Estimating the direct cost of Type 2 diabetes in Greece: the effects of blood glucose regulation on patient cost.

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 non-controlled (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 euro (95% confidence interval, 940.66-1023.01 euro), whereas for non-controlled patients it was 1566.12 euro (95% confidence interval, 1485.42-1650.20 euro). Non-controlled patients had 29.7% higher annual pharmaceutical costs (340.50 vs. 441.96 euro), 70% higher costs for laboratory/diagnostic tests (422.54 vs. 718.49 euro) and 85.5% higher consultation costs (218.68 vs. 405.67 euro) compared with their controlled peers. The average cost for a Type 2 diabetic patient in Greece, regardless of blood glucose regulation, was 1297.30 euro (95% confidence interval, 1244.42-1349.61 euro). 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.

Generic medicines: Greek physicians' perceptions and prescribing practices.

BACKGROUND AND OBJECTIVE: The penetration of generic drugs in the Greek pharmaceutical market is placed among the weakest in the EU. The Greek regulatory framework does not systematically support the development of this subsector and physicians are not provided with incentives for prescribing generics. The aim of this study was to investigate the prescribing profile of physicians in Greece with a focus on the factors that influence their decision on generics prescribing. METHODS: A structured questionnaire was sent by mail to a random national sample of 1463 physicians, stratified by sex, specialty and geographical region. RESULTS AND DISCUSSION: The response rate was 82.3%. Greek physicians have a positive view on generics but they prefer to prescribe the original products. According to our analysis, physician's age and their opinion on generics' efficacy and effectiveness are identified as important determinants of their prescribing decision. The primary reason that could make them change their prescribing habits is the appearance of side-effects. Patients' insurance coverage and income, as well as the drug cost are also referred as factors that influence their prescribing decision. Despite the fact that they do not usually prescribe generics in their clinical practice, they are willing to substitute an original drug by a generic product. CONCLUSIONS: Our findings suggest that Greek physicians could be persuaded to prescribe generic medicines, if a generic promotion policy was introduced in the country. To develop such a policy, a set of supply side and demand-side measures should be implemented along with provision of information on generics to physicians during their education and clinical practice.

[The cost of treating schizophrenia in Greece].

The objective of this study was to estimate the direct annual cost of treating patients with schizophrenia in Greece in 2005. Due to the lack of quantitative data, information on the treatment pathway and medical resource utilization of patients were collected from a consensus panel of 9 psychiatrists and 5 health economists. For estimating the costs a bottom up approach from the National Health System perspective was used. The panel of experts defined three patient categories based on the severity of the disease and the medical setting where treatment is received: (a) outpatient setting, (b) ambulatory care, (c) inpatient setting and long-term care. The annual direct cost of treatment per patient was found to be 3,187 € (2,659-4,166 €) in the first category, 10,135 € (7,429-13,972 €) in the second category and 20,782 € (17,482-25,462 €) in the third category. The total cost of treatment increased with the severity of the disease and the use of hospitalization. Systematic data collection on medical resource utilization must be established at the national level to facilitate further research, guide the efficient use of resources and improve the healthcare provision.

The impact of new antiretroic therapeutic schemes on the cost for AIDS treatment in Greece.

The paper attempts to evaluate the clinical and economic benefits between the administration of the dual and triple antiretroic schemes for the treatment of the HIV disease. Clinical and economic data are derived from patients hospitalized in 1996 and 1997 at the University Department of Dermatology and Venereology of Andreas Sygros Hospital. Methodology is based on the comparison of patients' nosological profile and direct annual cost before and after the administration of the triple treatment. The results of the study present that the triple combination therapy yields superior health outcomes, (decrease in the days of hospitalization and in the opportunistic disease events as well as fewer deaths and loss of production). Cost comparison presents a small decrease in the annual patient's cost, where all cost components are diminished, except the medication cost. A substitution of hospital care by drug therapy is revealed and a great change is taken place in the composition of the drugs' cost. Patient cost for antiretroic drugs has more than doubled from 1996 to 1997.

Cost analysis and estimation of thoracic surgical patients with lung cancer in Greece: the case of Sotiria ICU.

This study aimed to estimate the hospitalization cost of thoracic surgical patients with lung cancer, treated in the intensive care unit (ICU) of Sotiria Hospital in Athens. This is the largest specialist thoracic disease hospital in the greater region of Central and Southern Greece. Methodology was based on the prospective study of patients' medical records, from which clinical and economic data were derived for a six-month period. The study sample consisted of 95 thoracic surgical patients. Economic analysis and cost estimation were based on the differentiation between nominal and real prices, occurring in the public hospital sector in Greece. Real ICU cost per patient is estimated at US$ 2,011 in 1998, while the total patients hospitalization cost was US$ 6,958. The patient's ICU cost represents about 29% of his total hospitalization cost, while the price deviation in the amounts covered by social insurance compared to the real hospitalization cost is also confirmed. It is believed that the use of economic analysis techniques could substantially contribute to the assessment of resource consumption, initially at a microeconomic and later at a macroeconomic level, and thus to the adoption of prospective payment systems, as these are encountered on an international level.