ABSTRACT
Objective: To assess the economic impact associated with overactive bladder (OAB) patients, treated with mirabegron or antimuscarinics (AM) in Spain, over a 12-month period. Methods: A probabilistic model (second-order Monte Carlo simulation) was used in a hypothetical cohort of 1000 patients with OAB and a time horizon of 12 months. The use of resources was obtained from the retrospective observational study MIRACAT that included 3330 patients with OAB. The analysis was carried out from the perspective of the National Health System (NHS) including that of society with the indirect cost of abseenteism in a sensitivity analysis. Unit costs were obtained from Spanish public healthcare prices ( 2021) and from previously published Spanish studies. Results: The annual average savings for the NHS for each patient with OAB treated with mirabegron would be 1135 (95%confidence interval (CI) 390; 2421) compared with a patient treated with AM. Annual average savings were maintained in all the sensitivity analyses carried out, ranging from a minimum of 299 to a maximum of 3381 per patient. The substitution of 25% of the AM treatments (for 81534 patients) to mirabegron would generate, within 1 year, savings for the NHS of 92 million (95% CI 31; 197 million). Conclusions: According to the present model, the treatment of OAB with mirabegron would generate savings compared with treatment with AM in all scenarios and sensitivity analysis performed, and for the NHS and for society perspectives (AU)
Subject(s)
Humans , Male , Female , Aged , Urinary Bladder, Overactive/drug therapy , Urinary Bladder, Overactive/economics , Muscarinic Antagonists/economics , Muscarinic Antagonists/therapeutic use , Cost of Illness , Retrospective Studies , SpainABSTRACT
BACKGROUND: There are large inequalities in levels of physical activity in the UK, and this is an important determinant of health inequalities. Little is known about the effectiveness of community-wide interventions to increase physical activity and whether effects differ by socioeconomic group. METHODS: We conducted interrupted time series and difference-in-differences analyses using local administrative data and a large national survey to investigate the impact of an intervention providing universal free access to leisure facilities alongside outreach and marketing activities in a deprived local authority area in the northwest of England. Outcomes included attendances at swimming and gym sessions, self-reported participation in gym and swim activity and any physical activity. RESULTS: The intervention was associated with a 64% increase in attendances at swimming and gym sessions (relative risk 1.64, 95% CI 1.43 to 1.89, P<0.001), an additional 3.9% of the population participating in at least 30 min of moderate-intensity gym or swim sessions during the previous four weeks (95% CI 3.6 to 4.1) and an additional 1.9% of the population participating in any sport or active recreation of at least moderate intensity for at least 30 min on at least 12 days out of the last four weeks (95% CI 1.7 to 2.1). The effect on gym and swim activity and overall levels of participation in physical activity was significantly greater for the more disadvantaged socioeconomic group. CONCLUSIONS: The study suggests that removing user charges from leisure facilities in combination with outreach and marketing activities can increase overall population levels of physical activity while reducing inequalities.
Subject(s)
Exercise , Health Promotion/methods , Health Status Disparities , Leisure Activities , Adolescent , Adult , Community-Institutional Relations , England , Female , Humans , Interrupted Time Series Analysis , Male , Middle Aged , Program Evaluation , Socioeconomic Factors , Young AdultABSTRACT
Using a sequence of questions from the 1996 US Panel Study of Income Dynamics (PSID), we explore the implications of interpersonal differences in parent's attitudes towards risk for the academic test scores of their children focusing on information drawn from the 1997 Child Development Supplement of the PSID. In addition, we explore whether parental risk preference influences whether the child subsequently attends college. Our findings suggest that a parent's degree of risk aversion is inversely related to the academic test scores of their children as well as being inversely related to the probability of attending college post high school.
