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Tunis Med
Tunis Med
Tunis Med
La Tunisie Médicale
0041-4131
2724-7031
Tunisian Society of Medical Sciences

Article
Addressing methodological concerns in analysing direct cost: Letter to the Editor
Addressing methodological concerns in analysing direct cost: Letter to the EditorCherif Hela 11
1. Pulmonology department. Internal security forces hospital. University of Tunis El Manar. Faculty of medicine of Tunis. Tunisia
5 2023
05 5 2023
102 5 255255
2022
https://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 Unported License. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/
RESUME

ABSTRACT
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pmcAddressing methodological concerns in analysing direct cost: Letter to the Editor

Dear Editor,

We are writing to express our concerns regarding an article published in your esteemed journal by Hayder et al, titled "" Direct medical cost related to the management of pemphigus: A pilot Tunisian study" (1).

We appreciate the efforts made by the authors, but we have identified a significant flaw in their study.

The authors state that they employed an annual discount rate of 3% in accordance with the INEAS guideline.

These guidelines aim to assess the pharmaceutical industry in the submission of a drug evaluation dossier to the INEAS(2).

This discount rate is intended to be applied to future costs (future drug).

Indeed, costs and effects anticipated to arise in the future are deemed to hold lesser value than those experienced presently.

Furthermore, the authors referenced public tariffs from the years 2006 and 2008 for their calculations (3,4), which may introduce a gap since the study was conducted between 2015 and 2019.

This temporal discrepancy in timing poses a potential source of bias in the cost analysis.

In facts, costs should be from the current (or previous) year, adjusted for inflation using the Consumer Price Index provided by the Central Bank of Tunisia (2).

Finally, given that the study was carried out over a fiveyear period, the costs calculated at the beginning may differ from those at the end.

This may shed light on the kinetics of pemphigus management costs.
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References

Hayder F Bahloul E Yaich S Turki S Sellami K Litaiem N Direct medical cost related to the management of pemphigus: A pilot Tunisian study. Tunis Med 2024 102 2
Instance Nationale de l’Evaluation et de l’Accréditation en Santé (INEAS) Evaluation des technologies de santé. Choix méthodologiques pour les études pharmaco-économiques à l’INEAS. Tunis INEAS 2021
République Tunisienne Arrêté des ministres des finances et de la santé publique du 19 décembre 1996, fixant les tarifs de la prise en charge des malades payants dans les structures sanitaires publiques relevant du ministère de la santé publique. Journal Officiel 2008 11 July 2008
République Tunisienne Arrêté du ministre de la sante publique du 01 Juin 2006, fixant la nomenclature générale des actes professionnels des médecins, biologistes, médecins dentistes, psychologues cliniciens, sages-femmes et auxiliaires médicaux. Journal Officiel 2006 9 June 2006
