Cost Analysis Of Treatment Research Articles

A Multicenter Physician Survey Evaluating the Use of Ki-67 in Breast Cancer Management in Canada.

Ki-67's response to pre-operative endocrine therapy (ET) in early breast cancer is an evidence-based tool to guide adjuvant treatment decisions. Physicians across Canada were surveyed to explore current practice patterns and perceived barriers to the use of Ki-67 in practice. Physicians were invited to participate in an anonymous survey and were eligible if they prescribed systemic therapy for breast cancer in Canada. Respondents were asked to describe their usage of Ki-67, perceptions of the evidence surrounding Ki-67 ET response, and interest in future trials using this approach. The survey received 48/163 responses (29.4%). The majority of respondents (97.6%) reported access to Ki-67 testing upon request. Treatment decisions for adjuvant Abemaciclib was the most common reason (97.6%), followed by adjuvant chemotherapy decisions (16.7%). Only 19.0% had used Ki-67's response to pre-operative ET in practice. Common barriers to this approach that were identified included a lack of awareness from other providers (54.8%), an increased resource requirement (54.8%), and a lack of timely medical oncology consultation (52.4%). The majority of physicians (85.3%) reported that they would participate in future trials using the Ki-67 endocrine response, and that rate of treatment decision change (95.2%) and cost analysis (42.3%) were important endpoints. Despite the widespread availability of Ki-67 testing, few physicians in Canada currently use it to assess endocrine response, predominantly due to logistical and resource constraints. There is a high level of interest in participating in future trials using this strategy, which should focus on disease related outcomes, feasibility, and the financial impact on the public healthcare system.

Provider costs of treating opioid dependence with extended-release buprenorphine in Australia.

The costs of providing medication-assisted treatment for opioid dependence can determine its scale of provision. To provide estimates of the costs of extended-release buprenorphine (BUP-XR), we performed a bottom-up costing analysis of provider operational treatment costs. Data were collected in a single-arm open label trial of BUP-XR injections conducted in specialist public drug treatment services and primary care private practices in three Australian states (the CoLAB study). The unit costs of resources used for each activity were combined with quantities used at each participating facility to arrive at the average annual cost per client. One hundred participants across the six health facility sites received monthly subcutaneous BUP-XR injections administered by a health-care practitioner. The average cost of providing 1 year of treatment per participant was $6656 ($6026-$8326). Screening cost (initial assessment and medical history) was $282 while monthly follow-up appointments cost $531 per client. The main cost driver was the monthly treatment costs accounting for 79% of the average annual client cost, with medication costs comprising 95% of this cost. With medication costs making up the largest proportion of treatment costs, treatment using BUP-XR has the potential to free up other health system resources, for example, staff time. The costs reported in this study can be used in an economic evaluation to estimate the net benefit or cost-effectiveness of BUP-XR especially when compared to other opioid agonist treatments.

Numerical optimisation of microbially induced calcite precipitation (MICP) injection strategies for sealing the aquifer's leakage paths for CO2 geosequestration application

Carbon capture and storage (CCS) in deep geological aquifers has shown to be the most viable option for mitigating the greenhouse gas effect of carbon dioxide (CO2) at a large scale. However, the underground formations often possess discontinuities in the caprocks, leaking the stored CO2. Potential leakage paths, such as abandoned wells, have been growing due to excessively unplugged oil and gas exploration wells. The leakage of CO2 from these wells is a major concern, considering their negative impact on the environment and compromising CO2 storage efficiency. Recently, microbially induced calcite precipitation (MICP) technology has proven to be an effective and sustainable method for reducing the permeability of geomaterials. Nevertheless, the MICP process involves intricate interactions among bio-chemo-hydraulics (BCH) domains to comprehend the reactive transport of biochemicals. The complex nature of the MICP process poses difficulties in setting the biochemical injection durations for a particular target distance at the given injection rate. Given this, the present study developed a coupled numerical model and employed it as a workable tool for optimising MICP injections to plug the abandoned well connecting two deep geological aquifers. Following that, the study evaluated the leakage of CO2 using flow migration rates in the untreated and MICP-treated leaky aquifer. The study proposed a novel optimisation strategy for biochemical injections under near and far-field leakage conditions. The sensitivity of biochemical injection durations on the attached bacterial amount and permeability in the leak was also determined. The observations from the present study indicated a complete reduction in the CO2 migration rates from the abandoned well due to a reduced permeability after MICP, thereby indicating the efficacy of the proposed optimisation methodology. Further, a cost analysis of the MICP treatment indicated a rational application cost with the target distance compared to the detrimental effects of CO2 leakage.

Increasing cost of Trauma Hospitalizations in the Pediatric Population. Cost Analysis of Treatment of Musculoskeletal Injuries in Children and Adolescents

Background. Musculoskeletal injuries in children and adolescents have rarely been investigated in the recent literature. This study aimed to perform a comparative medical and economic analysis of the cost of treatment of musculoskeletal injuries and that of selected pediatric surgical procedures in children and adolescents.Material and methods, We performed a retrospective analysis of data of children treated in a pediatric surgery department for musculoskeletal injuries and selected general surgical conditions in 2021-2023. The number of hospitalizations, procedures, the number of NHF credits awarded, and the monetary value (PLN) of procedures performed were assessedResults. There were a total of 3,809 children hospitalized in 2021-2023, of whom 1,933 received surgical treatment (51%). In this group, 529 children (28%) were treated due to musculoskeletal injuries (Group I), and 402 (20%), due to general surgical conditions (Group II). The average monetary value of the procedures performed was 949,238.2 PLN / year for Group I and 740,583.6 PLN / year for Group II.Conclusions. 1. In the pediatric population, musculoskeletal injuries account for the highest percentage of injuries associated with serious sequelae. 2. The monetary value of procedures for treating musculoskeletal injuries is higher compared to selected general surgical procedures according to DRGs. 3. The cost of performing trauma procedures constitutes 56% of the NHF contract value and has been gradually increasing. 4. The significant and increasing incidence of traumatic injuries and the high cost of their treatment require an increase in the overall contract value for centers treating injuries in children and adolescents.

Economic impact of the use of anthelmintics in beef cattle in the rearing phase

The objective of the present study was to evaluate the effectiveness of anthelmintics and their influence on the performance of beef cattle supplemented during the rearing period, carrying out a cost analysis of the different treatments. 120 Nelore animals were used, with an average of 9 months of age, 60 males and 60 females. The animals were distributed into 6 groups of males and 6 of females, five treated with anthelmintics and a control group, G1: Moxidectin 1%, G2: Levamisole Phosphate 18.8%, G3: Ivermectin 0.8% + Albendazole Sulfoxide 10%, G4: Albendazole 10%, G5: Fenbendazole 10%, G6: Control (saline solution). Individual weighing was carried out using an electronic scale, at the beginning of the experiment (D0), fourteen days later (D14) and at the end of the experiment (D90), with performance assessed through weight gain (GP). Fecal collections were carried out on the same days as weighing, with individual egg counts per grams of feces (OPG) and stool culture to identify helminth genders. Economic viability was calculated based on the price of the calf and total production cost. The data obtained was subjected to the 5% Tukey test and the effectiveness of the anthelmintics was evaluated using the RESO program. It is concluded that the anthelmintics evaluated were effective, with the exception of Ivermectin 0.8% + Albendazole Sulfoxide 10%, which showed anthelmintic resistance. The anthelmintic treatment provided the animals with better performance, with the greatest weight gain observed in animals treated with Moxidectin 1%, demonstrating better economic indices.

Comparative Cost Analysis of Hypercholesterolemia Treatment: Allopathic Medicine and Ayurveda Medicine

The cost of treatment is very high for CVD and the prevalence of hypercholesterolemia is also very high in developing countries. Many Indian people do not have basic amenities and medical facilities are also not accessible. So alternative medicine can play an important role in the treatment of high cholesterol. Arjuna and Kutki are effective medicines in treating high cholesterol. Methodology: Comparative cross sectional study was planned to determine the socio-economic, and demographic status and comparison of treatment costs of high cholesterol patients in SS Hospital, IMS, BHU, Varanasi. Result: The overall expenditure for Group B is significantly high (3670.06) compared to Group A (1341.10). Medicine costs form the largest portion of expenses in Group B (1:4.8), while laboratory costs are the largest in Group A. Discussion: The economic burden poses a significant challenge in the treatment of any illness. Elevated cholesterol levels pose a significant problem in the current state of affairs in India. Developing countries face significant challenges in managing their financial issues.

Operation room nursing based on humanized nursing mode combined with nitric oxide on rehabilitation effect after lung surgery

BACKGROUND With advancements in the diagnosis and treatment of lung diseases, lung segment surgery has become increasingly common. Postoperative rehabilitation is critical for patient recovery, yet challenges such as complications and adverse outcomes persist. Incorporating humanized nursing modes and novel treatments like nitric oxide inhalation may enhance recovery and reduce postoperative complications. AIM To evaluate the effects of a humanized nursing mode combined with nitric oxide inhalation on the rehabilitation outcomes of patients undergoing lung surgery, focusing on pulmonary function, recovery speed, and overall treatment costs. METHODS A total of 79 patients who underwent lung surgery at a tertiary hospital from March 2021 to December 2021 were divided into a control group (n = 39) receiving a routine nursing program and an experimental group (n = 40) receiving additional humanized nursing interventions and atomized inhalation of nitric oxide. Key indicators were compared between the two groups alongside an analysis of treatment costs. RESULTS The experimental group demonstrated significant improvements in pulmonary function, reduced average recovery time, and lower total treatment costs compared to the control group. Moreover, the quality of life in the experimental group was significantly better in the 3 months post-surgery, indicating a more effective rehabilitation process. CONCLUSION The combination of humanized nursing mode and nitric oxide inhalation in postoperative care for lung surgery patients significantly enhances pulmonary rehabilitation outcomes, accelerates recovery, and reduces economic burden. This approach offers a promising reference for improving patient care and rehabilitation efficiency following lung surgery.

Real-World Treatment Patterns, Clinical Outcomes, Healthcare Resource Utilization, and Costs in Advanced Hepatocellular Carcinoma in Ontario, Canada.

The therapeutic landscape for aHCC has evolved in recent years, necessitating a comprehensive analysis of treatment patterns, clinical outcomes, HCRU, and costs to contextualize emerging treatments. This study aimed to investigate these outcomes using real-world data from Ontario, Canada. This retrospective cohort study was conducted using linked administrative databases from April 2010 to March 2020. Patients diagnosed with aHCC were included, and their clinical and demographic characteristics were analyzed, as well as treatment patterns, survival, HCRU, and economic burden. Among 7322 identified patients, 802 aHCC patients met the eligibility criteria for inclusion in the study. Treatment subgroups included 1L systemic therapy (53.2%), other systemic treatments (4.5%), LRT (9.0%), and no treatment (33.3%). The median age was 66 years, and the majority were male (82%). The mOS for the entire cohort from diagnosis was 6.5 months. However, patients who received 1L systemic therapy had an mOS of 9.0 months, which was significantly higher than the other three subgroups. The mean cost per aHCC-treated patient was $49,640 CAD, with oral medications and inpatient hospitalizations as the largest cost drivers. The results underscore the need for the continuous evaluation and optimization of HCC management strategies in the era of evolving therapeutic options.

Characterization of Peat Water Electrocoagulation Flocs from Sarawak Southern Region

Sarawak located in Borneo is endowed with the vast availability of peat water sources, particularly for the state southern region. Several investigations have shown that electrocoagulation treatment with aluminium electrodes is feasible to treat peat water in which the quality is comparable to the National Water Quality Standard (NWQS). Even though electrocoagulation treatment is feasible to treat peat water, the characteristics of peat water electrocoagulation flocs have not been reported. As such, this study aims to investigate the characteristics of the electrocoagulation flocs from peat water derived from the Sarawak southern region by using batch electrocoagulation treatment. The objectives of this study are to conduct an experimental study analysis of and identify the minerals on the electrocoagulation flocs along with operating energy cost analysis of peat water batch electrocoagulation treatment. Consequently, this study has found that reaction time and current density affect the production of flocs in which the amount of flocs increases with the increasing reaction time and current density. The flocs produced are found to consist of a large fraction of oxygen (O), carbon (C), iron (Fe), and aluminium (Al) along with a small fraction of potassium (K), magnesium (Mg), calcium (Ca) and Silicon (Si). The presence of Al observed in the flocs is due to the aluminium hydroxide generated during the electrocoagulation process. The total operating cost for peat electrocoagulation with a current density of 5A and reaction time of 20 minutes is about RM0.31 per m3. As a result, the electrocoagulation of peat water process is able to treat peat water as well as produce flocs in which earth elements and heavy metals could be recovered.

Effect of China national centralized drug procurement policy on anticoagulation selection and hemorrhage events in patients with AF in Suining.

Background: Launched in March 2019, the National Centralized Drug Procurement (NCDP) initiative aimed to optimize the drug utilization framework in public healthcare facilities. Following the integration of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) into the procurement catalog, healthcare establishments in Suining swiftly transitioned to the widespread adoption of NOACs, beginning 1 March 2020. Objective: This study aims to comprehensively assess the impact of the NCDP policy on the efficacy of anticoagulation therapy, patient medication adherence, and the incidence of hemorrhagic events in individuals with non-valvular atrial fibrillation (NVAF) residing in Suining. The analysis seeks to elucidate the broader impacts of the NCDP policy on this patient demographic. Methods: This study analyzed patient hospitalization records from the Department of Cardiology at Suining County People's Hospital, spanning 1 January 2017, to 30 June 2022. The dataset included demographic details (age, sex), type of health insurance, year of admission, hospitalization expenses, and comprehensive information on anticoagulant therapy utilization. The CHA2DS2-VASc scoring system, an established risk assessment tool, was used to evaluate stroke risk in NVAF patients. Patients with a CHA2DS2-VASc score of 2 or higher were categorized as high-risk, while those with scores below 2 were considered medium or low-risk. Results: 1. Treatment Cost Analysis: The study included 3,986 patients diagnosed with NVAF. Following the implementation of the NCDP policy, a significant increase in the average treatment cost for hospitalized patients was observed, rising from 8,900.57 ± 9,023.02 CNY to 9,829.99 ± 10,886.87 CNY (p < 0.001). 2. Oral Anticoagulant Utilization: Overall, oral anticoagulant use increased from 40.02% to 61.33% post-NCDP (p < 0.001). Specifically, NOAC utilization among patients dramatically rose from 15.41% to 90.99% (p < 0.001). 3. Hemorrhagic Events: There was a significant decrease in hemorrhagic events following the NCDP policy, from 1.88% to 0.66% (p = 0.01). Hypertension [OR = 1.979, 95% CI (1.132, 3.462), p = 0.017], history of stroke [OR = 1.375, 95% CI (1.023, 1.847), p = 0.035], age ≥65years [OR = 0.339, 95% CI (0.188, 0.612), p < 0.001], combination therapy of anticoagulants and antiplatelets [OR = 3.620, 95% CI (1.752, 7.480), p < 0.001], hepatic and renal insufficiency [OR = 4.294, 95% CI (2.28, 8.084), p < 0.001], and the NCDP policy [OR = 0.295, 95% CI (0.115, 0.753), p = 0.011] are significant risk factors for bleeding in patients with atrial fibrillation. 4. Re-hospitalization and Anticoagulant Use: Among the 219 patients requiring re-hospitalization, there was a notable increase in anticoagulant usage post-NCDP, from 36.07% to 59.82% (p < 0.001). NOACs, in particular, saw a substantial rise in usage among these patients, from 11.39% to 80.92% (p < 0.001). 5. Anticoagulant Type Change: The NCDP policy [OR = 28.223, 95% CI (13.148, 60.585), p < 0.001] and bleeding events [OR = 27.772, 95% CI (3.213, 240.026), p = 0.003] were significant factors influencing the alteration of anticoagulant medications in patients. Conclusion: The NCDP policy has markedly improved anticoagulation management in patients with AF. This policy has played a crucial role in enhancing medication adherence and significantly reducing the incidence of hemorrhagic events among these patients. Additionally, the NCDP policy has proven to be a key factor in guiding the selection and modification of anticoagulant therapies in the AF patient population.

Cost analysis of endovascular treatment for unruptured intracranial aneurysms at a private hospital in Brazil.

Intracranial aneurysms have a prevalence of 1-6% and significant rupture risks, leading to high morbidity and mortality. Endovascular therapy demands an understanding of its economic impacts. This study evaluates the costs and complications of unruptured intracranial aneurysm treatment in a private Latin American hospital. A retrospective longitudinal observational study was carried out in a private hospital in Brazil from February 2015 to January 2021. Patients undergoing elective endovascular treatment for unruptured intracranial aneurysms (UIAs) were included in the study. Data collected included patient demographics, aneurysm characteristics, treatment modalities, costs, and clinical outcomes. Costs were adjusted to their present value in 2023 US dollars (USD). Descriptive statistics summarized the data. A total of 77 patients (68 females and nine males) with 111 aneurysms were included. The average total cost per patient was $31,831.08, with materials (65.9%) and hospital daily rates (11.3%) being the primary cost drivers. Device associations included flow diverter (51.9%), stent-assisted coiling (19.2%), and coiling (11.5%). Clinical outcomes were favorable, with an average inpatient stay of 6.5 ± 10.2 days, 6.5% of patients requiring readmission for complications, and no deaths within 90 days. The highest costs were associated with coiling and stent-assisted coiling. The cost of endovascular treatment for UIAs at a private hospital in Brazil is substantial, primarily driven by materials and hospital daily rates. Despite high costs, clinical outcomes were favorable, with low complication rates. These findings underscore the need for continuous cost-effectiveness evaluation and treatment optimization to balance clinical benefits with financial considerations.

Economic Burden of Cancer on Indian Households: A Comprehensive Analysis of Treatment Seeking, Costs, Coping Strategies, and Financial Hardship

Economic Burden of Cancer on Indian Households: A Comprehensive Analysis of Treatment Seeking, Costs, Coping Strategies, and Financial Hardship

Oral propranolol for the treatment of hemangiomas in high-risk infants: safety and cost analysis of outpatient-initiated therapy.

To investigate the safety and cost analysis of oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting. A total of 41 high-risk infantile hemangioma patients from outpatient settings and 43 from inpatient settings were selected for the study. After routine pre-treatment examinations, patients were administered propranolol in a stepwise incremental dosing regimen over three consecutive days in the outpatient clinic. Changes in heart rate, blood pressure and PR interval before and after medication were compared. On the 10th day post-medication, liver and kidney functions, fasting blood glucose, tumor ultrasonography, and electrocardiogram were re-evaluated. The costs of treatment starting from the outpatient clinic (including pre-treatment examinations and the first three days of treatment) were calculated and compared with those of similarly managed inpatient cases. The majority of patients exhibited a reduction in heart rate and blood pressure, as well as an extended PR interval after treatment of medication (P < 0.05), which remained within normal limits without clinical symptoms. On the 10th day post-medication, statistical differences in blood biochemistry and electrocardiograms were observed when compared to pre-treatment values (P < 0.05), but all values remained within normal ranges. No severe adverse reactions such as hypoglycemia occurred. Additionally, the cost of treatment from the outpatient clinic was significantly lower than that of inpatient care. Oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting is associated with few adverse reactions and significantly reduced treatment costs. It is worthy of broader application in hospitals without dermatology wards.

The Megaendoprosthesis in Revision Arthroplasty - a Cost-revenue Analysis in the aG-DRG System.

Megaendoprosthesis offer a viable treatment in complex revision arthroplasty cases with good functional outcome. In the context of a neoplastic indication, the diagnosis-related group (DRG) I95A is usually assigned with a relative weight of 4.906 (2021). In contrast, in revision arthroplasty, the appropriate DRG is assigned, depending on the joint replacement. The additional costs compared to the invoiced DRG are to be compensated by agreeing on hospital-specific individual fees. These complex revision arthroplasties set high technical and operative demands and are mainly performed in specialised departments. We conducted a cost-benefit analysis of the use of the megaendoprosthesis in revision cases in a specialised orthopaedic clinic, as a single centre study. The question we sought to answer was: Is cost recovery possible in the modified German DRG system (aG-DRG)?A retrospective single centre analysis of treatment costs was performed. From 2018 to 2020, 113 patients treated with a megaendoprosthesis reconstruction in a referral centre due to extensive bone loss after aseptic or septic revision of a hip or knee prosthesis were included in the study. Relevant case-related cost drivers of the aG-DRG matrix (including staff and material costs of the operating theatre area and the ward) were taken into account. The actual costs were determined according to the specifications of the calculation manual published by the German institute for the remuneration system in hospitals (InEK). For each case, the contribution margin was calculated by relating the hospital's internal costs to the corresponding cost pool of the aG-DRG matrix.According to the DRG system 2021, 17 different DRGs were used for billing - in 70% based on a patient clinical complexity level (PCCL) ≥4. Compared with the InEK calculation, there is a deficit of -2,901€ per case in the examined parameters. The costs of physicians show a shortfall in both the operating theatre and on the ward. Implant costs, which were supposed to be compensated by hospital-specific additional charges, show a hospital-specific shortage of -2,181€. When analysing the risk factors for cost recovery, only these showed a significant difference.Implantation of the megaendoprosthesis in revision arthroplasty is often the last option to preserve limb function. At present, despite a high degree of specialisation and process optimisation, this treatment cannot be provided cost-effectively even in tertiary care. The politically desired specialised department structure requires sufficient reimbursement for complex cases. The economic outcome of each treatment case is often unpredictable, however the surgeon is confronted with these cases and is expected to treat them. The high standard deviation indicates large differences in the cost/revenue situation of each individual case. Our results show for the first time a realistic cost analysis for megaprosthesis in revision arthroplasty and underline the importance of an adequate hospital-specific charge, individually agreed by the funding units. The calculation should include not only the implant costs, but also the increased staff costs (increased, complex planning effort, quality management, surgery time, etc.).

Electrode Treatments for Redox Flow Batteries: An Industrial Perspective

Renewables sources of energy like solar and wind are expected to supply ~35% of the total electricity demand by 2050.1 The intermittent nature of solar and wind necessitates the development of energy storage technologies. Redox flow batteries (RFBs) are a promising technology for storing energy over several hours to days; however, RFBs suffer from inefficiencies in part due to the overvoltages at the electrode surface. Vanadium redox flow batteries (VRFBs) are the most commercialized RFB chemistry till date due to the use of same element both sides of battery, eliminating the issue of cross-contamination. Carbon felts (CFs) are the most commonly used electrodes in RFBs due to their high conductivity and porous nature. More than 70 electrode treatments for VRFBs alone have been previously shown to reduce the overvoltages and improve performance of VRFBs. Some of these CF electrode treatments include thermal, acid/base, elemental doping, and loading with electrocatalysts.2–5 However, the differences in the operating conditions between treatment studies in literature makes the comparison among different treatments very difficult. Additionally, the complexity associated with each treatment makes identification of industrially implementable treatments extremely challenging.In this talk, I will discuss our efforts to tackle the above problem by comparing treatments under similar operating conditions and accounting for the treatment complexity. We compare the VRFB performance, stability, and economic feasibility with various CF treatments, and treatment complexity to identify the most promising industrially implementable treatments. We extract the round-trip energy efficiencies (EE) of VRFBs using CFs with (and without) various treatments from literature at laboratory and industrial scale. The performance is evaluated using the EE at various operating current densities and stability is identified based on the change in EE per cycle. Economic feasibility of a treatment is measured based on the affordable capital cost (ACC) obtained from an in-house techno-economic model. ACC is defined as the maximum capital cost that can be invested in a treatment without an increase in the overall capital cost of VRFB without treated electrodes. The treatment complexity is measured using the number of steps and the process units required in a treatment. Based on carefully chosen metrics for satisfying the performance, stability, economic feasibility, and treatment complexity criteria, we identify the high performing, stable, and economic feasible treatments that are easy to implement industrially. We conduct a cost analysis of these promising treatments by utilizing the similarities in production of carbon fibers and CFs. We encourage the RFB community to standardize of RFB testing procedures for fast industrial implementation of CF treatments as we move towards a society powered by renewable energy.

Performance of different peroxide sources and UV-C radiation for the degradation of microcontaminants in tertiary effluent from a municipal wastewater treatment plant

Microcontaminants present in environmental aqueous matrices represent an emerging concern due to their recalcitrance to conventional wastewater treatment. This study aimed to (i) investigate the degradation of a mixture containing benzophenone-3, fipronil and propylparaben in a tertiary municipal wastewater effluent (100 µg L−1 each) by UV-C, UV-C/H2O2, UV−C/S2O82− and UV−C/HSO5− , and (ii) compare the degradation profile of this mixture with that of naproxen (a compound that reacts preferentially by electron transfer). Regarding the mixture, degradation increased from 50% (UV-C) to 74–87% by coupling UV-C with peroxides under the best peroxide concentration (400 μmol L−1) due to the generation of hydroxyl (HO•) and sulfate (SO4•−) radicals. In addition, the degradation efficiency was strongly dependent on the structure of the target compound, pH and peroxide source. Although high pseudo-first-order rate constants (kobs) were obtained at pH 3.0 for all peroxides, higher kobs were obtained at pH 7.0 (natural matrix pH) in the presence of H2O2. Kobs calculated for mixture degradation using different peroxides at pH 7 showed the following order: UV-C/H2O2 > UV−C/HSO5− >UV−C/S2O82−. In contrast, an opposite profile was observed for naproxen degradation (UV−C/S2O82− >UV−C/HSO5− > UV-C/H2O2). Finally, the analysis of energy efficiency and treatment costs showed that UV-C/H2O2 is highly cost-effective.

Preemptive TPMT Genotyping and Adherence to Genotype-Based Therapeutic Recommendations Reduces the Healthcare Cost in Patients Receiving Azathioprine or 6-Mercaptopurine for Autoimmune Diseases.

A cost analysis of thiopurine treatment was carried out in 257 patients, with 153 preemptively genotyped for TPMT and 104 retrospectively genotyped in a Spanish setting. The healthcare cost was significantly higher in patients retrospectively genotyped compared to those who were preemptively genotyped (p < 0.001). TPMT intermediate metabolizers (IMs) (n = 23) showed a 3.3-fold higher healthcare cost when compared to normal metabolizers (NMs) (p < 0.001). The healthcare cost in patients with a TPMT IM phenotype whose physician adhered to the genotype-informed recommendation was similar than the cost in TPMT NMs and was significantly lower than IMs whose physician did not adhere to the therapeutic recommendation (3.8-fold, p = 0.016). Myelotoxicity occurrence was significantly lower in patients preemptively vs. retrospectively genotyped (2.0% and 21.2%, respectively, p < 0.001). Patients who developed myelotoxicity showed a significantly higher healthcare cost than those who did not (4.10-fold, p < 0.001). Overall, 87% of patients whose dose was not adjusted despite being TPMT IMs suffered myelotoxicity, while only one of the eight patients (13%) whose dose was adjusted suffered myelotoxicity (p < 0.001). In conclusion, TPMT preemptive genotyping and physician adherence to genotype-informed therapeutic recommendations prevents myelotoxicity and significantly reduces the healthcare cost, and it is therefore essential for the sustainability of the Spanish healthcare system.

Integrated Malnutricion Management: A Comparative Analysis Of Treatment Costs For Enteral Nutrition Home-Based Care Versus Hospital-Based Care

Integrated Malnutricion Management: A Comparative Analysis Of Treatment Costs For Enteral Nutrition Home-Based Care Versus Hospital-Based Care

Cost Analysis of Diagnosis and Treatment of Tobacco-Related Cancer.

Tobacco use is the leading cause of cancer, accounting for approximately 20% of all cancer deaths and 70% of lung cancer deaths worldwide. The use of tobacco has multiple consequences; it damages health and pushes the household below the poverty line. The treatment of cancer is very costly. The study attempts to determine the cost associated with the diagnosis and treatment of tobacco-related cancer in Nepal. A descriptive cross-sectional study was conducted among 103 patients from public and private hospitals in 2019. Patients with the second and third stages of cancer who had ever used tobacco were randomly selected for the study purpose. All patients who met the inclusion criteria were selected for interviews. The data were analyzed using SPSS version 22, and summarized in descriptive form only. The total cost of tobacco-related cancer was NPR 9,81,370 per patient in 2019. A patient's average direct medical cost was found to be NPR 5,88,740 (60%), whereas the average direct non-medical cost was NPR 1,23,147(13%). The wage loss as a result of illness accounted for over one-fourth (27%) of the total cost. Approximately one-sixth of the patients sold their property for the treatment of cancer. The majority of the cancer patients were found to be illiterate or with primary education only, and financially dependent on their families. Treatment of cancer is costly and patients in Nepal can hardly afford the expenses. Enrolling clients in health insurance and increasing the government subsidy by raising the tax on tobacco products can be a long-term source of health financing to protect patients from sliding into poverty. The increased price of tobacco due to an increase in tax would reduce tobacco consumption, particularly among youth and the poor.

Regarding the article “Cost analysis of drug treatment in hypertensive patients at social security health care family medicine units”

Regarding the article “Cost analysis of drug treatment in hypertensive patients at social security health care family medicine units”