scholarly journals Cystic fibrosis as a social-economic burden

2021 ◽  
pp. 38-49
Author(s):  
A. S. Kolbin ◽  
Yu. M. Gomon ◽  
O. I. Karpov ◽  
Yu. E. Balykina ◽  
M. A. Proskurin
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Economic Burden ◽  
Main Part ◽  
New Technologies ◽  
Social Economic ◽  
Indirect Costs ◽  
Medical Costs ◽  
Insurance Fund ◽  
Social Burden

Cystic fibrosis (CF) is a chronic genetic disease with social significant weight because it influences on social humanitarian part of health and on sources of health care system as well. Materials and methods. Data of CF Register and treatment methodology based on clinical guidelines were used for analysis. Direct and indirect medical costs as well as indirect costs have been calculated per one patient per year. Direct costs included diagnostic costs and treatment based on Obligatory medical Insurance fund tariffs, costs of drugs and medical devices, rehabilitation, payments due to disability; indirect costs included loss of GDP. Results. Total expenditures were calculated as 3,1 mln RUR for one patient annually, direct medical costs were 71 % of total. Main part of expenditures was allocated for out-patient stage of treatment — 1,57 mln RUR. Exacerbations costs were estimated as 399,4 thousand RUR. Indirect medical cost was 314,6 thousand RUR, and indirect cost as 582,9 thousand RUR as well annually. Total economic burden of CF for Russian Federation was calculated as 10,37 bln RUR/year, main part was a direct medical expenditures — 73 %. Conclusion. CF is a big social-economic burden in the Russian conditions. Reducing the number of exacerbations and improving lung function, as well as increasing the life expectancy of patients with CF due to introduction of new technologies in health care (targeted therapy) is aimed at reducing the social burden of the disease, which will require increasing the availability of effective (targeted) drugs in the future.

scholarly journals Economic Burden Associated with Head Louse (Pediculus humanus capitis) Infestation in Iran

2020 ◽  
Author(s):  
Mojtaba SALIMI ◽  
Abedin SAGHAFIPOUR ◽  
Hadi HAMIDI PARSA ◽  
Majid KHOSRAVI
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Economic Burden ◽  
Head Louse ◽  
Indirect Costs ◽  
Head Lice ◽  
Louse Infestation ◽  
Direct And Indirect Costs ◽  
Head Louse Infestation ◽  
Care System

Background: The head louse infestation is a public health issue in the world especially, affecting most people who live in camps, school-aged children and their families. Head lice treatment has economic ramifications that often under calculated. The aim of this study was evaluation of economic burden associated with head louse infestation in Iran. Methods: In a cross-sectional study, 500,002 infestations were diagnosed among suspected head lice infested people who referred to health care system in all provinces of Iran during 2017. Direct and indirect costs related to paid by patients and government systems were extracted by referring to accounting documents and interviews with patients and experts and were recorded in researcher-made forms. Microsoft Excel 2010 software was used for economic burden calculation. Results: The incidence rate of head lice infestation in Iran was 500,002/79,926,270 (625.5 per 100,000 populations). Economic burden of head lice in the country was calculated at 5,790,143$. Direct and indirect costs, governmental cost, out of pocket and total costs of head lice were included 3.14$, 2.84$, 5.98$, 5.60$ and 11.58$ per case respectively. Conclusion: The direct and indirect costs associated with treatment of infestations were relatively high. Therefore, the creation of medical facilities such as availability of diagnostic and treatment strategies can be effective in the control of infestation. The adoption of infestation prevention methods, such as health education to people at risk of infestation, reduces the incidence of head lice and imposition of related treatment costs on governmental health care system and head lice cases.

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.

A social-economic burden of rhinosinusitis with nasal polyps with comorbid asthma and influence of dupilumab

2021 ◽  
pp. 16-30
Author(s):  
I. S. Krysanov ◽  
V. S. Krysanova ◽  
V. Yu. Ermakova
Keyword(s):  
Medical Cost ◽  
Economic Burden ◽  
Nasal Polyps ◽  
Social Economic ◽  
Weighted Average ◽  
Indirect Costs ◽  
Biologic Drugs ◽  
State Position ◽  
The Russian Federation ◽  
Regions Of Russia

Rhinosinusitis with nasal polyps (RwNP) is a one of most common comorbidities in asthma and contrariwise and can lead to exacerbation of severe asthma (SA). Dupilumab is a perspective medicine for treatment of both, because it decreases exacerbations and prevents of a necessity of surgeon. Economics aspects of dupilumab treatment in RwNP + SA are not examined yet. Thus aim of this study was evaluation of social-economic burden of RwNP + SA in the Russian Federation and dupilumab influence on it. Materials and methods. Direct medical (cost of medicines, treatment in outpatients department and in hospital, including surgery and rate of exacerbations per year) and non-medical (payment for temporary and stable disability) and indirect costs (GDP loses) in RwNP + SA patients have been evaluated. Medical cure of a patient with RwNP + SA was created according to survey of experts from different regions of Russia. Modelling of expenditures was prepared on all calculated cohort of potential patients with RwNP + SA from “State” position and growing approach. Results. Expenditures for cure of one patient with RwNP were as 234 217,71 RUR/year. Weighted average costs for one patient with RwNP + SA were 1 881 883,39 RUR, and mostly were associated with indirect costs. Dupilumab can decrease expenditures for one patient with RwNP + SA till 1 593 162,87 RUR (on 15,3 %) annually. Potential cohort with RwNP + SA has been estimated above 39 thousand patients. Total economic burden of RwNP + SA in Russia were estimated as 1,7 bln RUR. Dupilumab usage in patients with RwNP + SA fixed in Register can help decrease economic burden on 259 mln RUR annually. Hidden economic burden of comorbidity can reach 73,4 bln RUR (for all calculated / modelled cohort of patients with RwNP + SA), dupilumab saves 11,3 bln RUR annually in this scenario. Conclusion. Comorbid pathology — RwNP+SA has a sufficient social-economic burden in Russia, that could be decreased by modern biologic drugs, in particular, with dupilumab.

scholarly journals The economic burden of cervical cancer in Eswatini: Societal perspective

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250113
Author(s):  
Cebisile Ngcamphalala ◽  
Ellinor Östensson ◽  
Themba G. Ginindza
Keyword(s):  
Cervical Cancer ◽  
Economic Burden ◽  
Invasive Cervical Cancer ◽  
Productivity Loss ◽  
Indirect Costs ◽  
Premature Mortality ◽  
Medical Costs ◽  
Cost Driver ◽  
Sub Saharan Africa ◽  
Care Utilization

Background Cervical cancer imposes considerable economic burden on societies and individuals. There is lack of evidence regarding this from the developing world and particularly from sub-Saharan Africa. Therefore, the study aimed to estimate the societal costs of cervical cancer in Eswatini. Materials and methods The cost of illness study (CoI) was applied using national specific clinical and registry data from hospitals, registries and reports to determine the prevalence of cervical intraepithelial neoplasia (CIN) and cervical cancer in Eswatini in 2018. Cost data included direct medical costs (health care utilization in inpatient and outpatient care), direct non-medical costs (patient costs for traveling) and indirect costs based on productivity loss due to morbidity (patient time during diagnosis and treatment) and premature mortality. Results The estimated total annual cost for cervical cancer was $19 million (ranging between $14 million and $24 million estimated with lower and upper bounds). Direct cost represented the majority of the costs at 72% ($13.7 million) out of which total pre-cancerous treatment costs accounted for 0.7% ($94,161). The management of invasive cervical cancer was the main cost driver with costs attributable to treatment for FIGO III and FIGO IV representing $1.7 million and $8.7 million respectively. Indirect costs contributed 27% ($5.3 million) out of which productivity loss due to premature mortality represented the majority at 67% ($3.5 million). Conclusion The economic burden of cervical cancer in Eswatini is substantial. National public health prevention strategies with prophylactic HPV vaccine and screening for cervical lesions should therefore be prioritized to limit the extensive costs associated with cervical cancer.

scholarly journals Rethinking the economic costs of hospitalization for malaria: accounting for the comorbidities of malaria patients in western Kenya

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Caroline Watts ◽  
Harrysone Atieli ◽  
Jason Alacapa ◽  
Ming-Chieh Lee ◽  
Guofa Zhou ◽  
...  
Keyword(s):  
Health System ◽  
Economic Burden ◽  
Indirect Costs ◽  
Malaria Diagnosis ◽  
Medical Costs ◽  
Malaria Episode ◽  
Economic Costs ◽  
Western Kenya ◽  
The Mean ◽  
Household Costs

Abstract Background Malaria causes significant mortality and morbidity in sub-Saharan Africa, especially among children under five years of age and places a huge economic burden on individuals and health systems. While this burden has been assessed previously, few studies have explored how malaria comorbidities affect inpatient costs. This study in a malaria endemic area in Western Kenya, assessed the total treatment costs per malaria episode including comorbidities in children and adults. Methods Total economic costs of malaria hospitalizations were calculated from a health system and societal perspective. Patient-level data were collected from patients admitted with a malaria diagnosis to a county-level hospital between June 2016 and May 2017. All treatment documented in medical records were included as health system costs. Patient and household costs included direct medical and non-medical expenses, and indirect costs due to productivity losses. Results Of the 746 patients admitted with a malaria diagnosis, 64% were female and 36% were male. The mean age was 14 years (median 7 years). The mean length of stay was three days. The mean health system cost per patient was Kenyan Shilling (KSh) 4288 (USD 42.0) (95% confidence interval (CI) 95% CI KSh 4046–4531). The total household cost per patient was KSh 1676 (USD 16.4) (95% CI KSh 1488–1864) and consisted of: KSh 161 (USD1.6) medical costs; KSh 728 (USD 7.1) non-medical costs; and KSh 787 (USD 7.7) indirect costs. The total societal cost (health system and household costs) per patient was KSh 5964 (USD 58.4) (95% CI KSh 5534–6394). Almost a quarter of patients (24%) had a reported comorbidity. The most common malaria comorbidities were chest infections, diarrhoea, and anaemia. The inclusion of comorbidities compared to patients with-out comorbidities led to a 46% increase in societal costs (health system costs increased by 43% and patient and household costs increased by 54%). Conclusions The economic burden of malaria is increased by comorbidities which are associated with longer hospital stays and higher medical costs to patients and the health system. Understanding the full economic burden of malaria is critical if future malaria control interventions are to protect access to care, especially by the poor.

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

2021 ◽  
Author(s):  
Grace Yang ◽  
Inna Cintina ◽  
Anne Pariser ◽  
Elisabeth Oehrlein ◽  
Jamie Sullivan ◽  
...  
Keyword(s):  
Rare Disease ◽  
Direct Medical Cost ◽  
Medical Cost ◽  
Economic Burden ◽  
Claims Data ◽  
Indirect Costs ◽  
Medical Costs ◽  
Hospital Inpatient ◽  
Care Providers ◽  
National Economic

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

P3812The economic burden of heart failure in Denmark from 1998 to 2016

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J S Bundgaard ◽  
U M Mogensen ◽  
S Christensen ◽  
U M Ploug ◽  
R Roerth ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Costs ◽  
Economic Burden ◽  
Indirect Costs ◽  
Economic Consequences ◽  
Control Group ◽  
Background Population ◽  
The Individual ◽  
Care Costs

Abstract Background Heart failure (HF) imposes a large burden on the individual as well as society and the aim of this study was to investigate the economic burden attributed to direct and indirect costs of patients with HF before, at, and after time of diagnosis. Methods Using Danish nationwide registries we identified all patients >18 years with a first-time diagnosis of HF from 1998–2016 and matched them 1:1 with a control group from the background population on age, gender, marital status, and educational level. The economic analysis of the total costs after diagnosis was based on direct costs including hospitalization, procedures, medication, and indirect costs including social welfare and lost productivity to estimate the annual cost of HF. Results We included a total of 176,067 HF patients with a median age of 76 years, and 55% were male. Patients with HF incurred an average of €17,039 in sum of total annual direct (€11,926) and indirect (€5,113) health-care costs peaking at year of diagnosis compared to €5,936 in the control group with the majorityattributable to inpatient admissions. The total annual net costs including social transfer after index HF were €11,957 higher in patients with HF compared to controls and the economic consequences increased markedly 2 years prior to the diagnosis of HF (Figure 1). Conclusion Patients with HF impose significantly higher total annual health-care costs compared to a matched control group with findings evident more than 2 years prior to HF diagnosis Acknowledgement/Funding Novartis

scholarly journals The economic burden of inadequate consumption of vegetables and fruit in Canada

2016 ◽  
Vol 20 (3) ◽  
pp. 515-523 ◽  
Author(s):  
John Paul Ekwaru ◽  
Arto Ohinmaa ◽  
Sarah Loehr ◽  
Solmaz Setayeshgar ◽  
Nguyen Xuan Thanh ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Economic Burden ◽  
Population Attributable Fraction ◽  
Indirect Costs ◽  
Care Physician ◽  
Excess Body Weight ◽  
Economic Implications ◽  
Risk Estimates ◽  
Care Costs

AbstractObjectivePublic health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada.DesignWe accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015.ResultsAbout 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion.ConclusionsFurther investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.

scholarly journals Economic Burden of Rare Diseases With Common Diseases as a Comorbidity in Poland

2020 ◽  
Vol 2/2020 (88) ◽  
pp. 103-120
Author(s):  
Joanna Leśniowska ◽  
Keyword(s):  
Health Care ◽  
Sensitivity Analysis ◽  
Health Care Providers ◽  
National Health ◽  
Rare Diseases ◽  
Economic Burden ◽  
Indirect Costs ◽  
Care Providers ◽  
Source Language ◽  
Common Diseases

Purpose: Some of the common diseases are the comorbidities of rare diseases and they impose a considerable economic burden on the national health care system and economy. We examined the economic burden of a rare disease (tuberous sclerosis complex – TSC) in Poland and its comorbidities (common diseases – epilepsy and status epilepticus) while taking into account a sensitivity analysis. Design/Methodology/Approach: This study is a prevalence-based top-down cost of illness study that analyzes the direct and indirect cost of TSC and its complications. The research was based on the data obtained from the National Health Fund (hereinafter referred to as “NFZ”, which is the abbreviation of the source language name of the institution), Social Insurance Institution (hereinafter referred to as “ZUS”, which is the abbreviation of the source language name of the institution), and Poland’s Central Statistical Office (hereinafter referred to as “GUS”, which is the abbreviation of the source language name of the institution) by using the human capital method. Findings: The total cost of TSC and its complications in Poland, when taking the sensitivity analysis into account, amounts to EUR 2.2 million – EUR 3.4 million, which has a prevalence of indirect costs (61%–83% of the total costs). The conducted analysis indicates that the higher costs of common diseases result from insufficient financing for research of rare diseases which in many cases have common diseases as a comorbidity. Research limitations/implications: The limitations of the research analysis result from the lack of registration of patients suffering from rare diseases in Poland and from the requirements for the billing codes in the documentation of NFZ and Polish health care providers. Therefore, the study includes a sensitivity analysis. Originality/value: This is the first attempt to evaluate the total economic burden of TSC in Poland. The study indicates that the indirect costs of diseases are often overlooked in health care planning in Poland.

scholarly journals The Treatment Pattern and Economic Burden of Homozygous Familial Hypercholesterolemia in China: A Study based on a Patient-Survey

2021 ◽  
Author(s):  
yan yang ◽  
Lvya Wang ◽  
Ya Yang ◽  
Wenhui Wen ◽  
Mi Tang ◽  
...  
Keyword(s):  
Economic Burden ◽  
Burden Of Disease ◽  
Indirect Costs ◽  
Medical Costs ◽  
Treatment Pattern ◽  
Lipid Lowering ◽  
Homozygous Familial Hypercholesterolemia ◽  
Economic Burden Of Disease ◽  
Diet Control ◽  
Per Capita

Abstract Objective: The study aimed to investigate the treatment pattern and economic burden of homozygous familial hypercholesterolemia (HoFH) in China, and to evaluate the incidence rate of catastrophic health expenditure (CHE) of HoFH patients and their families.Methods: Patients with HoFH diagnosed and treated in Beijing An’Zhen Hospital was included. A questionnaire was developed to investigate and capture the relevant variables of the participants.Results: A total of 120 HoFH patients were investigated, and the number of children (age under 18) was 1.2 times more than adults (age above 18). There were 113 patients with basic medical insurance (including 61 patients with new rural cooperative medical insurance), 4 patients with commercial insurance and 3 patients without any insurance. There were 35 patients with atherosclerotic cardiovascular disease (ASCVD), including 29 adults and 6 children. Only 6 pediatric patients achieved their low-density lipoprotein cholesterol (LDL-C) treatment targets, and all 54 adult patients did not achieve it. The most commonly used treatment method was diet control with lipid-lowering drugs (16.67%), followed by diet control and lipid-lowering drugs using separately (16.67%). The proportion of patients whose annual personal income reached GDP per capita in 2019 was only 2.5%. The total economic burden of disease was 5,529,100 CNY / year, including direct medical costs of 3,427,200 CNY / year, direct non-medical costs of 1,504,500 CNY / year and indirect costs of 611,300 CNY / year; the per capita economic burden of disease was 46,100 CNY / year, including direct medical costs of 28,600 CNY / year, direct non-medical costs of 12,500 CNY / year and indirect costs of 5,100 CNY / year. There were 32 families with CHE due to the disease, accounting for 26.67%.Conclusion: Patients with HoFH in China are generally at young age, and the economic burden of disease for the family is heavy. The existing treatment is not effective, and it is easy to cause premature death due to ASCVD.

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