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Sainte-Foy-lès-Lyon, France

Remy V.,Sanofi S.A. | Mathevet P.,Hopital Femme Mere Enfant | Largeron N.,Sanofi S.A. | Vainchtock A.,HEVA
Journal d'Economie Medicale

Objective: The objective of this study was to assess the annual cost associated with the management of vulvar and vaginal cancers and lesions from the health care payer perspective in France. Material and methods: This study is based on data extracted from the French national hospital database (PMSI) in 2006, which collects data from all public and private hospitals in France. Hospital costs were based on official tariffs for diagnosis-related groups. A complementary analysis allowed us to estimate outpatient and daily allowance costs for vulvar and vaginal cancers. Results: In France, 1237 patients were hospitalised for vulvar cancer and 728 for vaginal cancer in 2006. The total annual cost for the management of vulvar and vaginal cancers reaches 9.3 and 6.7 million Euros, respectively. The hospitalisation cost for vulvar and vaginal lesions is estimated at 1.3 million Euros. Conclusion: The overall annual cost for the management of vulvar and vaginal cancers and lesions is approximately 17.4 million Euros for the French health care payer. Since outpatient management cost for vulvar and vaginal lesions is not taken into account, the overall cost is probably underestimated. Source

Background: Long-acting somatostatin receptor ligands (SRL) with product-specific formulation and means of administration are injected periodically in patients with acromegaly and neuroendocrine tumors. A simple decision-tree model aimed at comparing cost savings with ready-to-use Somatuline Autogel® (lanreotide) and Sandostatin LAR® (octreotide) for the UK, France, and Germany. The drivers of cost savings studied were the reduction of time to administer as well as a reduced baseline risk of clogging during product administration reported for Somatuline Autogel®. Methods: The decision-tree model assumed two settings for SRL administration, ie, by either hospital-based or community-based nurses. In the case of clogging, the first dose was assumed to be lost and a second injection performed. Successful injection depended on the probability of clogging. Direct medical costs were included. A set of scenarios were run, varying the cost drivers, such as the baseline risk of clogging, SRL administration time, and percentage of patients injected during a hospital stay. Results: Costs per successful injection were less for Somatuline Autogel® /Depot, ranging from Euros (EUR) 13-45, EUR 52-108, and EUR 127-151, respectively, for France, Germany, and the UK. The prices for both long-acting SRL were the same in France, and cost savings came to 100% from differences other than drug prices. For Germany and the UK, the proportion of savings due to less clogging and shorter administration time was estimated to be around 32% and 20%, respectively. Based on low and high country-specific patient cohort size estimations of individuals eligible for SRL treatment among the patient population with acromegaly and neuro endocrine tumors, annual savings were estimated to be up to EUR 2,000,000 for France, EUR 6,000,000 for Germany, and EUR 7,000,000 for the UK. Conclusion: This model suggests that increasing usage of the Somatuline device for injection of SRL might lead to substantial savings for health care providers across Europe. © 2012 Marty et al, publisher and licensee Dove Medical Press Ltd. Source

Lacau St Guily J.,University Pierre and Marie Curie | Borget I.,Institute Gustave Roussy | Vainchtock A.,HEVA | Remy V.,Sanofi S.A. | Takizawa C.,Sanofi S.A.
Head and Neck Oncology

Background. With 16,005 new cases and 5,406 related deaths in 2005, France is particularly concerned by Head and Neck (H&N) cancers. In addition to tobacco and alcohol, Human Papillomavirus (HPV) has been reported as a risk factor for H&N cancers. The literature on the burden of these cancers in Europe is scarce. This study was performed to assess the medical and economical burden of hospitalisations for H&N cancers in France. Methods. The French national hospital database (PMSI), in which admissions to public and private hospitals are recorded, was retrospectively analysed to assess the annual number of patients hospitalised for H&N cancers and associated hospital costs from the healthcare payer perspective. ICD-10 codes (16 codes classified as oral cavity, oropharynx, pharynx, salivary glands and larynx) were used to extract admissions for these cancers. Hospital stays, chemotherapy and radiotherapy sessions were extracted to assess patients' management. Costs of admissions were obtained from French official tariffs. Results. In 2007, there were 36 268 patients hospitalised for H&N cancers, of whom 81% were men, corresponding to 60 200 hospital stays and 287 846 sessions of chemo- or radio-therapy. Oropharynx cancer was the most frequent (28% of patients), followed by oral cavity cancer (25% of patients). The peak of frequency was observed in the 55-59 years age group. Patients were mainly treated in medicine (48%) and surgery (23%) units. Mean annual cost per patient ranged from 2 764 to 7 673 leading to a total hospital cost of 323 millions in 2007 (including hospitalization and expensive drugs). With 26% of H&N cancers attributable to HPV infections, 9 430 patients were hospitalized due to HPV-related H&N cancers, representing 138 million in 2007. Conclusion. Even without taking into account the rehabilitation costs, the hospital burden of H&N cancers is considerable. © 2010 St Guily et al; licensee BioMed Central Ltd. Source

Blein C.,HEVA | Gavazzi G.,Grenoble University Hospital Center | Paccalin M.,University of Poitiers | Baptiste C.,Sanofi S.A. | And 2 more authors.
BMC Infectious Diseases

Background: The objectives of this study were to describe hospital stays related to HZ and to evaluate the direct and indirect cost of hospitalizations due to HZ among patients aged over 50 years. Methods: The hospitalizations of people aged over 50 years were selected from the French national hospital 2011 database (PMSI) using ICD-10 diagnosis codes for HZ. Firstly, stays with HZ as principal or related diagnostic were described through the patient characteristics, type of hospitalization and the related costs. Secondly, a retrospective case-control analysis was performed on stays with HZ as comorbidity in 5 main hospitalizations causes (circulatory, respiratory, osteo-articular, digestive systems and diabetes) to assess the impact of HZ as co-morbidity on the length of stay, mortality rate and costs. Results: In the first analysis, 2,571 hospital stays were collected (60 % of women, mean age: 76.3 years and mean LOS: 9.5 days). The total health assurance costs were 10,8 M€. Mean cost per hospital stay was 4,206€. In the second analysis, a significant difference in LOS and costs was shown when HZ was associated as comorbidity in other hospitalization's causes. Conclusions: HZ directly impacts on the hospital cost. When present as comorbidity for other medical reasons, HZ significantly increases the length of hospital stay with subsequent economic burden for the French Health System. © 2015 Blein et al. Source

Bresse X.,SP MSD SNC | Adam M.,SP MSD SNC | Largeron N.,SP MSD SNC | Roze S.,HEVA | Marty R.,HEVA
Human Vaccines and Immunotherapeutics

The aim was to compare the epidemiological and economic impact of bivalent HPV 16/18 and quadrivalent HPV 6/11/16/18 vaccinations in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14-23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544-1,020 million vs. EUR 177-538 million with the bivalent vaccination (100-y time horizon). Genital warts prevention thanks to quadrivalent HPV vaccination accounted for EUR 306-380 million savings (37-56% of costs saved). In contrast, the maximal assumed crossprotection against cervical cancer resulted in EUR 13-33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71-89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital warts. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. © 2013 Landes Bioscience. Source

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