17 research outputs found
Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)
Background
Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II).
Methods
Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K.
Results
Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results.
Interpretation
Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure
Analysis of the 2004-2007 literature on therapeutic patient education in diabetes: results and trends
Abstract The purpose of this study is to identify the recent
characteristics and the developments of therapeutic educa
tion in diabetes through an analysis of the international
articles published from 2004 to 2007. Studies were selected
from several databases: Medline, Embase, Eric, Cochrane
central database, using the following keywords: diabetes,
patient education, self management, programs. Two authors
independently reviewed each study and selected the data
using the same categories of analysis. Articles consistently
related to patient education in diabetes (80 among 118) were included. The selected articles have been published in 43 scientific joumals. The majority of them concern TPE for
adult patients with type 2 diabetes. TPE is delivered in sev-
eral structures and education to groups ofpatients represents
the most widespread educational strategy mostly provided
by a multiprofessional team. A total of 70% of the studies
show the effectiveness ofTPE based on bioclinical, educa-
tional, psychosocial, economical criteria. The problem of
barriers to TPE concerns Zl%o of the studies we have ana-
lysed and most of the authors propose the implementation of
specifically-designed TPE programs as strategy to overcome
them. A large number of studies still assess the positive
effects of TPE. Nowadays the problems of accessibility to
TPE and the barriers to this practice have become a major
issue for research