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Vardavas C, Zisis K, Nikitara K, Lagou I, Marou V, Aslanoglou K, Athanasakis K, Phalkey R, Leonardi-Bee J, Fernandez E, Condell O, Lamb F, Sandmann F, Pharris A, Deogan C, Suk JE. Cost of the COVID-19 pandemic versus the cost-effectiveness of mitigation strategies in EU/UK/OECD: a systematic review. BMJ Open 2023; 13:e077602. [PMID: 37907290 PMCID: PMC10619092 DOI: 10.1136/bmjopen-2023-077602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES The economic burden of COVID-19 pandemic is substantial, with both direct and indirect costs playing a significant role. DESIGN A systematic literature review was conducted to estimate the cost of the COVID-19 pandemic and the cost-effectiveness of pharmaceutical or non-pharmaceutical interventions. All cost data were adjusted to the 2021 Euro, and interventions compared with null. DATA SOURCES Ovid MEDLINE and EMBASE were searched from January 2020 through 22 April 2021. ELIGIBILITY CRITERIA Studies regarding COVID-19 outbreak or public health preparedness measures or interventions with outcome measures related to the direct and indirect costs for disease and preparedness and/or response in countries of the European Union (EU), the European Economic Area (EEA), the UK and the Organisation for Economic Co-operation and Development (OECD) of all relevant epidemiological designs which estimate cost within the selected time frame were considered eligible. DATA EXTRACTION AND SYNTHESIS Studies were searched, screened and coded independently by two reviewers with high measure of inter-rater agreement. Data were extracted to a predefined data extraction sheet. The risk of bias was assessed using the Consensus on Health Economic Criteria checklist. RESULTS We included data from 41 economic studies. Ten studies evaluated the cost of the COVID-19 pandemic, while 31 assessed the cost-benefit of public health surveillance, preparedness and response measures. Overall, the economic burden of the COVID-19 pandemic was found to be substantial. Community screening, bed provision policies, investing in personal-protective-equipment and vaccination strategies were cost-effective. Physical distancing measures were associated with health benefits; however, their cost-effectiveness was dependent on the duration, compliance and the phase of the epidemic in which it was implemented. CONCLUSIONS COVID-19 pandemic is associated with substantial short-term and long-term economic costs to healthcare systems, payers and societies, while interventions including testing and screening policies, vaccination and physical distancing policies were identified as those presenting cost-effective options to deal with the pandemic, dependent on population vaccination and the Re at the stage of the pandemic.
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Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Konstantinos Zisis
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Public Health Policy, University of West Attica, Egaleo, Greece
| | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Greece
| | | | | | - Revati Phalkey
- Public Health England, London, UK
- University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence-Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Orla Condell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Frank Sandmann
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Charlotte Deogan
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control, Solna, Sweden
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Vardavas C, Nikitara K, Zisis K, Athanasakis K, Phalkey R, Leonardi-Bee J, Johnson H, Tsolova S, Ciotti M, Suk JE. Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis. BMJ Open 2021; 11:e045113. [PMID: 33926982 PMCID: PMC8094385 DOI: 10.1136/bmjopen-2020-045113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Respiratory infectious disease outbreaks pose a threat for loss of life, economic instability and social disruption. We conducted a systematic review of published econometric analyses to assess the direct and indirect costs of infectious respiratory disease outbreaks that occurred between 2003 and 2019. SETTING Respiratory infectious disease outbreaks or public health preparedness measures or interventions responding to respiratory outbreaks in OECD countries (excluding South Korea and Japan) so as to assess studies relevant to the European context. The cost-effectiveness of interventions was assessed through a dominance ranking matrix approach. All cost data were adjusted to the 2017 Euro, with interventions compared with the null. We included data from 17 econometric studies. PRIMARY AND SECONDARY OUTCOME MEASURES Direct and indirect costs for disease and preparedness and/or response or cost-benefit and cost-utility were measured. RESULTS Overall, the economic burden of infectious respiratory disease outbreaks was found to be significant to healthcare systems and society. Indirect costs were greater than direct costs mainly due to losses of productivity. With regard to non-pharmaceutical strategies, prehospitalisation screening and the use of protective masks were identified as both an effective strategy and cost-saving. Community contact reduction was effective but had ambiguous results for cost saving. School closure was an effective measure, but not cost-saving in the long term. Targeted antiviral prophylaxis was the most cost-saving and effective pharmaceutical intervention. CONCLUSIONS Our cost analysis results provide evidence to policymakers on the cost-effectiveness of pharmaceutical and non-pharmaceutical intervention strategies which may be applied to mitigate or respond to infectious respiratory disease outbreaks.
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Affiliation(s)
| | | | | | - Konstantinos Athanasakis
- Department of Public Health Policy, School of Public Health, University of West Attica, Egaleo, Greece
| | - Revati Phalkey
- Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK
| | - Helen Johnson
- Epidemiological Methods, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Svetla Tsolova
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Massimo Ciotti
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
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Maltezou H, Dedoukou X, Pavi E, Theodoridou M, Athanasakis K. Costs associated with measles in healthcare personnel during the 2017–2018 epidemic in Greece: a real-world data cost-of-illness analysis. J Hosp Infect 2020; 105:91-94. [DOI: 10.1016/j.jhin.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
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Tsironis G, Koutsoukos K, Athanasakis K, Tsiara A, Tzannis K, Gerolympou M, Visvikis A, Oikonomopoulos G, Kollia A, Giannopoulou E, Dimitra M, Kostouros E, Papatsoris A, Dellis A, Stravodimos K, Varkarakis I, Samantas E, Aravantinos G, Kentepozidis N, Christodoulou C, Bozionelou V, Dimopoulos MA, Bamias A. Patterns of practice and pharmacoeconomic analysis of the management of patients with metastatic renal cell carcinoma (mRCC) in Greece--the CRISIS study. A retrospective analysis by the Hellenic Genitourinary Cancer Group (HGUCG). Expert Rev Pharmacoecon Outcomes Res 2018; 19:491-501. [PMID: 30417707 DOI: 10.1080/14737167.2019.1546121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background:Metastatic RCC (mRCC) treatment has been revolutionized with 11 approved targeted agents. We report patterns of practice, outcomes and pharmacoeconomic analyses after the introduction of targeted therapy. Patients and methods: CRISIS was a retrospective multicenter study of mRCCpatients who received targeted therapy . Results were related to the start of 1st-line therapy, with a cut off at 1 January 2011 in order to depict the impact of increased availability of effective options. Results: 164 patients, were included. 70.1% and 44.5% received 2nd and 3rd-line therapy, respectively. More patients were treated in 2nd-line after 1 January 2011. After a median follow-up of 55.1 months, median progression-free (PFS) and overall survival (OS) were 10.7 (95% confidence intervals [CI]: 8.3-13.7), 7.3 (95% CI: 5.1-8.6), 5.8 (95% CI: 3.8-7.8) and 34 (95% CI: 28.5-39.8), 22.4 (95% CI: 16-32.1), 18.3 (95% CI: 12.4-26.4) months for first, second and third line, respectively. Efficacy of sunitinib and pazopanib in 1st-line were similar. The mean total cost/patient was 35,012.2 Euros (standard deviation [SD]: 28,971.5). Conclusions: Our study confirms previous real-world data suggesting that continuing advances in the treatment of mRCC produce favorable outcomes in everyday practice. Pharmacoeconomic analyses are important for cost-effective utilization of emerging novel therapies.
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Affiliation(s)
- Georgiops Tsironis
- a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece.,b Hellenic Genito-Urinary Cancer Group , Athens , Greece
| | - Konstantinos Koutsoukos
- a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece.,b Hellenic Genito-Urinary Cancer Group , Athens , Greece
| | | | - Anna Tsiara
- a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece
| | - Kimon Tzannis
- b Hellenic Genito-Urinary Cancer Group , Athens , Greece
| | - Margarita Gerolympou
- d 3rd Oncology Clinic , General Oncology Hospital of Kifisias "Ag. Anargyroi" , Athens , Greece
| | - Anastasios Visvikis
- d 3rd Oncology Clinic , General Oncology Hospital of Kifisias "Ag. Anargyroi" , Athens , Greece
| | | | | | | | | | - Efthymios Kostouros
- a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece
| | - Athanasios Papatsoris
- b Hellenic Genito-Urinary Cancer Group , Athens , Greece.,f 2nd Department of Urology, Sismanoglio General Hospital , University of Athens , Athens , Greece
| | - Athanasios Dellis
- b Hellenic Genito-Urinary Cancer Group , Athens , Greece.,g 2nd Department of Surgery, Aretaieion Academic Hospital , University of Athens , Athens , Greece
| | - Konstantinos Stravodimos
- b Hellenic Genito-Urinary Cancer Group , Athens , Greece.,h 1st University Urology Clinic, Laiko Hospital , University of Athens , Athens , Greece
| | - Ioannis Varkarakis
- b Hellenic Genito-Urinary Cancer Group , Athens , Greece.,f 2nd Department of Urology, Sismanoglio General Hospital , University of Athens , Athens , Greece
| | - Epaminontas Samantas
- d 3rd Oncology Clinic , General Oncology Hospital of Kifisias "Ag. Anargyroi" , Athens , Greece
| | - Gerasimos Aravantinos
- i 2nd Oncology Clinic , General Oncology Hospital of Kifisias "Ag. Anargyroi" , Athens , Greece
| | | | | | - Vasiliki Bozionelou
- k Department of Medical Oncology , University Hospital of Heraklion , Heraklion , Greece
| | - Meletios Athanasios Dimopoulos
- a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece.,b Hellenic Genito-Urinary Cancer Group , Athens , Greece
| | - Aristotle Bamias
- a Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital , University of Athens , Athens , Greece.,b Hellenic Genito-Urinary Cancer Group , Athens , Greece
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Makras P, Boubouchairopoulou N, Katsarolis I, Athanasakis K. Cost-effective osteoporosis treatment thresholds for people living with HIV infection in Greece. J Musculoskelet Neuronal Interact 2017; 17:292-298. [PMID: 29199188 PMCID: PMC5749035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We aimed to specifically define the FRAX-based cost-effective treatment thresholds for osteoporosis among people living with HIV (PLWHIV) in Greece and to compare them with those of the general population. METHODS A previously described state transition Markov cohort model was used in order to estimate the cost-effective intervention thresholds for osteoporotic therapy among Greek PLWHIV employing the FRAX® tool. The model-derived relative risk at which an incremental cost-effectiveness ratio of 30,000€/QALY gained was observed for treatment versus no intervention was multiplied by the average Greek FRAX-based 10-year probabilities for both major osteoporotic and hip fractures. RESULTS There exists no significant difference in the cost-effective FRAX® based thresholds between PLWHIV and general population. The absolute 10-year probabilities of 2.5 and 10% for hip and major osteoporotic fractures, respectively, could be used for the initiation of treatment for PLWHIV of both genders under the age of 75; for older subjects the proposed intervention threshold is raised to 5 and 15% 10-year probability for hip and major osteoporotic fracture, respectively. CONCLUSIONS Our study confirms the general recommendation for the use of country specific FRAX® thresholds when managing bone fragility within PLWHIV. In any case, clinical judgment and appropriate screening are mandatory and irreplaceable.
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Affiliation(s)
- Polyzois Makras
- Department of Endocrinology and Diabetes, 251 Hellenic Air Force General Hospital, Athens, Greece,Corresponding author: Polyzois Makras, MD, PhD, Dept. of Endocrinology & Diabetes, 251 Hellenic Air Force General Hospital, 3 Kanellopoulou st, 115 25, Goudi, Athens, Greece E-mail:
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Karachaliou F, Athanasakis K, Tsentidis C, Soldatou A, Simatos G, Kyriopoulos J, Michalakos S, Karavanaki K. A cohort of children with type 1 diabetes in Greece: predictors of direct costs of care. Pediatr Diabetes 2017; 18:405-412. [PMID: 27444352 DOI: 10.1111/pedi.12408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 04/27/2016] [Accepted: 06/03/2016] [Indexed: 11/27/2022] Open
Abstract
AIM To examine the predictors of direct costs of pediatric type 1 diabetes (T1D) in a hospital-based outpatient clinic in Greece. METHODS The outpatient records of 89 children and adolescents (mean age: 12.05 ± 5.15 y) with T1D followed in the Second Department of Pediatrics, University of Athens Medical School, were analyzed. RESULTS The mean ± SD diabetes duration was 4.9 ± 3.88 y (range: 0.25-17) and glycated hemoglobin (HbA1c) was 8.2 ± 1.09% (66 ± 11.9 mmol/mol). A total of 80% of patients were on multiple daily injections regimen, 10% on pump therapy, and 10% on conventional regimen. Total direct costs per patient-year (ppy) were estimated at €2.712 [95% confidence interval (CI): 2.468-2.956]. Supply costs accounted for 73.7% of total costs and were the highest for pump therapy (P < .001). Multivariate linear regression analysis showed that costs were significantly higher for children (1) on multiple daily injections or pump therapy (r = 0.364, P < .001), (2) of older age (r = 0.25, P < .001) and (3) higher daily insulin dose (r = 0.46, P < .001). Patients on pump therapy had significantly higher costs €5.538 (95%CI 4480-6597) compared with patients on multiple daily injections €2.447 (95% CI 2320-2574) and conventional regimen €1.978.5 (95%CI 1682-2275) (P = .0001). Patients on pump therapy had better glycemic control compared with all other patients [HbA1c (mean ± SD): 7.2% ± 1.0 vs 8.3% ±1.5, P = .039]. CONCLUSION The total T1D cost in this cohort of Greek children was €2712 ppy. The main factor that predicted direct cost was the use of pump. However, pump therapy was associated with better glycaemic control, which may decrease the risk of total long-term diabetes care cost.
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Affiliation(s)
- Feneli Karachaliou
- Department of Endocrinology-Growth and Development, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | | | - Charalabos Tsentidis
- Diabetic Clinic, Second University Department "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Alexandra Soldatou
- Diabetic Clinic, Second University Department "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - George Simatos
- Department of Endocrinology-Growth and Development, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - John Kyriopoulos
- Diabetic Clinic, Second University Department "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Stefanos Michalakos
- Department of Endocrinology-Growth and Development, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Kyriaki Karavanaki
- Diabetic Clinic, Second University Department "P.&A. Kyriakou" Children's Hospital, Athens, Greece
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Boubouchairopoulou N, Flouri I, Drosos AA, Boki K, Settas L, Zisopoulos D, Skopouli FN, Papadopoulos I, Iliopoulos A, Kyriopoulos J, Boumpas DT, Athanasakis K, Sidiropoulos P. Treatment with the first TNF inhibitor in rheumatoid arthritis patients in the Hellenic Registry of Biologic Therapies improves quality of life especially in young patients with better baseline functional status. Clin Exp Rheumatol 2016; 34:999-1005. [PMID: 27749220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 03/07/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To assess in daily practice in patients with rheumatoid arthritis (RA) the effect of treatment with first tumour necrosis factor-α inhibitor (TNFi) in quality of life (Qol), disease activity and depict possible baseline predictors for gains in Qol. METHODS Patients followed prospectively by the Hellenic Registry of Biologic Therapies were analysed. Demographics were recorded at baseline, while RA-related characteristics at baseline and every 6 months. Paired t-tests were used to detect divergences between patient-reported (Health Assessment Questionnaire (HAQ), EuroQol (EQ-5D)) and clinical tools (Disease Activity Score-28 joints (DAS28)). Clinical versus self-reported outcomes were examined via cross-tabulation analysis. Multiple regression analysis was performed for identifying baseline predictors of improvements in QALYs. RESULTS We analysed 255 patients (age (mean±SD) 57.1±13.0, disease duration 9.2±9.1 years, prior non-biologic disease-modifying anti-rheumatic drugs 2.3±1.2). Baseline EQ-5D, HAQ and DAS28 were 0.36 (0.28), 1.01 (0.72) and 5.9 (1.3), respectively, and were all significantly improved after 12 months (0.77 (0.35), 0.50 (0.66), 3.9 (1.5), respectively, p<0.05 for all). 90% of patients who improved from high to a lower DAS28 status (low-remission or moderate) had clinically important improvement in Qol (phi-coefficient=0.531,p<0.05). Independent predictors of gains in Qol were lower baseline HAQ, VAS global and younger age (adjusted R2=0.27). CONCLUSIONS In daily practice TNFi improve both disease activity and Qol for the first 12 months of therapy. 90% of patients who improved from high to a lower DAS28 status had clinically important improvement in Qol. Younger patients starting with lower HAQ and VAS global are more likely to benefit.
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Affiliation(s)
| | - Irini Flouri
- Rheumatology, Clinical Immunology and Allergy, Medical School, University of Crete, Greece
| | - Alexandros A Drosos
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Kyriaki Boki
- Rheumatology Department, Sismanoglio Hospital, Athens, Greece
| | - Loukas Settas
- First Department of Internal Medicine, Rheumatology Section, AHEPA Hospital of the Aristotle University Medical School, Thessaloniki, Greece
| | | | - Fotini N Skopouli
- Department of Nutrition and Diebetics, Harokopio University, Athens, Greece
| | | | - Alexios Iliopoulos
- Department of Rheumatology, Veterans Administration Hospital, Athens, Greece
| | - John Kyriopoulos
- Department of Health Economics, National School of Public Health, Athens, Greece
| | - Dimitrios T Boumpas
- Joint Academic Rheumatology Program, Faculty of Medicine, National and Kapodestrian University of Athens, Athens, Greece
| | | | - Prodromos Sidiropoulos
- Rheumatology, Clinical Immunology and Allergy, Medical School, University of Crete, Greece.
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Tailachidis P, Tsimtsiou Z, Galanis P, Theodorou M, Kouvelas D, Athanasakis K. The Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) questionnaire: cultural adaptation and validation of the Greek version. Hippokratia 2016; 20:264-267. [PMID: 29416298 PMCID: PMC5788239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM To adapt cross-culturally the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) for use in Greek patients with atrial fibrillation (AF) and to evaluate its psychometric properties. METHODS Professional translators were involved in the inverse translation procedure. Twenty patients with AF participated in the cultural adaptation procedure. One hundred two consecutive patients participated in the validation process that included reliability (internal consistency, test-retest reliability) and validity assessment (face validity, construct validity). RESULTS Greek AFEQT showed high internal consistency (Cronbach's alpha for overall scale: 0.97, subscales: Symptoms: 0.90, Daily Activities: 0.93, Treatment Concern: 0.91, Treatment Satisfaction: 0.83) and test-retest reliability (Spearman's rho: 0.99, p <0.001, Wilcoxon's test, p =0.959). Face validity was rated with a median of 7 by the patients. Finally, Greek AFEQT showed appropriate construct validity of demonstrating adequate convergent validity with the moderate to strong correlations of AFEQT domains with the Physical and Mental Component Summaries of SF-12 (Spearman's rho: 0.53-0.78, p <0.001). CONCLUSIONS The Greek version of AFEQT has shown good psychometric properties and can be a useful tool in future studies on the quality of life of patients with AF. Hippokratia 2016, 20(4): 264-267.
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Affiliation(s)
- P Tailachidis
- 2nd Department of Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
| | - Z Tsimtsiou
- Department of Hygiene, Faculty of Medicine, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - P Galanis
- Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Center for Health Services Management and Evaluation, Department of Nursing, University of Athens, Athens, Greece
| | - M Theodorou
- Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
| | - D Kouvelas
- 2nd Department of Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Athanasakis
- Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Department of Health Economics, National School of Public Health, Athens, Greece
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Bertsias G, Karampli E, Sidiropoulos P, Gergianaki I, Drosos A, Sakkas L, Garyfallos A, Tzioufas A, Vassilopoulos D, Tsalapaki C, Sfikakis P, Panopoulos S, Athanasakis K, Perna A, Psomali D, Kyriopoulos J, Boumpas D. Clinical and financial burden of active lupus in Greece: a nationwide study. Lupus 2016; 25:1385-94. [DOI: 10.1177/0961203316642310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 03/08/2016] [Indexed: 11/16/2022]
Abstract
Analyses of the medical and economic burden of chronic disorders such as systemic lupus erythematosus (SLE) are valuable for clinical and health policy decisions. We performed a chart-based review of 215 adult SLE patients with active autoantibody-positive disease at the predefined ratio of 30% severe (involvement of major organs requiring treatment) and 70% non-severe, followed at seven hospital centres in Greece. We reviewed 318 patients consecutively registered over three months (sub-study). Disease activity, organ damage, flares and healthcare resource utilization were recorded. Costs were assessed from the third-party payer perspective. Severe SLE patients had chronic active disease more frequently (22.4% vs 4.7%), higher average SLE disease activity index (SLEDAI) (10.5 vs 6.1) and systemic lupus international collaborating clinics (SLICC) damage index (1.1 vs 0.6) than non-severe patients. The mean annual direct medical cost was €3741 for severe vs €1225 for non-severe patients. Severe flares, active renal disease and organ damage were independent cost predictors. In the sub-study, 19% of unselected patients were classified as severe SLE, and 30% of them had chronic active disease. In conclusion, this is the first study to demonstrate the significant clinical and financial burden of Greek SLE patients with active major organ disease. Among them, 30% display chronic activity, in spite of standard care, which represents a significant unmet medical need.
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Affiliation(s)
- G Bertsias
- Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece
| | - E Karampli
- Department of Health Economics, National School of Public Health, Athens, Greece
| | - P Sidiropoulos
- Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece
| | - I Gergianaki
- Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece
| | - A Drosos
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - L Sakkas
- Department of Medicine/Rheumatology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - A Garyfallos
- Fourth Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - A Tzioufas
- Department of Pathophysiology, University of Athens Medical School, Athens, Greece
- Joint Rheumatology Programme, Faculty of Medicine, University of Athens Medical School, Athens, Greece
| | - D Vassilopoulos
- Second Department of Medicine, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
- Joint Rheumatology Programme, Faculty of Medicine, University of Athens Medical School, Athens, Greece
| | - C Tsalapaki
- Second Department of Medicine, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - P Sfikakis
- Joint Rheumatology Programme, Faculty of Medicine, University of Athens Medical School, Athens, Greece
- First Department of Propaedeutic/Internal Medicine, University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - S Panopoulos
- First Department of Propaedeutic/Internal Medicine, University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - K Athanasakis
- Department of Health Economics, National School of Public Health, Athens, Greece
| | - A Perna
- Global Specialty Pharma Franchise, GlaxoSmithKline, London, UK
| | | | - J Kyriopoulos
- Department of Health Economics, National School of Public Health, Athens, Greece
| | - D Boumpas
- Joint Rheumatology Programme, Faculty of Medicine, University of Athens Medical School, Athens, Greece
- Fourth Department of Medicine, Attikon University Hospital, University of Athens Medical School, Athens, Greece
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Athanasakis K, Petrakis I, Kyriopoulos J. 'HepConomics': cost-effective, indeed, but how can we pay for it? J Viral Hepat 2015; 22:682. [PMID: 25727161 DOI: 10.1111/jvh.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- K Athanasakis
- Department of Health Economics, National School of Public Health, Athens, Greece.
| | - I Petrakis
- Department of Health Economics, National School of Public Health, Athens, Greece
| | - J Kyriopoulos
- Department of Health Economics, National School of Public Health, Athens, Greece
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Makras P, Athanasakis K, Boubouchairopoulou N, Rizou S, Anastasilakis AD, Kyriopoulos J, Lyritis GP. Cost-effective osteoporosis treatment thresholds in Greece. Osteoporos Int 2015; 26:1949-57. [PMID: 25740208 DOI: 10.1007/s00198-015-3055-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/28/2015] [Indexed: 01/29/2023]
Abstract
UNLABELLED A Greek-specific cost-effectiveness analysis determined the FRAX-based intervention thresholds. Assuming a willingness to pay of 30,000 <euro>, osteoporosis treatment is cost-effective in subjects under the age of 75 with 10-year probabilities for hip and major osteoporotic fractures of 2.5 and 10 %, respectively, while for older patients, the same thresholds are raised to 5 and 15 %. INTRODUCTION The purpose of this study was to determine the FRAX calculated fracture probabilities at which therapeutic intervention can be considered as cost-effective in the Greek setting. METHODS A Markov cohort model was populated with Greek data, and quality-adjusted life years (QALYs) were used to calculate the cost-effective thresholds for an annual medication cost of 733.7 <euro> by gender and age. Average FRAX-based 10-year probabilities for both major osteoporotic and hip fractures were multiplied by the model-derived relative risk at which a cost of 30,000 <euro> for each QALY gained was observed for treatment versus to no intervention. RESULTS A biphasic intervention threshold model is supported by our findings. Osteoporosis treatment becomes cost-effective when absolute 10-year probabilities for hip and major osteoporotic fractures reach 2.5 and 10 %, respectively, among both men and women under the age of 75. For older subjects, the proposed intervention thresholds are raised to 5 and 15 % 10-year probability for hip and major osteoporotic fractures, respectively. CONCLUSIONS Cost-effective osteoporosis treatment may be facilitated in Greece if FRAX algorithm is used to identify subjects with 10-year probabilities for hip and major osteoporotic fractures of 2.5 and 10 %, under the age of 75, while for older patients, the relevant thresholds are 5 and 15 %, respectively.
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Affiliation(s)
- P Makras
- Department of Endocrinology and Diabetes, 251 Hellenic Air Force General Hospital, Athens, Greece,
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Tsifetaki N, Migkos M, Papagoras C, Voulgari P, Athanasakis K, Drosos A. SAT0234 Counting Costs Under Severe Financial Constraints: A Cost of Illness Analysis of Spondyloarthropathies in Greece. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bertsias G, Karampli E, Sidiropoulos P, Drosos A, Sakkas L, Garyfallos A, Tzioufas A, Vassilopoulos D, Sfikakis P, Athanasakis K, Perna A, Psomali D, Kyriopoulos J, Boumpas D. FRI0401 Clinical and Financial Burden of SLE in Greece: A Nation-Wide, Multi-Centre Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Tsiantou V, Zavras D, Karampli E, Athanasakis K, Pavi E, Kyriopoulos J. Physicians Estimation Regarding The Impact Of Recession on Patient Adherence To Treatment In Diabetes Type 2 In Greece. Value Health 2014; 17:A357. [PMID: 27200718 DOI: 10.1016/j.jval.2014.08.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V Tsiantou
- National School of Public Health, Athens, Greece
| | - D Zavras
- National School of Public Health, Athens, Greece
| | - E Karampli
- National School of Public Health, Athens, Greece
| | | | - E Pavi
- National School of Public Health, Athens, Greece
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Athanasakis K, Karampli E, Ollandezos M, Igoumenidis M, Karabela P, Psomali D, Kyriopoulos J. Belimumab for the Treatment of Systemic Lupus Erythematosus (Sle) In Greece: A Cost-Effectiveness and Cost-Utility Analysis. Value Health 2014; 17:A532-A533. [PMID: 27201690 DOI: 10.1016/j.jval.2014.08.1694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - E Karampli
- National School of Public Health, Athens, Greece
| | - M Ollandezos
- National School of Public Health, Athens, Greece
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Tsiantou V, Karampli E, Zavras D, Athanasakis K, Pavi E, Kyriopoulos J. Is the rule of halves applicable in Diabetes Type 2? Evidence from Greece. Value Health 2014; 17:A357. [PMID: 27200717 DOI: 10.1016/j.jval.2014.08.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V Tsiantou
- National School of Public Health, Athens, Greece
| | - E Karampli
- National School of Public Health, Athens, Greece
| | - D Zavras
- National School of Public Health, Athens, Greece
| | | | - E Pavi
- National School of Public Health, Athens, Greece
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Boubouchairopoulou N, Karpettas N, Athanasakis K, Kollias A, Protogerou AD, Achimastos A, Stergiou GS. Cost Estimation Of Home Blood Pressure Monitoring Versus Combined Office And Ambulatory Measurements In Hypertension Management. Value Health 2014; 17:A481. [PMID: 27201402 DOI: 10.1016/j.jval.2014.08.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Athanasakis K, Karampli E, Psomali D, Perna A, Kyriopoulos J. The Cost of Active Systemic Lupus Erythematosus in Greece Results From the Lycos Study. Value Health 2014; 17:A529. [PMID: 27201678 DOI: 10.1016/j.jval.2014.08.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - E Karampli
- National School of Public Health, Athens, Greece
| | | | - A Perna
- GlaxoSmithKline, Brentford, UK
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Tsiantou V, Mylona K, Karampli E, Boubouchairopoulou N, Kyriopoulos II, Athanasakis K, Gabriel E, Makridaki D, Kyriopoulos J. Access To Orphan Drugs In Greece During Economic Crisis. Value Health 2014; 17:A541. [PMID: 27201742 DOI: 10.1016/j.jval.2014.08.1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V Tsiantou
- National School of Public Health, Athens, Greece
| | - K Mylona
- National School of Public Health, Athens, Greece
| | - E Karampli
- National School of Public Health, Athens, Greece
| | | | | | | | - E Gabriel
- Institute of Pharmaceutical Research and Technology, Pallini, Greece
| | - D Makridaki
- Panhellenic Association of Hospital Pharmacists, Marousi, Greece
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Athanasakis K, Boubouchairopoulou N, Retsa MP, Maiese EM, Elbasha EH, Kyriopoulos J. Cost-Effectiveness Analysis of Raltegravir in Hiv-Infected Treatment Naive Patients in Greece. Value Health 2014; 17:A675. [PMID: 27202485 DOI: 10.1016/j.jval.2014.08.2506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | | | - E M Maiese
- Merck & Co, Inc., Whitehouse Station, NJ, USA
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Athanasakis K, Boubouchairopoulou N, Alexiou V, Baroutsou B, Kyriopoulos J. Clinical Trial Activity in Greece From 2010 To 2012: Still Missing the Opportunities? Value Health 2014; 17:A433. [PMID: 27201139 DOI: 10.1016/j.jval.2014.08.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - V Alexiou
- National School of Public Health, Athens, Greece
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Boubouchairopoulou N, Athanasakis K, Chini M, Mangafas N, Lazanas MK, Kyriopoulos J. Cost Estimation of Hiv Infection in Greece: Data from an Infectious Diseases Unit. Value Health 2014; 17:A671. [PMID: 27202462 DOI: 10.1016/j.jval.2014.08.2484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - M Chini
- "Korgialeneio-Benakeio" Red Cross General Hospital, Athens, Greece
| | - N Mangafas
- "Korgialeneio-Benakeio" Red Cross General Hospital, Athens, Greece
| | - M K Lazanas
- "Korgialeneio-Benakeio" Red Cross General Hospital, Athens, Greece
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Athanasakis K, Makras P, Boubouchairopoulou N, Rizou S, Kyriopoulos J, Lyritis G. Estimating the Cost-Effective Intervention Thresholds for Osteoporotic Fractures Based on Frax® in the Greek Setting. Value Health 2014; 17:A379. [PMID: 27200839 DOI: 10.1016/j.jval.2014.08.2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - P Makras
- 251 Hellenic Air Force General Hospital, Athens, Greece
| | | | - S Rizou
- Hellenic Osteoporosis Foundation, Athens, Greece
| | | | - G Lyritis
- Hellenic Osteoporosis Foundation, Athens, Greece
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Tsalapati K, Vardavas CI, Athanasakis K, Thireos E, Vozikis A, Pavi E, Behrakis P, Kyriopoulos I. Going up in ashes? Smoking-attributable morbidity, hospital admissions and expenditure in Greece. Eur J Public Health 2014; 24:477-9. [DOI: 10.1093/eurpub/cku040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alpert HR, Vardavas CI, Chaloupka FJ, Vozikis A, Athanasakis K, Kyriopoulos I, Bertic M, Behrakis PK, Connolly GN. The recent and projected public health and economic benefits of cigarette taxation in Greece. Tob Control 2013; 23:452-4. [DOI: 10.1136/tobaccocontrol-2012-050857] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Athanasakis K, Petrakis I, Kyriopoulos J. Posaconazole vs fluconazole/itraconazole in the prophylaxis of invasive fungal infections in immunocompromised patients: a cost-effectiveness analysis in Greece. J Med Econ 2013; 16:678-84. [PMID: 23448409 DOI: 10.3111/13696998.2013.781028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Invasive fungal infections (IFIs) present a major issue in clinical practice, due to their high morbidity and mortality rates. In a pivotal multi-centre, randomized clinical trial, posaconazole prophylaxis prevented IFIs more effectively than did either fluconazole or itraconazole, and improved overall survival. OBJECTIVE The aim of this study was to perform an economic evaluation of the aforementioned therapeutic strategies for IFI prophylaxis in neutropenic patients, in the Greek healthcare setting. METHOD A decision analytic model was developed, which described the course of neutropenic patients under posaconazole or standard azole (fluconazole or itraconazole) treatment. Effectiveness data for each treatment regimen were derived from published results of a pivotal, multi-centre, randomized clinical trial. Cost and healthcare resources utilization data depict Greek clinical practice and are derived from official Greek sources, from a third party payer perspective. RESULTS Prophylaxis with posaconazole resulted in fewer IFIs (0.05 vs 0.11 per patient) compared to treatment with fluconazole or itraconazole, during the first 100 days from initiation of prophylaxis treatment. The cost per avoided IFI with posaconazole was €6455, while the incremental cost per life year gained (LYG) was estimated at €24,196. Extensive sensitivity analyses corroborated the base-case results. Possible limitations of the study are the exclusion of indirect and outpatient costs from the analysis and the inherent uncertainty with regards to the transferability of the clinical efficacy results of the clinical trial to the Greek healthcare setting. CONCLUSIONS The utilization of posaconazole for prophylaxis of IFIs neutropenic patients is a therapeutic strategy that provides superior clinical efficacy, while being cost-effective compared to alternative therapies.
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Affiliation(s)
- K Athanasakis
- Department of Health Economics, National School of Public Health, Athens, Greece.
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Ollandezos M, Constantinidis T, Athanasakis K, Lionis C, Kyriopoulos J. Trends of mortality in Greece 1980-2007: a focus on avoidable mortality. Hippokratia 2011; 15:330-334. [PMID: 24391415 PMCID: PMC3876849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Avoidable mortality (AM) refers to deaths from certain conditions considered avoidable given timely and effective health care. AM rates in Greece between 1980 and 2007 were examined in order to investigate the extent to which health care has contributed to the decline in mortality rates in Greece over recent decades and detect possible shortcomings in the Greek healthcare system. METHODS Mortality data from the General Secretariat of the National Statistic Service were used. The list of avoidable conditions was the basis of the analysis in which avoidable deaths were classified into conditions amenable to medical care (treatable avoidable mortality) and conditions responsive to health policy (preventable avoidable mortality). Ischaemic heart disease (IHD) was examined separately following relevant studies. Age standardized mortality rates were calculated according to the European Community standard population. RESULTS A steady decline of the percentage of AM over all-cause mortality was documented (1980-1984:27%; 2000- 2007:22.9%). AM rate fell by 30.5% (1980-1984:217.4/100,000 population; 2000-2007: 151.1/100,000). Treatable mortality rate fell by 48.1%, marking the largest contribution to the decline in AM (1980-1984:110.9/100,000; 2000- 2007:57.5/100,000). Ischaemic heart disease death rate fell by 13.1% (1980-1984:52.7/100,000; 2000-2007:45.8/100,000). Preventable mortality rates fell by 11%, marking a modest contribution to the decline in AM (1980-1984: 53.7/100,000; 2000-2007: 47.8/100,000). CONCLUSIONS Trends in AM in Greece between 1980-2007 were similar to those of other European countries, with Greece performing particularly well with respect to treatable mortality. Although the decline in AM may also reflect changes in factors that influence mortality, such as disease occurrence, environment and socioeconomic conditions, they are suggestive of the health care system being an important determinant of health improvements in Greece during the recent decades. Further studies are needed in order to access the quality of care and to examine the structure and adequacy of health care in Greece.
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Affiliation(s)
- M Ollandezos
- Department of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis 68100, Greece ; Department of Health Economics, National School of Public Health, 196 Alexandras Av., Athens 11521, Greece
| | - Th Constantinidis
- Department of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - K Athanasakis
- Department of Health Economics, National School of Public Health, 196 Alexandras Av., Athens 11521, Greece
| | - Ch Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - J Kyriopoulos
- Department of Health Economics, National School of Public Health, 196 Alexandras Av., Athens 11521, Greece
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Athanasakis K, Ollandezos M, Angeli A, Gregoriou A, Geitona M, Kyriopoulos J. Estimating the direct cost of Type 2 diabetes in Greece: the effects of blood glucose regulation on patient cost. Diabet Med 2010; 27:679-84. [PMID: 20546287 DOI: 10.1111/j.1464-5491.2010.03004.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To estimate the annual cost of treatment for Type 2 diabetic patients in Greece and investigate the effect of blood glucose regulation on patient cost. METHODS A multipoint data collection procedure based on the patient records of 51 geographically distributed physicians was used in order to obtain the necessary data for the analysis and the construction of the patient cost model. Patients were classified as controlled (i.e. maintaining blood glucose regulation for the 1 year retrospective time frame of the analysis) and non-controlled (the patients failing to do so in the specified time period). Cost categories included pharmaceutical expenditure, laboratory/diagnostic tests and consultation fees. Costs attributable to hospitalizations due to diabetic complications were not included. Calculations were based on 2007 fees and prices, and costs are expressed in Euros. RESULTS The average annual cost of treatment for controlled patients was estimated at 981.72 euro (95% confidence interval, 940.66-1023.01 euro), whereas for non-controlled patients it was 1566.12 euro (95% confidence interval, 1485.42-1650.20 euro). Non-controlled patients had 29.7% higher annual pharmaceutical costs (340.50 vs. 441.96 euro), 70% higher costs for laboratory/diagnostic tests (422.54 vs. 718.49 euro) and 85.5% higher consultation costs (218.68 vs. 405.67 euro) compared with their controlled peers. The average cost for a Type 2 diabetic patient in Greece, regardless of blood glucose regulation, was 1297.30 euro (95% confidence interval, 1244.42-1349.61 euro). CONCLUSIONS Failing to control blood glucose levels within 'glycaemic goals', apart from the clinical consequences, can also have a significant financial impact, resulting in a 59.5% increase in the mean annual patient cost.
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Affiliation(s)
- K Athanasakis
- Department of Health Economics, National School of Public Health, Athens, Greece.
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