BACKGROUND AND OBJECTIVE: Bladder cancer (BCa) imposes a substantial economic burden on health care systems and patients. Understanding these financial implications is crucial for effective resource allocation and optimization of treatment cost effectiveness. Here, we aim to systematically review and analyze the financial burden of BCa from the health care and patient perspectives. METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review was conducted, searching PubMed/Medline, Embase, and public sources for studies evaluating the financial impact of BCa, encompassing costs, cost effectiveness, and financial toxicity (FT). KEY FINDINGS AND LIMITATIONS: Non-muscle-invasive BCa (NMIBC) incurs significant costs for surveillance and treatment, with costs exceeding $200 000 after 5 yr for high-risk NMIBC patients progressing after bacillus Calmette-Guerin (BCG) treatment (including inpatient, outpatient, and physician service expenses). Muscle-invasive BCa generates substantial costs from radical cystectomy (RC) and neoadjuvant chemotherapy, averaging $30 000-40 000 from surgical costs of RC, with additional expenses in case of complications. Trimodal therapy has higher costs (1-yr management cost >$200 000) than RC because of higher outpatient, radiology, and medication costs. Metastatic BCa incurs the highest financial burden, with systemic therapy costs ranging from $40 000 to over $100 000 per five-cycle course, increasing further with combination therapies (ie, enfortumab vedotin and pembrolizumab), treatment-related toxicity, and supportive care. FT is particularly prevalent among younger, less educated, and minority populations. CONCLUSIONS AND CLINICAL IMPLICATIONS: BCa treatment, particularly in advanced stages, imposes a substantial economic burden. Innovations in care, while improving oncologic outcomes, necessitate detailed cost-effectiveness assessments. Addressing these economic challenges is essential for optimizing BCa management, targeting patients at a higher risk of FT, and improving patient quality of life.

• MeSH
• Cost-Benefit Analysis MeSH
• Cystectomy economics   adverse effects   MeSH
• Humans MeSH
• Neoplasm Metastasis MeSH
• Urinary Bladder Neoplasms * economics   therapy   pathology   MeSH
• Health Care Costs * MeSH
• Cost of Illness * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Systematic Review MeSH

Publikace, která se zaměřuje na různé aspekty dlouhodobé péče o pacienty, zejména o duševně nemocné. Určeno odborné veřejnosti.; První komplexní monografie u nás, týkající se tématu, které je trvale v popředí zdravotnické veřejnosti. Kniha je určena zejména praktickým lékařům, ošetřovatelskému personálu pobytových zařízení, činitelům v oblasti veřejného zdravotnictví. Publikace sleduje především dva cíle, a to přispět v českém prostředí k vymezení a pochopení agendy, závažnosti a aplikace dosud málo známého pojetí dlouhodobé péče jako 3. pilíře „péčové oblasti“ a za druhé upozornit na vybrané klinické a etické aspekty zdravotnické, především lékařské, ale také ošetřovatelské a rehabilitační praxe v rámci dlouhodobé péče, u jejích klientů/pacientů, včetně praxe v pobytových zařízeních.

• MeSH
• Long-Term Care MeSH
• Persons with Psychiatric Disorders MeSH
• Ethics, Medical MeSH
• Public Assistance MeSH
• Social Work MeSH
• Legislation, Medical MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• veřejné zdravotnictví
• sociologie
• NML Publication type
• kolektivní monografie

BACKGROUND AND OBJECTIVE: Non-muscle-invasive bladder cancer (NMIBC) poses a significant clinical challenge, particularly when failing bacillus Calmette-Guérin (BCG) therapy, necessitating alternative treatments. Despite radical cystectomy being the recommended treatment, many patients are unfit or unwilling to undergo this invasive procedure, highlighting the need for effective bladder-sparing therapies. This review aims to summarize and report the evidence on the efficacy and to estimate the costs of bladder-preserving strategies used in NMIBC recurrence after failure of intravesical BCG therapy. METHODS: We systematically searched online databases for prospective studies investigating intravesical therapy, systemic therapy, or combination of both in patients treated previously with BCG. Owing to significant heterogeneity across the studies, a meta-analysis was inappropriate. A sensitivity analysis was performed in an exploratory manner. We used a decision-analytic Markov model to compare novel U.S. Food and Drug Administration-approved treatments with a 2-yr time horizon. KEY FINDINGS AND LIMITATIONS: A total of 57 studies published between 1998 and 2024, with 68 unique study arms and consisting of 2589 patients, were identified. The 3-mo overall response rate (ORR) across all studies, complete response rate (CRR) in concomitant carcinoma in situ (CIS) or CIS only disease, and recurrence-free rate (RFR) in papillary disease were estimated to be 52.4% (95% confidence interval [CI]: 45.4-59.2), 52.8% (95% CI: 42.9-62.6), and 26.4% (95% CI: 13.3-45.6), respectively. The 12-mo ORR, CRR, and RFR were estimated to be 78% (95% CI: 52.9-91.8), 27.8% (95% CI: 21.3-35.4), and 25.4% (95% CI: 18.2-34.2), respectively. The progression rate was estimated to be 13% (95% CI: 9-18.2). The mean proportion of patients treated with radical cystectomy was estimated to be 24.7 (range 0-85.7). The reported toxicity grades were overall mild, with a median of 3.4% (range 0-33.3%) participants experiencing a dose limiting toxicity. Compared with using radical cystectomy to treat patients failing BCG therapy, at a willingness-to-pay threshold of 100 000 USD, nadofaragene firadenovec was cost effective, with an incremental cost-effectiveness ratio (ICER) of 10 014 USD per quality-adjusted life year (QALY), while nogapendekin alfa inbakicept was less cost effective than nadofaragene firadenovec (ICER of 44 602 USD per QALY). Pembrolizumab, which dominated, was both less costly and more effective than the other strategies. CONCLUSIONS AND CLINICAL IMPLICATIONS: Salvage bladder-sparing therapies show a response rate of around 50% at 3 mo in patients with NMIBC failing BCG. However, long-term data are heterogeneous. Nevertheless, recently developed agents show promising tumor control activity. In the rapidly evolving landscape of urothelial cancer, some of these treatment strategies might be cost effective and improve patients' quality of life. The findings of our review highlight the need for novel, more effective therapeutic strategies. PATIENT SUMMARY: In this study, we reviewed the evidence on the efficacy of bladder-preserving strategies used in patients with bladder cancer recurrence after failing bacillus Calmette-Guérin (BCG) therapy. We found that these strategies show a response rate of around 50% at 3 mo. However, long-term data are heterogeneous. Nevertheless, recently developed agents show promising tumor control activity. In the rapidly evolving landscape of urothelial cancer, some of these treatment strategies might be cost effective and improve patients' quality of life.

• MeSH
• Adjuvants, Immunologic * therapeutic use   economics   MeSH
• Cost-Benefit Analysis * MeSH
• Administration, Intravesical MeSH
• BCG Vaccine * therapeutic use   economics   MeSH
• Neoplasm Invasiveness MeSH
• Humans MeSH
• Neoplasm Recurrence, Local MeSH
• Non-Muscle Invasive Bladder Neoplasms MeSH
• Urinary Bladder Neoplasms * drug therapy   pathology   therapy   economics   MeSH
• Treatment Failure MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Systematic Review MeSH

INTRODUCTION: In a previously published randomised, placebo-controlled trial, 800 mg/day of pharmaceutical-grade chondroitin sulfate (CS) was shown to be superior to placebo in reducing pain and improving function over 6 months in patients with symptomatic knee osteoarthritis (OA). The aim of the current post hoc analyses was to evaluate the cost-effectiveness of CS compared with placebo in a European perspective using individual patient data from this clinical trial. METHODS: Patients with knee OA randomised to CS or placebo were followed up at 1, 3 and 6 months. The algo-functional Lequesne index was used to derive the EuroQol Five-Dimension Five-Level (EQ-5D-5L) score based on a validated formula. The EQ-5D-5L scores at each time point were used to calculate the changes in quality-adjusted life years (QALYs) with the area under the curve method. Costs were assessed using the average price of CS in the countries where the original study took place and where CS is currently marketed. The costs of CS in three countries were then used (i.e. the Czech Republic, Italy and Switzerland). The incremental cost-effectiveness ratio (ICER) threshold for CS to be considered cost-effective was set at 91,870 EUR per QALY (equivalent to the usually recommended threshold of US $100,000). The study used an intention-to-treat population, i.e. patients who received one dose of the study drug, and imputed missing values using the basal observation carried forward method. RESULTS: No significant differences in baseline characteristics were observed between the CS group (N = 199) and the placebo group (N = 205). The mean cost of CS for 6 months of treatment was 194.74 EUR. After 6 months of treatment, CS showed a mean ICER of 33,462 (95% CI 5130-61,794) EUR per QALY gained, indicating cost-effectiveness compared with placebo. The acceptability curve for cost-effectiveness shows that the CS treatment is likely to be cost-effective compared with placebo, with a 93% probability when the ceiling ratio is set at 91,870 EUR per QALY gained. CONCLUSIONS: These results highlight the role of CS as a cost-effective therapeutic option in the management of OA. However, further studies taking into account the use of other healthcare resources are warranted for a more complete understanding.

• MeSH
• Cost-Effectiveness Analysis MeSH
• Cost-Benefit Analysis * MeSH
• Osteoarthritis, Knee * drug therapy   economics   MeSH
• Chondroitin Sulfates * therapeutic use   economics   MeSH
• Quality-Adjusted Life Years * MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Randomized Controlled Trial MeSH
• Geographicals
• Czech Republic MeSH
• Italy MeSH
• Switzerland MeSH

INTRODUCTION: The objective of this study was to assess the impact of the Enhanced Recovery After Surgery (ERAS) programme implementation on treatment costs at a university-type centre, using the DRG scheme. MATERIALS AND METHODS: Retrospective analysis of patients' data in a group of 604 individuals enroled in the study. We evaluated three groups of patients according to the ERAS clinical protocol (CP): (1) CP oncogynaecology, (2) CP simple hysterectomy, (3) CP laparoscopy. The study aimed to evaluate the impact on the length of stay (LOS), savings in bed-days, and the reduction in direct treatment costs. Three parameters-antibiotic consumption, blood derivative consumption and laboratory test costs-were chosen to compare direct treatment costs. The statistical significance of the difference in the observed parameters was tested by a two-sample unpaired t test with unequal variances at the 0.05 significance level. RESULTS: We analysed data from 604 patients. In all three groups, the length of stay (LOS) was significantly reduced. The most significant reduction was observed in the CP oncogynaecology group, where the LOS was reduced from 11.1 days to 6.8 days (2022) and 7.6 days (2023) compared to 2019 (p < 0.05). Furthermore, there was a notable reduction in inpatient bed-days, which resulted in the capacity being made available to admit additional patients. A statistically significant reduction in direct costs was observed in the group of CP hysterectomy (antibiotic use) and in the CP laparoscopy (laboratory test costs). CONCLUSIONS: The implementation of the ERAS principles resulted in a number of significant positive economic impacts-reduction in the LOS and a corresponding increase in bed capacity for new patients. Additionally, direct treatment costs, including those related to antibiotic use or laboratory testing were reduced. The Czech Republic's acute healthcare system, like the majority of European healthcare systems, is financed by the DRG system. This flat-rate payment per patient encourages hospital management to seek cost-reduction strategies. The results of our study indicate that fast-track protocols represent a potential viable approach to reducing the cost of treatment while simultaneously meeting the recommendations of evidence-based medicine.

• MeSH
• Length of Stay statistics & numerical data   economics   MeSH
• Adult MeSH
• Gynecologic Surgical Procedures * economics   MeSH
• Hysterectomy economics   MeSH
• Diagnosis-Related Groups MeSH
• Laparoscopy economics   MeSH
• Middle Aged MeSH
• Humans MeSH
• Health Care Costs * statistics & numerical data   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Enhanced Recovery After Surgery * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVES: Decision-analytic models assessing the value of emerging Alzheimer's disease (AD) treatments are challenged by limited evidence on short-term trial outcomes and uncertainty in extrapolating long-term patient-relevant outcomes. To improve understanding and foster transparency and credibility in modeling methods, we cross-compared AD decision models in a hypothetical context of disease-modifying treatment for mild cognitive impairment (MCI) due to AD. METHODS: A benchmark scenario (US setting) was used with target population MCI due to AD and a set of synthetically generated hypothetical trial efficacy estimates. Treatment costs were excluded. Model predictions (10-year horizon) were assessed and discussed during a 2-day workshop. RESULTS: Nine modeling groups provided model predictions. Implementation of treatment effectiveness varied across models based on trial efficacy outcome selection (clinical dementia rating - sum of boxes, clinical dementia rating - global, mini-mental state examination, functional activities questionnaire) and analysis method (observed severity transitions, change from baseline, progression hazard ratio, or calibration to these). Predicted mean time in MCI ranged from 2.6 to 5.2 years for control strategy and from 0.1 to 1.0 years for difference between intervention and control strategies. Predicted quality-adjusted life-year gains ranged from 0.0 to 0.6 and incremental costs (excluding treatment costs) from -US$66 897 to US$11 896. CONCLUSIONS: Trial data can be implemented in different ways across health-economic models leading to large variation in model predictions. We recommend (1) addressing the choice of outcome measure and treatment effectiveness assumptions in sensitivity analysis, (2) a standardized reporting table for model predictions, and (3) exploring the use of registries for future AD treatments measuring long-term disease progression to reduce uncertainty of extrapolating short-term trial results by health-economic models.

• MeSH
• Alzheimer Disease * economics   drug therapy   MeSH
• Cost-Benefit Analysis * MeSH
• Models, Economic MeSH
• Cognitive Dysfunction * economics   MeSH
• Quality-Adjusted Life Years MeSH
• Humans MeSH
• Decision Support Techniques MeSH
• Disease Progression MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

OBJECTIVES: Smoking is an important risk factor leading to many diseases, which brings substantial healthcare costs as well as indirect costs due to decreased productivity. This article aims to quantify the social costs of smoking in the Czech Republic in 2019. METHODS: The prevalence-based, cost-of-illness approach is used, which assesses the costs as the sum of direct (healthcare) costs and indirect costs (productivity losses due to mortality and morbidity). The costs of healthcare utilization and pharmacotherapy in direct costs, and the costs of absenteeism, presenteeism, and premature mortality in indirect costs, are included. RESULTS: Total costs of smoking in the Czech Republic in 2019 are estimated as 2110.6 million EUR (0.94% of GDP). Direct costs amounted to 537.0 million EUR (2.9% of health expenditures in 2019) and indirect costs were 1573.6 million EUR, mainly driven by the costs of premature mortality (1062.5 million EUR). CONCLUSIONS: Despite the declining trend in the prevalence of smoking in the Czech Republic, the associated costs are considerable. Investments into strategies to reduce smoking continue to be needed.

• MeSH
• Absenteeism MeSH
• Adult MeSH
• Smoking * economics   epidemiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Health Care Costs * statistics & numerical data   MeSH
• Cost of Illness * MeSH
• Mortality, Premature MeSH
• Prevalence MeSH
• Aged MeSH
• Health Expenditures statistics & numerical data   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Publikace se zaměřuje na české nestátní neziskové organizace co se týče práva, daní, auditu a účetnictví. Určeno odborné veřejnosti a vysokoškolským studentům.; Publikace poskytuje komplexní pohled na nestátní neziskové organizace, mezi které patří především spolky, nadace, nadační fondy, ústavy, obecně prospěšné společnosti, církve a náboženské společnosti, politické strany a politická hnutí, veřejné vysoké školy, školské právnické osoby, společenství vlastníků jednotek, profesní komory a další. Popisuje právní úpravu jednotlivých typů nestátních neziskových organizací, možnosti vedení účetnictví, základní postupy účtování včetně sestavení účetní závěrky a jejího ověření auditorem, vyhotovení výroční zprávy a specifika jejich zdaňování. Publikace je určena širokému okruhu čtenářů. Může být přínosná nejen pro účetní a ekonomy, ale i členy statutárních orgánů a příznivce širokého spektra neziskových organizací. Publikace se rovněž může stát přehledným studijním materiálem pro studenty vysokých a vyšších odborných škol s ekonomickým zaměřením.

• MeSH
• Management Audit MeSH
• Taxes MeSH
• Organizations, Nonprofit MeSH
• Accounting MeSH
• Legislation as Topic MeSH
• Publication type
• Monograph MeSH
• Geographicals
• Czech Republic MeSH

• Conspectus
• Účetnictví
• Učební osnovy. Vyučovací předměty. Učebnice
• NML Fields
• ekonomie, ekonomika, ekonomika zdravotnictví
• NML Publication type
• učebnice vysokých škol

Publikace se zaměřuje na korupci, praní špinavých peněz a související zločiny v Česku a v Československu. Určeno široké veřejnosti.

• Keywords
• korupce, praní špinavých peněz,
• MeSH
• History, 20th Century MeSH
• History, 21st Century MeSH
• Financial Management MeSH
• Commerce MeSH
• Criminal Law MeSH
• Crime MeSH
• Criminals MeSH
• Check Tag
• History, 20th Century MeSH
• History, 21st Century MeSH
• Publication type
• Monograph MeSH
• Popular Work MeSH
• Geographicals
• Czech Republic MeSH
• Czechoslovakia MeSH

• Conspectus
• Trestní právo
• NML Fields
• ekonomie, ekonomika, ekonomika zdravotnictví
• sociologie

Publikace se zaměřuje na kybernetickou bezpečnost, kybernetické zločiny a související zákony v Česku. Určeno odborné veřejnosti.; Kybernetické hrozby a incidenty se stávají stále důležitějším tématem pro moderní společnost, ať už se jedná o státní organizace, obchodní společnosti nebo jednotlivce. Vzhledem k měnící se geopolitické situaci, vzrůstající aktivitě kyberzločinců i nové regulaci v oblasti kybernetické bezpečnosti (zejména směrnice NIS2, nařízení DORA a směrnice CER) vzrůstá důležitost správného řízení kybernetických bezpečnostních incidentů. Do hry vstupuje také stále se rozvíjející využití umělé inteligence (AI), jak na straně útočníků, tak organizací, které se kybernetickým hrozbám brání. Všechny tyto změny reflektuje druhé vydání monografie Kybernetický incident 3D: IT, právo a compliance. Všechny tři úhly pohledu na otázku předcházení a řízení kybernetických bezpečnostních incidentů, pohled IT, pohled právní i pohled compliance, jsou doplněny o poznatky a zkušenosti za uplynulé tři roky. Autoři rovněž detailně popisují nové legislativní požadavky, ať už v oblasti kybernetické bezpečnosti (směrnice NIS2, resp. nový zákon o kybernetické bezpečnosti), digitální provozní odolnosti finančních subjektů (nařízení DORA) i ochrany kritické infrastruktury (směrnice CER a zákon o kritické infrastruktuře). Monografie tak plní svoje poslání i v nové praktické i regulatorní realitě: Pomoci nastavit, doplnit či vyhodnotit interní procesy pro řízení kybernetických incidentů. Procesy, které jsou nezbytné jak pro zajištění souladu s regulacemi typu GDPR, nařízení DORA či nový zákon o kybernetické bezpečnosti (směrnice NIS2), tak pro ochranu životních zájmů každé organizace.

• Keywords
• kyberterorismus, korporátní compliance, ochrana osobních údajů,
• MeSH
• Confidentiality legislation & jurisprudence   MeSH
• Cybernetics legislation & jurisprudence   MeSH
• Entrepreneurship legislation & jurisprudence   MeSH
• Risk Management legislation & jurisprudence   MeSH
• Criminal Law MeSH
• Computer Security legislation & jurisprudence   MeSH
• Legislation as Topic MeSH
• Geographicals
• Czech Republic MeSH

• Conspectus
• Právo
• NML Fields
• knihovnictví, informační věda a muzeologie
• právo, zákonodárství
• NML Publication type
• kolektivní monografie