Economic Burden of Colorectal Cancer: A Case of Fars, Iran

Among cancers, colorectal cancer is the third most common cancer in the world and the fourth leading cause of cancer deaths worldwide. Some studies have shown that the incidence of colorectal cancer is increasing in Iran and in Fars province. The present study aimed to determine the economic burden of colorectal cancer in patients referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences in 2019 from the patients’ perspective. This is a partial economic evaluation and a cost-of-illness study conducted cross-sectionally in 2019. All the patients with colorectal cancer who had been referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences, and had medical records were studied through the census method (N = 96). A researcher-made data collection form was used to collect the cost data. The prevalence-based and bottom-up approaches were also used in this study. The human capital approach was applied to calculate indirect costs. The mean annual cost per patient with colorectal cancer in the present study was $10930.98 purchasing power parity (PPP) (equivalent to 5745.29 USD), the main part of which was the medical direct costs (74.86%). Also, among the medical direct costs per patient, the highest were those of surgeries (41.7%). In addition, the mean annual cost per patient with colorectal cancer in the country was $ 116917762 PPP (equivalent to 61451621.84 USD) in 2019. Regarding the considerable economic burden of colorectal cancer and in order to reduce the costs, these suggestions can be made: increasing the number of specialized beds through the cooperation of health donors, establishing free or low-cost accommodation centers for patients and their companions near the medical centers, using the Internet and cyberspace technologies to follow up the treatment of patients, and increasing insurance coverage and government drug subsidies on drug purchase.

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Direct costs of common osteoporotic fractures (Hip, Vertebral and Forearm) in Iran

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04535-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Marziyeh Rajabi ◽

Afshin Ostovar ◽

Ali Akbari Sari ◽

Sayed Mahmoud Sajjadi-Jazi ◽

Noushin Fahimfar ◽

...

Keyword(s):

Direct Cost ◽

Osteoporotic Fractures ◽

Direct Costs ◽

Fracture Incidence ◽

Inpatient Cost ◽

First Year ◽

Forearm Fractures ◽

Medical Sciences ◽

The Us ◽

The Mean

Abstract Background Osteoporotic fractures impose significant costs on society. The objective of this study was to estimate the direct costs of the hip, vertebral, and forearm fractures in the first year after fracture incidence in Iran. Methods We surveyed a sample of 300 patients aged over 50 years with osteoporotic fractures (hip, vertebral, and forearm) admitted to four hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2017 and were alive six months after the fracture. Inpatient cost data were obtained from the hospital patient records. Using a questionnaire, the data regarding outpatient costs were collected through a phone interview with patients at least six months after the fracture incidence. Direct medical and non-medical costs were estimated from a societal perspective. All costs were converted to the US dollar using the average exchange rate in 2017 (1USD = IRR 34,214) Results The mean ± standard deviation (SD) age of the patient was 69.83 ± 11.25 years, and 68% were female. One hundred and seventeen (39%) patients had hip fractures, 56 (18.67%) patients had vertebral fractures, and 127 (42.33%) ones had forearm fractures. The mean direct cost (medical and non-medical) during the year after hip, vertebral and forearm fractures were estimated at USD5,381, USD2,981, and USD1,209, respectively. Conclusion The direct cost of osteoporotic fracture in Iran is high. Our findings might be useful for the economic evaluation of preventive and treatment interventions for osteoporotic fractures as well as estimating the economic burden of osteoporotic fractures in Iran.

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The Economic Burden of Coronavirus Disease 2019 (COVID-19): Evidence from Iran

10.21203/rs.3.rs-60500/v1 ◽

2020 ◽

Author(s):

Mohsen Ghaffari Darab ◽

Khosro Keshavarz ◽

Elnaz Sadeghi ◽

Javad Shahmohamadi ◽

Zahra Kavosi

Keyword(s):

Economic Burden ◽

Indirect Costs ◽

Premature Death ◽

University Hospital ◽

Fars Province ◽

Income Loss ◽

Cross Sectional ◽

Accounting Information Systems ◽

Economic Production ◽

The Mean

Abstract This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and 59,203,409 Rials ($ 3,755) per person, a significant part of which (41 %) was that of intensive and general care beds (11,596,217,487 Rials equal to $ 735,510. (The second to which were the costs of medicines and medical consumables (28 %). The mean indirect costs including income loss due to premature death, economic production loss due to hospitalization and job absenteeism during recovery course were estimated 129,870,974 Rials ($ 11634) per person. Furthermore, the economic burden of the disease in the country for inpatient cases with the definitive diagnosis was 22,688,925,933,095 Rial equal to $ 1,439,083,784.Conclusion: The results of this study showed that the severe status of the disease would bring about the extremely high cost of illness in this case. It is estimated that the high prevalence rate of COVID-19 has been imposing a heavy economic burden on the country and health system directly that may result in rationing or painful cost-control approaches.

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Cyclomodulins and Hemolysis in E. coli as Potential Low-Cost Non-Invasive Biomarkers for Colorectal Cancer Screening

Life ◽

10.3390/life11111165 ◽

2021 ◽

Vol 11 (11) ◽

pp. 1165

Author(s):

Kristýna Mezerová ◽

Lubomír Starý ◽

Pavel Zbořil ◽

Ivo Klementa ◽

Martin Stašek ◽

...

Keyword(s):

Colorectal Cancer ◽

Low Cost ◽

E Coli ◽

Crc Screening ◽

Non Invasive ◽

Detection Approach ◽

Gene Assay ◽

Immunochemical Test ◽

The Mean ◽

And Performance

The frequent occurrence of E. coli positive for cyclomodulins such as colibactin (CLB), the cytotoxic necrotizing factor (CNF), and the cytolethal distending factor (CDT) in colorectal cancer (CRC) patients published so far provides the opportunity to use them as CRC screening markers. We examined the practicability and performance of a low-cost detection approach that relied on culture followed by simplified DNA extraction and PCR in E. coli isolates recovered from 130 CRC patients and 111 controls. Our results showed a statistically significant association between CRC and the presence of colibactin genes clbB and clbN, the cnf gene, and newly, the hemolytic phenotype of E. coli isolates. We also observed a significant increase in the mean number of morphologically distinct E. coli isolates per patient in the CRC cohort compared to controls, indicating that the cyclomodulin-producing E. coli strains may represent potentially preventable harmful newcomers in CRC patients. A colibactin gene assay showed the highest detection rate (45.4%), and males would benefit from the screening more than females. However, because of the high number of false positives, practical use of this marker must be explored. In our opinion, it may serve as an auxiliary marker to increase the specificity and/or sensitivity of the well-established fecal immunochemical test (FIT) in CRC screening.

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Economic burden of Huntington’s disease in Peru

BMC Health Services Research ◽

10.1186/s12913-019-4806-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Gustavo Silva-Paredes ◽

Rosa M. Urbanos-Garrido ◽

Miguel Inca-Martinez ◽

Danielle Rabinowitz ◽

Mario R. Cornejo-Olivas

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Economic Burden ◽

Annual Cost ◽

Healthcare Costs ◽

Neurodegenerative Disorder ◽

Indirect Costs ◽

Direct Costs ◽

Cross Sectional ◽

Direct And Indirect Costs

Abstract Background Huntington’s disease (HD) is a devastating and fatal neurodegenerative disorder that leads to progressive disability, and over time to total dependence. The economic impact of HD on patients living in developing countries like Peru is still unknown. This study aims to estimate the economic burden by estimating direct and indirect costs of Huntington’s disease in Peru, as well as the proportion of direct costs borne by patients and their families. Methods Disease-cost cross-sectional study where 97 participants and their primary caregivers were interviewed using a common questionnaire. Prevalence and human capital approaches were used to estimate direct and indirect costs, respectively. Results The average annual cost of HD reached USD 8120 per patient in 2015. Direct non-healthcare costs represented 78.3% of total cost, indirect costs 14.4% and direct healthcare costs the remaining 7.3%. The mean cost of HD increased with the degree of patient dependency: from USD 6572 for Barthel 4 & 5 (slight dependency and total independency, respectively) to USD 23,251 for Barthel 1 (total dependency). Direct costs were primarily financed by patients and their families. Conclusions The estimated annual cost of HD for Peruvian society reached USD 1.2 million in 2015. The cost impact of HD on patients and their families is very high, becoming catastrophic for most dependent patients, and thus making it essential to prioritize full coverage by the State.

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The Spillover of Inflation among the G7 Countries

Journal of Risk and Financial Management ◽

10.3390/jrfm14080392 ◽

2021 ◽

Vol 14 (8) ◽

pp. 392

Author(s):

Khandokar Istiak ◽

Aviral Kumar Tiwari ◽

Humaira Husain ◽

Kazi Sohag

Keyword(s):

United States ◽

Purchasing Power Parity ◽

Low Cost ◽

The United States ◽

Power Parity ◽

G7 Countries ◽

Monthly Data ◽

China Trade ◽

Global Shocks

Many global shocks, including the renegotiation of NAFTA, the United States–China trade war, the Brexit, and the COVID-19 pandemic, may have recently influenced the inflation spillover in the G7 countries. The current literature overlooks the influence of these important events on the inflation spillover of the G7 countries. This study fulfills this gap and investigates the nature of inflation spillover in the short, medium, and long term. Using the monthly data from 1956:6 to 2020:12, the study finds that Japan and the United States are the main transmitters of inflation. International trade, purchasing power parity, low-cost technology, and the Abenomics policy were found to be responsible for the inflation spillover. We suggest that the central banks of these countries collaborate to achieve the targeted inflation rate.

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COPD: The Annual Cost-Of-Illness during the Last Two Decades in Italy, and Its Mortality Predictivity Power

Healthcare ◽

10.3390/healthcare7010035 ◽

2019 ◽

Vol 7 (1) ◽

pp. 35 ◽

Cited By ~ 2

Author(s):

Roberto Dal Negro

Keyword(s):

Annual Cost ◽

Pathological Condition ◽

National Health System ◽

Direct Costs ◽

Cost Of Care ◽

Chronic Obstructive ◽

Care Providers ◽

Bode Index ◽

Hospitalization Costs ◽

The Mean

Chronic obstructive pulmonary disease (COPD) is a progressive pathological condition characterized by a huge epidemiological and socioeconomic impact worldwide. In Italy, the actual annual cost of COPD was assessed for the first time in 2002: the mean cost per patient per year was €1801 and ranged from €1500 to €3912, depending on COPD severity. In 2008, the mean annual cost per patient was €2723.7, ranging from €1830.6 in mild COPD up to €5451.7 in severe COPD. In 2015, it was €3291, which is 20.8% and 82.7% higher compared to the costs estimated in 2008 and 2002, respectively. In all these studies, the major cost component was direct costs, in particular hospitalization costs due to exacerbations, which corresponded to 59.9% of the total cost and 67.2% of direct costs, respectively. When the annual healthcare expenditure per patient is related to the length of survival by means of the PRO-BODE Index (PBI, which is the implementation of the well-known BODE Index with costs due to annual exacerbations and/or hospitalizations), the annual cost of care proved much more strictly and inversely proportional to patients’ survival at three years, with the highest regression coefficient (r = −0.58) of all the multidimensional indices presently available, including the BODE Index (r = −021). In Italy, even though tobacco smoking has progressively declined by up to 21% in the general population, the economic impact of COPD has shown relentless progression over the last two decades, confirming that the present national health system organization is still insufficient for facing the issue of chronic diseases, in particular COPD, effectively. The periodic assessment of costs is an effective instrument for care providers in predicting COPD mortality, and for decision makers for updating and planning their social, economic, and political strategies.

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Making India Globally Competitive

Vikalpa The Journal for Decision Makers ◽

10.1177/0256090920040401 ◽

2004 ◽

Vol 29 (4) ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Jagdish Sheth

Keyword(s):

Purchasing Power Parity ◽

Global Economy ◽

Low Cost ◽

Innovation Process ◽

Scale Efficiency ◽

Global Changes ◽

Public Enterprises ◽

Power Parity ◽

The World ◽

Indian Industries

The fast-paced economic and political changes across the world are forcing India to be more globally-oriented. This paper traces these global changes in a historical perspective and examines how India can be integrated into the global economy. It discusses the primary growth engines at different phases of the world growth cycle and suggests the main area around which there is a need to reengineer the country for global competitiveness. While Western Europe and the US/Canada engineered the 18th and the 19th century growth respectively, the author sees the large emerging nations as the 21st century growth engines and purchasing power parity (PPP) as the new measure of economic growth. As India integrates into the world economy, there is a need for it to reposition itself as a country. From the domestic-oriented, self-sufficient license raj, it has come a long way to become a globally-oriented economy focusing on those key sectors of the economy where it has a resource advantage over other nations. The objective is to offer better products at lower prices. Exports to the most demanding markets, after all, are the key to success for a globally competitive economy. To achieve this objective, India needs to reengineer itself in the following areas: Industrial policy through ideology-free policy; privatization of public enterprises; incentives for quality; innovation and productivity; employment through growth; intellectual property rights; and environment policy. International trade through convertible currency anchored to dollar; target exports to selective markets; balanced trade with anchor partners; and focus on selective exports based on comparative advantage. Domestic industry through industry consolidation for scale efficiency; globalization of domestic markets; investment in quality and innovation; process reengineering; and reduction in unorganized sector. National infrastructure through upgradation of transport and logistics; information infrastructure capital markets; financial institutions; special economic zones and energy reliability. Of these, domestic infrastructure is the weakest link. The Indian industries must reposition themselves from the diversified domestic corporations to focused global enterprises. To be a global hub, they need quality and reputation and must, therefore invest in design and research, create brand equity, increase productivity, leverage human capital, get access to low cost capital, and organize global supply chain. The author concludes with the following observations: India is destined to become a major economic power in the 21s century. India's future, however, will depend on the geopolitical realignment of nations and the emergence of ‘triad’ markets. Design is a very strong competitive advantage for India. Public enterprises should not be disinvested and should instead be encouraged to go global along with the private enterprises not just through exports but through mergers and acquisitions. The Indian industries must reposition themselves from the diversified domestic corporations to focused global enterprises.

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Comparison of chemotherapy use, cost, and survival in patients with metastatic colorectal cancer in Western Washington and British Columbia.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.18_suppl.lba3579 ◽

2018 ◽

Vol 36 (18_suppl) ◽

pp. LBA3579-LBA3579 ◽

Cited By ~ 3

Author(s):

Todd Yezefski ◽

Dan Le ◽

Leo Chen ◽

Jeremy Snider ◽

Caroline Speers ◽

...

Keyword(s):

Colorectal Cancer ◽

British Columbia ◽

Overall Survival ◽

Metastatic Colorectal Cancer ◽

Purchasing Power Parity ◽

Care Utilization ◽

Power Parity ◽

First Line ◽

First Line Therapy ◽

Western Washington

LBA3579 Background: Few studies have directly compared health care utilization, costs, and outcomes between geographically similar patients (pts) treated in the U.S.’ multi-payer health system versus Canada’s single-payer system. Using cancer registry and claims data, we assessed systemic therapy (ST) use, cost, and survival for metastatic colorectal cancer (mCRC) pts in Western Washington (WW) and British Columbia (BC). Methods: Pts age ≥ 18 diagnosed with mCRC in 2010 and later were identified from 1) the BC Cancer Agency database and 2) a regional database linking WW SEER to claims from two large commercial insurers. Demographic and treatment characteristics for the two populations were compared using two-sample T tests. ST costs (first-line and lifetime) were expressed as mean per patient per month costs; Canadian costs were expressed in US dollars using the Purchasing Power Parity for Health in 2009. Median survival was reported for both populations. Results: 1622 BC pts and 575 WW pts were included in the analysis. BC pts were more likely to be older (median age 60 vs 66) and male (57% vs 48%, p = < 0.01). A greater proportion of WW versus BC pts received ST (79% vs. 68%, p < 0.01). FOLFIRI plus bevacizumab was the most common first-line regimen in BC (32%) while FOLFOX was the most common first-line regimen in WW (39%). The mean monthly cost of first-line therapy per patient was significantly higher in WW than BC ($12,345 vs $6,195, p = < 0.01), and this was true for all regimens assessed. Mean lifetime monthly ST costs were significantly higher in WW ($7,883 vs $4,830, p = < 0.01). There was no difference in median overall survival between populations among those receiving ST (21.4 months (95% CI 18.0-26.2) in WW and 22.1 months (20.5-23.7) in BC) or among those not receiving ST (5.4 months (2.4-7.7) WW versus 6.3 months (5.2-7.3) BC). Conclusions: Utilization and cost of ST for mCRC was significantly higher for patients in WW compared to BC without differences in overall survival in treated and untreated patients.

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Testing For Purchasing Power Parity In A Panel Of Middle-Eastern Countries

International Business & Economics Research Journal (IBER) ◽

10.19030/iber.v4i12.3640 ◽

2011 ◽

Vol 4 (12) ◽

Author(s):

Hala El-Ramly

Keyword(s):

Middle East ◽

Exchange Rates ◽

Purchasing Power Parity ◽

Unit Root ◽

Middle Eastern ◽

Real Exchange Rates ◽

Purchasing Power ◽

Power Parity ◽

The Real ◽

The Mean

The attention given to testing for purchasing power parity (PPP) using middle-eastern data has so far been very limited. This paper tests for PPP in a panel of twelve countries from the Middle East. Four different unit root procedures are used to test for the mean reversion property in the real exchange rates of these countries. The evidence in support of PPP in the tested panel is generally found to be weak.

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Economic burden of multiple sclerosis: a cross-sectional study in Iran

Health Economics Review ◽

10.1186/s13561-021-00350-y ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Mehdi Rezaee ◽

Khosro Keshavarz ◽

Sadegh Izadi ◽

Abdosaleh Jafari ◽

Ramin Ravangard

Keyword(s):

Multiple Sclerosis ◽

Drug Therapy ◽

Economic Burden ◽

Purchasing Power Parity ◽

Indirect Costs ◽

Home Care Services ◽

Cross Sectional Study ◽

Power Parity ◽

Cost Information ◽

Cross Sectional

Abstract Background Multiple Sclerosis (MS) is a chronic debilitating disease that imposes a heavy socioeconomic burden on societies. This study aimed to determine the economic burden of MS on patients using the first (CinnoVex and ReciGen) and second (Fingolimod and Natalizumab) drug therapy lines. Methods This cost of illness study was an economic evaluation carried out as cross-sectional research in 2019 in southern Iran. A total of 259 patients were enrolled in two lines of drug therapy (178 patients in the first line and 81 ones in the second). The prevalence-based approach and the bottom-up approach were used to collect cost information and to calculate the costs from the societal perspective, respectively. The human capital approach was applied to calculate indirect costs. To collect the required data a researcher-made data collection form was utilized. The data were obtained using the information available in the patients’ medical records and insurance invoices as well as their self-reports or that of their companions. Results The results showed that the annual costs of MS in the first and second lines of drug therapy per patient were $ 1919 and $ 4082 purchasing power parity (PPP), respectively, and in total, $ 2721 PPP in 2019. The highest mean costs in both lines were those of direct medical costs, of which purchasing the main medicines in both lines accounted for the highest. Conclusion Considering the findings of this study and in order to reduce the burden of the disease, the following suggestions are presented: providing necessary facilities for the production of MS drugs in the country; proper and equitable distribution of neurologists; expanding the provision of home care services; and using the technologies related to the Internet, including WhatsApp, to follow up the MS patients’ treatment.

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