Constraints and perspectives of pharmacists counseling patients with depression at hospital discharge.

Objective Of The Study: This study aims to explore experiences, barriers and enabling factors during an antidepressant counseling study as well as to explore future initiatives.

Setting: 11 Flemish psychiatric hospitals.

Method: Focus group discussions were organized.

Palliative inpatients in general hospitals: a one day observational study in Belgium.

Background: Hospital care plays a major role at the end-of-life. But little is known about the overall size and characteristics of the palliative inpatient population. The aim of our study was to analyse these aspects.

[How to improve the continuity of pharmacotherapy at hospital admission and discharge].

The continuity of pharmacotherapy is of vital importance when patients move from one health care setting to another. Unfortunately, this continuity is not always guaranteed. The aim of this study is to propose solutions to enhance the continuity of pharmacotherapy at hospital admission and discharge.

Discharge management for patients in Flemish psychiatric hospitals.

Rationale And Aims: At the end of the 1990 s, a case management service called 'discharge management' was implemented in Belgian psychiatric hospitals. This study aimed to describe the profile of patients receiving discharge management in Flemish psychiatric hospitals as well as to analyse the discharge management indicators of these hospitals on micro and meso level.

Methods: Ten Flemish psychiatric hospitals participated.

Endometriosis cost assessment (the EndoCost study): a cost-of-illness study protocol.

Aims: The EndoCost study aims to calculate the costs of endometriosis from a societal perspective.

Methods: This multicentre, prevalence-based cost-of-illness analysis aggregates data on endometriosis costs and quality of life from a prospective hospital questionnaire and from both retrospective and prospective patient questionnaires. The EndoCost study comprises 12 representative tertiary care centres involved in the care of women with endometriosis in 10 countries.

[Medicine information for patients with a major depression at hospital discharge].

This article provides an overview of several parts of a doctoral thesis on medicine information for patients with a major depression at hospital discharge. A review of the international literature showed that medicine information can increase knowledge and adherence. Inpatients would like to receive more information on the medicines prescribed.

Costs of terminal patients who receive palliative care or usual care in different hospital wards.

Background: In addition to the effectiveness of hospital care models for terminal patients, policy makers and health care payers are concerned about their costs. This study aims to measure the hospital costs of treating terminal patients in Belgium from the health care payer perspective. Also, this study compares the costs of palliative and usual care in different types of hospital wards.

Use of economic evaluation in decision making: evidence and recommendations for improvement.

Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines.

Issues surrounding orphan disease and orphan drug policies in Europe.

An orphan disease is a disease with a very low prevalence. Although there are 5000-7000 orphan diseases, only 50 orphan drugs (i.e.

A comparative study of European rare disease and orphan drug markets.

Objectives: This article aims to compare regulatory aspects of rare disease and orphan drug markets in Belgium, France, Italy, the Netherlands, Sweden and the United Kingdom.

Methods: Information was derived from the international literature, analysis of legal texts, and a survey completed by national experts.

Results: These countries adopted varying approaches towards regulating rare disease and orphan drug markets and, hence, the availability, pricing and reimbursement of orphan drugs vary between countries.

The use of intravenous immunoglobulins in Belgium.

Background: In light of the limited supply of intravenous immunoglobulins, it is important to strive for their appropriate use. Off-label use needs to be discouraged because of the limited supply of intravenous immunoglobulins, their unproven effectiveness in many conditions, their high costs, and the risk of adverse effects. This study aims to document the use of intravenous immunoglobulins in registered and off-label conditions in Belgian hospitals.

Health economic assessment: cost-effectiveness thresholds and other decision criteria.

An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a theoretical perspective, the cost-effectiveness threshold model is not inconsistent with these two arguments. The observed annual variation in incremental cost-effectiveness ratios in New Zealand may originate from yearly differences in new medicines that request reimbursement and in the budget size, and from the fact that decision makers take into account other decision criteria in addition to cost-effectiveness.

The costs of treating terminal patients.

Context: In addition to the effectiveness of terminal care, policy makers and health care payers are concerned about the costs of treating terminal patients in a context of spiraling health care costs and limited resources.

Objectives: This article aims to review the international literature on the costs of treating terminal patients.

Methods: Studies were identified by searching PubMed, Centre for Reviews and Dissemination databases, Cochrane Database, and EconLit, up to April 2009.

Increasing nurse staffing levels in Belgian cardiac surgery centres: a cost-effective patient safety intervention?

Aim: This paper is a report of a cost-effectiveness analysis from a hospital perspective of increased nurse staffing levels (to the level of the 75th percentile) in Belgian general cardiac postoperative nursing units.

Background: A previous study indicated that increasing nurse staffing levels in Belgian general cardiac postoperative nursing units was associated with lower mortality rates. Research is needed to compare the costs of increased nurse staffing levels with benefits of reducing mortality rates.

Pharmacoeconomics of anti-epileptic drugs as adjunctive therapy for refractory epilepsy.

Epileptic seizures are associated with significant morbidity, impaired quality of life, mortality and substantial healthcare costs. Treatment with anti-epileptic drugs is the mainstay of therapy, with pharmacotherapy aiming to achieve seizure freedom or seizure reduction. Given that approximately 30% of patients are not controlled with monotherapy regimens, adjunctive therapy with multiple anti-epileptic drugs can be envisaged.

Budget impact analysis of orphan drugs in Belgium: estimates from 2008 to 2013.

Objective: This article aims to calculate the impact of orphan drugs on the Belgian drug budget in 2008 and to forecast its impact over the following 5 years.

Method: The 2008 budget impact was calculated by triangulating information derived from multiple Belgian data sources. The 2008-2013 budget impact analysis was based on three scenarios reflecting different levels of growth in the number of registered orphan drugs in the European Union, the number of drugs reimbursed in Belgium, and the average annual cost per patient per drug in Belgium.

Health Economics of Antibiotics.

Antibiotics have made a significant contribution to improving patient health, but policy makers and health care payers are concerned about the costs of antibiotics in addition to their effectiveness. This paper aims to assess the value of antibiotics by examining incremental cost-utility ratios of antibiotics. Evidence was derived from cost-utility analyses of antibiotics included in the Tufts-New England Center Cost-Effectiveness Analysis Registry through September 2009.

Treatment of primary immunodeficiency with Kiovig: a literature review.

Introduction: Primary immunodeficiency disorders are associated with increased patient susceptibility to recurrent infections. Since the 1950s, immunoglobulin products have been administered to treat infections in primary immunodeficiency, and patients often require lifelong therapy. The aim of this study is to carry out a literature review of a ready-to-use 10% liquid immunoglobulin preparation, Kiovig (Baxter, Brussels, Belgium), in the treatment of primary immunodeficiency.

The costs of breast cancer prior to and following diagnosis.

This retrospective incidence-based cost-of-illness analysis aims to quantify the costs associated with female breast cancer in Flanders for the year prior to diagnosis and for each of the 5 years following diagnosis. A bottom-up analysis from the societal perspective included direct health care costs and indirect costs of productivity loss due to morbidity and premature mortality. A case-control study design compared total costs of breast cancer patients with costs of an equivalent standardised population with a view to calculating the additional costs that can be attributed to breast cancer.

Cardiovascular drug use prior to diagnosis of diabetes: a pilot study in community pharmacy.

Objectives: The literature indicates that cardiovascular drug use is higher during the years prior to diagnosis of type 2 diabetes mellitus. As there are pharmaco-epidemiological and economic consequences of enhanced medication use prior to diagnosis of diabetes, there is a need for a comparative analysis of the drug-use pattern by patients with a subsequent diagnosis of diabetes and control patients. This pilot study aimed to investigate cardiovascular drug use in patients with a subsequent diagnosis of diabetes using data extracted from 200 community pharmacies in the Belgian township of Hasselt.

Generic Medicine Pricing Policies in Europe: Current Status and Impact.

Generic medicine pricing is an area of national responsibility of European Union countries. This article aims to present the current status and impact of generic medicine pricing policies in ambulatory care in Europe. The study conducts a literature review of policies relating to free-pricing systems, price-regulated systems, price differentiation, price competition and discounts, and tendering procedures; and a survey of European generic medicine pricing policies.