Daily costs of prostaglandin analogues as monotherapy or in fixed combinations with timolol, in Denmark, Finland, Germany and Sweden

BACKGROUND: To compare the daily costs of 3 prostaglandin analogues (bimatoprost, latanoprost, travoprost), alone, and associated with timolol in 4 European countries (Denmark, Finland, Germany, and Sweden). METHODS: Six glaucoma products were sampled by buying 5 bottles from 1 suburban pharmacy in each of the 4 countries. Drops were weighed by a single operator at 1 site according to standardized procedures. Residual drops were then counted. Unit bottle costs were estimated from tariff lists. Eye-drop weights were entered into a nested analysis of variance comprising drug, instillation day, country, the interaction, and a sample factor nested within the country factor. Effectiveness was represented by treatment failure rates estimated from a meta-analysis and a general practitioner survey. RESULTS: Every drug bottle contained sufficient drops to treat 1 patient for 28/31 days. Drop-size heterogeneity between countries was observed for bimatoprost and bimatoprost/timolol. Mean travoprost and travoprost/timolol drop-sizes were the smallest, and drop-counts per bottle were the lowest for latanoprost, or latanoprost/timolol. In all 4 countries annual costs were least for travoprost and travoprost/timolol. CONCLUSIONS: On taking into account drug costs and effectiveness, travoprost and travoprost/timolol were cheaper and more effective than latanoprost and latanoprost/timolol and were cheaper than bimatoprost and bimatoprost/timolol

Annual direct medical cost of active systemic lupus erythematosus in five European countries.

OBJECTIVES: To evaluate the annual direct medical cost of managing adult systemic lupus erythematosus (SLE) patients with active autoantibody positive disease in Europe. METHODS: A 2-year, retrospective, multicentre, observational study was conducted in five countries (France, Germany, Italy, Spain and the UK). Data included patients' characteristics, disease activity and severity, flare assessments and health resource use (eg, laboratory tests, medications, specialist visits and hospitalisations). Costs were assessed from the public payers' perspective. Cost predictors were estimated by multivariate regression models. RESULTS: Thirty-one centres enrolled 427 consecutive eligible patients stratified equally by disease severity. At baseline, mean (SD) age was 44.5 (13.8) years, 90.5% were women and mean (SD) SLE duration was 10.7 (8.0) years. The SELENA-SLEDAI (11.2 vs 5.3) and SLICC/ACR index (1.0 vs 0.7) scores were higher in severe patients. Over the study period, patients experienced on average 1.02 (0.71) flares/year. The mean annual direct medical cost was higher in severe compared to non-severe patients ( 4748 vs 2650, p<0.001). Medication costs were 2518 in severe versus 1251 in non-severe patients (p<0.001). Medications represented 53% and 47% of the total cost for severe and non-severe patients, respectively, primarily due to immunosuppressants and biologics. Flares, especially severe flares, were identified as the major cost predictor, with each flare increasing the annual total cost by about 1002 (p<0.001). CONCLUSIONS: The annual direct medical cost of SLE patients in Europe is related to disease severity and flares. Medical treatments were the main cost drivers. Severe flares and major organ involvement were identified as important cost predictors

Aspects juridiques de la gestion et du partage des données

National audienceOutil d'aide à la décision en matière de partage des données de la recherche

Évaluation du coût de la pratique de l'Endoscopie Digestive en 2004 (désinfection exclue)

Dans le cadre de l'entrée en vigueur de la nouvelle nomenclature des actes médicaux en 2005, ces derniers ont fait l'objet d'une réévaluation de libellé et de tarification. Ils ont été regroupés au sein d'une liste codée commune aux secteurs hospitalier et libéral : la Classification Commune des Actes Médicaux (CCAM). L'objectif de la réforme de la nomenclature est de créer ainsi un instrument unique de rémunération (remplaçant la Nomenclature Générale des Actes Professionnels (NGAP) utilisée en secteur libéral et le Catalogue des Actes Médicaux (CDAM) à usage hospitalier. Les actes techniques sont dissociés entre le travail médical (hiérarchisé en inter et intra spécialité de façon experte) et le coût de la pratique. La première partie scientifique, a été élaborée par des experts selon une méthodologie reconnue bien que source de conflits et de discussions avec la Caisse Nationale d'Assurance Maladie (CNAM); en revanche, le coût de la pratique a été évalué selon une méthode globale, fondée sur l'appréciation du taux de charges moyen de la spécialité à partir des chiffres produits par la Direction Générale des Impôts et le Ministère de la Santé [1] et validée par un comité d'experts. Ce taux de charges inclut les charges habituelles (charges professionnelles, dotation aux amortissements... etc.) et les charges liées aux actes d'endoscopie digestive. Le taux moyen de charge retenu pour les Médecins spécialistes de l'Appareil Digestif a été initialement chiffré à 47,8 % puis récemment révisé à environ 52 %. Aucune étude précise du coût de la pratique de l'endoscopie digestive n'a ainsi été réalisée Les études analytiques du coût spécifique de la pratique de l'endoscopie et de la désinfection publiées sont par ailleurs exceptionnelles [2]. L'étude que nous avons réalisée a donc eu pour objectif d'évaluer le coût de la pratique de plusieurs actes d'endoscopie digestive, en dehors du coût de la désinfection qui a fait l'objet d'une évaluation indépendante

[Cr(ttpy)2]3+ as a multi-electron reservoir for photoinduced charge accumulation

International audienceUnder visible light irradiation [Cr(ttpy)2]3+ can be reduced twice by a tertiary amine; the photoreduction processes are accelerated in the presence of [Ru(bpy) 3 ] 2+ acting as an antenna thanks to an efficient electron transfer reaction from [Ru(bpy) 3 ] 2+* to [Cr(ttpy) 2 ] 3+

The Economic Burden of Severe Osteoporotic Fractures in the French Healthcare Database: The FRACTOS Study

International audienceOsteoporosis carries a high medical, economic, and societal burden principally because of the risk of severe fractures. The objective of this cost-of-illness study was to describe health resource utilization and associated costs in all patients aged ≥50 years hospitalized for a severe osteoporotic fracture over a 6-year period (2009 to 2014) in France. Data were extracted from the French national healthcare database (SNDS) on all health care resource utilization between the index date (date of hospitalization for first fracture during the enrollment period) and study end (December 31, 2016) or until the patient died. Costing was restricted to direct costs and determined from the payer perspective. Variables related to costs were identified through multivariate logistic regression analysis. A total of 356,895 patients were included (median follow-up 39.1 months). In the year after the index fracture, 36,622 patients (10.5%) were rehospitalized for a fracture-related reason. Only 18,474 (5.3%) underwent bone densitometry and 58,220 (16.7%) received a specific treatment. The total annual per capita osteoporosis-related cost in the year after the index severe osteoporotic fracture was €18,040 (from €8598 for multiple ribs to €21,085 for hip fracture) of which €17,905 was incurred by fracture-related costs. The cost incurred by management of osteoporosis was €135. Over years 2 to 5, the mean annual per capita costs of fracture treatment (€806, mostly attributable to the treatment of refractures) continued to dominate those of osteoporosis management (€99). Total annual cost of care was €1260 million (year 2014). Variables associated with higher cost were older age, male sex, site of fracture, a history of prior osteoporotic fracture, and the number of refracture events. The 5-year cost of severe osteoporotic fractures to the French health care system is high and mostly attributable to the treatment of refractures. Improved fracture prevention measures in patients with osteoporosis is crucial to reduce the economic burden of the disease. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR)

[Cr(ttpy)2]3+ as a multi-electron reservoir for photoinduced charge accumulation

International audienceUnder visible light irradiation [Cr(ttpy)2]3+ can be reduced twice by a tertiary amine; the photoreduction processes are accelerated in the presence of [Ru(bpy) 3 ] 2+ acting as an antenna thanks to an efficient electron transfer reaction from [Ru(bpy) 3 ] 2+* to [Cr(ttpy) 2 ] 3+