The Checklist for Standard Methodological Requirements and Reporting of Economic Evaluation of Medicines in Slovakia.

OBJECTIVES: We have developed a scientifically well-grounded, methodological, and reporting checklist for economic evaluation (EE) of medicines in the Slovak health technology assessment process, which serves as a supplement to the Slovak pharmacoeconomic guidelines. METHODS: The checklist was developed using an iterative process in which items were generated and gradually added to the baseline checklist based on shortcomings identified in an analysis of Slovak EEs, using relevant published checklists, and Slovak, as well as international, methodological guidance that was identified in the systematic literature review. The selection of checklist recommendations, their clarity, and relevance to the Slovak setting were validated in the online survey. RESULTS: From the sample of 151 price and reimbursement submissions published between January 2018 and July 2021, almost half of them (n = 73) received at least 1 request from the Ministry of Healthcare to justify or modify the methodology used in the EE; and in 18 proceedings, a negative opinion was issued because of shortcomings identified in the EE. The 25-items preliminary checklist, resulting from an iterative working process, has been validated in an online survey conducted among members of ISPOR Chapter Slovakia. After incorporating relevant comments, the final proposal for the Slovak checklist consists of 55 recommendations. CONCLUSIONS: The research represented the first attempt to create a Slovak EE checklist, which serves as a part of ISPOR Slovakia pharmacoeconomic guidelines. Implementation of the checklist allows checking whether EE meets legislative and methodological requirements and thus helps in improving the appropriateness and standardization of EEs in Slovakia.

Costs of Diabetes Mellitus and Its Complications in Bosnia and Herzegovina.

Background: The economic burden induced by all types of Diabetes mellitus (DM) and their complications has reached 1.8% of gross domestic product (GDP) globally. The economic burden of diabetes mellitus in Bosnia & Herzegovina (B&H) is still unknown. Objective: To investigate the economic burden of diabetes in Bosnia and Herzegovina, including the costs of diagnosing and treating diabetes and its complications. Methods: The study was designed as a top-down cost of illness study, based on prevalence, analyzing both direct and indirect costs of DM and complications caused by DM. All types of DM were taken into account, and estimates were based on total B&H population. Costs of services per patient were calculated by multiplication of share of treated population, service utilization data and unit costs. Results: Annual economic burden associated with DM in B&H is around 189 million euro (739 euro per patient), which makes 1.11% of gross domestic product (GDP) of B&H in 2020 (16,993,101,523 euro, according to the World Bank data). The largest part of this burden was created by DM medication and costs of managing complications (heart failure and stable angina being major cost drivers among the complications), followed by laboratory tests and physician visits. Conclusion: Total costs of DM per patient in B&H are within the range of costs in other Central-Eastern European (CEE) countries, reflecting significant economic burden, but also determination of healthcare payers in B&H to provide optimal management of DM in congruence with contemporary clinical guidelines.

The Management of Type 2 Diabetes with Once-Weekly Semaglutide Versus Dulaglutide: A Long-Term Cost-Effectiveness Analysis in Slovakia.

INTRODUCTION: Glucagon-like peptide-1 (GLP-1) receptor agonists represent a class of treatments for type 2 diabetes that offer multifactorial benefits, including glycemic control, weight loss and low hypoglycemia risk. Once-weekly semaglutide is a novel GLP-1 analog that has been associated with improved glycemic control and reduced body mass index (BMI) versus once-weekly GLP-1 receptor agonist dulaglutide in SUSTAIN 7, which is reimbursed in patients with a BMI > 35 kg/m2 in Slovakia. The aim of the present study was to evaluate the long-term cost-effectiveness of once-weekly semaglutide 0.5 mg and 1 mg versus dulaglutide 1.5 mg in Slovakia. METHODS: Clinical and cost outcomes were projected over patient lifetimes using the IQVIA CORE Diabetes Model. Baseline cohort characteristics and treatment effects were based on the sub-group of patients with a BMI > 35 kg/m2 in SUSTAIN 7. Patients were modeled to receive once-weekly semaglutide or dulaglutide for 3 years, after which treatment was intensified to basal insulin. Treatment effects associated with once-weekly semaglutide and dulaglutide were maintained for the first 3 years before HbA1c increased to 7.0% and BMI reverted to baseline. Costs were accounted from a healthcare payer perspective in Slovakia and expressed in euros (EUR). Utilities relating to quality of life were taken from published sources. RESULTS: Once-weekly semaglutide 0.5 mg and 1 mg were associated with improvements in quality-adjusted life expectancy of 0.04 and 0.07 quality-adjusted life years (QALYs), respectively, versus dulaglutide 1.5 mg. Lifetime medical costs were similar, with cost savings of EUR 20 and EUR 140 per patient with once-weekly semaglutide 0.5 mg and 1 mg, respectively, versus dulaglutide 1.5 mg. Both doses of once-weekly semaglutide were therefore considered dominant versus dulaglutide 1.5 mg. CONCLUSION: Both doses of once-weekly semaglutide represent cost-saving treatment options versus dulaglutide 1.5 mg for obese patients with type 2 diabetes in Slovakia. FUNDING: Novo Nordisk A/S.

Effectiveness of a prevention campaign on HIV/AIDS knowledge among adolescents in Eastern Slovakia.

OBJECTIVES: The aim of this manuscript was to evaluate results of the questionnaire given to young people before and after the prevention campaign to determine whether the prevention campaign improved HIV/AIDS-related knowledge of young people. METHODS: A total of 533 students completed the pre-test and 496 students completed the post-test. Questionnaire was used as pre/post testing tool. Construct validity and measurement scale were assessed using the factor analysis. Rasch scaling was used to establish common scale for pre/post test and to transform raw score into the interval scale. A non-parametric Mann-Whitney U test was used to compare knowledge in pre-test and post-test. RESULTS: Students increased their knowledge of HIV/AIDS (Pearson's measure of effect size r = 0.74) and the risk of acquiring HIV infection (r = 0.68) statistically significantly (p = 0.001). Girls (risk estimation: r = 0.78, knowledge: r = 0.81) improved much more than boys (risk estimation: r = 0.57, knowledge: r = 0.62). CONCLUSIONS: This study suggests that, for the selected sample, the prevention campaign was an effective tool to increase young people's knowledge of HIV/AIDS. The authors recommend dividing and tailoring interventions by gender to achieve even more efficient preventive future interventions.