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Mokhtari AM, Barouni M, Moghadami M, Negahdaripour M, Mirahmadizadeh A. Estimating costs of hepatitis B vaccination in infants: experimental evidence of the expanded program on immunization in Southern Iran. J Public Health (Oxf) 2021; 44:558-564. [PMID: 33866375 DOI: 10.1093/pubmed/fdab118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 02/24/2021] [Accepted: 03/23/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Health costs have increased significantly around the world, and cost assessments have become important. This study aimed to collect cost of the resources used in the national hepatitis B immunization program in Southern Iran. METHODS Costs were calculated by investigating the available documents as well as consulting with knowledgeable personnel. These costs were collected using the data from Shiraz University of Medical Sciences. According to the health payer's perspective, the indirect costs of the people were not taken into account. All current and capital costs in year 2017 were calculated and converted to US dollars (USDs). RESULTS In 2017, 33 204 children received hepatitis B vaccine. The total cost of the national hepatitis B vaccination program in Shiraz and the cost of vaccination per child were 473 506 and 14.26 USD, respectively. However, the cost of inoculation of hepatitis B vaccine per dose was estimated at 3.20 USD. Personnel costs constituted the highest proportion (53.84%) of total costs. CONCLUSIONS The cost of hepatitis B vaccination in Iran was lower than other countries. Considering that personnel costs had the largest proportion, it is recommended that proper measures be taken to monitor and modify these costs if necessary.
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Affiliation(s)
- Ali Mohammad Mokhtari
- Department of Epidemiology and Biostatistics, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohsen Barouni
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manica Negahdaripour
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Marinho RT, Costa A, Pires T, Raposo H, Vasconcelos C, Polónia C, Borges J, Soares M, Vilar G, Nogueira AM. A multidimensional education program at substance dependence treatment centers improves patient knowledge and hepatitis C care. BMC Infect Dis 2016; 16:565. [PMID: 27733137 PMCID: PMC5062838 DOI: 10.1186/s12879-016-1883-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/01/2016] [Indexed: 12/11/2022] Open
Abstract
Background HCV treatment among people who inject drugs (PWID) is low. Education programs may be suitable strategies to improve patients’ knowledge about their condition and to overcome barriers to access treatment. Methods The Health Educational Program (HEP) consisted of patient workshops and educational videos and leaflets, and healthcare professionals’ workshops. HEP was implemented at seven substance dependence treatment centers (STDC) in Portugal. The study comprised two cross-sectional evaluations conducted before and after HEP. At both evaluations, adult patients with confirmed HCV diagnosis and registered in the STDC were consecutively included. For patients that completed both evaluations, the overall knowledge score were calculated and compared with McNemar test. Linear regression modelling was used to evaluate factors associated with baseline knowledge. Rates of referral and attendance to referral specialist, treatment proposal, initiation and retention at both evaluations were also compared with McNemar test. Results Overall, 504 patients with chronic hepatitis C were included: 78 % male, mean age 42.3 ± 6.6 years, 14 % school education ≤ 4 years, disease duration 11.0 ± 6.0 years and 26 % HIV co-infected. A higher baseline knowledge was independently associated with educational level ≥ 10 years (regression coefficient [B] =15.13, p < 0.001), current use of intravenous drugs (B = 7.99, p = 0.038), previous referral for treatment (B = 4.26, p = 0.008) and previous HCV treatment (B = 5.40, p = 0.003). Following HEP, mean knowledge score increased from 69 % to 79 % (p < 0.001). The rate of patient referral to a liver specialist increased from 56.2 % to 67.5 % (p < 0.001). Conclusions An HEP conducted at STDCs improved significantly patient knowledge about hepatitis C, even among patients with a high baseline knowledge. The HEP has also increased the rate of referral to the liver specialist and showed a great potential to support healthcare professionals in managing HCV. Education programs may promote treatment access among PWID, a population that represents the majority of HCV infected patients. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1883-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rui Tato Marinho
- Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Lisbon, Hospital Santa Maria - Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, Lisbon, 1649-035, Portugal.
| | - António Costa
- UD Centro das Taipas, Parque de Saúde de Lisboa - Av. Brasil n.° 53, Pavilhão 2, 1° andar, 1749-002, Lisbon, Portugal
| | - Teodomiro Pires
- ETET de Almada, Rua das Terras dos Cortes Reais n°1, 2805-025, Almada, Portugal
| | - Helena Raposo
- ETET do Barreiro, Rua Almirante Reis n°50, 2830-326, Barreiro, Portugal
| | - Carlos Vasconcelos
- ETET de Gondomar, Rua Caminho de Pevidal, R/C - S/N, 4420-264, Gondomar, Portugal
| | - Cristina Polónia
- ETET de Setúbal, Praça da República, 2900-587, Setúbal, Portugal
| | - Joaquim Borges
- ETET da Figueira da Foz, Rua Doutor Calado 2, Figueira da Foz, 3080-153, Figueira da Foz, Portugal
| | - Mariana Soares
- ETET Eixo Oeiras Cascais, Rua Professor Orlando Ribeiro, n.°3A, B, n.° 5A, B e n.° 7, 2740-222, Porto Salvo, Portugal
| | - Graça Vilar
- SICAD- General-Directorate for Intervention on Addictive Behaviours and Dependencies, Avenida da República, n° 61, 3° piso, 1050-189, Lisbon, Portugal
| | - Ana Maria Nogueira
- MSD Portugal, a subsidiary of Merck & Co., Inc., Quinta da Fonte, Edifício Vasco da Gama, 19, 2770-192, Paço de Arcos, Portugal
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Panduro A, Roman S. Need of righteous attitudes towards eradication of hepatitis C virus infection in Latin America. World J Gastroenterol 2016; 22:5137-42. [PMID: 27298556 PMCID: PMC4893460 DOI: 10.3748/wjg.v22.i22.5137] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 04/22/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023] Open
Abstract
Over the last few years, we have expanded our knowledge on numerous facets of the hepatitis C virus (HCV). Beginning with its discovery and viral life cycle, its impact on health, the development of liver disease and currently, effective antiviral treatments. The latter point has become of great interest throughout the developed world, where the possible eradication of HCV through specific strategies to reach all HCV-infected people has been announced. However, this scenario is very different in the countries of Latin America (LA), in which < 2% of infected patients requiring treatment have access to HCV medications. It has been estimated that at least ten million Latin Americans may be infected with HCV. Despite the numbers, viral hepatitis does not seem to be considered a health problem in this region of the world. This reality poses a challenge for politicians and governments of these countries, as well as to the pharmaceutical industry, the medical practitioners, and academics in LA. In this editorial, we state the need for alterations in the attitudes of the integral players involved in this situation. A recognition shift could help to create preventive strategies of viral hepatitis and to advocate for accessibility to new HCV treatments.
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Turner SJ, Brown J, Paladino JA. Protease inhibitors for hepatitis C: economic implications. PHARMACOECONOMICS 2013; 31:739-751. [PMID: 23839698 DOI: 10.1007/s40273-013-0073-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Chronic hepatitis C virus (HCV) infection, a blood-borne virus, is the leading cause of chronic liver disease and liver transplantation worldwide. Chronic HCV infection is usually asymptomatic in the early stages of the disease, making an estimation of the total population affected difficult to elicit. The gold standard treatment option to date has been a combination of pegylated interferon and ribavirin. Recent developments have led to the introduction of two protease inhibitors for use in chronic HCV-boceprevir and telaprevir. Phase III studies have shown both agents have the potential to significantly increase the probability of attaining a sustained virologic response (the primary outcome of interest in chronic HCV) in genotype 1 infections. However, the added cost of these agents also presents the need for decision makers to determine their place on drug formularies. The protease inhibitors are to be administered as triple therapy with the existing gold standard. However, significant variation exists as to the proposed duration of triple therapy, use of lead-in pegylated interferon and ribavirin and subsequent pegylated interferon therapy after finishing the course of triple therapy. Treatment algorithms also exist for the use of stopping rules in the case of early non-responders.The aim of this review is to highlight the current understanding of the economic impact protease inhibitors may have on health care systems and considerations required in the treatment of HCV. Economic and health-related quality of life issues are addressed from multiple viewpoints. The major aspects of the economic evaluations, to date, that included triple therapy as an alternative in the treatment of chronic HCV are brought to light. Future economic evaluations in alternative settings would be useful. The review also emphasizes the challenges for future research. This includes the potential for new therapies to no longer require inclusion of pegylated interferon and/or ribavirin, as well as the use of protease inhibitors in non-genotype 1 patients or those with significant co-morbidities such as HIV/AIDS.
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Affiliation(s)
- Stuart J Turner
- School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, 205 Kapoor Hall, Buffalo, NY 14214, USA
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Surjadi M, Torruellas C, Ayala C, Yee HF, Khalili M. Formal patient education improves patient knowledge of hepatitis C in vulnerable populations. Dig Dis Sci 2011; 56:213-9. [PMID: 20972850 PMCID: PMC3008930 DOI: 10.1007/s10620-010-1455-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 10/05/2010] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hepatitis C (HCV) knowledge is limited in injection drug users (IDU). Vulnerable populations including IDUs are disproportionally affected by HCV. Effective HCV education can potentially reduce disparity in HCV prevalence and its outcome in this population. AIM This study aimed to assess the impact of formal HCV education and factors associated with improved HCV knowledge in the vulnerable population. METHODS Over 18 months, 201 HCV-infected patients underwent a 2-h standardized education and completed demographic and pre- and post-education questionnaires. RESULTS Patient characteristics were: 69% male, mean age 49±10, 49% White (26% AA, 10% Latino), 75% unemployed, 83% high school education and above, 64% were IDU, and 7% were HIV co-infected. On multivariate analysis, baseline knowledge scores were higher in patients with at least a high school education (coef 7.1, p=0.045). Baseline knowledge scores were lower in African Americans (coef -12.3, p=0.004) and older patients (coef -0.7, p=0.03). Following HCV education, the overall test scores improved significantly by 14% (p=0.0001) specifically in the areas of HCV transmission (p=0.003), general knowledge (p=0.02), and health care maintenance (p=0.004). There was a high compliance with liver specialty clinic attendance following education. CONCLUSIONS Formal HCV education is effective in improving HCV knowledge. Although White race, younger age, and higher education were predictors of having more HCV knowledge prior to education, all patients independent of racial background had a significant improvement in their knowledge after education. Therefore, promoting effective HCV education among vulnerable populations may be an important factor in reducing the disparities in HCV disease.
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Affiliation(s)
- Miranda Surjadi
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110 USA
| | - Cara Torruellas
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110 USA
| | - Claudia Ayala
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110 USA
| | - Hal F. Yee
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110 USA ,UCSF/SFGH Center for Specialty Access & Quality, San Francisco, CA USA
| | - Mandana Khalili
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110 USA ,UCSF/SFGH Center for Specialty Access & Quality, San Francisco, CA USA
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