (QALY). Results: RESILIENT trial was stopped on its first interim analysis because of early efficacy. The incremental costs and QALYs gained with MT were estimated at I$ 8,369 and 0.75, respectively, compared with standard medical care, yielding an incremental cost-effectiveness ratio (ICER) of I$ 7,256 per QALY. Conclusion: The initially higher costs of MT were offset by the clear benefit of the intervention. RESILIENT trial demonstrated that such therapy is likely to be cost-effective despite the economical constraints in the Brazilian healthcare system.

Download Full-text