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Background/Objectives: Child malnutrition is a critical public health concern that significantly hampers children's physical and mental development and imposes serious economic burdens. The World Health Organization (WHO) estimates that malnutrition is responsible for half of all deaths among children under five, leading to long-term consequences such as lower educational achievement, decreased productivity, and deepened poverty. This study aims to estimate the burden of child malnutrition in Colombia for children up to four years old, assessing both direct and indirect costs from a societal perspective. Methods: A Markov chain model was utilized to simulate six health states related to malnutrition, integrating direct and indirect costs. Epidemiological data and international literature informed the transition probabilities between states, while caregiver surveys were conducted to capture the indirect costs. Results: The study found that malnutrition accounted for 419.84 disability-adjusted life years (DALYs) per 1000 inhabitants. The total cost of malnutrition over a four-year period was approximately USD 243.58 million, with an annual average of USD 60.89 million, of which 65% of the burden fell on households. Conclusions: Child malnutrition in Colombia presents a considerable burden on health systems, households, and the national economy, demonstrating the need for robust interventions to mitigate its long-term socioeconomic impact. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes increases preventative sickness and costs healthcare and productivity. Type 2 diabetes and macrovascular disease consequences cause most diabetes-related costs. Type 2 diabetes greatly costs healthcare institutions, reducing economic productivity and efficiency. This cost of illness (COI) analysis examines the direct and indirect costs of treating and managing type 1 and type 2 diabetes mellitus. Methodology: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Cochrane, PubMed, Embase, CINAHL, Scopus, Medline Plus, and CENTRAL were searched for relevant articles on type 1 and type 2 diabetes illness costs. The inquiry returned 873 2011–2023 academic articles. The study included 42 papers after an abstract evaluation of 547 papers. Results: Most articles originated in Asia and Europe, primarily on type 2 diabetes. The annual cost per patient ranged from USD87 to USD9,581. Prevalence-based cost estimates ranged from less than USD470 to more than USD3475, whereas annual pharmaceutical prices ranged from USD40 to more than USD450, with insulin exhibiting the greatest disparity. Care for complications was generally costly, although costs varied significantly by country and problem type. Discussion: This study revealed substantial heterogeneity in diabetes treatment costs; some could be reduced by improving data collection, analysis, and reporting procedures. Diabetes is an expensive disease to treat in low- and middle-income countries, and attaining Universal Health Coverage should be a priority for the global health community. [ABSTRACT FROM AUTHOR]

Aim. A systematic review of studies on pulmonary hypertension (PH) cost estimates.Material and methods. A systematic literature search was performed for studies assessing the cost of PH published up to November 30, 2023. The search was carried out in the PubMed/MEDLINE, EMBACE databases for publications in English and in the RSCI database for articles in Russian according to inclusion and exclusion criteria.Results. The systematic review included 13 studies. The mean direct costs per patient with PH after verification of the diagnosis per month ranged from 2023 to 9915 USD, while the median from 1141,5 to 8144 USD. Indirect costs were assessed in only 3 following studies: in Spain and USA, the mean indirect costs were 214 and 1226 USD per patient per month, respectively, while in Russia the median was 65 USD. The mean direct costs per patient with PH per month before diagnosis verification ranged from 1017 to 9723 USD. Indirect costs before diagnosis verification were assessed in only 1 study (median $102 per patient per month). After PH verification, in general, there was an increase in treatment costs with a decrease in other direct costs.Conclusion. PH causes great socio-economic damage to society and healthcare system. A decrease in non-drug therapy costs after PH verification may indicate not only the clinical effectiveness of PH-specific therapy, but also its potential costeffectiveness with reduced costs.

Kevin CJ Yuen,1 Lewis S Blevins,2 David R Clemmons,3 Mads Faurby,4 Andrew R Hoffman,5 Nicky Kelepouris,6 Janice M Kerr,7 Jens Magelund Tarp,4 Maria Fleseriu8 1Barrow Pituitary Center, Barrow Neurological Institute and St. Joseph’s Hospital and Medical Center, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA; 2Department of Neurosurgery, University of California, San Francisco, CA, USA; 3Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA; 4Global Evidence, Pricing and Access, Novo Nordisk A/S, Søborg, Denmark; 5Department of Medicine, Stanford University, Stanford, CA, USA; 6Department of Medical Affairs BioPharm, CMR, Novo Nordisk Inc., Plainsboro, NJ, USA; 7Department of Endocrinology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA; 8Pituitary Center, Departments of Medicine and Neurological Surgery, Oregon Health and Science University, Portland, OR, USACorrespondence: Kevin CJ Yuen, Barrow Pituitary Center, Barrow Neurological Institute and St. Joseph’s Hospital and Medical Center, University of Arizona College of Medicine and Creighton School of Medicine, 475 N. 5th Street, Phoenix, AZ, 85004, USA, Tel +1 602 406-2748, Fax +1 602 406-2770, Email kevin.yuen@commonspirit.orgPurpose: Adult growth hormone deficiency (AGHD) is often underdiagnosed and undertreated, leading to costly comorbidities. Previously, we developed an algorithm to identify individuals in a commercially insured US population with high, moderate, or low likelihood of having AGHD. Here, we estimate and compare direct medical costs by likelihood level.Patients and Methods: Retrospective, observational analysis using the Truven Health MarketScan database to analyze direct medical costs relating to inpatient and outpatient claims, outpatient prescription claims, medication usage, clinical utilization records, and healthcare expenditures. Patients were categorized into groups based on algorithmically determined likelihoods of AGHD. Likelihood groups were further stratified by age and sex. Trajectories of annual costs (USD) by likelihood level were also investigated.Results: The study cohort comprised 135 million US adults (aged ≥ 18 years). Individuals ranked as high-likelihood AGHD had a greater burden of comorbid illness, including cardiovascular disease and diabetes, than those ranked moderate- or low-likelihood. Those in the high-likelihood group had greater mean total direct medical monthly costs ($1844.51 [95% confidence interval (CI): 1841.24;1847.78]) than those in the moderate- ($945.65 [95% CI: 945.26;946.04]) and low-likelihood groups ($459.10 [95% CI: 458.95;459.25]). Outpatient visits accounted for the majority of costs overall, although cost per visit was substantially lower than for inpatient services. Costs tended to increase with age and peaked around the time that individuals were assigned a level of AGHD likelihood. Total direct medical costs in individuals with a high likelihood of AGHD exceeded those for individuals with moderate or low likelihood.Conclusion: Understanding the trajectory of healthcare costs in AGHD may help rationalize allocation of healthcare resources.Plain Language Summary: Growth hormone is an important substance found in the body. Adult growth hormone deficiency (AGHD) is the reduced production of growth hormone unrelated to the normal reduction seen with aging. Untreated AGHD can result in the development of other conditions, known as comorbidities, which can be expensive to manage.Previously, 135 million privately insured people in the US, aged 18– 64 years, were categorized into groups by their likelihood (high, medium, or low) of having AGHD. This study compared the estimated direct medical costs (eg hospital care and medication) across the different likelihood levels. People with a high likelihood of AGHD had more comorbidities than people with a medium/low likelihood, and an average total direct medical monthly cost of $1844.51, nearly twice as much as those with a medium likelihood ($945.65), and four times as much as those with a low likelihood ($459.10). These costs tended to increase with age, with the highest costs associated with people aged 50– 59 years and 60– 64 years. Outpatient costs (for treatments not requiring an overnight hospital stay) accounted for the greatest proportion of total medical costs, ahead of inpatient costs (for treatments requiring an overnight hospital stay) and medication costs.These findings suggest that diagnosing and treating AGHD earlier may help to reduce medical costs over time. Increased testing and treatment will cause an initial increase in the use of healthcare resources, but could improve overall cost effectiveness by reducing the long-term impact of the disease and avoiding unnecessary healthcare use. Keywords: AGHD, cost of comorbidities, cost of disease, likelihood of AGHD, medical costs, Truven Health MarketScan database

Resumen: Antecedentes y objetivo: No se dispone de datos españoles sobre el coste asociado al linfoma cutáneo de células T (LCCT). Además, la incorporación de nuevos tratamientos hace necesario analizar el coste real de la enfermedad. El estudio MICADOS analizó dos objetivos principales: Por un lado, evaluó el impacto en la calidad de vida en los pacientes con LCCT, y por otro lado, estudió los costes de la enfermedad. En esta publicación se recoge el segundo de los objetivos del estudio. Métodos: El coste de la enfermedad se estudió bajo la perspectiva del Sistema Nacional de Salud (SNS) con un horizonte temporal de un año. Participaron 23 dermatólogos y hematólogos de 15 hospitales públicos españoles. Se incluyeron pacientes adultos con LCCT del tipo micosis fungoide (MF) y síndrome de Sézary (SS). Resultados: Se incluyeron 141 pacientes, el 57,4% masculinos, con una edad media de 63,6 años (IC 95%: 61,4-65,7). Los costes directos anuales medios por pacientes del estudio fueron de 34.214€, siendo de 11.952,47€ en estadio I, 23.506,21€ en estadio II, 38.771,81€ en estadio III y 72.748,84€ en estadio IV. El coste anual directo total estimado de todos los pacientes en España con MF/SS resultó en 78.301.171€, donde el 81% de los costes fueron atribuibles a pacientes en estadio I, el 7% al estadio II, el 6% al estadio III y el 6% al estadio IV. Conclusiones: Este estudio ofrece una evaluación precisa del coste directo del LCCT en pacientes con MF/SS en España, mostrando costes que varían sustancialmente en función del estadio. Los costes soportados por el paciente y los costes indirectos deberán considerarse en futuras investigaciones. Abstract: Background and objective: The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1) to evaluate the impact of CTCL on patient quality of life, and 2) to evaluate the costs associated with the disease. This article reports the results of the cost analysis. Methods: We estimated the cost of treating CTCL over a period of 1 year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS). Results: A total of 141 patients (57.4% male) with a mean age of 63.6 years (95% CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was €34,214 per patient. The corresponding costs by stage were €11,952.47 for stage I disease, €23,506.21 for stage II disease, €38,771.81 for stage III disease, and €72,748.84 for stage IV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at €78,301,171; stage I disease accounted for 81% of all costs, stage II for 7%, and stages III and IV for 6% each. Conclusions: The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies.

Abstract Background Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies.

Background: Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods: This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results: 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion: The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Eliminating financial barriers and improving healthcare accessibility pertain to be key elements of the United Nation’s sustainable development goals. These have directed health policymakers to advocate private health insurance as a health promotion strategy to enable patients to obtain absolute and affordable medical care when needed. Against this backdrop, the current study investigates the coverage trend and financial risk-protective nature of private health insurance plans. MATERIALS AND METHOD: We examined 12 months’ hospital billing data of private health insurance holders with cancer, cardiac, neurological, and renal diseases. The billing and insurance claim data of 5002 patients were extracted from the billing section of a tertiary care teaching hospital located in southern India from April 2022 through March 2023. Five per cent of patients from each disease condition were selected through proportionate random sampling for analysis (n = 250). The cost incurred and reimbursement trend under various cost heads were investigated by examining the cost incurred by the patient during the hospitalization and comparing it with the amount reimbursed by the insurance company. RESULTS: The scrutiny exhibits that private health insurance fails to provide comprehensive coverage, resulting in under-insurance among subscribers. Reimbursement received for each cost category is also discussed. To the best of our knowledge, this is the first study that has used institutional data instead of large survey data or patient data. CONCLUSION: The research concludes by soliciting policymakers, healthcare providers, and insurers to develop strategies to enhance the affordability and accessibility of healthcare to promote health and wellness.

Background: The thyroid has a vital role in growth, neurodevelopment, reproduction, and metabolism. About 300 million people around the world had been reported to be suffering from thyroid disorders, but more than half were unaware. The factors of sex, age, weight of disease, and other accompanying conditions should be considered, otherwise, it will cause a long time treatment period in which the cost will become higher from year to year. Purpose: The systematic review aims to provide an overview of the financial burden caused by thyroid disease for the communities, governments and health care providers. Method: A systematic review of publications in several databases, namely PUBMED, SCIENCE DIRECT, DOAJ, SCOPUS and GOOGLE SCHOLAR. Results: Six research articles were obtained from publications selected for systematic review. The reviewed articles show overviews of the cost of thyroid disease in several countries. The financial burden of thyroid patients in some countries varies, with different perspectives. The lowest to highest cost ranges from 0.125 USD/patient - 8106 USD/patient. Conclusion: The study in this review illustrates the various costs in different countries; the cost of screening, and thyroid surgery has the largest contribution compared to other costs; research on the financial burden suffered by thyroid patients in the future must be carried out continuously and periodically to be able to estimate the cost of therapy more appropriately to provide a useful data for health care providers, governments and the community. Direct medical costs are the largest proportion. [ABSTRACT FROM AUTHOR]

ABSTRACT: A systematic review was conducted to assess the cost of ketosis in dairy cattle, and to elucidate how ketosis cost is estimated in each of the studies. Scientific papers addressing the economic impact of ketosis in dairy cows were identified through a search in 4 databases (Medline, ISI Web of Science, CAB Abstracts, and Agricola). The literature search was conducted with no restrictions on the date of study publication, publication type, or language. The methodological quality of the studies was assessed regarding study design, data collection, and analysis and interpretation of the study results. Of 531 identified records, 10 were selected, of which 9 were published from 2015 onward. Of the 10 studies reviewed, 9 report cost of a case of ketosis, and the estimates vary widely, with values ranging from €19 to €812. Two studies report ketosis cost at a farm level (€3.6–€29/cow per year). Among the studies, we observed great variation not only in the estimation models and inputs used (costs and losses associated with the disease) but also in the definition of ketosis and its prevalence or incidence figures. Moreover, the cost of ketosis was estimated for dairy farms in the United States, Canada, the Netherlands, Denmark, France, Germany, Spain, Sweden, Norway, and India. Consequently, there was great heterogeneity regarding herd characteristics, milk production, milk prices, culled cows' value, feed prices, and costs of veterinary services. Ketosis cost estimates vary as a consequence of all these aspects. Therefore, although most of the studies were well-designed and used high-quality data, the systematic approach review does not allow combination of the cost estimates of into a single figure. In conclusion, our review highlights an overall considerable economic impact of ketosis in dairy cattle. Economic prevention and mitigation strategies should be taken according to herd- and country-specific conditions. Ketosis cost figures reported in economic studies should always be considered carefully and interpreted with appropriate consideration of the inputs of the estimation, country context, and herd parameters.

Kjell Erik Julius Håkansson,1 Vibeke Backer,2,3 Charlotte Suppli Ulrik1,4 1Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark; 2Center for Physical Activity Research (CFAS), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; 3Department of ENT, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; 4Institute of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Kjell Erik Julius Håkansson, Respiratory Research Unit 237, Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Kettegård Allé 30, Hvidovre, 2650, Denmark, Email kjell@kjell.dkIntroduction: The impact of asthma and disease control on job absenteeism in young adults is sparsely investigated and conflicting evidence exist. Based on a nationwide cohort, the present study aims to describe the overall job absenteeism across asthma severities and describe the possible influence of asthma control.Methods: REASSESS is a nationwide cohort of Danish asthma patients aged 18– 45 using controller medication between 2014 and 2018, followed retrospectively for up to 15 years using national databases. Impact of asthma was investigated using negative binomial regression adjusted for age, sex, Charlson score and level of education and presented as adjusted incidence rate ratios with 95% confidence intervals.Results: A total of 60,534 patients with asthma (median age 33 (25, 39), 55% female, 19% uncontrolled disease and 5.7% possible severe asthma) were followed for 12.7 (6.5– 14.8) years. The prevalence of any absenteeism was more common in both mild-to-moderate and possible severe asthma compared to the background population (67%, 80% and 62%, respectively; p < 0.0001). Compared to the background population, mild-to-moderate and possible severe asthma were more likely to have temporary sick leave (1.37 (1.33– 1.42); 1.78 (1.62– 1.96)), unemployment (1.11 (1.07– 1.14); 1.26 (1.15– 1.38)) and obtain disability benefits (1.67 (1.66– 1.67); 2.64 (2.63– 2.65)). Uncontrolled asthma had increased temporary sick leave (1.42 (1.34– 1.50)), unemployment (1.40 (1.32– 1.48)) and disability (1.26 (1.26– 1.27)) when compared to controlled disease. Significant increases in absenteeism could be measured already at ≥ 100 annual doses of rescue medication (1.09 (1.04– 0.1.14)), patients’ first moderate or severe exacerbation (1.31 (1.15– 1.49) and 1.31 (1.24– 1.39), respectively). Further increases in absenteeism were observed with increasing rescue medication use and severe exacerbations.Conclusion: Across severities, job absenteeism is increased among patients with asthma compared to the background population. Increases in absenteeism was seen already at ≥ 100 annual doses of rescue medication, representing a substantial, and probably preventable, reduction in productivity among young adults.Keywords: airway diseases, burden of disease, cost of disease, observational cohort, societal cost

Resumen: Objetivo: Estimar el coste hospitalario de una muestra de casos atendidos en siete hospitales del Sistema Nacional de Salud de diferentes ciudades españolas. Método: Estudio basado en 78 casos de enfermedad profesional reconocida por la Seguridad Social, atendidos en centros hospitalarios de Badalona, Barcelona, Ferrol, Gijón, Girona, Madrid y Vigo entre 2017 y 2019. Resultados: La actividad asistencial generada en estos hospitales para atender estos procesos supuso un coste total para el Sistema Nacional de Salud de 282.927 €. Conclusiones: Urge mejorar la coordinación entre los dos sistemas públicos de salud: la asistencia sanitaria de la Seguridad Social y el Sistema Nacional de Salud. Abstract: Objective: To estimate the hospital cost of a sample of cases treated in seven hospitals of the National Health System in several Spanish cities. Method: Study based on 78 cases of occupational disease recognized by the social security, and previously treated in hospitals in Badalona, Barcelona, Ferrol, Gijón, Girona, Madrid and Vigo between 2017 and 2019. Results: The healthcare activity generated by these hospitals to attend these processes involved a total cost of 282,927€. Conclusions: It is urgent to improve the coordination between the two public health systems, the social security health care system and the National Health System.

Purpose – This paper aims to provide an estimation of the costs of the coronavirus (COVID-19) pandemic with a special focus on Spain. Costs include macroeconomic costs of foregone gross domestic product (GDP) attributable to the pandemic and the direct and indirect costs of prevention, treatment and lost productivity. This study also analyzes the cost-effectiveness of the test-tracking-quarantine (TTQ) strategy in Spain. Design/methodology/approach – The macroeconomic costs of foregone GDP attributable to the pandemic are estimated for different countries and areas by comparing the present GDP forecasts for 2020 and 2021 with counterfactuals estimated before the COVID-19 crisis aftermath. The total cost of the COVID-19 for Spain in 2020 was obtained using the cost of illness approach with a bottom-up process. A cost-effectiveness analysis of the TTQ strategy in Spain is based on the estimation of the total costs of TTQ and the health gains and avoided health-care costs associated with the TTQ strategy. A sensitivity analysis explores the consequences of uncertainty in key parameters. Findings – The GDP cost of the COVID-19 is by far larger than all the other components of the cost. The global cost of the Covid-19 crisis in 2020–2021 is estimated at 14% of 2019 GDP (around 12,206 mm$). In the specific case of Spain, it amounts to 24% of the 2019 GDP; which is 397.3 m €. Spain is and will be by far the European country most economically affected by the pandemic. In Spain 2020, the GDP cost accounts for 94.7% of the total cost of the COVID-19 and health-care direct costs are only 2.14%. TTQ is a dominant strategy in Spain. For each euro spent on it, 7 euros will be recovered only in terms of saved health-care resources. Research limitations/implications – Given the large degree of uncertainty and the fast-evolving nature of the epidemic, a number of assumptions are required to arrive at the estimates provided in this study. The results were found to be robust to the assumptions applied. Practical implications – TTQ is a key strategy for the contention of the epidemy and it is justified from the economic perspective. Originality/value – This is the first estimation of the cost of the COVID-19 and the cost-effectiveness of the TTQ strategy for Spain.

Aim. The study aimed to assess the economic effect of biological therapy with anti-interleukin (IL)-6 drugs: tocilizumab, olokizumab, and levilimab in patients with severe COVID-19 and cytokine storm.Materials and Methods. An assessment of the economic consequences of severe COVID-19 therapy was carried out using the cost of illness analysis in a model developed in Microsoft Excel 2016 (Microsoft, USA). The direct medical costs of providing care for COVID-19 were taken into account (ICU service, the cost of biological therapy, and the use of glucocorticosteroids (GC)). Data from a prospective, historical controlled CHIC study conducted in the Netherlands were used as a source of efficacy. A mathematical model has been developed for extrapolating the CHIC study results to clinical outcomes (transfer to mechanical ventilation, discharge from ICU, lethal outcome) and forecasting the costs of managing severe patients with COVID-19 in real clinical practice in the Russian Federation.Results. The reduction in the cost of therapy when the hypothesis of equal efficacy of tocilizumab, olokizumab, and levilimab is accepted by reducing the cost of drug therapy will be 1,251,698.99 rubles per 72 patients when comparing olokizumab with tocilizumab and 939,718.84 rubles per 72 patients when comparing olokizumab with levilimab.Conclusion. Anti-interleukin (IL)-6 drugs in combination with GC are an effective treatment option for moderate to severe patients with COVID-19 and cytokine storm symptoms. This group of drugs is indicated as the main one for the treatment of this condition.

Copyright of Public Health Forum is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT OBJECTIVE To examine and map the consequences of chronic pain in adulthood. METHOD Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included RESULTS Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning. CONCLUSIONS This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Metritis is a prevalent disease with effects on production, reproduction, and survival, thereby affecting dairy farm profitability. A component of the cost of metritis is antimicrobial therapy. Some antimicrobials result in milk withhold that adds to the cost of disease. The objectives were (1) to determine cost of metritis for 2 antimicrobial treatments using a herd budget that includes costs associated with incidence of concurrent diseases, milk production and reproduction losses, and removal from the herd and (2) to apply sensitivity analysis to determine the cost of different scenarios. Cows with metritis from a previous study assigned randomly to receive ampicillin (AMP, n = 259), an antimicrobial that requires milk withhold, or ceftiofur (CEFT, n = 269), an antimicrobial with no milk withhold, were used for the economic analysis. A group of cows with no metritis (NOMET, n = 268), matched by parity and calving day, served as the baseline for comparison. The incidence of other diseases in the first 60 d postpartum, culling and death, reproductive performance, discarded milk, milk yield, total milk sold per cow, and residual cow value were used as responses. The economic analysis considered the costs associated with therapy, reproductive management, discarded milk, estimated DM consumed, income from saleable milk, and the residual cow value at 300 d postpartum or earlier if the cow was removed from the herd. Sensitivity analyses were performed considering 3 scenarios for milk and feed prices. The incidence of diseases other than metritis (NOMET, 30.4%; AMP, 45.4%; CEFT, 34.0%) and days in the hospital (NOMET, 2.7 d; AMP, 8.6 d; CEFT, 3.5 d) were greater for cows treated with AMP than CEFT. Treatment did not affect the risk of leaving the herd (NOMET, 15.5%; AMP, 15.0%; CEFT, 19.1%). The 21-d pregnancy rate was lower for cows with metritis but did not differ between AMP and CEFT (NOMET, 24.9%; AMP, 18.9%; CEFT, 17.0%). Milk yield was greater for cows without metritis than those with metritis and greater for AMP than CEFT (NOMET, 33.7 kg/d; AMP, 32.5 kg/d; CEFT, 31.2 kg/d). Cost of metritis did not differ with choice of therapy, but it increased as milk price increased. When both milk and feed prices were the average values considered ($0.44/kg and $0.26/kg, respectively), the costs of a case of metritis for AMP and CEFT were, respectively, $344 and $410 when milk was discarded and $267 and $406 when milk was fed to calves. Cost of therapy for AMP and CEFT represented 16.6 and 24.6% of the total cost of metritis when milk was discarded and 21.5 and 24.8% of the total cost of metritis when milk was fed to calves. The largest component of cost of metritis for both therapies was the reduced income from milk minus feed cost, ranging from 40.0 to 56.7%. Collectively, metritis is an expensive disease, and choice of antimicrobial therapy did not influence survival, reproduction, or cost of the disease. [ABSTRACT FROM AUTHOR]

Objective: to estimate the cost of treatment in patients with complicated osteoporosis (OP) in the first year after fracture under the conditions of the Moscow municipal healthcare system.Patients and methods. The investigation enrolled 196 women (mean age, 65.8±9.1 years) who had sustained fractures at five major osteoporotic sites (proximal hip (PH), distal forearm (DF), surgical humeral neck, vertebral column, and medial and/or lateral ankle). A unified questionnaire that included data on inpatient and outpatient treatment, patients' personal costs, and social benefits, as well as tariffs on services of the Moscow City Fund of Obligatory Health Insurance was used to estimate the cost of treatment for complicated OP during one year after fracture.Results. The direct cost of treatment for PH fracture amounted to 101,243 rubles and was significantly higher (p < 0.01) than that for fractures at other sites: DF (22,080 rubles); humeral neck (39,855 rubles), vertebral column (51,167 rubles), and ankle (43,345 rubles). The average cost of treatment in terms of indirect costs of treatment for complicated OP during a year was as high as 61,151 rubles. In the overall cost structure for the disease, hospital costs accounted for 44%; social benefits were 12% and the cost of antiosteoporotic drugs was only 7%, which was associated with the fact that the latter were rarely prescribed by primary healthcare physicians.Conclusion. Costs of treatment in patients with complicated OP in Moscow were estimated in relation to the site of low-energy fracture. The disease was shown to cause considerable economic losses regardless of the site of osteoporotic fracture; however, the cost of antiosteoporotic drugs has an insignificant share in the overall cost structure for treatment. At the same time, secondary prevention of OP requires that combination antiosteoporotic therapy should be performed in all patients who have sustained low-energy fracture.

Background and Objective: The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1)to evaluate the impact of CTCL on patient quality of life, and 2)to evaluate the costs associated with the disease. This article reports the results of the cost analysis., Methods: We estimated the cost of treating CTCL over a period of 1year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS)., Results: A total of 141 patients (57.4% male) with a mean age of 63.6 years (95%CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was €34,214 per patient. The corresponding costs by stage were €11,952.47 for stageI disease, €23,506.21 for stageII disease, €38,771.81 for stageIII disease, and €72,748.84 for stageIV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at €78,301,171; stageI disease accounted for 81% of all costs, stageII for 7%, and stagesIII andIV for 6% each., Conclusions: The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies., (Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Resumen Objetivo: identificar el estado de desarrollo de la investigación sobre los costos de la enfermedad laboral que ha sido publicada en la literatura durante la última década en el mundo. Metodología: se realizó una búsqueda sistemática de literatura, altamente sensible, con el objetivo de identificar publicaciones que se adaptaran a los criterios de inclusión predefinidos por los autores. Se consultaron bases de datos como Pubmed, Ebsco, Lilacs, Online Wiley, Embase y Springer. El periodo de tiempo consultado fue 2000-2013. Resultados: Se incluyeron 54 artículos, de los cuales el mayor porcentaje están escritos en inglés, la mayoría fue producto de investigaciones realizadas en Estados Unidos. La metodología utilizada principalmente por los autores de los artículos fue del tipo de estudios de carga y costos de la enfermedad. Los costos incluidos en estas publicaciones fueron directos e indirectos en su mayoría y la perspectiva predominante fue la de tipo social. Conclusiones: Las economías más avanzadas del mundo son las que en su mayoría realizan este tipo de investigaciones, balance que resalta la importancia de realizar estos estudios para economías de países en desarrollo. Con respecto al lenguaje de publicación solamente se encontraron publicaciones en español realizadas en España, de ahí que sea necesario adelantar más estudios de este tipo en Latinoamérica. / Abstract Objective: look the development of research about the work related illness published in the literature in different years, countries and economic activities and knows about the point of view to calculate the cost. Methodology: it was performance a systematic search, highly sensivity with the purpose of identify publications that could be accomplishment with inclusion criteria predefined by the authors. Databases such as PubMed, Ebsco, Lilacs, Online Wiley, Springer and Embase were consulted. The consultation period was from 2000 to 2013. Results: it was included 54 articles; most of them were written in English and made in the United States. With respect to the methodology most of them are studies of burden of disease. The most of the costs include are indirect and direct costs and the point of view to calculate those were the social perspective. Conclusion: the most advanced economies in the world are the majority research about this subject. This is role model for economies in development such Colombian. Related to the language of publication there are few publication in Spanish all of them from Spain this is a reason to make more this kind of research in Latino America.

This article analyses the cost of diarrhoea in lambs on dairy sheep farms located in Grosseto (Italy). Farmers’ profits have recently declined due to a stable product price but increasing production costs. Animal diseases have a cascade of effects on farm productivity. Lamb enteric disease outbreaks, which result in mortality in the herd and reduced weight gain, can drastically compromise the income of farmers. An economic analysis of the impact of an outbreak of diarrhoea in lambs was thus performed, evaluating the cost of disease based on the main visible production losses (such as mortality, reduced weight gain and variation in milk production). A sensitivity analysis was also conducted by applying different observed ranges of prevalence and mortality associated with the disease. Finally, an economic scenario analysis was performed, considering different in-farm management options for delivering lambs to the abattoir, i.e. early, standard and late delivery. The results showed that a dairy sheep farm with around 300 lambs that delivers them to the abattoir at 30 days of age would experience a loss of between 50 and 1200 Euro during an outbreak of diarrhoea with a prevalence of 34.21 (23.54–44.88)% and a mortality of 15.69 (9.98–21.4)%. [ABSTRACT FROM AUTHOR]

Fifty years after anthelmintic resistance in livestock parasites was first reported, the prevalence of resistance has increased globally, and is of increasing significance in animal industries. It is now timely to reflect on what we have learnt, how research has unfolded, and what we hope to learn in the future. This Opinion paper examines ten important research events that were pivotal in resistance research. The moments include the discovery, description, and diagnosis of parasite resistance, as well as important physiological and genetic findings, and the development of online tools to help manage resistance. Despite our efforts, resistance remains the greatest challenge in parasite control. The future directions for research, including people and funding, are discussed. [ABSTRACT FROM AUTHOR]

The objective was to assess the cost of Medication Overuse Headache (MOH) at the time-point of withdrawal treatment. We implemented a protocol in which both direct and indirect cost were directly gathered from patients and referred to the previous three months. Direct costs were calculated by medications for acute treatment and prophylaxis, diagnostic procedures, visits, complementary treatments, informal care. Indirect costs were referred to missed workdays and workdays with reduced productivity: we asked patients to refer their salaries and to rate the overall level of performance in days worked with reduced productivity, and we calculated indirect costs on this basis. A total of 135 patients were enrolled: direct costs were around 415€/month; indirect costs were 530€/month, and were mostly due to presenteeism (350€, 66.3%) rather than to absenteeism (160€, 33.7%). Our data showed higher cost than those of a previous study: this is likely due to a different approach to cost definition, to the inclusion of direct non-medical cost, and of non-pharmacological treatments. [ABSTRACT FROM AUTHOR]

Objectives To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital’s and patient’s perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. Methods Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture–related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss. Results A total of 67 patients agreed to participate, giving a response rate of 64.4%. The mean (median) 3-month direct medical cost from the hospital’s perspective was found to be SGD 3,886.90 (SGD 413.10), of which 74.2% was accounted for by inpatient services, 25.2% by outpatient services, and 0.6% by accident and emergency services. Moreover, considerable variation (SD = SGD 2,615.40) was observed in the costs of outpatient rehabilitation services. Findings were similar when the patient’s perspective was taken. The total costs, with both direct and indirect costs included, were SGD 11,438.70 (acute) and SGD 1,015.40 (prevalent), of which 34.7% and 8.0%, respectively, were accounted for by inpatient services. Conclusions Hospitalization was associated with the highest cost borne by both the hospital and the patient, and informal care dominated indirect costs. Better knowledge of the financial consequences of fragility fractures could enable proactive and preventive measures to be undertaken, especially at sites of care with high cost drivers. [ABSTRACT FROM AUTHOR]

Background Globally, stroke is recognized as one of the main causes of long-term disability, accounting for approximately 5·7 million deaths each year. It is a debilitating and costly chronic condition that consumes about 2-4% of total healthcare expenditure. Aims To estimate the direct medical cost associated with stroke in Singapore in 2012 and to determine associated predictors. Methods The National Healthcare Group Chronic Disease Management System database was used to identify patients with stroke between the years 2006 and 2012. Estimated stroke-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, and medications. Results A total of 700 patients were randomly selected for the analyses. The mean annual direct medical cost was found to be S$12 473·7, of which 93·6% were accounted for by inpatient services, 4·9% by outpatient services, and 1·5% by A& E services. Independent determinants of greater total costs were stroke types, such as ischemic stroke ( P = 0·005), subarachnoid hemorrhage ( P < 0·001) and intracerebral haemorrhage ( P < 0·001), shorter poststroke period, more than one complications ( P = 0·045), and a greater number of comorbidities ( P = 0·001). Conclusion There is a considerable economic burden associated with stroke in Singapore. The type of stroke, length of poststroke period, and stroke complications and comorbidities are found to be associated with the total costs. Efforts to reduce inpatient costs and to allocate health resources to focus on the primary prevention of stroke should become a priority. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to analyze the economic effects of hospital malnutrition and the cost of longer hospital stays according to the Prevalence of Hospital Malnutrition and Associated Costs in Spain (PREDyCES) study data. Methods: This was a nested case-control study in a prospective cohort of patients (n = 114) who were at nutritional risk at admission and controls (n = 354) who were not at risk at admission. The total cost of hospital stay was the cost of the bed plus the cost of drugs administered during the stay. Hospital costs were extrapolated to Spanish National Health System admissions for 2009. Results: The mean hospital length of stay for patients at risk (cases) was significantly longer (11.5 ± 7.5 versus 8.5 ± 5.8 d; P < 0.001) than for the controls. The cost of patients at risk at admission was significantly higher than that of those not at risk (€8590 ± €6127 versus €7085 ± €5625; P = 0.015). The most significant difference in the cost of the hospital stay was observed between controls at nutritional risk at discharge and controls who remained not at risk throughout the hospital stay (€13 013 ± €9086 versus €6665 ± €5091; P < 0.001). Extrapolation of the study findings to Spanish National Health System hospital admissions showed that the potential cost of hospital malnutrition in Spain was at least €1.143 billion per year. Conclusion: Hospital malnutrition in Spain is associated with substantial costs, suggesting the need to establish procedures for screening, diagnosing, and treating malnutrition. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate the direct financial costs of hospital care for management of invasive group A streptococcal (GAS) infections using hospital records for cases diagnosed in England. We linked laboratory-confirmed cases (n = 3696) identified through national surveillance to hospital episode statistics and reimbursement codes. From these codes we estimated the direct hospital costs of admissions. Almost all notified invasive GAS cases (92% of 3696) were successfully matched to a primary hospital admission. Of these, secondary admissions (within 30 days of primary admission) were further identified for 593 (17%). After exclusion of nosocomial cases (12%), the median costs of primary and secondary hospital admissions were estimated by subgroup analysis as £1984–£2212 per case, totalling £4·43–£6·34 million per year in England. With adjustment for unmatched cases this equated to £4·84–£6·93 million per year. Adults aged 16–64 years accounted for 48% of costs but only 40% of cases, largely due to an increased number of surgical procedures. The direct costs of hospital admissions for invasive GAS infection are substantial. These estimated costs will contribute to a full assessment of the total economic burden of invasive GAS infection as a means to assess potential savings through prevention measures. [ABSTRACT FROM AUTHOR]

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Summary In most healthcare systems, third-party payers fund the costs for patients admitted to hospital for Clostridium difficile infection (CDI) whereas, for CDI cases arising as complications of hospitalization, not all related costs are refundable to the hospital. We therefore aimed to critically review and categorize hospital costs and length of hospital stay (LOS) attributable to Clostridium difficile infection and to investigate the economic burden associated with it. A comprehensive literature review selected papers describing the costs and LOS for hospitalized patients as outcomes of CDI, following the use of statistics to identify costs and LOS solely attributable to CDI. Twenty-four studies were selected. Estimated attributable costs, all ranges expressed in US dollars, were $6,774–$10,212 for CDI requiring admission, $2,992–$29,000 for hospital-acquired CDI, and $2,454–$12,850 where no categorization was made. The ranges for LOS values were 5–13.6, 2.7–21.3, and 2.8–17.9 days, respectively. The categorization of CDI attributable costs allows budget holders to anticipate the cost per CDI case, a perspective that should enrich the design of appropriate incentives for the various budget holders to invest in prevention so that CDI prevention is optimized globally. [ABSTRACT FROM AUTHOR]

Background Diabetes mellitus (DM) is recognised as a major health problem. Objectives The aims of this study are two-fold: (1) to describe the methods used in the identified cost-of-illness (COI) studies of DM and (2) to summarise their study findings regarding the economic impact of DM. Methods This is a systematic review of MEDLINE and Scopus journal articles reporting the cost of type 1 and/or 2 DM that were published in English from 2007 to 2011. Costs reported in the included studies were converted to US dollars. Results The systematic search yielded 30 articles. The studies varied considerably in their study design, perspective and included cost categories. Estimates for the total annual costs of DM ranged from US$141.6 million to US$174 billion; direct costs ranged from US$150 to US$14,060 per patient per year (pppy) whereas indirect costs ranged from US$39.6 to US$7,164 pppy. Inpatient cost was the major contributor to direct cost in half of the studies that included inpatient costs, physician services and medications. Conclusion There is a considerable economic burden associated with DM. Future research should focus on improving methods of estimating costs, enhancing the interpretation of study findings and facilitating comparisons between studies. [ABSTRACT FROM AUTHOR]

Abstract: Contagious bovine pleuropneumonia (CBPP) is an infectious disease which impacts cattle production in sub-Saharan Africa. To adequately allocate resources for its control, there is a need to assess its impact on cattle producers. The present study estimated the impact of CBPP on pastoralists through analysis of various strategies employed for its control in cattle herds including: preventive vaccination, antimicrobial treatment, slaughter of clinical cases and other combinations of these control strategies. The assessment was based on a loss-expenditure frontier framework to identify a control strategy with minimum cost from both expenditures on control strategies and output losses due to mortalities, reduced milk yield, reduced weight gain and reduced fertility rate. The analysis was undertaken in a stochastic spreadsheet model. The control strategy with minimum cost per herd was preventive vaccination with an estimated cost of US$ 193 (90% CI; 170–215) per 100 cows per year, while slaughter of clinical cases had an estimated cost of US$ 912 (90% CI; 775–1055) per 100 cows per year. The impact of CBPP to the nation was estimated at US$ 7.6 (90% CI; 6.5–8.7) million per year. Yet, if all pastoralists whose cattle are at high risk of infection adopted preventive vaccination, the aggregate national impact would be US$ 3.3 (90% CI; 2.9–3.7) million per year, with savings amounting to US$ 4.3 million through reallocation of control expenditures. The analysis predicted that control of CBPP in Kenya is profitable through preventive vaccination. However, further research is recommended for the technical and financial feasibility of implementing a vaccine delivery system in pastoral areas where CBPP is endemic. [Copyright &y& Elsevier]

Objective: This study sought to measure burden of disease and identifies health priorities from the Disability Adjusted Life Years (DALYs) indicator. Methods: By using the DALYs indicator, burden of disease was identified in the department of Nariño according to the guidelines established by the World Health Organization. Results: The DALYs in the Department of Nariño highlight the emergence of communicable, maternal, perinatal, and nutritional diseases during the first years of life; of accidents and lesions among youth, and non-communicable diseases in older individuals. Also, accidents and lesions are highlighted in men and non-communicable diseases in women. Conclusions: This is the first study on burden of disease for a department in Colombia by using a standardized methodology. This study is part of the knowledge management process in the Departmental Health Plan for Nariño - Colombia 2012-2015 and contributes to the system of indicators of the 2012 ten-year public health plan. This research evidences that communicable diseases generate the biggest part of the burden of disease in the Department of Nariño, that DALYs due to non-communicable diseases are on the rise, and that accidents and lesions, especially due to violence are an important cause of DALYs in this region, which is higher than that of the country. [ABSTRACT FROM AUTHOR]

Objective: Diabetes mellitus (DM) is a major health problem with severe complications and a significant impact on quality of life. It constitutes an enormous burden of disease due to high prevalence, severe co-morbidities and high costs for society. This study is the first comprehensive study on the direct and indirect costs of DM (type 1 and type 2) and associated complications in Poland. Methods: In order to estimate the direct medical costs of DM and its complications, including the costs of medical consultation, hospitalisation, rehabilitation, drugs and medical equipment, data from the National Health Fund were used. Indirect costs on loss of productivity due to diabetes and its complications were based on data obtained from the ZUS (Social Insurance Institution) and from GUS (Poland's Central Statistical Office). Attributable risk methodology was used to assess the burden of DM complications. Results: A continuous increase of the direct costs of diabetes has been observed since the year 2005. In the analysed time period (2005-2009) the direct costs of medical services for both types of DM doubled. DM is a cause of significant sickness absence and incapacity for work and therefore is associated with a growing productivity decline in Poland. The highest direct costs and indirect costs are associated with treatment of diabetes-related complications. Direct costs of hospital complication treatment were EUR 332 million, which exceeded by more than five times the direct costs of hospital treatment of diabetes per se, which in the same year amounted to EUR 58.5 million. The indirect costs of diabetes-related complications were higher by 41 % compared with indirect costs related to DM itself. Total costs of health care services for DM and its complications amounted to EUR 654 million, which constitutes a 2.8 % of total health care costs in Poland. Total DM cost in Poland in 2009 amounted EURO 1.5 billion. Conclusions: DM is causing a growing economic burden on the health care system and on Polish society in terms of health care and productivity losses. Most of the total cost of diabetes are indirect costs caused by productivity losses. Both direct and indirect costs are driven by the cost of diabetes complications. [ABSTRACT FROM AUTHOR]

Background: Acute coronary syndrome (ACS) is highly prevalent in Korea and is the third-leading cause of death in Korea; however, the economic cost of ACS on Korean society has not been investigated. This study examined the economic effect of ACS on the Korean population during the period 2004 to 2009. Methods: The analysis used the cost of illness (COI) framework. Data on direct medical costs, direct non-medical costs, and productivity loss related to ACS morbidity and mortality were included. The Korean National Health Insurance Corporation's claim database was used to obtain data on annual healthcare utilization and expenditures for the entire South Korean population. By using a data mining technique, we identified healthcare claims with ACS-related disease codes. Costs were estimated by using a macro-costing method. Results: In 2009, the prevalence of ACS in Korea was 6.4 persons per 1,000 population members and the associated mortality rate was 20.2 persons per 100,000 population members. The total cost of ACS in 2009 was USD 918.2 million. Of the total, direct medical cost was USD 425.3 million, direct non-medical cost was USD 11.4 million, and cost associated with morbidity and mortality was USD 481.5 million. Conclusions: The results show that the total cost of ACS to the Korean society is high. Early and effective management of ACS is required to reduce ACS-associated mortality and morbidity. We suggest that further research be undertaken to determine ways to reduce the economic effects of ACS and its treatment. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18 (Suppl. 5): 7-14 Abstract Streptococcus pneumoniae causes different types of acute, invasive and non-invasive clinical infections, being the most frequently detected pathogen responsible for community-acquired pneumonia. Pneumococcal pneumonia is accompanied by bacteraemia in 10-30% of cases. Streptococcus pneumoniae is gaining resistance to the in vitro activity of several antimicrobial agents and, even if questions remain regarding the clinical impact of this phenomenon, more and more reports indicate that antibiotic resistance can lead to more treatment failures if not higher mortality. Use of the 23-valent anti-pneumococcal vaccine appears to offer subpotimal protection against pneumococcal disease, particularly among high-risk adult populations. Vaccination against S. pneumoniae with new conjugate vaccines seems to be the most promising field for real improvement in the management of pneumococcal infections in adults. [ABSTRACT FROM AUTHOR]

Background: Cluster headache (CH) is the most frequent trigemino-autonomic cephalgia. CH can manifest as episodic (eCH) or chronic cluster headache (cCH) causing significant burden of disease and requiring attack therapy and prophylactic treatment. Methods: Treatment costs (direct costs) due to healthcare utilisation, as well as costs caused by disability and reduction in earning capacity (indirect costs), were obtained using a questionnaire in CH patients treated in a tertiary headache centre based at the University Duisburg-Essen over a 6-month period. Results: A total 179 patients (72 cCH, 107 eCH) were included. Mean attack frequency was 3.5±2.5 per day. Mean direct and indirect costs for one person were 5963 in the 6-month period. Direct costs were positively correlated E with attack frequency (r=0.467, p<0.001). Burden of disease measured with HIT -6 showed a significant correlation with attack frequency (r=0.467, p<0.001). Twenty-four (13.4%) of the participants were disabled and not able to work. Conclusion: CH leads to major socioeconomic impact on patients as well as society due to direct healthcare costs and indirect costs caused by loss of working capacity. [ABSTRACT FROM AUTHOR]

This panel-data study concerns the incidence of newly diagnosed tuberculosis (TB) in specific U.S. metropolitan areas among immigrants and, in turn, the possible transmission of the disease to the native-born population of these same metropolitan areas. The study includes 50 U.S. Metropolitan Statistical Areas as annual observations, 1993-2007. We find that a 10% increase in the number of high-incidence immigrants results in a 2.87% increase in TB among the foreign-born population, and that a 10% increase in the number of foreign-born TB cases increases the number of new TB cases among the native-born by 1.11%. The study concludes with a benefit/cost analysis of the societal cost of TB and suggests that testing all immigrants for TB would be a cost-effective method to limit the amount of TB that enters U.S. from abroad, thus limiting the transmission to both the foreign- and native-born populations. [ABSTRACT FROM AUTHOR]

The aim of this study, a retrospective cohort analysis, was to calculate the costs and consequences of exposure to and compliance with drug treatments recommended for refracture prevention in post-menopausal women with hip fracture. All women aged ≥65 years and admitted to hospital with a main or secondary diagnosis of hip fracture in the period 1 January 2006 - 31 December 2008 were included. These patients were classified as exposed/not exposedto a drug treatment for fracture prevention. Adherenceto treatment was calculated in the group of patients treated with bisphosphonates. The following items were considered in the cost analysis: drug treatments supplied, diagnostic tests administered and hospital admissions recorded during the observation period. In total, 5,167 patients were included in the analysis, of whom only 33.9% received drug therapy post hip fracture; of those treated with bisphosphonates, only 21.1% were found to have adhered to the treatment. Exposure to drug treatment reduced the risk of refracture by 39.5% and the risk of death by 55.1%. The mean cost increases observed in the patients who, according to indication, were exposed to drug treatment (+ £ 256) or submitted to a diagnostic test (+ £ 40) were offset by a sizeable reduction in costs of hospitalisation for refracture (- £ 703). Drug treatment for the prevention of bone refractures in hip fracture patients was found to be effectivein reducing the risk of refracture and death, and cost-effective, reducing overall patient management costs. [ABSTRACT FROM AUTHOR]

Abstract: An economic model for estimating the direct costs of disease in industrial aquaculture was developed to include the following areas: biological losses, extraordinary costs, costs of treatment, costs of prevention and insurance pay-out. Direct costs of a pancreas disease (PD) outbreak in Norwegian farmed Atlantic salmon were estimated in the model, using probability distributions for the biological losses and expenditures associated with the disease. The biological effects of PD on mortality, growth, feed conversion and carcass quality and their correlations, together with costs of prevention were established using elicited data from an expert panel, and combined with basal losses in a control model. Extraordinary costs and costs associated with treatment were collected through a questionnaire sent to staff managing disease outbreaks. Norwegian national statistics for 2007 were used for prices and production costs in the model. Direct costs associated with a PD-outbreak in a site stocked with 500,000 smolts (vs. a similar site without the disease) were estimated to NOK (Norwegian kroner) 14.4 million (5% and 95% percentile: 10.5 and 17.8) (NOK=€0.12 or $0.17 for 2007). Production was reduced to 70% (5% and 95% percentile: 57% and 81%) saleable biomass, and at an increased production cost of NOK 6.0 per kg (5% and 95% percentile: 3.5 and 8.7). [Copyright &y& Elsevier]