Browsing by Author "Malhan, S"

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    Economic burden of short-acting beta-2 agonist (SABA) overuse among asthma patients in Türkiye: a cost analysis with respect to the updated GINA treatment recommendations
    Yorgancioglu, A; Aksu, K; Cura, C; Yaman, Y; Dinç, M; Malhan, S
    BackgroundThis cost of illness study aimed to determine economic burden of short-acting beta 2-agonist (SABA) overuse in T & uuml;rkiye from payer perspective with respect to the updated GINA 2022 treatment recommendations.MethodsA total of 3,034,879 asthma patients comprised the study population, via estimations extrapolated from the T & uuml;rkiye arm of the global SABINA III study. The economic burden (costs related to the drug use and severe exacerbations) was compared in subgroups of overall (>= 0 canisters/year) vs. GINA-recommended (0-2 canisters/year, hypothetical population) SABA use and in subgroups of appropriate use (0-2 canisters/year, real population) vs. overuse (>= 3 canisters/year) of SABA with extrapolation of SABINA T & uuml;rkiye data to the T & uuml;rkiye asthma population.ResultsRecommended SABA use was predicted to prevent 127,505 of 157,512 severe exacerbations per year in mild asthma patients and 2,668,916 of 3,262,800 severe exacerbations per year in moderate-severe asthma patients. Annual cost burden of not applying recommended SABA use (overall [>= 0 canisters/year] vs. GINA-recommended [0-2 canisters/year] SABA use) in mild asthma and moderate-severe asthma patients was calculated to be 20.43 million and 427.65 million in terms of severe exacerbations, and to be 829,352 and 7.20 million in terms of drug costs, respectively. The total annual economic burden arising from not applying recommended SABA use was estimated to be 456.11 million. Appropriate use (0-2 canisters/year) vs. overuse (>= 3 canisters/year) of SABA was associated with decreased frequency of severe exacerbations per year in mild asthma (from 129,878 to 27,634) and moderate-severe asthma (from 2,834,611 to 428,189) patients. SABA overuse in mild and moderate-severe asthma patients was estimated to yield an additional annual cost of 16.38 million and 385.59 million, respectively in terms of severe exacerbations, and a total 11.30 million additional drug cost. The overall annual economic burden arising from SABA overuse was estimated to be 413.27 million.ConclusionsThe estimated annual total economic burden arising from not applying recommended SABA use (456.11 million) and SABA overuse (413.27 million) with respect to the updated GINA 2022 treatment recommendations indicates the substantial cost burden of SABA overuse to the Turkish National Health System, corresponding up to 26% of the total direct cost of asthma reported in our country.
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    Economic burden of severe asthma in Turkey: a cost of illness study from payer perspective
    Bavbek, S; Malhan, S; Mungan, D; Misirligil, Z; Erdinc, M; Gemicioglu, B; Oguzulgen, IK; Oksuz, E; Yildiz, F; Yorgancioglu, A
    Objective. To estimate economic burden of severe asthma in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. Methods. This cost of illness study was based on identification of per patient annual direct medical costs for the management of severe asthma in Take, from payer perspective. Average per patient direct medical cost was calculated based on cost items related to outpatient visits laboratory and radiological tests, hospitalizations and interventions drug treatment and equipment, and co-morbidities/complications. Results. Based on total annual per patient costs calculated for outpatient admission ($177.91), laboratory and radiological tests ($ 8232), hospitalization/interventions ($1,154.55), drug treatment/equipment ($2,289.63) and co-morbidities ($ 661.39) cost items, total per patient annual direct medical cost related to management of severe asthma was calculated to be $ 4,369.76 from payer perspective. Drug treatment/equipment (524%) was the main cost driver in the management of severe asthma in Turkey, as followed by hospitalizations/interventions (264%) and co-morbidities (15.2%). Conclusions. In conclusion, our findings indicate that managing patients with severe asthma pose a considerable burden to health economics in Turkey with medications as the main cost driver.
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    THE COST OF CARE OF RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS PATIENTS IN TERTIARY CARE RHEUMATOLOGY UNITS IN TURKEY
    Malhan, S; Pay, S; Ataman, S; Dalkilic, E; Dinc, A; Erken, E; Ertenli, I; Ertugrul, E; Gogus, F; Hamuryudan, V; Inanc, M; Karaaslan, Y; Karadag, O; Karakoc, Y; Keskin, G; Kisacik, B; Kiraz, S; Oksel, F; Oksuz, E; Parildar, T; Sari, I; Soy, M; Senturk, T; Taylan, A
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    The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in Turkey
    Malhan, S; Pay, S; Ataman, S; Dalkilic, E; Dinc, A; Erken, E; Ertenli, I; Ertugrul, E; Gogus, F; Hamuryudan, V; Inanc, M; Karaaslan, Y; Karadag, O; Karakoc, Y; Keskin, G; Kisacik, B; Kiraz, S; Oksel, F; Oksuz, E; Pirildar, T; Sari, I; Soy, M; Senturk, T; Taylan, A
    Objectives To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey. Methods An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using cost-of-illness methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the human capital approach, based on the minimum wage. Results The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey. Conclusion From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively.
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