scholarly journals Value appropriation in hepatitis C

2021 ◽  
Author(s):  
Peter Lindgren ◽  
Sofia Löfvendahl ◽  
Gunnar Brådvik ◽  
Ola Weiland ◽  
Bengt Jönsson
Keyword(s):  
Hepatitis C ◽  
Eligible Patient ◽  
Consumer Surplus ◽  
Indirect Costs ◽  
Cost Effective ◽  
New Drugs ◽  
Future Health ◽  
Eligibility Criteria ◽  
The Government ◽  
Social Surplus

Abstract Background In 2015, the Swedish government in an unprecedented move decided to allocate 150 million € to provide funding for new drugs for hepatitis C. This was triggered by the introduction of the first second generation of direct-acting antivirals (DAAs) promising higher cure rates and reduced side effects. The drugs were cost-effective but had a prohibitive budget impact. Subsequently, additional products have entered the market leading to reduction in prices and expansions of the eligible patient base. Methods We estimated the social surplus generated by the new DAAs in Stockholm, Sweden, for the years 2014–2019. The actual use and cost of the drugs was based on registry data. Effects on future health care costs, indirect costs and QALY gains were estimated using a Markov model based primarily on Swedish data and using previous generations of interferon-based therapies as the counterfactual. Results A considerable social surplus was generated, 15% of which was appropriated by the producers whose share fell rapidly over time as prices fell. Most of the consumer surplus was generated by QALY gains, although 10% was from reduced indirect costs. QALY gains increased less rapidly than the number of treated patients as the eligibility criteria was loosened. Conclusions The transfer of funds from the government to the regions helped generate substantial surplus for both consumers and producers with indirect costs playing an important role. The funding model may serve as a model for the financing of innovative treatments in the future.

scholarly journals Study on the Optimized Mode of Waste Governance with Sustainable Urban Development—Case from China’s Urban Waste Classified Collection

2020 ◽  
Vol 12 (9) ◽  
pp. 3706
Author(s):  
Liangjun Peng ◽  
Mengdi Gu ◽  
Zhijun Peng
Keyword(s):  
Environmental Pollution ◽  
Consumer Surplus ◽  
Sustainable Urban Development ◽  
Limited Resources ◽  
High Quality ◽  
Urban Waste ◽  
Producer Surplus ◽  
The Government ◽  
Social Surplus ◽  
Governance Modes

With the rapid growth of developing countries, their urban waste is increasing at the same pace, which, in turn, is worsening the environmental pollution and leading to an urgent demand for waste governance. Different waste governance modes will produce different social welfare levels. According to the principles of economics of maximizing the benefit of limited resources, the mathematical models of the three waste governance modes of government, market, and mixed government–market are constructed separately in this paper, and then comparisons are made as to which mode is optimal. The results show that, from the perspective of consumer surplus and producer surplus, the mode by government is optimal, while the mode by market is optimal from the perspective of total social surplus. Since the government acts as the provider of waste governance in China, its allocation of waste governance mode is not optimal from the perspective of total social surplus, as a result of which it fails to restrain the environmental pollution caused by garbage growth most effectively. Nevertheless, since the equilibrium point of waste governance quantity is dynamic, there is still much room for the optimization of waste governance in China, which will certainly inject new impetus to the high quality and sustainable development of its cities.

Recent Advances in Drug Repurposing for Parkinson’s Disease

2019 ◽  
Vol 26 (28) ◽  
pp. 5340-5362 ◽  
Author(s):  
Xin Chen ◽  
Giuseppe Gumina ◽  
Kristopher G. Virga
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Discovery ◽  
De Novo ◽  
Drug Repositioning ◽  
Drug Repurposing ◽  
Cost Effective ◽  
New Drugs ◽  
Recent Advances ◽  
Clinical Drugs

:As a long-term degenerative disorder of the central nervous system that mostly affects older people, Parkinson’s disease is a growing health threat to our ever-aging population. Despite remarkable advances in our understanding of this disease, all therapeutics currently available only act to improve symptoms but cannot stop the disease progression. Therefore, it is essential that more effective drug discovery methods and approaches are developed, validated, and used for the discovery of disease-modifying treatments for Parkinson’s disease. Drug repurposing, also known as drug repositioning, or the process of finding new uses for existing or abandoned pharmaceuticals, has been recognized as a cost-effective and timeefficient way to develop new drugs, being equally promising as de novo drug discovery in the field of neurodegeneration and, more specifically for Parkinson’s disease. The availability of several established libraries of clinical drugs and fast evolvement in disease biology, genomics and bioinformatics has stimulated the momentums of both in silico and activity-based drug repurposing. With the successful clinical introduction of several repurposed drugs for Parkinson’s disease, drug repurposing has now become a robust alternative approach to the discovery and development of novel drugs for this disease. In this review, recent advances in drug repurposing for Parkinson’s disease will be discussed.

The cost-effectiveness of insulin analogs and regular insulin for diabetes control: a case study in Iran

2020 ◽  
Vol 33 (4/5) ◽  
pp. 323-331
Author(s):  
Mohsen pakdaman ◽  
Raheleh akbari ◽  
Hamid reza Dehghan ◽  
Asra Asgharzadeh ◽  
Mahdieh Namayandeh
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Regular Insulin ◽  
Diabetes Control ◽  
Diabetic Patients ◽  
Insulin Analogs ◽  
Content Type ◽  
Patients With Diabetes ◽  
The Government ◽  
The Cost

PurposeFor years, traditional techniques have been used for diabetes treatment. There are two major types of insulin: insulin analogs and regular insulin. Insulin analogs are similar to regular insulin and lead to changes in pharmacokinetic and pharmacodynamic properties. The purpose of the present research was to determine the cost-effectiveness of insulin analogs versus regular insulin for diabetes control in Yazd Diabetes Center in 2017.Design/methodology/approachIn this descriptive–analytical research, the cost-effectiveness index was used to compare insulin analogs and regular insulin (pen/vial) for treatment of diabetes. Data were analyzed in the TreeAge Software and a decision tree was constructed. A 10% discount rate was used for ICER sensitivity analysis. Cost-effectiveness was examined from a provider's perspective.FindingsQALY was calculated to be 0.2 for diabetic patients using insulin analogs and 0.05 for those using regular insulin. The average cost was $3.228 for analog users and $1.826 for regular insulin users. An ICER of $0.093506/QALY was obtained. The present findings suggest that insulin analogs are more cost-effective than regular insulin.Originality/valueThis study was conducted using a cost-effectiveness analysis to evaluate insulin analogs versus regular insulin in controlling diabetes. The results of study are helpful to the government to allocate more resources to apply the cost-effective method of the treatment and to protect patients with diabetes from the high cost of treatment.

scholarly journals Evaluation of the effects of acetylcholinesterase inhibitors in the zebrafish touch-evoked response: quantitative vs. qualitative assessment

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Laura Guzman ◽  
Gisela Besa ◽  
Daniela Linares ◽  
Lara González ◽  
Caterina Pont ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Acetylcholinesterase Inhibitors ◽  
Cost Effective ◽  
Evoked Response ◽  
New Drugs ◽  
Screening Tools ◽  
Qualitative Assessment ◽  
Toxicity Screening ◽  
Novel Treatments ◽  
Ache Inhibitors

Abstract Background The difficulty of finding new treatments for neurological diseases with great impact in our society like Alzheimer’s disease can be ascribed in part to the complexity of the nervous system and the lack of quick and cost-effective screening tools. Such tools could not only help to identify potential novel treatments, but could also be used to test environmental contaminants for their potential to cause neurotoxicity. It has been estimated that 5–10% of the anthropogenic chemicals are developmental neurotoxic (DNT) and exposure to DNT compounds has been linked to several neurological diseases. Within this study we were testing the applicability of a quick and cost-effective behavioural test using zebrafish embryos: the touch-evoked response assay, in this case, an assay evaluating the swimming response to a tap in the tail. Two acetylcholinesterase (AChE) inhibitors positive controls (paraoxon and huprine Y), as well as 10 huprine-derivative compounds were tested and the results were evaluated using 2 different methods, a quantitative and a qualitative one. Results We could show that the methodology presented is able to detect behavioural effects of AChE inhibitors. A good correlation between the results obtained with the quantitative and the qualitative method was obtained (R2 = 0.84). Conclusions Our proposed method enables combination of screening for new drugs with toxicity screening in a whole embryo model alternative to animal experimentation, thereby merging 2 drug development steps into one.

How the United Kingdom Controls Pharmaceutical Prices and Spending: Learning From Its Experience

2021 ◽  
pp. 002073142199709
Author(s):  
Marc A. Rodwin
Keyword(s):  
United Kingdom ◽  
Cost Effective ◽  
Market Prices ◽  
The United Kingdom ◽  
Generic Market ◽  
Pharmaceutical Spending ◽  
The Difference ◽  
The Government ◽  
Pharmaceutical Prices ◽  
Limit Access

To control costs and improve access, nations can adopt strategies employed in the United Kingdom to control pharmaceutical prices and spending. Current policy evolved from a system created in 1957 that allowed manufacturers to set launch prices, capped manufacturers’ rates of return, and later cut list prices. These policies did not effectively control spending and had limited effects on purchase prices. The United Kingdom currently controls pharmaceutical spending in 4 ways. (a) Since 1999, it has typically paid no more than is cost-effective. (b) Since 2017, for medicines that will have a significant budget impact, National Health Service England seeks discounts from cost-effective prices or seeks to limit access for 2 years to patients with the greatest need. (c) Since 2014, statutes and a voluntary scheme have required branded manufacturers to pay the government rebates to recoup the difference between the global pharmaceutical budget and actual spending. (d) For hospitals, generics and some patented drugs are procured through competitive bidding; community pharmacies are reimbursed through a system that provides an incentive to beat average generic market prices. These policies controlled the growth of spending, with the largest effects following budget controls in 2014. Changes since 2008 have reduced savings, first by paying more than is cost-effective for cancer drugs and then by applying higher cost-effectiveness thresholds for some drugs used to treat cancer and certain other drugs.

scholarly journals Cost-of-illness for non-underweight binge-eating disorders

2021 ◽  
Author(s):  
Paul E. Jenkins
Keyword(s):  
Eating Disorders ◽  
Binge Eating ◽  
Economic Impact ◽  
Indirect Costs ◽  
Cost Effective ◽  
Level Of Evidence ◽  
Academic Impairment ◽  
The United Kingdom ◽  
Binge Eating Disorders ◽  
Low Weight

Abstract Purpose This study examined economic costs associated with untreated eating disorders (EDs) characterised by regular binge eating in the absence of low weight. Both direct and indirect costs were assessed, reporting a limited societal perspective of economic impact as some costs were not included. Methods One hundred and twenty six adults seeking treatment for recurrent binge eating were asked to report impairment associated with an ED. Costs were calculated using 2017 prices, including an examination of variables associated with costs. Results Estimated societal costs for the year preceding assessment were £3268.47 (€3758.54) per person. In multivariate analyses, no reliable baseline associates of cost were identified. Conclusion The economic burden of EDs characterised by regular binge eating is significant, and underscores the need for efficacious and cost-effective treatments. Individuals with binge-eating disorders report work impairment and healthcare use that may cost the United Kingdom economy upwards of £3.5 billion (€4bn) per annum. Further studies should consider academic impairment and the economic impact of EDs on families. Level of evidence III: evidence obtained from well-designed cohort or case–control analytic studies.

scholarly journals Prediction of Anti-COVID 19 Therapeutic Power of Medicinal Moroccan Plants Using Molecular Docking

2021 ◽  
Vol 15 ◽  
pp. 117793222110091
Author(s):  
Badreddine Nouadi ◽  
Abdelkarim Ezaouine ◽  
Mariame El Messal ◽  
Mohamed Blaghen ◽  
Faiza Bennis ◽  
...  
Keyword(s):  
Molecular Docking ◽  
Medicinal Plants ◽  
Drug Target ◽  
Cost Effective ◽  
Current Medical Research ◽  
New Drugs ◽  
Binding Affinities ◽  
Global Public Health ◽  
Public Health Challenge ◽  
Ucsf Chimera

The emerging pathogen SARS-CoV2 causing coronavirus disease 2019 (COVID-19) is a global public health challenge. To the present day, COVID-19 had affected more than 40 million people worldwide. The exploration and the development of new bioactive compounds with cost-effective and specific anti-COVID 19 therapeutic power is the prime focus of the current medical research. Thus, the exploitation of the molecular docking technique has become essential in the discovery and development of new drugs, to better understand drug-target interactions in their original environment. This work consists of studying the binding affinity and the type of interactions, through molecular docking, between 54 compounds from Moroccan medicinal plants, dextran sulfate and heparin (compounds not derived from medicinal plants), and 3CLpro-SARS-CoV-2, ACE2, and the post fusion core of 2019-nCoV S2 subunit. The PDB files of the target proteins and prepared herbal compounds (ligands) were subjected for docking to AutoDock Vina using UCSF Chimera, which provides a list of potential complexes based on the criteria of form complementarity of the natural compound with their binding affinities. The results of molecular docking revealed that Taxol, Rutin, Genkwanine, and Luteolin-glucoside have a high affinity with ACE2 and 3CLpro. Therefore, these natural compounds can have 2 effects at once, inhibiting 3CLpro and preventing recognition between the virus and ACE2. These compounds may have a potential therapeutic effect against SARS-CoV2, and therefore natural anti-COVID-19 compounds.

scholarly journals Why and How to Treat Chronic Hepatitis C

2000 ◽  
Vol 14 (suppl b) ◽  
pp. 45B-48B ◽  
Author(s):  
Stephanos J Hadziyannis
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Combination Therapy ◽  
Chronic Hepatitis C ◽  
Cost Effective ◽  
Genotype 1 ◽  
Related Factors ◽  
Major Health Problem ◽  
Hcv Genotype ◽  
End Stage

Chronic hepatitis C (CHC) is a major health problem worldwide, with approximately 200 million affected individuals and a significant rate of progression to end-stage cirrhosis and hepatocellular carcinoma (HCC). If hepatitis C virus (HCV) infection is left untreated in the population, then the number of liver-related deaths will soon double and the need for liver transplantation may increase to five times that seen today. Available therapies for CHC are restricted to interferon alpha (IFN-α ) monotherapy and to the combination of IFN-α and ribavirin. Despite their high cost and side effects, both of these therapies have proved to be cost effective, particularly combination therapy. IFN-α monotherapy for one year can induce sustained response (SR) rates of approximately 10% in naive patients infected with HCV genotype 1, and above 50% in those infected with other genotypes. Combination therapy can double or even triple the rate of SR in genotype 1 infections and may further increase the SR rate in the other HCV genotypes. Combination therapy has also been proven to be effective in approximately 50% of relapsed responders to IFN-α monotherapy. In clinical practice, the decision to treat should be individualized and tailored on the basis of several virus- and host-related factors, particularly the grade and stage of liver disease, HCV genotype and levels of viremia. Appropriate monitoring of therapy by careful clinical evaluation, liver biochemistry and serumHCVRNAtesting is mandatory. IFN-α therapy may also prove to be effective in reducing the rate of HCC development in CHC regardless of whether a virological response is achieved, but this remains to be established.

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