Víctor Granados-García

HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico

ObjectiveTo determine the incremental costs and effects of different HPV testing strategies, when compared to Papanicolau cytology (Pap), for cervical cancer screening in Mexico.MethodsA cost-effectiveness analysis (CEA) examined the specific costs and health outcomes associated with (1) no screening; (2) only the Pap test; (3) only self-administered HPV; (4) only clinician administered HPV; and (5) clinician administered HPV plus the Pap test. The costs of self- and clinician-HPV testing, as well as with the Pap test, were identified and quantified. Costs were reported in 2008 US dollars. The health outcome associated with these screening strategies was defined as the number of high-grade cervical intraepithelial neoplasia or cervical cancer cases detected. This CEA was performed using the perspective of the Mexican Institute of Social Security (IMSS) in Morelos, Mexico.ResultsScreening women between the ages of 30–80 for cervical cancer using clinical-HPV testing or the combination of clinical-HPV testing, and the Pap is always more cost-effective than using the Pap test alone.ConclusionsThis CEA indicates that HPV testing could be a cost-effective screening alternative for a large health delivery organization such as IMSS. These results may help policy-makers implement HPV testing as part of the IMSS cervical cancer screening program.

A workplace physical activity program at a public university in Mexico can reduce medical costs associated with type 2 diabetes and hypertension

OBJECTIVE To assess the impact of a workplace leisure physical activity program on healthcare expenditures for type 2 diabetes and hypertension treatment. MATERIAL AND METHODS We assessed a workplace programs potential to reduce costs by multiplying the annual healthcare costs of patients with type 2 diabetes and hypertension by the population attributable risk fraction of non-recommended physical activity levels. Feasibility of a physical activity program was assessed among 425 employees of a public university in Mexico. RESULTS If 400 sedentary employees engaged in a physical activity program to decrease their risk of diabetes and hypertension, the potential annual healthcare cost reduction would be 138 880 US dollars. Each dollar invested in physical activity could reduce treatment costs of both diseases by 5.3 dollars. CONCLUSIONS This research meets the call to use health economics methods to re-appraise health priorities, and devise strategies for optimal allocation of financial resources in the health sector.

Estimating the cost of treating patients with liver cirrhosis at the Mexican Social Security Institute

OBJECTIVE To estimate the annual cost of treating patients with cirrhosis at the Mexican Institute of Social Security (IMSS per its abbreviation in Spanish). MATERIAL AND METHODS The annual cost of treating three stages of cirrhosis (Child-Pugh A, Child-Pugh B and Child-Pugh C) was estimated using micro-costing techniques and medical experts. These results were compared and contrasted with prices reported by IMSS. RESULTS The annual cost of treatment, in USA dollars, by Child-Pugh stage was: a) micro-costing results:

Cost-effectiveness analysis of the use of palivizumab in the prophylaxis of preterm patients in Mexico

1110.17 stage A,

Burden of disease and costs of treating rotavirus diarrhea in Mexican children for the period 2001–2006

549.55 stage B and

Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study

348.16 stage C; b) opinion of medical experts:

Frailty in community-dwelling older adults: association with adverse outcomes

1 633.64,

Cost-Effectiveness Analysis of Different Testing Strategies that Use Antibody Levels to Detect Chronic Hepatitis C in Blood Donors.

6564.04 and

Factors associated with an outbreak of hospital-onset, healthcare facility-associated Clostridium difficile infection (HO-HCFA CDI) in a Mexican tertiary care hospital: A case-control study

19660.35, respectively; and c) IMSS costs:

Cost analysis of different cervical cancer screening strategies in Mexico

4269.00,