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Mitev A, Rencz F, Tamási B, Hajdu K, Péntek M, Gulácsi L, Szegedi A, Bata-Csörgő Z, Kinyó Á, Sárdy M, Brodszky V. Subjective well-being in patients with pemphigus: a path analysis. Eur J Health Econ 2019; 20:101-107. [PMID: 31098885 PMCID: PMC6544602 DOI: 10.1007/s10198-019-01067-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Pemphigus is a chronic autoimmune blistering disease of the skin and mucosa severely impairing patients' health-related quality of life (HRQoL). To date, no studies have measured subjective well-being in terms of life satisfaction in pemphigus. Our main objective was to evaluate satisfaction with life in patients with pemphigus, and to analyse its relationship with clinical severity and HRQoL. METHODS A cross-sectional survey was carried out enrolling 77 patients with pemphigus. Subjective well-being was measured using the Satisfaction with Life Scale (SWLS). HRQoL was assessed by the Dermatology Life Quality Index (DLQI) and EQ-5D-5L. Disease severity was measured by Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). RESULTS Mean ABSIS, DLQI, EQ-5D-5L and SWLS scores of patients were 11.7 (SD 17.3), 5.4 (6.8), 0.84 (0.22) and 4.76 (SD 1.52), respectively. The proportion of patients indicating extreme dissatisfaction, dissatisfaction, slightly below average in life satisfaction, average satisfaction, high satisfaction and very high satisfaction with life was 6 (7.8%), 5 (6.5%), 14 (18.2%), 16 (20.8%), 21 (27.3%) and 15 (19.5%), respectively. Life satisfaction was independent from age, gender, level of education and type of disease. A path analysis revealed that there was no direct relationship between ABSIS and SWLS (beta = - 0.09; p = 0.428); however, the following indirect path was confirmed: ABSIS → DLQI → EQ-5D-5L → SWLS. CONCLUSIONS Disease severity and HRQoL measures regularly used to assess patients' health status may be complemented with a measure of subjective well-being, such as SWLS, to achieve a more holistic assessment of patients' lives and optimise pemphigus care.
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Affiliation(s)
- Ariel Mitev
- Department of Marketing, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
- Hungarian Academy of Sciences, Premium Postdoctoral Research Program, Nádor u. 7, Budapest, 1051, Hungary
| | - Béla Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, Budapest, 1085, Hungary
| | - Krisztina Hajdu
- Departments of Dermatology, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
- Department of Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Andrea Szegedi
- Departments of Dermatology, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
- Department of Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Zsuzsanna Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Ágnes Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Akác u. 1, Pécs, 7632, Hungary
| | - Miklós Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, Budapest, 1085, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
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52
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Pónusz R, Endrei D, Kovács D, Németh N, Schiszler B, Molics B, Raposa LB, Gulácsi L, Gamal Eldin M, Boncz I. [Analysis of the utilization of one-day surgery in Hungary]. Orv Hetil 2019; 160:670-678. [PMID: 31010303 DOI: 10.1556/650.2019.31342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/19/2022]
Abstract
Introduction: The impact of one-day surgery has been increasing since the past few decades. This type of health service could fulfil many requirements of health policy, health care services, governments as well as patients. Aim: The aim of the research was to assess the publicly financed case numbers and interventions of one-day surgery in Hungary between 2010 and 2015 from different aspects. Method: A retrospective and quantitative research was made, based on data of the National Health Insurance Fund of Hungary. The database contained all publicly financed one-day surgery cases (both theoretical and performed cases), intervention codes (WHO) as well as the related medical field. Then the database also contained all relevant information related to the patients (age, sex, residency according to the county) and the type of the provider health care institutions. Results: Our results showed an increasing tendency according to the case numbers of one-day surgery from 130 995 (2010) to 251 328 (2015). The mean age of patients also increased in the analyzed period; in 2010: 47.4 years, in 2015: 54.5 years. In 2010, 42% of the theoretically defined one-day surgery cases were practically performed as one-day surgery cases which increased significantly to 65% in 2015. Gynecology, ophthalmology, general surgery and urology have had a significant impact in one-day surgery in Hungary. Conclusion: The analyzed data showed a significant increase of accounted cases, and we could identify the remarkable impact of gynecology and ophthalmology in one-day surgery in Hungary. Orv Hetil. 2019; 160(17): 670-678.
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Affiliation(s)
- Róbert Pónusz
- Egészségbiztosítási Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs, Mária utca 7., 7621
| | - Dóra Endrei
- Egészségbiztosítási Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs, Mária utca 7., 7621.,Klinikai Központ, Pécsi Tudományegyetem Pécs
| | - Dalma Kovács
- Egészségbiztosítási Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs, Mária utca 7., 7621
| | - Noémi Németh
- Egészségbiztosítási Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs, Mária utca 7., 7621
| | - Bence Schiszler
- Sürgősségi Ellátási és Egészségpedagógiai Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs
| | - Bálint Molics
- Fizioterápiás és Sporttudományi Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs
| | - László Bence Raposa
- Ápolástudományi Intézet, Alapozó Egészségtudományi és Védőnői Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs
| | - László Gulácsi
- Gazdaságpolitika és Közpolitika Intézet, Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest
| | | | - Imre Boncz
- Egészségbiztosítási Intézet, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs, Mária utca 7., 7621.,Klinikai Központ, Pécsi Tudományegyetem Pécs
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53
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata‐Csörgő Z, Kinyó Á, Rencz F. Validity of the EQ‐5D in pemphigus. Br J Dermatol 2019. [DOI: 10.1111/bjd.17652] [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: 11/27/2022]
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54
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata‐Csörgő Z, Kinyó Á, Rencz F. EQ‐5D 在天疱疮中的效度. Br J Dermatol 2019. [DOI: 10.1111/bjd.17668] [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: 11/28/2022]
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55
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Rencz F, Brodszky V, Gulácsi L, Péntek M, Poór A, Holló P, Szegedi A, Remenyik É, Sárdy M, Langenbruch A, Radtke M, Gutknecht M, Augustin M. Time to revise the Dermatology Life Quality Index scoring in psoriasis treatment guidelines. J Eur Acad Dermatol Venereol 2019; 33:e267-e269. [DOI: 10.1111/jdv.15537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Premium Postdoctoral Research Programme Hungarian Academy of Sciences Nádor u. 7 H‐1051 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Szegedi
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
- Department of Dermatological Allergology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
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56
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Rencz F, Gulácsi L, Péntek M, Poór A, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the DLQI in psoriasis. Br J Dermatol 2018. [DOI: 10.1111/bjd.17214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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57
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. 银屑病中 DLQI 新评分公式的提议. Br J Dermatol 2018. [DOI: 10.1111/bjd.17228] [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: 11/29/2022]
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58
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the Dermatology Life Quality Index in psoriasis. Br J Dermatol 2018; 179:1102-1108. [PMID: 29968311 DOI: 10.1111/bjd.16927] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Not relevant' responses (NRRs) on the Dermatology Life Quality Index (DLQI) may occur in up to 40% of patients with psoriasis. As these responses are scored as the item of the questionnaire having no impact on the patients' lives at all, it is more difficult for these patients to fulfil the DLQI > 10 criterion required by clinical guidelines to become candidates for systemic treatment including biologics. OBJECTIVES We propose a new scoring system for the DLQI that corrects for the bias in the NRR option and test its construct validity in a sample of patients with psoriasis. METHODS Data from 242 patients (104 of whom marked at least one NRR) from two earlier cross-sectional surveys were reanalysed. For each patient, the DLQI score was calculated in two ways: (i) according to the original scoring and (ii) by applying a new scoring formula (DLQI-R) that adjusts the total score for the number of NRRs. The construct validity of the DLQI-R was tested against the Psoriasis Area and Severity Index (PASI) and EQ-5D-3L. RESULTS The mean DLQI and DLQI-R scores were 9·99 ± 7·52 and 11·0 ± 8·02, respectively. The DLQI-R allowed eight more patients (3·3%) to achieve the 'PASI > 10 and DLQI > 10' threshold. The results were robust when limiting the maximum number of NRRs allowed to two or three. Compared with the DLQI, DLQI-R correlated slightly better with PASI (rs = 0·59 vs. 0·57) and EQ-5D-3L index scores (rs = -0·58 vs. -0·54). CONCLUSIONS The DLQI-R seems to be a valid scoring system for avoiding the bias in the NRR option and can help to improve patients' access to biologics.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Nádor u. 7, H-1051, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
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59
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata-Csörgő Z, Kinyó Á, Rencz F. Validity of the EQ-5D in patients with pemphigus vulgaris and pemphigus foliaceus. Br J Dermatol 2018; 180:802-809. [PMID: 29897626 DOI: 10.1111/bjd.16883] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND No studies to date have employed the EuroQoL EQ-5D questionnaire to assess health-related quality of life (HRQoL) in patients with pemphigus. OBJECTIVES To evaluate the HRQoL of patients with pemphigus by the EQ-5D and to analyse the convergent and known-groups validity of the EQ-5D in this patient population. METHODS Between 2014 and 2017, a multicentre cross-sectional study was carried out. Outcome measures included the five-level EQ-5D (EQ-5D-5L), Dermatology Life Quality Index (DLQI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and an average pain intensity visual analogue scale (VAS) for the past 3 months. RESULTS In total, 109 consecutive patients with pemphigus participated in the study (mean age 57 years; 64% women). Among the EQ-5D dimensions, the most problems were reported regarding pain/discomfort (50%), mobility (43%) and anxiety/depression (43%). No significant difference was found in mean EQ-5D index scores between patients with pemphigus vulgaris and those with pemphigus foliaceus (0·81 vs. 0·86, P = 0·14). The mean EQ-5D index scores of patients with limited, moderate, significant and extreme pemphigus were 0·88, 0·82, 0·72 and 0·67, respectively (P = 0·001). The number of comorbidities was associated with greater impairment in EQ-5D index scores (P < 0·001). DLQI (rs = -0·62, P < 0·001) and the average pain intensity VAS (rs = -0·59, P < 0·001) more strongly correlated with the EQ-5D index scores than did ABSIS (rs = -0·40, P < 0·001). CONCLUSIONS This is the first study employing the EQ-5D questionnaire in pemphigus. The EQ-5D is a valid measure of HRQoL in patients with pemphigus that can be useful both in clinical practice and in economic evaluations to assess the health gains associated with new effective treatments.
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Affiliation(s)
- B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - K Hajdu
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged, Korányi fasor 6, H-6720, Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Akác u. 1, H-7632, Pécs, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program, Nádor u. 7, H-1051, Budapest, Hungary
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60
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Rencz F, Lakatos PL, Gulácsi L, Brodszky V, Kürti Z, Lovas S, Banai J, Herszényi L, Cserni T, Molnár T, Péntek M, Palatka K. Validity of the EQ-5D-5L and EQ-5D-3L in patients with Crohn's disease. Qual Life Res 2018; 28:141-152. [PMID: 30225788 DOI: 10.1007/s11136-018-2003-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE The EuroQol five-dimension questionnaire (EQ-5D) is the most commonly used instrument to obtain utility values for cost-effectiveness analyses of treatments for Crohn's disease (CD). We aimed to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with CD. METHODS Between 2016 and 2017, a multicentre cross-sectional survey was carried out. Consecutive outpatients with CD completed the 3L, 5L and EQ visual analogue scale (VAS). Disease severity was graded by the Crohn's Disease Activity Index (CDAI) and Perianal Disease Activity Index (PDAI). The 3L and 5L were compared in terms of feasibility, agreement, ceiling effect, redistribution properties, discriminatory power, convergent and known-groups validity. RESULTS Two-hundred and six patients (54.9% male, mean age 35 ± 11 years) participated in the survey. For 3L, 25 unique health states were observed versus 59 for the 5L. The overall ceiling effect decreased from 29.6% (3L) to 25.5% (5L). Absolute discriminatory power improved (mean Shannon index 0.84 vs. 1.18). The 3L correlated stronger with EQ VAS and CDAI scores, whereas the 5L with PDAI. The 5L demonstrated a better known-groups validity on the basis of age, perianal fistulas, extraintestinal manifestations and disability. CONCLUSIONS This is the first study to report the impact of CD on quality of life using the EQ-5D-5L questionnaire. The 5L seems to perform better than 3L in terms of feasibility, ceiling effect, discriminatory power and known-groups validity. Understanding the differences in psychometrics between the 3L and 5L is essential as they have substantial implications for financial decision-making about CD treatments.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
- Premium Postdoctoral Research Program, Hungarian Academy of Sciences, Nádor u. 7, Budapest, 1051, Hungary.
| | - Peter L Lakatos
- 1st Department of Medicine, Semmelweis University, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
- Division of Gastroenterology, McGill University, MUHC, Montreal General Hospital, 1650 Ave. Cedar, D16.173.1, Montreal, QC, H3G 1A4, Canada
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Zsuzsanna Kürti
- 1st Department of Medicine, Semmelweis University, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - Szilvia Lovas
- Division of Gastroenterology, Department of Internal Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
| | - János Banai
- Medical Centre, Hungarian Defence Forces, Podmaniczky u. 109-111, Budapest, 1062, Hungary
| | - László Herszényi
- Medical Centre, Hungarian Defence Forces, Podmaniczky u. 109-111, Budapest, 1062, Hungary
| | - Tamás Cserni
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
- Faculty of Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Tamás Molnár
- 1st Department of Internal Medicine, University of Szeged, Korányi fasor 8-10, Szeged, 6720, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Károly Palatka
- Division of Gastroenterology, Department of Internal Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
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Poór AK, Sárdy M, Cserni T, Brodszky V, Holló P, Gulácsi L, Remenyik É, Szegedi A, Rencz F, Péntek M. [Assessment of health-related quality of life in psoriasis patients in Hungary]. Orv Hetil 2018; 159:837-846. [PMID: 29779387 DOI: 10.1556/650.2018.31061] [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: 11/19/2022]
Abstract
INTRODUCTION The health status and health-related quality of life (HRQoL) of patients with psoriasis in Hungary are understudied. AIM To assess HRQoL in psoriasis patients, to compare HRQoL of psoriasis patients to that of the general public in Hungary and to identify predictors of HRQoL. METHOD Between 2012 and 2016, two cross-sectional surveys were carried out among psoriasis patients at two academic dermatology departments. HRQoL was assessed by EQ-5D-3L, EQ Visual Analogue Scale (EQ VAS) and Dermatology Life Quality Index (DLQI). Predictors of HRQoL were analysed by multivariate linear regression. RESULTS 434 patients were enrolled (mean age 49 years, 65% male, 81% moderate-to-severe psoriasis, 43% treated with biologics). Mean EQ-5D-3L, EQ VAS and DLQI scores were 0.74 ± 0.28, 69.06 ± 20.98 and 6.78 ± 7.38, respectively. Overall, 54%, 43%, 40%, 32% and 15% of patients indicated at least some problems in pain/discomfort, anxiety/depression, mobility, usual activities and self-care. EQ-5D-3L index scores in patients were lower compared to the age- and gender-matched general population in Hungary. The difference was statistically significant for the age groups 25-34 and 45-64 in males, and 18-64 in females (p<0.05). Female gender (p = 0.042), psoriatic arthritis (p<0.001) and palmoplantar psoriasis (p = 0.031) were associated with lower EQ-5D-3L index scores. On the contrary, employed and highly educated patients reported higher EQ-5D-3L index scores (p<0.001). CONCLUSIONS We were the first to assess HRQoL in psoriasis patients by using EQ-5D questionnaire in Hungary, and more broadly in Central and Eastern Europe. Our findings are useful for cost-effectiveness modelling of psoriasis treatments and decision-making in healthcare. Orv Hetil. 2018; 159(21): 837-846.
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Affiliation(s)
- Adrienn Katalin Poór
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Miklós Sárdy
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Tamás Cserni
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 1093.,Közgazdaságtudományi Kar, Budapesti Corvinus Egyetem Budapest
| | - Valentin Brodszky
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 1093
| | - Péter Holló
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - László Gulácsi
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 1093
| | - Éva Remenyik
- Bőrgyógyászati Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar, Bőrgyógyászati Klinika Debrecen
| | - Andrea Szegedi
- Bőrgyógyászati Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar, Bőrgyógyászati Klinika Debrecen.,Bőrgyógyászati Allergológiai Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar, Bőrgyógyászati Klinika Debrecen
| | - Fanni Rencz
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 1093.,MTA Prémium Posztdoktori Kutatói Program Budapest
| | - Márta Péntek
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 1093
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Batóg P, Rencz F, Péntek M, Gulácsi L, Filipiak KJ, Prevolnik Rupel V, Simon J, Brodszky V, Baji P, Závada J, Petrova G, Rotar A, Golicki D. EQ-5D studies in cardiovascular diseases in eight Central and Eastern European countries: a systematic review of the literature. Kardiol Pol 2018; 76:860-870. [DOI: 10.5603/kp.a2018.0033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 12/23/2017] [Accepted: 01/18/2018] [Indexed: 11/25/2022]
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Baji P, Gulácsi L, Horváth C, Brodszky V, Rencz F, Péntek M. Comparing self-perceived and estimated fracture risk by FRAX® of women with osteoporosis. Arch Osteoporos 2017; 12:4. [PMID: 28004298 DOI: 10.1007/s11657-016-0300-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/12/2016] [Accepted: 12/09/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED In this study, we compared subjective fracture risks of Hungarian women with osteoporosis to FRAX®-based estimates. Patients with a previous fracture, parental hip fracture, low femoral T-score, higher age, and higher BMI were more likely to underestimate their risks. Patients also failed to associate risk factors with an increased risk of fractures. PURPOSE The main objectives were to explore associations between self-perceived 10-year fracture risks of women with osteoporosis (OP) and their risks calculated by the FRAX® algorithm and to identify determinants of the underestimation of risk. METHODS We carried out a cross-sectional study in 11 OP centers in Hungary and collected data on the risk factors considered by the FRAX® calculator. Patients estimated their subjective 10-year probability of any major osteoporotic and hip fracture numerically, in percentages and also on a visual analog scale (VAS). We compared subjective and FRAX® estimates and applied logistic regression to analyze the determinants of the underestimation of risk. Associations between risk factors and subjective risk were explored using linear probability models. RESULTS Nine hundred seventy-two OP patients were included in the analysis. Major OP and hip fracture risk by FRAX® were on average 20.1 and 10.5%, while subjective estimates were significantly higher, 30.0 and 24.7%, respectively. Correlations between FRAX® and subjective measures were very weak (r = 0.12-0.16). Underestimation of major OP fracture risk was associated with having had a single previous fracture (OR = 2.0), parental hip fracture (OR = 3.4), femoral T-score ≤-2.5 (OR = 4.2), higher age, body mass index, and better general health state. We did not find significant associations between subjective risk estimates and most of the risk factors except for previous fractures. CONCLUSIONS Hungarian OP patients fail to recognize most of the risk factors of fractures. Thus, education of patients about these risk factors would be beneficial especially for the elderly with a low femoral T-score and parental hip fracture history.
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Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, H-1093, Hungary. .,CERGE-EI Fellow, Praha 1, Politických věznů 7, 111 21, Prague, Czech Republic.
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, H-1093, Hungary
| | - Csaba Horváth
- 1st Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2/a, Budapest, H-1083, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, H-1093, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, H-1093, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, H-1093, Hungary.,Department of Rheumatology, Flór Ferenc Hospital, Semmelweis tér 1, Kistarcsa, Budapest, H-2143, Hungary
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64
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Rencz F, Poór AK, Péntek M, Holló P, Kárpáti S, Gulácsi L, Szegedi A, Remenyik É, Hidvégi B, Herszényi K, Jókai H, Beretzky Z, Brodszky V. A detailed analysis of 'not relevant' responses on the DLQI in psoriasis: potential biases in treatment decisions. J Eur Acad Dermatol Venereol 2017; 32:783-790. [PMID: 29114942 DOI: 10.1111/jdv.14676] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 10/16/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Dermatology Life Quality Index (DLQI) is the most common health-related quality of life measure in dermatology that is widely used in treatment guidelines for psoriasis. Eight of the 10 questions of the DLQI offer a 'not relevant' response (NRR) option that is scored as the item had no impact on patients' life at all. OBJECTIVE To explore the occurrence of NRRs on the DLQI in psoriasis patients and to examine the effect of several socio-demographic and clinical factors on giving NRRs. METHODS Data were obtained from two cross-sectional surveys among psoriasis patients at two academic dermatology clinics in Hungary. Health-related quality of life was measured by employing DLQI and EQ-5D-3L, while disease severity was graded by Psoriasis Area and Severity Index (PASI). Multivariate logistic regression was applied to determine the predictors of providing NRRs. RESULTS Mean age of the 428 patients was 49 years, and 65% were males. Mean PASI, DLQI and EQ-5D-3L index scores were 8.4 ± 9.5, 6.8 ± 7.4 and 0.74 ± 0.28, respectively. Overall, 38.8% of the patients had at least one NRR: 19.6% (one), 11.5% (two), 5.1% (three) and 2.6% (more than three). Most NRRs occurred in sport, sexual difficulties and working/studying items of the DLQI (28.4%, 16.4% and 14.0%, respectively). Female gender (OR 1.65; 95% CI 1.04-2.61), older age (OR 1.05; 95% CI 1.03-1.07) and higher PASI score (OR 1.03; 95% CI 1.01-1.06) were associated with providing more NRRs, whereas highly educated patients (OR 0.34; 95% CI 0.16-0.72) and those with a full-time job (OR 0.47; 95% CI 0.29-0.77) less frequently tended to tick NRRs. CONCLUSION The high rate of psoriasis patients with NRRs, especially among women, less educated and elderly patients, indicates a content validity problem of the measure. A reconsideration of the use of the DLQI for medical and financial decision-making in psoriasis patients is suggested.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, University of Debrecen, Debrecen, Hungary
| | - B Hidvégi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - K Herszényi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - H Jókai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Z Beretzky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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Poór AK, Brodszky V, Péntek M, Gulácsi L, Ruzsa G, Hidvégi B, Holló P, Kárpáti S, Sárdy M, Rencz F. Is the DLQI appropriate for medical decision-making in psoriasis patients? Arch Dermatol Res 2017; 310:47-55. [PMID: 29128966 DOI: 10.1007/s00403-017-1794-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/28/2017] [Accepted: 11/06/2017] [Indexed: 12/24/2022]
Abstract
Dermatology Life Quality Index (DLQI) is the most commonly applied measure of health-related quality of life (HRQoL) in psoriasis patients. It is among defining criteria of moderate-to-severe psoriasis and present in treatment guidelines. Our objective was to estimate preference-based HRQoL values (i.e., utilities) for hypothetical health states described by the 10 items of the DLQI in psoriasis patients. Moreover, we compare results to findings of a similar study previously conducted among the general public. A cross-sectional survey was carried out among 238 psoriasis patients. Seven hypothetical DLQI-defined health states with total scores of 6, 11, and 16 (3-3 and 1 states, respectively) were evaluated by time trade-off method. The difference in DLQI scores between hypothetical health states was set at 5 points, as it exceeds the minimal clinically important difference (MCID). Utility scores were found to be homogenous across the seven hypothetical health states (range of means for the 6-point states 0.85-0.91, range of means for the 11-point states 0.83-0.85, and mean of 0.84 for the 16-point state). Overall, mean utilities assessed by psoriasis patients were higher for all seven states compared with the general public (mean difference 0.16-0.28; p < 0.001). In 11 out of the 15 comparisons between health states with DLQI scores differing larger than the MCID, there was no statistically significant difference in utility. Thus, in clinical settings, patients with DLQI scores differing more than the MCID may have identical HRQoL. Improving the definition of moderate-to-severe disease and reconsideration of the DLQI in clinical assessment of psoriasis patients are suggested.
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Affiliation(s)
- Adrienn Katalin Poór
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária utca 41, 1085, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary
| | - Gábor Ruzsa
- Institute of Psychology, Doctoral School of Psychology, Eötvös Loránd University of Sciences, Izabella utca 46, 1064, Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary
| | - Bernadett Hidvégi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária utca 41, 1085, Budapest, Hungary
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária utca 41, 1085, Budapest, Hungary
| | - Sarolta Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária utca 41, 1085, Budapest, Hungary
| | - Miklós Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária utca 41, 1085, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary.
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Péntek M, Brodszky V, Biró Z, Kölkedi Z, Dunai Á, Németh J, Baji P, Rencz F, Gulácsi L, Resch MD. Subjective health expectations of patients with age-related macular degeneration treated with antiVEGF drugs. BMC Geriatr 2017; 17:233. [PMID: 29017463 PMCID: PMC5635533 DOI: 10.1186/s12877-017-0619-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/02/2017] [Indexed: 12/04/2022] Open
Abstract
Background Subjective expectations regarding future health may influence patients’ judgement of current health and treatment effects, as well as adherence to therapies in chronic diseases. We aimed to explore subjective expectations on longevity and future health-related quality of life (HRQOL) of patients with age-related macular degeneration (AMD) treated with antiVEGF injections and analyse the influencing factors. Methods Consecutive AMD patients in two ophthalmology centres were included. Demographics, clinical characteristics and informal care utilisation were recorded. Current health was evaluated by the EQ-5D generic health status questionnaire and time trade-off (TTO) methods. Happiness was measured on a visual analogue scale (VAS). Subjective life-expectancy and expected EQ-5D status at ages 70, 80 and 90 were surveyed. T-test was applied to compare subgroups and Pearson correlations were performed to analyse relationships between variables. Results One hundred twenty two patients were involved (females 62%) with a mean (SD) age of 75.2 (7.9) years and disease duration of 2.9 (2.5) years. The majority were in AREDS-4 state, the better eye’s ETDRS was 64.7 (15.4). EQ-5D and TTO revealed moderate deterioration of health (0.66 vs. 0.72, p = 0.131), happiness VAS was 6.3 (2.2). Correlation between EQ-5D and ETDRS was moderate (R = 0.242, p < 0.05) and having both versus one eye in AREDS-4 resulted lower TTO (0.68 vs. 0.83; p = 0.013). Subjective life-expectancy did not differ significantly from statistical life-expectancy and had no significant impact on TTO. The self-estimated mean EQ-5D score was 0.60, 0.40 and 0.24 for ages 70, 80 and 90 which is lower than the population norm of age-groups 65–74, 75–84 and 85+ (0.77, 0.63 and 0.63, respectively). Age, gender, current EQ-5D, need for informal care and happiness were deterministic factors of subjective health expectations. Conclusion AMD patients with antiVEGF treatment have comparable HRQOL as the age-matched general public but expect a more severe deterioration of health with age. Older patients with worse HRQOL have worse subjective expectations. Exploring patients’ health expectations provides an opportunity for ophthalmologists to correct misperceptions and improve the quality of AMD care. Further studies should provide evidences on the relationship between subjective expectations and actual health outcomes, and on its impact on patients’ AMD-specific health behaviour. Electronic supplementary material The online version of this article (10.1186/s12877-017-0619-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Zsolt Biró
- Department of Ophthalmology, Pécs University of Sciences, Nyár u. 8, Pécs, 7624, Hungary
| | - Zsófia Kölkedi
- Department of Ophthalmology, Pécs University of Sciences, Nyár u. 8, Pécs, 7624, Hungary
| | - Árpád Dunai
- Department of Ophthalmology, Semmelweis University Budapest, Mária u. 39, Budapest, 1085, Hungary
| | - János Németh
- Department of Ophthalmology, Semmelweis University Budapest, Mária u. 39, Budapest, 1085, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.,Clinical Medicine Doctoral School, Semmelweis University Budapest, Ulloi u. 26, Budapest, 1085, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary
| | - Miklós D Resch
- Department of Ophthalmology, Semmelweis University Budapest, Mária u. 39, Budapest, 1085, Hungary
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Tamási B, Brodszky V, Hajdu K, Kárpáti S, Gulácsi L, Szegedi A, Bata-Csörgö Z, Kinyó Á, Péntek M, Rencz F. 015 The impact of pemphigus on health-related quality of life: First results with the EQ-5D questionnaire. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.111] [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: 11/25/2022]
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Rencz F, Poór A, Péntek M, Holló P, Kárpáti S, Gulácsi L, Szegedi A, Remenyik É, Hidvégi B, Brodszky V. 017 Women, elderly and less educated psoriasis patients provide more ‘not relevant’ responses on the Dermatology Life Quality Index - is it a problem? J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.113] [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: 11/27/2022]
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Péntek M, Lakatos PL, Oorsprong T, Gulácsi L, Pavlova M, Groot W, Rencz F, Brodszky V, Baji P, Crohn’s Disease Research Group. Access to biologicals in Crohn’s disease in ten European countries. World J Gastroenterol 2017; 23:6294-6305. [PMID: 28974896 PMCID: PMC5603496 DOI: 10.3748/wjg.v23.i34.6294] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/05/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To analyze access (availability, affordability and acceptability) to biologicals for Crohn’s disease (CD) in ten European countries and to explore the associations between these dimensions, the uptake of biologicals and economic development.
METHODS A questionnaire-based survey combined with desk research was carried out in May 2016. Gastroenterologists from the Czech Republic, France, Germany, Hungary, Latvia, Poland, Romania, Slovakia, Spain and Sweden were invited to participate and provide data on the availability of biologicals/biosimilars, reimbursement criteria, clinical practice and prices, and use of biologicals. An availability score was developed to evaluate the restrictiveness of eligibility and administrative criteria applied in the countries. Affordability was defined as the annual cost of treatment as a share of gross domestic product (GDP) per capita. Correlations with the uptake of biologicals, dimensions of access and GDP per capita were calculated.
RESULTS At the time of the survey, infliximab and adalimumab were reimbursed in all ten countries, and vedolizumab was reimbursed in five countries (France, Germany, Latvia, Slovakia, Sweden). Reimbursement criteria were the least strict in Sweden and Germany, and the strictest in Hungary, Poland and Slovakia. Between countries, the annual cost of different biological treatments differed 1.6-3.3-fold. Treatments were the most affordable in Sweden (13%-37% of the GDP per capita) and the least affordable in the Central and Eastern European countries, especially in Hungary (87%-124%) and Romania (141%-277%). Biosimilars made treatments more affordable by driving down the annual costs. The number of patients with CD on biologicals per 100000 population was strongly correlated with GDP per capita (0.91), although substantial differences were found in the uptake among countries with similar economic development. Correlation between the number of patients with CD on biologicals per 100000 population and the availability and affordability was also strong (-0.75, -0.69 respectively).
CONCLUSION Substantial inequalities in access to biologicals were largely associated with GDP. To explain differences in access among countries with similar development needs further research on acceptance.
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Affiliation(s)
- Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary
| | - Peter L Lakatos
- McGill University, MUHC, Montreal General Hospital, H3G 1A4 Montreal, Canada
- 1st Department of Internal Medicine, Semmelweis University, H-1083 Budapest, Hungary
| | - Talitha Oorsprong
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands
- Top Institute Evidence Based Education Research (TIER), Teachers Academy, Maastricht University, 6211 KH Maastricht, The Netherlands
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary
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Zrubka Z, Rencz F, Závada J, Golicki D, Rupel VP, Simon J, Brodszky V, Baji P, Petrova G, Rotar A, Gulácsi L, Péntek M. EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis. Rheumatol Int 2017; 37:1957-1977. [PMID: 28849432 DOI: 10.1007/s00296-017-3800-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/17/2017] [Indexed: 02/05/2023]
Abstract
EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration's tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.
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Affiliation(s)
- Zsombor Zrubka
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
- Sandoz Hungária Kft, Bartók Béla u. 43-47, 1134, Budapest, Hungary
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Jakub Závada
- Institute of Rheumatology, Na Slupi 4, Prague, 128 00, Czech Republic
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, ul. Banacha 1b, 02-097, Warsaw, Poland
| | | | - Judit Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1 1090, Vienna, Austria
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria
| | - Alexandru Rotar
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary.
- Department of Rheumatology, Flór Ferenc County Hospital, Semmelweis tér 1, 2143, Kistarcsa, Hungary.
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71
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Baji P, Gulácsi L, Brodszky V, Végh Z, Danese S, Irving PM, Peyrin-Biroulet L, Schreiber S, Rencz F, Lakatos PL, Péntek M. Cost-effectiveness of biological treatment sequences for fistulising Crohn's disease across Europe. United European Gastroenterol J 2017; 6:310-321. [PMID: 29511561 DOI: 10.1177/2050640617708952] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 09/08/2016] [Accepted: 04/15/2017] [Indexed: 12/18/2022] Open
Abstract
Background In clinical practice, treatment sequences of biologicals are applied for active fistulising Crohn's disease, however underlying health economic analyses are lacking. Objective The purpose of this study was to analyse the cost-effectiveness of different biological sequences including infliximab, biosimilar-infliximab, adalimumab and vedolizumab in nine European countries. Methods A Markov model was developed to compare treatment sequences of one, two and three biologicals from the payer's perspective on a five-year time horizon. Data on effectiveness and health state utilities were obtained from the literature. Country-specific costs were considered. Calculations were performed with both official list prices and estimated real prices of biologicals. Results Biosimilar-infliximab is the most cost-effective treatment against standard care across the countries (with list prices: €34684-€72551/quality adjusted life year; with estimated real prices: €24364-€56086/quality adjusted life year). The most cost-effective two-agent sequence, except for Germany, is the biosimilar-infliximab-adalimumab therapy compared with single biosimilar-infliximab (with list prices: €58533-€133831/quality adjusted life year; with estimated prices: €45513-€105875/quality adjusted life year). The cost-effectiveness of the biosimilar-infliximab-adalimumab-vedolizumab three-agent sequence compared wit biosimilar-infliximab -adalimumab is €87214-€152901/quality adjusted life year. Conclusions The suggested first-choice biological treatment is biosimilar-infliximab. In case of treatment failure, switching to adalimumab then to vedolizumab provides meaningful additional health gains but at increased costs. Inter-country differences in cost-effectiveness are remarkable due to significant differences in costs.
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Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Zsuzsanna Végh
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Silvio Danese
- Department of Gastroenterology, Istituto Clinico Humanitas, Milan, Italy
| | - Peter M Irving
- IBD Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Stefan Schreiber
- Department Internal Medicine I, Kiel University, University Hospital, Kiel, Germany
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary
| | - Péter L Lakatos
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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Gulácsi L, Brodszky V, Baji P, Rencz F, Péntek M. Erratum to: The Rituximab Biosimilar CT-P10 in Rheumatology and Cancer: A Budget Impact Analysis in 28 European Countries. Adv Ther 2017; 34:1234. [PMID: 28447267 PMCID: PMC5427141 DOI: 10.1007/s12325-017-0538-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- László Gulácsi
- Corvinus University of Budapest and HTA Consulting Budapest, Budapest, Hungary.
| | - Valentin Brodszky
- Corvinus University of Budapest and HTA Consulting Budapest, Budapest, Hungary
| | - Petra Baji
- Corvinus University of Budapest and HTA Consulting Budapest, Budapest, Hungary
| | - Fanni Rencz
- Corvinus University of Budapest and HTA Consulting Budapest, Budapest, Hungary
| | - Márta Péntek
- Corvinus University of Budapest and HTA Consulting Budapest, Budapest, Hungary.,Flór Ferenc County Hospital, Kistarcsa, Hungary
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73
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Rencz F, Gulácsi L, Péntek M, Gecse KB, Dignass A, Halfvarson J, Gomollón F, Baji P, Peyrin-Biroulet L, Lakatos PL, Brodszky V. Cost-utility of biological treatment sequences for luminal Crohn's disease in Europe. Expert Rev Pharmacoecon Outcomes Res 2017; 17:597-606. [PMID: 28434387 DOI: 10.1080/14737167.2017.1322509] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 12/21/2022]
Abstract
BACKGROUND This study aims to compare the cost-effectiveness of treatment sequences with available biologics, including adalimumab (ADA), biosimilar infliximab (bsIFX), originator infliximab (IFX) and vedolizumab (VEDO) for luminal Crohn's disease in nine European countries. METHODS A Markov-model was constructed to simulate five-year medical costs and quality-adjusted life years (QALYs). Data on clinical efficacy were obtained from randomised controlled trials. Country-specific unit costs, discount rates and a third-party payer perspective were applied. RESULTS The bsIFX versus conventional therapy resulted in the most favourable incremental cost-utility ratios (ICURs) ranging from €34,580 (Hungary) to €77,062/QALY (Sweden). Compared to bsIFX, the bsIFX-ADA sequence was more cost-effective than the bsIFX-VEDO sequence with ICURs varying between €70,277 (France) and €162,069/QALY (Germany). The ICURs of the bsIFX-ADA-VEDO sequence versus the bsIFX-ADA strategy were between €206,266 (The Netherlands) and €363,232/QALY (Spain). CONCLUSION We are the first to compare cost-effectiveness of multiple biological sequences for luminal Crohn's disease. Based on our findings, bsIFX can be recommended as a first-line treatment in patients unresponsive to conventional treatments. While biological sequences only slightly differ in their associated health gains, their costs vary greatly. The bsIFX-ADA-VEDO seems to be the most cost-effective sequence of the available biologics across Europe.
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Affiliation(s)
- Fanni Rencz
- a Department of Health Economics , Corvinus University of Budapest , Budapest , Hungary
| | - László Gulácsi
- a Department of Health Economics , Corvinus University of Budapest , Budapest , Hungary
| | - Márta Péntek
- a Department of Health Economics , Corvinus University of Budapest , Budapest , Hungary
| | - Krisztina B Gecse
- b 1st Department of Medicine , Semmelweis University , Budapest , Hungary
| | - Axel Dignass
- c Department of Medicine 1 , Agaplesion Markus Krankenhaus , Frankfurt , Germany
| | - Jonas Halfvarson
- d Department of Gastroenterology, Faculty of Medicine and Health , Örebro University , Örebro , Sweden
| | - Fernando Gomollón
- e Gastroenterology Unit , Clinical Universitary Hospital Lozano IIS Aragón (Blesa, IIS Aragón, CIBEREHD) , Zaragoza , Spain
| | - Petra Baji
- a Department of Health Economics , Corvinus University of Budapest , Budapest , Hungary.,f Center for Economic Research and Graduate Education (CERGE) Economics Institute (EI) Research Fellow , Charles University , Praha 1 , The Czech Republic
| | - Laurent Peyrin-Biroulet
- g Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy-Brabois , Lorraine University , Vandoeuvre-lès-Nancy , France
| | - Peter L Lakatos
- b 1st Department of Medicine , Semmelweis University , Budapest , Hungary
| | - Valentin Brodszky
- a Department of Health Economics , Corvinus University of Budapest , Budapest , Hungary
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Brodszky V, Bíró A, Szekanecz Z, Soós B, Baji P, Rencz F, Tóthfalusi L, Gulácsi L, Péntek M. Determinants of biological drug survival in rheumatoid arthritis: evidence from a Hungarian rheumatology center over 8 years of retrospective data. Clinicoecon Outcomes Res 2017; 9:139-147. [PMID: 28243133 PMCID: PMC5317255 DOI: 10.2147/ceor.s124381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective To compare drug survival of biological therapies in patients with rheumatoid arthritis (RA), and analyze the determinants of discontinuation probabilities and switches to other biological therapies. Materials and methods Consecutive RA patients initiating first biological treatment in one rheumatology center between 2006 and 2013 were included. Log-rank test was used to analyze the differences between the survival curves of different biological drugs. Cox regression was applied to analyze the discontinuation due to inefficacy, the occurrence of adverse events, or to any reasons. Results A total of 540 patients were included in the analysis. The most frequently used first-line biological treatments were infliximab (N=176, 33%), adalimumab (N=150, 28%), and etanercept (N=132, 24%). Discontinuation of first tumor necrosis factor-alpha (TNF-α) treatment was observed for 347 (64%) patients, due to inefficacy (n=209, 60%), adverse events (n=103, 30%), and other reasons (n=35, 10%). Drug survival rates for TNF-α and non-TNF-α therapies were significantly different, and were in favor of non-TNF-α therapies. Every additional number of treatment significantly increased the risk of inefficacy by 27% (p<0.001) and of adverse events by 35% (p=0.002). After the discontinuation of the initial TNF-α treatment, switching to rituximab and tocilizumab was associated with significantly longer treatment duration than switching to a second TNF-α. The non-TNF-α therapies resulted in significantly longer treatment duration, due to both less adverse events and longer maintenance of effectiveness. Conclusion Non-TNF-α therapies resulted in significantly longer treatment duration, and lost their effectiveness later. Increase in the number of switches significantly increased the risk of discontinuation of any biological therapy.
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Affiliation(s)
- Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Anikó Bíró
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; School of Economics, The University of Edinburgh, Edinburgh, UK
| | - Zoltán Szekanecz
- Department of Rheumatology, Institute of Medicine, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Boglárka Soós
- Department of Rheumatology, Institute of Medicine, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary
| | - László Tóthfalusi
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Department of Rheumatology, Flór Ferenc County Hospital, Kistarcsa, Hungary
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75
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Baji P, Gulácsi L, Golovics PA, Lovász BD, Péntek M, Brodszky V, Rencz F, Lakatos PL. Perceived Risks Contra Benefits of Using Biosimilar Drugs in Ulcerative Colitis: Discrete Choice Experiment among Gastroenterologists. Value Health Reg Issues 2016; 10:85-90. [PMID: 27881284 DOI: 10.1016/j.vhri.2016.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/12/2016] [Accepted: 07/17/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND In middle-income countries, access to biological therapy is limited in ulcerative colitis in terms of the number of patients and the length of therapy. Because of their cost advantages, biosimilars have the potential to improve access to therapy, but physicians have concerns toward their use because of the lack of evidence from randomized clinical trials. OBJECTIVES To explore the preferences of gastroenterologists for biosimilar drugs in ulcerative colitis as well as to compare our results with results of previous studies on gastroenterologists' preferences toward biosimilars. METHODS A discrete choice experiment was carried out involving 51 Hungarian gastroenterologists treating patients with inflammatory bowel disease in May 2014 with the following attributes: type of treatment (biosimilar/originator), severity of disease, availability of continuous medicine supply, and the stopping rule (whether the treatment is covered after 12 months). A conditional logit model was used to estimate the probabilities of choosing a given profile. RESULTS According to the results, the stopping rule was the most important attribute. The type of treatment mattered only for patients already on biologicals. The probabilities of choosing the biosimilar option with all the benefits offered in the discrete choice experiment over the originator option under the present reimbursement conditions are 85% for new patients and 63% for patients already treated. CONCLUSIONS Most gastroenterologists have concerns about using biosimilars. They, however, are willing to consider the use of biosimilars if they could reallocate the potential savings to provide their patients better access to biological treatment.
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Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; CERGE-EI, Nové Město, The Czech Republic
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
| | - Petra A Golovics
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Barbara D Lovász
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Department of Rheumatology, Flór Ferenc County Hospital, Kistarcsa, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary
| | - Péter L Lakatos
- First Department of Medicine, Semmelweis University, Budapest, Hungary
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76
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Rencz F, Poór A, Péntek M, Gulácsi L, Beretzky Z, Holló P, Kárpáti S, Brodszky V. 017 Is it appropriate to use the Dermatology Life Quality Index for medical-decision making in psoriasis patients? J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.034] [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: 11/27/2022]
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77
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Baji P, García-Goñi M, Gulácsi L, Mentzakis E, Paolucci F. Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries. Eur J Health Econ 2016; 17:791-9. [PMID: 26296623 DOI: 10.1007/s10198-015-0721-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 08/05/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND In addition to cost-effectiveness, national guidelines often include other factors in reimbursement decisions. However, weights attached to these are rarely quantified, thus decisions can depend strongly on decision-maker preferences. OBJECTIVE To explore the preferences of policymakers and healthcare professionals involved in the decision-making process for different efficiency and equity attributes of interventions and to analyse cross-country differences. METHOD Discrete choice experiments (DCEs) were carried out in Austria, Hungary, and Norway with policymakers and other professionals working in the health industry (N = 153 respondents). Interventions were described in terms of different efficiency and equity attributes (severity of disease, target age of the population and willingness to subsidise others, potential number of beneficiaries, individual health benefit, and cost-effectiveness). Parameter estimates from the DCE were used to calculate the probability of choosing a healthcare intervention with different characteristics, and to rank different equity and efficiency attributes according to their importance. RESULTS In all three countries, cost-effectiveness, individual health benefit and severity of the disease were significant and equally important determinants of decisions. All countries show preferences for interventions targeting young and middle aged populations compared to those targeting populations over 60. However, decision-makers in Austria and Hungary show preferences more oriented to efficiency than equity, while those in Norway show equal preferences for equity and efficiency attributes. CONCLUSION We find that factors other than cost-effectiveness seem to play an equally important role in decision-making. We also find evidence of cross-country differences in the weight of efficiency and equity attributes.
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Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary.
- CERGE-EI, Prague, Czech Republic.
| | - Manuel García-Goñi
- Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Madrid, Spain
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Emmanouil Mentzakis
- Economics Department, School of Social Sciences, University of Southampton, Southampton, UK
| | - Francesco Paolucci
- University of Bologna, Bologna, Italy
- Murdoch University, Murdoch, Australia
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78
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Péntek M, Herczegfalvi Á, Molnár MJ, Szőnyi LP, Kosztolányi G, Pfliegler G, Melegh B, Boncz I, Brodszky V, Baji P, Szegedi M, Pogány G, Gulácsi L. [DISEASE BURDEN OP DUCHENNE MUSCULAR DYSTROPHY PATIENTS AND THEIR CAREGIVERS]. Ideggyogy Sz 2016; 69:183-93. [PMID: 27468608 DOI: 10.18071/isz.69.0183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Data on the disease burden of Duchenne Muscular Dystrophy are scarce in Hungary. The aim of this study was to assess patients' and their caregivers' health related quality of life and healthcare utilisations. METHODS A cross sectional survey was performed as part of the European BURQOL-RD project. The EQ-5D-5L and Barthel Index questionnaires were applied, health care utilisations and patients' informal carers were surveyed. RESULTS One symptomatic female carer, 50 children (boys 94%) and six adult patients (five males) participated in the study, the latter two subgroups were included in the analysis. The average age was 9.7 (SD = 4.6) and 24.3 (SD = 9.8) years, respectively. Median age at time of diagnosis was three years. The average EQ-5D score among children and adults was 0.198 (SD = 0.417) and 0.244 (SD = 0.322), respectively, the Barthel Index was 57.6 (SD = 29.9) and 53.0 (SD = 36.5). Score of satisfaction with healthcare (10-point Likert-scale) was mean 5.3 (SD = 2.1) and 5.3 (SD = 2.9). 15 children were hospitalised in the past 12 months for mean 12.9 (SD = 24.5) days. Two patients received help from professional carer. 25 children (mean age 11.1, SD = 4.4 years) were helped/supervisied by principal informal carer (parent) for mean 90.1 (SD = 44.4) hours/week and further family members helped in 21 cases. Correlation between EQ-5D and Barthel Index was strong and significant (0.731; p < 0.01) as well as with informal care time (-0.770; p < 0.01), but correlation with satisfaction with health care was not significant (EQ-5D: 0.241; Barthel Index: 0.219; informal care: -0.142). CONCLUSION Duchenne muscular dystrophy leads to a significant deterioration in the quality of life of patients. Parents play outstanding role in the care of affected children. This study is the first in the Central and Eastern European region that provides quality of life data in this rare disease for further health economic studies.
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79
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Rencz F, Brodszky V, Stalmeier PFM, Tamási B, Kárpáti S, Péntek M, Baji P, Mitev AZ, Gulácsi L. Valuation of pemphigus vulgaris and pemphigus foliaceus health states: a convenience sample experiment. Br J Dermatol 2016; 175:593-9. [PMID: 27062497 DOI: 10.1111/bjd.14647] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) in pemphigus has been widely investigated; nevertheless, utility values for economic evaluations are still lacking. OBJECTIVES To estimate health utilities for hypothetical pemphigus vulgaris (PV) and pemphigus foliaceus (PF) health states in a general population sample. METHODS Three health states (uncontrolled PV, uncontrolled PF and controlled pemphigus) were developed based on a systematic literature review of HRQoL studies in pemphigus. Utilities were obtained from a convenience sample of 108 adults using a visual analogue scale (VAS) and 10-year time trade-off (TTO). Lead-time TTO was applied for health states regarded as worse than dead with a lead time to disease time ratio of 1 : 1. RESULTS The mean VAS utility scores for PV, PF and controlled pemphigus were 0·25 ± 0·15, 0·37 ± 0·17 and 0·63 ± 0·16, respectively. Corresponding TTO utilities were as follows: 0·34 ± 0·38, 0·51 ± 0·32 and 0·75 ± 0·31. Overall, 14% and 6% judged PV and PF as being worse than dead. For both VAS and TTO values, significant differences were observed between all health states (P < 0·001). VAS utilities were rated significantly lower compared with TTO in each health state (P < 0·001). CONCLUSIONS This is the first study that reports health utility values for PV and PF. Successful treatment of pemphigus might result in significant utility gain (0·24-0·41). These empirical findings with respect to three health states in pemphigus may serve as anchor points for further utility studies and cost-effectiveness analyses.
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Affiliation(s)
- F Rencz
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Pf. 2, H-1428, Budapest, Hungary
| | - V Brodszky
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
| | - P F M Stalmeier
- Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - M Péntek
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - P Baji
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - A Z Mitev
- Departments of Marketing Research and Consumer Behaviour, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - L Gulácsi
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
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Rencz F, Gulácsi L, Drummond M, Golicki D, Prevolnik Rupel V, Simon J, Stolk EA, Brodszky V, Baji P, Závada J, Petrova G, Rotar A, Péntek M. EQ-5D in Central and Eastern Europe: 2000-2015. Qual Life Res 2016; 25:2693-2710. [PMID: 27472992 DOI: 10.1007/s11136-016-1375-6] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. METHODS An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. RESULTS We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n = 11), Bulgaria (n = 6), Czech Republic (n = 18), Hungary (n = 47), Poland (n = 51), Romania (n = 2), Slovakia (n = 3) and Slovenia (n = 14). Cardiovascular (21 %), neurologic (17 %), musculoskeletal (15 %) and endocrine, nutritional and metabolic diseases (13 %) were the most frequently studied clinical areas. Overall, 112 (78 %) of the studies reported EQ VAS results and 86 (60 %) EQ-5D index scores, of which 27 (31 %) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. CONCLUSIONS Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Üllői út 26., Budapest, H-1085, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary.
| | - Michael Drummond
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland, ul. Banacha 1b, 02-097, Warsaw, Poland
| | | | - Judit Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Elly A Stolk
- Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
| | - Jakub Závada
- Institute of Rheumatology, 1st Faculty of Medicine, Charles University, Na Slupi 4, 128 00, Prague, Czech Republic
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria
| | - Alexandru Rotar
- Department of Social Medicine, University of Amsterdam, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
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81
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Rencz F, Gulácsi L, Péntek M, Wikonkál N, Baji P, Brodszky V. Alopecia areata and health-related quality of life: a systematic review and meta-analysis. Br J Dermatol 2016; 175:561-71. [PMID: 26914830 DOI: 10.1111/bjd.14497] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND No systematic review has yet evaluated the available evidence on health-related quality of life (HRQOL) in alopecia areata (AA). OBJECTIVES To conduct a systematic review and meta-analysis of HRQOL studies among patients diagnosed with AA. METHODS A systematic search was performed for papers published between 1946 and 15 December 2014 in Medline, Embase, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Random-effects meta-analyses were conducted to pool data. RESULTS Twenty-one studies were included, representing a total of 2530 adult patients with AA. Of the 14 different HRQOL measures used in the studies, Dermatology Life Quality Index (DLQI; n = 8) and SF-36 (n = 7) were the most common. Three AA-specific HRQOL instruments were identified: Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale. The mean pooled DLQI score of patients with AA was 6·3 (95% confidence interval 5·6-7·1). Comparing age- and sex-matched controls, the meta-analysis of SF-36 studies revealed significantly reduced HRQOL across the role-emotional, mental health and vitality domains (P < 0·001). Wearing a wig had a positive impact, while scalp involvement, anxiety and depression had a negative impact on HRQOL. Conflicting results were found regarding the association between HRQOL and age, sex, marital status and disease duration. CONCLUSIONS Patients with AA experience significant impairment in HRQOL, especially in the area of mental health. Several generic and dermatology-specific HRQOL instruments have been used, but no validation studies have confirmed their applicability in AA. The newly developed AA-specific measures seem very promising; however, a more extensive assessment of validity and reliability is needed.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University, Pf. 2, H-1428, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
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Cavazza M, Kodra Y, Armeni P, De Santis M, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Taruscio D, Schieppati A, Iskrov G, Gulácsi L, von der Schulenburg JMG, Kanavos P, Chevreul K, Persson U, Fattore G. Social/economic costs and quality of life in patients with haemophilia in Europe. Eur J Health Econ 2016; 17 Suppl 1:53-65. [PMID: 27048374 DOI: 10.1007/s10198-016-0785-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with haemophilia in Europe. METHODS We conducted a cross-sectional study of patients with haemophilia from Bulgaria, France, Germany, Hungary, Italy, Spain Sweden and the UK. Data on demographic characteristics, health resource utilisation, informal care, loss of labour productivity and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire. The costs have been estimated from a societal perspective adopting a bottom-up approach. RESULTS A total of 401 questionnaires were included in the study, of which 339 were collected from patients with haemophilia and 62 from caregivers. The lowest average annual cost per person was reported in Bulgaria (€6,660) and the highest in Germany (€194,490). Our results demonstrate both a large difference from country to country in the average annual cost per patient in 2012 and the driving role of drugs in costs. Drugs represent nearly 90 % of direct healthcare costs in a majority of the countries analysed (Hungary, Italy, Spain and Germany). In Bulgaria, France and Sweden, however, healthcare services (visits, tests and hospitalisations) prevail. Costs are also shown to differ between children and adults. The mean EQ-5D index score for adult patients was 0.69 and mean EQ-5D VAS was 66.6. The mean EQ-5D index score for carers was 0.87 and mean EQ-5D VAS was 75.5. In the disability score, 60 % showed no disability and measuring caregiver burden with the Zarit Index produced an overall mean score of 25.3. CONCLUSION We have shown that haemophilia is associated with a substantial economic burden and impaired HRQOL. Studies on cost of illness and HRQOL are important for haemophilia as the future of this disease is likely to change with the development of new innovative treatments. The introduction of these treatments will most likely impact future costs related to haemophilia.
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Affiliation(s)
- Marianna Cavazza
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy.
| | - Yllka Kodra
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Patrizio Armeni
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy
| | - Marta De Santis
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Julio López-Bastida
- University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Renata Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - Juan Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- University of Castilla-La Mancha, Toledo, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | | | - Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Arrigo Schieppati
- "Aldo and Cele Daccò" Clinical Research Center for Rare Diseases, Mario Negri Institute for Pharmacological Research, Ranica (Bergamo), Italy
| | - Georgi Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | | | - Panos Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, UK
| | - Karine Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - Ulf Persson
- The Swedish Institute for Health Economics, Lund, Sweden
| | - Giovanni Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy
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Péntek M, Gulácsi L, Brodszky V, Baji P, Boncz I, Pogány G, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Taruscio D, Iskrov G, Schieppati A, von der Schulenburg JMG, Kanavos P, Chevreul K, Persson U, Fattore G. Social/economic costs and health-related quality of life of mucopolysaccharidosis patients and their caregivers in Europe. Eur J Health Econ 2016; 17 Suppl 1:89-98. [PMID: 27062257 DOI: 10.1007/s10198-016-0787-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To assess the health-related quality of life (HRQOL) of patients with mucopolysaccharidosis (MPS) and their caregivers and to quantify the disease-related costs from a societal perspective. METHODS In the context of a multi-country study of rare diseases (BURQOL-RD project), a cross-sectional survey was performed among MPS patients in seven European countries. Data on demographic characteristics, health resource utilization, informal care, and loss of labor productivity were collected. The EQ-5D, Barthel index (BI), and Zarit burden interview (ZBI) questionnaires were used to assess patients' and their informal caregivers' quality of life, patients' functional ability, and caregivers' burden, respectively. RESULTS Altogether, 120 patients (children 62 %, females 40 %) and 66 caregivers completed the questionnaire. Patients' mean age was 16.5 years and median age at diagnosis was 3 years. Adult patients' average EQ-5D and EQ VAS scores varied across countries from 0.13 to 0.43 and 30.0 to 62.2, respectively, mean BI was 46.7, and ZBI was 32.7. Mean informal care time was 51.3 h/week. The mean total annual cost per patient (reference year 2012) was €24,520 in Hungary, €25,993 in France, €84,921 in Italy, €94,384 in Spain, and €209,420 in Germany. Costs are also shown to differ between children and adults. Direct costs accounted for most of the costs in all five countries (80, 100, 99, 98, and 93 %, respectively). CONCLUSIONS MPS patients experience substantial loss of HRQOL and their families take a remarkable part in their care. Although utilization of health and social care resources varies significantly across countries, MPS incurs considerable societal costs in all the countries studied.
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Affiliation(s)
- Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Imre Boncz
- Institute for Health Insurance, University of Pécs, Pécs, Hungary
| | - Gábor Pogány
- Hungarian Federation of People with Rare and Congenital Diseases (RIROSZ), Budapest, Hungary
| | - Julio López-Bastida
- University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Renata Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - Juan Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- University of Castilla-La Mancha, Toledo, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | | | - Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Georgi Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Arrigo Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | | | - Panos Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, UK
| | - Karine Chevreul
- URC Eco Ile de France, AP-HP, Hôtel Dieu, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - Ulf Persson
- The Swedish Institute for Health Economics, Lund, Sweden
| | - Giovanni Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Chevreul K, Gandré C, Brigham KB, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Taruscio D, Schieppati A, Iskrov G, Gulácsi L, von der Schulenburg JMG, Kanavos P, Persson U, Fattore G. Social/economic costs and health-related quality of life in patients with fragile X syndrome in Europe. Eur J Health Econ 2016; 17 Suppl 1:43-52. [PMID: 27072054 DOI: 10.1007/s10198-016-0784-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 01/13/2016] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To estimate the social/economic costs of fragile X syndrome (FXS) in Europe and to assess the health-related quality of life (HRQOL) of patients and caregivers. METHODS A cross-sectional study was conducted in a sample of European countries. Patients were recruited through patients' associations. Data on their resource use and absence from the labour market were retrospectively obtained from an online questionnaire. Costs were estimated by a bottom-up approach and the EuroQol-5 Domain (EQ-5D) questionnaire was used to measure patients' and caregivers' HRQOL. RESULTS Five countries were included in the analysis. The mean annual cost of FXS per patient varied from €4951 in Hungary to €58,862 in Sweden. Direct non-healthcare costs represented the majority of costs in all countries but there were differences in the share incurred by formal and informal care among those costs. Costs were also shown to differ between children and adults. Mean EQ-5D utility score for adult patients varied from 0.52 in France (n = 42) to 0.73 in Hungary (n = 2), while for caregivers this score was consistently inferior to 0.87. CONCLUSION Our findings underline that, although its prevalence is low, FXS is costly from a societal perspective. They support the development of tailored policies to reduce the consequences of FXS on both patients and their relatives.
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Affiliation(s)
- Karine Chevreul
- URC Eco Ile de France, AP-HP, Paris, France.
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France.
- INSERM, ECEVE, U1123, Paris, France.
| | - Coralie Gandré
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - Karen Berg Brigham
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Est, Créteil, France
| | - Julio López-Bastida
- University of Castilla-La Mancha, Talavera De La Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Renata Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - Juan Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- University of Castilla-La Mancha, Toledo, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | | | - Domenica Taruscio
- National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Arrigo Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | - Georgi Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | | | - Panos Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, UK
| | - Ulf Persson
- The Swedish Institute for Health Economics, Lund, Sweden
| | - Giovani Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Abstract
INTRODUCTION So far, the latest survey which used the EQ-5D questionnaire to measure the health status of the Hungarian population was carried out in 2000. AIM To explore the health state of the Hungarian population by socio-demographic characteristics, and to compare it with the results from 2000. METHOD As part of an international research project, a cross-sectional, online survey was carried out among the general population in 2010 using the EQ-5D-3L questionnaire. RESULTS In total, 2281 respondents (female: 62.3%) completed the questionnaire with an average age of 40.8 years. The EQ-5D score ranged from 0.902 (in age-group 18-24) to 0.795 (65+). The authors found significant association between the EQ-5D score and all the socio-demographic variables (gender, age, education, income) included in the regression model (F(4,1967)=35.12, p=0.000). The results did not differ significantly from the health survey in 2000, except for the youngest population group (age 18-24), where significantly lower scores were found in the sample. CONCLUSIONS While life expectance increased by 3 years between 2000 and 2010, the health status of the Hungarian population did not change significantly, and might even decreased among young adults in fact. Inequalities in health status by income and education remain significant. In international comparison, the health status of the Hungarian population remains among the worst ones.
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Affiliation(s)
- Petra Baji
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 265. szoba, 1093.,CERGE-EI Prága, Csehország
| | - Valentin Brodszky
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 265. szoba, 1093
| | - Fanni Rencz
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 265. szoba, 1093.,Klinikai Orvostudományok Doktori Iskola, Semmelweis Egyetem Budapest
| | - Imre Boncz
- Egészségbiztosítási Intézet, Pécsi Tudományegyetem Pécs
| | - László Gulácsi
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 265. szoba, 1093
| | - Márta Péntek
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8., 265. szoba, 1093.,Reumatológiai és Fizioterápiás Osztály, Pest Megyei Flór Ferenc Kórház Kistarcsa
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86
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Dörner T, Strand V, Cornes P, Gonçalves J, Gulácsi L, Kay J, Kvien TK, Smolen J, Tanaka Y, Burmester GR. The changing landscape of biosimilars in rheumatology. Ann Rheum Dis 2016; 75:974-82. [PMID: 26964144 PMCID: PMC4893105 DOI: 10.1136/annrheumdis-2016-209166] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/18/2016] [Indexed: 12/30/2022]
Abstract
Biosimilars remain a hot topic in rheumatology, and some physicians are cautious about their application in the real world. With many products coming to market and a wealth of guidelines and recommendations concerning their use, there is a need to understand the changing landscape and the real clinical and health-economic potential offered by these agents. Notably, rheumatologists will be at the forefront of the use of biosimilar monoclonal antibodies/soluble receptors. Biosimilars offer cost savings and health gains for our patients and will play an important role in treating rheumatic diseases. We hope that these lower costs will compensate for inequities in access to therapy based on economic differences across countries. Since approved biosimilars have already demonstrated highly similar efficacy, it will be most important to establish pharmacovigilance databases across countries that are adequate to monitor long-term safety after marketing approval.
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Affiliation(s)
- Thomas Dörner
- Department of Medicine/Rheumatology and Clinical Immunology, Charité Universitätsmedizin, Berlin, Germany Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Vibeke Strand
- Division Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - João Gonçalves
- Faculty of Pharmacy at University of Lisbon, iMed- Research Institute for Medicines, Portugal
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Jonathan Kay
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, Massachusetts, USA
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Josef Smolen
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria Department of Medicine, Hietzing Hospital, Vienna, Austria
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Gerd R Burmester
- Department of Medicine/Rheumatology and Clinical Immunology, Charité Universitätsmedizin, Berlin, Germany
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87
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Gulácsi L, Rencz F, Poór G, Szekanecz Z, Brodszky V, Baji P, Péntek M. Patients' access to biological therapy in chronic inflammatory conditions; per capita GDP does not explain the intercountry differences. Ann Rheum Dis 2016; 75:942-3. [PMID: 26888946 DOI: 10.1136/annrheumdis-2015-208741] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/31/2016] [Indexed: 12/31/2022]
Affiliation(s)
- László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
| | - Gyula Poór
- First Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Zoltán Szekanecz
- Department of Rheumatology, University of Debrecen Medical and Health Science Center, Institute of Medicine, Debrecen, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary Department of Rheumatology and Physiotherapy, Flór Ferenc County Hospital, Kistarcsa, Hungary
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Baji P, Gulácsi L, Lovász BD, Golovics PA, Brodszky V, Péntek M, Rencz F, Lakatos PL. Treatment preferences of originator versus biosimilar drugs in Crohn's disease; discrete choice experiment among gastroenterologists. Scand J Gastroenterol 2016; 51:22-7. [PMID: 26059967 DOI: 10.3109/00365521.2015.1054422] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To explore preferences of gastroenterologists for biosimilar drugs in Crohn's disease. MATERIAL AND METHODS Discrete choice experiment was carried out involving 51 Hungarian gastroenterologists in May 2014. The following attributes were used to describe hypothetical choice sets: 1) type of the treatment (biosimilar/originator), 2) severity of disease, 3) availability of continuous medicine supply, 4) frequency of the efficacy check-ups. Multinomial logit model was used to differentiate between three attitude types: 1) always opting for the originator, 2) willing to consider biosimilar for biological-naïve patients only, 3) willing to consider biosimilar treatment for both types of patients. Conditional logit model was used to estimate the probabilities of choosing a given profile. RESULTS Men, senior consultants, working in inflammatory bowel disease center and treating more patients were more likely willing to consider biosimilar for biological-naïve patients only. Treatment type (originator/biosimilar) was the most important determinant of choice for patients already treated with biologicals, and the availability of continuous medicine supply in case of biological-naïve patients. The probabilities of choosing the biosimilar with all the benefits offered over the originator under current reimbursement conditions are 89% versus 11% for new patients, and 44% versus 56% for patients already treated with biological. CONCLUSIONS For gastroenterologist, the continuous medical supply would be one of the major benefits of biosimilars. However, benefits offered in the scenarios do not compensate for the change from the originator to the biosimilar treatment of patients already treated with biologicals.
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Affiliation(s)
- Petra Baji
- a 1 Department of Health Economics, Corvinus University of Budapest , Fővám tér 8, H-1093 Budapest, Hungary, Europe.,b 2 CERGE-EI Fellow, Politických vězňů 936/7 , 110 00 Praha 1-Nové Město, The Czech Republic, Europe
| | - László Gulácsi
- a 1 Department of Health Economics, Corvinus University of Budapest , Fővám tér 8, H-1093 Budapest, Hungary, Europe
| | - Barbara D Lovász
- c 3 1st Department of Medicine, Semmelweis University, Korányi Sándor utca 2a , H-1083 Budapest, Hungary, Europe
| | - Petra A Golovics
- c 3 1st Department of Medicine, Semmelweis University, Korányi Sándor utca 2a , H-1083 Budapest, Hungary, Europe
| | - Valentin Brodszky
- a 1 Department of Health Economics, Corvinus University of Budapest , Fővám tér 8, H-1093 Budapest, Hungary, Europe
| | - Márta Péntek
- a 1 Department of Health Economics, Corvinus University of Budapest , Fővám tér 8, H-1093 Budapest, Hungary, Europe.,d 4 Department of Rheumatology, Flór Ferenc County Hospital , Semmelweis tér 1, H-2143 Kistarcsa, Hungary, Europe
| | - Fanni Rencz
- a 1 Department of Health Economics, Corvinus University of Budapest , Fővám tér 8, H-1093 Budapest, Hungary, Europe.,e 5 Semmelweis University Doctoral School of Clinical Medicine , Üllői út 26, H-1085 Budapest, Hungary, Europe
| | - Péter L Lakatos
- c 3 1st Department of Medicine, Semmelweis University, Korányi Sándor utca 2a , H-1083 Budapest, Hungary, Europe
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Péntek M, Gulácsi L, Tóth E, Baji P, Brodszky V, Horváth C. A szakellátásban megjelenő osteoporosisos nők 10 éves csonttöréskockázata a FRAX ® alapján. Orv Hetil 2016; 157:146-53. [DOI: 10.1556/650.2015.30347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Identification of patients with high fracture risk is a key-point in osteoporosis care. Aim: To assess the fracture risk among osteoporotic women attending osteoporosis care in Hungary. Method: A cross-sectional survey was conducted in 2009 in 11 centres among women with osteoporosis aged ≥50 years. Main risk factors were recorded and 10-year fracture risk was calculated using the FRAX® for Hungary. Health status was assessed by EQ VAS. Results: 1301 patients with mean age of 68.5 (SD = 8.3) years and EQ VAS of 62.0 (SD = 17.2) participated, of whom 690 (53.0%) have already had previous fracture. Major osteoporotic and hip fracture FRAX® scores were 20.1 (SD = 13.9) and 10.6 (SD = 12.5), respectively (by 10-year age groups, mean: 18.5/9.3; 16.2/6.7; 23/13.5; 28.9/18.3). Patients with previous fracture had significantly higher scores (p<0.05). Conclusions: Similar rate of patients attend osteoporosis care for primary and secondary prevention. FRAX® score was higher than 7% in the majority of patients. The findings provide inputs for cost-effectiveness analyses and development of intervention thresholds in Hungary. Orv. Hetil., 2016, 157(4), 146–153.
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Affiliation(s)
- Márta Péntek
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8. 265. sz., 1026
- Reumatológiai és Fizioterápiás Osztály, Pest Megyei Flór Ferenc Kórház Kistarcsa
| | - László Gulácsi
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8. 265. sz., 1026
| | - Edit Tóth
- Reumatológiai és Fizioterápiás Osztály, Pest Megyei Flór Ferenc Kórház Kistarcsa
| | - Petra Baji
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8. 265. sz., 1026
| | - Valentin Brodszky
- Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem Budapest, Fővám tér 8. 265. sz., 1026
| | - Csaba Horváth
- I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
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90
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Rencz F, Baji P, Gulácsi L, Kárpáti S, Péntek M, Poór AK, Brodszky V. Discrepancies between the Dermatology Life Quality Index and utility scores. Qual Life Res 2015; 25:1687-96. [DOI: 10.1007/s11136-015-1208-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2015] [Indexed: 12/01/2022]
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91
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Moradi M, Rencz F, Brodszky V, Moradi A, Balogh O, Gulácsi L. Health status and quality of life in patients with psoriasis: an Iranian cross-sectional survey. Arch Iran Med 2015; 18:153-9. [PMID: 25773688 DOI: 0151803/aim.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psoriasis has a significant negative impact on patients' health-related quality of life (HRQOL). This study aims to evaluate HRQOL of adult patients with psoriasis in Iran, and explore the relationship between general and disease-specific outcome measures in psoriasis. METHODS Between May and August 2013, a cross-sectional questionnaire survey of consecutive outpatients was conducted at a single clinic in Shiraz, Iran. HRQOL was assessed by the general measure EuroQol 5 dimensions (EQ-5D), visual analogue scale (EQ VAS), and the disease-specific Dermatology Life Quality Index (DLQI). Disease severity was measured by the Psoriasis Area and Severity Index (PASI). RESULTS Sixty-two patients (76% males) completed the questionnaire with a mean age (SD) of 40.4 (17.5) years. Overall, 39% of the patients used only topical and 48% received systemic non-biological therapy in the past 12 months. Median EQ-5D, EQ VAS, DLQI and PASI scores were 0.73, 60, 8 and 11.75, respectively. Out of the 62 patients, 18%, 26%, 28%, 63%, and 63% reported some or severe problem in mobility, self-care, usual activities, pain/discomfort and anxiety/depression, respectively. EQ-5D and EQ VAS correlated moderately with DLQI (rs = -0.44 for both, p < 0.001), but only EQ VAS correlated significantly with PASI (rs = -0.31, p < 0.01). CONCLUSION This is the first study from Iran that assesses HRQOL in adult patients with psoriasis by EQ-5D and EQ VAS. Reduction in general HRQOL measured with EQ-5D and EQ-VAS is considerable, mostly in anxiety/depression and pain/discomfort dimensions. EQ-5D scores evaluated in this study provide country-specific data for economic evaluations.
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Affiliation(s)
- Mahshid Moradi
- Corvinus University of Budapest, Department of Health Economics, H-1093 Fővám tér 8, Budapest, Hungary.
| | - Fanni Rencz
- Corvinus University of Budapest, Department of Health Economics, H-1093 Fővám tér 8, Budapest, Hungary, Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
| | - Valentin Brodszky
- Corvinus University of Budapest, Department of Health Economics, H-1093 Fővám tér 8, Budapest, Hungary
| | | | - Orsolya Balogh
- Corvinus University of Budapest, Department of Health Economics, H-1093 Fővám tér 8, Budapest, Hungary
| | - László Gulácsi
- Corvinus University of Budapest, Department of Health Economics, H-1093 Fővám tér 8, Budapest, Hungary
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Gulácsi L, Brodszky V, Baji P, Kim H, Kim SY, Cho YY, Péntek M. Biosimilars for the management of rheumatoid arthritis: economic considerations. Expert Rev Clin Immunol 2015; 11 Suppl 1:S43-52. [DOI: 10.1586/1744666x.2015.1090313] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Rencz F, Kemény L, Gajdácsi J, Owczarek W, Arenberger P, Tiplica G, Stanimirović A, Niewada M, Petrova G, Marinov L, Péntek M, Brodszky V, Gulácsi L. Use of biologics for psoriasis in Central and Eastern European countries. J Eur Acad Dermatol Venereol 2015; 29:2222-30. [DOI: 10.1111/jdv.13222] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/12/2015] [Indexed: 01/31/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics; Corvinus University of Budapest; Budapest Hungary
- Semmelweis University Doctoral School of Clinical Medicine; Budapest Hungary
| | - L. Kemény
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - J.Z. Gajdácsi
- National Health Insurance Fund Administration of Hungary; Budapest Hungary
| | - W. Owczarek
- Department of Dermatology; Military Institute of Medicine; Warsaw Poland
| | - P. Arenberger
- Department of Dermatology; Charles University 3rd Medical Faculty; Prague Czech Republic
| | - G.S. Tiplica
- Dermatology Clinic 2; Colentina Clinical Hospital; Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - A. Stanimirović
- Department of Clinical Medicine; University of Applied Health Sciences; Zagreb Croatia
| | - M. Niewada
- Department of Experimental and Clinical Pharmacology; Medical University of Warsaw; Warsaw Poland
| | - G. Petrova
- Department of Social Pharmacy and Pharmacoeconomics; Faculty of Pharmacy; Medical University; Sofia Bulgaria
| | - L.T. Marinov
- Department of Social Pharmacy and Pharmacoeconomics; Faculty of Pharmacy; Medical University; Sofia Bulgaria
| | - M. Péntek
- Department of Health Economics; Corvinus University of Budapest; Budapest Hungary
| | - V. Brodszky
- Department of Health Economics; Corvinus University of Budapest; Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics; Corvinus University of Budapest; Budapest Hungary
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Rencz F, Gulácsi L, Tamási B, Kárpáti S, Péntek M, Baji P, Brodszky V. Health-related quality of life and its determinants in pemphigus: a systematic review and meta-analysis. Br J Dermatol 2015; 173:1076-80. [DOI: 10.1111/bjd.13848] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
- Semmelweis University Doctoral School of Clinical Medicine; Üllői út 26 H-1085 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Mária u. 41 H-1085 Budapest Hungary
| | - S. Kárpáti
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Mária u. 41 H-1085 Budapest Hungary
| | - M. Péntek
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
| | - P. Baji
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
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Baji P, Pavlova M, Gulácsi L, Groot W. Does the Implementation of Official User Charges Help to Eradicate Informal Payments - Lessons to be Learnt from the Hungarian Experience. Front Public Health 2015; 3:181. [PMID: 26236705 PMCID: PMC4505068 DOI: 10.3389/fpubh.2015.00181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/06/2015] [Indexed: 12/02/2022] Open
Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest , Budapest , Hungary ; Center for Economic Research and Graduate Education - Economics Institute (CERGE-EI) , Prague , Czech Republic
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht University , Maastricht , Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest , Budapest , Hungary
| | - Wim Groot
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht University , Maastricht , Netherlands ; Topinstitute for Evidence-Based Education Research (TIER), Maastricht University , Maastricht , Netherlands
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Brodszky V, Rencz F, Péntek M, Baji P, Lakatos PL, Gulácsi L. A budget impact model for biosimilar infliximab in Crohn's disease in Bulgaria, the Czech Republic, Hungary, Poland, Romania, and Slovakia. Expert Rev Pharmacoecon Outcomes Res 2015; 16:119-25. [PMID: 26162458 DOI: 10.1586/14737167.2015.1067142] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 12/15/2022]
Abstract
OBJECTIVES To estimate the budget impact of the introduction of biosimilar infliximab for the treatment of Crohn's disease (CD) in Bulgaria, the Czech Republic, Hungary, Poland, Romania and Slovakia. METHODS A 3-year, prevalence-based budget impact analysis for biosimilar infliximab to treat CD was developed from third-party payers' perspective. The model included various scenarios depending on whether interchanging originator infliximab with biosimilar infliximab was allowed or not. RESULTS Total cost savings achieved in biosimilar scenario 1 (interchanging not allowed) and BSc2 (interchanging allowed in 80% of the patients) were estimated to €8.0 million and €16.9 million in the six countries. Budget savings may cover the biosimilar infliximab therapy for 722-1530 additional CD patients. CONCLUSIONS Introduction of biosimilar infliximab to treat CD may offset the inequity in access to biological therapy for CD between Central and Eastern European countries.
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Affiliation(s)
- Valentin Brodszky
- a 1 Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093 Budapest, Hungary
| | - Fanni Rencz
- a 1 Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093 Budapest, Hungary.,b 2 Semmelweis University Doctoral School of Clinical Medicine, Üllői út 26, H-1085 Budapest, Hungary
| | - Márta Péntek
- a 1 Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093 Budapest, Hungary
| | - Petra Baji
- a 1 Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093 Budapest, Hungary
| | - Péter L Lakatos
- c 3 First Department of Medicine, Semmelweis University, Koranyi S. 2/A, H-1083 Budapest, Hungary
| | - László Gulácsi
- a 1 Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093 Budapest, Hungary
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Rencz F, Brodszky V, Péntek M, Balogh O, Remenyik E, Szegedi A, Holló P, Kárpáti S, Jókai H, Herszényi K, Herédi E, Szántó S, Gulácsi L. [Disease burden of psoriasis associated with psoriatic arthritis in Hungary]. Orv Hetil 2015; 155:1913-21. [PMID: 25417138 DOI: 10.1556/oh.2014.30044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 11/19/2022]
Abstract
INTRODUCTION Psoriasis is a frequent, chronic, systemic immune-mediated disease mainly affecting the skin and joints. AIM To assess health related quality of life and cost-of-illness in moderate to severe psoriasis associated with psoriatic arthritis. METHOD A cross-sectional questionnaire survey was conducted at two academic dermatology clinics in Hungary. RESULTS Fifty-seven patients (65% males) completed the survey with a mean age of 54.3±11.6 years and mean EQ-5D score of 0.48±0.4. Mean annual total cost was €8,977 per patient, of which 71% occurred due to biological therapy and 21% were indirect costs, respectively. Permanent work disability due to psoriasis accounted for €1,775 (95% of the indirect costs). Per patient costs of subgroups not receiving systemic therapy (21%), traditional systemic therapy (32%), and biological systemic therapy (47%) amounted to the sum of €1,729, €1,799, and €16,983, respectively. CONCLUSIONS Patients on biological therapy showed significantly better health related quality of life. As for health economics, the efficacy of systemic treatments is appropriate to be assessed together in patients with moderate to severe psoriasis associated with psoriatic arthritis, since actual health gain might exceed that reported in psoriasis or psoriatic arthritis separately.
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Affiliation(s)
- Fanni Rencz
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093 Semmelweis Egyetem, Általános Orvostudományi Kar Klinikai Orvostudományok Doktori Iskola Budapest
| | - Valentin Brodszky
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
| | - Márta Péntek
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093 Pest Megyei Flór Ferenc Kórház Reumatológiai Osztály Kistarcsa
| | - Orsolya Balogh
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
| | - Eva Remenyik
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Bőrgyógyászati Klinika, Bőrgyógyászati Allergológiai Tanszék Debrecen
| | - Andrea Szegedi
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Bőrgyógyászati Klinika, Bőrgyógyászati Allergológiai Tanszék Debrecen
| | - Péter Holló
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Sarolta Kárpáti
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Hajnalka Jókai
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Krisztina Herszényi
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Emese Herédi
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Bőrgyógyászati Klinika, Bőrgyógyászati Allergológiai Tanszék Debrecen
| | - Sándor Szántó
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Belgyógyászati Intézet, Reumatológiai Tanszék Debrecen
| | - László Gulácsi
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
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Péntek M, Kosztolányi G, Melegh B, Halász A, Pogány G, Baji P, Brodszky V, Vártokné Hevér N, Boncz I, Gulácsi L. [Cystic fibrosis -- disease burden and health-related quality of life of patients and their caregivers: results of the European BURQOL-RD survey in Hungary]. Orv Hetil 2015; 155:1673-84. [PMID: 25305725 DOI: 10.1556/oh.2014.30016] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Data on disease burden of cystic fibrosis in Hungary are scarce. AIM To assess quality of life and resource utilisations of patients with cystic fibrosis. METHOD In a cross-sectional survey (BURQOL-RD project), the EQ-5D-5L questionnaire was applied and healthcare utilisations were retrospectively surveyed. RESULTS 110 patients participated in the study (age-groups, year: 0-13, N = 48; 14-17, N = 12; ≥18, N = 50), median age at the diagnosis was 1 year. EQ-5D-5L score in age-groups 18-24 and 25-34 was significantly lower than in the general population (p<0.05). 75 patients (68%) attended pulmonology care, 55 patients (50%) were hospitalised in the past 6 and 12 months, respectively, and 57 patients (52%) were taking dornase alpha. Five adult patients (10%) received help from non-professional caregiver. CONCLUSIONS Cystic fibrosis leads to significant deterioration of quality of life. This study is the first from the Central Eastern European region that provides basic inputs for further health economic evaluations of cystic fibrosis care.
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Affiliation(s)
- Márta Péntek
- Budapesti Corvinus Egyetem Budapest Fővám tér 8., 265-ös szoba 1093 Pest Megyei Flór Ferenc Kórház Kistarcsa
| | | | - Béla Melegh
- Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
| | | | - Gábor Pogány
- Ritka és Veleszületett Rendellenességgel élők Országos Szövetsége Budapest
| | - Petra Baji
- Budapesti Corvinus Egyetem Budapest Fővám tér 8., 265-ös szoba 1093
| | | | | | - Imre Boncz
- Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
| | - László Gulácsi
- Budapesti Corvinus Egyetem Budapest Fővám tér 8., 265-ös szoba 1093
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Brodszky V, Péntek M, Komoly S, Bereczki D, Embey-Isztin D, Torzsa P, Gulácsi L. Nem diabeteses perifériás neuropathiás betegek életminőségének mérése magyarországi háziorvosi praxisokban végzett keresztmetszeti vizsgálat eredményei alapján. Ideggyogy Sz 2015. [DOI: 10.18071/isz.68.0325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Rencz F, Holló P, Kárpáti S, Péntek M, Remenyik É, Szegedi A, Balogh O, Herédi E, Herszényi K, Jókai H, Brodszky V, Gulácsi L. Moderate to severe psoriasis patients' subjective future expectations regarding health-related quality of life and longevity. J Eur Acad Dermatol Venereol 2014; 29:1398-405. [PMID: 25491660 DOI: 10.1111/jdv.12884] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/28/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Unrealistic expectations regarding treatments and clinical outcomes may lead to disappointment about therapy and sub-optimal compliance; nonetheless, these expectations have not been studied in psoriasis patients yet. OBJECTIVE To evaluate psoriasis patients' subjective future expectations regarding health-related quality of life (HRQOL) and life expectancy, and to explore clinical features associated with under- or overestimating behaviour. METHODS A cross-sectional questionnaire survey of consecutive adult patients with moderate to severe psoriasis was conducted. HRQOL expectations were recorded by applying the EQ-5D descriptive system for 6 months ahead and for future ages of 60, 70, 80 and 90 respectively. RESULTS In total, 167 patients (71% males) were included in the analysis with mean age of 50.4 ± 12.4 years and mean EQ-5D score of 0.71 ± 0.30. Overall 65% had chronic plaque psoriasis, 35% nail psoriasis, 35% scalp involvement, 29% psoriatic arthritis, 9% inverse psoriasis and 5% palmoplantar psoriasis respectively (combinations occurred). Participants expected 0.1 ± 0.23 mean improvement in EQ-5D within 6 months (P < 0.001) that achieves the minimum clinically important difference. Overall 37% expected improvement and 13% decline; however, 49% expected no changes in any of the five dimensions of EQ-5D within 6 months. Female gender, inverse or palmoplantar involvement and more severe psoriasis were likely associated with higher expectations. Patients at the initiation of their first biological at the time of the survey expected 0.18 ± 0.24 increase that seems to be realistic compared to the EQ-5D utility gain achieved in randomized controlled trials. Males expected by 2.7 ± 11.1 more, while females expected by 5.2 ± 9.3 less life years compared to the average statistical gender- and age-matched life expectancy (P < 0.05). Patients who expected to be alive at ages of 60, 70, 80 and 90 scored their future EQ-5D at ages of 60 to 90: 0.59 ± 0.46, 0.48 ± 0.41, 0.42 ± 0.41 and 0.22 ± 0.47 respectively. CONCLUSION Our findings highlight the importance of exploring expectations that might help to increase patients' compliance.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - É Remenyik
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - O Balogh
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - E Herédi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - K Herszényi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - H Jókai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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