Increasing prevalence of obesity (BMI > 30) is a pressing public health issue in the Czech Republic as well as world-wide, affecting up to 2.1 billion people. Increasing trend in the prevalence of obesity in adults and children generates large social costs. The main aim of this study is to estimate both direct and indirect costs of obesity in the Czech Republic. Social costs of obesity are estimated using the cost-of-illness approach. Direct costs (healthcare utilization costs and costs of pharmacotherapy of 20 comorbidities) are estimated using the top-down approach, while indirect costs (absenteeism, presenteeism and premature mortality) are estimated using the human capital approach. In aggregate, the annual costs attributable to obesity in the Czech Republic in 2018 were 40.8 bn CZK (1.6 bn EUR, 0.8% GDP). Direct costs were 14.5 bn CZK (0.6 bn EUR) and accounted for 3.4% of Czech healthcare expenditures. The highest healthcare utilization costs were attributable to type II diabetes (20.6%), ischemic heart disease (18.8%) and osteoarthritis (16.7%). The largest indirect costs were attributable to premature mortality (10 bn CZK/0.39 bn EUR), absenteeism (9.2 bn CZK/0.36 bn EUR) and presenteeism (7.1 bn CZK/0.27 bn EUR). This article demonstrates that obesity is a serious problem with considerable costs. Several preventive interventions should be applied in order to decrease the prevalence of obesity and achieve cost savings.

• Klíčová slova
• Cost-of-illness study, Czech Republic, Obesity, Social costs,
• MeSH
• diabetes mellitus 2. typu * MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• náklady na zdravotní péči MeSH
• obezita epidemiologie   MeSH
• osobní újma zaviněná nemocí MeSH
• poskytování zdravotní péče MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: Multiple sclerosis (MS) is a progressive autoimmune disease of the central nervous system that is often disabling and for which there is currently no cure, though disease-modifying treatment is now available. The aim of this study is to describe the current values of the direct costs of multiple sclerosis (MS) in the Czech Republic. METHODS: Attention is focused on direct medical costs. The costs were monitored in the Czech Republic among 5673 patients in the period between 2011 and 2015. These costs included complex, special and targeted visits at the neurologist, blood collection and the costs of hospitalisation. The results refer to the diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. The attention is focused on MS G35 (NS; brain stem; spinal cord; disseminated; generalised). RESULTS: The average total direct costs per patient per year are 4838.1 €. Not every patient has to be hospitalised during the year, and not every patient has prescribed medication. According to the above data, 12% of patients are hospitalised and 55% of patients are prescribed medication. The minimum average cost per patient without medication and hospitalisation is 54.1 €. CONCLUSION: Cost evaluation across countries is difficult due to the different evidence. If only selected direct costs considered in this study are compared, the absolute economics burden increases over time. The only statistically significant difference in the average price and the time spent is between 2012 and 2013, where the correlation value is 0.597.

• Klíčová slova
• Czech Republic, Direct costs, Multiple sclerosis, Neurological disease,
• MeSH
• hospitalizace ekonomika   MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• osobní újma zaviněná nemocí * MeSH
• retrospektivní studie MeSH
• roztroušená skleróza ekonomika   epidemiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: The importance of the issue of the economic burden of treatment and care for people with dementia is crucial in the developed countries. The European Union and other developed countries are trying to improve the course of aging population which leads to rising costs. Their uniform registration is also one of the objectives of the developed countries' strategic plans to fight dementia. The individual steps of the plans in practical terms so far are mainly directed to the early diagnosis of diseases, records of the associated data are so far in the background. AIM: The aim of this paper is to specify a set of costs that should be constantly monitored at the national level within dementia. METHODS: The main method is a literature review focused on Alzheimer's disease. The searched keywords were "Alzheimer's disease" and "costs" incurred after 2010. The studies will specify the monitored costs and determine their minimal penetration, which will then form the basis for recommendations for the monitored group of costs on a national level. RESULTS: Results of the analysis indicate that the following main cost groups are monitored: medical direct costs (inpatient care, outpatient treatment, medication), non-medical direct costs (day care centres, community health services, respite care, accommodation costs for patients) and indirect costs (time that the carers dedicate to the patient). The issue of different naming and groups of costs calls for a common strategy in this area and defining the minimum items that should be monitored.

• Klíčová slova
• Alzheimer's disease, Cost classification, aging, dementia, direct costs, indirect costs.,
• MeSH
• Alzheimerova nemoc ekonomika   terapie   MeSH
• lidé MeSH
• náklady na zdravotní péči * klasifikace   MeSH
• osobní újma zaviněná nemocí * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

OBJECTIVE: The aim of this study was to estimate the cost of dementia in the Czech Republic. METHODS: One hundred and nineteen patient-caregiver dyads participated in our multicenter observational cost-of-illness study. The modified Resource Utilization in Dementia Questionnaire was used as the main tool to collect data from patients and caregivers. Medical specialists provided additional data from medical records. The average costs of dementia were calculated and patients were then divided by the level of cognitive impairment. A generalized linear model was used to determine if differences were present for selected cost variables. RESULTS: The mean (standard deviation) for direct cost per a patient in a month was estimated to be €243.0 (138.0), €1727.1 (1075.6) for the indirect cost, and €1970.0 (1090.3) for the total cost of dementia in the Czech Republic. All of the costs increased as dementia severity increased. Both the indirect and total costs significantly (p < 0.05) increased if patients were living with their primary caregiver, and if the severity of cognitive impairment was increased. CONCLUSIONS: The indirect cost, which was represented mainly by informal care, comprised the main part of the total cost of care for patients with dementia in the Czech Republic. Both total and indirect care costs increased significantly the cognition declined.

• Klíčová slova
• Alzheimer’s disease, Direct medical care, Indirect expenses, Informal care, Social care,
• MeSH
• demence ekonomika   terapie   MeSH
• lidé MeSH
• náklady na zdravotní péči MeSH
• osobní újma zaviněná nemocí * MeSH
• osoby pečující o pacienty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

AIMS: To estimate the direct and indirect costs associated with disability due to multiple sclerosis (MS) in Poland. METHODS: Recently a cost-of-illness study was conducted in the Czech Republic, involving 909 patients with different levels of disability (the COMS study). Data on resource use from this trial was extrapolated to Polish patients and combined with Polish unit costs in 2012. The mean annual costs from societal and payers perspective were calculated for patients according to EDSS. RESULTS: The estimated mean annual cost per patient with MS from a societal perspective ranges from 6970 EUR to 26,791 EUR. Indirect costs (production loss due to early retirement, sick-leave and informal care) cover up to 70% of total costs. CONCLUSIONS: With an estimated 40-60,000 patients with MS in Poland, the disease poses a high economic burden. Indirect costs have a substantial share in these costs. A high-quality prospective study on costs is needed.

• Klíčová slova
• cost-of-illness, costs, economic burden, multiple sclerosis,
• MeSH
• lidé MeSH
• osobní újma zaviněná nemocí * MeSH
• roztroušená skleróza ekonomika   MeSH
• zdravotnické zdroje statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Polsko 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.

• Klíčová slova
• I12, I18,
• MeSH
• absentérství MeSH
• dospělí MeSH
• kouření * ekonomika   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• náklady na zdravotní péči * statistika a číselné údaje   MeSH
• osobní újma zaviněná nemocí * MeSH
• předčasná smrt MeSH
• prevalence MeSH
• senioři MeSH
• výdaje na zdravotnictví statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Implementation of strict policies for mitigating climate change has a direct impact on public health as far as the external health costs of electricity generation can be reduced, thanks to the reduction of emission of typical pollutants by switching to cleaner low carbon fuels and achieving energy efficiency improvements. Renewables have lower external health costs due to the lower life cycle emission of typical air pollutants linked to electricity generation, such as SO2, NOx, particulate matter, NH3, or NMVOC (Non-methane volatile organic compounds), which all appear to have serious negative effects on human health. Our case study performed in the Baltic States analyzed the dynamics of external health costs in parallel with the dynamics of the main health indicators in these countries: life expectancy at birth, mortality rates, healthy life years, self-perceived health, and illness indicators. We employed the data for external health costs retrieved from the CASES database, as well as the health statistics data compiled from the EUROSTAT database. The time range of the study was 2010-2018 due to the availability of consistent health indicators for the EU Member States. Our results show that the decrease of external health costs had a positive impact on the increase of the self-perceived good health and reduction of long-standing illness as well as the decrease of infant death rate. Our conclusions might be useful for other countries as well as for understanding the additional benefits of climate change mitigation policies and tracking their positive health impacts. The cooperation initiatives on clean energy and climate change mitigation between countries like One Belt One Road initiative by the Chinese government can also yield additional benefits linked to the public health improvements.

• Klíčová slova
• Baltic States, dynamics, electricity generation, external health costs, health indicators,
• MeSH
• elektřina * MeSH
• látky znečišťující vzduch analýza   MeSH
• náklady na zdravotní péči MeSH
• pevné částice analýza   MeSH
• znečištění ovzduší analýza   MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• pobaltské republiky MeSH
• Názvy látek
• látky znečišťující vzduch MeSH
• pevné částice MeSH

Background: Alcohol is a risk factor with serious consequences for society and individuals. This study aims to present methods and approaches that might be used to estimate the costs related to excessive alcohol consumption. It emphasizes the need for general methods and approaches that are easily applicable, because the level of digitalization and data availability vary across regions. The lack of data makes many methods inapplicable and useless. The ease of applicability will help to make cost-of-illness studies and their results comparable globally. Methods: This study is based on data from the Czech Republic in 2017. Drinking alcohol results in costs of healthcare, social care, law enforcement, and administrative costs of public authorities. To quantify the cost of drinking in the Czech Republic, the top-down approach, bottom-up approach, human capital approach and attributable fractions were used. Results: In 2017, the cost related to alcohol was estimated at 0.66% of the national GDP. Lost productivity represented 54.45% of total cost related to alcohol. All cost related to alcohol is considered to be avoidable. Conclusions: The methods and approaches applied to estimate the cost of disease or any other health issue should be generalized regarding the availability of data and specifics of provided services to people who are addicted or have any kind of disability.

• Klíčová slova
• Czech Republic, alcohol addiction, cost of illness, lost productivity,
• MeSH
• lidé MeSH
• náklady na zdravotní péči * MeSH
• osobní újma zaviněná nemocí * MeSH
• pití alkoholu epidemiologie   MeSH
• prosazení zákonů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Life expectancy is increasing worldwide and the burden of Parkinson's disease (PD) is growing. There are several cost-of-illness studies for PD from Western Europe and the USA, however, data about the costs associated with PD in Eastern Europe are still lacking. The objective of this study was to evaluate direct and indirect costs in a cohort of Czech patients with idiopathic PD and to identify cost-driving factors. Study participants (n=100) were recruited from the neurological department of the Charles University in Prague. Health-economic data were collected using a "bottom-up" approach. Costs were calculated from the societal perspective and the human capital approach was used to estimate indirect costs. Czech currency was converted into 2004 Euros (EUR) and inflated to 2008 prices. Independent cost-driving factors were identified in multivariate regression analysis. Total semi-annual costs of PD were EUR 5510 (95% CI: 4470-7090) per patient. Direct costs accounted for 60% of the total costs and indirect costs for 40%. Patients' expenditures accounted for 40% of their income. Independent cost-driving factors included disease severity, motor complications, psychosis and age. In conclusion, our study demonstrates a considerable economic burden of PD in the Czech Republic. Total costs are generally lower than in Western Europe but the proportion of costs that fall on patients is higher because of lower incomes. More intensive government support for patients with chronic diseases such as PD and the development of disease-management programs that incorporate both the clinical and economic effects of PD treatment are needed.

• MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• náklady na zdravotní péči * MeSH
• osobní újma zaviněná nemocí * MeSH
• Parkinsonova nemoc ekonomika   epidemiologie   MeSH
• senioři MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: To estimate the direct and indirect costs of active smoking in Vietnam. METHOD: A prevalence-based disease-specific cost of illness approach was utilised to calculate the costs related to five smoking-related diseases: lung cancer, cancers of the upper aerodigestive tract, chronic obstructive pulmonary disease, ischaemic heart disease and stroke. Data on healthcare came from an original survey, hospital records and official government statistics. Morbidity and mortality due to smoking combined with the average per capita income were used to calculate the indirect costs of smoking by applying the human capital approach. The smoking-attributable fraction was calculated using the adjusted relative risk values from phase II of the American Cancer Society Cancer Prevention Study (CPS-II). Costs were classified as personal, governmental and health insurance costs. RESULTS: The total economic cost of smoking in 2011 was estimated at 24 679.9 billion Vietnamese dong (VND), equivalent to US$1173.2 million or approximately 0.97% of the 2011 gross domestic product. The direct costs of inpatient and outpatient care reached 9896.2 billion VND (US$470.4 million) and 2567.2 billion VND (US$122.0 million), respectively. The government's contribution to these costs was 4534.3 billion VND (US$215.5 million), which was equivalent to 5.76% of its 2011 healthcare budget. The indirect costs (productivity loss) due to morbidity and mortality were 2652.9 billion VND (US$126.1 million) and 9563.5 billion VND (US$454.6 million), respectively. These indirect costs represent about 49.5% of the total costs of smoking. CONCLUSIONS: Tobacco consumption has large negative consequences on the Vietnamese economy.

• Klíčová slova
• Economics, Low/Middle income country, Smoking Caused Disease,
• MeSH
• kouření ekonomika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• osobní újma zaviněná nemocí * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Vietnam MeSH