Health care costs and functional outcomes of road traffic injuries in the Lazio region of Italy

Analisi di impatto sul budget sanitario italiano di enzalutamide per il trattamento del carcinoma prostatico metastatico ormono-sensibile

Backgroud:

After demonstrating additional benefit versus standard of care in ARCHES and ENZAMET studies, enzalutamide was reimbursed in Italy in May 2022 by the National Health Service (NHS) for the treatment of hormone-sensitive metastatic prostate cancer (mHSPC).

Objective:

This study estimates the financial impact associated to the introduction of enzalutamide for patients with mHSPC.

Methods:

A budget impact model was developed with a dynamic cost calculator approach, in which the impact on subsequent lines of therapy was considered. The analysis considered the NHS perspective and a 3-year time horizon. Included costs were related to drug acquisition and administration, monitoring, patient follow-up and adverse events. Eligible population was estimated based on published literature, real-world data and experts’ opinion while market shares were assessed considering real-world data and assumptions. National tariffs and published literature were considered for unit costs.

Results:

Eligible population was estimated at 6,200, 6,206 and 6,212 in years 1, 2 and 3 respectively. The introduction of enzalutamide, considering a progressive increase of market shares of 10%, 18% and 25%, is expected to overall increase NHS healthcare expenditure by € 688 thousands and € 2.6 and € 5.6 million in years 1, 2 and 3 respectively, corresponding on average to 1.55% of the overall prostate cancer expenditure.

Results are robust across one-way sensitivity analyses, while confidential discount agreements of on-patent drugs might significantly impact the estimates.

Conclusion:

The introduction of enzalutamide for the treatment of adult patients with mHSPC is expected to increase patients’ health with a moderate impact on costs for the Italian NHS.

The Orthopedic Injury Burden of Personal Mobility Devices in Singapore - Our Experience in the East Coast

PURPOSE

Personal mobility devices (PMDs) have become increasingly popular as a modality of transport worldwide. Starting out as novelty toys, PMDs are gradually being adopted as the mainstream mode of travel. There is an increasing number of accidents involving both PMD riders and other road users since its introduction, leading to a concomitant increase in demand for healthcare resources to manage the injuries. The main objective of this study was to evaluate the inpatient cost and the orthopedic injury pattern due to PMD accidents.

METHODS

All patients admitted to the Department of Orthopedic Surgery between December 2016 to February 2018 with injuries due to PMD accidents were recruited. Data collection was performed retrospectively on the demographic profiles, injury patterns, admission related outcomes and expenditures of these patients.

RESULTS

43 patients were included in this study. The mean duration of admission was 7.81 days and the median cost of admission was S$7835.01 (approximately US$5620). These were comparable to accidents arising from other modes of transport, such as motorcycles and bicycles. In addition, more than 80% of patients were not wearing protective gear at time of accident. These patients had a slightly higher median cost payable per patient as compared to those who donned protective gear, with a difference of S$1669.78 (approximately US$1221).

CONCLUSION

There is a significant health and financial cost to the individual and society from PMD injuries and admission. This can be reduced with strict regulations on PMD use, advocating protective gear use, and promoting awareness on safety measures and the consequences of PMD accidents. The most common injury mechanism and orthopedic injury type for PMD accidents are different from motorcycle accidents.

Comparative Study of Stewardship of Road Traffic Injuries Prevention with a Focus on the Role of Health System; Three Pioneer Countries and Three Similar to Iran

OBJECTIVE

To compare the stewardship of road traffic accidents (RTIs) prevention in three pioneer countries and three similar ones to Iran.

METHODS

In this descriptive comparative study, the United States of America, Sweden, and Brazil as the pioneer countries in RTIs prevention were compared to the India, Pakistan, and Turkey as the countries socioeconomically similar to Iran. Embase, PubMed, Scopus, IranDoc, IranMedex, SID, and MagIran were searched. Also a hand search conducted on websites and search engines using related keywords.

RESULTS

In the pioneer countries in RTIs prevention there was a delegation to a particular organization. In the other three countries a part of the Ministry of Transportation had the overall responsibility of RTIs. In Iran there was uncertainty in the stewardship of RTIs prevention. There was little evidence on the role and activities of health systems in RTIs prevention.

CONCLUSION

It seems necessary to define a lead agency organization on RTIs prevention in Iran with sufficient authority and resources. This study also recommends conducting reliable studies to investigate the possible roles that the health system of a country can assume regarding the RTIs prevention.

[Road traffic injuries in Catalonia (Spain): an approach using the minimum data set for acute-care hospitals and emergency resources]

OBJECTIVE

To verify the usefulness of the minimum data set (MDS) for acute-care hospitals and emergency resources for the study of road traffic injuries and to describe the use of health resources in Catalonia (Spain).

METHODS

The study population consisted of patients treated in any kind of emergency service and patients admitted for acute hospitalization in Catalonia in 2013. A descriptive analysis was performed by age, gender, time and clinical variables.

RESULTS

A total of 48,150 patients were treated in hospital emergency departments, 6,210 were attended in primary care, and 4,912 were admitted to hospital. There was a higher proportion of men (56.2%), mainly aged between 20 and 40 years. Men accounted for 54.9% of patients with minor injuries and 75.1% of those with severe injuries. Contusions are the most common injury (30.2%), followed by sprains (28.7%). Fractures mostly affected persons older than 64 years, internal injuries particularly affected men older than 64 years, and wounds mainly affected persons younger than 18 years and older than 64 years. In the adult population, the severity of the injuries increased with age, leading to longer length of stay and greater complexity. Hospital mortality was 0.2%. Fractures, internal injuries and wounds were more frequent in the group of very serious injuries, and sprains and contusions in the group of minor injuries.

CONCLUSIONS

MDS records (acute hospitals and emergency resources) provide information that is complementary to other sources of information on traffic accidents, increasing the completeness of the data.