scholarly journals The cost of clinical management of SARS-COV-2 (COVID-19) infection by level of disease severity in Ghana: a protocol-based cost of illness analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hamza Ismaila ◽  
James Avoka Asamani ◽  
Virgil Kuassi Lokossou ◽  
Ebenezer Oduro-Mensah ◽  
Juliet Nabyonga-Orem ◽  
...  
Keyword(s):  
Early Detection ◽  
Disease Severity ◽  
Cost Of Illness ◽  
Resource Use ◽  
Clinical Management ◽  
Average Cost ◽  
Cost Of Treatment ◽  
Home Based ◽  
The Cost ◽  
Home Based Care

Abstract Background As the global strategies to fight the SARS-COV-2 infection (COVID-19) evolved, response strategies impacted the magnitude and distribution of health-related expenditures. Although the economic consequence of the COVID-19 pandemic has been dire, and its true scale is yet to be ascertained, one key component of the response is the management of infected persons which its cost has not been adequately examined, especially in Africa. Methods To fill gaps in context-specific cost of treating COVID-19 patients, we adopted a health system’s perspective and a bottom-up, point of care resource use data collection approach to estimate the cost of clinical management of COVID-19 infection in Ghana. The analysis was based on the national protocol for management of COVID-19 patients at the time, whether in public or private settings. No patients were enrolled into the study as it was entirely a protocol-based cost of illness analysis. Result We found that resource use and average cost of treatment per COVID-19 case varied significantly by disease severity level and treatment setting. The average cost of treating COVID-19 patient in Ghana was estimated to be US$11,925 (GH¢68,929) from the perspective of the health system; ranging from US$282 (GH¢1629) for patients with mild/asymptomatic disease condition managed at home to about US$23,382 (GH¢135,149) for critically ill patients requiring sophisticated and specialised care in hospitals. The cost of treatment increased by some 20 folds once a patient moved from home management to the treatment centre. Overheard costs accounted for 63–71% of institutionalised care compared to only 6% for home-based care. The main cost drivers in overhead category in the institutionalised care were personal protective equipment (PPEs) and transportation, whilst investigations (COVID-19 testing) and staff time for follow-up were the main cost drivers for home-based care. Conclusion Cost savings could be made by early detection and effective treatment of COVID-19 cases, preferably at home, before any chance of deterioration to the next worst form of the disease state, thereby freeing up more resources for other aspects of the fight against the pandemic. Policy makers in Ghana should thus make it a top priority to intensify the early detection and case management of COVID-19 infections.

scholarly journals The Cost of Clinical Management of SARS-COV-2 (COVID-19) Infection in Ghana: A Cost of Illness Analysis

2021 ◽  
Author(s):  
Hamza Ismaila ◽  
James Avoka Asamani ◽  
Virgil Kuassi Lokossou ◽  
Ebenezer Oduro-Mensah ◽  
Juliet Nabyonga-Orem ◽  
...  
Keyword(s):  
Early Detection ◽  
Resource Use ◽  
Clinical Management ◽  
Point Of Care ◽  
Cost Savings ◽  
African Countries ◽  
Cost Of Treatment ◽  
Home Based ◽  
Context Specific ◽  
The Cost

Abstract Background: As the global strategies to fight the SARS-COV-2 infection (COVID-19) evolved, global response strategies impacted the magnitude and distribution of health-related expenditures. Although the economic consequence of the COVID-19 pandemic has been dire, and its true scale yet to be ascertained, one key component of the response is the management of infected persons which its cost has not been adequately examined, especially in the context of African countries. Methodology: To partly fill gaps in context-specific cost of treating COVID-19 patients, we adopted a health system’s perspective and a bottom-up, point of care resource use data collection approach to estimate the cost of clinical management of COVID-19 infection in Ghana. Findings: We found that resource use and average cost of treatment per COVID-19 case varied significantly by level of disease severity and treatment setting. The cost of treating COVID-19 patients in Ghana from the perspective of the health system ranged from US$282 (GH ¢1,629) to US$23,382 (GH ¢135,149), with an average of US$11,925 (GH ¢68,929). The cost of treatment increased by at least 20 folds once a patient moved from home management to the treatment centre. PPEs and Transportation were the main cost drivers for institutionalised care, whilst investigations (COVID-19 testing) and staff time were for home-based care. Conclusion: Cost savings could be made by early detection and effective treatment of COVID- 19 cases, preferably at home, before any chance of deterioration to the next worst form of the disease state, thereby freeing up more resources for other aspects of the fight against the pandemic. Policy makers in Ghana should thus make it a top priority to intensify the early detection and case management of COVID-19 infections.

Comparison of treatment costs of pembrolizumab versus nivolumab in head and neck squamous cell carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19368-e19368
Author(s):  
Justin Yeh ◽  
Achuta Kumar Guddati
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Average Cost ◽  
Standard Of Care ◽  
Neck Squamous Cell Carcinoma ◽  
Published Data ◽  
Cost Of Treatment ◽  
The Cost

e19368 Background: Pembrolizumab and Nivolumab are PD-1 inhibiting immunotherapy agents approved for the treatment of metastatic or recurrent head and neck squamous cell carcinoma in patients previously treated with platinum-based chemotherapy. Both therapies have demonstrated similar survival benefits and adverse event profiles, but there is no published comparison of treatment cost and survival between the two agents. This study aims to analyze the cost-effectiveness of pembrolizumab compared to nivolumab through network meta-analysis techniques. Methods: Data published from the KEYNOTE-040 (pembrolizumab) and CheckMate 141 (nivolumab) studies were used to generate a model incorporating the cost of each drug in both the arms. The cost of treatment of side effects was extracted from previously published data and used for cost estimation in the model. Data from the standard of care arms (cetuximab, methotrexate, or docetaxel) in each study were adjusted to provide a common reference between the two studies. The number of years added in terms of overall survival was calculated for the entire experimental arm and the cost of each such year was calculated. All costs were adjusted for inflation. Results: Using published data from the KENOTE-040 trial, the average cost per patient adjusted for inflation over time, over 24 months in the pembrolizumab arm was $159,302, and similarly using data from the Checkmate 141 trial, the average cost per patient over 18 months in the nivolumab arm was $118,790. The cost of management of adverse effects was $18,728 vs $16,685 (pembrolizumab vs. nivolumab) during these time periods. Our model suggests that the adjusted total cost per month for patients on these drugs is very similar: $7417.91 vs. $7526.38. Assuming that the quality of life was similar in both groups and using an average OS for the standard of care arms, our model predicts that ICER for pembrolizumab is higher than nivolumab ($203,085 vs. 132,644). Conclusions: Both pembrolizumab and nivolumab improve survival benefit compared to their respective standard of care arms. However, the ICER for both medications is higher than the threshold set by many payers and health provider organizations. The model makes several assumptions which may render it less accurate to compare between trials but the cost of treatment for both drugs is not in the cost-effective range. To utilize these drugs in a cost-conscious practice, further research is needed to investigate lower doses at a slower frequency along with reduction of the price for each medication.

Home-based versus hospital-based care for serious mental illness

1998 ◽  
Vol 172 (6) ◽  
pp. 506-512 ◽  
Author(s):  
Martin R. J. Knapp ◽  
Isaac M. Marks ◽  
Jane Wolstenholme ◽  
Jennifer K. Beecham ◽  
Jack Astin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Controlled Study ◽  
Sample Attrition ◽  
Home Based ◽  
The Difference ◽  
Randomised Controlled ◽  
The Cost ◽  
Home Based Care

BackgroundThe Daily Living Programme (DLP) offered intensive home-based care with problem-centred case management for seriously mentally ill people facing crisis admission to the Maudsley Hospital, London. The cost-effectiveness of the DLP was examined over four years.MethodA randomised controlled study examined cost-effectiveness of DLP versus standard in/out-patient hospital care over 20 months, followed by a randomised controlled withdrawal of half the DLP patients into standard care. Three patient groups were compared over 45 months: DLP throughout the period, DLP for 20 months followed by standard care, and standard care throughout. Bivariate and multivariate analyses were conducted (the latter to standardise for possible inter-sample differences stemming from sample attrition and to explore sources of within-sample variation).ResultsThe DLP was more cost-effective than control care over months 1–20, and also over the full 45-month period, but the difference between groups may have disappeared by the end of month 45.ConclusionsThe reduction of the cost-effectiveness advantage for home-based care was perhaps partly due to the attenuation of DLP care, although sample attrition left some comparisons under-powered.

scholarly journals Disease Management and Resource Use for the Management of Melanoma stage IIIc or IV Positive for BRAF V600 Mutations in Greece

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Carayanni V ◽  
Gogas H ◽  
Bafaloukos D ◽  
Boukovinas I ◽  
Latsou D ◽  
...  
Keyword(s):  
Resource Use ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Cost Of Treatment ◽  
Management Scenario ◽  
Third Line ◽  
The Cost ◽  
Third Line Treatment ◽  
First Line Treatment

Objective: Melanoma is one of the most aggressive cancers and is responsible for the majority of skin cancer deaths, with the presence of metastases prognostic for poor survival. At a time when most cancer incidences are falling, the annual incidence of melanoma has risen as rapidly as 4-6% in many European countries, with a substantial economic burden in advanced stages. The objective of this study is the investigation of treatment pathways and healthcare resource use related to advanced BRAF-mutated melanoma in Greece. Methods: This study is based on the information collected by an expert panel comprising of 3 oncologists of major public and private melanoma clinics around Greece. A 3-round survey was undertaken, according to a modified Delphi method. The treatment phases studied were: pre-progression; disease progression and terminal care. Oncology drug costs, medical visits, laboratory tests, imaging examinations, hospitalization and concomitant medications were the resources considered in the context of the Greek National Services Organization (EOPYY). Results: Τhe most common management scenario (80% of cases) in Greece for patients of stage IV BRAF V600 mutated melanoma was: targeted therapies as first line treatment at 95%, followed by immunotherapies at 100% as second line as well as third line treatment at 65% of cases. The weighted annual cost of treatment was 89.215,78 €, (90%CI:62,451.05; 115,980.51) for first line treatment at list price and around 41.584,50 (90%CI:29,109.15; 54,059.85) based on the negotiated price. At second line, the cost of treatment has been estimated between 15,704.272 (90%CI:10,992.990; 20,415.553) and 19,800.92€, (90%CI: 16,489; 30,622) for the two most common management scenarios for immunotherapies. For third line treatment the cost was 37,778.93 (90%CI 26,445.25; 49,112.61€) for the mostly used management scenario (50% ipilimumab). Conclusions: Μetastatic BRAF mutant melanoma requires prolonged and costly treatment with new therapies shown to substantially increase life expectancy. Identifying the appropriate treatment options in order to optimize health outcomes should be an important priority in healthcare system.

The cost of home-based care for HIV/AIDS patients in Zimbabwe

AIDS Care ◽  
1998 ◽  
Vol 10 (6) ◽  
pp. 751-759 ◽  
Author(s):  
K. HANSEN ◽  
G. WOELK ◽  
H. JACKSON ◽  
R. KERKHOVEN ◽  
N. MANJONJORI ◽  
...  
Keyword(s):  
Aids Patients ◽  
Home Based ◽  
The Cost ◽  
Home Based Care ◽  
Hiv Aids

scholarly journals Economic aspects of pharmacotherapy of servicemen with injury and wound of the brain

2018 ◽  
pp. 16-23
Author(s):  
A. P. Shmatenko ◽  
Yu. V. Rumyancev ◽  
O. M. Vlasenko ◽  
O. V. Pleshkova
Keyword(s):  
Average Cost ◽  
Brain Metabolism ◽  
Medical Documentation ◽  
Symptomatic Therapy ◽  
Support Functions ◽  
Cost Of Treatment ◽  
Injuries And Wounds ◽  
Anti Inflammatory ◽  
The Cost ◽  
The Brain

The fighting in the area of the antiterrorist operation led to a large number of injuries among servicemen who are serving in the east of the country. Injuries and wound of the brain occupy about 35–40% among the total level of injury. and mortality in severe traumatic brain injury is 70%. All this has determined the relevance of the study of medical treatment of servicemen with injury and wound of the brain., Numerous pharmacotherapeutic schemes have been proposed for the treatment of victims with this pathology, aimed at preventing brain hypoxia, improving metabolic processes, normalizing life support functions and intracranial pressure, and the price range of pharmacotherapy of this pathology varies considerably, that’s why the aim of our work is to establish the cost indicators of the main directions of pharmacotherapy of affected servicemen with injury and wound of the brain.The main directions of the pharmacotherapy of injuries and wounds of the brain have been identified as a result of the analysis of the scientific literature and primary medical documentation, which include: normalization of life-supporting functions and brain metabolism; treatment of intracranial hypertension; restoration of microcirculation and cerebral circulation; elimination of excitation and convulsions; antibacterial, analgesic, anti-inflammatory, blood-resuscitating and symptomatic therapy. Analysis of the dependence of the cost of treatment on the severity of the affected servicemen with injury and wound of the brain showed that the most expensive is the pharmacotherapy of severe injuries and wounds, the average cost of treatment of the affected is 139,98 UAH for 1 patient per day. The average cost of medicines for the treatment of servicemen with injuries and wounds of medium and mild severity was 67,23 and 42,26 UAH per day respectively We analyzed the total costs spent on these directions of pharmacotherapy and found that the greatest cost is characterized by the costs of normalizing brain metabolism, the costs are 1 261,21 UAH per patient, this accounts for 38% of the total cost of medicines. Also, the most expensive directions are antibacterial – 649,27 UAH (19%) and analgesic therapy – 375,90 UAH (11%). The least expenses are expended on anti-inflammatory therapy, the cost of which is 19,96 UAH. Analyzing the daily cost of one day of treatment of affected it was found that the most expensive are the first 7 days of treatment.

scholarly journals Skin infections due to Panton-Valentine leukocidin (PVL)-producing S. aureus—Cost effectiveness of outpatient treatment

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253633
Author(s):  
Marc-Nicolas Rentinck ◽  
Renate Krüger ◽  
Pia-Alice Hoppe ◽  
Daniel Humme ◽  
Michaela Niebank ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Outpatient Treatment ◽  
Average Cost ◽  
Main Diagnosis ◽  
Skin Infections ◽  
Soft Tissue Infections ◽  
Cost Of Treatment ◽  
The Cost ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

Introduction Skin and soft tissue infections (SSTI) caused by Panton-Valentine leukocidin (PVL)-producing strains of Staphylococcus aureus (PVL-SA) are associated with recurrent skin abscesses. Secondary prevention, in conjunction with primary treatment of the infection, focuses on topical decolonization. Topical decolonization is a standard procedure in cases of recurrent PVL-SA skin infections and is recommended in international guidelines. However, this outpatient treatment is often not fully reimbursed by health insurance providers, which may interfere with successful PVL-SA decolonization. Aim Our goal was to estimate the cost effectiveness of outpatient decolonization of patients with recurrent PVL-SA skin infections. We calculated the average cost of treatment for PVL-SA per outpatient decolonization procedure as well as per in-hospital stay. Methods The study was conducted between 2014 and 2018 at a German tertiary care university hospital. The cohort analyzed was obtained from the hospital’s microbiology laboratory database. Data on medical costs, DRG-based diagnoses, and ICD-10 patient data was obtained from the hospital’s financial controlling department. We calculated the average cost of treatment for patients admitted for treatment of PVL-SA induced skin infections. The cost of outpatient treatment is based on the German regulations of drug prices for prescription drugs. Results We analyzed a total of n = 466 swabs from n = 411 patients with recurrent skin infections suspected of carrying PVL-SA. PVL-SA was detected in 61.3% of all patients included in the study. Of those isolates, 80.6% were methicillin-susceptible, 19.4% methicillin-resistant. 89.8% of all patients were treated as outpatients. In 73.0% of inpatients colonized with PVL-SA the main diagnosis was SSTI. The median length of stay was 5.5 days for inpatients colonized with PVL-SA whose main diagnosis SSTI; the average cost was €2,283. The estimated costs per decolonization procedure in outpatients ranged from €50-€110, depending on the products used. Conclusion Our data shows that outpatient decolonization offers a highly cost-effective secondary prevention strategy, which may prevent costly inpatient treatments. Therefore, health insurance companies should consider providing coverage of outpatient treatment of recurrent PVL-SA skin and soft tissue infections.

scholarly journals Programmatic implications of a cost study of home-based care programs in South Africa

2005 ◽  
Author(s):  
Rick Homan ◽  
Catherine Searle
Keyword(s):  
Rural Areas ◽  
Chronically Ill ◽  
Cost Study ◽  
Aids Epidemic ◽  
Use Of Resources ◽  
Home Based ◽  
Care And Support ◽  
The Cost ◽  
Home Based Care ◽  
Hiv Aids

The HIV/AIDS epidemic has meant that an increasing number of chronically ill people need ongoing assistance with care and support. Programs providing home-based care (HBC) services are a key component of the response to HIV/AIDS. However, few programs are using operations research, including cost studies, to decide what services to provide and how to structure their services. In 2004, the Horizons Program undertook a study of six HBC programs from different South African provinces to provide key information to NGOs, government ministries, donors, and the programs themselves to inform decisions about service delivery. The study analyzed the cost of HBC services, the best use of resources, and how well programs are able to meet the needs of beneficiaries and their families. The sample represents programs that operate in rural areas and informal settlements. This brief focuses on the coverage, organization, volume, and costs of the services and on findings from two of the methods of data collection: financial records and service statistics, and interviews with financial officers, program managers, and caregivers.

Sign in / Sign up

Export Citation Format

Share Document