Lege Artis Medicinae

[Systemic adjuvant pharmacotherapy of colorectal cancer]

BODOKY György

DECEMBER 10, 2009

Lege Artis Medicinae - 2009;19(12)

[Colorectal cancer is one of the most frequent cancer in the postindustrial world; its most common form is adenocarcinoma. In Hungary, colorectal cancer has the second highest mortality among tumours. If diagnosed early, it might be successfully treated by surgery, however, chemotherapy is necessary to prevent tumor relapse and development of metastases and achieve adequate palliation. In the past few years, adjuvant treatment of colorectal cancer has improved substantially. Many new drugs have been developed, which are also being used in combination with previously known agents. This article will discuss the novelties in the field of adjuvant chemotherapy for colorectal cancer and the main guidelines of adjuvant treatment.]

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[Direct health care costs of diabetes mellitus in Hungary]

VOKÓ Zoltán, NAGYJÁNOSI László, KALÓ Zoltán

[INTRODUCTION - Diabetes mellitus is responsible for a huge burden of disease all over the world, including Hungary, as well. The object of our study was to estimate the direct health care costs of treating patients with diabetes, in order to characterize this aspect of the burden of disease, and to facilitate the use of this information in further analyses. METHODS - We used the data of the National Health Fund. Diabetic patients were defined as persons who filled in a prescription of oral antidiabetics (OAD) or insulin in the second half of 2007. We divided this study population into two groups depending on whether they were or were not hospitalised for major complications of diabetes in 2007-2008. The group that was not hospitalised was further divided into three subgroups according to the use of drugs (only OAD, only insulin, OAD and insulin). In all study groups, we estimated the mean, the standard deviation, and the median of health care costs for each cost item by age group in the whole study group and among those who actually used a particular service. Additionally, we took samples of patients who were hospitalised for specific complications, and estimated the health care costs for the first and for the second year after the occurrence of the complication. RESULTS - The mean health care cost of the 521,545 diabetic patients involved in the analysis was 335 thousand HUF. It was 633 thousand HUF for those who were hospitalised for complications, 242 thousand for OAD users without complications, and 449 thousand for insulin users without complications. 53% of the total cost covered drug treatment and 27% acute hospital treatment. 26% of the total drug cost was spent on OADs and on insulin. The acute hospital cost and the drug cost had multiplied within the first year of complication. The latter remained high or further increased in the second year. CONCLUSION - The healthcare cost of diabetes is already very high in Hungary, especially the care for its complications. Considering the burden of disease that manifests in premature mortality, reduction in quality of life, and high cost, and the epidemiological trends, diabetes mellitus should be a public health priority in Hungary.]

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