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- Polyzoi, M., et al.
(författare)
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The Prevalence of Plaque Psoriasis, Psoriatic Arthritis And The Overlap Between Them In Norway
- 2016
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Ingår i: Value in Health. - : Elsevier. - 1098-3015 .- 1524-4733. ; 19:7, s. A578-A578
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Psoriasis (PsO) and psoriatic arthritis (PsA) are chronic diseases that affect 1.5% to 8.5% and 8% to 21% of the Norwegian population, respectively, according to estimates in recent studies. The most common type of PsO is plaque psoriasis and the majority of patients with PsA also suffer from PsO. The disease burden of PsO and PsA are substantial and comparable to other major severe chronic diseases such as diabetes and rheumatoid arthritis. Patients with moderate to severe PsO and PsA are routinely referred from primary care to specialist care services.Objectives: The objective of this study was to estimate the prevalence of moderate to severe plaque psoriasis and PsA, and the overlap between them, as reported diagnosis in the National Patient Registry (NPR) in Norway.Methods: The total numbers of unique adult patients with main diagnoses of PsO and PsA (ICD-10 codes: L40+) in 2014, hospitalized or in contact with specialist services, were extracted from the NPR. Based on the Norwegian general population in 2014 (n=5,109,056), the prevalence of each disease was estimated.Results: The prevalence of moderate to severe plaque psoriasis was estimated to 0.14%. The prevalence of PsA was estimated to 0.18%, while the prevalence of the coexistence of moderate to severe plaque psoriasis and PsA equaled 0.02%.Conclusions: Since the milder PsO cases are treated in the primary care setting in Norway, the prevalence of plaque psoriasis reported in this study reflected the moderate to severe cases with registered visits to specialist health services. This population constitutes approximately 10% of the total PsO population, based on the literature. The results indicate that very few of the estimated prevalent PsO patients are treated by specialists. Also, to our knowledge this is the first study reporting the prevalence of PsO and PsA in specialist care services in Norway.
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| 2. |
- Virhage, M., et al.
(författare)
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Review of health economic models for antibiotics
- 2016
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Ingår i: ISPOR 19TH ANNUAL EUROPEAN CONGRESS RESEARCH ABSTRACTS. - : ELSEVIER SCIENCE INC. ; , s. A373-A373
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Konferensbidrag (refereegranskat)abstract
- Objectives: Critically appraise published health economic models evaluating treatments of bacteria resistant to antibiotics, focusing on methicillin-resistant Staphylococcus aureus (MRSA) and extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae.Methods: A structured literature review was conducted in Embase, identifying relevant publications by combining search facets for MRSA or ESBL, economic models, and antibiotics, excluding publications including the terms “animal” or “farm”. All search facets were search in the abstract and title, resulting in 40 publications. Two reviewers, blinded to the other’s initial evaluation, evaluated each of the titles and abstracts and found that 25 were relevant for a full review.Results: The absolute majority of the identified studies presented cost-effectiveness models with a decision-analytic approach and a time horizon ranging from two to four weeks. The site of infection studied was dominated by nosocomial pneumonia as well as skin and soft tissue infections caused by MRSA. Only one model concerned gram-negative pathogens. No model was identified studying ESBL as the cause of infection. The most common antibiotic agents modelled were linezolid, vancomycin, daptomycin or their combination with a median of two treatment lines modelled. One model studies the cost-effectiveness of carbapenems. Sources used for informing antibiotic efficacy data were primarily published literature, clinical trials or clinical expert opinion. The most common outcome measures modelled were direct medical costs and resource utilization as well as efficacy measured by treatment success or antibacterial usage estimates. Four models (16%) included quality-adjusted life years (QALYs) as outcome measure.Conclusions: The cost-effectiveness of linezolid and vancomycin for treatment of MRSA has been well-studied in various types of infections. There is a need for further cost-effectiveness and cost-benefit studies on antibiotic failure in more than two treatment lines, especially in carbapenem treatment of infections caused by ESBL, as these pose a significant resistance threat today.
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| 3. |
- Geale, Kirk, et al.
(författare)
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Estimating the Value of A New Antibiotic : A Novel Approach Using Esbl As A Case Study
- 2016
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Ingår i: Value in Health. - : Elsevier. - 1098-3015 .- 1524-4733. ; 19:7, s. A422-A423
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Develop a model capable of estimating the value of a new antibiotic for use in treating last-line patients not eligible for, or having failed on, all currently available antibiotic treatments.Methods: Ten annual cohorts of incident last-line patients (total of 314) infected with extended spectrum beta-lactamase (ESBL) -producing bacteria were modelled from the onset of the last-line infection over the course of their remaining life, in a scenario where a new antibiotic was available and one where it was not. Efficacy was measured by mortality, where 5% (95%) of patients died due to the infection in the scenario with(out) a new antibiotic. In the scenario with a new antibiotic, the mortality rate increased by 0.5% annually. Costs including lab tests, hospital stays, and productivity loss were calculated in both scenarios. Quality-adjusted life-years gained (QALYs) were estimated using weights for patients with an infection (0.61) and after recovery (0.84), in addition to disutility incurred by one caregiver per patient (-0.14). Differences in costs, QALYs, deaths, and days off work were calculated between the two arms; costs and QALYs were discounted to the present year. The value of a new antibiotic is reflected in the incremental results.Results: In the last-line ESBL population of 314 patients over 10 years, the availability of a new antibiotic resulted in SEK 20.4 million in cost saving, 2795 QALYs gained, 273 fewer infection-caused deaths, and 2198 fewer days off work.Conclusions: Valuation of a new antibiotic is a high public health priority due to increasing antibiotic resistance and decreasing rates of development of new antibiotics. Access to a new antibiotic for last-line patients provides a large benefit to society, using ESBL as case-study. The results are conservative as they exclude factors that are relatively difficult to estimate such as the risk of an outbreak.
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