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  • 1. Gerdtham, Ulf-Göran
    et al.
    Andersson, L Fredrik
    Ericsson, Asa
    Borg, Sixten
    Jansson, Sven-Arne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Rönmark, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundbäck, Bo
    Factors affecting chronic obstructive pulmonary disease (COPD)-related costs: a multivariate analysis of a Swedish COPD cohort.2009In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 10, no 2, p. 217-26Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease (COPD) is an increasing public health problem, generating considerable costs. The objective of this study was to identify factors affecting COPD-related costs. A cohort of 179 subjects with COPD was interviewed over the telephone on four occasions about their annual use of COPD-related resources. The data set and explanatory variables were analysed by means of multivariate regression techniques for six different types of cost: societal (or total), direct (health care) and indirect (productivity), and three subcomponents of direct costs-hospitalisation, outpatient and medication. Poor lung function, dyspnoea and asthma were independently associated with higher costs. Poor lung function (severity of COPD) significantly increased all six examined cost types. Dyspnoea (breathing problems) also increased costs, though to a varying extent. The presence of reported asthma increased total, direct, outpatient and medication costs. Poor lung function and, to a lesser extent, extent of dyspnoea and concomitant asthma, were all strongly associated with higher COPD-related costs. Strong efforts should be made to prevent the progression of COPD and its symptoms.

  • 2.
    Granlund, David
    Umeå University, Faculty of Social Sciences, Department of Economics.
    The effect of health care expenditure on sickness absence2010In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 11, no 6, p. 555-568Article in journal (Refereed)
    Abstract [en]

    Increased health care expenditure could be used to improve quality of care or reduce waiting time and could therefore be expected to affect the health and sickness absence of a population. Still, based on data from a panel of Swedish municipalities, public health care expenditure was found to have no, or only a negligible effect on absence due to sickness or disability. The same result was obtained when separate estimates were done for men and women and for absence due to sickness and disability.

  • 3.
    Granlund, David
    et al.
    Umeå University, Faculty of Social Sciences, Department of Economics. HUI Research, SE-103 29, Stockholm, Sweden.
    Köksal, Miyase Yesim
    Parallel Imports and Mandatory Substitution Reform: a kick or a muff for price competition in pharmaceuticals?2015In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 16, no 9, p. 969-983Article in journal (Refereed)
    Abstract [en]

    What has been the effect of competition from parallel imports on prices of locally-sourced on-patent drugs? Did the 2002 Swedish mandatory substitution reform increase this competition? To answer these questions, we carried out difference-in-differences estimation on monthly data for a panel of all on-patent prescription drugs sold in Sweden during the 40 months from January 2001 through April 2004. On average, facing competition from parallel imports caused a 15-17% fall in price. While the reform increased the effect of competition from parallel imports, it was only by 0.9%. The reform, however, did increase the effect of therapeutic competition by 1.6%.

  • 4.
    Granlund, David
    et al.
    Umeå University, Faculty of Social Sciences, Department of Economics.
    Rudholm, Niklas
    Umeå University, Faculty of Social Sciences, Department of Economics.
    Wikström, Magnus
    Umeå University, Faculty of Social Sciences, Department of Economics.
    Fixed budgets as a cost containment measure for pharmaceuticals2006In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 7, no 1, p. 37-45Article in journal (Other academic)
    Abstract [en]

    In Västerbotten County, Sweden, there are two health centers which (in contrast to all other health centers in the region) bear strict responsibility over their pharmaceutical budget. This study examined whether the prices and quantities of pharmaceuticals prescribed by physicians working at these health centers differ significantly from those prescribed by physicians at health centers with open-ended budgets. Estimation results using matching methods, which allows us to compare similar patients at the different health centers, show that the introduction of fixed pharmaceutical budgets did not affect physicians' prescription behavior, indicating that fixed budgets may not be an efficient measure to reduce costs. Another explanation is that the health centers under study already had taken measures to contain costs, making it hard to further reduce costs.

  • 5.
    Neumann, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Center of Evidence-Based Healthcare, University Hospital, Technische Universität Dresden, Germany.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Schoffer, Olaf
    Klug, Stefanie J.
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program2017In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 18, no 7, p. 905-919Article in journal (Refereed)
    Abstract [en]

    Background: Policymakers need to know the cost-effec-tiveness of interventions to prevent type 2 diabetes (T2D). The objective of this study was to estimate the cost-effectiveness of a T2D prevention initiative targeting weight reduction, increased physical activity and healthier diet in persons in pre-diabetic states by comparing a hypothetical intervention versus no intervention in a Swedish setting. Methods: A Markov model was used to study the cost-effectiveness of a T2D prevention program based on lifestyle change versus a control group where no prevention was applied. Analyses were done deterministically and probabilistically based on Monte Carlo simulation for six different scenarios defined by sex and age groups (30, 50, 70 years). Cost and quality adjusted life year (QALY) differences between no intervention and intervention and incremental cost-effectiveness ratios (ICERs) were estimated and visualized in cost-effectiveness planes (CE planes) and cost-effectiveness acceptability curves (CEA curves). Results: All ICERs were cost-effective and ranged from 3833 € /QALY gained (women, 30 years) to 9215 € /QALY gained (men, 70 years). The CEA curves showed that the probability of the intervention being cost-effective at the threshold value of 50,000 € per QALY gained was very high for all scenarios ranging from 85.0 to 91.1%. Discussion/conclusion: The prevention or the delay of the onset of T2D is feasible and cost-effective. A small investment in healthy lifestyle with change in physical activity and diet together with weight loss are very likely to be cost-effective.

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