Second-line drug treatment cost effective for chronic TB in Peru

Background In the present study, we examined real-world treatment patterns for squamous cell carcinoma of the head and neck (scchn) in Canada, which are largely unknown.Methods Oncologists across Canada provided data for disease history, characteristics, and treatment patterns during May–July 2016 for 6–8 consecutive patients receiving first-line or second-line drug treatment for scchn (including locally advanced and recurrent or metastatic disease).Results Information from 16 physicians for 109 patients receiving drug treatment for scchn was provided; 1 patient was excluded from the treatment-pattern analysis. Median age in the cohort was 63 years [interquartile range (iqr): 57–68 years], and 24% were current smokers, with a mean exposure of 26.2 ± 12.7 pack–years. The most common tumour site was the oropharynx (48%). Most patients (84%) received platinum-based regimens as first-line treatment (44% received cisplatin monotherapy). Use of cetuximab-based regimens as first-line treatment was limited (17%). Of 53 patients receiving second-line treatment, 87% received a first-line platinum-based regimen. Median time between first-line treatment with a platinum-based regimen and initiation of second-line treatment was 55 days (iqr: 20–146 days). The most common second-line regimen was cetuximab monotherapy (43%); platinum-based regimens were markedly infrequent (13%).Conclusions Our analysis provides real-world insight into scchn clinical practice patterns in Canada, which could inform reimbursement decision-making. High use of platinum-based regimens in first-line drug treatment was generally reflective of treatment guidelines; cetuximab use in the second-line was higher than anticipated. Additional real-world studies are needed to understand the effect of novel therapies such as immuno-oncology agents on clinical practice and outcomes, particularly for recurrent or metastatic scchn.

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Feasibility and cost-effectiveness of standardised second-line drug treatment for chronic tuberculosis patients: a national cohort study in Peru

The Lancet ◽

10.1016/s0140-6736(02)08830-x ◽

2002 ◽

Vol 359 (9322) ◽

pp. 1980-1989 ◽

Cited By ~ 121

Author(s):

Pedro G Suárez ◽

Katherine Floyd ◽

Jaime Portocarrero ◽

Edith Alarcón ◽

Elisabetta Rapiti ◽

...

Keyword(s):

Cohort Study ◽

Cost Effectiveness ◽

Drug Treatment ◽

Second Line ◽

Tuberculosis Patients ◽

National Cohort ◽

Line Drug

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Second-line drug treatment in rheumatoid arthritis associated with depressed autologous mixed lymphocyte reaction

Rheumatology International ◽

10.1007/bf00270661 ◽

1986 ◽

Vol 6 (1) ◽

pp. 25-29 ◽

Cited By ~ 6

Author(s):

G. S. Panayi ◽

M. McKenzie Mills

Keyword(s):

Rheumatoid Arthritis ◽

Drug Treatment ◽

Mixed Lymphocyte Reaction ◽

Second Line ◽

Autologous Mixed Lymphocyte Reaction ◽

Line Drug

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Drug Treatment Costs: Projected Impact of Using the Integrated Management of Childhood Illnesses

Tropical Doctor ◽

10.1177/004947550303300210 ◽

2003 ◽

Vol 33 (2) ◽

pp. 86-88 ◽

Cited By ~ 6

Author(s):

R D Wammanda ◽

C L Ejembi ◽

T Iorliam

Keyword(s):

Drug Treatment ◽

Treatment Cost ◽

Health Workers ◽

Integrated Management ◽

Cost Savings ◽

Cost Effective ◽

Inappropriate Drugs ◽

Sick Children ◽

Cost Of Drugs ◽

The Cost

The strategy of integrated management of childhood illness (IMCI) aims at improving the skills of first level health workers and consequently, improving the survival chances of children. The guidelines have been shown to be cost-effective. We aimed to determine the potential impact of using IMCI guidelines on drug treatment cost. The cost of drugs prescribed for 129 sick children, by first level health workers, who were managed at three primary health facilities in Sabon Gari Local Government Area of Kaduna State, was calculated. The corresponding cost using the IMCI guidelines was also calculated. There were 74 males and 55 females (M:F=1.3:1). An average of 4.5 drugs per patient were prescribed by the health workers compared to 2.3 drugs per patient when using the IMCI guidelines. The total cost of drugs prescribed by the health workers was N15 279.39 with an average of N118.44 per child. The corresponding costs had the IMCI guidelines been used were N3 062.53 and N23.73, respectively. Treatment cost using the traditional method was 4.98 times more expensive than using methods advocated by the IMCI guidelines. The projected cost savings related to drugs when using IMCI guidelines were based on the assumption that inappropriate drugs would not be prescribed by health workers once they are introduced to and started using the IMCI guidelines.

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The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on multidrug-resistant tuberculosis in India and China

BMC Medicine ◽

10.1186/s12916-021-01932-7 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Chathika K Weerasuriya ◽

Rebecca C Harris ◽

C Finn McQuaid ◽

Fiammetta Bozzani ◽

Yunzhou Ruan ◽

...

Keyword(s):

Cost Effectiveness ◽

Cost Effective ◽

Multidrug Resistant ◽

Second Line ◽

Second Line Therapy ◽

China And India ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Line Therapy ◽

Mdr Tb

Abstract Background Despite recent advances through the development pipeline, how novel tuberculosis (TB) vaccines might affect rifampicin-resistant and multidrug-resistant tuberculosis (RR/MDR-TB) is unknown. We investigated the epidemiologic impact, cost-effectiveness, and budget impact of hypothetical novel prophylactic prevention of disease TB vaccines on RR/MDR-TB in China and India. Methods We constructed a deterministic, compartmental, age-, drug-resistance- and treatment history-stratified dynamic transmission model of tuberculosis. We introduced novel vaccines from 2027, with post- (PSI) or both pre- and post-infection (P&PI) efficacy, conferring 10 years of protection, with 50% efficacy. We measured vaccine cost-effectiveness over 2027–2050 as USD/DALY averted-against 1-times GDP/capita, and two healthcare opportunity cost-based (HCOC), thresholds. We carried out scenario analyses. Results By 2050, the P&PI vaccine reduced RR/MDR-TB incidence rate by 71% (UI: 69–72) and 72% (UI: 70–74), and the PSI vaccine by 31% (UI: 30–32) and 44% (UI: 42–47) in China and India, respectively. In India, we found both USD 10 P&PI and PSI vaccines cost-effective at the 1-times GDP and upper HCOC thresholds and P&PI vaccines cost-effective at the lower HCOC threshold. In China, both vaccines were cost-effective at the 1-times GDP threshold. P&PI vaccine remained cost-effective at the lower HCOC threshold with 49% probability and PSI vaccines at the upper HCOC threshold with 21% probability. The P&PI vaccine was predicted to avert 0.9 million (UI: 0.8–1.1) and 1.1 million (UI: 0.9–1.4) second-line therapy regimens in China and India between 2027 and 2050, respectively. Conclusions Novel TB vaccination is likely to substantially reduce the future burden of RR/MDR-TB, while averting the need for second-line therapy. Vaccination may be cost-effective depending on vaccine characteristics and setting.

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