Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: A cost effectiveness study

Correction to Geitona M, Kousoulakou H, Ollandezos M, Athanasakis K, Papanicolaou S and Kyriopoulos I: Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: a cost effectiveness study. Annals of General Psychiatry 2008, 7:16. This correction reports changes in the values listed for Ziprasidone and Aripiprazole in Table Ten

Клінічні та поведінкові практики лікарів первинної ланки при призначенні антибіотиків у Греції

Aim: To evaluate primary health physicians’ clinical and behavioral practices towards antibiotics administration in a specific region in Greece. Materials and methods: A cross sectional study was conducted using a questionnaire in all structures of primary health care (PHC) of the Peloponnese Region. The study was conducted in May-October 2020. Results: In total, 306 out of 404 primary healthcare physicians completed the questionnaire (response rate of 75.8%). Our results showed that most of physicians used to prescribing antibiotics empirically in common diseases, except for the prevention of secondary respiratory tract infection. Overall, 66.3% answered that they do not feel diagnostic uncertainty that would lead them to prescribe antibiotics. Approximately 40% of the physicians stated an increase on antibiotics use and patients demand for antibiotic prescribing, however 71.4% “rarely/never” affected by this requirement. 51.9% of the sample used to prescribed brand name antibiotics. Statistically significant differences were found between demographic and professional characteristics, and physicians’ clinical and behavioral practices (p≤ 0.05). Conclusions: Our findings could provide decision makers with information on how to manage antibiotic prescribing in primary health care in the country, focusing mainly on the use of specific diagnostic tests as well as relevant guidelines and protocols for changing prescription behavior.Мета: оцінити клінічну та поведінкову практику лікарів первинної медико-санітарної допомоги щодо введення антибіотиків у конкретному регіоні Греції. Матеріали і методи: Було проведено перехресне дослідження з використанням анкети у всіх структурах первинної медико-санітарної допомоги (ПМСД) Пелопоннесу Дослідження проводилося у травні-жовтні 2020 року. Результати: Загалом анкету заповнили 306 з 404 лікарів первинної ланки (відсоток відповідей 75,8%). Наші результати показали, що більшість медиків звикли призначати антибіотики дослідним шляхом при поширених захворюваннях, крім профілактики вторинної інфекції дихальних шляхів. Загалом 66,3% відповіли, що не відчувають діагностичної невизначеності, яка змусила б їх призначати антибіотики. Приблизно 40% лікарів заявили про збільшення щодо використання антибіотиків та попиту пацієнтів на призначення антибіотиків, однак 71,4% «рідко/ніколи» не постраждали від цієї вимоги. 51,9% вибірки звиклих до призначення антибіотиків. Статистично значущі відмінності були виявлені між демографічними та професійними характеристиками, а також клінічними характеристиками лікарів і поведінкових практик (с≤ 0,05). Висновки: Наші висновки можуть надати особам, які приймають рішення, інформацію про те, як керувати призначенням антибіотиків у первинній медико-санітарній допомозі в країні, зосередження уваги головним чином на використанні специфічних діагностичних тестів, а також відповідних керівних принципів та протоколів для зміни рецептурної поведінки

Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece

BACKGROUND: Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. PURPOSE: To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. METHODS: A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). RESULTS: The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. CONCLUSIONS: PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes

Characteristics of patients presenting to the vascular emergency department of a tertiary care hospital: a 2-year study

<p>Abstract</p> <p>Background</p> <p>The structure of health care in Greece is receiving increased attention to improve its cost-effectiveness. We sought to examine the epidemiological characteristics of patients presenting to the vascular emergency department of a Greek tertiary care hospital during a 2-year period. We studied all patients presenting to the emergency department of vascular surgery at Red Cross Hospital, Athens, Greece between 1^stJanuary 2009 and 31st December 2010.</p> <p>Results</p> <p>Overall, 2452 (49.4%) out of 4961 patients suffered from pathologies that should have been treated in primary health care. Only 2509 (50.6%) needed vascular surgical intervention.</p> <p>Conclusions</p> <p>The emergency department of vascular surgery in a Greek tertiary care hospital has to treat a remarkably high percentage of patients suitable for the primary health care level. These results suggest that an improvement in the structure of health care is needed in Greece.</p

The Gifted Rating Scales - School Form in Greek elementary and middle school learners: a closer insight into their psychometric characteristics

The Gifted Rating Scales - School Form (GRS-S), an evaluation tool for the identification of gifted elementary and middle school children, was the subject of the current study, which focused on its psychometric features (internal consistency reliability and structural validity). Four hundred and eighty-nine teachers (342 women, 139 men, and 8 without gender declaration) used the GRS-S to estimate the dimensions of giftedness in their students for the current study. Particularly, 489 children (253 girls and 236 boys) were evaluated by their teachers. Eight elementary and middle school classes and sixteen 6-month age bands were used to stratify the student population. The scales’ outstanding internal consistency and good factorial validity were revealed by statistical analyses (EFA, CFA, and Cronbach’s coefficients). According to the current research findings, the GRS-S as a reliable and valid assessment tool for identifying gifted students (by their teachers) within the Greek cultural environment

Comparative Analysis of Legislative Requirements About Patients' Access to Biotechnological Drugs for Rare Diseases in Central and Eastern European Countries

Objectives: The aim of the study was to compare the access of patients with rare diseases (RDs) to biotechnological drugs in several Central and Eastern European countries (CEECs). We focused on the legislative pricing and reimbursement requirements, availability of biotechnological orphan medicinal products (BOMPs) for RDs, and reimbursement expenditures. Methods: A questionnaire-based survey was conducted among experts from 10 CEECs: Bulgaria, Croatia, Estonia, Greece, Hungary, Poland, Romania, Slovakia, Serbia, and Macedonia. The legal requirements for reimbursement and pricing of BOMPs were collected. All BOMPs and medicines without prior orphan designations were extracted from the European list of orphan medicinal products, 2017. The reimbursement status of these medicinal products in 2017 in the public coverage of the included CEECs as well as the share of their costs in relation to the total public pharmaceutical spending for the period from 2014 to 2016 were defined. Results: Our survey revealed that some differences in the legal requirements for pricing and reimbursement of BOMPs amongst the countries included in the study. All European Union countries have developed and implemented pharmacoeconomic guidelines with or without some specific reimbursement requirements for orphan medicinal products. Cost-effectiveness analysis, cost-utility analysis, Markov models, meta-analysis, and discount levels of costs and results were required only in Bulgaria, Poland and Hungary. The number of reimbursed BOMPs and biotechnological medicinal products for RDs without prior orphan designation was the highest in Hungary (17 and 40, respectively). Patient-based reimbursement schemes were available only in Hungary for 11 out of 17 BOMPs. Poland and Greece have the highest pharmaceutical expenditure of reimbursed BOMPs with are similar to 214 million and 180 million EUR, respectively in the observed period from 2014 to 2016. High proportion of the pharmaceutical expenditure on the reimbursed biotechnological medicinal products for RDs for the observed period 2014-2016 is presented in Bulgaria and Slovakia. Conclusions: The non-European Union CEECs face a significant delay in the legal implementation of pharmacoeconomic guideline for assessment of BOMPs. The access to BOMPs is similar among the observed CEECs and the countries with the best access are Hungary and Greece. The influence of BOMP expenditures on the budget in the individual countries is significant

An exploratory study of the costs and consequences of prenatal care in the Family Health Program.

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Estudo exploratório de custos e conseqüências do pré-natal no Programa Saúde da Família

OBJECTIVE: To assess costs and consequences of prenatal care on perinatal morbidity and mortality. METHODS: Evaluation study using two types of analysis: implementation and efficiency analysis, carried out at 11 Family Health Units in the Recife, Northeastern Brazil, in 2006. The costs were calculated by means of the activity-based costing technique and the cost-effectiveness ratio was calculated for each consequence. Data sources were information systems of the Ministry of Health and worksheets of costs provided by the Health Department of Recife and Instituto de Medicina Integral Prof. Fernando Figueira. Healthcare units with implemented or partially implemented prenatal care were compared in terms of their cost-effectiveness and perinatal results. RESULTS: In 64% of the units, prenatal care was implemented with a mean total cost of R$39,226.88 and variation of R$ 3,841,87 to R$8,765.02 per healthcare unit. In the units with partially implemented prenatal care (36$ 30,092.61 (R$4,272.12 to R$ 11,774.68). The mean cost per pregnant woman was R$196.13 with implemented prenatal care and R$ 150.46 with partially implemented prenatal care. A higher proportion of low birth weight, congenital syphilis, perinatal and fetal deaths was found in the partially implemented group. CONCLUSIONS: Prenatal care is cost-effective for several studied consequences. The adverse effects measured by the health indicators were lower in the units with implemented prenatal care. The mean cost in the partially implemented group was higher, which suggests a possible waste of resources, as the teams' productivity is insufficient for the installed capacity.OBJETIVO: Avaliar custos e conseqüências da assistência pré-natal na morbimortalidade perinatal. MÉTODOS: Estudo avaliativo com dois tipos de análise - de implantação e de eficiência, realizado em 11 Unidades de Saúde da Família do Recife, PE, em 2006. Os custos foram apurados pela técnica activity-based costing e a razão de custo-efetividade foi calculada para cada conseqüência. As fontes de dados foram sistemas de informação do Ministério da Saúde e planilhas de custos da Secretaria de Saúde do Recife e do Instituto de Medicina Integral Prof. Fernando Figueira. As unidades de saúde com pré-natal implantado ou parcial foram comparadas quanto ao seu custo-efetividade e resultados perinatais. RESULTADOS: Em 64% das unidades, o pré-natal estava implantado com custo médio total de R$39.226,88 e variação de R$ 3.841,87 a R$8.765,02 por Unidade de Saúde. Nas unidades parcialmente implantadas (36$ 30.092,61 (R$4.272,12 a R$ 11.774,68). O custo médio por gestante foi de R$196,13 com pré-natal implantado e R$ 150,46 no parcial. Encontrou-se maior proporção de baixo peso ao nascer, sífilis congênita, óbitos perinatais e fetais no grupo parcialmente implantado. CONCLUSÕES: Pré-natal é custo-efetivo para várias conseqüências estudadas. Os efeitos adversos medidos pelos indicadores de saúde foram menores nas unidades com pré-natal implantado. O custo médio no grupo parcialmente implantado foi mais elevado, sugerindo possível desperdício de recursos, uma vez que a produtividade das equipes é insuficiente para a capacidade instalada.OBJETIVO: Evaluar costos y consecuencias de la asistencia prenatal en la morbimortalidad perinatal. MÉTODOS: Estudio evaluativo con dos tipos de análisis: de implantación y de eficiencia, realizado en 11 Unidades de Salud de la Familia de Recife, Sureste de Brasil, en 2006. Los costos fueron mejorados por la técnica activity-based costing y la razón de costo-efectividad fue calculada para cada consecuencia. Las fuentes de datos fueron sistemas de información del Ministerio de la Salud y planillas de costos de la Secretaria de la Salud de Recife y del Instituto de Medicina Integral Prof. Fernando Figueira. Las unidades de salud con prenatal implantado o parcial fueron comparadas con relación a su costo-efectividad y resultados perinatales. RESULTADOS: En 64% de las unidades, el prenatal estaba implantado con costo promedio total de R$39.226,88 y variación de R$ 3.841,87 a R$8.765,02 por unidad de salud. En las unidades parcialmente implantadas (36$ 30.092,61 (R$4.272,12 a R$ 11.774,68). El costo promedio por gestante fue de R$196,13 con prenatal implantado y R$ 150,46 en el parcial. Se encontró mayor proporción de bajo peso al nacer, sífilis congénita, óbitos perinatales y fetales en el grupo parcialmente implantado. CONCLUSIONES: El prenatal es costo-efectivo para varias consecuencias estudiadas. Los efectos adversos medidos por los indicadores de salud fueron menores en las unidades con prenatal implantado. El costo promedio en el grupo parcialmente implantado fue más elevado, sugiriendo posible desperdicio de recursos, dado que la productividad de los equipos es suficiente para la capacidad instalada