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Erratum inCorrection to: Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study.Mounié M, Costa N, Gourdy P, Latorre C, Schirr-Bonnans S, Lagarrigue JM, Roussel H, Martini J, Buisson JC, Chauchard MC, Delaunay J, Taoui S, Poncet MF, Cosma V, Lablanche S, Coustols-Valat M, Chaillous L, Thivolet C, Sanz C, Penfornis A, Lepage B, Colineaux H, Hanaire H, Molinier L, Turnin MC; Educ@dom Study Group, Benhamou PY, Rodier M, Ayon F, Puel-Olivier F, Fontaine S, Perron M, Arrivié J, Cousty-Pech F, Rouby C, Lafon F, Moura I.Diabetes Ther. 2022 May;13(5):1131-1132. doi: 10.1007/s13300-022-01248-6.PMID: 35316510 Free PMC article. No abstract available.; International audience; INTRODUCTION: Telemedicine programs using health technological innovation to remotely monitor the lifestyles of patients with type 2 diabetes (T2D) can improve glycaemic control and thus reduce the incidence of complications as well as management costs. In this context, an assessment was made of the 1-year and 2-year cost-effectiveness of the EDUC@DOM telemonitoring and tele-education program. METHODS: The EDUC@DOM study was a multicentre randomized controlled trial conducted between 2013 and 2017 that compared a telemonitoring group (TMG) to a control group (CG) merged with health insurance databases to extract economic data on resource consumption. Economic analysis was performed from the payer perspective, and direct costs and indirect costs were considered. The clinical outcome used was the intergroup change in glycated haemoglobin (HbA1c) levels from baseline. Missing economic data were imputed using multiple imputation, and fitted values from a generalized linear mixed model were used to calculate the incremental cost-effectiveness ratio (ICER). Bootstrapped 95% confidence ellipses were drawn in the cost-effectiveness plan. RESULTS: The main analysis included data from 256 patients: 126 in the TMG and 130 in the CG. Incremental costs over 1 and 2 years were equal to €2129 and €5101, respectively, in favour of the TMG. Once imputed and adjusted for confounding factors, the TMG trends to a 21% cost decrease over 1 and 2 years of follow-up (0.79 [0.58; 1.08], p = 0.1452 and 0.79 [0.61; 1.03], p = 0.0879, respectively). The EDUC@DOM program led to a €1334 cost saving and a 0.17 decrease in HbA1c over 1 year and a €3144 cost saving and a 0.14 decrease in HbA1c over 2 years. According to the confidence ellipse, EDUC@DOM was a cost-effective strategy. CONCLUSION: This study provides additional economic information on telemonitoring and tele-education programs to enhance their acceptance and promote their use. In the light of this work, the EDUC@DOM program is a cost-saving strategy in T2D management. TRIAL REGISTRATION: This trial was registered in the Clinical Trials Database on 27 September 2013 under no. NCT01955031 and bears ID-RCB no. 2013-A00391-44.

OBJECTIVE To assess the cost-effectiveness of vaginal misoprostol (PGE1; 25 μg) compared with a slow-release dinoprostone (PGE2) pessary (10 μg) for labor induction due to an unfavorable cervix at term. METHODS We used data from an open-label multicenter, randomized non-inferiority trial that recruited women for whom labor was induced for medical reasons. The incremental cost-effectiveness ratio was assessed from the payer's perspective, with the focus on inpatient care costs and using the cesarean deliveries avoided (CDA) rate as the primary analysis and the rate of vaginal delivery within 24 h (VD24) as the secondary analysis. RESULTS Analyses were based on 790 women in each group. Differences between treatment arms were the mean cost per patient of €4410 and €4399, a CDA rate of 80.1% and 77.9% and a VD24 rate of 46.1% and 59.4% for dinoprostone and misoprostol, respectively. Dinoprostone is not cost-effective according to the CDA rate and misoprostol was either a cost-effective or a dominant strategy according to the VD24. CONCLUSION Misoprostol and dinoprostone have equal cost management with mixed efficacy according to the clinical outcome used. Finally, misoprostol may be an attractive option for hospitals as the price is lower and it is easier to use. TRIAL REGISTRATION ClinicalTrials.gov: NCT01765881. URL: https://clinicaltrials.gov/ct2/show/NCT01765881. ClinicalTrialRegistrer.eu: 2011-000933-35. URL: https://www.clinicaltrialsregister.eu/ctr-search/trial/2011-000933-35/FR.

International audience; Background: Lymphomas are costly diseases that suffer from a lack of detailed economic information, notably in a real-world setting. Decision-makers are increasing the search for Real-World Evidence (RWE) to assess the impact, in real-life, of healthcare management and to support their public decisions. Thus, we aimed to assess the real-world net costs of the active treatment phases of adult Hodgkin Lymphoma (HL), Follicular Lymphoma (FL) and Diffuse Large B Cell Lymphoma (DLBCL).Methods: We performed a retrospective cohort study using population-based data from a national representative sample of the French population covered by the health insurance system. Cost analysis was performed from the French health insurance perspective and took into account direct and sick leave compensation costs (e2,018). Healthcare costs were studied over the active treatment phase. We used multivariate modeling to adjust cost differences between lymphoma subtypes.Results: Analyses were performed on 224 lymphoma patients and 896 controls. The mean additional monthly costs due to HL, FL and DLBCL patients were respectively e5,188, e3,242 and e7,659 for the active treatment phase. The main additional cost driver was principally inpatient stay (hospitalization costs and costly cancer-related drugs), followed by outpatient medication and productivity loss. When adjusted, DLBCL remains significantly the most costly lymphoma subtype.Conclusion: This study provides an accurate assessment of the main lymphoma subtypes related cost with high magnitude of details in a real-world setting. We underline where potential cost saving could be realized via the use of biosimilar medication, and where lymphoma management could be improved with the early management of adverse events.

Objectives Trans-nasal endoscopic sphenopalatine artery ligation (TESPAL) and endovascular arterial embolisation both provide excellent success rates for intractable epistaxis. Recent economic models suggest that TESPAL could be a cost-saving strategy. Our main aim was to perform cost-effectiveness analyses on TESPAL compared with embolisation to treat patients with epistaxis. Design We performed retrospective, monocentric, comparative analyses on patients referred to our centre and treated with embolisation or TESPAL. Setting This economic evaluation was carried out from a payer's perspective (ie French National Health Insurance) within a time horizon of 12 months. Participants Thirty-seven TESPAL procedures and thirty-nine embolisation procedures to treat intractable epistaxis were used in the analyses. Main outcome measures The primary outcome is presented as the cost per 1% of non-recurrence. Effectiveness was defined as avoiding recurrence of epistaxis during the 1-year follow-up. Cost estimates were performed from the payer's perspective. Results Hospitalisation costs were higher for embolisation compared with TESPAL (5972 vs 3769 euros). On average, hospitalisation costs decreased by 41% when a patient was treated by TESPAL compared with an embolisation strategy (P = 0.06). The presence of comorbidities increased hospitalisation costs by 79% (P = 0.04). TESPAL enabled 1867€ to be gained in intractable epistaxis. Conclusions The outcomes from our decision model confirm that TESPAL is more cost-effective for patients with intractable epistaxis.

Resume Objectif Evaluer le taux de couverture vaccinale anti grippale saisonniere (CVG) chez les patients presentant une arterite a cellules geantes (ACG) incidente, par rapport aux temoins. Materiel et methode Nous avons mene une etude retrospective descriptive de janvier 2005 a avril 2011 incluant des patients de plus de 65 ans presentant une ACG incidente, en Midi-Pyrenees, a partir des donnees du Systeme national d’information inter-regimes de l’assurance maladie francais (SNIIRAM). Nous avons selectionne de facon aleatoire 6 temoins apparies sur le sexe et l’âge. Le taux de vaccination a ete estime a partir de la date de delivrance du vaccin enregistree dans le SNIIRAM. La CVG a ete comparee entre les personnes atteintes d’ACG et les temoins, a l’aide d’une regression de Poisson longitudinale multivariee. Resultats Quatre-vingt-sept patients atteints d’ACG incidente, de plus de 65 ans et 509 dans le groupe temoin ont ete inclus. La duree moyenne de suivi etait de 4,4 ± 1,2 et de 4,2 ± 1,2 ans, respectivement. Lors des campagnes annuelles de vaccination anti grippale de 2005–2006 a 2010–2011, les taux de CVG dans le groupe ACG et le groupe temoin allaient de 60,8 a 74,7 % vs 56,6 a 70,4 %, respectivement. Le taux de vaccination anti grippale chez les personnes atteintes d’ACG incidente etait de 20 % superieur a celui des temoins (RR = 1,20 ; IC 1,09 a 1,32, p Conclusion Les taux de vaccinations anti grippales sont insuffisants chez les patients de plus de 65 ans atteints d’ACG. La vaccination adequate au cours d’une ACG devrait faire l’objet d’une attention plus importante.

Objectives To assess and compare direct costs between giant cell arteritis (GCA) patients and matched-controls and identify incremental cost drivers. Methods We carried out a population-based, retrospective, cohort study using the French National Health Insurance System Database. Cost analysis was performed from the French health insurance perspective and took into account direct medical and non-medical costs (€, 2014). Costs were evaluated according to different cost components and divided into periods of 6 months for the accurate assessment of care consumption. Longitudinal multivariate regression analyses using Generalized Estimating Equations (GEE) were used to adjust the effect of GCA on the mean cost over time. Results Analyses were performed on 96 incident GCA patients and 563 matched-controls. The cumulative incremental cost due to GCA was €6,406 and €7,236 for 3 and 5 years, respectively. Total incremental costs were significant for the first 18 months, amounting to €1,342 for the first 6 months, €1,498 between 6 and 12 months and €1,165 between 12 and 18 months (p=0.012, p=0.065, p=0.029, respectively). The most important cost drivers were paramedical procedures, in-patient stays, medication and medical procedures. Multivariate analysis shows the significant effect of GCA on mean cost during the first 3 years of follow-up (RR=1.72; 95% CI: 1.31-2.27, p

Objective To assess and compare direct costs between patients with giant cell arteritis (GCA) that is associated or not associated with polymyalgia rheumatic (PMR), and to identify the additional cost drivers due to PMR. Methods A population-based, retrospective cohort study using the French National Health Insurance System Database was conducted. Cost analysis was performed from the French health insurance perspective and direct medical and nonmedical costs were taken into account (based on 2014 costs [€]). Costs were analyzed according to different components and divided into 6-month periods to assess care consumption. Longitudinal multivariate analyses, using generalized estimating equations, were used to adjust the effect of PMR on the mean cost over time. Results Analyses were performed on 100 incident patients with GCA, 54 of whom had PMR. The cumulative additional cost due to PMR was €8,801 for 3 years, and €10,532 for 5 years. The significant additional costs occurred especially during the second and third years of follow-up, amounting to €1,769 between 12 and 18 months (P = 0.02), €1,924 between 18 and 24 months (P = 0.17), €1,458 between 24 and 30 months (P = 0.08), and €1,307 between 30 and 36 months (P = 0.07). The most important cost drivers were inpatient stays, paramedic procedures, and medications. Multivariate analyses showed a significant effect of PMR on mean cost during the first 3 years of follow-up (relative risk 1.76 [95% confidence interval 1.03-2.99], P = 0.038). Conclusion To our knowledge, this study is the first to accurately assess the cost of PMR care in patients with GCA and to highlight that PMR is largely responsible for the high cost of GCA.

Waterborne disease outbreaks (WBDOs) remain a public health issue in developed countries, but to date the surveillance of WBDOs in France, mainly based on the voluntary reporting of clusters of acute gastrointestinal infections (AGIs) by general practitioners to health authorities, is characterized by low sensitivity. In this context, a detection algorithm using health insurance data and based on a space&ndash, time method was developed to improve WBDO detection. The objective of the present simulation-based study was to evaluate the performance of this algorithm for WBDO detection using health insurance data. The daily baseline counts of acute gastrointestinal infections were simulated. Two thousand simulated WBDO signals were then superimposed on the baseline data. Sensitivity (Se) and positive predictive value (PPV) were both used to evaluate the detection algorithm. Multivariate regression was also performed to identify the factors associated with WBDO detection. Almost three-quarters of the simulated WBDOs were detected (Se = 73.0%). More than 9 out of 10 detected signals corresponded to a WBDO (PPV = 90.5%). The probability of detecting a WBDO increased with the outbreak size. These results underline the value of using the detection algorithm for the implementation of a national surveillance system for WBDOs in France.