Background: To compare the costs and effects of paliperidone extended release (ER), a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone) over a 1-year time period.

Aims To estimate the annual cost of treatment for Type 2 diabetic patients in Greece and investigate the effect of blood glucose regulation on patient cost.Methods A multipoint data collection procedure based on the patient records of 51 geographically distributed physicians was used in order to obtain the necessary data for the analysis and the construction of the patient cost model. Patients were classified as controlled (i.e. maintaining blood glucose regulation for the 1 year retrospective time frame of the analysis) and noncontrolled (the patients failing to do so in the specified time period). Cost categories included pharmaceutical expenditure, laboratory ⁄ diagnostic tests and consultation fees. Costs attributable to hospitalizations due to diabetic complications were not included. Calculations were based on 2007 fees and prices, and costs are expressed in Euros.Results The average annual cost of treatment for controlled patients was estimated at 981.72€ (95% confidence interval, 940.66-1023.01€), whereas for non-controlled patients it was 1566.12€ (95% confidence interval, 1485.42-1650.20€). Noncontrolled patients had 29.7% higher annual pharmaceutical costs (340.50 vs. 441.96€), 70% higher costs for laboratory ⁄ diagnostic tests (422.54 vs. 718.49€) and 85.5% higher consultation costs (218.68 vs. 405.67€) compared with their controlled peers. The average cost for a Type 2 diabetic patient in Greece, regardless of blood glucose regulation, was 1297.30€ (95% confidence interval, 1244.42-1349.61€).Conclusions Failing to control blood glucose levels within 'glycaemic goals', apart from the clinical consequences, can also have a significant financial impact, resulting in a 59.5% increase in the mean annual patient cost. Diabet. Med. 27, 679-684 (2010)

IntroductionMeticillin-resistant staphylococcus aureus (MRSA) is an important cause of antimicrobial-resistant infections worldwide. Its prevalence remains high in the Greek hospital setting. Complicated skin and soft tissue infections (cSSTIs) due to MRSA are associated with prolonged hospitalization, additional healthcare costs and significant morbidity. The purpose of this study was to conduct a cost analysis and a budget impact analysis relative to different management scenarios for MRSA-cSSTIs from a hospital perspective.MethodsEqual efficacy was assumed for the pharmacotherapies under evaluation and resource use was elicited via an expert panel of seven local infectious disease specialists. The model was based on a previously published economic model that was adapted for the Greek hospital setting and included a decision tree for the management of hospitalized patients with MRSA-cSSTIs, which simulated costs and outcomes for the duration of hospitalization according to the therapeutic scenario. Inpatient costs consisted of hospitalization, diagnostic/laboratory testing, physician visits and antibiotic treatment.ResultsCurrent economic impact of MRSA-cSSTIs for the inpatient setting in Greek hospitals was estimated at €29,196,218. Total per patient cost according to first-line agent was €2,457, €2,762, €2,850, €3,494 and €3,094 and mean length of stay was 9.2, 12.5, 10.3, 13.0 and 14.0 days for linezolid, vancomycin, daptomycin, tigecycline, and teicoplanin, respectively. An estimated 10,287 MRSA-cSSTI patients are treated annually in Greek hospitals. Thus, increasing the use of linezolid by 11% over a 3-year period (current use 19%; 3 year projection 30%), for the management of MRSA-cSSTIs, could result in 3-year savings of €896,065.ConclusionManagement of MRSA-cSSTI requires intensive resource use; overall healthcare costs differ according to the chosen first-line treatment. In light of considerable budget constraints, development of hospital strategies which facilitate early discharge, such as the introduction of clinical criteria and guidelines for switching from intravenous to oral MRSA-cSSTI therapy, could result in substantial savings for the Greek hospital budget.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-014-0044-8) contains supplementary material, which is available to authorized users.

longstanding illness, absenteeism due to health problems, and at least some limitations in usual activities. The differences of the distributions between the two waves were examined with the χ 2 test. Income and education-related health inequalities were explored with the Erreygers Normalised Concentration index (C), and the overall performance with the Health Achievement index (I). Results: The prevalence of self-rated bad health decreased from 8.1% to 6.8% (p< 0.001), while it increased for long-term illness (39.7% vs. 49.3%, p< 0.001), absenteeism (15.9% vs. 16.3%, p< 0.001) and limitations (22.8% vs. 29.8%, p< 0.001) during the crisis. Pro-rich inequalities in self-rated bad health, longstanding illness and limitations became pro-poor in 2014 (all p< 0.001), while absenteeism was further concentrated in richer individuals (p = 0.108). Self-rated bad health and longstanding illness was less concentrated in the less educated categories (p< 0.001 and p= 0.522, respectively), and absenteeism was more concentrated in more educated individuals in 2014 (p= 0.039), while only the distribution changes in limitations favoured the less educated ones (p= 0.070). The overall country performance improved for self-rated bad health and absenteeism, and declined for limitations and longstanding illness concerning both income and education health inequalities. ConClusions: In general, population health has deteriorated during the crisis in Greece, while health inequalities have dampened in favour of the lower strata, possibly due to latent health effects of downward socioeconomic mobility.

chart review study of patients aged 1-12 years with a primary varicella diagnosis between 2011 and 2015. Healthcare resource utilization (HCRU) associated with varicella, unit costs, and work loss were used to estimate direct and indirect costs. All costs are presented in 2015 Polish Zloty (PLN) / Euros (€ ). Results: 150 children with varicella were included (75 outpatients, 75 inpatients), with a mean age of 3.9 (SD: 2.6) and 4.2 (SD: 2.3) years, respectively. One or more complications were experienced by 14.7% of outpatients and 82.7% of inpatients, the most common being skin and soft tissue infections, dehydration, pneumonia, and cerebellitis. HCRU estimates included use of over-the-counter (OTC) medications (80.0% outpatients, 81.3% inpatients), prescription medications (80.0% outpatients, 93.3% inpatients), tests/procedures (0.0% outpatients, 69.3% inpatients), and consultation with allied health professionals (0.0% outpatients, 24.0% inpatients). The average duration of hospital stay was 4.7 (95% CI: 4.1 , 5.3) days for inpatients. The total combined direct and indirect cost per varicella case was 5013.3 PLN / € 1,198.1, for inpatients and 1027.2 PLN/ € 245.5, for outpatients. The overall annual cost of varicella in Poland for children aged 1-15 years in 2015 was estimated at 177,655,759.6 PLN,/€ 42,458,716.0. ConClusions: Varicella is associated with substantial clinical burden in Poland, resulting in the utilization of a significant amount of healthcare resources.