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Background:The Immense cost of cancer treatment is one of the main challenges of health care systems all over the world including Iran. The aim of this study was to analyze the direct treatment costs of colorectal cancer patients in Isfahan, Iran.Methods:In this cross sectional study, the medical records of colorectal cancer (CRC) patients admitted to the Seyyed-al-Shohada Hospital “SSH” from 2005-2010 were reviewed. The profiles of 452 patients were examined. However based on inclusion, exclusion criteria a total number of 432 profiles were analyzed. All records including age, sex, treatment processes and treatment costs were extracted from the patients’ profiles and analyzed using Kruskal-Wallis test.Findings:The results showed that 56.1% of CRC patients were male. The mean age of patients suffering from CRC was 56 ± 13.4. More than Thirty-six percent of the patients were in stages 1-3 of CRC and more than half of them (64.4%) were in the 4th stage. The higher the stage of the cancer the higher the percentage of treatments used. 5-Fluorouracil and Leucovorin (5FU/LV) was the most common used chemical treatment protocol. The mean treatment cost for stage one was 10715 (±4927), for stage two 15920 (±3440), stage three 16452 (±2828) and for stage four was 16723 (±2555) US Dollars. The cost of drug treatment was the first cost driven between the medical services.Conclusion:CRC in Iranian population starts in younger age than people in western countries. This imposed considerable direct and indirect economic cost to the society. The direct medical cost of colorectal cancer in Iran is very higher than 38 million $. Screening programs could reduce the economic cost of CRC significantly.

BACKGROUND: The pharmaceutical bill is increasing at an alarming rate. The physician practice variation has a pronounced effect on healthcare spending. A number of factors can influence the prescribing behavior of physicians. The aim of this review was to identify the factors affecting the prescribing decision of physicians.METHODS: Electronic databases including Scopus, PubMed/MEDLINE CENTRAL, Cochrane Libraries and Google scholar were searched systematically for literatures on factors influencing prescribing decisions of physicians from 2000 to 2016. There was no restriction on the study designs.RESULTS: Thirty-three studies met the inclusion criteria from 1122 search results. A total of 33 factors were identified. The most frequent factors were patients’ clinical condition, pharmaceutical industries, physician attributes, patient preference and cost of medicine.CONCLUSION: Physicians’ personal attributes, cost of the medicine and pharmaceutical industries’ marketing and promotion strategies were mostly mentioned to influence prescribing decision. The identified factors showed that prescribing is not only geared for patient benefit, but also towards personal interest. The use of valid and reliable practice guidelines could reduce the negative impact of wide ranges of factors and promote the rational prescribing effectively.

Objectives The aim of this study was to evaluate the effect of antiretroviral therapy (ART) with or without condom use on the risk of sexual transmission of HIV. Methods A search of the literature was conducted in the PubMed, Web of Science, Cochrane, SCOPUS and EMBASE databases for studies dating back to 2008. The results were summarized as relative risks and incidence rates with 95% confidence intervals (CIs). The effect sizes were pooled using random‐effects models and heterogeneity was evaluated using the Cochrane Q test and I2. Results Of the 1424 studies retrieved in the initial search, 10 met the eligibility requirements. ART was associated with a 52% reduction in transmission risk compared to no ART, with a relative risk of 0.48 (95% CI 0.439–0.525) (Q = 0.524; I2 = 0.0%; overall effect Z = 15.99, P < 0.0001). ART vs. no ART caused a reduction in the risk from 5.6 person‐years (95% CI 3.26–9.62 person‐years) (Q = 0.771; I2 = 0.0%; overall effect Z = 6.25, P < 0.0001) in the untreated group to 0.85 person‐years (95% CI 0.28–2.99 person‐years) (Q = 0.038; I2 = 76.7%; overall effect Z = 0.11, P = 0.772) in the treated group, but not significantly so, which is equivalent to an 84% reduction in the risk of sexual transmission. In accordance with the Swiss National AIDS Commission declaration, ART with suppressed viral loads was associated with a minimal risk of transmission, with a median time at risk of 0.00 person‐years (95% CI 0.00–0.00 person‐years) (Q = 1.00; I2 = 0.0%; overall effect Z = 6.80, P < 0.0001). Conclusions ART and condom use were found to cause a significant reduction in the risk of sexual transmission of HIV in both homosexual and heterosexual populations, based on previous systematic reviews and meta‐analyses.

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