Economic burden of Huntington’s disease in Peru

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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A prospective cross-sectional study to evaluate the economic burden of patients diagnosed with depression in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20201746 ◽

2020 ◽

Vol 9 (5) ◽

pp. 722

Author(s):

D. K. Dhodi ◽

S. R. Sinha ◽

F. Dawer ◽

M. S. Chavan

Keyword(s):

Economic Burden ◽

Tertiary Care ◽

Indirect Costs ◽

Cross Sectional Study ◽

Direct Costs ◽

Cost Of Care ◽

Hospitalisation Cost ◽

Care Hospital ◽

Cross Sectional ◽

Case Record

Background: The objective of the study was to evaluate the cost of care of depression in terms of direct and indirect costs.Methods: 150 patients diagnosed with depression attending psychiatry OPD at Sir J.J. Group of Hospitals, Mumbai, fulfilling the inclusion criteria were explained about the study. Written informed consent were taken. Direct and Indirect costs were recorded in structured case record forms by interviewing the patients. Cost driving factors were identified.Results: Total annual direct cost were INR 6,378.16 which included drug costs, travel expenses, physician’s consultation, cost of investigations, hospitalisation cost while total Indirect costs were INR 16,860 which included days of work both of the patient and the caretaker.Conclusions: The indirect cost was almost thrice the direct costs. Hospitalisation cost and loss of working days due to depression was contributed the most to the direct costs and indirect costs respectively. Economic burden of depression is found out to be 16.30% of per capita gross domestic product in year 2018-19.

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Volumetric MRI-Based Biomarkers in Huntington's Disease: An Evidentiary Review

Frontiers in Neurology ◽

10.3389/fneur.2021.712555 ◽

2021 ◽

Vol 12 ◽

Author(s):

Kirsi M. Kinnunen ◽

Adam J. Schwarz ◽

Emily C. Turner ◽

Dorian Pustina ◽

Emily C. Gantman ◽

...

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Disease Progression ◽

Neurodegenerative Disorder ◽

Motor Impairment ◽

Cag Repeat ◽

Longitudinal Change ◽

Cross Sectional ◽

Brain Volumes ◽

Basal Ganglia Structures

Huntington's disease (HD) is an autosomal-dominant inherited neurodegenerative disorder that is caused by expansion of a CAG-repeat tract in the huntingtin gene and characterized by motor impairment, cognitive decline, and neuropsychiatric disturbances. Neuropathological studies show that disease progression follows a characteristic pattern of brain atrophy, beginning in the basal ganglia structures. The HD Regulatory Science Consortium (HD-RSC) brings together diverse stakeholders in the HD community—biopharmaceutical industry, academia, nonprofit, and patient advocacy organizations—to define and address regulatory needs to accelerate HD therapeutic development. Here, the Biomarker Working Group of the HD-RSC summarizes the cross-sectional evidence indicating that regional brain volumes, as measured by volumetric magnetic resonance imaging, are reduced in HD and are correlated with disease characteristics. We also evaluate the relationship between imaging measures and clinical change, their longitudinal change characteristics, and within-individual longitudinal associations of imaging with disease progression. This analysis will be valuable in assessing pharmacodynamics in clinical trials and supporting clinical outcome assessments to evaluate treatment effects on neurodegeneration.

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Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran

Cost Effectiveness and Resource Allocation ◽

10.1186/s12962-020-00250-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Vahid Alipour ◽

Hamed Zandian ◽

Vahid Yazdi-Feyzabadi ◽

Leili Avesta ◽

Telma Zahirian Moghadam

Keyword(s):

Cardiovascular Diseases ◽

Economic Burden ◽

Indirect Costs ◽

Structured Interviews ◽

Cross Sectional ◽

Direct And Indirect Costs ◽

North West ◽

The North ◽

Hospitalization Costs ◽

Before And After

Abstract Background Different countries have set different policies to control and decrease the costs of cardiovascular diseases (CVDs). Iran was aiming to reduce the economic burden of different disease by a recent reform from named as health transformation plan (HTP). This study aimed to examine the economic burden of CVDs before and after of HTP. Methods This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using the cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran’s Ministry of Cooperatives, Labor, and Social Welfare, the central bank of Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials (IRR). Results Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after (62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p = 0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2 to 36.7%. All hospitalization costs, except patients’ OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. Conclusion Economic burden of CVDs increased in the north-west of Iran after the HTP due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, more detailed studies should be carried out on the reasons for the significant increase in CVDs costs in the region.

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Economic Burden of Cardiovascular Diseases Before and After the Iran’s Health Transformation Plan: A Cross-Sectional Study on Referral Hospital in the North-West of Iran

10.21203/rs.2.22249/v1 ◽

2020 ◽

Author(s):

Vahid Alipour ◽

Hamed Zandian ◽

Vahid Yazdi-Feyzabadi ◽

Leili Avesta ◽

Telma Zahirian Moghadam

Keyword(s):

Economic Burden ◽

Indirect Costs ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Direct And Indirect Costs ◽

North West ◽

The North ◽

Hospitalization Costs ◽

Before And After

Abstract Background Different countries have set different policies to control and decrease the costs of Cardiovascular Diseases(CVDs). Iran aiming reducing the economic burden of different disease by a recent reform from named as health transformation plan(HTP). This study aimed to examine economic burden of CVDs before and after of HTP, Methods This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran's Ministry of Cooperatives, Labor, and Social Welfare, central bank of the Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials(IRR). Results Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after(62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p=0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2% to 36.7%. All hospitalization costs, except patients' OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. Conclusion The economic burden of CVDs after the HTP increased in the north-west of Iran due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, studies that are more detailed should be carried out on the reasons for the significant increase in CVDs costs in the region.

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HSR19-102: Direct and Indirect Economic Burden of Cervical Cancer (CxCa) in the United States in 2015: A Mixed-Methods Analysis

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2018.7182 ◽

2019 ◽

Vol 17 (3.5) ◽

pp. HSR19-102

Author(s):

Chizoba Nwankwo ◽

Shelby L. Corman ◽

Ruchit Shah ◽

Youngmin Kwon

Keyword(s):

United States ◽

Mixed Methods ◽

Economic Burden ◽

Healthcare Costs ◽

Indirect Costs ◽

Early Death ◽

The United States ◽

Productivity Costs ◽

Direct And Indirect Costs ◽

Lost Productivity

Background: An estimated 12,820 women in the United States will be diagnosed with CxCa in 2018, with 4,210 deaths from the disease. The economic burden of CxCa, both in terms of healthcare costs and lost productivity, has not been adequately studied. Methods: This was a mixed-methods study that evaluated the direct and indirect costs of CxCa using data from the Medical Expenditure Panel Survey (MEPS) for prevalent CxCa cases and the National Center for Health Statistics (NCHS) for deaths due to CxCa. Total healthcare costs and number of work days missed were compared between CxCa cases and controls in MEPS, using propensity scores calculated from baseline demographics and comorbidities. Missed work was converted to costs using the average hourly wage for women in 2015. Per-patient incremental healthcare and lost work productivity costs were then multiplied by the number of prevalent cases of CxCa in 2015 obtained from the Surveillance, Epidemiology, and End Results Program (SEER). NCHS data on the age-stratified number of CxCa deaths per year (1935–2015) and life expectancy data from the Social Security Administration were then used to calcluate the number of women who would be alive in 2015 if they had not died from CxCa and the lost earnings resulting from early mortality. The primary study outcome was the total direct and indirect cost of CxCa in 2015, calculated as the sum of the incremental direct healthcare costs, incremental lost productivity costs due to missed work, and lost productivity costs resulting from early death due to CxCa. Results: An estimated 257,524 women were alive with CxCa in 2015. Total healthcare costs were $4,221 higher, and an additional 0.37 work days were missed in women with CxCa compared to propensity-matched controls. Of the 488,475 women who died of CxCa prior to 2015, 108,832 would be alive in 2015 and 38,540 would be part of the workforce. Lost earnings in 2015 attributable to these deaths totaled $2.19 billion. The total economic burden of CxCa in the United States in 2015 was thus estimated at $3.3 billion (Table 1). Conclusions: CxCa was responsible for nearly $3.3 billion in direct and indirect costs in 2015. Early death among women with CxCa was the biggest driver of total economic burden.

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Cost analysis of informal care: estimates from a national cross-sectional survey in Sweden

BMC Health Services Research ◽

10.1186/s12913-021-07264-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Björn Ekman ◽

Kevin McKee ◽

Joana Vicente ◽

Lennart Magnusson ◽

Elizabeth Hanson

Keyword(s):

Informal Care ◽

Adult Population ◽

Informal Caregivers ◽

Indirect Costs ◽

Direct Costs ◽

Care Providers ◽

Cross Sectional Survey ◽

Income Loss ◽

Cross Sectional ◽

Direct And Indirect Costs

Abstract Background Over the past decades, informal care has increased in most OECD-countries. Informal care is costly to caregivers and to society in the form of lost income and direct costs of providing care. Existing evidence suggests that providing informal care affects caregivers’ overall health. However, estimates of the social costs of informal care based on national data on individuals are currently scarce. Objective This study contributes to the existing evidence on the costs of informal care by estimating the direct and indirect costs to caregivers using a purposive national household survey from Sweden. Methods Adopting a bottom-up, prevalence approach, the direct and indirect costs are estimated using the survey data and the value of working time and leisure time from existing sources. Results The results suggest that around 15% of the adult population of Sweden provide informal care and that such care costs around SEK 152 billion per year (around 3% of GDP; USD 16,3 billion; EUR 14,5 billion), or SEK 128000 per caregiver. Around 55% of costs are in the form of income loss to caregivers. The largest cost items are reduced work hours and direct costs of providing informal care. Replacing informal caregivers with professional care providers would be costly at around SEK 193,6 billion per year. Conclusions Findings indicate that, even in a country with a relatively generous welfare system, significant resources are allocated toward providing informal care. The costing analysis suggests that effective support initiatives to ease the burden of informal caregivers may be cost-effective.

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Estimation of direct and indirect costs of occupational injuries: A case study in one of the refining industries in Iran in 2015

Occupational Medicine ◽

10.18502/tkj.v11i4.3651 ◽

2020 ◽

Author(s):

A Mohamadinejad ◽

SB Mortazavi ◽

A Jonidi Jafari ◽

A Mofidi

Keyword(s):

Occupational Injuries ◽

Indirect Costs ◽

Cross Sectional Study ◽

Direct Costs ◽

Production Costs ◽

Cross Sectional ◽

Direct And Indirect Costs ◽

Productivity Losses ◽

The Status ◽

Health Related

Introduction: Occupational injuries can impose a significant cost to the country’s economy. In developing countries, it is usually difficult to get access to occupational injuries data mainly because the lack of appropriate reporting and recording system, and in these countries, making it difficult to accurately estimate the costs of these injuries. The purpose of this study is to estimate the direct and indirect costs of occupational injuries in one of the Iranian refining industries. Materials and Methods: This cross-sectional study was performed on all occupational injuries, including outpatient injuries to deaths in 2015. Data was collected based on a bottom-up approach, by using the recorded documents and a researcher-made questionnaire. Lastly the direct and indirect costs for different stockholders, including workers and their families, industry and society as a whole, were calculated. Investigated direct costs of occupational injuries included The healthcare costs, out of pocket cost and informal caregiving and Indirect costs included productivity losses, reorganization and investigation costs and home production costs. Results: It is estimated that occupational injuries impose 103,385 million Rials to the society over a year. Investigated direct costs of occupational injuries imposed 14,152 million Rials (48 million Rials per case). Indirect costs imposed 89,232 million Rials to the society (308 million Rials per case). Also the average healthcare cost per case for fatal injuries is estimate 125 million, for serious injuries 12 million Rials and for outpatient injuries 780,000 Rials Conclusion: According to the results of the study, occupational injuries annually bring significant economic costs to the industry, workers and their families which a significant portion of these costs are indirect costs. These results indicates the status and importance of occupational injuries and therefore can be used by decision-makers and planners in occupational health-related issues.

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Direct and Indirect Costs of Obesity in Brazil: A Systematic Review

Current Developments in Nutrition ◽

10.1093/cdn/nzaa063_021 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1623-1623

Author(s):

Bianca Curi Braga ◽

Camila Ricardo ◽

Vitor Carvalho ◽

Ana Clara Duran

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Indirect Costs ◽

Well Being ◽

Direct Costs ◽

Health Care Facilities ◽

Public Health Care ◽

Cross Sectional ◽

Direct And Indirect Costs ◽

Lower Productivity

Abstract Objectives Obesity burdens families, governments, and companies with a variety of direct costs for healthcare, and also indirect costs in lower productivity and well-being. To measure these costs in a middle-income country with rapidly rising obesity rates, we conducted a systematic review of the literature on the direct and indirect costs of obesity in Brazil. Methods We searched for English and Portuguese language publications from 2004 to 2017 in EconLit, SciELO, NBER, PubMed, and Scopus. We included all studies that calculated the direct and indirect costs of obesity, except those that exclusively measured costs associated with bariatric surgery. No studies included were based on interventions. When studies calculated costs of obesity for a subset of the population, we extrapolated to the whole of Brazil, and all values were adjusted for inflation and expressed in 2017 prices. Results The initial search identified 811 abstracts, of which eight publications met our criteria and were included. Seven of them have direct costs, while only one assessed indirect costs of obesity. Total costs of obesity in Brazil ranged from USD 133.8 million to USD 6.3 billion per year. This wide variance was driven by the difference in methods employed as well as diseases considered. Medication and out-of-pocket expenses were higher in households with obese individuals. The studies included were assessed according to the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Institute of Health, complying from 40% to 60% of the applicable criteria. All studies included only a fraction of known costs. Most included only data from public health care facilities, omitting expenditures at private clinics and pharmacies, and they used different comorbidities and criteria for measurement. Studies are also cross-sectional, and cannot determine causality. Conclusions Evidence of the cost of obesity in Brazil is limited. The wide variance in methods used to calculate direct costs in the country restricts our ability to summarize the available evidence. However, all studies resulted in high costs of obesity. Studies that measure the indirect costs of obesity in Brazil are needed. Funding Sources Bloomberg Philanthropies through a sub-award agreement (5,104,695) between the University of North Carolina at Chapel Hill and Fundação Faculdade de Medicina, Brazil.

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Economic Burden Analysis of Parkinson’s Disease Patients in China

Parkinson s Disease ◽

10.1155/2017/8762939 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Jun-Xiu Yang ◽

Lei Chen

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Economic Burden ◽

Neurodegenerative Disorder ◽

Indirect Costs ◽

Prescription Medication ◽

Multivariate Regression Analysis ◽

Special Equipment ◽

Direct And Indirect Costs ◽

Healthcare Optimization

Background and Objective. Parkinson’s Disease (PD) is a progressive neurodegenerative disorder, which is prevalent in people over 65 years old. PD reduces patients’ quality of life and exerts a heavy economic burden on patients and their families. The purpose of this research is to identify the costs of PD and to evaluate the economic distribution of medical care for PD patients in China. Methods. A professional survey was administered to 116 patients with PD. Records of medical cost were reviewed. Direct and indirect costs were analyzed. The main cost-driving factors of PD were identified using multivariate regression analysis. Results. The average annual cost per PD patient in China is $3,225.94, with direct and indirect costs accounting for $2,503.46 and $722.48, respectively. Direct costs consist of $556.27 for surgery, $44.67 for appointment fees, $605.67 for prescription medication, $460.29 for hospitalization, $71.03 for auxiliary examination, $35.64 for transportation, $10.39 for special equipment, and $719.50 for formal care. The total cost is closely related to surgical treatment, dopamine agonist, and levodopa costs. Conclusion. The cost of PD patients in China is considerable and exceeds average economic capacity, especially antiparkinson medication and caring costs. This study may provide a reference for PD healthcare optimization in the future.

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Economic burden and mental health of primary caregivers of perinatally HIV infected adolescents from Kilifi, Kenya

10.21203/rs.2.17246/v1 ◽

2019 ◽

Author(s):

Patrick V Katana ◽

Amina Abubakar ◽

Moses K. Nyongesa ◽

Derrick Ssewanyana ◽

Paul Mwangi ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Economic Burden ◽

Primary Caregivers ◽

Indirect Costs ◽

Direct Costs ◽

Economic Costs ◽

Direct And Indirect Costs ◽

Living With Hiv ◽

Hiv Aids

Abstract Background: Eighty per cent of perinatally HIV infected (PHI) adolescents live in sub-Saharan Africa (SSA), a setting also characterized by huge economic disparities. Caregiving is crucial to the management of chronic illness such as HIV/AIDS, but the economic costs and mental disorders borne by caregivers of PHI adolescents often go unnoticed. In this study, we evaluated economic costs, coping strategies and association between economic cost and mental health functioning of caregivers of perinatally HIV infected adolescents in Kilifi, Kenya. Methods: We used a cost of illness descriptive analysis approach and mental health was assessed using the Patient Health Questionnaire (PHQ-9). Cross-sectional data were collected from 121 primary caregivers of PHI adolescents in Kilifi using a structured cost questionnaire. Economic costs (direct costs and indirect costs) were measured from primary caregivers’ perspective. We used descriptive statistics in reporting the results of this study. Results: Average monthly direct and indirect costs per primary caregiver was Ksh 2,784.51 (USD 27.85). Key drivers of direct costs were transportation (66.5%) and medications (13.8%). Total monthly costs represented 28.8% of the reported caregiver monthly earnings. Majority of the caregivers borrowed resources to cope with high economic burden. About 10.7% of primary caregivers reported depressive symptoms. Caregivers with positive depression screen (PHQ-9 score ≥10) had high average monthly direct and indirect costs. However, this was not statistically different compared to costs incurred by caregivers who screened negative for depressive symptoms. Conclusion: Our study indicates that HIV/AIDS is associated with a significant economic burden for caregivers of adolescents living with HIV. These high economic burdens seem to negatively influence the mental health of caregivers of adolescents living with HIV. Results underscore the need for developing economic empowerment and social support programmes that reduce the economic burden of caring for perinatally infected adolescent. These efforts may improve the mental health and quality of life of caregivers of adolescents living with HIV.

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