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Kamusheva, Maria, Yanitsa Rusenova, Silvia Vandeva, et al. "Economic and pharmaco-economic analysis of acromegaly treatment: a systematic review." Biotechnology & Biotechnological Equipment 33, no. 1 (2019): 1560–71. http://dx.doi.org/10.1080/13102818.2019.1680317.
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Кадысева, Э. Р., and В. Н. Хазиахметова. "PHARMACO-ECONOMIC ANALYSIS OF ANTICOAGULANTS USED IN THE BURN DEPARTMENT." Фармакология & Фармакотерапия, no. 1 (May 29, 2024): 14–16. http://dx.doi.org/10.46393/27132129_2024_1_14.
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Проблема профилактики и лечения тромбозов продолжает оставаться актуальной для современной медицины. Ранняя диагностика тромботической готовности имеет важное практическое значение для первичной и вторичной профилактики. Особую группу пациентов хирургического профиля составляют больные с ожоговой травмой. Данные пациенты, с повреждением кожи и подлежащих тканей, относятся к группе умеренного и высокого риска венозных тромбоэмболических осложнений ввиду изменений состояния системы гемостаза, которые могут проявляться в виде тромботических или геморрагических осложнений. В статье представлен сравнительный анализ эффективности, безопасности и стоимости применения различных антикоагулянтов у пациентов ожогового профиля. The problem of prevention and treatment of thrombosis continues to be relevant for modern medicine. Early diagnosis of thrombotic readiness is of great practical importance for primary and secondary prevention. A special group of surgical patients consists of patients with burn injuries. These patients, with damage to the skin and underlying tissues, belong to the group of moderate and high risk of venous thromboembolic complications due to changes in the state of the hemostatic system, which can manifest themselves in the form of thrombotic or hemorrhagic complications. The article presents a comparative analysis of the efficacy, safety and cost of using various anticoagulants in burn patients.
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Valpiani, G., Esposti L. Degli, S. Saragoni, and Esposti E. Degli. "PCV29: PERSISTENCY OF TREATMENT IN PATIENTS INITIATED ON FIVE DIFFERENT CLASSES OF ANTIHYPERTENSIVE THERAPY: A PHARMACO-UTILIZATION AND PHARMACO-ECONOMIC ANALYSIS." Value in Health 4, no. 6 (2001): 499. http://dx.doi.org/10.1016/s1098-3015(11)71731-4.
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Zure, Diaiti, Meng-Hau Sung, Abdul Rahim, and Hsion-Wen Kuo. "In Silico Assessment of Chemical Disinfectants on Surface Proteins Unveiled Dissimilarity in Antiviral Efficacy and Suitability towards Pathogenic Viruses." International Journal of Molecular Sciences 25, no. 11 (2024): 6009. http://dx.doi.org/10.3390/ijms25116009.
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Viral pathogens pose a substantial threat to public health and necessitate the development of effective remediation and antiviral strategies. This short communication aimed to investigate the antiviral efficacy of disinfectants on the surface proteins of human pathogenic viruses. Using in silico modeling, the ligand-binding energies (LBEs) of selected disinfectants were predicted and combined with their environmental impacts and costs through an eco-pharmaco-economic analysis (EPEA). The results revealed that the binding affinities of chemical disinfectants to viral proteins varied significantly (p < 0.005). Rutin demonstrated promising broad-spectrum antiviral efficacy with an LBE of −8.49 ± 0.92 kcal/mol across all tested proteins. Additionally, rutin showed a superior eco-pharmaco-economic profile compared to the other chemicals, effectively balancing high antiviral effectiveness, moderate environmental impact, and affordability. These findings highlight rutin as a key phytochemical for use in remediating viral contaminants.
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Iwai, Mina, Michio Kimura, Eiseki Usami, Tomoaki Yoshimura, and Hitomi Teramachi. "Pharmaco-economic analysis of adjuvant chemotherapy for stage II and III colorectal cancer." Molecular and Clinical Oncology 6, no. 5 (2017): 794–98. http://dx.doi.org/10.3892/mco.2017.1218.
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Sørensen, Henrik Toft, Flemming Hald Steffensen, Gunnar Lauge Nielsen, and Poul Grøn. "Variation in antibiotic prescribing costs in Danish general practice: an epidemiological pharmaco-economic analysis." International Journal of Risk and Safety in Medicine 8, no. 3 (1996): 243–50. http://dx.doi.org/10.3233/jrs-1996-8308.
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Brīdiņa, Linda, Angelika Krūmiņa, Oļegs Šuba, Vinita Cauce, Indulis Vanags, and Ludmila Vīksna. "Severe Sepsis – Clinical Manifestations and Pharmaco-Economic Analysis in an Intensive Care Unit in Latvia." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 70, no. 4 (2016): 237–44. http://dx.doi.org/10.1515/prolas-2016-0024.
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Abstract Sepsis is widespread among hospitalised patients worldwide. In fact, severe sepsis and septic shock is a major cause of patient admission and mortality in intensive care units and the difficulty in diagnosing the initial stage of the disease is a major obstacle to the reduction of mortality from sepsis. Retrospective analysis of medical records of 72 patients was carried out within the framework of the study. The study included patients of both sexes and all ages, who were hospitalised at the stationary “Gaiļezers” of the Rīga East Clinical University Hospital from 2011 to 2014. The study aim was to determine the clinical course of treated septic patients and conduct a pharmaco-economic analysis. In the course of the disease, almost half of the patients - 34 (48.6%) showed development of septic shock. Mortality in these patients exceeded a half (60.0%; 21 patients). Artificial lung ventilation during hospitalisation was received by 43 (59.7%) of patients. Artificial lung ventilation had been required in a significantly larger number of cases in the dead patient group (75%, p = 0.01). The average costs per one patient day (including bed-day price and manipulation costs) was 383 euros. Septic shock was associated with high mortality. Severe sepsis is an expensive diagnosis, as the average cost of one patient exceeds costs of other departments by 4.5 times.
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Krasavtsev, E. L., V. M. Mitsura та A. P. Demchilo. "EFFICIENCY OF VARIOUS SCHEMES OF INTERFERON THERAPY IN PATIENTS WITH CHRONIC HEPATITIS С". Health and Ecology Issues, № 1 (28 березня 2011): 90–95. http://dx.doi.org/10.51523/2708-6011.2011-8-1-17.
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Comparison of different schemes of interferon therapy efficiency is studied in patients with chronic hepatitis C with various viral genotypes. On treatment of chronic hepatitis C it is necessary to be guided not only on clinical, but also pharmaco-economic efficiency of therapy. By means of «cost-effectiveness» analysis it is established that the best price/quality ratio has the scheme with use of interferon monotherapy with high-doses beginning.
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McNamara, J., and S. Gillis. "SR2: A PHARMACO-ECONOMIC CASE STUDY IN ANAESTHESIA, INCLUDING A RECENT RE-ANALYSIS USING BOOTSTRAP TECHNIQUES." Value in Health 2, no. 5 (1999): 364. http://dx.doi.org/10.1016/s1098-3015(10)75794-6.
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Elsamany, Shereef Ahmed, Mohamed Jafal, and Fayza Hassanin. "Pharmaco-economic assessment of subcutaneous compared to intravenous trastuzumab in HER2-positive breast cancer patients: A single institution experience." Journal of Clinical Oncology 38, no. 15_suppl (2020): e19409-e19409. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19409.
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e19409 Background: Traditionally, trastuzumab is given through intravenous (IV) administration. Recently, subcutaneous (SC) trastuzumab formulation has been developed showing similar efficacy and safety with shorter administration time. This study aims to assess the pharmaco-economics of SC compared to IV trastuzumab in patients with HER2-positive breast cancer treated in a single institution in Saudi Arabia. Methods: We checked the average number of trastuzumab doses, both IV and SC, given per year in King Abdullah Medical City, Saudi Arabia. One-year pharmaco-economic analysis of either trastuzumab forms were performed separately. This analysis included direct medication price based on hospital purchasing in addition to costs of drug preparation kits, nursing administration utilities and staff working time, based on average duration of drug preparation/ administration in chemotherapy unit records. IV trastuzumab dose was calculated based on an average body weight of 80 kg. Results: On average, the total number of trastuzumab doses, both IV and SC, were 1000 doses per year. We calculated the overall cost of 1000 doses of IV compared to SC trastuzumab separately. The average costs of one dose of IV and SC trastuzumab were 2,099 and 1,619 USD, respectively. This is translated to 2,099,000 and 1,619,000 USD per year for IV and SC trastuzumab, respectively. Other costs of trastuzumab administration were 24,933 and 2,666 USD per year of IV and SC trastuzumab, respectively. IV and SC trastuzumab administration needed 2,000 and 83 working hours per year, respectively, resulting in 1,917 saving in nursing working hours per year. This is translated to 18,106 USD saving per year based on average nursing salary. IV and SC trastuzumab pharmacy preparation needed 333 and 33 working hours per year, respectively, corresponding to annual saving of 300 hours in pharmacist- working time and 10,106 USD of pharmacist salary. The overall cost of IV trastuzumab per year was 2,153,667 compared to 1,623,236 USD for SC trastuzumab which corresponds to 2,153 and 1,623 USD per dose for IV and SC trastuzumab, respectively. This is translated to 24.6% overall cost reduction with the SC formulation. Conclusions: SC trastuzumab is associated with favorable pharmaco-economic profile with considerable cost saving compared to the IV counterpart. This is coupled with significant reduction of administration time and improved convenience.
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Gupta, Kajal S., Milind L. Pardeshi, and Rajesh S. Hiray. "Cost variation analysis of commonly prescribed anti-diabetic drugs available in Indian market: a pharmaco-economic study." International Journal of Basic & Clinical Pharmacology 11, no. 1 (2021): 47. http://dx.doi.org/10.18203/2319-2003.ijbcp20214888.
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Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary lifestyle, the incidence of DM is increasing. The chronic nature of DM causes significant personal suffering and economic difficulty to families. The was aimed at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various pharmaceutical companies were obtained from current index of medical specialties (CIMS) website, Indian drug review (IDR) 2021 issue and National pharmaceutical pricing authority-pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, metformin 500 mg sustained release showed highest price variation (3668%). Minimum cost variation was found with glipizide 2.5 mg (65%). Amongst the fixed dose combinations, highest cost variation was seen with glimepiride 2 mg+metformin 1000 mg (2703%) while minimum cost variation was found with repaglinide 1 mg+voglibose 0.3 mg (29%).Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all.Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands
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Bruno, Giacomo Matteo, Federico Dovera, Antonio Ciccarone, and Giorgio Lorenzo Colombo. "Overview of Nutraceuticals and Cardiometabolic Diseases following Socio-Economic Analysis." Endocrines 3, no. 2 (2022): 255–95. http://dx.doi.org/10.3390/endocrines3020023.
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The importance of functional food and nutraceutical products to deal with cardiometabolic diseases (CMDs) and metabolic syndrome (MetS) has gained attention in the past few years. The aim of this narrative review is to highlight the potential and effectiveness of nutraceutical in the improvement of CMDs and MetS biomarkers, alongside their burden of disease and economic health expenditure. A science database search was conducted between May and June 2021. A total of 35 studies were included in this paper. We included male and female subjects, children, and adults, in good health or with cardiovascular or metabolic disease. CMDs and MetS have gradually become worldwide health problems, becoming two of the major causes of morbidity and mortality in western countries. The results indicate a positive link between daily consumption of nutraceutical products and an improvement in cardiometabolic and anthropometric biomarkers. In this paper we included a wide range of nutraceutical products. Most of them showed promising data, indicating that nutraceuticals could provide a new therapeutic treatment to reduce prevalence and pharmaceutical expenditures attributed to CMDs and MetS. Unfortunately, there is a huge vacuum of data on nutraceutical usage, savings, and burden reduction. Therefore, further clinical and pharmaco-economic research in the field is highly required.
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Abrosimov, Andrei B., Elizaveta V. Rumyantseva, and Dmitry S. Blinov. "Assessment of the Pharmacoeconomical Effectiveness of Second Stage Personalized Rehabilitation in Children with Primary Immunodeficiencies: the Experience of One Center." Acta medica Eurasica, no. 3 (September 30, 2024): 1–9. http://dx.doi.org/10.47026/2413-4864-2024-3-1-9.
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Primary immunodeficiencies as a heterogeneous group of orphan diseases are of particular interest for the pharmaco-economical assessment of applied medical interventions due to diversity of their clinical presentation and complexity of standardizing approaches. In connection with increasing detectability due to neonatal screening and the potential for its expansion, it is increasingly important not only to treat, but to rehabilitate such patients as well in order to maintain a high quality of their lives, and therefore social and economic activity. The purpose of the research is a pharmaco-economical assessment of personalized bidirectional rehabilitation technology at the second stage in children with primary immunodeficiencies with the study of clinical and economic features of the method before including it in existing sources of financing for medical care. Materials and methods. A sample of patients from published data on evaluating the clinical component of the method was used based on determining the quality of life indicator. In this paper, data from calculations of direct expenses for providing care to one patient are used to calculate the costs as part of implementing the 2019-55-7 clinical approbation protocol. As an integral criterion of clinical and economic efficiency, QALY was calculated for one year of life, a pharmacoeconomical analysis of discounting at rates of 3 and 5%, a cost-effectiveness analysis, an incremental cost-effectiveness analysis, and a comparison of the results with the threshold of willingness to pay for the end of 2023 were carried out. Research results. The QALY for one year of life was 0.75. According to discounting results, since 2019, the amount of expenses has decreased from 603,071 to 452,303 rubles at the rate of 5% and up to 512 604 rubles at the rate of 3%. According to the results of the cost-effectiveness analysis, the cost of one unit of efficiency (QALY) in 2019 was 804,095 rubles, in 2024 – 683,480 rubles at the rate of 3% and 603,071 rubles at the rate of 5%. According to the results of the incremental cost-effectiveness analysis, the cost of one additional unit of efficiency (QALY) cost 6,884,372 rubles in 2019, in 2024 it is 5,851,716 rubles for the rate of 3% and 5,136,279 rubles for a 5% rate. Conclusions. When compared with the threshold of willingness to pay, the method is borderline acceptable. A significant factor contributing the most to the total cost of expenses is the cost of purchasing inventory. Additional criteria of clinical efficacy are required to recognize the method as pharmaco-economically effective. The transfer of catamnesis to the pre-rehabilitation stage, exclusion of provision with medicines at the second stage of rehabilitation at the expense of the medical organization's funds serve as ways to reduce the cost of the method.
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Fendrikova, A. V., and V. V. Skibitskyi. "Effectiveness of the original trimetazidine MR in patients with stable coronary heart disease and angina attacks resistant to trimetazidine generics (ETALON study)." Cardiovascular Therapy and Prevention 10, no. 4 (2011): 96–100. http://dx.doi.org/10.15829/1728-8800-2011-4-96-100.
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Aim. To assess the clinical benefits of the original trimetazidine medication (Preductal® MR) in patients with stable coronary heart disease and angina attacks resistant to trimetazidine generics. Material and methods. The study included 112 patients with stable coronary heart disease (CHD), who experienced angina attacks, despite the treatment with trimetazidine generics added to the standard CHD therapy (antiaggregants, statins, β-аadrenoblockers, ACE inhibitors). All participants received Preductal® MR (35 mg twice a day) instead of trimetazidine generics. The follow-up duration was 3 months. Treatment effectiveness was assessed by the changes in angina attack incidence, short-acting nitrate consumption, and general status, using a visual analogue scale (VAS). In addition, pharmaco-economic analysis of the treatment effectiveness was performed. Results. The replacement of trimetazidine generics with Preductal® MR was associated with a reduction in angina attack incidence by 63 % and in the number of nitroglycerine tablets/doses by 65 % (p<0,01). VAS score increased from 45,3±13,8 to 71,6±11,9 (р<0,0001). Preductal® MR therapy is the best pharmaco-economic option, since the ratio between weekly treatment costs (RUB) and the weekly number of prevented angina attacks is minimal for this original medication. Conclusion. In patients with stable CHD and angina attacks, resistant to trimetazidine generics, Preductal® МR therapy is associated with a significant reduction in angina attack incidence and consumption of short-acting nitrates. Preductal® MR is the most cost-effective medication, providing optimal effectiveness with minimal costs.
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Kolbin, A. S., L. S. Namazova-Baranova, E. A. Vishneva, et al. "A Pharmaco-Economic Analyzis of Treating Severe Uncontrolled Child Asthma with Omalizumab — Actual Russian Clinical Practice Data." Pediatric pharmacology 13, no. 4 (2016): 345–53. http://dx.doi.org/10.15690/pf.v13i4.1606.
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Background:Omalizumab is the first and yet the only biopreparation for asthma which combines high efficiency and high cost. The clinical-economic expediency of using omalizumab in asthmatic children has not been previously studied in Russia.Objective:Our aim was to evaluate the clinical and economic expediency of using omalizumab as additive treatment (to basic or supporting therapy) in children with severe uncontrolled atopic asthma under the Russian economic conditions.Methods:We conducted a mathematical simulation of asthma treatment in children with an increased frequency of hospitalization (9 times per year) with an average monthly omalizumab requirement of 558 mg. The model is based on the Markov chain. The model includes direct and non-direct costs. The planning horizons were 2 and 5 years. We analyzed the efficiency and utility of the costs and their influence on the budget. The stability of received data is proven by sensitivity analyzis.Results:Over a 5-year planning horizon the cost of an additional year of quality life (due to using omalizumab) was 1,259,185 roubles, while the “society’s solvency” is 1 341 308 roubles (cost utility analizis). It takes 39,820 rubles to prevent one hospitalization with omalizumab over a 5-year planning horizon (cost efficiency analizis), which is comparable to the cost of hospitalization (43,141 rubles). Total costs for treating 100 children with asthma, 7 of which would be treated with omalizumab, were equal to the amount of money which is enough to treat 105 children without omalizumab (analysis of budgetary influence).Conclusion:The analyses of cost efficiency and utility have shown that the strategy of using omalizumab together with standard treatment is economically expedient. Budgetary influence analysis has not detected a significant burden on the budget.
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Mazina, N. K., and P. V. Mazin. "Comparative pharmaco-economic analysis of using enzalutamide, abiraterone and cabazitaxel in post-docetaxel castration-resistant prostate cancer patients." PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology 10, no. 3 (2017): 12–21. http://dx.doi.org/10.17749/2070-4909.2017.10.3.012-021.
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Atthobari, J., C. Boersma, R. Gansevoort, PE De Jong, LT De Jong-van den Berg, and MJ Postma. "PUK8 COST-EFFECTIVENESS OF SCREENING FOR ALBUMINURIA AND SUBSEQUENT TREATMENT WITH AN ACE-INHIBITOR; A PHARMACO-ECONOMIC ANALYSIS." Value in Health 8, no. 6 (2005): A79—A80. http://dx.doi.org/10.1016/s1098-3015(10)67385-8.
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Laforgia, Mariarita, Anna Elisa Quatrale, Nicola A. Colabufo, Amalia Azzariti, Angelo Paradiso, and Patrizia Nardulli. "Evaluations about the physico-chemical stability of docetaxel and irinotecan pre-diluted and diluted solutions: pharmaco-economic perspectives." Drugs and Therapy Studies 3, no. 1 (2013): 6. http://dx.doi.org/10.4081/dts.2013.e6.
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Several clinically used anticancer drugs are well-known as far as their pharmacologic properties are concerned, but scarcely ever the interest towards their physico-chemical characteristics in solution led to practical acknowledgement in their management. Thanks to the Units for Centralized Anticancer Drug Handling, the importance to evaluate the concentration of saturation (physical stability) or the possible transformations undergone by a drug in solution (chemical stability) has become the starting point for avoiding useless wasting drugs and economic resources. By HPLC experiments we have demonstrated that the solutions of two drugs, docetaxel and irinotecan, are particularly stable at different concentrations and times of analyses in our experimental conditions. The best mobile phase for docetaxel was water/methanol/acetonitrile in 42/32/26 volumetric ratio: for halving concentrations (0.72-0.36-0.18-0.09 mg/mL) in NaCl 0.9%, the highest value gave a six-day and the three lower concentrations a fourteen-day stability, when storage occurred at room temperature and light protected. Elution of irinotecan was possible through an analysis in mobile phase gradient: at t0 a 20% ammonium acetate 10 mM and 80% methanol mixture, and after 5 min, a 80% ammonium acetate 10 mM and 20% methanol mixture. The physico-chemical stability was showed for five days, for any concentration of analysis when storage occurred at 2-8°C and light protected.
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Alena, Marushchak, and Shorikov Evgeniy. "Pharmacoeconomic analysis of the use of ramipril and candesartan in patients with arterial hypertension." ScienceRise: Pharmaceutical Science, no. 3(13) (June 29, 2018): 8–13. https://doi.org/10.15587/2519-4852.2018.135771.
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Arterial hypertension (AH) is the most common cardiovascular disease in the world and is the cause of disability of the population of the developed countries of the world. A feature of hypertension pharmacotherapy is a lifelong intake of medications. Indicators of economic evaluation of the effectiveness of different methods of treatment contribute to the selection of pharmacotherapy, which will provide the patient with the highest effectiveness of treatment, taking into account the financial capabilities of a particular patient. The main objectives of antihypertensive therapy is to achieve the target level of blood pressure (BP), the protection of target organs and a positive impact on risk factors for cardiovascular complications. The "cost-effectiveness" method makes it possible to compare costs with the same therapeutic effectiveness, which was the purpose of our study. Materials and methods. 100 protocols of medical cards of inpatients were studied. Two groups of patients were isolated: the first group for the treatment of AH received candesartan, and the second group – ramipril. The parameters were taken into account: achievement of target blood pressure, as well as possible complications of drug therapy - hypotension, cough, angioedema. To assess the cost of treatment against the background of the use of ramipril and candesartan, a "cost-effectiveness" pharmaco-economic analysis was carried out. Results of the study. Using the "cost-effectiveness" method, an analysis of ramipril and candesartan was carried out. The minimum, average and maximum costs of a single, daily, and course dose were calculated and the cost of BP normalization was calculated. The data obtained by us indicate a lower cost of treatment with ramipril. Analysis of the effectiveness of the drugs showed that ramipril is more effective in achieving the target blood pressure, but the percentage of side effects among which heart failure and cough were significantly higher. The data obtained indicate a high therapeutic efficacy of candesartan and ramipril, which allows us to draw conclusions: Conclusions. The most effective in achieving target BP was ramipril than candesartan. Analysis of the efficacy of drugs has established that ramipril has side effects and causes cough and heart failure, and candesartan can cause angioedema and hypotension. In analyzing the direct costs of treating hypertension, based on current standards of medical care for patients with AH, it was found that the least expensive is the treatment with ramipril. The analysis "cost-effectiveness", showed that ramipril possesses the greatest pharmaco-economic advantage
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Contreras-Hernández, I., J. F. Mould-Quevedo, A. Silva, et al. "A pharmaco-economic analysis of second-line treatment with imatinib or sunitinib in patients with advanced gastrointestinal stromal tumours." British Journal of Cancer 98, no. 11 (2008): 1762–68. http://dx.doi.org/10.1038/sj.bjc.6604367.
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Vasilyeva, I. A., A. G. Samoylova, A. V. Rudakova, O. V. Lovacheva, K. A. Glebov, and L. N. Chernousova. "ECONOMIC FEASIBILITY OF NEW CHEMOTHERAPY REGIMENS FOR TREATMENT OF TUBERCULOSIS PATIENTS WITH EXTENSIVE DRUG RESISTANCE." Tuberculosis and Lung Diseases 96, no. 6 (2018): 7–14. http://dx.doi.org/10.21292/2075-1230-2018-96-6-7-14.
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The article presents economic feasibility evaluation for using high-priced drugs in the regimens for treatment of tuberculosis patients with extensive drug resistance.Subjects and Methods. Treatment efficiency was evaluated in 175 tuberculosis patients with extensive drug resistance, treated by four different regimens, including third line drugs and without them; the economic impact of each regimen was evaluated. Two types of pharmaco-economic analysis were used: costs – effectiveness and budget impact analysis.Results of the study. Despite the significant costs of regimens containing moxifloxacin, linezolid, and bedaquiline, the co-efficient of costs – effectiveness turned out to be the lowest. When using models for comparing costs and losses over 5 year period of XDR TB patients treatment it was found out that regimens containing moxifloxacin, linezolid and bedaquiline possessed significant economic predominance which required major investment at the initial stages of introduction, and by the end providing savings from 46.3 to 65.3% of the budget compared to the regimens without these drugs. The obtained results provide the evidence that use of regimens containing new highly effective drugs (moxifloxacin, linezolid and bedaquiline) in rational combinations with basic and reserve drugs, prescribed with consideration of drug resistance profile allow achieving the significant economic effect.
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Larionova, V. B., I. S. Krysanov, A. V. Snegovoy, P. A. Zeinalova, V. S. Krysanova, and V. Yu Ermakova. "RATIONAL SUPPORTIVE THERAPY FOR CHEMOTHERAPY INDUCED ANEMIA: A PHARMACO-ECONOMIC ANALYSIS OF ERYTHROPOIETIN THERAPY IN CANCER PATIENTS IN RUSSIAN FEDERATION." Oncohematology 13, no. 2 (2018): 48–61. http://dx.doi.org/10.17650/1818-8346-2018-13-2-48-61.
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Modern anticancer therapy due to its intensity and molecular biology orientation allows achieving higher efficiency and theoretically reducing the incidence of complications. However, the increase in efficacy in the modern oncology really exists, but reducing complication frequency, unfortunately, is far from being solved. In many respects the problems of diagnosis, treatment and complications monitoring are associated with the impact on the complex physiological processes occurring in oncological patient. Timely implementation of modern and adequate programs for the prevention and treatment of these complications defines the concept of “supportive therapy”, which provides at least half the effectiveness of antitumor treatment.To date, according to most studies, the most frequent complications of antitumor therapy are hematologic, in particular – anemia. In clinical practice, blood transfusions, recombinant human erythropoietins, hemopoiesis stimulating cofactors are used to correct this type of complications. The need for anemia treatment is determined by its negative impact on quality of life, as well as a negative prognostic impact on the life expectancy of cancer patients, because hypoxia of tumor tissue can be associated with resistance to chemoand radiation therapy, the stimulation of genetic mutations and neoangiogenesis, which make it difficult to control of tumor growth. In numerous studies using multivariate analysis confirmed the association of low hemoglobin levels and/or tumor tissue hypoxia with worsening prognosis and overall survival in many types of tumors. The modern anemia treatment should not be determined only by increased in hemoglobin level, but should be considered as an active prophylaxis for its reducing. Recombinant forms of human erythropoietin and intravenous forms of iron preparations should be the most popular correction methods in everyday practice.The high cost of complex anemia therapy and the social significance of oncological diseases necessitate a pharmaco-economic analysis of registered in Russia erythropoietin preparations and the optimization of existing anemia treatment regimens in cancer patients in order to reduce the expenditures of the health budget. At present, an active import substitution program is underway in the Russian Federation to support the development of the Russian pharmaceutical industry and provide the population with more affordable medicines while maintaining its quality and efficiency. The need to address these issues, and the effective use of the domestic biological analogue epoetin alfa, served as an excuse for performing a comparative clinical and economic analysis. They were selected drugs that differ in pharmacokinetic properties: Eralfon® – analogue of epoetin alfa and Aranesp® – darbepoetin alfa.The treatment model of adults oncological patients with anemia receiving chemotherapy was created, which takes into account various therapies using erythropoietin preparations. The total therapy cost for an oncological patient with anemia is less when using short-acting erythropoietin – epoetin alfa – 131 609 rubles in comparison with the long-acting erythropoietin – darbepoetin alfa – 245 159.2 rubles, the difference was 113 550.2 rubles (–46 %) in favor of the epoetin alfa.According to pharmaco-economic analysis, the treatment of anemia with a Russian-produced drug epoetin alfa (Eralfon®) is preferred in comparison to darbepoetin alfa (Aranesp) in adult cancer patients with nonmyeloid malignancies in the Russian Federation, as it allows increasing the number of treated patients at a cost reduction.
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J. K., Akshay, and Basavanna P. L. "Cost-effectiveness of newer anti-emetics in the prevention of chemotherapy induced nausea and vomiting: a pharmaco-economic study analysis." International Journal of Basic & Clinical Pharmacology 7, no. 6 (2018): 1141. http://dx.doi.org/10.18203/2319-2003.ijbcp20182096.
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Background: Chemotherapy induced Nausea and Vomiting (CINV) is one the most common adverse effects associated with chemotherapeutic management of carcinoma breast. Preventing CINV becomes a vital part in treatment of these cancer patients for better compliance. The conventional regimen of newer 5-HT3 receptor antagonist and dexamethasone along with newer agents - Aprepitant, a NK-1 receptor antagonist and a recently approved atypical antipsychotic, Olanzapine have shown better control of CINV. These newer agents are effective but also very expensive.Methods: The study included carcinoma breast patients scheduled for chemotherapy (n = 55 in each group) who either received aprepitant or olanzapine or a combination of both as the anti-emetic regimen. Considering Cost-Effectiveness Analysis (CEA), the cost included was the cost of anti-emetic agents (sponsor’s perspective) and outcome measured as control of nausea and vomiting - as Complete Protection (CP), Complete Response to Best (CRB) and Incomplete Response (IR) for acute (0-24 hours) and delayed (24-120 hours) phases. The cost effectiveness(CE) ratio for emesis and CINV free days were calculated.Results: CP was seen better during the acute period than the delayed period. With Aprepitant, delayed CRB and IR was seen with 13 (23.6%) and 10 (18.2%) subjects. 16 (29.1%) showed IR with Olanzapine during the delayed period.The average number of Emesis and CINV free days were 4.65, 4.51, 4.89 and 3.38, 3.96, 4.15 for the three groups respectively. The cost required to achieve 1 emesis and 1 CINV free day per subject in the 3 groups was INR 351.19, INR 27.20, INR 339.54 and INR 483.36, INR 30.94, INR 400.60 respectively.Conclusions: The newer anti-emetic even though being expensive at cost, pharmacoeconomically provide better outcomes and seem to have better control rates than the conventional regimen.
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Sandal, Nidhi, and Avinash Kumar. "Commercialisation of Innovations: A Case Study of Liposomal Formulations." Defence Life Science Journal 10, no. 2 (2025): 121–26. https://doi.org/10.14429/dlsj.10.20390.
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Liposomes are the potential drug delivery systems for various therapeutic categories. During the past 60 years, researchers have explored this drug delivery system which has resulted in a large pool of documents in terms of patents and publications. The paper’s objective is to understand why after 60 years of extensive research with more than 50,000 patent documents and 35,000 research publications, only 17 products based on liposomes are commercially available. After detailed analysis, the authors found that the research publications and patent documents are primarily focused on the basic research aspects and have limited participation from the industry. Therefore, in this paper, it has been emphasised how the research projects on liposomes must re-orient its focus so that it leads to the commercialisation of liposomes. This paper also provides a comprehensive analysis of challenges and opportunities for researchers concerning various research areas of liposomes like manufacturing techniques, characterisations, stability, storage, pre-clinical and clinical evaluations, regulatory requirements as well as pharmaco-economic analysis.
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Li, M., M. T. Krishna, S. Razaq, and D. Pillay. "A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of ‘penicillin allergy’ in a UK teaching hospital." Journal of Clinical Pathology 67, no. 12 (2014): 1088–92. http://dx.doi.org/10.1136/jclinpath-2014-202438.
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AimsTo perform a pharmaco-economic analysis of prescribing alternative antibiotics in patients with a diagnostic label of ‘penicillin allergy’ and assess whether collation of information from a structured history and liaison with the family physician could reduce costs.MethodsA prospective pro-forma-based interview of randomly selected in-patients and their family physician was used to assess the validity of the diagnostic label of ‘penicillin allergy’. Cost analysis of prescription of alternative antibiotics was performed and compared with first-line agents.Results102 patients were assessed and only 40% (n=41) were found to have a history consistent with penicillin hypersensitivity, 40% (n=41) were likely ‘not allergic’ and 20% (n=20) had ‘indeterminate’ reactions. Total cost of antibiotics prescribed for patients with penicillin allergy was 1.82–2.58-fold higher than for first-line antibiotics.ConclusionsObtaining a structured history from the patient and family physician alone can enable an accurate identification of penicillin allergy status. Total acquisition cost of second-line antibiotics is higher than if these patients were prescribed first-line antibiotics.
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Barone, Carlo, Andrea Belisari, Fortunato Ciardiello, et al. "Cetuximab in first line treatment of metastatic colorectal cancer." Farmeconomia. Health economics and therapeutic pathways 13, no. 1S (2012): 1–80. http://dx.doi.org/10.7175/fe.v13i1s.305.
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The present health technology assessment report evaluates the clinical and economic profile of cetuximab in first-line metastatic colorectal cancer (mCRC) in Italy. The first part of the report addresses the epidemiological, clinical, social and economic impact of mCRC. In the second part, evidence of efficacy, safety and cost-effectiveness of cetuximab and its available alternatives is shown. Finally, a model-based economic evaluation aimed at comparing cetuximab-based regimens vs. alternative therapeutic strategies indicated in mCRC in Italy is presented. The model estimates the incremental cost-effectiveness of adding cetuximab to FOLFOX-4 or FOLFIRI based on KRAS status, vs. adding bevacizumab to FOLFOX-4 or vs. FOLFOX-4 or FOLFIRI alone. A theoretical analysis vs. panitumumab has also been performed, despite panitumumab is not yet reimbursed in Italy in first-line mCRC. Survival outcomes, quality of life and costs of patient management are estimated through a Markov model, using the Italian National Healthcare Service (NHS) perspective, over a 10 year period, taking into account KRAS status of patients. The results of the pharmaco-economic analysis show that cetuximab + FOLFOX-4 and cetuximab + FOLFIRI are associated with increased survival, increased cost and increased quality adjusted survival, compared to all other treatments currently indicated and reimbursed in Italy. Adding cetuximab to FOLFOX-4 or FOLFIRI, based on KRAS status shows favorable incremental cost-effectiveness ratio (ICER) vs. adding bevacizumab to FOLFIRI or vs. FOLFOX-4 or FOLFIRI alone. ICER of cetuximab (in combination with FOLFOX-4 or FOLFIRI), compared to currently reimbursed alternatives, is estimated between 6 and 13 thousand Euros per QALY gained, depending on alternative treatment. These estimates are robust in extensive sensitivity analyses. As a final result, both clinical and economic evidence analyzed in this health technology assessment leads to recommend cetuximab as preferred option for the first-line treatment of mCRC KRAS wild-type patients in Italy.
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Mantovani, Lorenzo Giovanni, Giovanni Di Minno, and Gianluca Furneri. "Venous thrombo-embolism (VTE) prevention of patients undergoing total hip and knee replacement: budget impact analysis of apixaban in Italy." Farmeconomia. Health economics and therapeutic pathways 14, no. 3 (2013): 119–29. http://dx.doi.org/10.7175/fe.v14i3.670.
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BACKGROUND: Venous thromboembolism (VTE) is a common and burdensome cardiovascular condition, frequently leading to severe complications and requiring high-cost healthcare interventions. New oral anticoagulants (nOACs) have demonstrated to be efficacious and safe in VTE prevention of patients undergoing total hip replacement (THR) and total knee replacement (TKR), a condition that is typically associated to cardiovascular disease. The Italian Healthcare Service (SSN) has recently approved the latest nOAC, apixaban. The present article aims to evaluate its economic impact in the perspective of the Italian SSN.METHODS: We conducted a budget impact analysis to estimate clinical outcomes and economic consequences associated to the reimbursement of apixaban, in the prevention of VTE as a consequence of major orthopedic surgery, over a three-year time horizon. In our analysis we compared two alternative scenarios, with apixaban either reimbursed (Scenario B) or not reimbursed (Scenario A) by the Italian SSN, and estimated the difference of healthcare costs between the two scenarios. Only direct healthcare costs have been considered.RESULTS: According to market assumptions, it is estimated that 1.2%, 3.7%, and 6.5% of THR patients, and 1.2%, 3.8% and 6.7% of TKR patients, would be treated with apixaban over the first three years since launch. At the estimated daily cost of apixaban (€2.48/die), this would translate into a budget impact of €14.3 mln, €45.5 mln, and €81.4 mln at years 1, 2 and 3 since launch, respectively. This expenditure would be more than offset by savings, due to: i) reduction of prescriptions of alternative treatment options (other nOACs, low-molecular weight heparins, fondaparinux); ii) reduction of the economic burden attributable of CV complications of VTE. Finally, Scenario B resulted slightly favourable compared to Scenario A, leading to economic savings for about €50 thousands over three years. Sensitivity analyses confirmed findings of the base-case analysis.CONCLUSIONS: Reimbursement of apixaban does not determine a budget impact increase for Italian SSN. Its usage may be considered fully sustainable from a pharmaco-economic viewpoint.
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Corvaja, E. "Decision-making: The roots of therapeutic protocols." Urologia Journal 65, no. 1 (1998): 113–17. http://dx.doi.org/10.1177/039156039806500128.
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The decisions taken in medicine every day cover a vast field, stretching from prescriptions and biohumoral and instrumental examinations to the choice of nutritional, pharmacological or surgical therapy. The decision communicated to the patient is both the end result of the individual cultural and clinical preparation of the therapist and the start of a technical and scientific programme aimed at improving the conditions (and quality of life) of the patient. Scientific application of a decisional analysis study tends to guarantee the possibility of ensuring the most suitable treatment on the basis of available resources and thereby introduces a further pharmaco-economic instrument of assessment. Moreover, if this method is programmed for rationalising the operating methods of several teams which operate on the same type of patients, decisional analysis becomes the first step in setting up ‘therapeutic protocols”, systematic and scientific distribution of professional activity over the territory. An experimental study is therefore presented regarding a recurrent urologic pathology, which starting from an analysis of life expectation, quality of life and cost of applied resources, aims at constructing an operating routine and the formation of a therapeutic protocol.
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Gaygolnik, T. V., I. V. Demko, E. N. Bochanova, A. Yu Kraposhina, N. V. Gordeeva, and I. A. Soloveva. "PHARMACO-ECONOMIC ANALYSIS OF COST IN TERMS OF MAINTENANCE OF PREFERENTIAL MEDICINES PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE ON THE TERRITORY OF KRASNOYARSK REGION." PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology 9, no. 2 (2016): 49–59. http://dx.doi.org/10.17749/2070-4909.2016.9.2.049-059.
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Carlos, FDJ, JA Guzman, DM D'ector, C. Castillejos, and F. Fon. "PCV59 PHARMACO-ECONOMIC ANALYSIS OF VALSARTAN/HYDROCHLOROTHIAZIDE (HCTZ)VERSUS CANDESARTAN/HCTZ AND VERSUS TELMISARTAN/HCTZ IN THE TREATMENT OF SYSTEMIC ARTERIAL HYPERTENSION IN MEXICO." Value in Health 8, no. 6 (2005): A106—A107. http://dx.doi.org/10.1016/s1098-3015(10)67470-0.
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Kozulina, I. E., K. S. Pavlova, and O. M. Kurbacheva. "Clinical efficacy of subcutaneous and sublingual allergen-specific immunotherapy of allergic rhinitis and conjunctivitis." Russian Journal of Allergy 13, no. 6 (2016): 63–69. http://dx.doi.org/10.36691/rja389.
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Objective. To evaluate the efficacy and safety of subcutaneous and sublingual allergen-specific immunotherapy (AIT), a comparative pharmaco-economic analysis. Materials and methods. The study included 60 patients with allergic rhinitis and conjunctivitis with or without asthma induced by birch pollen. In the first group patients received subcutaneous AIT (SCIT) by «Phostal - allergen of trees pollen», in the second group - sublingual AIT (SLIT) by «Staloral - allergen of birch pollen». Results. All patients after the SCIT or SLIT in the first pollen season noted a decrease in the severity of nasal and conjunctival symptoms (SMD -1,93 [95% CI -2,39; -1,47] and -1,57 [95% CI -2,39; -0,75] for groups 1 and 2, respectively) and a decrease in the rescue medication requirement (SMD -1,98 [95% CI -2,57; -1,39] and -1,86 [95% CI -2,61; -1,11] for groups 1 and 2, respectively). There were no statistically significant differences between the SCIT and SLIT efficacy. After AIT in both groups there was a significant reduction in the cost of medication and medical services (on average 5 times). In a comparative pharmacoeconomic analysis «cost/efficacy» and «cost/utility» was showed comparable results of SCIT and SLIT.
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Kozhanova, I. N. "Health technology assessment: factors affecting the results." Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice, no. 3 (December 8, 2021): 64–72. http://dx.doi.org/10.37489/2588-0519-2021-3-64-72.
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Purpose: to identify factors influencing the results of health technology assessment (HTA). Methods. This analysis is based on previously performed clinical (pharmaco-) economic studies in the Republic of Belarus. The primary data analysis methods for inclusion in this publication have been cost-of-illness analysis (COI). The studies were carried out from 2010 to 2021. All costs are presented in US dollars based on exchange rates at the time of execution. Ranges are presented as maximum and minimum values. Results. The analysis of the influence of the stage of the disease, the stage of medical care, the form of release for drugs, the age of the target population for the use of health technology, the source of information on the price of technology on the results of the procedure for assessing medical technology has been performed. Evaluation of the ratio of the results of COI for implementation the clinical protocol and capabilities of the healthcare system (stable angina pectoris, type 2 diabetes mellitus), as well as for a number of special health technologies (hemophilia A; post-stroke spasticity; mantle cell lymphoma; chronic lymphocytic leukemia; chronic myeloid leukemia; lung cancer). Conclusions. It can be concluded that there is a need for clear formulations of goals and objectives at the stage of formation of the study design, considering the influence of the position of the researcher, the source of costs, the selected population, form of release (for drugs) on the main clinical and economic indicators and on the subsequent interpretation of the results of HTA.
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Yosmar, Rahmi, Dian Febiana, and Najmiatul Fitria. "Evaluating Economic Outcomes: Single-Use Aspirin vs. Aspirin-Clopidogrel in Ischemic Stroke Patients Based on Barthel Index Scores." Jurnal Sains Farmasi & Klinis 10, no. 3 (2023): 293. http://dx.doi.org/10.25077/jsfk.10.3.293-299.2023.
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Ischemic stroke is a catastrophic disease that causes large costs in Indonesia. The high prevalence of stroke results in increased morbidity and mortality rates, which will impact the socioeconomic status of stroke patients. Cost Effectiveness Analysis (CEA) is a method in pharmaco-economics that aims to make decisions regarding the rational choice of therapy and evaluate the economic impact on ischemic stroke patients. This study aims to determine the Incremental Cost Effectiveness Ratio (ICER) value of antiplatelet therapy in the aspirin-clopidogrel combination group and the single aspirin group in ischemic stroke patients treated at the Regional General Hospital. Dr. M. Djamil Padang. The clinical parameter observed was the Barthel Index (BI) value. This research is a descriptive study with retrospective data collection using medical record data and the Hospital Management Information System (SIMRS) at RSUD Dr. M.Djamil Padang. The cost data shows the total direct medical costs incurred in treating ischemic stroke. Based on the results obtained, the Incremental Cost Effectiveness Ratio (ICER) value is IDR (-) 401,302. 71 per 1% increase. In this study it can be concluded that the aspirin-clopidogrel combination has better cost effectiveness than aspirin alone.
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Bacchieri, Antonella, and Ermanno Attanasio. "L’analisi delle decisioni negli studi di farmacoeconomia." Farmeconomia. Health economics and therapeutic pathways 6, no. 2 (2005): 141–52. http://dx.doi.org/10.7175/fe.v6i2.831.
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This paper is a review of the decision tree methodology. This is a very useful technique in complex decision making, when the consequences of the decisions are distant in time and the information upon which we can rely is uncertain. Decision trees are the basic structure underlying most applications of decision analysis in medicine. However, in this review we only cover their application to the pharmaco-economic field. The main steps of this decision analysis are explained. Thereafter, a case study from the literature is used as an example, i.e. an application of the decision tree analysis to a study aimed at comparing two different drugs in the treatment of gastro-esophageal reflux. The main focus of our paper is on the statistical aspects, which include the definition and quantification of the outcome variables, the definition and quantification of the probabilities of occurrence of the uncertain events considered in the decision tree, and the sensitivity analysis. The knowledge of the basic laws of the probability theory is mandatory for assigning correct values to the parameters of the decision tree (outcomes and probabilities). Finally, the sensitivity analysis is an important part of the work to be performed in the last stage of the decision analysis in order to measure the degree of robustness of the results when varying the assumptions.
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Marbaix, S., H. Vandenberghe, and L. Van Gaal. "EE5 COST-EFFECTIVENESS OF ATORVASTATIN IN TYPE 2 DIABETES PATIENTS: A PHARMACO-ECONOMIC ANALYSIS OF THE COLLABORATIVE ATORVASTATIN DIABETES STUDY (CARDS) IN THE BELGIAN POPULATION." Value in Health 11, no. 6 (2008): A343. http://dx.doi.org/10.1016/s1098-3015(10)66189-x.
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Loskutova, E. E., M. M. Kurashov, I. V. Radysh, G. A. Galkina, A. L. Savastenko, and S. V. Klochkova. "Clinical and economic evaluation of the use of enteral nutrition products." Meditsinskiy sovet = Medical Council, no. 22 (January 19, 2024): 102–9. http://dx.doi.org/10.21518/ms2023-445.
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Introduction. The development and study of new enteral nutrition (EN) formulas is a major challenge to modern practical medicine. The creation of enteral nutrition products, which in addition to their intrinsic nutritional properties have detoxifying properties, will contribute to enhanced clinical efficacy and more active recovery of patients.Aim. To conduct a comparative pharmaco-economic analysis of the effectiveness of using new domestic products for enteral nutrition produced by LEOVIT Nutrio (Russia), which have detoxifying activity, and products from other manufacturers.Materials and methods. The studies were carried out using standard cost-effectiveness analysis techniques. A comparative analysis of following products:Nutrien Standard (JSC Infaprim, Russia), Supportan drink (FreseniusKabi, Germany), Nutridrink compact protein (Nutricia, Holland) and Peptamen (Nestle, Switzerland), Detoxifying Protein Cocktail, Restoring Protein Cocktail and Detoxifying Drink (LEOVIT Nutrio LLC, Russia).Results and discussion. Calculations for all analyzed economic parameters showed the advantages of using new domestic products for enteral nutrition. It was found that the total direct costs for enteral nutrition in the group of cancer patients who additionally took a detoxification cocktail were the smallest and amounted to 3332.0 rub, the increase in blood protein concentration over 14 days of therapy was 11.1 g/l, and for albumin over the indicated period is 6.7 g/l. Compared to products from other manufacturers, the lowest cost in relation to the achieved effect (CER) was observed when using a restorative cocktail – 305.69 rub. for protein and 512.62 rub. by albumin. The total direct costs for enteral nutrition in the group of patients who took the Detoxification Drink in comparison with other products on the Russian market were also the lowest and amounted to 840.00 rubles.Conclusions. The authors concluded that there are significant economic advantages of using the new domestic enteral nutrition LEOVIT compared to other products and consider them as the product of choice when providing enteral protein nutrition to patients with various diseases accompanied by intoxication of the organism.
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Tran, Giao, Stephen P. Hack, Annette Kerr, et al. "Pharmaco-economic analysis of direct medical costs of metastatic colorectal cancer therapy with XELOX or modified FOLFOX-6 regimens: Implications for health-care utilization in Australia." Asia-Pacific Journal of Clinical Oncology 9, no. 3 (2012): 239–48. http://dx.doi.org/10.1111/ajco.12044.
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Verdier, C., and A. Flory. "An Information System for Epidemiology based on a Computer-Based Medical Record." Methods of Information in Medicine 33, no. 05 (1994): 496–501. http://dx.doi.org/10.1055/s-0038-1635052.
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Abstract:A new way is presented to build an information system addressed to problems in epidemiology. Based on our analysis of current and future requirements, a system is proposed which allows for collection, organization and distribution of data within a computer network. In this application, two broad communities of users – physicians and epidemiologists – can be identified, each with their own perspectives and goals. The different requirements of each community lead us to a client-service centered architecture which provides the functionality requirements of the two groups. The resulting physician workstation provides help for recording and querying medical information about patients and from a pharmacological database. All information is classified and coded in order to be retrieved for pharmaco-economic studies. The service center receives information from physician workstations and permits organizations that are in charge of statistical studies to work with “real” data recorded during patient encounters. This leads to a new approach in epidemiology. Studies can be carried out with a more efficient data acquisition. For modelling the information system, we use an object-oriented approach. We have observed that the object-oriented representation, particularly its concepts of generalization, aggregation and encapsulation, are very usable for our problem.
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Gianetti, Jacopo, Gianfranco Gensini, and Raffaele De Caterina. "A Cost-effectiveness Analysis of Aspirin versus Oral Anticoagulants after Acute Myocardial Infarction in Italy." Thrombosis and Haemostasis 80, no. 12 (1998): 887–93. http://dx.doi.org/10.1055/s-0037-1615383.
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SummaryAims. The recent publication of two large trials of secondary prevention of coronary artery disease with oral anticoagulants (WARIS and ASPECT) has caused a revival of the interest for this antithrombotic therapy in a clinical setting where the use of aspirin is common medical practice. Despite this, the preferential use of aspirin has been supported by an American cost-effectiveness analysis (JAMA 1995; 273: 965). Methods and Results. Using the same parameters used in that analysis and incidence of events from the Antiplatelet Trialists Collaboration and the ASPECT study, we re-evaluated the economic odds in favor of aspirin or oral anticoagulants in the Italian Health System, which differs significantly in cost allocation from the United States system and is, conversely, similar to other European settings. Recalculated costs associated with each therapy were 2,150 ECU/ patient/year for oral anticoagulants and 2,187 ECU/patient/year for aspirin. In our analysis, the higher costs of oral anticoagulants versus aspirin due to a moderate excess of bleeding (about 10 ECU/ patient/year) and the monitoring of therapy (168 ECU/ patient/year) are more than offset by an alleged savings for recurrent ischemic syndromes and interventional procedures (249 ECU/ patient/year). Conclusions. Preference of aspirin vs. oral anticoagulants in a pharmaco-economical perspective is highly dependent on the geographical situation whereupon calculations are based. On a pure cost-effectiveness basis, and in the absence of data of direct comparisons between aspirin alone versus I.N.R.-adjusted oral anticoagulants, the latter are not more expensive than aspirin in Italy and, by cost comparisons, in other European countries in the setting of post-myocardial infarction.
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Трибунцева, L. Tribuntseva, Будневский, and Andrey Budnevskiy. "Monitoring System in the Patients with Chronic Obstructive Puemonary Disease." Journal of New Medical Technologies 20, no. 4 (2013): 50–53. http://dx.doi.org/10.12737/2727.
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The results of the analysis of the clinical features of disease and the efficacy of therapy in the patients with chronic obstructive pulmonary disease on the outpatient level by means of computer pulmonological register are presented. It was shown by the use of the computer program &#34;The monitoring system in the patients with chronic obstructive pulmonary disease&#34; that vaccination in the patients with chronic obstructive pulmonary disease stage II-III leads to a decrease the incidence of acute respiratory viral infections, hospitalizations chronic obstructive pulmonary disease patients in a hospital, the number of outpatient visits and medical emergencies. The progressive nature of chronic obstructive pulmonary disease involves the steady weakening of the natural defense systems of the respiratory system, which creates favorable conditions for infection of the respiratory system. Influenza virus leads to reduction of functional activity of ciliated epithelium atrophy followed cilia. The modern concept of influenza vaccination focused on vaccination of the persons with high risk of infection, including the patients with chronic obstructive pulmonary disease. In this promising method for assessing the effectiveness of vaccination may be to use the computer program &#34;The monitoring system in the patients with chronic obstructive pulmonary disease&#34; and allows to evaluate pharmaco-economic aspects of care of the patients and the effect of preventive measures on clinical course of this disease.
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Agulló, Laura, Isidro Aguado, Javier Muriel, et al. "Pharmacogenetic Guided Opioid Therapy Improves Chronic Pain Outcomes and Comorbid Mental Health: A Randomized, Double-Blind, Controlled Study." International Journal of Molecular Sciences 24, no. 13 (2023): 10754. http://dx.doi.org/10.3390/ijms241310754.
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Interindividual variability in analgesic response is at least partly due to well-characterized polymorphisms that are associated with opioid dosing and adverse outcomes. The Clinical Pharmacogenetics Implementation Consortium (CPIC) has put forward recommendations for the CYP2D6 phenotype, but the list of studied drug-gene pairs continues to grow. This clinical trial randomized chronic pain patients (n = 60), referred from primary care to pain unit care into two opioid prescribing arms, one guided by CYP2D6, μ-opioid receptor (OPRM1), and catechol-O-methyl transferase (COMT) genotypes vs. one with clinical routine. The genotype-guided treatment reduced pain intensity (76 vs. 59 mm, p < 0.01) by improving pain relief (28 vs. 48 mm, p < 0.05), increased quality of life (43 vs. 56 mm p < 0.001), and lowered the incidence of clinically relevant adverse events (3 [1–5] vs. 1 [0–2], p < 0.01) and 42% opioid dose (35 [22–61] vs. 60 [40–80] mg/day, p < 0.05) as opposed to usual prescribing arm. The final health utility score was significantly higher (0.71 [0.58–0.82] vs. 0.51 [0.13–0.67] controls, p < 0.05) by improving sleepiness and depression comorbidity, with a significant reduction of 30–34% for headache, dry mouth, nervousness, and constipation. A large-scale implementation analysis could help clinical translation, together with a pharmaco-economic evaluation.
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Robin George, Eluru Niranjani, Mandla Rekha, Golla Sai Teja, Sarangan Nithya Lakshmi, and Ellampati Sunil Kumar. "Study to Evaluate the Pharmacoeconomics in Diabetic Foot Ulcer Management." European Journal of Pharmaceutical Research 3, no. 3 (2023): 6–12. http://dx.doi.org/10.24018/ejpharma.2023.3.3.62.
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Background: Diabetic foot ulceration (DFU) is one of the macrovascular complications of diabetes, its prevalence was estimated to be about 8-11% of individuals with uncontrolled diabetes experience for long time. The pathogenic cascade of DFU is a combination of vascular complications of peripheral arteries, Peripheral neuropathy and the raised blood glucose makes it as a non-healing ulcer followed by secondary infection which will progress to end with leg Amputation. The recurrent nature of Diabetic foot ulcer can impact on the health status as well as the economical stability of the affected patients and are associated with the major health care consumption with high cost. Methodology: It was a Mono centered prospective observational comparative study conducted in the department of general surgery for 6 months duration. Results: Total samples of 100 diabetic foot ulcer patients were enrolled into the study, 74 (74%) were males and 26 (26%) were females. The age group between51-60 and 61-70 years was observed as the highest percentage 27% (27). Highest percentage 42% (42) of patients were none (without any comorbidities) followed by 32(32%) patients are with combined (more than one comorbidity like HTN, CKD, CAD…etc.) with utmost percentage of 43% was peripheral neuropathy. 23 patients were diagnosed with gangrene and23 patients underwent major amputation, The economic burden of diabetic foot ulcer for conservative treatment was slightly more when compared to amputated patients. Conclusion: Study concludes that, economic burden on diabetic foot ulcer in conservative patients was slightly more while compared to amputated patients by descriptive statistics even the statistical analysis shown less significant difference. Because the necessity rate for extra hospitalization and medical services was more for conservative treatment (Debridement, Fasciotomy, Incision and Drainage) when compared to amputation patients with diabetic foot ulcer. whereas in the pharmaco-economics there was not much significant difference among both amputated and conservative patients.
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Schuette, Wolfgang, Wilfried Ernst Erich Eberhardt, J. Mathias Graf von der Schulenburg, et al. "EGFR mutation analysis from REASON: A registry for the epidemiologic and scientific evaluation of EGFR mutation status in newly diagnosed NSCLC patients stage IIIB/IV." Journal of Clinical Oncology 30, no. 15_suppl (2012): e18016-e18016. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e18016.
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e18016^ Background: Somatic mutations in the EGFR gene predict for sensitivity to EGFR TKI in patients with adv. NSCLC, yet limited data exists on EGFR mutation rates of all 4 exons in all NSCLC histologies. Methods: The REASON study (NCT00997230) aims to generate data on EGFR mutation (M) status, association of EGFR-M status with clinico-pathological parameters, treatment decisions and clinical outcomes for EGFR M+ patients from a large sample of stage IIIB/IV NSCLC patients in Germany. 4279 subjects for whom EGFR M testing was planned were enrolled at 151 sites (85% hospital based) in Germany. Standard test method was Sanger sequencing. While analysis of exons 19 and 21 was obligatory, exons 18 and 20 were not routinely done at all labs. Primary objectives are epidemiological data on EGFR M status and correlation with clinico-pathological features. Secondary aims are clinical outcome of all EGFR M+ patients (PFS, OS, DCR), clinical management and pharmaco-economic data associated with diagnosis and treatment of EGFR M+ patients. Results: A 2nd interim analysis provided baseline data on 3973 patients. 63% were male; 82% ever-smokers, 18% never-smokers. Adenocarcinoma is most frequent (69%), followed by squamous epithelial carcinoma (19%). 379 patients had EGFR mutations (9.9%) with 9.5% predicting TKI sensitivity and 0.4% resistance. Most common were exon 19 deletions (50%; with 35% DelE746-A750) followed by exon 21 mutations (36.8%; with 72% L858R). Multivariate analysis revealed association of gender, smoking status and histological subtype with EGFR M status (Table). 50% of M+ patients received 1st line TKI vs. 48% doublet CTX. Conclusions: REASON provides the largest data base yet on EGFR M status in Caucasian patients with newly diagnosed stage IIIB/IV NSCLC. Smoking followed by adeno-carcinoma was the strongest predictive factor for EGFR M. Only 50% of EGFR M+ patients received 1st line TKI. [Table: see text]
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Perrone, Valentina, Melania Dovizio, Chiara Veronesi, et al. "Real-World Evaluation of Calcimimetics for the Treatment of Secondary Hyperparathyroidism in Chronic Kidney Disease, in an Italian Clinical Setting." Healthcare 10, no. 4 (2022): 709. http://dx.doi.org/10.3390/healthcare10040709.
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This Italian real-world data analysis evaluated the pharmaco-utilization of calcimimetics, cinacalcet or etelcalcetide, and the economic burden of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients. From 1 January 2010 to 30 June 2020, adult patients with: (i) ≥1 prescription of etelcalcetide or cinacalcet, (ii) ≥3 hemodialysis/week, and (iii) without parathyroidectomy, were included. Based on the drug firstly prescribed, patients were allocated into etelcalcetide- and cinacalcet-treated cohorts, and the propensity score matching (PSM) methodology was applied to abate potential cohorts’ unbalances. Overall, 1752 cinacalcet- and 527 etelcalcetide-treated patients were enrolled. In cinacalcet- and etelcalcetide-treated patients, respectively, the most frequent comorbidities were hypertension (75.3% and 74.4%), diabetes mellitus (21.0% and 21.3%), and cardiovascular disease (18.1% and 13.3%, p < 0.01). In covariate-balanced cohorts, the treatment adherence and persistence rates were significantly higher in the etelcalcetide-treated (80.1% and 62.7%, respectively) vs. cinacalcet-treated cohort (62.3% and 54.7%, respectively). After PSM, the total costs for the management of cinacalcet- and etelcalcetide-treated patients, respectively, averaged EUR 23,480 and EUR 22,958, with the disease-specific drug costs (EUR 2629 vs. EUR 2355, p < 0.05) and disease-specific hospitalization costs (EUR 1241 vs. EUR 855) in cinacalcet- and etelcalcetide-treated patients. These results showed that, in etelcalcetide-treated patients, a higher treatment adherence and persistence was found, with disease-specific costs savings, especially those related to drugs and hospitalizations.
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Anandhasayanam, A., S. Kannan, and R. Rajamurugan. "A pharmacoeconomic study on Jan Aushadhi generics versus branded pharmaceutical formulations in India." Indian Journal of Community Health 36, no. 3 (2024): 478–84. http://dx.doi.org/10.47203/ijch.2024.v36i03.023.
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Background: Healthcare costs are a major burden on the society of developing countries like India. Countries like India try to limit healthcare costs in support of generic medicine. So, the Indian government initiated the Jan Aushadhi scheme in 2008 to provide high-quality generic medication at a low cost. Aim: The aim of the study was to compare the cost difference between Jan Aushadhi generic pharmaceutical formulations and branded medications in Tamil Nadu. Settings and Design: Pharmaco economic - Cost minimization observational study. Methods and Material: Study Duration: Five months, from February 2023 to June 2023. Study Place: 10 Jan Aushadhi outlets from various districts of Tamil Nadu. Sampling technique: Convenience sampling technique Statistical analysis used: Mean median, mode and Percentage. Results: A total of 729 medications were available in 10 Jan Aushadhi outlets. The Jan Aushadhi outlet has the most cardiovascular medications and the fewest antimalarial medications among different categories of drugs. Erythropoietin has the biggest cost difference between the average cost of branded medications and Jan Aushadhi drug costs, while Digoxin has the lowest cost difference. Antitubercular drugs, Oxytocics, Antileprosy drugs, Antiparkinsonism categories of drugs also delisted in Jan Aushadhi outlet. Conclusions: Compared to branded drugs, Jan Aushadhi's generic drugs are 64.65 % less costly on an average as observed in our study. The manufacturer of Jan Aushadhi shops is a WHO and GMO-certified company, and they manufacture branded drugs. So, there will be no quality compromise in Jan Aushadhi’s generic drugs.
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Birnbaum, A. E., T. Ng, B. O'Connor, A. Plette, and D. Berz. "Is survival improving in stage IV non-small cell lung cancer?" Journal of Clinical Oncology 27, no. 15_suppl (2009): 6577. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.6577.
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6577 Background: Non small cell lung cancer (NSCLC) represents the number one cause of cancer mortality in the United States. Over several decades clinical research has focused on the development of new, more active chemotherapeutic drugs to improve survival. Over the time period from 1994 to 2003 six drugs have been approved for the treatment of metastatic NSCLC. We are presenting a population based analysis of the survival in patients with metastatic NSCLC in the US from 1981–1990, 1991–1997 and 1998–2003. We also provide a pharmaco-economic view of this observation. Methods: We analyzed the SEER (Surveillance, Epidemiology, and End Results) program database for cancer specific survival rates in stage IV NSCLC patients who were diagnosed between 1980 and 2003 in the SEER catchment geographic areas. The primary exposure of interest was the year of diagnosis. Results: We identified 52,086 eligible patients in total. 8,950, 21,111 and 18,712 patients were diagnosed 1981 to1990, 1991 to 1997 and 1998 to 2003 respectively. The cox proportional hazard ratios were 0.97 (95% CI 0.94–0.99) and 0.85 (0.83–0.88) for the time periods 1991 to 1997 and 1998 to 2003, respectively, using the time period from 1981 to1990 as reference. This subtle increase in survival was strictly paralleled by increasing costs for the medical care of this patient population. Conclusions: The survival of stage IV NSCLC patients seems to be mildly improving, what is paralleled by increasing cost for the care of those patients. [Table: see text] No significant financial relationships to disclose.
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Eiman, Fatima, Arain Mudassar Iqbal, Suheryani Imran, et al. "EVALUATION OF PHARMACOECONOMICS AND PRESCRIPTION TRENDS OF ANTIHYPERTENSIVE MEDICATIONS AT VARIOUS CLINICAL SETTINGS OF HYDERABAD, PAKISTAN." International Journal of Research in Ayurveda and Pharmacy 11, no. 5 (2020): 94–98. http://dx.doi.org/10.7897/2277-4343.1105148.
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Pharmacoeconomics is the branch of health-economics where cost and outcomes are compared for patient’s treatment therapies and services in a health care system. Hypertension is one of the most common serious medical conditions in Pakistan and throughout the world. A large number of antihypertensive medications alone or in combinations are being prescribed. Pharmaco-economic studies are helpful in prescribing the most appropriate medication with required outcomes at minimum cost. Objective of study was to assess the prescription trends and cost-effectiveness among different classes of antihypertensive medications prescribed at different clinical setups of Hyderabad, Pakistan. A Prospective observational study was carried out at cardiac OPD of Liaquat University Hospital, Hyderabad from April 2018 to April 2019. According to inclusion and exclusion criteria, 400 prescriptions containing antihypertensive Drugs were collected via purposive sampling technique for pharmacoeconomic analysis during the study period. In Government setting, Monotherapy (83%) was more frequent than combination therapy (17%). The most frequent and the most cost-effective monotherapy was Enalapril maleate 5 mg having cost/day 4 Rs. In combination therapies, Lisinopril 20 mg + HTZ 12.5 mg was the most frequent. Spironolactone 50 mg + furosemide 40 mg was found to be the most cost-effective combination with cost/day 5 Rs. In private settings, the trends of antihypertensive monotherapy (75.5%) were more frequent than combination therapy (24.5%). The most frequent monotherapy was Telmisartan 40 mg while the most frequent antihypertensive combination was Amlodipine besylat 10 mg + Valsartan 160 mg. Metoprolol tartarate 100 mg and lisinopril 5 mg were cost-effective monotherapies with cost/day 5 Rs each and the combination of candesartancelexetil 16 mg + HTZ 12.5 mg was the most cost-effective. It is concluded from the current study that the prescription trends of antihypertensive medications were relatively cost-effective at Government setting but overall, the antihypertensive treatment cost was high which puts a substantial economic burden on patients.
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Iannazzo, Sergio, Laura Santoni, Cecilia Saleri, et al. "[Cost-effectiveness analysis of peginterferon beta-1a in Italian relapsing remitting multiple sclerosis management]." Farmeconomia. Health economics and therapeutic pathways 17, no. 2S (2016): 13–36. http://dx.doi.org/10.7175/fe.v17i2s.1230.
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BACKGROUND: Peginterferon beta-1a is indicated in adult patients for the treatment of relapsing remitting multiple sclerosis (RRMS). The efficacy and safety of peginterferon beta-1a was demonstrated in the placebo-controlled ADVANCE trial.OBJECTIVE: The objective of this study was to assess the cost-effectiveness of peginterferon beta-1a as compared with injectable first-line treatments for RRMS in Italy.METHODS: The cost-effectiveness analysis was developed through a Markov model with lifetime simulation in the perspective of the Italian National Healthcare Service (NHS). It was added an alternative scenario to take into account the Italian societal perspective. Outcomes were measured in terms of life years (LYs), quality adjusted life years (QALYs), lifetime costs and incremental cost-effectiveness ratio (ICER). The natural progression of the disease was informed by the published literature and previously published modelling exercises. The efficacy of treatments was simulated as reduction of disability progression (EDSS) and relapse rate. Efficacy data were derived from a published network meta-analysis. Unit costs were based on current prices and tariffs, and the published literature. A 3.5% discount rate was applied to costs and outcomes. One-way and probabilistic sensitivity analyses were developed and cost-effectiveness acceptability curves generated.RESULTS: Peginterferon beta-1a was more effective than the comparators in terms of survival (19.94 vs.19.68-19.81 discounted LYs, respectively), and QALYs (9.07 vs. 8.06 and 8.55 discounted QALY, respectively). In the perspective of the Italian NHS, the ICER was € 11,111/QALY vs. interferon beta-1a 30 µg, € 12,604/QALY vs. interferon beta-1a 22 µg, € 10,580/QALY and € 16,702/QALY vs. interferon beta-1b 250 µg and € 22,023/QALY vs. glatiramer acetate 20 mg. Peginterferon beta-1a dominated interferon beta-1a 44 µg. In the societal perspective, peginterferon beta-1a was dominant due to being more effective and with a lower social cost compared to first-line injectable treatments (interferon beta -1a, interferon beta-1b, glatiramer acetate) for RRMS. The outcomes of the sensitivity analyses confirmed the trend of the base case results.CONCLUSIONS: Peginterferon beta-1a shows a favourable pharmaco-economic profile for the treatment of RRMS. Even if an official threshold for the cost-effectiveness does not exist in Italy, the ICER values obtained were far below the commonly accepted thresholds (30,000-50,000 €/per QALY gained).[Article in Italian]
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Groshilin, V. S., E. I. Kharabet, A. A. Pogosyan, V. D. Kuznetsov, and O. A. Dubinskiy. "Modern technologies in treatment of pilonidal sinus." Astrakhan medical journal 18, no. 3 (2023): 67–74. http://dx.doi.org/10.17021/1992-6499-2023-3-67-74.
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Objective. Improvement of treatment results and reduction of the number of relapses in patients with pilonidal disease, by developing and substantiating a two-stage treatment method (with the use of laser treatment and subsequent radical surgical intervention). Materials and Methods. A prospective analysis of the treatment results of 76 patients at the clinical sites of the Rostov State Medical University was carried out. The patients were divided into three clinical observation groups: In Group I (the main group, 26 patients), two-stage treatment was carried out according to the original technique (patent № 2770283). In Group II (the first control group, 28 observations), we used the "сleft lift" procedure according to the Bascom authentic method Bascom II method modified by Karydakis). In Group III (the second control group, 22 observations), the pilonidal sinus was dissected with the traditional technique of plastic surgery of the sacrococcygeal region with "deaf" sutures along the gluteal cleft. Results. Analysis of the results showed that the postoperative period was smoother in Group I patients due to the smaller size of the surgical defect and the radical surgical stage in the absence of local inflammatory tissue reaction. There were no significant infiltrative-inflammatory complications in the patients operated on according to the original two-stage method. There were no recurrences during the one-year outpatient follow-up period. According to the VAS score, postoperative pain syndrome was significantly lower in Group I patients. The duration of hospitalization and period of disability were reduced in the patients of the main group in comparison with the same parameters in the control groups. The indicated pharmaco-economic effect in comparison with the traditional methods of surgical treatment was obtained due to early healing of the operative wounds with a smaller inflammatory reaction of the soft tissues and a reduced risk of suppurative complications. Conclusion. The developed method of two-stage surgical treatment of pilonidal sinus helps to increase the effectiveness of radical treatment, reduce the number of relapses and complications, and reduce the duration of patients' disability. The described efficacy of the technology is achieved with early healing and stable qualitative aesthetic result.
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Hryn, К. V. "The Role of Heredity in the Development of Anxiety Disorders among Patients with a Difficult Family History of Dementia." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, no. 6 (2022): 70–75. http://dx.doi.org/10.26693/jmbs07.06.070.
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Dementia has a physical, psychological, social and economic impact not only on the sick person, but also on the people who care for him / her, on family members and society as a whole. Family members are prone to the development of anxiety and depressive disorders, and are often in "anxious anticipation" of the development of dementia in themselves, since the role of genetic burden in the etiology of this pathological process is undeniable. The purpose of the study was to analyze the degree of depth of anxiety disorders in first-line descendants of patients with dementia. Materials and methods. The study used clinical and anamnestic, clinical and psychopathological research methods, the syndromic approach to establishing a diagnosis and the genealogical method with the construction and analysis of a family tree. After obtaining informed consent, 26 patients (all female patients) who sought medical help from a psychiatrist during 2021-2022 with symptoms of anxiety disorder were examined. Results and discussion. Clinical and anamnestic analysis revealed a 100% hereditary susceptibility to dementia. In the genealogical analysis of pedigrees, in 65.4% of cases, the hereditary burden was traced in two previous generations, in 11.5% ‒ in three previous generations. Analyzing the results of the clinical-psychopathological examination of the level of anxiety according to the General Anxiety Disorder-7 scale, it was found that all patients had signs of generalized anxiety disorder (medium – 10–14 points and high level – 15–21 points). The results of anxiety analysis according to the Hamilton Anxiety Rating Scale confirmed the clinical results. The anxiety indicators of all patients reached from 20 to 25 points, which corresponds to an anxious state. At the same time, a clear correlation was found between the hereditary burden and the level of anxiety: patients with a hereditary burden for dementia in three generations had the highest level of anxiety, patients with a hereditary burden in two generations had a slightly lower level of anxiety, a moderate level of anxiety was detected in patients with a family history of dementia no more than in one of the previous generations. Conclusion. Considering the polygenic nature of dementia, it can be concluded that not only the genetic component plays a role in the development of certain multifactorial diseases, in particular dementia. Given the presence of an environmental component, a patient with a hereditary predisposition and genealogical burden of this disease must make efforts to minimize environmental influences. The identification of a clear correlation between the hereditary burden of dementia in generations and the severity of an anxiety disorder makes it possible to understand the approaches to pharmaco- and psychotherapeutic interventions in this contingent of individuals