scholarly journals Pharmacoeconomic feasibility of using the drug Hemangiol (propranolol, oral solution) in the treatment of proliferating infantile hemangioma requiring systemic therapy

2021 ◽  
Vol 13 (4) ◽  
pp. 356-365
Author(s):  
I. N. Dyakov ◽  
S. R. Varfolomeеva
Keyword(s):  
Sensitivity Analysis ◽  
Systemic Therapy ◽  
Dosage Form ◽  
Infantile Hemangioma ◽  
Oral Solution ◽  
Surgical Methods ◽  
Surgical Treatments ◽  
The Cost ◽  
Methods Of Treatment ◽  
Propranolol Therapy

Aim. The study aimed to evaluate the pharmacoeconomic feasibility of propranolol application in the dosage form of the oral solution in the treatment of proliferating infantile hemangioma requiring systemic therapy.Materials and methods. The study design was a retrospective analysis of the published data. The methods of pharmacoeconomic analysis included a clinical-economic analysis (cost-effectiveness analysis) with a sensitivity analysis; and a "budget impact" analysis with a sensitivity analysis. The authors compared the pharmacoeconomic effectiveness of pharmacotherapy for infant hemangiomas with propranolol and surgical methods of treatment.Results. The efficacy of propranolol therapy was 39% higher than surgical methods of treatment. The relative increase in the efficacy of propranolol therapy compared to surgical treatments was 68.4%. At the same time, the cost of propranolol therapy was lower than the cost of surgical treatments by 31.7% or 56,486,07 RUR per patient per year. The application of propranolol in the treatment for proliferating infantile hemangioma allowed reducing the burden on the budget of the state guarantee program in comparison with surgical methods of treatment for 3 years by 1,562.0 million RUR with a proportion of 12% of patients with infant hemangiomas requiring systemic therapy (9,694 patients per year). The sensitivity analysis of the cost and effectiveness of the compared medical technologies showed that the obtained results are resistant to the fluctuations in these parameters in the range from − 20% to + 20%.Conclusion. The application of propranolol preparation in a dosage form of oral solution for the treatment of patients with proliferating infantile hemangioma will significantly increase the efficiency of therapy and reduce costs associated with the application of surgical methods of treatment.

Modern molecular and biological aspects of endometriosis-associated infertility

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 12-15
Author(s):  
Anastasiia S Safronova ◽  
Mikhail Yu Vysokikh ◽  
Vladimir D Chuprynin ◽  
Natalia A Buralkina
Keyword(s):  
Signaling Pathways ◽  
Recurrence Rate ◽  
High Recurrence Rate ◽  
Modern Drug ◽  
Surgical Methods ◽  
Prevention And Treatment ◽  
Biological Aspects ◽  
Methods Of Treatment ◽  
New Strategies

There is currently no consensus on the etiopathogenetic nature of endometriosis. The causes of aggressive, progressive, infiltrative growth of endometrioid tissue also remain unclear. An important problem remains the high recurrence rate of endometriosis, despite the availability of modern drug and surgical methods of treatment. The study of the central signaling pathways and the search for new key molecules is of paramount importance for a better understanding of the pathogenesis of the disease, and is also an important step in the development of new strategies for the diagnosis, prevention and treatment of endometriosis.

METASTATIC LESION OF THE SPINE: DIAGNOSIS AND TACTICS OF SURGICAL TREATMENT

2019 ◽  
Vol 65 (6) ◽  
pp. 868-876
Author(s):  
Anton Yarikov ◽  
Anton Yermolaev ◽  
Igor Smirnov ◽  
Anton Denisov ◽  
Olga Perlmutter ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Epidemiological Studies ◽  
Metastatic Lesion ◽  
Spinal Cord Damage ◽  
Metastatic Lesions ◽  
Spinal Lesions ◽  
Cancer Pathology ◽  
Surgical Methods ◽  
The Stability ◽  
Methods Of Treatment

Epidemiological studies show an increase in the number of people with cancer. Bone metastases are a frequent manifestation of generalized cancer, because it is in malignant tumors of the spine more often than other bones of the skeleton becomes a target for metastasis. The article describes in detail the methods of diagnosis of spinal lesions in cancer pathology. Particular attention is paid to the scales reflecting the severity of the patient’s condition, the degree of spinal cord damage, the severity of pain in metastasis to the spine, the prognosis of survival in oncovertebrology and evaluation of the stability of the spine in metastatic lesions. Further, the paper presents non-radical (decompression, vertebroplasty) and radical (spondylectomy, corporectomy) surgical methods of treatment

scholarly journals Itraconazole Oral Solution for a Case of Infantile Hemangioma: Monitoring the Efficacy by Dermoscopy and MRI

2021 ◽  
Author(s):  
Ying Huang ◽  
Xin Ran ◽  
Xiaoxi Xu ◽  
Sushmita Pradhan ◽  
Jiayu Sun ◽  
...  
Keyword(s):  
Infantile Hemangioma ◽  
Oral Solution

scholarly journals Cost-effectiveness of pembrolizumab for treatment of platinum-resistant recurrent or metastatic head and neck squamous cell carcinoma in China: an economic analysis based on a randomised, open-label, phase III trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038867 ◽  
Author(s):  
Wenxiu Xin ◽  
Haiying Ding ◽  
Qilu Fang ◽  
Xiaowei Zheng ◽  
Yinghui Tong ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Squamous Cell Carcinoma ◽  
Cost Effectiveness ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Probabilistic Sensitivity Analysis ◽  
Cost Effective ◽  
Platinum Resistant ◽  
The Cost

BackgroundPembrolizumab was recently demonstrated to have survival benefit in patients with recurrent or metastatic head and neck squamous cell carcinoma (r/mHNSCC). However, the cost-effectiveness of pembrolizumab versus chemotherapy in China remains uncertain.ObjectiveThis analysis aimed to describe the cost-effectiveness of pembrolizumab versus standard-of-care (SOC) therapy in r/mHNSCC in China.DesignA Markov model consisting of three health states (stable, progressive and dead) was developed to compare the cost and effectiveness of pembrolizumab with SOC in platinum-resistant r/mHNSCC. Model inputs for transition probabilities and toxicity were collected from the KEYNOTE-040 trial, while health utilities were estimated from a literature review. Cost data were acquired for the payer’s perspective in China. Costs and outcomes were discounted at an annual rate of 3.0%. Sensitivity analyses were conducted to test the uncertainties surrounding model parameters.Outcome measuresThe primary outcome was incremental cost-effectiveness ratios (ICERs), which were calculated as the cost per quality-adjusted life years (QALYs).ResultsThe total mean cost of pembrolizumab and SOC was US$45 861 and US$41 950, respectively. As for effectiveness, pembrolizumab yielded 0.31 QALYs compared with 0.25 QALYs for SOC therapy. The ICER for pembrolizumab versus SOC was US$65 186/QALY, which was higher than the willingness-to-pay threshold (WTP) of US$28 130/QALY in China. The univariate sensitivity analysis indicated that utility values for progressive state, probability from stable to progressive in the SOC group, as well as cost of pembrolizumab were the three most influential variables on ICER. The probabilistic sensitivity analysis demonstrated that standard therapy was more likely to be cost-effective compared with pembrolizumab at a WTP value of US$28 130/QALY. Results were robust across both univariate analysis and probabilistic sensitivity analysis.ConclusionsPembrolizumab is not likely to be a cost-effective strategy compared with SOC therapy in patients with platinum-resistant r/mHNSCC in China.Trial registration numberNCT02252042; Post-results.

scholarly journals A cost analysis to address issues of budget constraints on the implementation of the indoor residual spray programme in two districts of Maputo Province, Mozambique

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Neide Canana
Keyword(s):  
Sensitivity Analysis ◽  
Cost Analysis ◽  
Financial Analysis ◽  
Indoor Residual Spraying ◽  
Economic Cost ◽  
Cost Information ◽  
Financial Cost ◽  
Provider Perspective ◽  
The Government ◽  
The Cost

Abstract Background It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions. Methods Cost information was collected retrospectively from the provider perspective, and both economic and financial costs were calculated. A “one-way” deterministic sensitivity analysis was performed. Results The average economic costs totaled US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. The average financial cost totaled US$69,174.83, with an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Vehicle, salary, and insecticide costs were the greatest contributors to overall cost in the economic and financial analysis, corresponding to 52%, 17%, and 13% in the economic analysis and 21%, 27%, and 22% in the financial analysis, respectively. The sensitivity analysis was adapted to a range of ± (above and under) 25% change. There was an approximate change of 14% in the average economic cost when vehicle costs were decreased by 25%. In the financial analysis, the average financial cost was lowered by 7% when salary costs were decreased by 25%. Conclusions Altogether, the current cost analysis provides an impetus for the consideration of targeted IRS operationalization within the available governmental budget, by using locally-available human resources as spray operators to decrease costs and having IRS rounds be correctly timed to coincide with the build-up of vector populations.

scholarly journals Cost-effectiveness of TAS-102 plus bevacizumab versus TAS-102 monotherapy in patients with metastatic colorectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kiyoaki Sugiura ◽  
Yuki Seo ◽  
Takayuki Takahashi ◽  
Hideyuki Tokura ◽  
Yasuhiro Ito ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Combination Therapy ◽  
Metastatic Colorectal Cancer ◽  
Cost Effective ◽  
Model Parameters ◽  
Combination Regimen ◽  
The Cost

Abstract Background TAS-102 plus bevacizumab is an anticipated combination regimen for patients who have metastatic colorectal cancer. However, evidence supporting its use for this indication is limited. We compared the cost-effectiveness of TAS-102 plus bevacizumab combination therapy with TAS-102 monotherapy for patients with chemorefractory metastatic colorectal cancer. Method Markov decision modeling using treatment costs, disease-free survival, and overall survival was performed to examine the cost-effectiveness of TAS-102 plus bevacizumab combination therapy and TAS-102 monotherapy. The Japanese health care payer’s perspective was adopted. The outcomes were modeled on the basis of published literature. The incremental cost-effectiveness ratio (ICER) between the two treatment regimens was the primary outcome. Sensitivity analysis was performed and the effect of uncertainty on the model parameters were investigated. Results TAS-102 plus bevacizumab had an ICER of $21,534 per quality-adjusted life-year (QALY) gained compared with TAS-102 monotherapy. Sensitivity analysis demonstrated that TAS-102 monotherapy was more cost-effective than TAS-102 and bevacizumab combination therapy at a willingness-to-pay of under $50,000 per QALY gained. Conclusions TAS-102 and bevacizumab combination therapy is a cost-effective option for patients who have metastatic colorectal cancer in the Japanese health care system.

scholarly journals Addition of Flucytosine to Fluconazole for the Treatment of Cryptococcal Meningitis in Africa: A Multicountry Cost-effectiveness Analysis

2019 ◽  
Vol 70 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Tinevimbo Shiri ◽  
Angela Loyse ◽  
Lawrence Mwenge ◽  
Tao Chen ◽  
Shabir Lakhi ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cryptococcal Meningitis ◽  
Cost Effective ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
The Cost ◽  
The Impact ◽  
Costing Analysis ◽  
Very High

Abstract Background Mortality from cryptococcal meningitis remains very high in Africa. In the Advancing Cryptococcal Meningitis Treatment for Africa (ACTA) trial, 2 weeks of fluconazole (FLU) plus flucytosine (5FC) was as effective and less costly than 2 weeks of amphotericin-based regimens. However, many African settings treat with FLU monotherapy, and the cost-effectiveness of adding 5FC to FLU is uncertain. Methods The effectiveness and costs of FLU+5FC were taken from ACTA, which included a costing analysis at the Zambian site. The effectiveness of FLU was derived from cohorts of consecutively enrolled patients, managed in respects other than drug therapy, as were participants in ACTA. FLU costs were derived from costs of FLU+5FC in ACTA, by subtracting 5FC drug and monitoring costs. The cost-effectiveness of FLU+5FC vs FLU alone was measured as the incremental cost-effectiveness ratio (ICER). A probabilistic sensitivity analysis assessed uncertainties and a bivariate deterministic sensitivity analysis examined the impact of varying mortality and 5FC drug costs on the ICER. Results The mean costs per patient were US $847 (95% confidence interval [CI] $776–927) for FLU+5FC, and US $628 (95% CI $557–709) for FLU. The 10-week mortality rate was 35.1% (95% CI 28.9–41.7%) with FLU+5FC and 53.8% (95% CI 43.1–64.1%) with FLU. At the current 5FC price of US $1.30 per 500 mg tablet, the ICER of 5FC+FLU versus FLU alone was US $65 (95% CI $28–208) per life-year saved. Reducing the 5FC cost to between US $0.80 and US $0.40 per 500 mg resulted in an ICER between US $44 and US $28 per life-year saved. Conclusions The addition of 5FC to FLU is cost-effective for cryptococcal meningitis treatment in Africa and, if made available widely, could substantially reduce mortality rates among human immunodeficiency virus–infected persons in Africa.

Treatment of inflammatory diseases of the female genitalia with iontophoresis

1927 ◽  
Vol 23 (4) ◽  
pp. 425-429
Author(s):  
N. S. Utochnikova
Keyword(s):  
Young Women ◽  
Surgical Intervention ◽  
Inflammatory Diseases ◽  
The Other ◽  
Female Genitalia ◽  
Physical Methods ◽  
Surgical Methods ◽  
The One ◽  
Methods Of Treatment ◽  
Female Genital

The treatment of inflammatory diseases of the female genitalia has long been one of the most important tasks of the gynecologist. With the development of surgery, surgical methods of treatment began to be applied: exudates were removed, the uterus and inflamed appendages were extirpated, etc.; but the danger of surgical intervention on the one hand, and on the other - the severe consequences of removal of organs such as ovaries, especially in young women - forced gynecologists to spend much effort in discovering and improving non-operative methods of treatment of inflammatory diseases of the female genital parts. Among these methods, physical methods such as water, mud, light baths, massage, etc., as well as those related to electricity have long been prominent.

COST-EFFECTIVENESS ANALYSIS OF IVABRADINE IN TREATMENT OF PATIENTS WITH HEART FAILURE IN IRAN

2018 ◽  
Vol 34 (6) ◽  
pp. 576-583 ◽  
Author(s):  
Saeed Taheri ◽  
Elham Heidari ◽  
Mohammad Ali Aivazi ◽  
Mehran Shams-Beyranvand ◽  
Mehdi Varmaghani
Keyword(s):  
Heart Failure ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Transition Probabilities ◽  
Drug Acquisition ◽  
Sensitivity Analyses ◽  
Baseline Heart Rate ◽  
Life Years ◽  
The Cost

Objectives:This study aimed to assess the cost-effectiveness of ivabradine plus standard of care (SoC) in comparison with current SoC alone from the Iranian payer perspective.Methods:A cohort-based Markov model was developed to assess the incremental cost-effectiveness ratio (ICER) over a 10-year time horizon in a cohort of 1,000 patients. The baseline transition probabilities between New York Heart Association (NYHA), mortality rate, and hospitalization rate were extracted from the literature. The effect of ivabradine on mortality, hospitalization, and NYHA improvement or worsening were retrieved from the SHIFT study. The effectiveness was measured as quality-adjusted life-years (QALYs) using the utility values derived from Iranian Heart Failure Quality of Life study. Direct medical costs were obtained from hospital records and national tariffs. Deterministic and probabilistic sensitivity analyses were conducted to show the robustness of the model.Results:Ivabradine therapy was associated with an incremental cost per QALY of USD $5,437 (incremental cost of USD $2,207 and QALYs gained 0.41) versus SoC. The probabilistic sensitivity analysis showed that ivabradine is expected to have a 60 percent chance of being cost-effective accepting a threshold of USD $6,550 per QALY. Furthermore, deterministic sensitivity analysis indicated that the model is sensitive to the ivabradine drug acquisition cost.Conclusions:The cost-effectiveness model suggested that the addition of ivabradine to SoC therapy was associated with improved clinical outcomes along with increased costs. The analysis indicates that the clinical benefit of ivabradine can be achieved at a reasonable cost in eligible heart failure patients with sinus rhythm and a baseline heart rate ≥ 75 beats per minute (bpm).

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