scholarly journals Estimating the Theoretical Cost Implications of Funding New Drugs Considered Not to Be Cost-Effective

2021 ◽  
Author(s):  
Cormac Kennedy ◽  
Laura McCullagh ◽  
Roisin Adams ◽  
Lea Trela-Larsen ◽  
Lesley Tilson ◽  
...  
2019 ◽  
Vol 26 (28) ◽  
pp. 5340-5362 ◽  
Author(s):  
Xin Chen ◽  
Giuseppe Gumina ◽  
Kristopher G. Virga

: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.


2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Laura Guzman ◽  
Gisela Besa ◽  
Daniela Linares ◽  
Lara González ◽  
Caterina Pont ◽  
...  

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.


2021 ◽  
Vol 15 ◽  
pp. 117793222110091
Author(s):  
Badreddine Nouadi ◽  
Abdelkarim Ezaouine ◽  
Mariame El Messal ◽  
Mohamed Blaghen ◽  
Faiza Bennis ◽  
...  

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.


2021 ◽  
Vol 27 (9) ◽  
pp. 1-9
Author(s):  
Isobel Clough

The NHS is facing an unprecedented backlog in both patient care and building maintenance, with severe implications for service delivery, finance and population wellbeing. This article is the first in a series discussing modular healthcare facilities as a potential solution to these issues, providing flexible and cost-effective spaces to allow services to increase capacity without sacrificing care quality. The first of three instalments, this paper will outline the problems facing the NHS estate, many of which have been exacerbated to critical levels by the COVID-19 pandemic, and what this means for service delivery. It will then make the case for modular infrastructure, outlining the potential benefits for healthcare services, staff and patients alike. Using modern methods of construction, this approach to creating physical space in healthcare can provide greater flexibility and a reduced impact on the environment. The next two articles in this series will go on to provide detailed case studies of successful modular implementation in NHS trusts, an analysis of the cost implications and guidance on the commissioning process and building a business case.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014880 ◽  
Author(s):  
Eva Pike ◽  
Vida Hamidi ◽  
Ingvil Saeterdal ◽  
Jan Odgaard-Jensen ◽  
Marianne Klemp

ObjectiveTo assess the relative effectiveness and cost-effectiveness of seven new drugs (cobimetinib, dabrafenib, ipilimumab, nivolumab, pembrolizumab, trametinib and vemurafenib) used for treatment of patients with advanced malignant melanoma in the Norwegian setting.DesignA multiple technology assessment.PatientsPatients with advanced malignant melanoma aged 18 or older.Data sourcesA systematic search for randomised controlled trials in relevant bibliographic databases.MethodsWe performed network meta-analyses using both direct and indirect evidence with dacarbazine as a common comparator. We ranked the different treatments in terms of their likelihood of leading to the best results for each endpoint. The cost-utility analysis was based on a probabilistic discrete-time Markov cohort model. The model calculated the costs and quality-adjusted life years (QALYs) with different treatment strategies from a healthcare perspective. Sensitivity analysis was performed by means of Monte Carlo simulation.ResultsMonotherapies with a programmed cell death 1 (PD-1) immune-checkpoint-inhibitor had a higher probability of good performance for overall survival than monotherapies with ipilimumab or BRAF/MEK inhibitors. The combination treatments had all similar levels of effectiveness to the PD-1 immune-checkpoint-inhibitors.PD-1 immune-checkpoint-inhibitors are more effective and more costly compared with ipilimumab in monotherapy. Nivolumab in combination with ipilimumab had higher costs and the same level of effectiveness as the PD-1 immune-checkpoint-inhibitors in monotherapy.BRAF/MEK inhibitor combinations (dabrafenib and trametinib or vemurafenib and cobimetinib) had both similar effectiveness and cost-effectiveness; however, the combination therapies are more likely to give higher quality adjusted life year gains than BRAF or MEK inhibitor monotherapies, but to a higher cost.ConclusionsNone of the drugs investigated can be considered cost-effective at what has normally been considered a reasonable willingness-to-pay (WTP) in Norway. Price reductions (from the official list prices) in the region of 63%–84% would be necessary for these drugs to be cost-effective at a WTP of €55 850 per QALY.


2021 ◽  
Vol 32 (2) ◽  
pp. 45-51
Author(s):  
Ryan Fair ◽  
Jean van Laar ◽  
Kristy Nell ◽  
Diaan Nell ◽  
Edward Mathews

The weather directly impacts ventilation systems, especially large industrial systems found in underground mines. Underground mine ventilation systems have high cost implications that add to the financial strains and uncertainties of future mining operations. In addition, the dynamic nature of underground ventilation systems makes the accurate prediction of underground conditions extremely difficult using traditional steady-state methods. Therefore, improved prediction methods of dynamic underground environmental conditions are needed to ensure cost-effective ventilation systems. This paper investigates simulating the sensitivity that underground ventilation systems have to fluctuating ambient conditions. Simulation software was applied to a case study on a gold mine in South Africa. The results showed that transient software can now be applied to entire mine ventilation systems, and can improve predicting the underground environment because of fluctuating ambient conditions.


Author(s):  
Shehnila Zardari ◽  
Funmilade Faniyi ◽  
Rami Bahsoon

In this chapter, the authors motivate the need for a systematic approach to cloud adoption from the risk perspective. The enormous potential of cloud computing for improved and cost-effective service delivery for commercial and academic purposes has generated unprecedented interest in its adoption. However, a potential cloud user faces numerous risks regarding service requirements, cost implications of failure, and uncertainty about cloud providers’ ability to meet service level agreements. Hence, the authors consider two perspectives of a case study to identify risks associated with cloud adoption. They propose a risk management framework based on the principle of GORE (Goal-Oriented Requirements Engineering). In this approach, they liken risks to obstacles encountered while realising cloud user goals, therefore proposing cloud-specific obstacle resolution tactics for mitigating identified risks. The proposed framework shows benefits by providing a principled engineering approach to cloud adoption and empowering stakeholders with tactics for resolving risks when adopting the cloud.


2020 ◽  
Vol 16 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Sammer-ul Hassan ◽  
Xunli Zhang

Background: Antimicrobial resistance (AMR) occurs when microbes become resistant to antibiotics causing complications and limited treatment options. AMR is more significant where antibiotics use is excessive or abusive and the strains of bacteria become resistant to antibiotic treatments. Current technologies for bacteria and its resistant strains identification and antimicrobial susceptibility testing (AST) are mostly central-lab based in hospitals, which normally take days to weeks to get results. These tools and procedures are expensive, laborious and skills based. There is an ever-increasing demand for developing point-of-care (POC) diagnostics tools for rapid and near patient AMR testing. Microfluidics, an important and fundamental technique to develop POC devices, has been utilized to tackle AMR in healthcare. This review mainly focuses on the current development in the field of microfluidics for rapid AMR testing. Method: Due to the limitations of conventional AMR techniques, microfluidic-based platforms have been developed for better understandings of bacterial resistance, smart AST and minimum inhibitory concentration (MIC) testing tools and development of new drugs. This review aims to summarize the recent development of AST and MIC testing tools in different formats of microfluidics technology. Results: Various microfluidics devices have been developed to combat AMR. Miniaturization and integration of different tools has been attempted to produce handheld or standalone devices for rapid AMR testing using different formats of microfluidics technology such as active microfluidics, droplet microfluidics, paper microfluidics and capillary-driven microfluidics. Conclusion: Current conventional AMR detection technologies provide time-consuming, costly, labor-intensive and central lab-based solutions, limiting their applications. Microfluidics has been developed for decades and the technology has emerged as a powerful tool for POC diagnostics of antimicrobial resistance in healthcare providing, simple, robust, cost-effective and portable diagnostics. The success has been reported in research articles; however, the potential of microfluidics technology in tackling AMR has not been fully achieved in clinical settings.


2018 ◽  
Vol 14 (3) ◽  
Author(s):  
Frank R Lichtenberg

Abstract This study provides econometric evidence about the impact that new chemical entity (NCE) launches had on premature mortality from 17 diseases in 9 Middle Eastern and African countries during the period 2007–2015. The greater the relative number of NCEs for a disease launched in a country, the greater the subsequent relative decline in premature mortality from that disease, controlling for the average rate of mortality decline in each country and from each disease. An 8-year increase in the number of post-1992 NCEs ever launched is estimated to have reduced the number of years of potential life lost before age 75 (YPLL75) in 2015 by 9.5 %. This is approximately half of the 18.9 % reduction in YPLL75, and about one-third of the 29.7 % reduction in the premature mortality rate. In the absence of 8 previous years of NCE launches, 2.80 million additional YPLL before age 75 would have been lost in 2015. Expenditure on new drugs per life-year below age 75 gained in 2015 from the drugs was $US 834. According to the standards of the WHO’s Choosing Interventions that are cost–effective project, new drugs launched in the nine ME&A countries were very cost–effective overall.


Drug Research ◽  
2018 ◽  
Vol 69 (08) ◽  
pp. 458-466 ◽  
Author(s):  
César Portela

AbstractTraditionally, the first step in the development of drugs is the definition of the target, by choice of a biological structure involved in a disease or by recognition of a molecule with some degree of a biological activity that presents itself as druggable and endowed with therapeutic potential. The complexity of the pathophysiological mechanisms of disease and of the structures of the molecules involved creates several challenges in this drug discovery process. These difficulties also come from independent operation of the different parts involved in drug development, with little interaction between clinical practitioners, academic institutions and large pharmaceutical companies. Research in this area is purpose specific, performed by specialized researchers in each field, without major inputs from clinical practitioners on the relevance of such strategy for future therapies. Translational research can shift the way these relationships operate towards a process in which new therapies can be generated by linking experimental discoveries directly to unmet clinical needs. Computational chemistry methods provide valuable insights on experimental findings and pharmacological and pathophysiological mechanisms, allow the virtual construction of new possibilities for the synthesis of new molecular entities, and pave the way for informed cost-effective decisions on expensive research projects. This text focus on the current computational methods used in drug design, how they can be used in a translational research model that starts from clinical practice and research-based theorization by medical practitioners and moves to applied research in a computational chemistry setting, aiming the development of new drugs for clinical use.


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