Cost-utility analysis of IEV drug regimen versus ESHAP drug regimen for the patients with relapsed and refractory Hodgkin and non-Hodgkin's lymphoma in Iran

Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program

Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen [ifosfamide, epirubicin and etoposide] versus ESHAP regimen [etoposide, methylprednisolone, high-dose cytarabine, and cisplatin] in patients with lymphoma in the south of Iran

Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years [QALYs] and the incremental cost-effectiveness ratio [ICER] were estimated. In addition, the robustness of results was examined by sensitivity analysis

Results: The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP [43 patients with Hodgkin's and 22 with non-Hodgkin lymphoma]. The results of decision tree showed that in the IEV arm, the expected cost was dollar 20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was dollar 31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen

Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance

study of the problems between basic insurance organizations and teaching hospitals of Shiraz University of Medical Sciences as viewed by the staff of income hospitals and representative of the insurer's organization in 2013

Introduction: In Iran health insurance is a significant tool in healthcare costs, financing health care and equal access to health services for people. Problems between hospitals and insurance organizations impose extra cost to the patient, leading to financial losses they will infringe upon the rights of patients. This study aimed to determine the issues between hospitals and basic insurance organizations and proposed practical solutions to solve problems in Shiraz University of Medical Sciences

Method: This research was a qualitative study [content analysis], which was conducted in 2013. The research population consisted of teaching hospitals of Shiraz University of Medical Sciences; Purposeful sampling was used and continued until data saturation. The representative of the insurers and staff of income hospitals were asked questions using a semi-structured interview. In this study, we used NVIVO for data analysis

Results: The results of this study showed that the most common problems between basic insurance organizations and teaching hospitals include the lack of prompt payment of hospital bills and imposing deduction on the hospitals

Conclusion: Based on the results of this study, it seems that cooperation between hospitals and insurance organizations could be improved by timely payment of hospital bills and codifying appropriate rules and regulations by basic insurance organizations and, on the other hand, with timely completion of bills and training of hospital staff by the hospital authorities

Economic burden of hepatitis B virus infection in different stages of disease; a report from southern Iran

To estimate the total annual cost due to chronic hepatitis B [CHB]-related diseases imposed on each patient and his/her family in Iran. Economic burden of CHB-related diseases [CHB, cirrhosis, and hepatocellular carcinoma] were examined. In this retrospective study, 100 Iranian patients were identified to obtain their socioeconomic status, utilization [direct and indirect costs] and costs of treatment, and work days lost due to illness with a structured questionnaire during 2012. Costs of hospital admissions were extracted from databases of Nemazee Hospital, Shiraz, Iran. The outpatient expenditure per patient was measured through the rate of outpatient visits and average cost per visit reported by the patients, while the inpatient costs were calculated through annual rate of hospital admissions and average expenditure. Self-medication and direct non-medical costs were also reported. The Human Capital Approach was used to measure the work loss cost. The total annual cost per patient for CHB, cirrhosis, and hepatocellular carcinoma were US[dollar sign] 3094.5, US[dollar sign]17483, and US[dollar sign] 32958 during 2012, respectively. CHB-related diseases impose a substantial economic burden on patients, families, and the society. This study provides useful information on cost of treatment and work loss for different disease states, which can be further used in cost-effectiveness evaluations

Evaluation of socio-economic factors affecting the demand for health

Introduction: Individual health has been proved to be under the influence of various factors such as the use of health care services, diet, smoking and alcohol, physical environment, and health-related behaviors. Therefore, the main determinants of health are factors such as income, education, and access to health services, and systematic changes in these factors lead to socio-economic injustice in health. The present study was carried out through library and internet search. Medline and Google Scholar databases were also utilized

Combining Contents and Results: According to the present study, an increase in health input expenses would inevitably lead to aggravation of the health situation and decrease in income would result in the worst health status of the poor. Moreover, people with higher education use less health inputs; however, they enjoy higher status than those with lower educational levels

Conclusion: Health demand approach provides only a part of the information needed for policy-makers and decision-makers in health system. Theoretical and empirical analyses of the health claim could indicate that policy actions are likely to be more effective in overcoming barriers to health but are not capable of determining which one is likely to be more cost-effective . The demand for information about the health only provides the necessary tools about the benefits of special policy making decisions. So the tool should be combined with other techniques including cost-effectiveness and cost-benefit analyses