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      Costes sociales de las enfermedades ¿Cuán relevantes son para las evaluaciones económicas? Translated title: Social costs of diseases: How relevant are they for economic evaluations?

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          Abstract

          RESUMEN Fundamentos: En el campo de la evaluación económica (EE), existe un debate abierto sobre la perspectiva más apropiada a aplicar. Pese a la relevancia del tema, apenas hay trabajos que analicen las consecuencias prácticas de aplicar la perspectiva social o la del financiador. El objetivo fue realizar una revisión sistemática para analizar si la inclusión/exclusión de los cuidados informales y/o pérdidas laborales influyen en los resultados y conclusiones de las EE. Métodos: Se realizó una búsqueda sistemática en PubMed y Econlit para determinar las publicaciones que contenían EE sobre Alzheimer, Parkinson e Ictus. Criterios de inclusión: a) EE completas sobre las enfermedades en estudio; b) periodo enero 2006-julio 2016; y c) en inglés o español. Resultados: Se obtuvieron 6.292 referencias, seleccionándose 245 artículos que podían cumplir los criterios de inclusión. Tras el análisis a texto completo, se seleccionaron 20 publicaciones de las cuales se obtuvieron 27 EE completas (20 corresponden a Alzheimer, 1 a Parkinson y 6 al Ictus). En 20 EE (74,1%) el cambio de perspectiva modifica los resultados, pasando a ser dominantes o incrementando el ahorro de recursos comparando las alternativas desde la perspectiva social. En las 7 restantes, la inclusión de los costes sociales supone un incremento en los costes de la intervención evaluada frente a su control. Únicamente en una EE varían las conclusiones al incluir los costes sociales. Conclusiones: En general, la inclusión de los costes sociales puede modificar los resultados de las EE, pero su impacto sobre las conclusiones de las mismas es poco relevante.

          Translated abstract

          ABSTRACT Background: In the field of the economic evaluation (EE), there is an open debate on the most appropriate perspective to apply. Despite the relevance of the topic, there are hardly any studies that have analyzed the practical consequences of applying the social perspective vs. health care funder. The aim of this study was performed a systematic review of the available evidence to analyze whether the inclusion/exclusion of informal care and/or loss of productivity influence the results and conclusions of economic evaluations. Methods: A systematic review of the literature was carried out using PubMed and Econlit databases, to determine the publications that contained EE on Alzheimer, Parkinson and Stroke. Inclusion criteria were: a) full EE of the diseases under study; b) from January 2006-July 2016; and c) in English or Spanish. Results: 6,292 references were identified, of which 245 publications meet the selection criteria and were analyzed. After the full-text analysis, 20 references were selected, of which 27 full EE were obtained (20 corresponding to Alzheimer, 1 to Parkinson and 6 to Stroke). In 20 EE (74.1%) the change of the perspective modifies the results, becoming dominant or increasing the saving of the resources by comparing the alternatives from the social perspective. In the remaining 7, the inclusion of social costs involves an increase in the costs of the intervention evaluated against its control. In a single EE, the conclusions vary when including social costs. Conclusions: The inclusion of social costs can modify the results of EE but their impact on the conclusions is not relevant.

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          Economic burden of cancer across the European Union: a population-based cost analysis.

          In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness. Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%). Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Impacts of Informal Caregiving on Caregiver Employment, Health, and Family

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              The economic value of informal caregiving

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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2018
                : 92
                : e201808051
                Affiliations
                [1] Pozuelo de Alarcón Madrid orgnamePharmacoeconomics & Outcomes Research Iberia (PORIB) España
                [3] Toledo orgnameUniversidad de Castilla-La Mancha orgdiv1Departamento de Análisis Económico y Seminario de Economía y Salud España
                [2] Madrid Madrid orgnameUniversidad Carlos III de Madrid orgdiv1Máster en Evaluación Sanitaria y Acceso al Mercado Spain
                Article
                S1135-57272018000100503 S1135-5727(18)09200000503
                da4ea0a4-e629-4709-903f-29f13653a1f3

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 19 June 2018
                : 26 January 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 60, Pages: 0
                Product

                SciELO Public Health


                Evaluación económica,Loss of productivity,Pérdidas laborales,Priorización,Costes sociales,Prioritization,Cuidado informal,Toma de decisiones,Informal care,Decision-making,Economic evaluation,Social costs

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