I Contreras-Hernandez

Cost-effectiveness analysis for joint pain treatment in patients with osteoarthritis treated at the Instituto Mexicano del Seguro Social (IMSS): Comparison of nonsteroidal anti-inflammatory drugs (NSAIDs) vs. cyclooxygenase-2 selective inhibitors

BackgroundOsteoarthritis (OA) is one of the main causes of disability worldwide, especially in persons >55 years of age. Currently, controversy remains about the best therapeutic alternative for this disease when evaluated from a cost-effectiveness viewpoint. For Social Security Institutions in developing countries, it is very important to assess what drugs may decrease the subsequent use of medical care resources, considering their adverse events that are known to have a significant increase in medical care costs of patients with OA. Three treatment alternatives were compared: celecoxib (200 mg twice daily), non-selective NSAIDs (naproxen, 500 mg twice daily; diclofenac, 100 mg twice daily; and piroxicam, 20 mg/day) and acetaminophen, 1000 mg twice daily. The aim of this study was to identify the most cost-effective first-choice pharmacological treatment for the control of joint pain secondary to OA in patients treated at the Instituto Mexicano del Seguro Social (IMSS).MethodsA cost-effectiveness assessment was carried out. A systematic review of the literature was performed to obtain transition probabilities. In order to evaluate analysis robustness, one-way and probabilistic sensitivity analyses were conducted. Estimations were done for a 6-month period.ResultsTreatment demonstrating the best cost-effectiveness results [lowest cost-effectiveness ratio

Direct costs associated with the appropriateness of hospital stay in elderly population

17.5 pesos/patient (

Antiprolactin autoantibodies are associated with hyperprolactinemic status in men infected with human immunodeficiency virus.

1.75 USD)] was celecoxib. According to the one-way sensitivity analysis, celecoxib would need to markedly decrease its effectiveness in order for it to not be the optimal treatment option. In the probabilistic analysis, both in the construction of the acceptability curves and in the estimation of net economic benefits, the most cost-effective option was celecoxib.ConclusionFrom a Mexican institutional perspective and probably in other Social Security Institutions in similar developing countries, the most cost-effective option for treatment of knee and/or hip OA would be celecoxib.

The hospital appropriateness evaluation protocol in elderly patients: a technique to evaluate admission and hospital stay

BackgroundAgeing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated.MethodsAppropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP). Direct medical costs associated with hospital stay under the third-party payers institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS), in Mexico City.ResultsThe sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8) of hospital stay, of which 12.4% (n = 90) were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7). The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89). The mean cost for an appropriate hospitalization per patient resulted in US

El uso de evaluación económica para la toma de decisiones en intervenciones oncológicas: la experiencia de México, Colombia y Brasil

1,497.2 (95% CI = US

Análisis coste-efectividad de vareniclina (Champix®) frente a los parches de nicotina en el tratamiento del tabaquismo en México

323.2 – US

Calidad de Vida en Mujeres Mexicanas con Cáncer de Mama en Diferentes Etapas Clínicas y su Asociación con Características Socio-Demográficas, Estados Co-Mórbidos y Características del Proceso de Atención en el Instituto Mexicano del Seguro Social

4,931.4), while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US

Evaluación de la Calidad de Vida en Pacientes con Linfoma no Hodgkin y Cáncer Colo-Rectal en Diferentes Etapas Clínicas Atendidos en el Instituto Mexicano del Seguro Social

2,323.3 (95% CI = US

Evaluación económica de antimicóticos en pacientes no neutropénicos con candidiasis invasiva en México

471.7 – US

Análisis de coste-efectividad del tratamiento empírico antimicrobiano de pacientes con neumonía asociada a la ventilación mecánica en unidades de cuidados intensivos del Instituto Mexicano del Seguro Social

6,198.3), (p < 0.001).ConclusionElderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.