Burden of disease attributed to acute respiratory infections in South America.

Introduction: Respiratory diseases (RD) are an important public health problem. Their burden has not been comprehensively evaluated in South America (SA). This study describes the burden of acute respiratory infections (ARIs) in SA in 2019.

Health-Economic Analyses of Diagnostics: Guidance on Design and Reporting.

Cost-effectiveness analyses (CEAs) can be used to assess the value of diagnostics in clinical practice. Due to the introduction of the European in vitro diagnostic and medical devices regulations, more clinical data on new diagnostics may become available, which may improve the interest and feasibility of performing CEAs. We present eight recommendations on the reporting and design of CEAs of diagnostics.

Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review.

Background: Diagnostic testing for respiratory tract infections is a tool to manage the current COVID-19 pandemic, as well as the rising incidence of antimicrobial resistance. At the same time, new European regulations for market entry of in vitro diagnostics, in the form of the in vitro diagnostic regulation, may lead to more clinical evidence supporting health-economic analyses.

Objective: The objective of this systematic review was to review the methods used in economic evaluations of applied diagnostic techniques, for all patients seeking care for infectious diseases of the respiratory tract (such as pneumonia, pulmonary tuberculosis, influenza, sinusitis, pharyngitis, sore throats and general respiratory tract infections).

Effects of economic and health policies on the consumption of antibiotics in a Spanish region.

Objectives: Inappropriate and indiscriminate use of antibiotics is one of the main factors contributing to the increasing bacterial resistance. Surveillance of antibiotic consumption is fundamental for assessing the effects of rational use-oriented measures introduced under economic or health policies. This study quantifies and assesses the introduction of a pharmaceutical co-payment and implementation of campaigns to increase awareness about and rational use in the consumption of antibiotics (volume and expenditure).

[Risk sharing contracts in the national health care system: Perceptions of health care professionals].

Objective: Risk-sharing contracts (RSC) present a novel management tool, which link the payment to the pharmaceutical company to health outcomes. The objective of this work was to know the perception of health professionals about the utility of these agreements in the Spanish National Health System.

Methods: A questionnaire was designed to conduct a series of semi-structured interviews with hospital pharmacy, laboratory and oncology professionals from Spanish hospitals in Madrid, Aragón, Castilla-La Mancha, Castilla y León, Cataluña, La Rioja, País Vasco and Navarra.

Unlocking the potential of established products: toward new incentives rewarding innovation in Europe.

: Many established products (EPs - marketed for eight years or more) are widely used off-label despite little evidence on benefit-risk ratio. This exposes patients to risks related to safety and lack of efficacy, and healthcare providers to liability. Introducing new indications for EPs may represent a high societal value; however, manufacturers rarely invest in R&D for EPs.

[A Dynamic Model to Estimate the Budget Impact of a Pneumococcal Vaccination Program in a 65 Year-old immunocompetent Spanish Cohort with 13-Valent Pneumococcal Conjugate Vaccine].

Objective: To estimate the 5-year clinical and economic impact of a pneumococcal vaccination program on immunocompetent population aged 65-year-old in Spain.

Methods: A 5 year dynamic model based on differential equations was built for the conceptualization of the burden of pneumococcal disease (PD) on a 65 year-old cohort. A 36.

Cost-effectiveness analysis of levobupivacaine 0.5 %, a local anesthetic, infusion in the surgical wound after modified radical mastectomy.

Background And Objective: Effective treatment of postoperative pain contributes to decreasing the rate of complications as well as the total cost of the operated patients. The aim of this study was to analyze the costs and the efficiency of use of continuous infusion of levobupivacaine 0.5 % with the help of an infusion pump in modified radical mastectomy.

Postoperative analgesia by infusion of local anesthetic into the surgical wound after modified radical mastectomy: a randomized clinical trial.

Background: There is no consensus on the efficacy of postoperative infusion of local anesthetics after radical mastectomy.

Methods: A randomized, double-blind, placebo-controlled, parallel-groups clinical trial was conducted in a tertiary hospital. Eighty consecutive women with operable breast cancer with indications for modified radical mastectomy without breast reconstruction were assigned randomly to receive infusion of levobupivacaine (0.

[Impact of the Royal Decree-Law 16/2012 on the number of prescriptions and pharmaceutical expenditures].

Background: this research aims to understand if the consequences on drug expenditures and number of prescriptions of Royal Decree-Law 16/2012 as estimated by the Ministry of Health, Social Services and Equality (MHSSE) are similar to those found by using common statistical approaches. In addition, several models have been built to forecast the evolution of both variables for the period September 2013-December 2014.

Methods: the Box-Jenkins methodology and the Box-Tiao intervention analysis were applied to data of the period 2003-13 to forecast the monthly values of the number of prescriptions and pharmaceutical expenditures.

[Non safety costs in the Spanish health care system].

Background: In the context of budgetary difficulties, the estimation of non safety costs is an additional tool that may be useful in the decision making process of the health system as well as to improve the health care management. Until now there is no study that has estimated the costs of non safety in Spain in an integral way. The objective of this article is to show a first approach to the calculation of the costs of non safety referred to the year 2011.

[Costs-analysis of methadone program in the autonomous community La Rioja, Spain].

Background: Methadone programs have been organized in each Spanish region in a specific way. In spite of the regional interests to manage those programs in a more efficient way, so far the costs of the programs are unknown. As a previous step, it would be desirable to understand the activities related to these programs as well as their respective costs.

[Mathematical models for economic evaluation: dynamic models based on differential equations].

The joint utilization of both decision trees and epidemiological models based on differential equations is an appropriate method for the economic evaluation of preventative interventions applied to infectious diseases. These models can combine the dynamic pattern of the disease together with health resource consumption. To illustrate this type of model, we adjusted a dynamic system of differential equations to the epidemic behavior of influenza in Spain, with a view to projecting the epidemiologic impact of influenza vaccination.

Cost-utility analysis of eprosartan compared to enalapril in primary prevention and nitrendipine in secondary prevention in Europe--the HEALTH model.

Objective: To investigate the cost-utility of eprosartan versus enalapril (primary prevention) and versus nitrendipine (secondary prevention) on the basis of head-to-head evidence from randomized controlled trials.

Methods: The HEALTH model (Health Economic Assessment of Life with Teveten for Hypertension) is an object-oriented probabilistic Monte Carlo simulation model. It combines a Framingham-based risk calculation with a systolic blood pressure approach to estimate the relative risk reduction of cardiovascular and cerebrovascular events based on recent meta-analyses.

[Use of European Quality of Life-5 Dimensions (EQ-5D) questionnary to value the health related quality of life variation because of influenza].

Objective: To describe self-perceived health status and health-related quality of life (HRQoL) in healthy individuals of working age, to measure changes due to influenza infection, and to evaluate the effect of influenza infection on HRQoL in monetary terms.

Method: We performed a descriptive observational study through questionnaires administered to 50 patients of working age infected with the influenza virus during the epidemiologic year 2004-2005 and living in private homes of the city of Logroño (Spain). The patients completed the questionnaires twice: with and without influenza.

Dynamic modelling of infectious diseases: an application to the economic evaluation of influenza vaccination.

Objective: To evaluate the economic efficiency of influenza vaccination using both dynamic and static modelling approaches.

Setting: The Spanish National Health System.

Design And Methods: We modelled the progress of an influenza epidemic in Spain according to the epidemiological pattern of susceptible-->infective-->resistant, employing a non-linear system of ordinary differential equations that enables the measurement of epidemiological effects of an anti-influenza vaccination.

[Use of a retail sales tax on tobacco to fund drug therapy for smoking cessation].

Objectives: To analyze the revenue-generating potential of a new retail sales tax on tobacco and its effects on public health if the tax revenues were allocated to finance smoking cessation programs.

Methods: We provide an extensive review of the legislation on the authority of autonomous communities to order the levy and collection of special taxes and describe the new tobacco retail sales tax. We calculated collected tax revenues with a simulation model of indirect taxation -the SINDIEF (Simulador de Imposición Indirecta del Instituto de Estudios Fiscales) model- and determined the potential number of smokers who would quit smoking.

Healthcare rationing in Spain: framework, descriptive analysis and consequences.

This paper describes the main healthcare rationing policies implemented in Spain over the last 2 decades, and analyses the consequences of these policies on the healthcare system, patients, healthcare practitioners, the pharmaceutical industry and policymakers. The primary explicit healthcare rationing policies utilised in Spain include a catalogue that defines the healthcare rights of citizens. However, the existing system may lead to inequity between regions, and is not structured to direct resources towards the most cost-effective options.

[Economic evaluation studies in health].

Clinical journals often publish economic evaluation studies of health technologies and programs. To improve the peer review process and, hence, the quality and validity of published studies, the British Medical Journal (BMJ) established publication guidelines for the publication of economic evaluations aimed at authors, reviewers and editors. The present article analyzes the opportunity of adopting the BMJ's or similar guidelines by Medicina Clínica and the probable effectiveness of this measure.

[Cost-effectiveness analysis of samario-153 (Quadramet) for the treatment of patients with prostate cancer and bone metastases].

Objective: To evaluate the cost-effectiveness of samarium [153Sm-EDTMP] (Quadramet) compared to conventional therapy in the treatment of pain in patients with prostate cancer and bone metastases.

Method: A decision tree model for the treatment of bone pain due to metastases was adapted to the Spanish context. The model represents the standard treatment patterns in Spain for the study population.