Development and Evaluation of an Electronic Drug and Therapeutics Bulletin

2002 ◽  
Vol 36 (10) ◽  
pp. 1637-1641 ◽  
Author(s):  
Christopher P Alderman
Keyword(s):  
Electronic Mail ◽  
Cost Effective ◽  
Extensive Literature ◽  
Therapeutics Bulletin ◽  
Level Of Satisfaction ◽  
The Us ◽  
High Level ◽  
Effective Use ◽  
The Cost ◽  
E Mail

OBJECTIVE: To describe the development, implementation, and initial evaluation of a paperless drug and therapeutics bulletin that is distributed by electronic mail from the pharmacy department of an Australian teaching hospital. OUTCOMES: A standardized format for the bulletin was designed and approved in February 2001. The aim of the bulletin is to facilitate the timely dissemination of concise, factual information about issues of current interest in therapeutics, drug safety, and the cost-effective use of medicines. A simple and attractive graphic design was chosen, and the hospital's clinical pharmacists and drug information staff developed an initial bank of content during the period immediately preceding the launch. The bulletin is presented as a 1-page, read-only file in Word for Windows format and was initially distributed by electronic mail to all users of the hospital's computerized communication network. As the popularity of the bulletin increased, healthcare practitioners from outside of the hospital began to request permission for inclusion on the circulation list, and the content was frequently forwarded by E-mail to workers in other hospitals and community-based settings. The bulletin is now distributed to pharmacists around Australia via 2 separate moderated discussion lists, one of which provides an archive site for previous editions. Healthcare workers in Singapore, the US, Canada, and New Zealand also receive the bulletin, which is now also abstracted by a major Australian pharmacy journal. A readership survey (also electronically distributed) was used to seek feedback after the publication of the first 12 editions. Readers indicated a high level of satisfaction with the content, format, and frequency of distribution of the materials. CONCLUSIONS: Although the concept and execution of this project was relatively simple, an extensive literature review did not reveal any previously published reports describing this type of approach to the distribution of a pharmacy bulletin. The development and implementation of the electronic drug and therapeutics bulletin has provided an opportunity to use modern communication technology to promote safe and effective medication use and appears to have been well received.

First-Line Pembrolizumab Plus Chemotherapy for Extensive-Stage Small-Cell Lung Cancer: A Cost-Effectiveness Analysis

2021 ◽  
Author(s):  
Youwen Zhu ◽  
Huabin Hu ◽  
Dong Ding ◽  
Shuosha Li ◽  
Mengting Liao ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Small Cell ◽  
Sensitivity Analyses ◽  
Small Cell Lung ◽  
First Line ◽  
The Us ◽  
Extensive Stage ◽  
The Cost ◽  
First Line Treatment

Abstract Background：The phase III clinical trial Keynote-604 indicated that pembrolizumab plus chemotherapy could generate clinical benefits in Extensive-Stage Small-Cell Lung Cancer (ES-SCLC). We aim to evaluate the cost-effectiveness of pembrolizumab plus chemotherapy as the first-line treatment of ES-SCLC from the United States (US) payers’ perspective.Methods: A synthetical Markov model was used to evaluate cost and effectiveness of pembrolizumab plus platinum-etoposide (EP) versus EP in first-line therapy for ES-SCLC from the data of Keynote-604. Lifetime costs life-years (LYs), quality adjusted LYs (QALYs), and incremental cost-effectiveness ratios (ICERs) were estimated. One-way and probabilistic sensitivity analyses were performed. In addition, We also considered subgroup cost-effectiveness.Results: Pembrolizumab plus EP resulted in additional 0.18 QALYs (0.32 LYs) and corresponding incremental costs $113,625, resulting an ICER of $647,509 per QALY versus EP. The most influential factor in this model was the cost of pembrolizumab. Probabilistic sensitivity analysis showed there was 0% probability that pembrolizumab combination chemotherapy was cost-effective at willingness-to-pay (WTP) values of $150,000 per QALY in the US. The results of subgroup probabilistic sensitivity analyses suggested that all subgroups were not cost-effective.Conclusion: From the perspective of the US payer, pembrolizumab plus EP is not a cost-effective option as first-line treatment for patients with ES-SCLC at a WTP threshold of $150,000 per QALY.

Making E-Training Cost Effective through Quality Assurance

2009 ◽  
pp. 623-631
Author(s):  
Lichia Yiu ◽  
Raymond Saner
Keyword(s):  
High Performance ◽  
Cost Effective ◽  
Web Based ◽  
Corporate Learning ◽  
Use Of Technology ◽  
Training Cost ◽  
E Learning ◽  
American Society ◽  
High Level ◽  
The Cost

Since the 1990s, more and more corporate learning has been moved online to allow for flexibility, just-in-time learning, and cost saving in delivering training. This trend has been evolved along with the introduction of Web-based applications for HRM purposes, known as electronic Human Resource Management (e-HRM). By 2005, 39.67% of the corporate learning, among the ASTD (American Society for Training and Development) benchmarking forum companies, was delivered online in comparison to 10.5% in 2001. E-learning has now reached “a high level of (technical) sophistication, both in terms of instructional development and the effective management of resources” in companies with high performance learning function (ASTD, 2006, p.4). The cost per unit, reported by ASTD in its 2006 State of Industry Report, has been declining since 2000 despite the higher training hours received per employee thanks to the use of technology based training delivery and its scalability. However, the overall quality of e-learning either public available in the market or implemented at the workplace remains unstable.

Cascade Strengthening of Bent Elements by Polymers with Adhesive Joints

2019 ◽  
Vol 974 ◽  
pp. 583-588
Author(s):  
Alexander I. Danilov
Keyword(s):  
Fem Simulation ◽  
High Strength ◽  
Cost Effective ◽  
Adhesive Joints ◽  
Joint Analysis ◽  
Analysis And Design ◽  
Full Analysis ◽  
Cascade Method ◽  
Effective Use ◽  
The Cost

The subject of the article is to give a full analysis of the cascade type layouts in elements strengthening design in bending by gluing the fiber reinforced polymer (FRP) materials on their surfaces’ applicability and effectiveness. The research objectives are the substantiation elements cascade method application reinforcement with adhesive joints. Materials and methods are revealed in a few variants of FRP-reinforcement with application of FEM simulation. A number of diagrams and tables represent the results. The results are defined in the cost-effective efficient method presentation of the bent elements strengthening to increase their bearing capacity reserves, the features of the bonded joint behavior, the equations and formulae for the glue joint analysis and design. Conclusions are formulated in depicting the “cascade” reflects, the features of the proposed strengthening design, the base element unloading, which is gradual with each successive element attached. The design examples are oriented on the adhesive joints’ application possibility analysis of attaching the FRP elements. The results suggest the effective use possibility of the adhesive joints to strengthen rather stiff, including steel, elements in bending. The cascade method eliminates the indispensability of highly expensive high-strength materials, thereby reducing the reinforcement structures cost.

scholarly journals Improving Access to Cancer Treatments: The Role of Biosimilars

2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Health Care Providers ◽  
Cost Effective ◽  
Cancer Therapies ◽  
Care Providers ◽  
Cancer Treatments ◽  
Reference Drug ◽  
Effective Use ◽  
The Cost

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).

Economic Evaluation of Ibrutinib Versus Acalabrutinib Versus Zanubrutinib for Patients with Relapsed or Refractory Mantle Cell Lymphoma

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 9-10
Author(s):  
Neda Alrawashdh ◽  
Ali McBride ◽  
Marion Slack ◽  
Ivo Abraham
Keyword(s):  
Clinical Trials ◽  
Cost Effectiveness ◽  
Phase I ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Cost Effective ◽  
Health States ◽  
Mantle Cell ◽  
The Us ◽  
The Cost

Background . Refractory or relapsed mantle cell lymphoma (R/R MCL) is generally associated with poor outcomes; median overall survival (OS) is 4-5 years. First generation Bruton's tyrosine kinase inhibitor (BTKi) (Ibrutinib) and second generation BTKi (acalabrutinib and zanubrutinib) have led to significant improvements in efficacy and safety over conventional chemoimmunotherapy in treating R/R MCL. In the absence of direct head to head clinical trials compare between BTKi, indirect comparisons between the first and second BTKi generations show possible differences in safety and efficacy. We used existing evidence from phase I/II clinical trials for second BTKi generation to evaluate the cost-effectiveness of ibrutinib vs acalabrutinib vs zanubrutinib in treating patients with R/R MCL from the US payer perspective. Methods. A Markov model with two health states (progression-free [PF] and progression or death) was specified. Kaplan-Meier (KM) curves of PF survival (PFS) from the phase III trial by Dreyling et al. (Lancet 2016) for ibrutinib, the phase II trial by Wang et al. (Lancet 2018) for acalabrutinib, and the phase I/II trial by Tam et al. (Blood 2019) for zanubrutinib were fitted to exponential distributions to extract transition probabilities between the two health states for each drug. Wholesale acquisition costs (WAC) were obtained from RedBook and costs of adverse events management were derived from the literature. The analysis was conducted over a lifetime horizon with health utility outcomes and costs discounted at 3.5% per year after the first year. The cost and PFS life years (LYs) and PFS quality-adjusted LYs (QALYs) for each treatment, the incremental PFS LYs and PFS QALYs gained with acalabrutinib or zanubrutinib over ibrutinib, and the incremental cost-effectiveness ratio (ICER) and cost-utility ratio (ICUR) were estimated in both base and probabilistic sensitivity analyses (PSA: 100,000 simulations). Results. As detailed in the table, acalabrutinib and zanubrutinib were associated with better clinical outcomes than ibrutinib, with incremental PFS LYs gained of 1.61 and 0.98, and incremental PFS QALYs of 1.27 and 0.77, respectively. The incremental costs when comparing acalabrutinib and zanubrutinib with ibrutinib were $110,931and $64,624, respectively. In probabilistic analyses, the ICERs ($61,689/LYg for acalabrutinib; $53,438/LYg for zanubrutinib) and ICURs ($86,750/QALYg for acalabrutinib; $82,897/QALYg for zanubrutinib) were lower than the US willingness to pay (WTP) threshold of $100,000 to $150,000 per QALY for cancer treatment. At WTP of $100,000, the cost-effectiveness acceptability curves showed the probabilities of acalabrutinib, zanubrutinib, and ibrutinib being cost-effective to be 50%, 34%, and 16%, respectively. Conclusions. Acalabrutinib is more cost-effective compared with ibrutinib and zanubrutinib and improves health outcomes more in R/R MCL patients. This analysis using phase I/II trials should be validated as additional trial and real-world evidence about efficacy, safety, and associated health-related quality of life outcomes. Based on the current data, acalabrutinib offers the most cost-effective treatment option in R/R MCL. Disclosures McBride: Coherus BioSciences: Consultancy, Speakers Bureau; Merck: Speakers Bureau; Pfizer: Consultancy; Sandoz: Consultancy; MorphoSys: Consultancy; Bristol-Myers Squibb: Consultancy. Abraham:Janssen: Consultancy; Coherus BioSciences: Research Funding, Speakers Bureau; Celgene: Consultancy; Sandoz: Consultancy; MorphoSys: Consultancy; Mylan: Consultancy; Rockwell Medical: Consultancy; Terumo: Consultancy.

Cost-effectiveness of nab-paclitaxel plus gemcitabine versus erlotinib plus gemcitabine in metastatic pancreatic cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 353-353 ◽  
Author(s):  
E. Gabriela Chiorean ◽  
Scott Whiting ◽  
Gary Binder ◽  
George Dranitsaris ◽  
Victoria Manax
Keyword(s):  
Pancreatic Cancer ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Phase Iii ◽  
Metastatic Pancreatic Cancer ◽  
Payer Perspective ◽  
The Us ◽  
Recent Phase ◽  
Cost Effective Alternative ◽  
The Cost

353 Background: In a recent phase III trial nab-paclitaxel (albumin-bound paclitaxel) + gemcitabine (nab-P/G) demonstrated a 1.8 month, or 27%, improvement in median overall survival (OS) (HR = 0.72, P < 0.001) vs gemcitabine (G) in first-line metastatic pancreatic cancer (mPC). nab-P/G had higher 1 year OS (35% vs 22%) and improved PFS by 1.8 months (HR = 0.69, P < 0.01). nab-P/G is the first taxane based therapy to show a significant OS improvement in a phase III mPC trial. Erlotinib + gemcitabine (E/G) has also demonstrated activity in mPC, with a 0.3 month OS benefit vs G (HR = 0.82, P = 0.04), a 1 year OS of 23% vs 17%, and 0.2 months PFS benefit (HR = 0.77, P = 0.004) vs G. A cost-effectiveness analysis measuring the cost per life year (LY) gained for nab-P/G and E/G was conducted from the US payer perspective. Methods: Costs and clinical outcomes were evaluated fromnab-P/G vs G and E/G vs G trials of mPC. Health care resource use and the management of grade III/IV adverse events (AE) were collected from a large multisite US oncology clinic, expert opinion, and literature (2012 US dollars). Drug cost per cycle was multiplied by the median cycles delivered from the trials for nab-P/G and E/G. Results: Duration of therapy was 4 months for nab-P/G vs 3.9 months for E/G. Total cost for nab-P/G was $24,984 vs $23,044 for E/G, including drug, administration and AE management. AE costs were similar between the two therapies (Table). Differences of > 5% were noted in neutropenia (rates: nab-P/G = 33%; E/G = 24%), neuropathy (nab-P/G = 17%; E/G = 1%), and rash (nab-P/G = 0%; E/G = 6%). The net survival advantage for nab-P/G vs E/G was 1.5 incremental life months gained. Nab-P/G was cost-effective relative to E/G, at a cost of $15,522 per incremental life year gained. Conclusions: nab-P/G is a cost-effective alternative to E/G in mPC, bringing more months of OS at < $16,000 cost per incremental life year gained. [Table: see text]

scholarly journals Cost Effectiveness of First-Line Treatment with Doxorubicin/Ifosfamide Compared to Trabectedin Monotherapy in the Management of Advanced Soft Tissue Sarcoma in Italy, Spain, and Sweden

Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Julian F. Guest ◽  
Monica Panca ◽  
Erikas Sladkevicius ◽  
Nicholas Gough ◽  
Mark Linch
Keyword(s):  
Cost Effectiveness ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Cost Effective ◽  
Line Treatment ◽  
First Line ◽  
Advanced Soft Tissue Sarcoma ◽  
Effective Use ◽  
The Cost ◽  
First Line Treatment

Background. Doxorubicin/ifosfamide is a first-line systemic chemotherapy for the majority of advanced soft tissue sarcoma (ASTS) subtypes. Trabectedin is indicated for the treatment of ASTS after failure of anthracyclines and/or ifosfamide; however it is being increasingly used off-label as a first-line treatment. This study estimated the cost effectiveness of these two treatments in the first-line management of ASTS in Italy, Spain, and Sweden.Methods. A Markov model was constructed to estimate the cost effectiveness of doxorubicin/ifosfamide compared to trabectedin monotherapy, defined as the cost per QALY gained, in each country.Results. First-line treatment with doxorubicin/ifosfamide resulted in lower two-year healthcare costs and more QALYs than first-line treatment with trabectedin monotherapy in all three countries. Probabilistic sensitivity analysis showed that at a cost per QALY threshold of €35,000, >90% of a cohort would be cost effectively treated with doxorubicin/ifosfamide compared to trabectedin monotherapy in all three countries.Conclusion. Within the model’s limitations, first-line treatment of patients with ASTS with doxorubicin/ifosfamide instead of trabectedin monotherapy affords a cost-effective use of publicly funded healthcare resources in Italy, Spain, and Sweden and is therefore the preferred treatment in all three countries. These findings support the recommendation that trabectedin should remain a second-line treatment.

scholarly journals Ефективність використання мінеральних добрив і стимуляторів росту на посівах пивоварного ячменю

2013 ◽  
pp. 162-165
Author(s):  
В. С. Шкурко
Keyword(s):  
Sugar Beet ◽  
Economic Indicators ◽  
Mineral Fertilizers ◽  
Net Income ◽  
Malting Barley ◽  
Cost Of Production ◽  
Complete Fertilizer ◽  
High Level ◽  
Effective Use ◽  
The Cost

Аналіз економічних показників досліду, в якому ви-вчалася дія попередників і добрив показав, що найви-щий рівень рентабельності зафіксовано у варіантах досліду, які розміщувалися після цукрових буряків і на яких застосовувався «Нутрівант Плюс пивоварний ячмінь» (71,8 %). У частині досліду, де попередником була кукурудза на зерно, найкращий ефект також було досягнуто на варіантах, на яких застосовувало-ся це комплексне добриво. Застосування «Нутріван-ту Плюс пивоварний ячмінь» також дозволяє істот-но зменшити собівартість продукції порівняно з ко-нтрольним варіантом без добрив та варіантами із застосуванням N30P30K30. Найефективнішим викори-стання стимуляторів росту було переважно у варіа-нтах, де рослини удобрювалися «Нутрівантом». Найкращі результати досягнуто в разі використання «Nano Gro» та «Вітазиму». Застосування стимуля-торів росту дає змогу збільшити показники рента-бельності та чистого доходу майже в два рази, про-те дія препаратів суттєво коригується вибраною системою удобрення посівів. На посівах ячменю, які удобрюються мінеральними добривами, потрібно застосовувати препарати «Вітазим» і «Nano Gro». Analysis of economic indicators of the experiment in which the effect of precursors and fertilizers were studied, showed that a high level of profitability was recorded in the experiments, which were placed after sugar beet and on which «Nutrivant Plus malting barley» (71.8%) was used. In the part of the experiment, where the predecessor was the maize on grain, the best effect has also been achieved on the variants on which a complete fertilizer was applied. Application of «Nutrivant Plus malting barley» can significantly reduce the cost of production compared to the control without fertilizer and options using N30P30K30. Effective use of growth stimulators was mainly in cases where the plants were fertilized with «Nutrivant». The best results were achieved by using drugs «Nano Gro» and «Vitazim». Application of growth stimulators can increase performance of profitability and net income almost twice, but the action of drugs is largely corrected by the selected system of fertilizing crops. On crops of barley, which are fertilized with mineral fertilizers, it is advisable to use drugs «Vitazim» and «Nano Gro».

Sign in / Sign up

Export Citation Format

Share Document