Browsing St. James's Hospital by Subjects
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Hepatitis C in the era of direct-acting antivirals: real-world costs of untreated chronic hepatitis C; a cross-sectional study.Recent advances in Hepatitis C therapeutics offer the possibility of cure but will be expensive. The cost of treatment may be partially offset by the avoidance of advanced liver disease. We performed a micro-costing study of the ambulatory healthcare utilisation of patients with Hepatitis C supplemented with inpatient diagnosis related group costs.
Insights and concerns of patients and GPs regarding introduction of universal health insurance in IrelandThe implementation of a universal health insurance (UHI) model is a key political policy in Ireland. The objective here was to determine the understanding of general practitioners (GPs) and patients regarding UHI, its implementation and impact on both sets of stakeholders. Postal questionnaire to GPs, and opportunistic survey sampling of patients in two different GP practices were carried out. Response rates were 92.5% (patients) and 78% (GPs). 79.4% of patients (n=418) and 96.7% of GPs (n=149) have a â poorâ understanding of how UHI will be implemented. 89% (n=493) of patients and 98.7% (n=153) of GPs feel government communication about UHI has been â poorâ . 98.1% of GPs (n=152) and 77.3% of patients (n=383) are not confident that â UHI will be ready for implementation by 2015â . Neither stakeholder group is confident in the governmentâ s ability to deliver UHI within the given timeframe. There is a lack of knowledge and consultation on proposals for its implementation.
Pharmacoeconomic evaluation in Ireland: A review of the processThe aim of this review is to describe the pharmacoeconomic assessment process in Ireland and to provide examples of recent appraisals and the subsequent impact on pricing and reimbursement decisions. Method: The pharmacoeconomic appraisals conducted by the National Centre for Pharmacoeconomics (NCPE) between September 2006 and February 2009 were reviewed. The NCPE recommendations and subsequent reimbursement decisions by the Health Service Executive (HSE) were recorded. Recommendations made by the NCPE were compared with those of UK agencies. The duration of the NCPE pharmacoeconomic process and the time from marketing authorisation to reimbursement was estimated. The budget impact assessments from the pharmaceutical companies were reviewed and compared for consistency. Results: The NCPE conducted twelve single technology appraisals during the study period. Eight of the medicines assessed were either recommended as a cost-effective use of resources or recommended with certain restrictions, and were funded by the HSE. Of the four medicines that were not considered cost-effective, two were reimbursed after a price reduction was negotiated and the remaining two were not reimbursed. The NCPE recommendations concurred with those of the UK agencies for the majority of appraisals, with the exception of sunitinib and lapatinib. The average duration of the NCPE process was 2.7 months. The average time from marketing authorisation to reimbursement was 7 months. The review of budget impact assessments highlighted a high degree of variability between submissions. Conclusions: The findings of this review demonstrate the efficiency of the pharmacoeconomic process and the acceptance of the NCPE recommendations by the HSE for pricing and reimbursement decisions. NCPE recommendations broadly concurred with those of UK agencies for the majority of appraisals.