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1.
Actas urol. esp ; 47(1): 27-33, jan.- feb. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-214419

RESUMO

Introducción El objetivo de este estudio fue comparar los resultados del tratamiento antibiótico continuado, la autovacuna MV140 y la vacuna bacteriana polivalente MV140 de cepas de colección en la prevención de ITU recurrentes no complicadas. Métodos Se analizaron prospectivamente 377 pacientes desde enero de 2017 hasta agosto de 2019 y se dividieron en 3 grupos según la profilaxis administrada. Grupo A (126): tratamiento antibiótico, Grupo B (126), autovacuna MV140; Grupo C (125), vacuna bacteriana polivalente MV140 a partir cepas seleccionadas. Las variables analizadas fueron: sexo, edad, menopausia, número de episodios de ITU al inicio y a los 3 y 6 meses de finalizar la profilaxis, costes sanitarios a lo largo del seguimiento a los 3 y 6 meses. Resultados A los 3 meses, los episodios de ITU se redujeron a 0-1 en el 65% del grupo A, en el 80,8% del grupo B y en el 81,7% del grupo C. A los 6 meses, se presentaron 0-1 episodios de ITU en el 44,4% del grupo A, en el 61,6% del grupo B y en el 74,6% del grupo C. En cuanto a los costes sanitarios a lo largo del seguimiento, a los 3 meses el grupo A registró 21.171,87 euros, el grupo B 20.763,73 euros y el grupo C 18.866,14 euros. A los 6 meses, los costes sanitarios fueron de 32.980,35 euros en el grupo A, de 28.133,42 euros en el grupo B y de 23.629,19 euros en el grupo C. Conclusiones La autovacuna MV140 y la vacuna bacteriana polivalente MV140 fueron más eficaces reduciendo el número de episodios de ITU a los 3 y 6 meses y con unos costes sanitarios menores durante el seguimiento, en comparación con la profilaxis antibiótica continuada (p < 0,05). La vacuna bacteriana polivalente MV140 de cepas seleccionadas fue más eficaz en la reducción del número de episodios de ITU con unos costes sanitarios menores que la autovacuna (AU)


Introduction The objective of this study was to compare the results on prevention of uncomplicated recurrent UTI between continuous use of antibiotics, MV140 autovaccine and MV140 polybacterial vaccine from collection strain. Methods 377 patients were prospectively analyzed from January 2017 to August 2019 and divided into 3 groups according to the prophylaxis. Group A (126): antibiotics, Group B (126): MV140 autovaccine, Group C (125): MV140 polybacterial vaccine from the collection strain. Variables analyzed were: gender, age, menopause, number of UTI at baseline and 3 and 6 months after the end of prophylaxis, health cost along follow-up at 3 and 6 months. Results At 3 months, group A had 0-1 UTI in 65%, group B had 0-1 UTI in 80.8% and group C in 81.7%. At 6 months, group A had 0-1 UTI in 44.4%, group B had 0-1 UTI in 61.6% and group C in 74.6%. Regarding health cost along follow-up, at 3 months group A had €21,171.87, group B had €20,763.73 and group C €18,866.14. At 6 months, health cost was €32,980.35 in group A, €28,133.42 in group B, and €23,629.19 in group C. Conclusions MV140 autovaccine and MV140 polybacterial vaccine were more efficient with lower number of UTI at 3 and 6 months and lower health cost along follow-up compared to continued prophylaxis with antibiotics (p < .05). Polybacterial MV140 vaccine from collection strain had higher effect to reduce the number of UTI and less health cost than autovaccine (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Autovacinas/uso terapêutico , Custos de Cuidados de Saúde , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/prevenção & controle , Vacinas/uso terapêutico , Estudos Prospectivos , Resultado do Tratamento , Seguimentos , Recidiva , Infecções Urinárias/economia , Análise Custo-Benefício
3.
Nature ; 613(7945): 791-793, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36639444
4.
Artigo em Inglês | MEDLINE | ID: mdl-36674286

RESUMO

(1) Background: Maxillofacial injury (MI) occurs universally, for it disregards preference for age, gender, and geographical region. The global incidence and prevalence of facial fractures rose by 39.45% and 54.39%, respectively, between the years 1990 to 2017. Projections indicate that the burden of injuries will persist in sub-Saharan Africa (SSA) in the next twenty years. This scoping review aims to map the literature on MI epidemiology and the economic burden on society in SSA. (2) Methods: The methodology presented by Arksey and O'Malley and extended by Levac and colleagues will be employed in the scoping review. The researcher will report the proposed review through the Preferred Reporting Items for Systematic Review, and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The review will include studies encompassing MI in sub-Saharan African adults 18 years and above. (3) Results: This will be presented as a thematic analysis of the data extracted from the included studies, and the Nvivo version 12 will be employed. (4) Discussion: We anticipate searching for related literature on the prevalence, incidence, risk factors, mortality, and cost associated with MI in the adult population of SSA. The conclusion from the review will assist in ascertaining research gaps, informing policy, planning, authorizing upcoming research, and prioritizing funding for injury prevention and management.


Assuntos
Traumatismos Maxilofaciais , Adulto , Humanos , África ao Sul do Saara/epidemiologia , Incidência , Políticas , Prevalência , Fatores de Risco , Revisões Sistemáticas como Assunto , Traumatismos Maxilofaciais/economia , Traumatismos Maxilofaciais/epidemiologia , Custos e Análise de Custo
5.
JAMA ; 329(1): 87-89, 2023 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-36594955

RESUMO

This study quantifies the revenue earned on all brand-name inhalers approved by the US Food and Drug Administration from 2000 to 2021 and compared earnings before and after expiration of primary patents on these products.


Assuntos
Indústria Farmacêutica , Competição Econômica , Nebulizadores e Vaporizadores , Patentes como Assunto , Medicamentos Genéricos , Competição Econômica/economia , Nebulizadores e Vaporizadores/economia , Estados Unidos , Patentes como Assunto/legislação & jurisprudência , Indústria Farmacêutica/economia , Indústria Farmacêutica/legislação & jurisprudência
6.
JAMA ; 329(1): 89-92, 2023 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-36594954

RESUMO

This study uses annual Medicare Part B spending data to examine the potential savings from the drug pricing reforms in the Inflation Reduction Act of 2022.


Assuntos
Redução de Custos , Custos de Medicamentos , Inflação , Medicare Part B , Medicare Part D , Redução de Custos/economia , Gastos em Saúde , Medicare Part B/economia , Estados Unidos
7.
Arch. Soc. Esp. Oftalmol ; 98(1): 2-10, ene. 2023. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-214329

RESUMO

Antecedentes y objetivo Evaluar el impacto económico en España derivado de la introducción del implante XEN®63 como alternativa quirúrgica en el manejo del glaucoma primario de ángulo abierto (GPAA) con o sin cataratas en pacientes refractarios. Materiales y métodos Se diseñó un análisis de impacto presupuestario para estimar los costes del tratamiento quirúrgico del GPAA desde la perspectiva del Sistema Nacional de Salud (SNS) español, en un horizonte temporal de1 año. Los comparadores considerados (trabeculectomía, esclerectomía profunda no perforante, válvula de Ahmed, iStent inject®, Preserflo® microshunt y XEN®45) se corresponden a los empleados en la práctica clínica pública española. Para el cálculo de la población diana, cuotas de mercado y uso de recursos en términos de visitas de seguimiento, procedimientos adicionales y complicaciones poscirugía, se emplearon datos de la literatura y se validaron con un panel de cuatro expertos. Los costes unitarios (€de2021) se obtuvieron de la base de datos ESALUD Resultados la inclusión de XEN®63 podría generar un ahorro de 2.569.737€ tras un año desde su introducción, derivado del ahorro en el coste del implante y del procedimiento (−423.120; −0,7%), de las visitas de seguimiento (−777.407€; −4,5%), de los procedimientos adicionales (−1.048.145€, −20,6%) y de las complicaciones poscirugía (−321.065€, −14,2%). Conclusiones La incorporación de XEN®63 en el arsenal quirúrgico para el tratamiento del GPAA refractario con y sin cataratas podría generar ahorros para el SNS (AU)


Background and objective To evaluate the economic impact in Spain derived from the introduction of the XEN®63 implant as a surgical alternative in the management of primary open angle glaucoma (POAG) with or without cataract in refractory patients. Materials and methods A budget impact analysis was designed to estimate the costs of surgical treatment of POAG from the perspective of the Spanish National Health System (NHS), over a time horizon of 1year. The comparators considered (trabeculectomy, deep non-perforating sclerectomy, Ahmed valve, iStent inject®, Preserflo® microshunt and XEN®45) correspond to those used in Spanish public clinical practice. For the calculation of the target population, market shares and resource use in terms of follow-up visits, additional procedures and post-surgery complications, data from the literature were used and validated with a panel of 4 experts. Unit costs (€2021) were obtained from the ESALUD database. Result The inclusion of XEN®63 could generate savings of €2,569,737 after one year since its introduction, derived from savings in the cost of the implant and procedure (−€423,120; −0.7%), follow-up visits (−€777,407; −4.5%), additional procedures (−1,048,145; −20.6%) and post-surgery complications (−€321,065; −14.2%). Conclusion The incorporation of XEN®63 in the surgical arsenal for the treatment of refractory POAG with and without cataracts could generate savings for the NHS (AU)


Assuntos
Humanos , Glaucoma de Ângulo Aberto/cirurgia , Custos de Cuidados de Saúde , Trabeculectomia/métodos , Glaucoma de Ângulo Aberto/economia , Extração de Catarata , Trabeculectomia/economia , Espanha
8.
BMC Public Health ; 23(1): 28, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36604686

RESUMO

BACKGROUND: Informal care is a key element of health care and well-being for society, yet it is scarcely visible and rarely studied in health economic evaluations. This study aims to estimate the time use and cost associated with informal care for cardiovascular diseases, pneumonia and ten different cancers in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico and Peru). METHODS: We carried out an exhaustive literature review on informal caregivers' time use, focusing on the selected diseases. We developed a survey for professional caregivers and conducted expert interviews to validate this data in the local context. We used an indirect estimate through the interpolation of the available data, for those cases in which we do not found reliable information. We used the proxy good method to estimate the monetary value of the use of time of informal care. National household surveys databases were processed to obtain the average wage per hour of a proxy of informal caregiver. Estimates were expressed in 2020 US dollars. RESULTS: The study estimated approximately 1,900 million hours of informal care annually and $ 4,300 million per year in average informal care time cost for these fifteen diseases and eight countries analyzed. Cardiovascular diseases accounted for an informal care burden that ranged from 374 to 555 h per year, while cancers varied from 512 to 1,825 h per year. The informal care time cost share on GDP varied from 0.26% (Mexico) to 1.38% (Brazil), with an average of 0.82% in the studied American countries. Informal care time cost represents between 16 and 44% of the total economic cost (direct medical and informal care cost) associated with health conditions. CONCLUSIONS: The study shows that there is a significant informal care economic burden -frequently overlooked- in different chronic and acute diseases in Latin American countries; and highlights the relevance of including the economic value of informal care in economic evaluations of healthcare.


Assuntos
Cuidadores , Assistência ao Paciente , Humanos , Doenças Cardiovasculares/terapia , Cuidadores/economia , América Latina , Neoplasias/terapia , Custos e Análise de Custo , Pneumonia/terapia , Assistência ao Paciente/economia , Assistência ao Paciente/estatística & dados numéricos , Fatores de Tempo
9.
BMC Health Serv Res ; 23(1): 13, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36604670

RESUMO

BACKGROUND: Colorectal cancer is one of the most prevalent gastrointestinal cancers in Iran i.e., the fourth and the second prevalent cancer among Iranian males and females, respectively. A routine screening program is effective in the early detection of disease which can reduce the cancer burden both for individuals and society. In 2015, Iran's Package of Essential Non- communicable Diseases program had been piloted in Shahreza city in Isfahan province. Colorectal cancer screening for the population aged 50-70 was a part of this program. So far, there was no study about the cost and outcomes of that program. Thus, this study aimed to analyze the costs and outcomes of colorectal cancer screening done from 2016 to 2019 in Shahreza. METHODS: This cost-outcome description study used the data of 19,392 individuals who were 50-70 years old experienced a fecal immunochemical test (FIT) and had an electronic health record. All direct costs including personnel, building space, equipment, training, etc. were extracted from the financial documents existing in the Isfahan province Health Center. The outcome was defined as positive FIT, detection of adenoma or malignancy as recorded in the E-integrated health system. RESULTS: The results of this study indicated that the direct costs of the colorectal cancer screening program during the years 2016-2019 were 7,368,707,574 Rials (321,029 PPP$) in Shahreza, Isfahan province. These costs resulted in identifying 821 people with a positive FIT test, of those 367 individuals were undergone colonoscopy. Of whom 8 cases of colorectal cancer, and 151 cases with polyps were diagnosed. CONCLUSION: This study showed that by paying a small amount of 320 thousand international dollars we could prevent 151 cases of polyps to be progressed to colorectal cancer,resulting in a significant reduction in colorectal cancer incidence.


Assuntos
Colonoscopia , Neoplasias Colorretais , Detecção Precoce de Câncer , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Colonoscopia/economia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Custos e Análise de Custo , Detecção Precoce de Câncer/métodos , Irã (Geográfico)/epidemiologia , Programas de Rastreamento/métodos , Sangue Oculto , Avaliação de Programas e Projetos de Saúde
15.
Nature ; 613(7942): 77-84, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36600068

RESUMO

Cropland is a main source of global nitrogen pollution1,2. Mitigating nitrogen pollution from global croplands is a grand challenge because of the nature of non-point-source pollution from millions of farms and the constraints to implementing pollution-reduction measures, such as lack of financial resources and limited nitrogen-management knowledge of farmers3. Here we synthesize 1,521 field observations worldwide and identify 11 key measures that can reduce nitrogen losses from croplands to air and water by 30-70%, while increasing crop yield and nitrogen use efficiency (NUE) by 10-30% and 10-80%, respectively. Overall, adoption of this package of measures on global croplands would allow the production of 17 ± 3 Tg (1012 g) more crop nitrogen (20% increase) with 22 ± 4 Tg less nitrogen fertilizer used (21% reduction) and 26 ± 5 Tg less nitrogen pollution (32% reduction) to the environment for the considered base year of 2015. These changes could gain a global societal benefit of 476 ± 123 billion US dollars (USD) for food supply, human health, ecosystems and climate, with net mitigation costs of only 19 ± 5 billion USD, of which 15 ± 4 billion USD fertilizer saving offsets 44% of the gross mitigation cost. To mitigate nitrogen pollution from croplands in the future, innovative policies such as a nitrogen credit system (NCS) could be implemented to select, incentivize and, where necessary, subsidize the adoption of these measures.


Assuntos
Produção Agrícola , Produtos Agrícolas , Poluição Ambiental , Nitrogênio , Solo , Humanos , Análise Custo-Benefício , Ecossistema , Fertilizantes/análise , Nitrogênio/análise , Solo/química , Poluição Ambiental/economia , Poluição Ambiental/prevenção & controle , Produção Agrícola/economia , Produção Agrícola/métodos , Produção Agrícola/tendências
17.
J Environ Manage ; 326(Pt A): 116679, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36403320

RESUMO

Despite significant drop in pollinator abundance, no studies exist on the benefits and costs of pollinator conservation in the public domain. An in-person survey was conducted at three large, public US universities to estimate benefits to become Bee Campus USA certified. We test whether different types of reminders on existing student sustainability fees affect Willingness to Pay. Costs of achieving this certification per university were obtained. Net Present Value demonstrates that the net benefits to each school are largely positive, except under the most restrictive assumption. Information reminders of existing fees lead to little change in support of pollinator conservation.


Assuntos
Criação de Animais Domésticos , Certificação , Análise Custo-Benefício , Animais , Abelhas , Certificação/economia , Setor Público , Universidades/economia , Criação de Animais Domésticos/economia , Criação de Animais Domésticos/legislação & jurisprudência , Polinização
19.
Am J Obstet Gynecol ; 226(2): 228.e1-228.e9, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34547295

RESUMO

BACKGROUND: The guidelines for managing abnormal cervical cancer screening tests changed from a results-based approach in 2012 to a risk-based approach in 2019. OBJECTIVE: We estimated the cost-effectiveness of the 2019 management guidelines and the changes in resource utilization moving from 2012 to 2019 guidelines. STUDY DESIGN: We utilized a previously published model of cervical cancer natural history and screening to estimate and compare the lifetime costs and the number of screens, colposcopies, precancer treatments, cancer cases, and cancer deaths associated with the 2012 vs 2019 management guidelines. We assessed these guidelines under the scenarios of observed screening practice and perfect screening adherence to 3-year cytology starting at age 21, with a switch to either 3-year or 5-year cytology plus human papillomavirus cotesting at age 30. In addition, we estimated the lifetime costs and life years to determine the cost-effectiveness of shifting to the 2019 management guidelines. RESULTS: Under the assumptions of both observed screening practice and perfect screening adherence with a strategy of 3-year cytology at ages 21 to 29 and switching to 3-year cotesting at age 30, the management of the screening tests according to the 2019 guidelines was less costly and more effective than the 2012 guidelines. For 3-year cytology screening at ages 21 to 29 and switching to 5-year cotesting at age 30, the 2019 guidelines were more cost-effective at a willingness-to-pay threshold of $100,000 per life year gained. Across all scenarios, the 2019 management guidelines were associated with fewer colposcopies and cancer deaths. CONCLUSION: Our model-based analysis suggests that the 2019 guidelines are more effective overall and also more cost-effective than the 2012 guidelines, supporting the principle of "equal management of equal risks."


Assuntos
Detecção Precoce de Câncer/economia , Infecções por Papillomavirus/diagnóstico , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Colo do Útero/patologia , Colo do Útero/virologia , Análise Custo-Benefício , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/patologia , Guias de Prática Clínica como Assunto , Neoplasias do Colo do Útero/economia , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/economia , Adulto Jovem , Displasia do Colo do Útero/economia , Displasia do Colo do Útero/patologia
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