Cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in Bouaké University Hospital

Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .

Economic Burden of Illness of the Cervical Cancer Treatment Protocol in Bangladesh

Background: Cervical cancer is a significant health concern in Bangladesh, with high mortality rates due to limited awareness and costly treatments. The disease stages influence treatment protocols, ranging from surgery and radiotherapy for early stages to chemotherapy and radiation for advanced stages, but survival rates decrease as the cancer progresses. Objective: The objective of this study is to determine the economic impact of the disease and recommend cost-efficient strategies for prevention and treatment. Methods: A population-based, cross-sectional study was conducted with a stratified sample of cervical cancer patients from selected healthcare facilities across Bangladesh. Data collection involved structured interviews and validated questionnaires. The study measured the economic impact, treatment costs, and other related expenses. Quantitative data analysis was performed using SPSS v22, MS-Excel, and R Programming, with Multivariate regression analysis and Post Hoc tests, including the chi-square test, applied to selected indicators. Results: All respondents in the study were female, aged 34 - 75, with 72.3% aged 40 - 50. Most were illiterate (38.6%) and housewives (95.0%). Additionally, 98% were married, 85.10% married before age 18, and 46.50% experienced their first menstruation before age 12. Families typically had a monthly income of 10,000 - 30,000 Taka, spending similar amounts on treatment. Significant relationships were found between educational qualifications, occupation, personal hygiene practices, history of oral contraceptive use, and age of marriage (p Conclusion: The article emphasizes the impact of monthly family income on cervical cancer treatment costs, stressing the need for comprehensive support services to address the financial and emotional burdens faced by patients. Improving access to quality care and implementing measures can enhance outcomes for cervical cancer patients in Bangladesh.

Efficacy, patterns of use and cost of Pertuzumab in the treatment of HER2+ metastatic breast cancer in Singapore: The National Cancer Centre Singapore experience

BACKGROUND Pertuzumab is a humanized anti-human epidermal growth factor receptor 2(HER2)monoclonal antibody found in a Phase III clinical trial to significantly improve median survival in HER2 positive metastatic breast cancer(MBC)when used in combination with a taxane and Trastuzumab,and its clinical efficacy has transformed the therapeutic landscape of HER2-positive breast cancer.There are currently few reports on the pattern of use and value of Pertuzumab in real world settings.Our study describes the clinical efficacy and treatment costs of Pertuzumab in HER2-positive MBC treated in a tertiary cancer centre in Singapore in a predominantly Asian population.AIM To investigate the clinical efficacy and treatment costs of Pertuzumab in HER2-positive MBC in an Asian population in Singapore.METHODS A retrospective study of 304 HER2-positive MBC patients seen at National Cancer Centre Singapore between 2011-2017 was conducted.Demographic and clinical data were extracted from electronic medical records.Clinical characteristics and billing data of patients who received Pertuzumab were compared with those who did not.RESULTS Thirty-one(62.0%)of the fifty(16.4%)patients who received Pertuzumab as firstline therapy.With a median follow-up of 21.5 mo,there was a statistically significant difference in the median overall survival between Pertuzumab and non-Pertuzumab groups[51.5(95%CI:35.8–60.0)vs 32.9(95%CI:28.1–37.5)mo;P=0.0128].Two(4.88%)patients in the Pertuzumab group experienced grade 3(G3)cardiotoxicity.The median treatment cost incurred for total chemotherapy for the Pertuzumab group was 130456 Singapore Dollars compared to 34523 Singapore Dollars for the non-Pertuzumab group.The median percentage of total chemotherapy costs per patient in the Pertuzumab group spent on Pertuzumab was 50.3%.CONCLUSION This study shows that Pertuzumab use in the treatment of metastatic breast cancer is associated with a significantly better survival and a low incidence of serious cardiotoxicity.However,the proportionate cost of Pertuzumab therapy remains high and further cost-effectiveness studies should be conducted.

Environmental and economic vision of plasma treatment of waste in Makkah

An environmental and economic assessment of the development of a plasma-chemical reactor equipped with plasma torches for the environmentally friendly treatment of waste streams by plasma is outlined with a view to the chemical and energetic valorization of the sustainability in the Kingdom of Saudi Arabia（KSA）. This is especially applicable in the pilgrimage season in the city of Makkah, which is a major challenge since the amount of waste was estimated at about 750 thousand tons through Arabic Year 1435 H（2015）, and is growing at a rate of 3%–5% annually. According to statistics, the value of waste in Saudi Arabia ranges between 8 and 9 billion EUR. The Plasma-Treatment Project（PTP） encompasses the direct plasma treatment of all types of waste（from source and landfill）, as well as an environmental vision and economic evaluation of the use of the gas produced for fuel and electricity production in KSA, especially in the pilgrimage season in the holy city Makkah. The electrical power required for the plasmatreatment process is estimated at 5000 kW（2000 kW used for the operation of the system and 3000 kW sold）, taking into account the fact that：（1） the processing capacity of solid waste is 100 tons per day（2） and the sale of electricity amounts to 23.8 MW at 0.18 EUR per kWh.（3） The profit from the sale of electricity per year is estimated at 3.27 million EUR and the estimated profit of solid-waste treatment amounts to 6 million EUR per year and（4） the gross profit per ton of solid waste totals 8 million EUR per year. The present article introduces the first stage of the PTP, in Makkah in the pilgrimage season, which consists of five stages：（1） study and treatment of waste streams,（2） slaughterhouse waste treatment,（3） treatment of refuse-derived fuel,（4）treatment of car tires and（5） treatment of slag（the fifth stage associated with each stage from the four previous stages）.

Efficacy of compound Bai Yu San in treating diabetic skin ulcer

Objective:To assess the efficacy of compound Bai Yu San(CBYS)as a new treatment option,in healing diabetic skin ulcer.Materials and Methods:A total of 64 diabetic patients with skin ulcer were enrolled and randomly assigned to experimental group(n=33)and control group(n=31).In the control group,normal saline(NS)was used to cleanse the wound.After debridement,the wound was dressed with modern materials.In the experimental group,the NS‑cleansed wound was dressed with CBYS.The infection rate,healing rate,treatment cost,and patient satisfaction between the two groups were compared.Results:On the 35th day after treatment,the infection rate and healing rate showed no between‑group difference(P>0.05);the experimental group showed lower treatment cost and higher satisfaction than the control group(P<0.05).Conclusion:As a new treatment option for diabetes‑induced skin ulcer,CBYS can effectively control the infection,promote the healing,reduce treatment cost,and increase patient satisfaction.Dressing with CBYS can be clinically replicated in the treatment of diabetic skin ulcer.

Treatment satisfaction with rheumatoid arthritis in patients with different disease severity and financial burden:A subgroup analysis of a nationwide survey in China

Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patientassessed) and proportions of treatment cost to household income.Methods:This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients’ treatment satisfaction.Results:When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 13.183, P = 0.004). For biological diseasemodifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups ( F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 8.794, P = 0.032). Conclusion:Higher disease severity and higher financial burden were associated with lower patient satisfaction.