Prostate cancer in Spain: A retrospective database analysis of hospital incidence and the direct medical costs.

INTRODUCTION: The goal of this study is to determine the medical costs, comorbidity profile, and health care resources use of patients diagnosed with prostate cancer who have been treated in Spanish hospitals. METHODS: The admission records of the patients diagnosed with prostate cancer used in the study were registered between January 2016 and December 2020. These records have been collected from a Spanish hospital discharge database and have been evaluated in a retrospective multicenter analysis. RESULTS: 8218 patients from the database met the criteria and were thus analyzed. The median aged of the diagnosed patients was 71.68 years. The median Charlson comorbidity index (CCI) score was 4, and the updated median CCI was 3. Hypertension was diagnosed in the 49.76% of the individuals, 37.03% had chronic obstructive pulmonary disease and 34.51% had hyperlipidaemia. The mortality rate was 9.30%. The most common medical procedure was prostate resection with percutaneous endoscopic approach (31.18%). The mean annual cost per admission was 5212.98€ €. CONCLUSIONS: Technologies, such as the prostate-specific antigen (PSA) testing for screening has helped in the diagnosis in the past decades, enhancing a decrease in the mortality rate of the patients throughout the years.

Epidemiology, management, and economic impact of acute myeloid leukemia and myelodysplastic syndrome in Spain at the hospital level: a claims database analysis.

OBJECTIVES: This study reviewed patient characteristics, management, and medical costs of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDSs) in Spanish hospitals. METHODS: Data were extracted from the Spanish Ministry of Health records via a claims database containing patient records from 192 private and 313 public hospitals between 1997 and 2015 for AML, and 2008 and 2015 for MDS. Direct medical costs at the hospital level were calculated based on mean medical procedure costs determined per the Spanish Ministry of Health. RESULTS: Records for 39,568 patients with AML and 33,091 with MDS were analyzed. The median age of AML patients was 65 years (interquartile range (IQR) = 27) and of MDS patients was 81 years (IQR = 12). In terms of disease management, 58% and 83% of admissions were due to emergencies for patients with AML and MDS, respectively; median length of hospital stay was 14 days (IQR = 25) for AML and seven days (IQR = 9) for MDS. There was an increase in allogeneic hematopoietic stem cell transplantations over time for patients with AML or MDS. Mean annual direct medical costs of AML and MDS, respectively, were €66,422,245 and €42,635,313 for total costs, and €30,775 and €10,312 per patient. Of the total costs, transplantations contributed total annual costs of €15,843,982 and €2,705,791 for patients with AML and MDS, respectively. CONCLUSIONS: This study provides novel data to assist decision makers in allocating resources. AML and MDS represent a significant burden for the National Spanish Healthcare System, with substantial costs incurred in secondary care, principally associated with the increasing number of transplantations.

Therapy for Gastroenteropancreatic Neuroendocrine Tumors: drug evaluation reports review in Spain.

OBJECTIVES: In Spain it is necessary to conduct additional studies to determine place in therapy and cost-effectiveness of a drug. The main objective of this study is to identify all drug assessments and health technology assessment reports of the drugs for gastroenteropancreatic (GEP) neuroendocrine tumors (NET) at a national, regional and hospital level and to summarize the efficacy in terms of outcome measures, adverse events, economic impact and final recommendations. METHODS: A search was made on the GENESIS website for drug evaluation reports regarding GEP NET, including gastrointestinal and bronchopulmonary, to identify the drug assessments at a regional and hospital level. 8 reviews at regional and hospital level were considered. Two clinical guidelines have been reviewed to determine the current management and available treatments. RESULTS: Surgery is the main treatment for NETs in different phases of their evolution. If there is recurrence there are other possible treatments as chemotherapy, somatostatin analogues and new biological agents, also called \"targeted treatments\", that currently have a palliative and symptom control role, since they rarely achieve the elimination of the disease themselves. CONCLUSIONS: Everolimus and sunitinib are new drugs available for the treatment of GEP NET patients reported to have promising effects in advanced diseases. However, the reports are limited and thus new clinical studies on the impact of these drugs on clinical outcome, prognosis, financial burden and feasibility are necessary to support further recommendations.

The current performance-linked and risk sharing agreement scene in the Spanish region of Catalonia.

Background: Traditional drug payment schemes in Catalonia are generally based on the negotiation of fixed prices; however, disadvantages arise in the case of innovative therapies. Risk sharing agreements distribute potential health and economic uncertainties and high prices on access across the interested parts.Objectives: To identify, characterize and analyze current publicly available agreement reports signed by the Catalan Health Service and different pharmaceutical companies evaluating the current market access scene for new drugs in Catalonia.Methods: A database of agreements implemented between 2013 and 2018 was developed by using publicly available data. Data analysis was performed in a descriptive way, presenting summaries in datasheets.Results: A total of 7 managed entry agreements were analyzed. Two extensions regarding previous agreements were also taken into account. The main involved disease area is oncology (57%) and the most common length is 1 year, whereas the longest is 3 years.Conclusions: Managed entry agreements are gaining popularity and are viewed as positive schemes by stakeholders, payers and health services, leading to a general increase of accords during the last years. However, there are hardly any studies regarding the impact of RSA post-implementation, a field of great relevance regarding health policies.

Budget Impact Analysis of Oral Fisiogen Ferro Forte® versus Intravenous Iron for the Management of Iron Deficiency in Chronic Kidney Disease in Spain.

BACKGROUND: Iron deficiency is a frequent complication of chronic kidney disease (CKD) that is associated with a decrease in the quality of life of patients and an increase in the risk of other clinical complications. Iron therapy represents one of the fundamentals of patients with CKD. Sucrosomial® oral iron allows Fisiogen Ferro Forte® to be used in all patients who are intolerant to treatment by the oral route of administration, or who present with malabsorption of conventional oral iron preparations. OBJECTIVE: The main objective of this study was to assess the economic impact of the oral iron Fisiogen Ferro Forte® for the management of iron deficiency in CKD patients in Spain. METHODS: A 4-year budget impact model was developed for the period 2017-2020 for CKD patients with iron deficiency who were candidates for intravenous iron due to a lack of response to oral iron, from the perspective of the Spanish healthcare system. Three subgroups of CKD patients were included in the analysis: predialysis, peritoneal dialysis, and post-transplant. The intravenous iron formulations Ferinject®, Venofer®, and Feriv® were considered appropriate comparators to be used in the model. National data on the prevalence of CKD for the three subgroups of patients were obtained from the literature, and input data on drug utilization and outpatient hospitalizations associated with iron administration were obtained by consulting nephrologists. Nephrology experts were also asked about resources used during medical visits and monitoring tests. Based on the unit costs for each iron therapy and the resources used, the total treatment cost per patient associated with each product was obtained to estimate the global budget impact of increasing the use of Fisiogen Ferro Forte®. RESULTS: The average annual budget savings due to an increase in Fisiogen Ferro Forte® and a decrease in intravenous iron have been estimated at €398,685, €180,937, and €195,842 over 4 years for the predialysis, peritoneal dialysis, and post-transplant groups, respectively. CONCLUSIONS: The increase in the use of Fisiogen Ferro Forte® leads to overall budget savings of €775,464 for the Spanish National Health Service over 4 years.