Abstract WMP98: Economic Impact Of Dabigatran For Prevention Of Stroke In Patients With Atrial Fibrillation In Colombia

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Rafael Alfonso-Cristancho ◽  
Andres I Vecino ◽  
Santiago Herran
Keyword(s):  
Atrial Fibrillation ◽  
Societal Perspective ◽  
Indirect Costs ◽  
Medical Costs ◽  
Separate Analysis ◽  
Health States ◽  
Usual Practice ◽  
Direct Medical Costs ◽  
Good Investment ◽  
Life Years

INTRODUCTION: Dabigatran is a novel oral anticoagulant considered as an alternative to warfarin in patients with non-valvular Atrial Fibrillation (AF) to prevent Stroke. Hypothesis: dabigatran compared to warfarin for stroke prevention in AF is a good investment for the health care system in Colombia. Methods: We developed a Markov model to represent the health states of AF and its complications: 6 health states (disabling and non-disabling stroke, myocardial infarction, pulmonary embolism and death) and 2 transitional states (major and minor hemorrhage). Probabilities were derived from clinical trials; resource use was estimated from the guidelines of the Colombian Society of Cardiology and validated to adjust to usual practice. Direct medical costs were extracted from public and private insurers and hospitals, and indirect costs (e.g. wages lost, transportation costs, etc.) were obtained from the most recent National Health Survey. Utilities were obtained from a systematic literature review. Two separate analysis, payer and societal perspective, were performed in a 20-year horizon. Multivariate sensitivity analysis was also performed and results were discounted at 3% annually. Results: After 20 years of follow up, cumulative discounted direct medical costs per patient accounted for USD$70,500 for warfarin and $78,840 and $79,860 for 150mg and 110mg of dabigatran, respectively. When taking into account indirect costs, warfarin increased their costs by 13% while dabigatran costs were increased by 7%. Estimated life years (LY) for Dabigatran were higher (9.4 and 9.3 for 150mg and 110mg) as well as the QALYs (8.5, 8.4) than for warfarin 9.1 LY and 8.1 QALYs. The calculated ICER was $23,760 and $34,690 per additional QALY gained with dabigatran 150mg and 110 mg from the payer perspective and $19,380 and $28,730 from the societal perspective. The budget impact of including coverage for dabigatran would not surpass 3% of the current unit of payment per capita. CONCLUSIONS: In Colombia, coverage for dabigatran for the management of non-complicated AF could increase LY and QALYs at a modest financial impact.

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

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.

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.

Medical Costs and Outcomes for Australian Women With Ovarian Cancer: A Patient-Level Analysis Over 2.5 Years

2010 ◽  
Vol 20 (5) ◽  
pp. 757-765 ◽  
Author(s):  
Louisa G. Gordon ◽  
Paul A. Scuffham ◽  
Vanessa L. Beesley ◽  
Adèle C. Green ◽  
Anna DeFazio ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adverse Effects ◽  
Medical Costs ◽  
Stage I ◽  
Disease Stage ◽  
Quality Adjusted Life Years ◽  
First Line ◽  
Direct Medical Costs ◽  
Life Years ◽  
Quality Adjusted Life

Objective:As treatment costs for gynecological cancer escalate, real-world data on use of resources and costs becomes increasingly important. This study investigated medical costs, quality of life, and survival end points for women with ovarian cancer in Australia.Methods:Women with primary epithelial ovarian cancer referred for chemotherapy (n = 85) were recruited through 7 hospitals in Australia. Overall survival, progression-free interval, and quality-adjusted life years were assessed by stage using the Cox proportional hazards models. Direct medical costs, including those for surgeries, hospitalizations, supportive care, chemotherapy, and adverse effects (while on chemotherapy), were calculated over 2.5 years and assessed by nonparametric bootstrapping.Results:Quality-adjusted life years decreased with increased disease stage at diagnosis and ranged from 2.3 for women with stage I or II disease to 1.3 for those with stage IV disease. A total of AU $4.1 million (2008) were spent on direct medical costs for 85 women over approximately 2.5 years. Medical costs were significantly higher for women with stage III or IV disease compared with that for women with stage I or II disease ($50,945 vs $31,958,P< 0.01) and/or women who experienced surgical complications and/or adverse effects requiring hospitalization while on chemotherapy ($57,821 vs $34,781,P< 0.01). Costs after first-line chemotherapy were significantly higher for women with advanced disease (mean, $20,744) compared with those for women with early disease (mean, $5525;P< 0.01).Conclusions:Whereas for women with early-stage ovarian cancer, costs are concentrated in the period of primary treatment, cumulated costs are especially high for women with recurrent disease rising rapidly after first-line therapy.

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.

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

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

scholarly journals The Trade-Off between Optimizing Flight Patterns and Human Health: A Case Study of Aircraft Noise in Queens, NY, USA

2018 ◽  
Vol 15 (8) ◽  
pp. 1753 ◽  
Author(s):  
Zafar Zafari ◽  
Boshen Jiao ◽  
Brian Will ◽  
Shukai Li ◽  
Peter Muennig
Keyword(s):  
Indirect Costs ◽  
Ground Level ◽  
Status Quo ◽  
Current Status ◽  
Decision Analytic Model ◽  
Health States ◽  
Life Years ◽  
Automation Systems ◽  
The U.S

Objectives: Airports in the U.S. have gradually been transitioning to automated flight systems. These systems generate new flight paths over populated areas. While they can improve flight efficiency, the increased noise associated with these novel flight patterns potentially pose serious health threats to the overflown communities. In this case study, we estimated the monetary benefits relative to health losses associated with one significant change in flight patterns at LaGuardia Airport, year-round use of “TNNIS Climb”, which happened in 2012 as a result of flight automation in New York City. Prior to that, the use of the TNNIS Climb was limited to the U.S. Open tennis matches. Methods: We developed a decision-analytic model using Markov health states to compare the costs and quality-adjusted life years (QALYs) gained associated with the limited use of TNNIS (old status quo) and the year-round use of TNNIS (current status quo). The TNNIS Climb increases airplane noise to above 60 decibels (dB) over some of the most densely populated areas of the city. We used this increased exposure to noise as the basis for estimating ground-level health using data from sound monitors. The total costs (including both direct and indirect costs), QALYs, and the incremental cost-effectiveness ratio (ICER) were estimated for the limited versus the year-round use of the TNNIS Climb. Results: The incremental lifetime costs and QALYs per person exposed to noise associated with the limited versus the year-round use of TNNIS was $11,288, and 1.13, respectively. Therefore, the limited use of TNNIS had an ICER of $10,006/QALY gained relative to the year-round of TNNIS. Our analyses were robust to changes in assumptions and data inputs. Conclusions: Despite increases in efficiency, flight automation systems without a careful assessment of noise might generate flight paths over densely populated areas and cause serious health conditions for the overflown communities.

PP538 Burden Of Disease For Patients With Acute Myocardial Infarction Combining Dyslipidemia In China

2020 ◽  
Vol 36 (S1) ◽  
pp. 41-41
Author(s):  
Mengran Zhang ◽  
Hongchao Li ◽  
Aixia Ma ◽  
Pingyu Chen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Disease Burden ◽  
Indirect Costs ◽  
Medical Costs ◽  
Chinese Patients ◽  
Direct Medical Costs ◽  
The Times ◽  
Serious Disease ◽  
High Hospitalization Cost

IntroductionPrevalence of dyslipidemia in Chinese adults is increasing rapidly. Dyslipidemia is one of the most important risk factors for acute myocardial infarction (AMI), which represents a serious disease burden to the country. However, there is no published research on the costs of Chinese patients diagnosed with AMI combining dyslipidemia. This study aimed to report key findings of the disease burden in China, including direct medical costs and direct non-medical costs.MethodsSix hospitals from different geographic areas were selected in China for data collection. Patients who were hospitalized due to AMI combining dyslipidemia from January 1 2016 to December 31 2016 in the six sites were enrolled. Direct medical costs including inpatient and outpatient costs were extracted through electronic medical records; medical costs occurred in other healthcare institutions and direct non-medical costs were collected by a face-to-face questionnaire survey. Results were analyzed with descriptive statistics.ResultsData of 900 patients were analyzed. There were more males (78.40%) than females. The mean age was 62.1 (SD: 11.5). The times of inpatient and outpatient per year were 0.57 and 8.67, respectively. Medium direct medical costs and medium direct non-medical costs were 31,440 RMB (Interquartile range (IQR): 21,533–48,202) (4,443 USD: 3043–6812) and 665 RMB (IQR: 351–1328) (94 USD: 50–188), respectively; while corresponding medium indirect costs per year were 659 RMB (IQR: 226–1579) (93 USD: 32–223).ConclusionsThis is the first study comprehensively analyzing the disease burden of patients diagnosed with AMI combining dyslipidemia in China. The results suggested that the medical cost of this population is still high. Hospitalization cost accounted for 81 percent of the total cost, which was around 1.3 times of the annual per capita disposable income over the same period. Therefore, the importance of providing effective clinical management as well as dyslipidemia prevention and control intervention should be highlighted, especially for middle-aged and elderly males with dyslipidemia.

scholarly journals Inflammatory Bowel Disease: A Canadian Burden of Illness Review

2012 ◽  
Vol 26 (11) ◽  
pp. 811-817 ◽  
Author(s):  
Angela Rocchi ◽  
Eric I Benchimol ◽  
Charles N Bernstein ◽  
Alain Bitton ◽  
Brian Feagan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Burden Of Illness ◽  
Indirect Costs ◽  
Medical Costs ◽  
Patient Costs ◽  
Direct Medical Costs ◽  
Inflammatory Bowel ◽  
Incident Cases

BACKGROUND: Inflammatory bowel diseases (IBD) – Crohn’s disease (CD) and ulcerative colitis (UC) – significantly impact quality of life and account for substantial costs to the health care system and society.OBJECTIVE: To conduct a comprehensive review and summary of the burden of IBD that encompasses the epidemiology, direct medical costs, indirect costs and humanistic impact of these diseases in Canada.METHODS: A literature search focused on Canadian data sources. Analyses were applied to the current 2012 Canadian population.RESULTS: There are approximately 233,000 Canadians living with IBD in 2012 (129,000 individuals with CD and 104,000 with UC), corresponding to a prevalence of 0.67%. Approximately 10,200 incident cases occur annually. IBD can be diagnosed at any age, with typical onset occurring in the second or third decade of life. There are approximately 5900 Canadian children <18 years of age with IBD. The economic costs of IBD are estimated to be $2.8 billion in 2012 (almost $12,000 per IBD patient). Direct medical costs exceed $1.2 billion per annum and are driven by cost of medications ($521 million), hospitalizations ($395 million) and physician visits ($132 million). Indirect costs (society and patient costs) total $1.6 billion and are dominated by long-term work losses of $979 million. Compared with the general population, the quality of life patients experience is low across all dimensions of health.CONCLUSIONS: The present review documents a high burden of illness from IBD due to its high prevalence in Canada combined with high per-patient costs. Canada has among the highest prevalence and incidence rates of IBD in the world. Individuals with IBD face challenges in the current environment including lack of awareness of IBD as a chronic disease, late or inappropriate diagnosis, inequitable access to health care services and expensive medications, diminished employment prospects and limited community-based support.

scholarly journals Cost consequences analysis of hypertensive outpatients: a study in a private hospital in Yogyakarta special province

2021 ◽  
Vol 17 (2) ◽  
pp. 116-126
Author(s):  
Dinasari Bekti Pratidina ◽  
Fithria Dyah Ayu Suryanegara ◽  
Diesty Anita Nugraheni
Keyword(s):  
Clinical Outcome ◽  
Antihypertensive Therapy ◽  
Private Hospital ◽  
Indirect Costs ◽  
Medical Costs ◽  
Patient’S Perspective ◽  
Direct Medical Costs ◽  
Significant Difference ◽  
The Cost ◽  
Real Costs

Background: Hypertension is a chronic disease that requires long-term treatment and has an impact on the cost of treatment. The costs will be greater given the loss of productivity, family burden, and social life impacted by hypertension based on patient’s perspective. Objective: The purpose of the study was to determine the costs and clinical outcome of antihypertensive therapy from the patient's perspective and to identify the discrepancies between the costs and the INA-CBGs (Indonesia Case Based Groups) tariff. Methods: The research was an observational study with a cross-sectional design. The targeted population was outpatients who had received antihypertensive therapy for at least 1 month at a private hospital in Yogyakarta. The costs included direct medical costs, direct non-medical costs, and indirect costs, while the clinical outcomes were patient’s blood pressure. The descriptive analysis was carried out to describe the characteristics of the research subjects, the clinical outcome, and the cost. Analysis of the discrepancies between the costs and the INA-CBGs tariff used the Mann-Whitney test and One-Sample t-test. Results: The results showed that the average direct medical costs, direct non-medical costs, and indirect costs from the patient’s perspective were IDR359,408.00, IDR24,617.00, and IDR 40,583.00, respectively. There was a significant difference between the real costs and the rate of INA-CBGs based on the results of statistical tests, while the cost discrepancy was IDR5,287,045.00. Conclusion: The direct non-medical costs and indirect costs of hypertensive outpatients were less than the direct medical costs. A significant difference occurred between the real costs and INA CBG’s tariff. Keywords: hypertension, cost consequences, pharmacoeconomics, patient’s perspective

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