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Indications for Sleeve Gastrectomy-Is It Worth Waiting for Comorbidities to Develop?

(1) Background and Objectives: Morbid obesity significantly increases the prevalence of comorbidities, such as heart disease, restrictive lung disease, stroke, diabetes mellitus and more. (2) Methods: Patients undergoing gastric sleeve surgery were divided into three groups with BMI between 30-34.9 kg/m2 (Group I), 35-39.9 kg/m2 (Group II), and over 40 kg/m2 (Group III). Preoperative examinations included cardiac ultrasound, respiratory function and laboratory tests, and preoperative comorbidities were also recorded. Following a one-year follow-up, we compared the rate of weight loss in the th

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… Regarding healthcare financing, the positive financing effects of lower morbidity and mortality rates, operations performed with shorter hospital stays, and the financial resources not spent on healthcare due to untreated multimorbidity can be reallocated to other realms of the healthcare system. …

Оказываешь новую клиническую услугу - что у тебя в лифте?

Люди с множественным склерозом (PwMS) определяют эмоциональное благополучие как одну из ключевых неудовлетворенных потребностей в уходе. Меры, основанные на заботливости, могут повысить эмоциональное благосостояние в ПВМС; вместе с тем отсутствует информация о том, как они применяются в рамках обычного ухода. Лица, оказывающие влияние на политику в области здравоохранения, могут получить критическую информацию о процессе осуществления. Цель этого исследования заключалась в изучении потребностей и приоритетов тех, кто оказывает влияние на политику в области здравоохранения, в деле внедрения МБМ

Quality of life assessment & out-of-pocket expenditure in multiple myeloma: An observational study.

BACKGROUND & OBJECTIVES: Prognosis of patients with multiple myeloma (MM) has improved significantly in the past two decades. However, the symptoms burden is high at onset and treatment is generally prolonged with significant financial burden. This study was undertaken to assess the quality of life (QoL) and to analyse out-of-pocket expenditure (OOPE) incurred on MM patients being treated at a tertiary care cancer centre in north India. METHODS: This observational, cross-sectional study included 116 patients (aged >18 yr) of MM (both newly diagnosed and those with recurrent disease). For QoL

The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023.

BACKGROUND: Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050. METHODS: Ca

Epidemiological and economic impact of pre-exposure prophylaxis with targeted immunotherapies for COVID-19 among immunosuppressed patients in Argentina.

BACKGROUND: Some immunosuppressive disorders have shown substantially lower protection after COVID-19 vaccination against severe outcomes. Therefore, pre-exposure prophylaxis is proposed. Targeted immunotherapy with monoclonal antibodies represents an option for preventing severe COVID-19. However, there is a lack of epidemiological and economic information on pre-exposure prophylaxis with targeted immunotherapies against COVID-19 among immunosuppressed patients. Thus, this study aims to identify and estimate the size of target population and direct medical costs related to pre-exposure prophy

Health inequalities in cancer care: a literature review of pathways to diagnosis in the United Kingdom.

This literature review discusses current health disparities in cancer care in the United Kingdom, spanning access to services, diagnosis, and outcomes. These inequities stem from a complex interplay of factors such as health literacy, ethnicity, socioeconomic status, age, gender, geography, and lifestyle choices. Health literacy plays a crucial role in timely healthcare seeking and diagnosis, while cultural beliefs significantly shape perceptions and behaviours. Socioeconomic barriers often result in delayed diagnosis and inferior outcomes due to limited access to preventive measures and high-

A systematic literature review of the assessment of treatment burden experienced by patients and their caregivers.

BackgroundMany older adults with multiple chronic conditions, particularly those who are functionally impaired, spend considerable time juggling the competing demands of managing their conditions often assisted by caregivers. We examined methods of assessing the treatment burden experienced by this population as a first step to identifying strategies to reduce it.MethodsSystematic searches were performed of the peer-reviewed and grey-literature (PubMed, Cochrane library, CINAHL, EMBASE, Web of Science, SCOPUS, New York Academy of Medicine Grey Literature Review, NLM catalog and ProQuest Digita

Potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement process of orphan drugs.

BackgroundThe objective of this study was to assess the potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement (P&R) process with regard to orphan drugs.MethodsA four step approach was designed. Firstly, a systematic literature review was conducted to select the MCDA criteria. Secondly, a database of orphan drugs was established. Thirdly, health technology appraisals (HTA recommendations) were categorized and an MCDA appraisal was conducted. Finally, a comparison of HTA and MCDA outcomes was carried out. An MCDA outcome was

Моделирование использования первой линии Daratumumab для новых диагностированных, трансплантированных, не отвечающих установленным требованиям, множественных миелом: анализ эффективности затрат и рисков для работников системы здравоохранения.

СПРАВОЧНАЯ ИНФОРМАЦИЯ И ЦЕЛЬ: Это исследование было направлено на оценку эффективности затрат two Режимы, рассматриваемые в качестве стандарта для лечения недавно диагностированной, сносимой трансплантацией множественной миеломы в Сингапуре:1) Даратумумаб, линалидомид и дексаметасон и ()2Бортезомиб, линалидомид и дексаметасон. Кроме того, она направлена на изучение потенциальных стратегий регулирования неопределенности при принятии решений и снижения финансового риска.МЕТОДЫ: Анализ эффективности затрат с точки зрения системы здравоохранения был проведен с использованием модели раздельного выж

Global comparison of cancer outcomes: standardization and correlation with healthcare expenditures.

BackgroundCancer outcomes vary widely among different countries. However, comparisons of cost-effectiveness and cost-efficiency of different systems are complex because the incidences of different cancers vary across countries and their chances of cure also differ substantially. We aim to propose a new standardized method for global comparison and to explore its relationship with economic indicators.MethodsCancer statistics from all 184 countries and 27 cancers listed in GLOBOCAN 2012 were analyzed. The complement of age-standardized mortality/incidence ratio [1 - (ASM/ASI)] was taken as the p

Healthcare-resource utilization associated with radiation to bone across eight European countries: Results from a retrospective study.

BackgroundBone metastases and lytic lesions due to multiple myeloma are common in advanced cancer and can lead to debilitating complications (skeletal-related events [SREs]), including requirement for radiation to bone. Despite the high frequency of radiation to bone in patients with metastatic bone disease, our knowledge of associated healthcare resource utilization (HRU) is limited.MethodsThis retrospective study estimated HRU following radiation to bone in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland. Eligible patients were ≥ 20 years old, had bone

The Burden of Cancer, Government Strategic Policies, and Challenges in Pakistan: A Comprehensive Review.

Cancer is a severe condition characterized by uncontrolled cell division and increasing reported mortality and diagnostic cases. In 2040, an estimated 28.4 million cancer cases are expected to happen globally. In 2020, an estimated 19.3 million new cancer cases (18.1 million excluding non-melanoma skin cancer) had been diagnosed worldwide, with around 10.0 million cancer deaths. Breast cancer cases have increased by 2.26 million, lung cancer by 2.21 million, stomach by 1.089 million, liver by 0.96 million, and colon cancer by 1.93 million. Cancer is becoming more prevalent in Pakistan, with 19

A review of big data and medical research.

Universally, the volume of data has increased, with the collection rate doubling every 40 months, since the 1980s. "Big data" is a term that was introduced in the 1990s to include data sets too large to be used with common software. Medicine is a major field predicted to increase the use of big data in 2025. Big data in medicine may be used by commercial, academic, government, and public sectors. It includes biologic, biometric, and electronic health data. Examples of biologic data include biobanks; biometric data may have individual wellness data from devices; electronic health data include t

Guidelines for the use of survivorship care plans: a systematic quality appraisal using the AGREE II instrument.

BackgroundSurvivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers. A growing number of guidelines for the use of SCPs exist, yet SCP use in the United States remains limited. Limited use of SCPs may be due to poor quality of these guidelines. The purpose of the study was to evaluate the quality of guidelines for SCP use, tools that are intended to promote evidence-based medicine.MethodsWe conducted a comprehensive search of th

Reconciling uncertainty of costs and outcomes with the need for access to orphan medicinal products: a comparative study of managed entry agreements across seven European countries.

BackgroundNational payers across Europe have been increasingly looking into innovative reimbursement approaches - called managed entry agreements (MEAs) - to balance the need to provide rapid access to potentially beneficial orphan medicinal products (OMPs) with the requirements to circumscribe uncertainty, obtain best value for money or to ensure affordability. This study aimed to identify, describe and classify MEAs applied to OMPs by national payers and to analyse their practice in Europe.MethodsTo identify and describe MEAs, national health technology assessments and reimbursement decision

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… These countries, spread across the northern and southern parts of the EU and characterised by different healthcare financing methods, are usually considered as priority market targets for new drug launches. They were selected to ensure representation of key healthcare markets in Europe. …

[Health technology assessment report: Computer-assisted Pap test for cervical cancer screening].

UNLABELLED: HEALTH PROBLEM: Cervical cancer is a disease which is highly preventable by means of Pap test screening for the precancerous lesions, which can be easily treated. Furthermore, in the near future, control of the disease will be enhanced by the vaccination which prevents the infection of those human papillomavirus types that cause the vast majority of cervical cancers. The effectiveness of screening in drastically reducing cervical cancer incidence has been clearly demonstrated. The epidemiology of cervical cancer in industrialised countries is now determined mostly by the Pap test c

Efficacy, safety and economy of denosumab and zoledronic acid in the treatment of bone metastases of solid tumors and multiple myeloma: a systematic review and meta-analysis.

ObjectiveTo conduct a comprehensive comparison of the efficacy, safety, and cost-effectiveness of denosumab versus zoledronic acid in patients with bone metastases from solid tumors and multiple myeloma.MethodsA systematic search of PubMed, Web of Science, Embase, and major Chinese databases was performed for studies published up to 30 September 2025. Eligible evidence included randomized controlled trials, cohort studies, and pharmacoeconomic analyses. Random-effects models were applied for quantitative synthesis. The certainty of evidence for key outcomes was assessed using the GRADE framewo

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… Given the inherent context-dependence of cost-effectiveness analyses, the results were synthesized by geographic region to account for differences in willingness-to-pay (WTP) thresholds, healthcare financing structures, and pricing policies. … Pharmacoeconomic evidence further indicates that the cost-effectiveness of denosumab is highly context-specific, shaped primarily by regional willingness-to-pay thresholds, healthcare financing structures, and drug pricing policies. …

Demographics, Cost, and Sustainability of Haemodialysis among End-Stage Kidney Disease Patients in Southern Nigeria: A Single-Center Study.

ContextAccess to chronic hemodialysis for patients with end-stage kidney disease has improved over the years. However, it is unclear if this has resulted in lower cost and improved dialysis vintage.AimWe aimed to assess the demographics, cost implication, and sustainability of maintenance hemodialysis in our cohort of end-stage kidney disease (ESKD) patients.MethodsRetrospective descriptive study of ESKD patients on maintenance HD from 2014 to 2018 using hemodialysis records. Time-to-HD discontinuation and reasons for discontinuation were recorded. Using Kaplan-Meier graphs, the time-to-dialys

Экономическое бремя лечения раковых заболеваний в частном страховом населении Ливана: a seven- Ретроспективный когортный анализ (год)2018-2024).

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Рак создает растущее экономическое бремя для систем здравоохранения во всем мире, однако в странах с низким и средним уровнем дохода по-прежнему ощущается нехватка продольных данных о расходах на лечение раковых заболеваний на уровне населения в рамках частного страхования. Частный страховой сектор Ливана, находящийся в ведении администраторов третьих сторон, охватывает значительную долю экономически активного населения, однако ни одно из опубликованных исследований не характеризовало его экономического бремени, связанного с раком, в том числе во время экономического спа

How Risky Is That Risk Sharing Agreement? Mean-Variance Tradeoffs and Unintended Consequences of Six Common Risk Sharing Agreements.

Background. Pharmaceutical risk sharing agreements (RSAs) are commonly used to manage uncertainties in costs and/or clinical benefits when new drugs are added to a formulary. However, existing mathematical models of RSAs ignore the impact of RSAs on clinical and financial risk. Methods. We develop a model in which the number of patients, total drug consumption per patient, and incremental health benefits per patient are uncertain at the time of the introduction of a new drug. We use the model to evaluate the impact of six common RSAs on total drug costs and total net monetary benefit (NMB). Re