Criterios de financiación y reembolso de los medicamentos huérfanos

Dado su elevado precio, los medicamentos huérfanos no suelen ser coste-efectivos bajo los umbrales estándares de aceptación de la evaluación económica. Sin embargo, la sociedad puede considerar relevante tener en cuenta otros criterios adicionales en su decisión de financiación y reembolso público. Este trabajo pretende identificar los criterios que podrían ser relevantes, y aquéllos que efectivamente imperan en la práctica real de los países desarrollados.RESUMEN 1. INTRODUCCIÓN Y OBJETIVO 2. METODOLOGÍA 3. CRITERIOS DE FINANCIACIÓN DE LOS MEDICAMENTOS HUÉRFANOS DESDE UNA PERSPECTIVA TEÓRICA 4. CRITERIOS DE FINANCIACIÓN DE LOS MEDICAMENTOS HUÉRFANOS EN DISTINTOS PAÍSES DESARROLLADOS 5. DISCUSIÓN 6. CONCLUSIONES REFERENCIAS BIBLIOGRÁFICA

Opposite poles: A comparison between two Spanish regions in health-related quality of life, with implications for health policy

<p>Abstract</p> <p>Background</p> <p>Although health is one of the main determinants of the welfare of societies, few studies have evaluated health related quality of life in representative samples of the population of a region or a country. Our aim is to describe the health-related quality of life of the inhabitants of two quite different Spanish regions (Canary Islands and Catalonia) and to compare the prevalence of health problems between age-sex groups.</p> <p>Methods</p> <p>We use data obtained from the 2006 Health Survey of Catalonia and the 2004 Canary Islands Health Survey. With an ordinal composite variable measuring HRQOL we identify the association of characteristics of individuals with self-reported quality of life and test for differences between the regions.</p> <p>Results</p> <p>The prevalence of problems in the five EQ-5 D dimensions increases with age and is generally higher for women than for men. The dimension with the highest prevalence of problems is "anxiety/depression", and there is noteworthy the extent of discomfort and pain among Canary Island women. Education, especially among the elderly, has an important effect on health-related quality of life.</p> <p>Conclusions</p> <p>There are substantial structural and compositional differences between the two regions. Regional context is a significant factor, independent of the compositional differences, and the effects of context are manifest above all in women. The findings show the importance of disease prevention and the need for improving the educational level of the population in order to reduce health inequalities.</p

Valoración y determinantes del stock de capital salud en la Comunidad Canaria y Cataluña

En los últimos años estamos asistiendo a cambios en la definición del concepto de salud aplicable a individuos y poblaciones. En el presente trabajo se propone la estimación del stock de capital salud de la población residente en la Comunidad Canaria. Para ello, en primer lugar, se estiman la Esperanza de Vida Ajustados por Calidad de dicha población (ajustada por edad y género), para a continuación proponer una valoración monetaria de los resultados obtenidos. En la segunda parte del trabajo se analiza los principales determinantes de la Calidad de Vida Relacionada con la Salud de la población estudiada, empleando la Encuesta Canaria de Salud. Con tal fin, se plantea un modelo probit ordenado, estimándose los efectos marginales de las variables explicativas utilizadas (sociodemográficas, salud “objetiva” y estilos de vida). La edad, el género, el nivel educativo y las enfermedades diagnosticadas son las principales variables significativas, siendo más complicado determinar el efecto de los hábitos y estilos de vida. En ambas fases de trabajo se compara los resultados obtenidos con los de un trabajo previo correspondientes a la población residente en Cataluña.

Measuring Changes in Health Capital

This study is aimed to estimate the value of the change in health observed in Catalonia, from 1994 to 2002. Quality-adjusted years of life (QALYs) and years of life (YOL) for genders and different ages were calculated and then transformed in monetary values. Our results shown that the health capital stock has diminished from 1994 to 2002 due to a worsening in the quality of life of the population. Different estimation procedures have been applied for revealing relevant variables that help to explain this negative result

Estudios de coste de la diabetes tipo 2: una revisión de la literatura

La diabetes mellitus tipo 2 (DM2) es una enfermedad crónica, compleja y de alta prevalencia, relacionada con una elevada morbi-mortalidad. Según los estudios empíricos, la DM2 está asociada a importantes costes socioeconómicos. Sin embargo, la disparidad metodológica utilizada dificulta la extrapolación de resultados y conclusiones, lo que puede obstaculizar las decisiones a nivel de gestión. El objetivo de este trabajo es realizar una revisión narrativa de la literatura para identificar y analizar los principales estudios de coste asociados a la DM2, con el fin de comparar sus metodologías y determinar los principales factores que influyen en los costes de la DM2.RESUMEN 1. INTRODUCCIÓN 2. JUSTIFICACIÓN Y OBJETIVO 3. TIPOS DE COSTES ASOCIADOS A LA DIABETES 4. METODOLOGÍA DE LA REVISIÓN 5. RESULTADOS DE LA REVISIÓN 5.1 Aspectos metodológicos de los estudios incluidos . 5.2 Resultados de costes asociados a la diabetes 5.2.1 Tipos de costes incluidos 5.2.1.1 Costes directos sanitarios 5.2.1.2 Costes directos no sanitarios 5.2.1.3 Pérdidas de productividad laboral 5.2.2 Resultados para España 5.2.3 «Exceso de costes» atribuibles a la población con diabetes 5.2.4 Coste de las complicaciones de la diabetes 6. DISCUSIÓN Y CONCLUSIONES REFERENCIAS BIBLIOGRÁFICAS ANEX

The impact of obesity on health-related quality of life in Spain

Abstract Background It is well documented that obesity is strongly associated with mortality and morbidity, but less is known about its impact on functional status and health-related quality of life (HRQOL). The purpose of this study was to calculate the impact of the Body Mass Index (BMI) on the HRQOL of the Spanish adult population, with special emphasis on BMI ≥ 35. Methods We used the Spanish National Health Survey (SNHS) 2011–2012 to assess the statistical association between HRQOL, measured through the EuroQol-5D-5L questionnaire, and the BMI. We conducted linear regression analysis for the EuroQol-5D-5L Visual Analogue Scale (VAS) and probit regressions for each of the five dimensions of the EuroQol-5D-5L. Results Self-perceived problems in the five dimensions of the EuroQol-5D-5L increased along the BMI, especially in the mobility and pain/discomfort dimensions. Having a BMI ≥ 35 reduced HRQOL even in the absence of chronic diseases. After controlling for comorbidities, severe obesity decreased the VAS score by an average of 1.9 points and increased the probability of reporting any HRQOL problem in mobility (11.8%), self-care (2.2%), usual activities (4.3%) and pain/discomfort (7.4%). No association was found between obesity and mental problems. All the parameters analysed suggest that HRQOL in women and people aged 65 years and over was significantly worse than average. Conclusions BMI is an explanatory factor of self-perceived quality of life. Obesity is associated with a worse HRQOL, especially in women and people aged over 64 years. These results may be useful for designing prevention or treatment health policies to target obesity among the Spanish population

Costes directos e indirectos del cáncer en España

En el presente trabajo se estiman los costes directos e indirectos (pérdidas de productividad laboral) ocasionados en España por los tumores, y en particular por cuatro tipos concretos: mama, cérvix, próstata y colon. Además de los costes que originan su tratamiento y prevención, las enfermedades generan otro tipo de costes que no siempre se tienen en cuenta. El objetivo del presente trabajo es identificar, medir y valorar una parte de estos costes en el caso de uno de los grupos de enfermedades que más muertes causan en España

The economic burden of pulmonary arterial hypertension in Spain.

Pulmonary Arterial Hypertension (PAH) is a rare, debilitating, and potentially fatal disease. This study aims to quantify the economic burden of PAH in Spain. The study was conducted from a societal perspective, including direct and indirect costs associated with incident and prevalent patients. Average annual costs per patient were estimated by multiplying the number of resources consumed by their unit cost, differentiating the functional class (FC) of the patient. Total annual costs per FC were also calculated, taking the 2020 prevalence and incidence ranges into account. An expert committee validated the information on resource consumption and provided primary information on pharmacological consumption. Unit costs were estimated using official tariffs and salaries in Spain. A deterministic sensitivity analysis was conducted to test the uncertainty of the model. The average annual total cost was estimated at €98,839 per prevalent patient (FC I-II: €65,233; FC III: €103,736; FC IV: €208,821), being €42,110 for incident patients (FC I-II: €25,666; FC III: €44,667; FC IV: €95,188). The total annual cost of PAH in Spain, taking into account a prevalence between 16.0 and 25.9 cases per million adult inhabitants (FC I-II 31.8%; FC III 61.3%; FC IV 6.9%) and an incidence of 3.7, was estimated at €67,891,405 to €106,131,626, depending on the prevalence considered. Direct healthcare costs accounted for 64% of the total cost, followed by indirect costs (24%), and direct non-healthcare costs (12%). The total costs associated with patients in FC I-II ranged between €14,161,651 and €22,193,954, while for patients in FC III costs ranged between €43,763,019 and €68,391,651, and for patients in FC IV between €9,966,735 and €15,546,021. In global terms, patients with the worst functional status (FC IV) account for only 6.9% of the adults suffering from PAH in Spain, but are responsible for 14.7% of the total costs. PAH places a considerable economic burden on patients and their families, the healthcare system, and society as a whole. Efforts must be made to improve the health and management of these patients since the early stages of the disease