Acupuncture's Place within Mainstream Medicine

1997 ◽  
Vol 15 (2) ◽  
pp. 104-107 ◽  
Author(s):  
Keyword(s):  
Bladder Dysfunction ◽  
Cost Effective ◽  
Discussion Paper ◽  
Effective Treatment Option ◽  
Medical Practitioners ◽  
Mainstream Medicine ◽  
Cost Effective Treatment ◽  
Pain Clinics ◽  
Medical Acupuncture ◽  
Needle Stimulation

This is a discussion paper reviewing the evidence for acupuncture in the fields of its current Western medical use. It is proven by controlled trials to be effective in pain relief, for dysmenorrhoea, and in nausea and vomiting. It has been found clinically useful in a wide variety of other areas including allergy bladder dysfunction, drug dependency and stroke. There is an increasing body of evidence that acupuncture is a cost-effective treatment option, and its use has become widespread in pain clinics, hospital rheumatology and physiotherapy departments, and in general practice. Medical acupuncture is now based firmly on modern physiological principles, and an understanding of the opioid and other neurotransmitters involved in needle stimulation has made clinically useful acupuncture practice readily accessible to medical practitioners.

scholarly journals The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria

10.36469/9865 ◽  
2013 ◽  
Vol 1 (2) ◽  
pp. 184-199 ◽  
Author(s):  
Nadir Hammoumraoui ◽  
Sid Ahmed Kherraf ◽  
Joaquin Mould-Quevedo ◽  
Tarek A. Ismail
Keyword(s):  
Cost Effectiveness ◽  
Adverse Events ◽  
Proton Pump ◽  
Cost Effective ◽  
Private Clinic ◽  
Effective Treatment Option ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background: Cyclooxygenase-2 inhibitors such as celecoxib are as effective as non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) in the treatment of osteoarthritis (OA), have fewer gastrointestinal side effects, but are more expensive. Objective: To evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib versus ns-NSAIDs, with/without proton-pump inhibitor (PPI) co-therapy, for treating OA in Algeria. Methods: The National Institute for Health and Clinical Excellence (NICE) health economic model from UK, updated with relative risks of adverse events using CONDOR trial data, was adapted for costeffectiveness analysis in OA patients aged ≥65 years. Patients could initiate treatment with celecoxib or ns-NSAIDs with/without omeprazole. Conditional probabilities were obtained from published clinical trials; effectiveness measure was quality-adjusted life years (QALYs) gained/patient. The analysis was conducted from a healthcare payer’s perspective. The average daily treatment costs and frequencies of resource use for adverse events were based on data collected in August 2011 from a private clinic located in Cheraga, Algiers, Algeria. Probabilistic sensitivity analysis (PSA) was performed to construct cost-effectiveness acceptability curves (CEACs). Results: QALYs gained/patient over a 6-month horizon were higher with celecoxib (0.368) and celecoxib+PPI (0.40) versus comparators. The lowest expected cost/patient was associated with ibuprofen (US$134.76 versus US$175.67 with celecoxib+PPI, and US$177.57 with celecoxib). Celecoxib+PPI was the most cost-effective drug treatment, with an ICER of US$584.43, versus ibuprofen. Treatment with celecoxib alone showed an ICER of US$1,530.56 versus diclofenac+PPI. These ICERs are <1 gross domestic product per capita in Algeria (US$7,500). Over 1-year, 3-year and 5-year horizons, celecoxib with/without PPI co-therapy showed higher QALYs/patient versus comparators, and decreasing ICERs. The ICER of celecoxib+PPI was lower than that of comparators over all time horizons. These findings were confirmed with CEACs generated via PSA. Conclusion: Using data from a single private clinic in Cheraga, Algiers, Algeria, and after considering new adverse event risks, we showed that celecoxib with/without PPI co therapy is more cost-effective than ns-NSAID+PPI for treating OA patients aged ≥65 years. Celecoxib+PPI remains dominant over a 5-year horizon, making it the most cost-effective treatment option for medium- and long-term use.

Allograft Augmentation of Hamstring Autograft for Younger Patients Undergoing Anterior Cruciate Ligament Reconstruction: Clinical and Cost-Effectiveness Analyses

2016 ◽  
Vol 45 (4) ◽  
pp. 892-899 ◽  
Author(s):  
Cale A. Jacobs ◽  
Jeremy M. Burnham ◽  
Eric C. Makhni ◽  
Chaitu S. Malempati ◽  
Eric C. Swart ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Cost Effective ◽  
Effective Treatment Option ◽  
Younger Patients ◽  
Cost Effective Treatment ◽  
Anterior Cruciate ◽  
Graft Diameter ◽  
Return To Activity

Background: Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients. Hypothesis: Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure. Study Design: Cohort study (economic and decision analysis); Level of evidence, 3. Methods: We retrospectively identified patients younger than 18 years who had undergone ACL reconstruction by a single surgeon between 2010 and 2015. During this period, the operating surgeon’s graft selection algorithm included the use of bone–patellar tendon–bone (BTB) autografts for the majority of patients younger than 18 years. However, hamstring autografts (hamstring) or hybrid hamstring autografts with allograft augment (hybrid) were used in skeletally immature patients and in those whom the surgeon felt might have greater difficulty with postoperative rehabilitation after BTB graft harvest. Patient demographics, graft type, graft diameter, the time the patient was cleared to return to activity, and the need for secondary surgical procedures were compared between the hamstring and hybrid groups. The clinical results were then used to assess the potential cost-effectiveness of hybrid grafts in this select group of young patients with an ACL injury or reconstruction. Results: This study comprised 88 patients (hamstring group, n = 46; hybrid group, n = 42). The 2 groups did not differ in terms of age, sex, timing of return to activity, or prevalence of skeletally immature patients. Graft diameters were significantly smaller in the hamstring group (7.8 vs 9.9 mm; P < .001), which corresponded with a significantly greater rate of graft failure (13 of 46 [28.3%] vs 5 of 42 [11.9%]; P = .049). As a result of the reduced revision rate, the hybrid graft demonstrated incremental cost savings of US$2765 compared with the hamstring graft, and the hybrid graft was the preferred strategy in 89% of cases. Conclusion: Driven by increased graft diameters and the reduced risk of revision, hybrid grafts appear to be a more cost-effective treatment option in a subset of younger patients with an ACL injury.

scholarly journals Cost of Hemodialysis in a Tertiary Care Hospital in North India

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 47-50
Author(s):  
Mushtaq Ahmad ◽  
Ajaz Mustafa ◽  
M Saleem Najar ◽  
Farooq Ahmad Jan ◽  
Anil Manhas ◽  
...  
Keyword(s):  
Average Cost ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cost Effective ◽  
Chronic Hemodialysis ◽  
North India ◽  
Care Hospital ◽  
Effective Treatment Option ◽  
Cost Effective Treatment ◽  
Cost Efficient

BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem with significant health consequences and involvement of high cost on treatment worldwide. Although renal transplant is a cost effective treatment option for ESRD, use of hemodialysis in patients with ESRD patients remains one of the most resource intensive and expensive therapeutic intervention. OBJECTIVE: To estimate cost of hemodialysis treatment for patients with ESRD that would help in making policy decisions and enable cost efficient utilization of ESRD programme and hemodialysis. METHODS: 58 patients with ESRD on chronic hemodialysis were incorporated in the present study at a tertiary care teaching hospital between January 2010 to December 2010. Patients who survived less than 3 months after commencement of treatment were excluded. RESULTS: Mean age of the study patients was 46.4±8 in yrs. Among the 54 patients studied 51 % were male. 86% of patients received three sessions of hemodialysis weekly, with duration per session varying between 2 - 4 hours. Average cost was Rs. 2001.84 per session. Estimated total annual burden was Rs. 209449.10 per patient. Average cost borne by hospital was Rs. 951.84 per session/patient (47.55 % of cost bone by the patient); cost born by hospital per patient per year was Rs. 123647.70. Principal expenses (% wise) were: staff salary cost 20.84 %, instrument cost (purchased locally from market) 32.50%, salary cost 20.84%, and rental cost 18.20 %. CONCLUSION: The costs estimated in this study comparable with national average cost of hemodialysis in India but lower as compared to that in other SARC countries; approaches to reduce cost further are needed. JMS 2012;15(1):47-50.

scholarly journals Need for evidence on long-term prognosis of PD+HD: a commentary

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mototsugu Tanaka ◽  
Naobumi Mise
Keyword(s):  
High Risk Patient ◽  
Cost Effective ◽  
Effective Treatment Option ◽  
Hospitalization Rates ◽  
Appropriate Treatment ◽  
Risk Of Mortality ◽  
Cost Effective Treatment ◽  
Long Term Prognosis ◽  
End Stage

AbstractCombination therapy with peritoneal dialysis and hemodialysis (PD+HD) is an alternative dialysis method for patients with end-stage kidney disease (ESKD). The complementary use of once-weekly HD expedites to achieve adequate dialysis and enables to prolong PD duration. Although PD+HD has been widely employed among Japanese PD patients, it is much less common outside Japan. Clinical evidences are still not enough, especially in long-term prognosis and appropriate treatment duration, suitable patients, and generalizability. A retrospective cohort study by Chung et al. (BMC Nephrol 21:348, 2020) compared the risk of mortality and hospitalization between PD patients who were transferred to PD+HD and those who were transferred to HD in Taiwan. Because the mortality and hospitalization rates did not differ between the groups, the authors concluded that, PD+HD may be a rational and cost-effective treatment option. It should be noted that the effects of PD+HD on long-term prognosis are still unknown due to too-short PD+HD duration. However, the study identified the high-risk patient population and showed the generalizability of PD+HD. PD+HD is a treatment of choice in patients with ESKD who prefer PD lifestyles even after decline in residual kidney function.

scholarly journals Retinoid agonist Am80-enhanced neutrophil bactericidal activity arising from granulopoiesis in vitro and in a neutropenic mouse model

Blood ◽  
2013 ◽  
Vol 121 (6) ◽  
pp. 996-1007 ◽  
Author(s):  
Wanjing Ding ◽  
Hiroyuki Shimada ◽  
Lin Li ◽  
Rahul Mittal ◽  
Xiaokun Zhang ◽  
...  
Keyword(s):  
Mouse Model ◽  
Effective Treatment ◽  
Treatment Option ◽  
Bactericidal Activity ◽  
Cost Effective ◽  
Effective Treatment Option ◽  
New Therapy ◽  
Cost Effective Treatment ◽  
Key Points

Key PointsNeutrophils mobilized by Am80 display greater bactericidal activity than those by G-CSF. These findings suggest a molecular rationale for developing new therapy for neutropenia by using Am80 as a cost-effective treatment option.

scholarly journals Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

2015 ◽  
Vol 45 (14) ◽  
pp. 3019-3031 ◽  
Author(s):  
L. Koeser ◽  
V. Donisi ◽  
D. P. Goldberg ◽  
P. McCrone
Keyword(s):  
Cost Effectiveness ◽  
Effective Treatment ◽  
Combination Treatment ◽  
Severe Depression ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Effective Treatment Option ◽  
Cognitive Behavioural ◽  
Cost Effective Treatment ◽  
The Cost

Background.The National Institute of Health and Care Excellence (NICE) in England and Wales recommends the combination of pharmacotherapy and psychotherapy for the treatment of moderate to severe depression. However, the cost-effectiveness analysis on which these recommendations are based has not included psychotherapy as monotherapy as a potential option. For this reason, we aimed to update, augment and refine the existing economic evaluation.Method.We constructed a decision analytic model with a 27-month time horizon. We compared pharmacotherapy with cognitive–behavioural therapy (CBT) and combination treatment for moderate to severe depression in secondary care from a healthcare service perspective. We reviewed the literature to identify relevant evidence and, where possible, synthesized evidence from clinical trials in a meta-analysis to inform model parameters.Results.The model suggested that CBT as monotherapy was most likely to be the most cost-effective treatment option above a threshold of £22 000 per quality-adjusted life year (QALY). It dominated combination treatment and had an incremental cost-effectiveness ratio of £20 039 per QALY compared with pharmacotherapy. There was significant decision uncertainty in the probabilistic and deterministic sensitivity analyses.Conclusions.Contrary to previous NICE guidance, the results indicated that even for those patients for whom pharmacotherapy is acceptable, CBT as monotherapy may be a cost-effective treatment option. However, this conclusion was based on a limited evidence base, particularly for combination treatment. In addition, this evidence cannot easily be transferred to a primary care setting.

scholarly journals Potential Solutions for Sustaining the Costs of Cancer Drugs

2017 ◽  
Vol 13 (02) ◽  
pp. 102 ◽  
Author(s):  
Gilberto Lopes ◽  
Arnold Vulto ◽  
Nils Wilking ◽  
Wim van Harten ◽  
Klaus Meier ◽  
...  
Keyword(s):  
Cost Effective ◽  
Cancer Drugs ◽  
Generic Medicines ◽  
Effective Treatment Option ◽  
Sustainable Solutions ◽  
Cost Effective Treatment ◽  
Number Of Patients ◽  
Managed Entry Agreements ◽  
The Cost ◽  
Response Biomarkers

The growing burden of cancer urgently requires sustainable solutions to ensure continued access to effective and safe treatments for all patients within Europe. The aim of this article, the third in a series of perspectives, is to discuss potential approaches to sustain cancer care and increase patient access to treatments. Much work remains to ensure the sustainability ceiling (where costs of care exceed the benefits) is not reached. Immediate steps must be taken to avoid this, including patient education to encourage earlier diagnosis, use of treatment-response biomarkers, improving efficiency of healthcare systems, use of managed-entry agreements, introduction of value-based medicines with measurable outcomes and use of less expensive medicines. Here we discuss these potential solutions with a focus on reducing the cost of cancer drugs, using biosimilar medicines as an example. Biosimilar and generic medicines offer a cost-effective treatment option that may help combat the substantially increasing costs of cancer drugs. Competition from biosimilar medicines is expected to drive a decrease in the cost of medicines, resulting in increased affordability and access to therapy, and therefore a greater number of patients could be treated. However, various barriers must be overcome to increase the uptake of biosimilar medicines and education is needed to allay misperceptions and encourage greater use.

Sign in / Sign up

Export Citation Format

Share Document