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Efecto de la edad y el género sobre las consecuencias clínicas y económicas del tratamiento con especialidad farmacéutica de marca o genérica en pacientes con dolor neuropático periférico en práctica clínica habitual
Clinical and economic consequences of treating patients with peripheral neuropathic pain with brand name or generic drugs in routine clinical practice: The effects of age and sex
R. Navarro-Artiedaa, J. Rejas-Gutiérrezb,
Autor para correspondencia
Javier.rejas@pfizer.com

Autor para correspondencia.
, M. Pérez-Paramoc, A. Sicras-Mainard
a Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
b Farmacoeconomía e Investigación de Resultados en Salud, Pfizer SLU, Alcobendas, Madrid, España
c Departamento Médico, Pfizer GEP SLU, Alcobendas, Madrid, España
d CAP Vicenç Papaciet, La Roca del Vallès, Barcelona, España
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por lo que conlleva unos altos costes directos e indirectos para el conjunto de la sociedad&#44; siendo considerado como uno de los principales problemas de salud p&#250;blica<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Estos acontecimientos se traducen en una p&#233;rdida de la calidad de vida que afecta a su entorno familiar y sociolaboral<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; En este aspecto&#44; muchos pacientes no est&#225;n correctamente diagnosticados&#44; o no reciben el tratamiento farmacol&#243;gico adecuado&#44; o las dosis prescritas son inferiores a las que deber&#237;an ser pautadas<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1&#44;5&#44;6</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La terapia farmacol&#243;gica constituye una de las bases fundamentales del tratamiento<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a>&#46; En este aspecto&#44; la gabapentina &#40;anticonvulsivante&#41; es una de las opciones terap&#233;uticas para el manejo del DNp&#44; existiendo presentaciones de especialidades farmac&#233;uticas de marca y gen&#233;ricas &#40;EFG&#41;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Las EFG son medicamentos con la misma eficacia&#44; seguridad y calidad que el original&#44; y son bioequivalentes a la marca original<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a>&#46; La motivaci&#243;n&#44; el conocimiento por parte del m&#233;dico y las pol&#237;ticas de intervenci&#243;n sanitaria sobre las EFG son algunos de los factores influyentes sobre su uso<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">11</span></a>&#46; En nuestro pa&#237;s&#44; las actuales pol&#237;ticas en cuanto a la restricci&#243;n del precio de los medicamentos de marca frente a las EFG ya no es un argumento tan s&#243;lido para exigir su consumo en igualdad de precio &#40;precios de referencia&#41;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Revisando la literatura de algunos autores se constata que son inciertos los argumentos farmacol&#243;gicos a favor y en contra a la prescripci&#243;n de estos productos<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9&#44;13</span></a>&#46; Otros estudios manifiestan discordancias &#40;marca vs&#46; EFG&#41; por diversas circunstancias&#44; entre ellas la adherencia al tratamiento&#44; ocasionando generalmente una disminuci&#243;n de la efectividad cl&#237;nica &#40;confusi&#243;n de los pacientes&#44; mal control terap&#233;utico&#44; bajos resultados en salud&#41; y un posible aumento de los costes sanitarios<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">14&#44;15</span></a>&#46; Recientemente hemos constatado diferencias significativas en el tratamiento del DNp cr&#243;nico seg&#250;n que se use marca original o EFG del mismo principio activo<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a>&#44; pero no se hab&#237;a analizado el efecto de la edad o el g&#233;nero sobre esos resultados&#46; Por otra parte&#44; las evidencias disponibles acerca de la relaci&#243;n entre estas variables son escasas &#40;situaci&#243;n de pr&#225;ctica cl&#237;nica habitual y efecto del sexo y el g&#233;nero&#41;&#44; tanto en la literatura internacional como en nuestro entorno sanitario&#44; por lo que la realizaci&#243;n de este estudio puede ser pertinente&#46; Por lo tanto&#44; el objetivo de este an&#225;lisis fue analizar el efecto de la edad y el g&#233;nero sobre las consecuencias cl&#237;nicas y econ&#243;micas asociadas a pacientes con DNp cr&#243;nico que inician tratamiento con gabapentina &#40;marca original&#41; frente a gabapentina EFG en condiciones de pr&#225;ctica cl&#237;nica habitual&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o y poblaci&#243;n de estudio</span><p id="par0025" class="elsevierStylePara elsevierViewall">An&#225;lisis del objetivo secundario de un estudio observacional&#44; multic&#233;ntrico y longitudinal &#40;de car&#225;cter retrospectivo&#41;&#44; realizado a partir de la revisi&#243;n de los registros m&#233;dicos electr&#243;nicos &#40;RME&#41; de bases de datos informatizadas&#44; con datos disociados&#44; de pacientes seguidos en r&#233;gimen ambulatorio y hospitalario&#46; La poblaci&#243;n de estudio estuvo formada por pacientes pertenecientes a 6 centros de atenci&#243;n primaria gestionados por Badalona Serveis Assistencials S&#46;A&#46; La poblaci&#243;n asignada a los centros fue en su mayor&#237;a urbana&#44; de nivel socioecon&#243;mico medio-bajo&#44; con predominio industrial&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Criterios de inclusi&#243;n y exclusi&#243;n</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se incluyeron en el estudio los pacientes que demandaron atenci&#243;n y que iniciaron un nuevo tratamiento con gabapentina &#40;Neurontin<span class="elsevierStyleSup">&#174;</span> o EFG&#41; durante los a&#241;os 2008 a 2012 &#40;periodo de reclutamiento&#44; fecha &#237;ndice&#41;&#46; Deb&#237;an reunir las siguientes caracter&#237;sticas&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>edad &#62;<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>a&#241;os&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>pacientes activos en la base de datos un m&#237;nimo de 12<span class="elsevierStyleHsp" style=""></span>meses antes de iniciar el estudio&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>estar en el programa de prescripciones cr&#243;nicas para la obtenci&#243;n de las recetas m&#233;dicas &#40;con registro constatado de la dosis diaria&#44; el intervalo de tiempo y la duraci&#243;n de cada tratamiento administrado&#59; &#8805;<span class="elsevierStyleHsp" style=""></span>2 recetas durante el periodo de seguimiento&#41;&#59; d&#41;<span class="elsevierStyleHsp" style=""></span>que se pudiera garantizar el seguimiento regular de los pacientes durante el periodo de estudio &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>2 registros sanitarios en el sistema inform&#225;tico&#41;&#44; y e&#41;<span class="elsevierStyleHsp" style=""></span>con diagn&#243;stico de DNp &#40;con anterioridad o al inicio del tratamiento&#41;&#46; Fueron excluidos&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>los sujetos trasladados a otros centros&#44; los desplazados o fuera de zona&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>los pacientes institucionalizados permanentemente&#44; y c&#41;<span class="elsevierStyleHsp" style=""></span>los que cambiaron de tratamiento &#40;marca vs&#46; EFG y viceversa&#41;&#46; Se consideraron 4 grupos de pacientes&#44; en funci&#243;n de la edad y del g&#233;nero&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>hombres&#44; y d&#41;<span class="elsevierStyleHsp" style=""></span>mujeres&#46; El seguimiento de los pacientes a partir de la fecha &#237;ndice fue de un a&#241;o&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Diagn&#243;stico y escalas utilizadas</span><p id="par0035" class="elsevierStylePara elsevierViewall">Los registros de los pacientes con DNp se obtuvieron a partir de la Clasificaci&#243;n Internacional de la Atenci&#243;n Primaria &#40;CIAP-2&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a>&#44; c&#243;digos N92-N99&#44; y&#47;o de la Clasificaci&#243;n Internacional de Enfermedades &#40;novena edici&#243;n&#41; Modificaci&#243;n Cl&#237;nica &#40;CIE-9-MC&#59; c&#243;digos 350&#46;1&#44; 352&#46;9&#44; 353&#46;1&#44; 353&#46;3&#44; 353&#46;8&#44; 354&#46;0&#44; 355&#46;1&#44; 355&#46;5&#44; 357&#46;2&#44; 357&#46;4&#44; 357&#46;8&#44; 357&#46;9&#44; 053&#46;13&#41;&#46; Los criterios seguidos siempre fueron a juicio del m&#233;dico&#46; Se consider&#243; DNp como el dolor iniciado o causado por una lesi&#243;n primaria o disfunci&#243;n del sistema nervioso perif&#233;rico&#44; es decir&#44; ra&#237;ces nerviosas&#44; plexos nerviosos y nervios&#46; Como una aproximaci&#243;n a la efectividad cl&#237;nica se obtuvo la informaci&#243;n recogida en las historias cl&#237;nicas de la escala num&#233;rica de dolor &#40;END&#41;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> graduada num&#233;ricamente para valoraci&#243;n de la intensidad del DNp en un rango de 0 &#40;no dolor&#41; a 10 &#40;m&#225;ximo dolor imaginable&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables demogr&#225;ficas y comorbilidades</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se recogieron el tiempo desde el diagn&#243;stico y los antecedentes personales obtenidos a partir de la CIAP-2<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a>&#59; hipertensi&#243;n arterial &#40;K86&#44; K87&#41;&#44; diabetes mellitus &#40;T89&#44;T90&#41;&#44; dislipidemia &#40;T93&#41;&#44; obesidad &#40;T82&#41;&#44; tabaquismo activo &#40;P17&#41;&#44; alcoholismo &#40;P15&#44; P16&#41;&#44; todos los tipos de fallos org&#225;nicos &#40;cardiaco&#44; hep&#225;tico y renal&#41;&#44; cardiopat&#237;a isqu&#233;mica &#40;c&#243;digos&#58; K74&#44; K76&#44; K75&#41;&#44; accidente cerebrovascular &#40;K90&#44; K91&#44; K93&#41;&#44; demencias o trastornos de memoria &#40;P70&#44; P20&#41;&#44; enfermedades neurol&#243;gicas&#58; enfermedad de Parkinson &#40;N87&#41;&#44; epilepsia &#40;N88&#41;&#44; esclerosis m&#250;ltiple &#40;N86&#41; y otras enfermedades neurol&#243;gicas &#40;N99&#41;&#44; y neoplasias malignas &#40;todos los tipos&#59; A79&#44; B72-75&#44; D74-78&#44; F75&#44; H75&#44; K72&#44; L71&#44; L97&#44; N74-76&#44; T71-73&#44; U75-79&#44; W72-73&#44; X75-81&#44; Y77-79&#41;&#46; Como variable resumen de la comorbilidad general&#44; para cada paciente atendido se utiliz&#243;&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>el &#237;ndice de comorbilidad de Charlson<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">18</span></a> como una aproximaci&#243;n a la gravedad del paciente&#44; y b&#41;<span class="elsevierStyleHsp" style=""></span>el &#237;ndice de casu&#237;stica individual&#44; obtenido a partir de los <span class="elsevierStyleItalic">Adjusted Clinical Groups</span> &#40;ACG&#41;&#44; que es un sistema de clasificaci&#243;n de pacientes por iso-consumo de recursos<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a>&#46; El aplicativo ACG proporciona las bandas de utilizaci&#243;n de recursos &#40;BUR&#41;&#44; con lo que cada paciente en funci&#243;n de su morbilidad general queda agrupado en una de las 5 categor&#237;as mutuamente excluyentes &#40;1&#58; usuarios sanos o de morbilidad muy baja&#59; 2&#58; morbilidad baja&#59; 3&#58; morbilidad moderada&#59; 4&#58; morbilidad elevada&#44; y 5&#58; morbilidad muy elevada&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Medicaci&#243;n administrada&#44; adherencia&#47;cumplimiento y persistencia al tratamiento</span><p id="par0045" class="elsevierStylePara elsevierViewall">Gabapentina &#40;principio activo&#41;&#44; indicada para el tratamiento del DNp&#44; se identific&#243; seg&#250;n la clasificaci&#243;n <span class="elsevierStyleItalic">Anatomical Therapeutic Chemical Classification System</span> &#40;ATC&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a>&#58; N03AX12&#46; La informaci&#243;n se obtuvo de los registros procedentes de la dispensaci&#243;n farmacol&#243;gica de medicamentos emitida por la aplicaci&#243;n &#40;RCMPS&#41; del CatSalut&#46; La elecci&#243;n del medicamento de marca o EFG a un paciente en concreto fue a criterio del m&#233;dico &#40;pr&#225;ctica cl&#237;nica&#41;&#46; La <span class="elsevierStyleItalic">tasa de adherencia&#47;cumplimiento</span> se defini&#243; seg&#250;n los criterios de la Sociedad Internacional de Farmacoeconom&#237;a y Resultados en Salud &#40;ISPOR&#41; y se calcul&#243; en funci&#243;n de la tasa de uso&#47;posesi&#243;n del medicamento &#40;RPM&#41;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a>&#46; Este se evalu&#243; desde la primera a la &#250;ltima prescripci&#243;n y representa el n&#250;mero de d&#237;as de medicaci&#243;n suministrada entre el n&#250;mero de d&#237;as en tratamiento &#40;a partir de la fecha &#237;ndice&#41;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a>&#46; La <span class="elsevierStyleItalic">persistencia</span> se defini&#243; como el tiempo&#44; medido en meses&#44; sin abandono del tratamiento inicial o sin cambio a otra medicaci&#243;n al menos 30 d&#237;as despu&#233;s de la prescripci&#243;n inicial&#46; La persistencia al tratamiento se obtuvo a los 3&#44; 6&#44; 9 y 12<span class="elsevierStyleHsp" style=""></span>meses del seguimiento&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Uso de recursos y an&#225;lisis de costes</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se consideraron <span class="elsevierStyleItalic">costes sanitarios</span> los relacionados con la actividad asistencial &#40;visitas m&#233;dicas&#44; d&#237;as de hospitalizaci&#243;n&#44; urgencias hospitalarias y solicitudes diagn&#243;sticas o terap&#233;uticas&#41; efectuada por los profesionales&#46; El coste fue expresado en coste medio por paciente &#40;promedio coste&#47;unitario&#41;&#46; Los costes unitarios correspondientes al a&#241;o 2013 se obtuvieron a partir de la contabilidad anal&#237;tica de los centros&#44; excepto la medicaci&#243;n&#46; Esta &#250;ltima se obtuvo del Bot Plus del Consejo General de Colegios de Farmac&#233;uticos Oficiales de Espa&#241;a&#46; Las prescripciones &#40;recetas m&#233;dicas&#41; se cuantificaron seg&#250;n el precio de venta al p&#250;blico por envase en el momento de la prescripci&#243;n&#46; Para el c&#225;lculo de los costes tambi&#233;n se incluy&#243; la siguiente medicaci&#243;n concomitante&#58; antiinflamatorios no esteroides &#40;AINE&#44; M01&#41;&#44; opi&#225;ceos &#40;N02A&#41;&#44; analg&#233;sicos &#40;N02B&#41;&#44; sedantes&#47;hipn&#243;ticos &#40;ansiol&#237;ticos&#58; N05<span class="elsevierStyleHsp" style=""></span>C&#41; y antidepresivos &#40;N06A&#41;&#46; Los costes unitarios no farmacol&#243;gicos incluidos en el an&#225;lisis se corresponden con visitas m&#233;dicas de atenci&#243;n primaria &#40;23&#44;7<span class="elsevierStyleHsp" style=""></span>&#8364; por visita&#41;&#44; visita m&#233;dica a urgencias &#40;119&#44;9<span class="elsevierStyleHsp" style=""></span>&#8364;&#41;&#44; hospitalizaci&#243;n &#40;327&#44;3<span class="elsevierStyleHsp" style=""></span>&#8364; por d&#237;a&#41;&#44; visita m&#233;dica a especialista &#40;68&#44;9<span class="elsevierStyleHsp" style=""></span>&#8364;&#41;&#44; hospital de d&#237;a &#40;184&#44;8<span class="elsevierStyleHsp" style=""></span>&#8364; por sesi&#243;n&#41;&#44; pruebas de laboratorio &#40;22&#44;7<span class="elsevierStyleHsp" style=""></span>&#8364; por anal&#237;tica convencional&#41;&#44; radiolog&#237;a convencional &#40;18&#44;9<span class="elsevierStyleHsp" style=""></span>&#8364;&#41; y pruebas diagn&#243;sticas &#40;37&#44;9<span class="elsevierStyleHsp" style=""></span>&#8364;&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Aspectos &#233;ticos</span><p id="par0055" class="elsevierStylePara elsevierViewall">El estudio sigui&#243; los principios &#233;ticos b&#225;sicos contenidos en la Declaraci&#243;n de Helsinki para estudios en humanos&#46; El protocolo del estudio fue clasificado por la Agencia Espa&#241;ola de Medicamentos y Productos Sanitarios como Estudio Post-autorizaci&#243;n-Otros dise&#241;os &#40;EPA-OD&#41; y fue aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital Germans Trias i Pujol de Badalona &#40;Barcelona&#41;&#46; Este estudio no intervencionista se llev&#243; a cabo de acuerdo con la regulaci&#243;n vigente sobre estudios observacionales basados en bases de datos retrospectivos&#46; Los datos de los sujetos se sometieron a un proceso de disociaci&#243;n&#44; de forma que se preserv&#243; de forma an&#243;nima la identidad del paciente&#44; tal y como se establece en la L&#46;O&#46; 15&#47;1999 de 13 de diciembre&#44; de Protecci&#243;n de Datos de Car&#225;cter Personal&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lisis estad&#237;stico</span><p id="par0060" class="elsevierStylePara elsevierViewall">Como paso previo al an&#225;lisis&#44; y en particular a la fuente de informaci&#243;n perteneciente a las historias cl&#237;nicas informatizadas&#44; se revisaron cuidadosamente los datos&#44; mediante an&#225;lisis exploratorio y preparaci&#243;n de datos para el an&#225;lisis&#44; observando sus distribuciones de frecuencia y buscando posibles errores de registro o de codificaci&#243;n&#46; Se efectu&#243; un an&#225;lisis estad&#237;stico descriptivo-univariante con valores de media&#44; mediana&#44; desviaci&#243;n t&#237;pica e intervalos de confianza &#40;IC&#41; del 95&#37; en variables param&#233;tricas&#44; y mediana e intervalos intercuart&#237;licos &#40;percentiles 25 y 75 de la distribuci&#243;n&#41; en variables no param&#233;tricas&#44; una vez comprobada la normalidad de la distribuci&#243;n con la prueba de Kolmogorov-Smirnov&#46; La persistencia al tratamiento se calcul&#243; mediante el m&#233;todo de Kaplan-Meier&#46; Para el an&#225;lisis bivariante se emplearon pruebas de ANOVA y ji al cuadrado &#40;&#967;<span class="elsevierStyleSup">2</span>&#41; seg&#250;n la distribuci&#243;n de los datos&#46; La comparaci&#243;n de los costes sanitarios se realiz&#243; seg&#250;n las recomendaciones de Thompson y Barber<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a> mediante un modelo lineal general &#40;an&#225;lisis de la covarianza &#91;ANCOVA&#93;&#41; corregido por las covariables g&#233;nero&#44; edad&#44; comorbilidad general &#40;BUR&#44; &#237;ndice de Charlson&#41;&#44; RPM y persistencia al tratamiento&#46; Las comparaciones por pares se ajustaron al procedimiento de estimaci&#243;n de medias marginales&#44; aplicando la correcci&#243;n de Bonferroni para estimar el valor p de significaci&#243;n estad&#237;stica&#46; Los datos se presentaron como diferencias de medias ajustadas entre tratamientos con su correspondiente intervalo de confianza del 95&#37; calculado con t&#233;cnicas de re-muestreo <span class="elsevierStyleItalic">&#40;bootstraping&#41;</span> corregido por el sesgo&#44; dadas las distribuciones no normales de las variables utilizaci&#243;n de recursos y costes&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">La variable cl&#237;nica de intensidad de dolor en la escala num&#233;rica se analiz&#243; despu&#233;s de realizar una imputaci&#243;n simple de los valores ausentes mediante un modelo lineal general &#40;ANCOVA&#41; para la variaci&#243;n absoluta y relativa&#44; entre inicio del tratamiento y discontinuaci&#243;n&#44; de las puntuaciones de dolor&#44; y mediante un modelo de regresi&#243;n log&#237;stica para la proporci&#243;n de pacientes respondedores &#40;reducci&#243;n del dolor basal &#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41; y sin dolor&#47;dolor leve &#40;puntuaci&#243;n inferior a 4 en la END&#41;&#46; Las covariables usadas en el ANCOVA y en el modelo de regresi&#243;n log&#237;stica fueron la edad&#44; el g&#233;nero y la puntuaci&#243;n en la escala al inicio del tratamiento&#46; No respondieron la END un total del 9&#44;7&#37; de los pacientes&#44; sin diferencias significativas entre la marca &#40;8&#44;5&#37;&#41; y el gen&#233;rico &#40;10&#44;2&#37;&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;382&#46; El m&#233;todo de imputaci&#243;n de los datos faltantes fue el arrastre de la peor observaci&#243;n disponible&#44; que en este caso fue la puntuaci&#243;n observada en la visita de inicio de tratamiento&#46; Se compararon las puntuaciones en la visita inicial y final&#44; la variaci&#243;n absoluta &#40;puntos&#41; y relativa &#40;&#37;&#41; de la intensidad del dolor entre ambas visitas&#44; la proporci&#243;n de respondedores y la proporci&#243;n de pacientes sin dolor&#47;dolor leve&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Resultados</span><p id="par0070" class="elsevierStylePara elsevierViewall">De una selecci&#243;n inicial de 90&#46;831 sujetos mayores de 18<span class="elsevierStyleHsp" style=""></span>a&#241;os asignados a los centros&#44; se reclutaron 1&#46;369 pacientes que reun&#237;an los criterios de selecci&#243;n para ser incluidos en el estudio &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; En general&#44; de los pacientes que recibieron tratamiento con gabapentina&#44; en 400 &#40;29&#44;2&#37;&#41; fue de marca y en 969 &#40;70&#44;8&#37;&#41; de EFG&#59; la media de edad fue de 64&#44;6 &#40;DE&#58; 15&#44;9&#41; a&#241;os&#44; y el 61&#44;1&#37; fueron mujeres&#46; Del conjunto de pacientes&#44; el 43&#44;0&#37; presentaron hipertensi&#243;n arterial y el 41&#44;2&#37; dislipidemia&#46; Se compararon los pacientes en tratamiento de marca o EFG por los 4 grupos de estudio&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>edad &#60;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#58; marca &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>187&#59; 28&#44;7&#37;&#41; vs&#46; EFG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>465&#59; 71&#44;3&#37;&#41;&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>edad &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#58; marca &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>213&#59; 29&#44;7&#37;&#41; vs&#46; EFG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>504&#59; 70&#44;3&#37;&#41;&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>hombres&#58; marca &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>175&#59; 32&#44;9&#37;&#41; vs&#46; EFG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>357&#59; 67&#44;1&#37;&#41;&#44; y d&#41;<span class="elsevierStyleHsp" style=""></span>mujeres&#58; marca &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&#59; 26&#44;9&#37;&#41; vs&#46; EFG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>612&#59; 73&#44;1&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se describen las caracter&#237;sticas basales y las comorbilidades asociadas a los pacientes con DNp por grupos de estudio&#46; Los 4 grupos de estudio fueron comparables en sus caracter&#237;sticas basales entre marca vs&#46; EFG&#46; Con gabapentina de marca&#44; la duraci&#243;n media del tratamiento fue superior a la del EFG &#40;7&#44;3 vs&#46; 6&#44;3<span class="elsevierStyleHsp" style=""></span>meses&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El RPM &#40;86&#44;5&#37; vs&#46; 81&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y la media diaria de dosis de medicamento &#40;1&#46;322&#44;5 vs&#46; 1&#46;153&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41; tambi&#233;n fueron superiores&#46; La persistencia al tratamiento de marca vs&#46; EFG &#40;en todos los rangos de tiempo&#58; 3&#44; 6&#44; 9 y 12<span class="elsevierStyleHsp" style=""></span>meses&#41; fue mayor&#46; El RPM &#40;por grupos&#41; comparando marca vs&#46; EFG fue el siguiente&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>en &#60;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 86&#44;3&#37; &#40;81&#44;3-91&#44;2&#41; vs&#46; 81&#44;4&#37; &#40;77&#44;8-84&#44;9&#41;&#44; diferencias no significativas&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>en &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 86&#44;6&#37; &#40;82&#44;0-91&#44;2&#41; vs&#46; 81&#44;1&#37; &#40;77&#44;6-84&#44;5&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>en hombres&#44; 86&#44;8&#37; &#40;81&#44;7-91&#44;8&#41; vs&#46; 83&#44;1&#37; &#40;79&#44;2-87&#44;0&#41;&#44; diferencias no significativas&#44; y d&#41;<span class="elsevierStyleHsp" style=""></span>en mujeres&#44; 86&#44;2&#37; &#40;82&#44;0-91&#44;2&#41; vs&#46; 80&#44;2&#37; &#40;77&#44;0-83&#44;4&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#44; respectivamente&#46; La persistencia anual fue&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>en &#60;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 19&#44;9&#37; vs&#46; 14&#44;0&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>en &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 21&#44;1&#37; vs&#46; 13&#44;9&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>en hombres&#44; 20&#44;7&#37; vs&#46; 15&#44;2&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; y d&#41;<span class="elsevierStyleHsp" style=""></span>en mujeres&#44; 18&#44;7&#37; vs&#46; 11&#44;4&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; respectivamente&#46; En la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> se detallan las curvas de persistencia al tratamiento&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En las <a class="elsevierStyleCrossRefs" href="#fig0015">figuras 3 y 4</a> se muestra la comparaci&#243;n de marca vs&#46; EFG en el uso de recursos sanitarios por los diferentes grupos de estudio&#46; En general&#44; los pacientes en tratamiento con gabapentina de marca utilizaron menos recursos sanitarios&#44; especialmente en visitas m&#233;dicas en atenci&#243;n primaria &#40;12&#44;5 frente a 15&#44;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y urgencias hospitalarias &#40;0&#44;4 frente a 0&#44;7&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Estas diferencias se constataron en los 4 grupos de estudio &#40;edad y g&#233;nero&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se detallan los diferentes componentes del coste sanitario seg&#250;n los grupos de estudio&#46; El promedio&#47;unitario del coste sanitario bruto fue mayor con la administraci&#243;n de EFG en comparaci&#243;n con la marca &#40;1&#46;275 vs&#46; 1&#46;083<span class="elsevierStyleHsp" style=""></span>&#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; mientras que el coste sanitario corregido por covariables fue de 1&#46;277 vs&#46; 1&#46;057<span class="elsevierStyleHsp" style=""></span>&#8364; &#40;diferencia&#58; 220<span class="elsevierStyleHsp" style=""></span>&#8364;&#41;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Una parte de esta diferencia de costes entre marca vs EFG se observ&#243; en los costes producidos en atenci&#243;n primaria&#44; puesto que las diferencias observadas en atenci&#243;n especializada no llegaron a ser estad&#237;sticamente significativas&#46; Por grupos de estudio se mantuvieron estas diferencias &#40;costes corregidos&#44; ANOVA&#41;&#58; en &#60;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 974 vs&#46; 1&#46;195<span class="elsevierStyleHsp" style=""></span>&#8364; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>en &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 1&#46;146 vs&#46; 1&#46;363<span class="elsevierStyleHsp" style=""></span>&#8364; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>en hombres&#44; 1&#46;015 vs&#46; 1&#46;255<span class="elsevierStyleHsp" style=""></span>&#8364; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y d&#41;<span class="elsevierStyleHsp" style=""></span>en mujeres&#44; 1&#46;102 vs&#46; 1&#46;299<span class="elsevierStyleHsp" style=""></span>&#8364; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; respectivamente&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">No se observaron diferencias estad&#237;sticamente significativas en las puntuaciones de las escalas de dolor al inicio del estudio&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se detalla la variaci&#243;n de la intensidad del dolor entre inicio y discontinuaci&#243;n del tratamiento seg&#250;n grupos de estudio&#46; Comparado con EFG&#44; el tratamiento con marca mostr&#243; una reducci&#243;n adicional del dolor basal&#58; 13&#44;5&#37; &#40;IC&#58; 10&#44;9-16&#44;2&#41; y 10&#44;8&#37; &#40;IC&#58; 8&#44;2-13&#44;5&#41;&#44; en &#60;<span class="elsevierStyleHsp" style=""></span>65 y &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 en ambos casos&#41;&#44; y 10&#44;7&#37; &#40;IC&#58; 8&#44;2-13&#44;2&#41; y 13&#44;8&#37; &#40;IC&#58; 11&#44;0-16&#44;5&#41; en mujeres y hombres&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 en ambos casos&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">Mientras que en la literatura cient&#237;fica internacional y nacional se pueden localizar referencias al efecto diferencial de la marca original versus la EFG del mismo principio activo&#44; y previamente hemos publicado nuestra experiencia en DNp<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a>&#44; sin embargo no hemos podido encontrar datos que analicen el efecto del g&#233;nero o de la edad sobre estos resultados&#44; por lo que este estudio parece pertinente y oportuno&#46; Los resultados observados ponen de manifiesto que gabapentina EFG en comparaci&#243;n con la marca original en pacientes con DNp se asoci&#243; a una menor persistencia del tratamiento y peores resultados cl&#237;nicos &#40;reducci&#243;n del dolor&#41;&#44; repercutiendo en un mayor uso de los recursos y costes sanitarios&#59; y que estos hallazgos se reproducen cuando se analizan los datos por rangos de edad y g&#233;nero&#44; mostrando diferencias en costes por paciente similares &#40;en el rango de los 200<span class="elsevierStyleHsp" style=""></span>&#8364; por paciente y a&#241;o de ahorro cuando se usa la marca original&#41;&#44; a la vez que se muestran reducciones adicionales del dolor que alcanzan la significaci&#243;n estad&#237;stica&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Es conocido que un medicamento EFG tiene la misma composici&#243;n cualitativa y cuantitativa en principio activo y forma farmac&#233;utica&#44; con una bioequivalencia demostrada &#40;estudios de biodisponibilidad&#41; con el medicamento de referencia&#44; aunque las diferencias en la composici&#243;n de los excipientes y su apariencia externa son distintas&#44; lo que puede ser responsable de problemas de bioapariencia y potencial efecto nocebo&#46; La entrada al mercado de estos f&#225;rmacos ha contribuido a una reducci&#243;n en la factura farmac&#233;utica de la sanidad p&#250;blica&#44; aunque actualmente en nuestro pa&#237;s medicamentos gen&#233;ricos y los de marca presentan el mismo coste&#44; por lo que a la luz de las normativas actuales no se encuentran argumentos farmacol&#243;gicos que impidan indistintamente la prescripci&#243;n de medicamentos de marca o EFG&#46; Sin embargo&#44; adem&#225;s de las conocidas razones de incumplimiento &#8212;que pueden ser intencionadas &#40;factores sociodemogr&#225;ficos&#44; efectos secundarios&#44; precio de los medicamentos&#44; falta de comprensi&#243;n del tratamiento o del estado de salud&#44; etc&#46;&#41; o no intencionadas &#40;olvido de c&#243;mo tomar la medicaci&#243;n correctamente&#44; etc&#46;&#41;&#8212;&#44; los resultados del estudio muestran que la administraci&#243;n de un EFG podr&#237;a considerarse un factor m&#225;s a tener en cuenta&#59; es posible que la bioapariencia o la prescripci&#243;n de marcas de medicamentos EFG distintas&#44; y no medidas en el estudio&#44; pueda influir en nuestros resultados &#40;falta de cumplimiento&#47;adherencia&#41;&#46; Entre estos factores figuran la distinta apariencia &#40;colores&#44; formas&#41;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a>&#44; la carencia de determinadas presentaciones &#40;retardadas&#44; liberaci&#243;n lenta o de absorci&#243;n&#41;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">25&#44;26</span></a>&#44; variabilidad en cuanto a sus excipientes<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">27</span></a>&#44; el efecto del copago<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a> o incluso como consecuencia del efecto nocebo<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Sin una adecuada estandarizaci&#243;n de las metodolog&#237;as en cuanto a las caracter&#237;sticas de los pacientes&#44; as&#237; como en el n&#250;mero y medida de las variables estudiadas&#44; los resultados obtenidos deben interpretarse con prudencia en su validez externa&#46; Nuestros resultados muestran tasas de adherencia&#47;persistencia al tratamiento de marca significativamente superiores a las del EFG&#46; A pesar de que estos datos no est&#225;n generalizados en la literatura&#44; s&#237; est&#225;n en consonancia con diversos autores<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">30&#44;31</span></a>&#46; Los resultados de nuestro estudio muestran que el uso de EFG se asocia con un mayor uso de los recursos sanitarios y costes&#44; con un grado de efectividad cl&#237;nica algo inferior al medicamento de marca indistintamente del grupo de edad o g&#233;nero de los pacientes&#46; La relaci&#243;n temporal existente entre la falta de adherencia&#44; la menor efectividad cl&#237;nica y un mayor uso de los recursos sanitarios est&#225; fuera de toda duda y es muy consistente en la bibliograf&#237;a<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9&#44;28-33</span></a>&#46; Estos datos son de dif&#237;cil comparaci&#243;n por la falta de estudios publicados&#44; como se mencionaba previamente&#46; Tran et al&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">34</span></a> detallan que el uso de gen&#233;ricos se asocia a una reducci&#243;n de los objetivos terap&#233;uticos de control &#40;efectividad cl&#237;nica&#58; colesterol LDL&#41; en el tratamiento de la dislipidemia&#44; y Gagne et al&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">35</span></a>&#44; en un estudio prospectivo&#44; observan que los pacientes que inician un tratamiento con estatinas gen&#233;ricas frente a las de marca presentaban un mayor incumplimiento y mayores tasas de episodios cardiovasculares&#59; son datos no generalizables&#44; pero coincidentes con otros estudios publicados<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9&#44;33</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Los resultados tambi&#233;n detallan que el coste de los medicamentos de base fue mayor en los pacientes en tratamiento con gabapentina de marca&#44; y se observ&#243; tanto en hombres como mujeres o en menores y mayores de 65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; Una posible explicaci&#243;n al respecto podr&#237;a deberse a 3 circunstancias&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>el estudio ha tenido un periodo de inclusi&#243;n de pacientes elevado &#40;5 a&#241;os&#41;&#44; con lo que en los primeros a&#241;os el precio de los medicamentos de marca era superior a los EFG &#40;no estaban a precio de referencia&#41;&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>el cumplimiento terap&#233;utico de estos pacientes tambi&#233;n fue superior&#44; y c&#41;<span class="elsevierStyleHsp" style=""></span>existe una mayor proporci&#243;n de pacientes &#40;especialmente en el grupo con gabapentina&#41; que hab&#237;an recibido dosis m&#225;s altas del f&#225;rmaco&#59; aunque la explicaci&#243;n m&#225;s plausible puede deberse a una mayor persistencia al tratamiento de marca<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a>&#46; No obstante&#44; merece la pena resaltar que en los 4 grupos analizados la suma del coste de la medicaci&#243;n de base con la medicaci&#243;n concomitante para el dolor alcanz&#243; magnitudes num&#233;ricamente inferiores &#40;&#8722;20<span class="elsevierStyleHsp" style=""></span>&#8364;&#44; &#8722;10<span class="elsevierStyleHsp" style=""></span>&#8364;&#44; &#8722;25<span class="elsevierStyleHsp" style=""></span>&#8364; y &#8722;3<span class="elsevierStyleHsp" style=""></span>&#8364;&#44; respectivamente&#44; en los grupos de &#60;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; hombres y mujeres&#44; respectivamente&#41; cuando se compara gabapentina de marca con gabapentina EFG&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Los resultados de este estudio sugieren algunas estrategias de intervenci&#243;n&#44; sobre todo para los responsables pol&#237;ticos y de la administraci&#243;n sanitaria&#46; Los cambios en la apariencia del f&#225;rmaco pueden causar que los pacientes pierdan la confianza en la seguridad o eficacia de la prescripci&#243;n gen&#233;rica&#44; repercutiendo en la falta de adherencia al tratamiento&#44; especialmente en enfermedades cr&#243;nicas y en pacientes polimedicados&#46; La reducci&#243;n de la variabilidad en la apariencia entre medicamentos qu&#237;micamente id&#233;nticos podr&#237;a ayudar a promover la adhesi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">13-15</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Las posibles limitaciones del estudio inciden en las propias de los estudios retrospectivos&#44; como por ejemplo el infrarregistro de la enfermedad o la posible variabilidad de los profesionales y de los pacientes al ser un dise&#241;o observacional&#44; o incluso al sistema de costes empleado&#44; o a la posibilidad de la existencia de un sesgo de clasificaci&#243;n&#46; En este aspecto&#44; la posible inexactitud de la codificaci&#243;n diagn&#243;stica en cuanto al diagn&#243;stico de DNp&#44; o bien la falta de alguna variable que pudiera influir en los resultados finales &#40;nivel socioecon&#243;mico de los pacientes&#44; evoluci&#243;n de la dosis farmacol&#243;gica prescrita&#44; cambios de forma y presentaci&#243;n en los EFG&#44; etc&#46;&#41;&#44; deben considerarse como una limitaci&#243;n del estudio&#46; Adem&#225;s&#44; no se pudieron obtener los datos en todos los pacientes&#44; como la medida de efectividad cl&#237;nica&#44; especialmente en el periodo final&#59; no obstante&#44; este impedimento qued&#243; repartido de forma similar entre los subgrupos de estudio&#44; y el hecho de que se hiciera una imputaci&#243;n muy conservadora &#40;peor valor disponible&#41; confiere cierta robustez a los resultados observados&#46; Aunque a nuestro entender la principal objeci&#243;n al estudio fueron&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>el sesgo de selecci&#243;n por parte del m&#233;dico responsable a la hora de iniciar el tratamiento de marca o EFG&#44; puesto que no se realiz&#243; de forma aleatoria&#44; como es habitual en la pr&#225;ctica cl&#237;nica diaria&#44; y b&#41;<span class="elsevierStyleHsp" style=""></span>en la validez externa de los resultados &#40;generalizaci&#243;n de los datos&#41;&#44; puesto que el estudio se ha realizado en una &#250;nica entidad proveedora de servicios sanitarios&#44; por lo que la interpretaci&#243;n de los resultados debe efectuarse con prudencia&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Las perspectivas futuras que nos ofrece este estudio se centran en replicarlo en otras instituciones sanitarias y en promover estrategias de intervenci&#243;n orientadas a fomentar la adherencia de los pacientes a los tratamientos prescritos por sus m&#233;dicos&#46; En conclusi&#243;n&#44; y teniendo en cuenta las limitaciones apuntadas&#44; este an&#225;lisis ha mostrado que los pacientes que iniciaron tratamiento con gabapentina de marca vs&#46; gen&#233;rico se asociaron a un mayor grado de adherencia al tratamiento&#44; repercutiendo en unos menores costes sanitarios&#44; a la vez que se observaron mejores resultados cl&#237;nicos en la reducci&#243;n del dolor&#44; y que estos hallazgos fueron similares tanto en hombres como en mujeres&#44; y tanto en &#60;<span class="elsevierStyleHsp" style=""></span>65 como en &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Autor&#237;a</span><p id="par0125" class="elsevierStylePara elsevierViewall">La concepci&#243;n y el dise&#241;o del estudio fueron realizados por A&#46; Sicras y J&#46; Rejas&#59; la recogida de los datos y el an&#225;lisis estad&#237;stico&#44; por A&#46; Sicras&#44; y la interpretaci&#243;n de los datos&#44; la redacci&#243;n&#44; la revisi&#243;n y la aprobaci&#243;n del manuscrito remitido&#44; por todos los autores&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicto de intereses</span><p id="par0130" class="elsevierStylePara elsevierViewall">J&#46; Rejas y Mar&#237;a P&#233;rez son empleados de Pfizer SLU&#46; Los dem&#225;s autores declaran no tener conflictos de intereses&#46;</p></span></span>"
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              "titulo" => "Criterios de inclusi&#243;n y exclusi&#243;n"
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              "titulo" => "Medicaci&#243;n administrada&#44; adherencia&#47;cumplimiento y persistencia al tratamiento"
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              "titulo" => "Uso de recursos y an&#225;lisis de costes"
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          "titulo" => "Conflicto de intereses"
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    "fechaRecibido" => "2016-03-10"
    "fechaAceptado" => "2016-03-29"
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            1 => "Gabapentina"
            2 => "Medicamentos de marca"
            3 => "Gen&#233;ricos"
            4 => "Adherencia"
            5 => "Costes"
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            0 => "Neuropathic pain"
            1 => "Gabapentin"
            2 => "Brand name drugs"
            3 => "Generic drugs"
            4 => "Adherence"
            5 => "Costs"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar el efecto de la edad y el g&#233;nero sobre el dolor y los costes en pacientes con dolor neurop&#225;tico perif&#233;rico &#40;DNp&#41; cr&#243;nico que inician tratamiento con gabapentina &#40;marca&#41; frente a gabapentina gen&#233;rica &#40;EFG&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio multic&#233;ntrico-retrospectivo&#44; realizado con registros m&#233;dicos electr&#243;nicos &#40;RME&#41; de pacientes de ambos g&#233;neros&#44; &#62;<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; que iniciaron nuevo tratamiento con gabapentina de marca o gen&#233;rico&#46; Durante un a&#241;o se midi&#243; la adherencia &#40;ratio posesi&#243;n medicaci&#243;n &#91;RPM&#93;&#41; y la persistencia&#44; la utilizaci&#243;n de recursos sanitarios&#44; los costes y la reducci&#243;n del dolor&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 1&#46;369 RME &#40;61&#44;1&#37; mujeres&#59; edad 64&#44;6 &#91;15&#44;9&#93; a&#241;os&#44; 52&#44;4&#37; &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#41;&#59; marca&#58; 400&#44; EFG&#58; 969&#46; La persistencia y la adherencia fueron mayores con marca&#58; 7&#44;3 vs&#46; 6&#44;3<span class="elsevierStyleHsp" style=""></span>meses &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y 86&#44;5 vs&#46; 81&#44;3&#37; de RPM &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Con marca&#44; se observaron costes sanitarios menores&#44; tanto en &#60;<span class="elsevierStyleHsp" style=""></span>65 como en &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os &#40;diferencias medias por paciente de 221<span class="elsevierStyleHsp" style=""></span>&#8364; &#91;IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 59-382&#93; y de 217<span class="elsevierStyleHsp" style=""></span>&#8364; &#91;51-382&#93;&#44; respectivamente &#91;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#93;&#41;&#44; como en hombres &#40;diferencias medias de 197<span class="elsevierStyleHsp" style=""></span>&#8364; &#91;63-328&#93;&#41; o mujeres &#40;diferencias de 239<span class="elsevierStyleHsp" style=""></span>&#8364; &#91;96-397&#93;&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005 y p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#44; respectivamente&#46; Comparado con EFG&#44; el tratamiento con marca mostr&#243; una reducci&#243;n mayor del dolor&#58; 13&#44;5&#37; &#40;10&#44;9-16&#44;2&#41; y 10&#44;8&#37; &#40;8&#44;2-13&#44;5&#41; en &#60;<span class="elsevierStyleHsp" style=""></span>65 y &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; as&#237; como del 10&#44;7&#37; &#40;8&#44;2-13&#44;2&#41; y del 13&#44;8&#37; &#40;11&#44;0-16&#44;5&#41; en mujeres y hombres&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Con independencia del g&#233;nero o la edad&#44; los pacientes que iniciaron tratamiento del DNp con gabapentina de marca vs&#46; gen&#233;rico mostraron un mayor grado de adherencia y persistencia al tratamiento&#44; repercutiendo en unos menores costes sanitarios&#44; a la vez que se observaron mayores reducciones del dolor&#46;</p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We aimed to analyse the effects of age and sex on pain and cost for patients with chronic peripheral neuropathic pain &#40;PNP&#41; who have started treatment with brand name gabapentin versus generic gabapentin &#40;EFG&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We conducted a retrospective multicentre study using electronic medical records &#40;EMR&#41; for patients of both sexes&#44; older than 18&#44; who began treatment with brand name or generic gabapentin&#46; Adherence &#40;medication possession ratio &#91;MPR&#93;&#41;&#44; persistence&#44; use of healthcare resources&#44; cost&#44; and pain reduction were measured for one year&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We analysed 1369 EMRs &#91;61&#46;1&#37; women&#59; mean age 64&#46;6 &#40;15&#46;9&#41;&#44; 52&#46;4&#37;<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 years&#93;&#59; 400 used brand name drugs while 969 used generic gabapentin&#46; Persistence and adherence were higher in patients using brand name gabapentin &#40;7&#46;3 vs 6&#46;3 months&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#59; 86&#46;5&#37; vs 81&#46;3&#37; MPR&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Lower healthcare costs were observed in patients using brand-name gabapentin in both age groups &#40;&#60;<span class="elsevierStyleHsp" style=""></span>65 and &#8805;<span class="elsevierStyleHsp" style=""></span>65&#41;&#46; Mean difference in cost per patient amounted to &#8364;221 &#40;95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#58; 59-382&#41; and &#8364;217 &#40;95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#58; 51-382&#41; in the &#60;<span class="elsevierStyleHsp" style=""></span>65 and &#8805;<span class="elsevierStyleHsp" style=""></span>65 age groups&#44; respectively &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; Mean difference in cost among men amounted to &#8364;197 &#40;63-328&#41;&#44; while mean difference in cost among women amounted to &#8364;239 &#40;96-397&#41; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;005 and <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#44; respectively&#41;&#46; Compared with EFG&#44; brand treatment showed greater pain relief&#58; 13&#46;5&#37; &#40;10&#46;9-16&#46;2&#41; and 10&#46;8&#37; &#40;8&#46;2-13&#46;5&#41; in &#60;<span class="elsevierStyleHsp" style=""></span>65 and &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>year patients&#44; respectively &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; and 10&#46;7&#37; &#40;8&#46;2-13&#46;2&#41; and 13&#46;8&#37; &#40;11&#46;0-16&#46;5&#41; in women and men respectively &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Regardless of sex and age&#44; patients who started PNP treatment with brand name medication showed greater persistence and adherence to treatment than those taking generic drugs&#46; Brand name treatment also involved lower healthcare costs&#44; and greater pain relief&#46;</p></span>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Grupos de estudio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>187 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>465 &#40;71&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>213 &#40;29&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>504 &#40;70&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>175 &#40;32&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>357 &#40;67&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225 &#40;26&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>612 &#40;73&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas demogr&#225;ficas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Promedio de edad&#44; a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#44;7 &#40;10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#44;3 &#40;9&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#44;9 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;2 &#40;7&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;6 &#40;17&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;9 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#44;4 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#44;3 &#40;15&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>G&#233;nero &#40;mujeres&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pensionista&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidad general</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Promedio de diagn&#243;sticos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;9 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;1 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;4 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;3 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;6 &#40;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Promedio &#237;ndice de Charlson&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;8 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;9 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;7 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;8 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;6 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;6 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Promedio de BUR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;8 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;8 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;1 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;1 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;9 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;9 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;9 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BUR-1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BUR-2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BUR-3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BUR-4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BUR-5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades asociadas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obesidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;9&#37;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fumadores activos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alcoholismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Accidente cerebrovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Evento cardiovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencias org&#225;nicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asma bronquial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neuropat&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Demencias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Psicosis org&#225;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;ndrome depresivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Grupos de estudio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad &#8805; 65 a&#241;os</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hombres</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mujeres</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Subgrupos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Marca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">EFG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Marca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">EFG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Marca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">EFG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Marca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">EFG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&#250;mero de pacientes&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>187 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>465 &#40;71&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>213 &#40;29&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>504 &#40;70&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>175 &#40;32&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>357 &#40;67&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225 &#40;26&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>612 &#40;73&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Coste&#44; atenci&#243;n primaria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">686 &#40;470&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">774 &#40;365&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">809 &#40;482&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">921 &#40;499&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">709 &#40;434&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">831 &#40;512&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">785 &#40;511&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">862 &#40;402&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Visitas m&#233;dicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">265 &#40;213&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">319 &#40;193&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">324 &#40;244&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">411 &#40;288&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">280 &#40;240&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">360 &#40;235&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">310 &#40;224&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">371 &#40;260&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pruebas de laboratorio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;25&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;29&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;26&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;28&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Radiolog&#237;a convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;20&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;20&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;20&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;19&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pruebas complementarias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;18&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;19&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medicaci&#243;n basal &#40;gabapentina&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">246 &#40;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">206 &#40;64&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">264 &#40;128&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">209 &#40;70&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">262 &#40;124&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">216 &#40;72&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">251 &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">203 &#40;63&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medicaci&#243;n concomitante<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;330&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200 &#40;235&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">183 &#40;301&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">248 &#40;334&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">135 &#40;275&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">206 &#40;384&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">185 &#40;342&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">236 &#40;220&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">327 &#40;611&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">405 &#40;848&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">336 &#40;619&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">442 &#40;868&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">323 &#40;605&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">415 &#40;818&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">338 &#40;623&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">429 &#40;882&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>D&#237;as de hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;294&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101 &#40;524&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;406&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">119 &#40;627&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122 &#40;447&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">110 &#40;545&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;266&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">111 &#40;600&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Visitas hospitalarias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">172 &#40;254&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">174 &#40;245&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">162 &#40;249&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">183 &#40;244&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">129 &#40;193&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">174 &#40;260&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196 &#40;286&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">181 &#40;236&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sesiones&#44; hospital de d&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;267&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;343&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;236&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 &#40;358&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;205&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;329&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;282&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;364&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urgencias hospitalarias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;109&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;99&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;96&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;97&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;98&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Coste sanitario</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;014 &#40;838&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;179 &#40;991&#41;<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;145 &#40;848&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;363 &#40;1&#46;098&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;032 &#40;808&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;246 &#40;1&#46;023&#41;<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;123 &#40;872&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;291 &#40;1&#46;068&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Modelo de costes corregidos</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Costes en atenci&#243;n primaria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">655&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">780<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">779&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">924<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">688&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">841<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">759&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">872<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">599-711&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">743-815&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">712-845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">880-968&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">619-757&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">793-889&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">703-814&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">838-905&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diferencia &#40;marca-gen&#233;rico&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;153&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Costes en atenci&#243;n especializada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">319&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">415&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">367&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">439&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">327&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">414&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">343&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">427&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">194-424&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">335-483&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">253-475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">359-504&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">214-439&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">335-492&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">233-452&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">362-493&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diferencia &#40;marca-gen&#233;rico&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Costes sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;195<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;363<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;255<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;299<span class="elsevierStyleSup">&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">839-1&#46;110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;110-1280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;009-1&#46;284&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;274-1&#46;451&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">876-1&#46;155&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;157-1&#46;352&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">968-1&#46;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;219-1&#46;380&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diferencia &#40;marca-gen&#233;rico&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;221&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;197&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Marca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">EFG&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;1 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;2 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;1 &#40;&#8722;0&#44;3&#59; 0&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;481&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;0 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;2 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;2 &#40;&#8722;0&#44;6&#59; 0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Discontinuaci&#243;n tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#44;0 &#40;&#8722;1&#44;2&#59; &#8722;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;5 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;5 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#44;0 &#40;&#8722;1&#44;2&#59; &#8722;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#44;7 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#44;0 &#40;&#8722;1&#44;2&#59; &#8722;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;4&#44;4 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#44;7 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#44;0 &#40;&#8722;1&#44;2&#59; &#8722;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;51&#44;4 &#40;13&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;13&#44;5 &#40;&#8722;16&#44;2&#59; &#8722;10&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;64&#44;0 &#40;14&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;50&#44;5 &#40;13&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;13&#44;8 &#40;&#8722;16&#44;5&#59; &#8722;11&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;6 &#40;2&#44;4&#59; 5&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;2 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;2 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;1 &#40;&#8722;0&#44;2&#59; 0&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;4 &#40;1&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;4 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;7 &#40;&#8722;0&#44;9&#59; &#8722;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;4&#44;4 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#44;8 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;7 &#40;&#8722;0&#44;9&#59; &#8722;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;4&#44;5 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#44;8 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;7 &#40;&#8722;0&#44;9&#59; &#8722;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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ISSN: 02134853
Idioma original: Español
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