[Economic aspects of osteoporosis]. / Ekonomické aspekty osteoporózy.

BACKGROUND: The objective of this study was to evaluate expenditures and efficacy of osteoporosis treatment in the Czech Republic (CZ) (1.38 million women and 0.99 million men > 55 years of age). METHODS AND RESULTS: Demographic data, incidence of hip fractures and prevalence of osteoporosis and osteopenia in Czech women and men, cost burden to healthcare agencies due to hip fractures and costs of diagnostic procedures, preventive measures and therapies of osteoporosis were obtained from published data and from database of the main health insurance agency (VZP) and the State Institute for Drug Control. The direct costs for treatment of hip fractures in the CZ in 1997 averaged Kc (Czech Crown) 2.5 billion, diagnosis of osteoporosis, Kc 150 million, prevention of osteoporosis using hormone replacement therapy, Kc 66 million, and treatments of osteoporosis which has been applied to less than 5% of osteoporosis patients, 482 million. However, despite the continuously increasing expenditures for treatments of osteoporosis, the incidence of hip fractures doubled in the last 10 years. This is mainly due to increased life expectancy in Czech women and men. CONCLUSIONS: The results of this first economic evaluation of diagnosis, treatment and consequences of osteoporosis in the CZ indicate a need for conceptual decisions in both treatment and prevention of osteoporosis.

Effects of drug administration in pregnancy on children's school behaviour.

Files with prescription data were used to assess possible behavioural changes in children, whose mothers used benzodiazepines or neuroleptic drugs during the second half of their pregnancy. Prescriptions, bearing the identification number of women resident in one district of Prague, filed in pharmacies during 1974 and the first three months of 1975 represent the first part of the data. During 1984, children born in the appropriate earlier period were searched and linked with the earlier prescription data. A group of 68 children with possible exposure to neuroleptics and a group of 15 children possibly exposed to diazepam during the second half of their intrauterine development were found. Two groups of 55 and 7 children, respectively, born of mothers without exposure to these drugs, were chosen as controls. The teachers of classes attended by these children were addressed by a letter and asked to evaluate their behaviour at school. This was done by means of a form containing analogue scales evaluating different features of behaviour. Each child was compared with its control. The statistical evaluation with Student's t-test, regression analysis and analysis of variance did not reveal any significant difference between both groups and their controls.

[Prognosis for requirements for oral antidiabetic agents in Bohemia]. / Prognóza potreby perorálních antidiabetik v CSR.

The authors elaborated the prognosis of requirements of oral antidiabetics (PAD) in the CSR, based on the estimate of the number of diabetics, using the method of demographic projection and the estimate of the number of diabetics treated by this therapy. The respective numbers of diabetics are circulated for five-year age-groups, separately for men and women. The need of PAD is derived from the mean daily dose per diabetic patient treated with PAD, separately for biguanides and derivatives of sulphonyl urea. The prognosis respects the basic factors which influence the need of PAD, i.e. the development of the diabetic population, incl. the evolution of its structure, and the development of the attitude to PAD therapy. The application of various assumptions on the future development leads various to variants of the prognosis. Comparison with the actual development is important for evaluation of applied therapeutic methods and for planning purposes. The results of the prognosis indicate that in 1995 the need of PAD in the CSR will vary between 140 and 190% of the consumption in 1980, however, as a result of an uneven development the annual increment could be as high as 19% or there could be a slight drop.

[Prognosis for insulin requirements in Czechoslovakia]. / Prognóza potreby inzulínu v CSR.

The submitted prognosis of insulin requirements in the CSR is based on the estimated number of type 1 diabetics and the estimated number of insulin treated type 2 diabetics. For the purpose of the prognosis these numbers are calculated for five-year age groups, separately for men and women. In the first approximation the authors assume that in the treatment of type 1 diabetics four typical therapeutic regimes are used which are consistent with conventional therapy and its intensified modification. In type 2 diabetics in the first approximation it is assumed that another four variants of therapeutic regimes will be mostly used which are typical for these patients. The sum of daily doses needed by all patients gives an estimate of the total requirements of the four basic types of insulin. This prognosis respects the basic factors which influence insulin requirements, whereby the basis is the development of the health status of the population. Comparison of different variants of the prognosis of requirements with the actual consumption makes it possible to formulate some conclusions for planning production and for evaluating the used and perspectively foreseen insulin therapy. From the results of the prognosis ensues that in 1995 the insulin consumption in the CSR will vary between 150 and 185% of the consumption in 1980.