Objective: To estimate the effect of obesity prevention on annual and lifetime drug spending as well as other sector-specific expenditures, i.e. the hospital segment, long-term care segment and primary healthcare.
Methods: The RIVM (Dutch National Institute for Public Health and the Environment) Chronic Disease Model and Selleckchem PND-1186 Dutch cost of illness data were used to simulate, using a Markov-type model approach, the lifetime expenditures in the pharmaceutical segment and three other healthcare segments for a hypothetical cohort of obese (body mass index [BMI] >= 30 kg/m(2)), non-smoking people
with a starting age of 20 years. In order to assess the sector-specific consequences of obesity prevention, these costs were compared with the costs of two other similar cohorts, i.e. a ‘healthy-living’ cohort (non-smoking and a BMI >= 18.5 and <25kg/m(2)) and a smoking cohort. To assert whether preventing obesity results in cost savings in any of the segments, net present values were estimated using different discount rates. Sensitivity analyses were conducted across key input values and using a broader definition of healthcare.
Results: Lifetime drug expenditures are higher for obese people than for ‘healthy-living’ people, despite shorter life expectancy for the obese. Obesity prevention results in savings on drugs for obesity-related diseases until the age of 74 years, which outweigh
additional drug costs for diseases unrelated to obesity in life-years gained. Furthermore, obesity prevention will increase long-term care expenditures substantially, while savings in the other healthcare segments are small or non-existent. phosphatase inhibitor library Discounting costs more heavily or using lower relative mortality risks for obesity would make obesity prevention a relatively more attractive strategy in terms of healthcare costs, especially for the long-term care segment. Application of a broader definition of healthcare costs has the opposite effect.
Conclusions: Obesity prevention will Belnacasan in vitro likely result in savings in the pharmaceutical segment, but substantial additional costs for long-term care. These
are important considerations for policy makers concerned with the future sustainability of the healthcare system.”
“Background: Peritoneal dialysis (PD)-related peritonitis is a common and morbid complication of PD. Bacteria are able to create a biofilm on the PD catheter, which can be a source of recurrent infection. Biofilms undergo a phenotypic change resulting in increased antibiotic resistance.
Methods: 21 clinical isolates of different patients with PD peritonitis secondary to Staphylococcus aureus were collected. They were analyzed for their antibiotic susceptibility in the planktonic form using the standard minimum inhibitory concentration (MIC) and in a biofilm using minimum biofilm eradication concentration (MBEC). Chi-square was used to compare the sensitivity results.