PCV106 Affordability of Anti-Hypertensive Medication in Egypt Under Current Reimbursement Systems

Abstract

OBJECTIVES:To assess item analysis and dimensional validity of a new questionnaire developed to measure Satisfaction with medical care in patients with atrial fibrillation, in order to accomplish item reduction. METHODS: The initial instrument was composed by 37 items, arranged in 6 dimensions: 1-Efficacy (4 items), 2-Ease and convenience (7 items), 3-Impact on daily activities (11 items), 4-Satisfaction with medical care (6 items), 5-Medication undesired effects (6 items), and 6-Overall satisfaction (4 items). Items and dimensions where extracted from reviewing previous English instruments, 3 focus groups with chronic patients, and a panel composed by 8 experts. Additionally 3 Visual Analog Scales (VAS) measuring Quality of Life, Effectiveness and Overall Satisfaction were applied. A convenience sample of 118 patients was used. Classic psychometric theory item analysis techniques, exploratory factor and confirmatory factor analysis, test-retest and correlation with VAS scales were used. RESULTS: The questionnaire was reduced in length to 25 items, but the Impact dimension had to be divided in 2 dimensions: Treatment inconvenience and Treatment Control. The reduced version presents an overall Cronbach alpha of 0.861, with acceptable dimensional reliabilities (0.764-0.908). Individual dimensions were well formed and correlated in different degrees, being the dimension of Satisfaction with medical care the most independent one. Test-retest correlations were high (0.784-0.965) and correlations with VAS scales were meaningful. CONCLUSIONS: The 25-item questionnaire shows good reliability and validity to assess satisfaction with medical care in patients with atrial fibrillation. Further research is needed to examine if the questionnaire could be generalized to different populations of patients with atrial fibrillation. OBJECTIVES:To describe demographical and medical characteristics of patients treated with bi-or multi-antihypertensive therapies and to outline the link between therapeutic scheme, blood pressure control and patients co morbidities. METHODS: A retrospective study was undertaken, based on the IMS Lifelink Electronic Medical Records database (Disease Analyzer), investigating age, gender, blood pressure control and co morbidities according to the number and type of associated antihypertensive therapies. RESULTS: A total of 13,618 patients, treated by bi-or multi-antihypertensive therapies and for whom blood pressure levels were available have been included in a 2008 study cohort (mean age ϭ 66.8, 48% men). Respectively 39% and 58% of patients had a controlled blood pressure depending on the threshold of the control (Ͻ140/90 or Ͻϭ140/90), showing the importance of the precise threshold in real-life. Respectively 1.5% and 0.3% of patients had a blood pressure of over 160/100 and over 180/110. Significantly more patients (p Ͻ0.05) have a controlled blood pressure under tri-therapy (41.6%/64.2% according to the two previous thresholds) rather than under bi-therapy (37.9%/57.8%), but no control difference is se...

HTA roadmap for Egypt : Health Technology Assessment Roadmap and Implementation Action Plan for Egypt

“…The mean was 63% whereas the median was 60% , with the latest average in 2017 being 56% (Radwan, 2019), as demonstrated in Figure 5. whereas the mean was similar to the latest average in 2011 -32.5% - (Abbas, 2012;El-Zanaty, 2018), as shown in Figure 6.…”

“…(Sustaining Health Outcomes through the Private Sector Project and Health Finance and Governance Project, 2018) to 72% (Abbas, 2012). The mean was 63% whereas the median was 60% , with the latest average in 2017 being 56% (Radwan, 2019), as demonstrated in Figure 5.…”

Healthcare financing in Egypt: a systematic literature review.

“…Pharmaceutical expenditure as a value after adjustment to 2019 EGP ranged from 40 billion EGP [ 54 ] to 67 billion EGP [ 33 ]. Notably, the pharmaceutical expenditure represented about 43% [ 55 ] of OOP.…”

“…OOP payments are considered the largest source of healthcare financing in Egypt. It ranged from 41% [ 47 ] to 72% [ 55 ], the mean was 63%, the median was 60% [ 55 ], and the most recent reported value in 2017 was 56% [ 18 ], as demonstrated in Fig. 3 .…”

“…Due to external price referencing, innovative pharmaceuticals have a narrower price corridor than outpatient and hospitalization services [ 81 ]. It results in pharmaceutical expenditure composing a significant part of the healthcare budget in Egypt compared to other countries, as it presents 32% of THE and 43% of household expenditures [ 55 ].…”