scholarly journals Valutazione farmacoeconomica dell’uso di tramadolo vs ketorolac nella gestione del dolore postoperatorio

2003 ◽  
Vol 4 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Lorenzo G. Mantovani
Keyword(s):  
Economic Evaluation ◽  
Cost Minimization ◽  
Drug Acquisition ◽  
Economic Consequences ◽  
Analgesic Action ◽  
Surgical Pain ◽  
Consumption Data ◽  
Lower Drug ◽  
Acquisition Costs ◽  
The Mean

This article represents the first evaluation that compares the economic consequences of managing postsurgical pain with tramadol or ketorolac in the Italian setting. The economic evaluation was based on 5 clinical trials that directly compared the efficacy and tolerability of tramadol and ketorolac treatments in different settings and that contained drug consumption data. Since the review of these data confirmed that their efficacy is comparable (tramadol showed a quicker onset of the analgesic action, which was not considered for the purposes of the economic evaluation), it was chosen to conduct a cost minimization analysis. The calculations were made considering two different drug acquisition costs: the hypothetical price for the hospital, computed by discounting 50% off the retail price, and the mean price really paid by hospitals according to the IHS. The analyses showed that, when the discounted price is applied, tramadol induces costs that are similar to those induced by ketorolac in 2/3 of the cases and lower in the remaining 1/3. Considering the mean price paid by hospitals, tramadol results economically more advantageous than ketorolac in all considered settings. In conclusion, ketorolac and tramadol are two effective and tolerable drugs in the management of post-surgical pain, although they differ in the adverse event pattern and in the rapidity of their action. In the Italian setting, tramadol appears to be economically more efficient, due to lesser consumption and lower drug acquisition costs.

scholarly journals Valutazione economica di Infliximab (Remicade®) vs Etanercept (Enbrel®) nel trattamento dell’artrite reumatoide

2003 ◽  
Vol 4 (2) ◽  
pp. 77-86
Author(s):  
G. L. Colombo ◽  
A. Muzio ◽  
A. Longhi
Keyword(s):  
Drug Administration ◽  
Cost Minimization ◽  
National Health System ◽  
Drug Acquisition ◽  
Joint Damage ◽  
New Drugs ◽  
Lower Drug ◽  
Acquisition Costs ◽  
Differential Costs ◽  
The Cost

Rheumatoid arthritis is one of the most severe chronic pathologies, affecting the whole organism, with invalidating outcomes that affect the quality of life of the patients. Its prevalence is estimated to be about 0,5% in Italy, with elevated costs for the national health system (NHS) and the society, in spite of the best treatment with traditional therapies that include anti-inflammatory and disease modifying antirheumatic drugs (DMARDs). The introduction of new drugs with biological activity, mainly acting through an antagonism of tumor necrosis factor (anti-TNF), is a great advance in the management of the disease, as their use has been shown to be effective in slowing the progression of the joint damage, and sometimes in reversing it,. The present article present a cost-minimization study conducted by comparing the two anti-TNFs available in Italy, etanercept and infliximab, assuming equal efficacy and approached from the perspectives of the Italian NHS and society. Only differential costs were considered, i.e. drug acquisition, drug administration and patient monitoring costs, and the analysis comprised two treatment years, in order two account for the cost differences between the first treatment year and the following. The analysis showed that infliximab represents the more convenient alternative from both the NHS and the society points of view, mainly due to lower drug acquisition costs, which offset the higher drug administration costs: the total two year treatment costs per patient with etanercept resulted of 20.173 euro and 22.164 euro from the societal and NHS perspectives, respectively, while the same costs resulted of 13.715 euro and 14.795 euro with infliximab. These results were tested with thorough sensitive analyses, conducted by varying the principal cost and time consumption estimates, that showed that etanercept results less convenient in all the hypothesis tested.

scholarly journals P592 Costs savings associated with ferric maltol and the reduced use of intravenous iron based on real world data

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S541-S542
Author(s):  
S Howaldt ◽  
C K Becker ◽  
J A Becker ◽  
A C Poinas
Keyword(s):  
Real World ◽  
Productivity Loss ◽  
Drug Acquisition ◽  
Cost Savings ◽  
Intravenous Iron ◽  
Ferric Carboxymaltose ◽  
Real World Data ◽  
Iv Iron ◽  
Acquisition Costs ◽  
The Mean

Abstract Background Intravenous (IV) iron is frequently used in patients with iron deficiency (ID) when conventional oral ferrous products are ineffective or cannot be used (e.g. due to poor tolerability). Oral ferric maltol is a new iron ferric product registered in Europe and US. The aim of this study was to quantify the use of IV iron before and after the introduction of the new oral ferric maltol in real world settings and extrapolate the overall costs involved. Methods Data were collected from a single centre German clinical practice, MVZ für Immunologie, in inflammatory bowel disease (IBD) patients treated with iron therapy for ID with or without anaemia between 2013 and 2019 through the systematic CEDUR IBD registry and local medical records. The first cohort was formed of patients treated between 2013 and 2015, receiving only IV iron as ferric carboxymaltose (FCM). The second cohort was formed of patients treated between 2017 and 2019, receiving either oral ferric maltol only or ferric maltol in combination with FCM. Costs involved in each cohort were extrapolated using a societal perspective. Results Following the introduction of oral ferric maltol, the actual total number of FCM infusions observed was 138, showing a decrease of 70% compared to the first cohort in which oral ferric maltol was not available. This decreased number of infusions between the two cohorts was associated with total costs-savings of €56,933. In the first cohort, the administration costs were €44,536, the drug acquisition costs were €59,536 and the productivity loss were €30,944. In the second cohort, the administration costs were €13,597 the drug acquisition costs were €55,028 and the productivity loss were €9,447. A secondary scenario strictly applying the doses taken from respective SmPCs was tested and resulted in greater costs-savings. Noteworthy, the mean (SD) haemoglobin (Hb) level at baseline in the first cohort was lower with 11.5g/dl (1.19) vs. 12.2g/dl (1.18) in the second cohort. Three to six months after the treatment had been stopped, the mean (SD) Hb level was 13g/dl in both the first and second cohort with a SD of 1.31 and 1.37 respectively, showing that Hb levels were maintained in both cohorts. Conclusion The introduction of the new oral ferric maltol resulted in a decrease of 70% in terms of number of FCM infusions which was associated with costs-savings of €56,933 in terms of administration, drug acquisition and productivity loss costs. Considering that Hb levels were maintained in both cohorts, these results indicate that ID patients with or without anaemia previously treated with IV iron can also be managed effectively with oral ferric maltol resulting in overall societal cost-savings.

scholarly journals Parecoxib nel trattamento del dolore postoperatorio: considerazioni farmacoeconomiche

2003 ◽  
Vol 4 (1) ◽  
pp. 39-50
Author(s):  
Lorenzo Pradelli ◽  
Mario Eandi
Keyword(s):  
Patient Monitoring ◽  
Scientific Evidence ◽  
Drug Acquisition ◽  
Effective Management ◽  
Efficacy And Safety ◽  
Analgesic Action ◽  
Surgical Pain ◽  
Minor Surgery ◽  
Safety Studies

Parecoxib sodium is the first selective COX- 2 inhibitor to be available for parenteral administration. This pharmaceutical feature, alongside its favorable efficacy and safety profile, makes the new drug particularly suitable for simple and effective management of post-surgical pain. The first part of the present article describes the most important pharmacological characteristics of parecoxib and reviews the main efficacy and safety studies that were performed on patients presenting with post-surgical pain. Starting from these clinical data, the second part outlines the pharmacoeconomical profile of the drug in the Italian setting, focusing on the comparison with parenteral ketorolac, the most widely prescribed treatment for post-surgical pain in Italy. The available scientific evidence suggests that the introduction of parecoxib in the arsenal of available options for the management of this kind of patients in Italy may have a positive clinical and economical impact, despite of the higher drug acquisition price. In particular, the better tolerability shown by parecoxib in the comparison with non-selective NSAIDs would permit a reduction in the costs for the prevention and the cure of drugrelated adverse events and reduce the need for patient monitoring. Furthermore, the improved safety and the longer duration of the analgesic action could allow the management of more minor surgery patients in daysurgery units, with great economical advantages for the hospital and the health system and improved quality of life for the patients.

scholarly journals Dietary acrylamide intake by potato crisps consumers: A case of Nairobi County

2020 ◽  
Vol 5 (1) ◽  
pp. 871-878
Author(s):  
George Ooko Abong ◽  
Jackline Akinyi Ogolla ◽  
Michael Wandayi Okoth ◽  
Bruno De Meulenaer ◽  
Jackson Ntongai Kabira ◽  
...  
Keyword(s):  
Probabilistic Approach ◽  
Mean Value ◽  
Mitigation Measures ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Potato Crisps ◽  
Flame Ionization ◽  
Consumption Data ◽  
Dietary Acrylamide ◽  
The Mean

AbstractThe levels of acrylamide intake because of potato crisps consumption remains unknown in Kenyan context. This study assessed the exposure to acrylamide because of consumption of potato crisps in Nairobi, Kenya. A cross-sectional survey was carried out among 315 crisps consumers in Nairobi, and consumption patterns were collected using a pre-tested structured 7-day recall questionnaire. A total of 43 branded and 15 unbranded potato crisps samples were purchased in triplicates of 100 g and acrylamide was quantified using a gas chromatograph with a flame ionization detector. Consumption data were combined with the data on acrylamide contents from which dietary acrylamide intake was calculated using a probabilistic approach based on @Risk TopRank 6 risk analysis software for excel. The mean estimated acrylamide intake was 1.57 µg/kg body weight (BW) per day while the 95th (P95) percentile was 5.1 µg/kg BW per day, with margins of exposures (MOE) being 197 and 61, respectively. The intake of acrylamide was significantly (P < 0.05) higher in unbranded crisps with a mean value of 2.26 and 95th percentile of 6.54 µg/kg BW per day, MOE being 137 and 47, respectively. There were extremely lower MOE indicating higher exposure to acrylamide by the consumers mainly because of the higher acrylamide contents in potato crisps, and hence the need for mitigation measures.

scholarly journals Cost-effectiveness of habit-based advice for weight control versus usual care in general practice in the Ten Top Tips (10TT) trial: economic evaluation based on a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e017511 ◽  
Author(s):  
Nishma Patel ◽  
Rebecca J Beeken ◽  
Baptiste Leurent ◽  
Rumana Z Omar ◽  
Irwin Nazareth ◽  
...  
Keyword(s):  
General Practice ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Health Service ◽  
Usual Care ◽  
Controlled Trial ◽  
Cost Effective ◽  
The Mean ◽  
Randomised Controlled

ObjectiveTen Top Tips (10TT) is a primary care-led behavioural intervention which aims to help adults reduce and manage their weight by following 10 weight loss tips. The intervention promotes habit formation to encourage long-term behavioural changes. The aim of this study was to estimate the cost-effectiveness of 10TT in general practice from the perspective of the UK National Health Service.DesignAn economic evaluation was conducted alongside an individually randomised controlled trial.Setting14 general practitioner practices in England.ParticipantsAll patients were aged ≥18 years, with body mass index ≥30 kg/m2. A total of 537 patients were recruited; 270 received the usual care offered by their practices and 267 received the 10TT intervention.Outcomes measuresHealth service use and quality-adjusted life years (QALYs) were measured over 2 years. Analysis was conducted in terms of incremental net monetary benefits (NMBs), using non-parametric bootstrapping and multiple imputation.ResultsOver a 2-year time horizon, the mean costs and QALYs per patient in the 10TT group were £1889 (95% CI £1522 to £2566) and 1.51 (95% CI 1.44 to 1.58). The mean costs and QALYs for usual care were £1925 (95% CI £1599 to £2251) and 1.51 (95% CI 1.45 to 1.57), respectively. This generated a mean cost difference of −£36 (95% CI −£512 to £441) and a mean QALY difference of 0.001 (95% CI −0.080 to 0.082). The incremental NMB for 10TT versus usual care was £49 (95% CI −£1709 to £1800) at a maximum willingness to pay for a QALY of £20 000. 10TT had a 52% probability of being cost-effective at this threshold.ConclusionsCosts and QALYs for 10TT were not significantly different from usual care and therefore 10TT is as cost-effective as usual care. There was no evidence to recommend nor advice against offering 10TT to obese patients in general practices based on cost-effectiveness considerations.Trial registration numberISRCTN16347068; Post-results.

scholarly journals Poor Dietary Polyphenol Intake in Childhood Cancer Patients

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2835 ◽  
Author(s):  
Ashly Liu ◽  
Jennifer Cohen ◽  
Orazio Vittorio
Keyword(s):  
Childhood Cancer ◽  
Cancer Patients ◽  
Food Sources ◽  
Total Polyphenol ◽  
Nutritional Interventions ◽  
Dietary Recall ◽  
Consumption Data ◽  
Food Consumption Data ◽  
The Mean ◽  
Polyphenol Intake

Emerging research demonstrates polyphenol-rich diets like the Mediterranean diet may play a role in improving the outcomes of adult cancer therapy. To date, there are no trials assessing the intake or efficacy of polyphenol-rich diets in childhood cancer patients. In this study we collected dietary data on 59 childhood cancer patients on treatment using a three-pass 24-h dietary recall (24-HDR), which is based on a validated and structured three-part methodology. Polyphenol consumption was calculated by matching the food consumption data with polyphenol content extracted from the most updated Phenol-Explorer database. The mean total polyphenol intake was 173.31 ± 141.02 mg/day. The major food sources of polyphenols were fruits, beverages, and cereals. There were no significant associations with time since diagnosis, body mass index (BMI) z-score, types of cancer, treatment intensity, food-related symptoms, relapse, and total daily polyphenol intake. Further investigation with larger studies will facilitate the steps in assessing the value of polyphenol-rich dietary patterns in future nutritional interventions for childhood cancer patients.

AN ECONOMIC EVALUATION OF PAIN THERAPY AFTER HYSTERECTOMY

1999 ◽  
Vol 15 (3) ◽  
pp. 548-562 ◽  
Author(s):  
Brian E. Rittenhouse ◽  
Manon Choinière
Keyword(s):  
Pain Management ◽  
Cost Minimization ◽  
Study Drug ◽  
Independent Study ◽  
Nursing Time ◽  
Treatment Groups ◽  
Wage Rates ◽  
Acquisition Costs ◽  
The Cost ◽  
Activity Costs

Objectives: To assess the economics of patient-controlled analgesia (PCA) treatment versus regular intramuscular (IM) injections of opioid analgesia for pain management after hysterectomy.Methods: Cost-minimization analysis was used based on the comparable pain control results achieved in the two treatment groups. Observations were taken of treatment-related events with personnel (mostly nursing) time implications during the trial. Times were then associated with these events in an independent study of personnel activity. Costs were linked by using average wage rates for the various personnel for the Montreal area during the time of the study. Drug and material costs were hospital acquisition costs for all items. The cost of the PCA pump itself was not included in the analysis. Several analyses were performed to test the sensitivity of the results to various assumptions.Results: The results for total costs of the two therapies generally showed PCA to be more costly than regular IM injections despite no costs of the pump being included in the analyses. These results were robust with respect to changes in assumptions. Even when intentionally biasing the analysis against IM therapy, it was difficult to obtain results that favored PCA.Conclusions: Based upon the institutions and assumptions in this analysis, PCA offers no cost advantages over regular IM therapy in the pain management after hysterectomy. Regular IM injections provided less costly analgesia.

Phyto-oestrogen database of foods and average intake in Finland

2003 ◽  
Vol 89 (S1) ◽  
pp. S31-S38 ◽  
Author(s):  
Liisa M. Valsta ◽  
Annamari Kilkkinen ◽  
Witold Mazur ◽  
Tarja Nurmi ◽  
Anna-Maija Lampi ◽  
...  
Keyword(s):  
Adult Population ◽  
Analytical Data ◽  
Meat Products ◽  
Food Composition ◽  
Processed Meat ◽  
Consumption Data ◽  
Average Intake ◽  
Food Consumption Data ◽  
The Mean ◽  
Plant Lignans

Information on phyto-oestrogen intake in various populations has been scanty until now, primarily because data on the content of these compounds in foods were lacking. We report here on expansion of the Finnish National Food Composition Database (Fineli®) with values for the plant lignans matairesinol and secoisolariciresinol and the isoflavones daidzein and genistein. The values, expressed as aglycones, were based on food analyses (mainly GC–MS) or imputed from analytical data for 180 foods for lignans and 160 foods for isoflavones; additionally, over 1000 values were derived from the recipe database of Fineli. Average intake of these phyto-oestrogens was calculated using food consumption data of the National Dietary Survey FINDIET 1997, which was carried out in a random sample of the adult population in five areas in Finland. The dietary data were collected by 24 h recall (n=2862). The mean lignan intake was 434 (standard deviation (SD) 1575) μg/d and the mean isoflavone intake was 788 (SD 673) μg/d. Women had a higher lignan density (μg lignans/MJ) in their diet than men (P<0·05). Men had a higher mean daily isoflavone intake, 902 (SD 368) μg, than women, 668 (SD 963) μg (P<0·05). The sources of lignans were many: seeds, cereals, fruit, berries and vegetables. The main sources of isoflavones appeared to be processed meat products/sausages containing soya as an ingredient, and legumes as such. The average intake of lignans and isoflavones in Finland seems to be low, but intake varies throughout the population.

Total costs of therapy with lenalidomide or bortezomib in relapsed/refractory multiple myeloma (rrMM).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18561-e18561
Author(s):  
Ivan Borrello ◽  
Gary Binder ◽  
Zeba M. Khan ◽  
Chris L Pashos ◽  
Brian G. Durie
Keyword(s):  
Treatment Cost ◽  
Drug Acquisition ◽  
Economic Assessment ◽  
Cost Of Care ◽  
Sensitivity Analyses ◽  
Medical Resource ◽  
Total Cost ◽  
Treatment Regimens ◽  
Acquisition Costs ◽  
Alternative Scenarios

e18561 Background: Advances in survival are increasing payers’ focus on the cost of care in rrMM. An economic assessment was conducted from the perspective of a US payer to compare the total costs of treatment with two NCCN guideline-listed therapies frequently used in rrMM: lenalidomide plus dexamethasone (LEN/DEX) and bortezomib (BORT). Methods: Costs of drug treatment, medical resource utilization, and adverse event (AE) management were determined for each regimen over a common 12-month time-period. Utilization rates and costs of specific medical procedures (e.g., lab tests, hydration, AE prophylaxis, and physician administration) as well as incidence and costs of grade 3/4 AEs, were calculated based on published literature, 3Q2011 fee schedules, and respective package inserts. Median time to progression (TTP) was obtained from the respective pivotal clinical trials (BORT, 6.2 months [APEX] and LEN/DEX, 13.4 months [MM-009/MM-010]). Univariate sensitivity analyses and alternative scenarios were conducted to confirm robustness. Relative cost per outcome (i.e., treatment cost per month during which disease control had been maintained) was also analyzed for the treatment regimens. Results: Although drug acquisition costs for the two regimens were similar (difference of <$10/day), total rrMM treatment cost per day was $58 higher with BORT ($356/day) vs. LEN/DEX ($298/day) due to higher physician administration, lab tests, and other medical and AE management costs for BORT. Annual total cost for BORT treatment was more than $20,000 higher than for LEN/DEX. A cost advantage for LEN/DEX was maintained across a variety of sensitivity analyses and alternative scenarios, including alternate therapy after relapse, changes to patient cost-sharing, and shorter time periods. Total cost per month without progression was 14% lower for treatment with LEN/DEX vs BORT. Conclusions: In rrMM, LEN/DEX and BORT had comparable drug acquisition costs, yet BORT had higher total costs due to physician administration and other medical resource and AE costs. Total cost per outcome (defined as month without progression) was lower with LEN/DEX.

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