TY  - JOUR
A1  - Frings, Verena Gerlinde
A1  - Schöffski, Oliver
A1  - Goebeler, Matthias
A1  - Presser, Dagmar
T1  - Economic analysis of the costs associated with Hidradenitis suppurativa at a German University Hospital
JF  - PLoS One
N2  - Background and objectives
Hidradenitis suppurativa (HS) significantly affects the patient`s quality of life and leads to multiple medical consultations. Aim of this study was to assess the utilization of medical care of HS patients.

Patients and methods
All patients presenting in 2017 for an outpatient, day patient and / or inpatient treatment with leading claim type HS at the Department of Dermatology, University Hospital Würzburg, were included. Primary outcome was the economic burden of HS patients, measured by resource utilization in €.

Results
The largest share of the direct medical costs for HS were the inpatient costs with a leading surgical diagnosis-related group (DRG). Antiseptics were the predominant topical prescription. While doxycycline was the most frequently prescribed systemic therapy, adalimumab was the main cost driver. The difference between in-patient (€ 110.25) and outpatient (€ 26.34) direct non-medical costs was statistically significant (p < 0.001). With regards to indirect medical costs, a statistically significantly higher loss of gross value added (inpatient mean € 1,827.00; outpatient mean € 203.00) and loss of production (inpatient mean € 1,026.00; outpatient mean € 228.00) could be noted (p < 0.001), respectively.

Conclusions
The present study on disease-specific costs of HS confirms that the hospital care of patients with this disease is cost-intensive. However, the primary goal of physicians is not and should not be to save costs regarding their patients`treatment, but rather the premise to utilize the existing resources as efficient as possible. Reducing the use of costly therapeutics and inpatient stays therefore requires more effective therapy options with an improved cost-benefit profile.
KW  - inpatients
KW  - outpatients
KW  - health insurance
KW  - dermatology
KW  - surgical and invasive medical procedures
KW  - health economics
KW  - psoriasis
KW  - indirect costs
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-261668
VL  - 16
IS  - 8
ER  - 
TY  - JOUR
A1  - Rudovick, Ladius
A1  - Brauner, Jan M.
A1  - Englert, Johanna
A1  - Seemann, Carolina
A1  - Plugaru, Karina
A1  - Kidenya, Benson R.
A1  - Kalluvya, Samuel E.
A1  - Scheller, Carsten
A1  - Kasang, Christa
T1  - Prevalence of pretreatment HIV drug resistance in Mwanza, Tanzania
JF  - Journal of Antimicrobial Chemotherapy
N2  - Background: In a 2008-10 study, we found a pretreatment HIV drug resistance (PDR) prevalence of 18.2% in patients at Bugando Medical Centre (BMC) in Mwanza, Tanzania. 

Objectives: To determine the prevalence of PDR and transmitted HIV drug resistance (TDR) in patients visiting the BMC from 2013 to 2015.

Methods: Adult outpatients were sequentially enrolled into two groups, separated by whether they were initiating ART. Previous exposure to antiretroviral drugs, except for prevention of mother-to-child transmission, was an exclusion criterion. HIV pol sequences were analysed according to WHO guidelines for surveillance of PDR and TDR.

Results: Two hundred and thirty-five sequences were analysed (138 ART initiators, 97 non-initiators). The prevalence of PDR was 4.7% (95% CI 2.6%-8.2%) overall, 3.1% (95% CI 1.1%-8.7%) for non-initiators and 5.8% (95% CI 3.0%-11.0%) for ART initiators. PDR to NNRTIs and nucleoside or nucelotide reverse transcriptase inhibitors was found in 3.0% (95% CI 1.5%-6.0%) and 1.7% (95% CI 0.7%-4.3%) of patients, respectively. Resistance to PIs was not observed. The prevalence of TDR was 6.0% (95% CI 3.6%-9.8%). 

Conclusions: Prevalence of PDR significantly decreased compared with 2008-10 and was below the WHO-defined threshold for triggering a public health response. National and systematic surveillance is needed to inform Tanzania's public health strategy.
KW  - HIV
KW  - adult
KW  - anti-hiv agents
KW  - child
KW  - mothers
KW  - nucleosides
KW  - outpatients
KW  - reverse transcriptase inhibitors
KW  - tanzania
KW  - world health organization
KW  - guidelines
KW  - public health medicine
KW  - anti-retroviral agents
KW  - non-nucleoside reverse transcriptase inhibitors
KW  - surveillance
KW  - medical
KW  - exclusion criteria
KW  - prevention
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227124
VL  - 73
IS  - 12
ER  -