Objectives: The aim of this study was to conduct a review of health technology assessments (HTAs) in cervical cancer screening to highlight the most common metrics HTA agencies use to evaluate and recommend cervical cancer screening technologies.Methods: The Center for Reviews and Dissemination (CRD), MedLine, and national HTA agency databases were searched using keywords (“cervical cancer screening” OR “cervical cancer” OR “cervical screening”) and “HTA” from January 2000 to October 2014. Non-English language reports without English summaries, non-HTA reports, HTAs unrelated to a screening intervention and HTAs without sufficient summaries available online were excluded. We used various National Institute for Health and Care Excellence (NICE) methods to extract key assessment criteria and to determine whether a change in screening practice was recommended.Results: One hundred and ten unique HTA reports were identified; forty-four HTAs from seventeen countries met inclusion criteria. All reports evaluated technologies for use among women. Ten cervical screening technologies were identified either as an intervention or a comparator. The most common outcome metric evaluated was diagnostic accuracy, followed by economic effectiveness. Additional outcome metrics such as the use of adjunct testing, screening intervals, and age-specific testing were commonly evaluated. Nearly one-third (fifteen of forty-four) of HTAs recommended a change in practice.Conclusions: This review highlights popular metrics used in HTAs for cervical cancer screening. Clinical and economic effectiveness metrics have been consistently assessed in HTAs, while the use of adjunct testing, screening intervals, and age-specific screening became increasingly prevalent from after 2007. Moreover, we observed an increase in optimized recommendations after 2007.

Background: The peak prevalence of iron deficiency is in children 6 months to 3 years of age, a sensitive period for neuro development. Our study objective was to examine the costutility of a proposed iron deficiency screening program for 18monthold children. Methods: We used a decision tree model to estimate the costs in 2019 Canadian dollars and qualityadjusted life years (QALYs) associated with 3 iron deficiency screening strategies: no screening, universal screening and targeted screening for a highrisk popu lation. We used a societal perspective and assessed lifetime QALY gains. We derived outcomes from the literature and prospectively collected data. We performed oneway and probabilistic sensitivity analyses to assess parameter uncertainty.

The Pharmacy and Therapeutic Committee in the hospital planned to study the aggregate medicine use in the hospital. After implementation of the Essential Drug List (EDL) 2011, it was important to know the consumption and cost contributed by each pharmaceuticals in the list so that further revisions could be done on the list annually. METHODS: The study was conducted for one year using Always Better Control (ABC) analysis of pharmaceuticals in the EDL. Pharmaceuticals from the EDL were categorized for A (70%) B (20%) C (10%) categories. The calculations were done from a period of January 11, 2011 to January 11, 2012 using the data from the hospital billing database. RESULTS: The total annual drug expenditure (ADE) was Rs. 2,61,78,251. Out of 311 pharmaceuticals in the list, 47 (15%) were in A group, 60 (19%) were in B group and the remaining 204 (66%) were in C group. In the A group 45% of the pharmaceuticals were belong to ATC category J (Antimicrobials). Out of the top 10 pharmaceuticals, the costlier one was Anti D Immunoglobulin costing Rs. 1995. But it came on sixth position as the consumption was lesser than the other ones in the top. The first one was Lopinavir-Ritonavir combination with an annual cost of 13, 76529. Insulin was on fourth position with an annual expenditure just short of one million Indian Rupees. The top 10 include 3 antivirals and 2 anti-bacterial preparations showing the high consumption and costs of the anti-microbial agents. The least unit cost in the A category was Rs. 0.18 for ferrous sulphate -folic acid combination. CONCLUSIONS: Antimicrobilas consumed major resources of the charity hospital. Control on antimicrobial prescription with updated protocols and adoption of government free supply of anti-retroviral drugs will substantially reduce the hospital budget on medicines.

No abstract

No abstract