Cost comparisons of five leading brands of the Antiplatelet drug, Clopidogrel, available in an Indian town

2019 ◽  
Vol 8 (8) ◽  
pp. 1734
Author(s):  
Vikram A. Rajadnya
Keyword(s):  
Annual Cost ◽  
Major Part ◽  
Financial Stress ◽  
Antiplatelet Drugs ◽  
Antiplatelet Drug ◽  
Front Seat ◽  
The Cost ◽  
Economic Considerations ◽  
Cost Differences ◽  
Yearly Cost

Background: Antiplatelet drugs need to be prescribed lifelong, for most of the selected patients, once started. Price disparity can lead to large financial stress on the patients, especially when cost related aspects are not paid heed to by the prescribing physician. This study was conducted to compare the cost, to the patient, of five most commonly prescribed preparations of different brands of Clopidogrel seventy five milligram, in Kolhapur city.Methods: The present study was undertaken during February 2019 to June 2019. Authors purchased a strip of 10 tablets each of the five leading brands of Clopidogrel seventy five milligram. The prices of the strip of 10 tablets of each of the five chosen brands were compared. Finally, the yearly cost of each of these five different preparations, was compared directly as well as using percentages. The data was collected, analyzed and presented in tabular forms and figures.Results: The data of the cost of five different brands of a single antiplatelet drug, Clopidogrel seventy five milligram shows that the annual cost of the costliest among the five brands of this drug is almost three times that of the cheapest brand, or in other words almost 300 percent that of the cheapest brand.Conclusions: The cost differences between the five brands were not negligible. India, with a major part of the population being very sensitive to the cost of medications, the prescribing physician must select the preparation wisely. The most costly preparation of Clopidogrel can significantly add to the the financial stress on the patient’s yearly expenditure. Thus, Pharmaco economic considerations must take a front seat while making a decision to prescribe medicines, especially in a country like India.

scholarly journals Cost comparisons of seven leading brands of the Hypolipidemic drug, Rosuvastatin available in an India city

2019 ◽  
Vol 8 (7) ◽  
pp. 1514
Author(s):  
Vikram A. Rajadnya ◽  
Archana G. Dhavalshankh
Keyword(s):  
Medical Practitioner ◽  
Financial Strain ◽  
Price Variation ◽  
Hypolipidemic Drug ◽  
Prime Concern ◽  
One Year ◽  
The Cost ◽  
Economic Considerations ◽  
Cost Differences ◽  
Hypolipidemic Drugs

Background: Hypolipidemic drugs need to be prescribed lifelong for most of the selected patients, once started. Price variation can lead to huge financial strain on the patients, especially when cost associated issues are not considered by the prescribing medical practitioner. This study was conducted to compare the cost, to the patient, of seven most commonly prescribed preparations of different brands of Rosuvastatin ten milligram, in Kolhapur city.Methods: Authors purchased a strip of 10 capsules each of the seven leading brands of Rosuvastatin ten milligrams. The prices of the strip of 10 capsules of each of the seven chosen brands were compared. Finally, the cost of each of these seven brands for one year, was compared directly as well as using percentages. The data was collected, analysed and presented in tabular forms and figures.Results: The data of the cost of seven different brands of a single hypolipidemic drug, Rosuvastatin ten milligram shows that the cost of the costliest among the seven brands of this drug for one year is almost two times that of the cheapest brand, or in other words almost 200 percent that of the cheapest brand.Conclusions: The cost differences between the cheapest and the costliest brands were substantial. The cost of remaining five brands was dispersed in between these two extremes. India, with a major part of the population being highly concerned about the cost of medications, the prescribing medical practitioner must select the preparation wisely . The most costly preparation of Rosuvastatin ten milligram can substantially add to the financial strain on the patient’s yearly expenses. Thus, Pharmaco economic considerations must be a prime concern while making a decision to prescribe medicines, especially in a country like India.

scholarly journals Fresh Water Supply Aboard Ocean-Going Merchant Ships: The Economic Merit of Distillation From the Sea

1969 ◽  
Vol 6 (02) ◽  
pp. 134-146
Author(s):  
J. B. Woodward
Keyword(s):  
Fresh Water ◽  
Annual Cost ◽  
Attractive Alternative ◽  
General Belief ◽  
Merchant Ship ◽  
Average Annual Cost ◽  
Domestic Use ◽  
The Cost ◽  
Cost Differences ◽  
Significant Factors

The average annual cost of obtaining fresh water for boiler feed and domestic use by distillation from the sea is calculated for two distinct types of merchant ship, and compared to the cost of carrying purchased shore water for these uses. Results are presented as annual cost differences between the alternatives as functions of voyage length, with other significant factors as parameters. These results confirm the general belief that distillation is to be preferred, even if shore water did not typically require redistillation before use. Circumstances in which shore water might nonetheless be an attractive alternative are pointed out.

scholarly journals Accommodating Taste and Scale Heterogeneity for Front-Seat Passenger’ Choice of Seat Belt Usage

Mathematics ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 460 ◽  
Author(s):  
Mahdi Rezapour ◽  
Khaled Ksaibati
Keyword(s):  
Mixed Model ◽  
Seat Belt ◽  
Model Fit ◽  
Model Parameters ◽  
Extended Model ◽  
Random Parameters ◽  
Front Seat ◽  
Scale Heterogeneity ◽  
Error Terms ◽  
The Cost

There is growing interest in implementation of the mixed model to account for heterogeneity across population observations. However, it has been argued that the assumption of independent and identically distributed (i.i.d) error terms might not be realistic, and for some observations the scale of the error is greater than others. Consequently, that might result in the error terms’ scale to be varied across those observations. As the standard mixed model could not account for the aforementioned attribute of the observations, extended model, allowing for scale heterogeneity, has been proposed to relax the equal error terms across observations. Thus, in this study we extended the mixed model to the model with heterogeneity in scale, or generalized multinomial logit model (GMNL), to see if accounting for the scale heterogeneity, by adding more flexibility to the distribution, would result in an improvement in the model fit. The study used the choice data related to wearing seat belt across front-seat passengers in Wyoming, with all attributes being individual-specific. The results highlighted that although the effect of the scale parameter was significant, the scale effect was trivial, and accounting for the effect at the cost of added parameters would result in a loss of model fit compared with the standard mixed model. Besides considering the standard mixed and the GMNL, the models with correlated random parameters were considered. The results highlighted that despite having significant correlation across the majority of the random parameters, the goodness of fits favors more parsimonious models with no correlation. The results of this study are specific to the dataset used in this study, and due to the possible fact that the heterogeneity in observations related to the front-seat passengers seat belt use might not be extreme, and do not require extra layer to account for the scale heterogeneity, or accounting for the scale heterogeneity at the cost of added parameters might not be required. Extensive discussion has been made in the content of this paper about the model parameters’ estimations and the mathematical formulation of the methods.

scholarly journals Why Do Some Firms Spend So Much on Medical Care? Accounting for Variation

2000 ◽  
Vol 3 (1) ◽  
Author(s):  
Matthew Eichner ◽  
Mark McClellan ◽  
David A. Wise
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Health Care Expenditures ◽  
Cost Of Treatment ◽  
Consistent Method ◽  
The Difference ◽  
The Cost ◽  
Cost Differences ◽  
Average Expenditure

We are engaged in a long-term project to analyze the determinants of health care cost differences across firms. An important first step is to summarize the nature of expenditure differences across plans. The goal of this article is to develop methods for identifying and quantifying those factors that account for the wide differences in health care expenditures observed across plans.We consider eight plans that vary in average expenditure for individuals filing claims, from a low of $1,645 to a high of $2,484. We present a statistically consistent method for decomposing the cost differences across plans into component parts based on demographic characteristics of plan participants, the mix of diagnoses for which participants are treated, and the cost of treatment for particular diagnoses. The goal is to quantify the contribution of each of these components to the difference between average cost and the cost in a given firm. The demographic mix of plan enrollees accounts for wide differnces in cost ($649). Perhaps the most noticeable feature of the results is that, after adjusting for demographic mix, the difference in expenditures accounted for by the treatment costs given diagnosis ($807) is almost as wide as the unadjusted range in expenditures ($838). Differences in cost due to the different illnesses that are treated, after adjusting for demographic mix, also accounts for large differences in cost ($626). These components of cost do not move together; for example, demographic mix may decrease expenditure under a particular plan while the diagnosis mix may increase costs.Our hope is that understanding the reasons for cost differences across plans will direct more focused attention to controlling costs. Indeed, this work is intended as an important first step toward that goal.

A comprehensive assessment of the cost of multiple sclerosis in the United States

1998 ◽  
Vol 4 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Kathryn Whetten-Goldstein ◽  
Frank A Sloan ◽  
Larry B Goldstein ◽  
Elizabeth D Kulas
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Informal Care ◽  
Annual Cost ◽  
Lifetime Cost ◽  
The United States ◽  
Personal Health ◽  
Secondary Sources ◽  
The Cost

Comprehensive data on the costs of multiple sclerosis is sparse. We conducted a survey of 606 persons with MS who were members of the National Multiple Sclerosis Society to obtain data on their cost of personal health services, other services, equipment, and earnings. Compensation of such cost in the form of health insurance, income support, and other subsidies was measured. Survey data and data from several secondary sources was used to measure costs incurred by comparable persons without MS. Based on the 1994 data, the annual cost of MS was estimated at over $34 000 per person, translating into a conservative estimate of national annual cost of $6.8 billion, and a total lifetime cost per case of $2.2 million. Major components of cost were earnings loss and informal care. Virtually all persons with MS had health insurance, mostly Medicare/Medicaid. Health insurance covered 51 per cent of costs for services, excluding informal care. On average, compensation for earnings loss was 27 per cent. MS is very costly to the individual, health care system, and society. Much of the cost (57 per cent) is in the form of burdens other than personal health care, including earnings loss, equipment and alternations, and formal and informal care. These costs often are not calculated.

Economic considerations and decision support tool for wastewater reuse scheme planning

2007 ◽  
Vol 56 (5) ◽  
pp. 175-182 ◽  
Author(s):  
R. Hochstrat ◽  
D. Joksimovic ◽  
T. Wintgens ◽  
T. Melin ◽  
D. Savic
Keyword(s):  
Water Reuse ◽  
Net Present Value ◽  
Wastewater Reuse ◽  
Reclaimed Water ◽  
Decision Support Tool ◽  
Critical Issue ◽  
Economic Feasibility ◽  
Support Tool ◽  
The Cost ◽  
Economic Considerations

The reuse of upgraded wastewater for beneficial uses is increasingly adopted and accepted as a tool in water management. However, funding of schemes is still a critical issue. The focus of this paper is on economic considerations of water reuse planning. A survey of pricing mechanisms for reclaimed water revealed that most schemes are subsidised to a great extent. In order to minimise these state contributions to the implementation and operation of reuse projects, their planning should identify a least cost design option. This also has to take into account the established pricing structure for conventional water resources and the possibility of gaining revenues from reclaimed water pricing. The paper presents a case study which takes into account these aspects. It evaluates different scheme designs with regard to their Net Present Value (NPV). It could be demonstrated that for the same charging level, quite different amounts of reclaimed water can be delivered while still producing an overall positive NPV. Moreover, the economic feasibility and competitiveness of a reuse scheme is highly determined by the cost structure of the conventional water market.

Abstract P241: One-Year Cost-Effectiveness of Cytochrome P450 2C19 Genotype-Guided Antiplatelet Therapy in Patients With Acute Coronary Syndromes

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Scott L Charland ◽  
Barnabie C Agatep ◽  
Daniel C Malone ◽  
Eric J Stanek
Keyword(s):  
Cytochrome P450 ◽  
Cost Effectiveness ◽  
Antiplatelet Therapy ◽  
Annual Cost ◽  
Extensive Metabolizers ◽  
Cyp2c19 Genotype ◽  
Event Management ◽  
Test Cost ◽  
Cytochrome P450 2C19 ◽  
The Cost

OBJECTIVES: Cytochrome P450 2C19 (CYP2C19) genotype has been shown to affect cardiovascular (CV) outcomes for clopidogrel but not prasugrel. This study evaluates the cost-effectiveness of CYP2C19-guided vs. routine antiplatelet therapy in ACS patients. METHODS: We constructed a literature-based, decision analytic, Markov model (TreeAge 2009) to estimate the cost-effectiveness of CYP2C19-guided aspirin plus either clopidogrel or prasugrel therapy vs. no genotyping. Post-initial ACS CV events were based on the TRITON-TIMI 38 study and related costs were derived primarily using 2007 Healthcare Cost and Utilization Project DRGs for nonfatal MI and stroke, CV death, intracranial hemorrhage, other life-threatening bleed, and minor bleed. Additional costs and disease-state utilities were obtained from other published sources. All costs were adjusted to 2009 $US using the Consumer Price Index medical care component. The model allowed for clopidogrel/prasugrel discontinuation and aspirin monotherapy. Model sensitivity was assessed using 1-way and multi-way analysis of influential parameters. RESULTS: The base case model demonstrated that CYP2C19 genotype guided antiplatelet therapy yielded lower overall annual cost and greater efficacy vs. no genotyping ( Table ). The model was sensitive to (in declining order): clopidogrel cost/day ($1 to $5.78), prasugrel cost/day ($4.09 to $ 6.81), % CYP2C19 extensive metabolizers on clopidogrel (60% to 100%), CYP2C19 test cost ($60 to $250), and monthly CV event management cost. A threshold value for clopidogrel at <$2.14/day favored the no genotyping strategy. However, the genotyping strategy was dominant when clopidogrel cost =$1/day and a CYP2C19 test cost threshold of <$125 on 2-way analysis. CONCLUSIONS: CYP2C19 genotype-guided clopidogrel or prasugrel therapy is cost-effective for up to 1 year in ACS patients, and can remain a preferred strategy at a hypothetical generic clopidogrel cost of $1.00/day. Table Strategy1 Annual Cost Incremental Cost Quality Adjusted Life Year (QALY) Incremental QALY Cost/QALY Incremental Cost Effectiveness (ICER) CYP2C19 Genotype-Guided $ 3,211 0.7212 $ 4,452 No Gentoyping $ 3,331 $120 0.6767 - (0.0445) $ 4,921 (Dominated) 1Base case values:Drug wholesale acquisition cost/day: clopidogrel $4.62, prasugrel $5.45; Baseline post-ACS utility = 0.83; Monthly cost for post-CV event management = $351; CYP2C19 genotyping =$185; After genotyping: 80% of extensive metabolizers, 20% of intermediate metabolizers and 10% of poor metabolizers on clopidogrel; 80% on clopidogrel without genotyping; Willingness to pay = $200

Screening of Synthetic Heterocyclic Compounds as Antiplatelet Drugs

2021 ◽  
Vol 17 ◽  
Author(s):  
Marcel Hrubša ◽  
Khondekar Nurjamal ◽  
Alejandro Carazo ◽  
Nayana Nayek ◽  
Jana Karlíčková ◽  
...  
Keyword(s):  
Mechanism Of Action ◽  
Biological Effects ◽  
Antiplatelet Drugs ◽  
Antiplatelet Drug ◽  
Breast Adenocarcinoma ◽  
Antiplatelet Activity ◽  
Major Mechanism ◽  
Treatment And Prevention ◽  
Impedance Aggregometry ◽  
Thromboxane Receptors

Background: Antiplatelet drugs represent the keystone in the treatment and prevention of diseases of ischemic origin, including coronary artery disease. The current palette of drugs represents efficient modalities in most cases, but their effect can be limited in certain situations or associated with specific side effects. In this study, representatives of compounds selected from series having scaffolds with known or potential antiplatelet activity were tested. These compounds were previously synthetized by us, but their biological effects have not yet been reported. Objective: The aim of this study was to examine the antiplatelet and anticoagulation properties of selected compounds and determine their mechanism of action. Methods: Antiplatelet activity of compounds and their mechanisms of action were evaluated using human blood by impedance aggregometry and various aggregation inducers and inhibitors and compared to appropriate standards. Cytotoxicity was tested using breast adenocarcinoma cell cultures and potential anticoagulation activity was also determined. Results: In total, four of 34 compounds tested were equally or more active than the standard antiplatelet drug acetylsalicylic acid (ASA). In contrast to ASA, all 4 active compounds decreased platelet aggregation triggered not only by collagen, but also partly by ADP. The major mechanism of action is based on antagonism at thromboxane receptors. In higher concentrations, inhibition of thromboxane synthase was also noted. In contrast to ASA, the tested compounds did not block cyclooxygenase-1. Conclusion: The most active compound, 2-amino-4-(1H-indol-3-yl)-6-nitro-4H-chromene-3-carbonitrile (2-N), which is 4-5x times more potent than ASA, is a promising compound for the development of novel antiplatelet drugs.

EXPLORING TWO COST-ADJUSTMENT METHODS FOR SELECTION BIAS IN A SMALL SAMPLE: USING A FETAL CARDIOLOGY DATASET

2014 ◽  
Vol 30 (3) ◽  
pp. 325-332 ◽  
Author(s):  
Hema Mistry
Keyword(s):  
Selection Bias ◽  
Small Sample ◽  
Economic Evaluations ◽  
Scoring Methods ◽  
Regression Analyses ◽  
Cost Estimates ◽  
Propensity Scoring ◽  
The Cost ◽  
Cost Differences ◽  
Direct Referral

Objectives: In economic evaluations of healthcare technologies, situations arise where data are not randomized and numbers are small. For this reason, obtaining reliable cost estimates of such interventions may be difficult. This study explores two approaches in obtaining cost estimates for pregnant women screened for a fetal cardiac anomaly.Methods: Two methods to reduce selection bias in health care: regression analyses and propensity scoring methods were applied to the total mean costs of pregnancy for women who received specialist cardiac advice by means of two referral modes: telemedicine and direct referral.Results: The observed total mean costs of pregnancy were higher for the telemedicine group than the direct referral group (4,918 versus 4,311 GBP). The regression model found that referral mode was not a significant predictor of costs and the cost difference between the two groups was reduced from 607 to 94 GBP. After applying the various propensity score methods, the groups were balanced in terms of sizes and compositions; and again the cost differences between the two groups were smaller ranging from -62 (matching “by hand”) to 333 GBP (kernel matching).Conclusions: Regression analyses and propensity scoring methods applied to the dataset may have increased the homogeneity and reduced the variance in the adjusted costs; that is, these methods have allowed the observed selection bias to be reduced. I believe that propensity scoring methods worked better for this dataset, because after matching the two groups were similar in terms of background characteristics and the adjusted cost differences were smaller.

scholarly journals Exploring drug cost and disease outcome in rheumatoid arthritis patients treated with biologic and targeted synthetic DMARDs in Norway in 2010–2019 – a country with a national tender system for prescription of costly drugs

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Alen Brkic ◽  
Andreas P. Diamantopoulos ◽  
Espen Andre Haavardsholm ◽  
Bjørg Tilde Svanes Fevang ◽  
Lene Kristin Brekke ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Annual Cost ◽  
Treatment Costs ◽  
Disease Outcomes ◽  
Health Authorities ◽  
Das28 Remission ◽  
Synthetic Dmards ◽  
Data Files ◽  
The Mean ◽  
The Cost

Abstract Background In Norway, an annual tender system for the prescription of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) has been used since 2007. This study aimed to explore annual b/tsDMARDs costs and disease outcomes in Norwegian rheumatoid arthritis (RA) patients between 2010 and 2019 under the influence of the tender system. Methods RA patients monitored in ordinary clinical practice were recruited from 10 Norwegian centers. Data files from each center for each year were collected to explore demographics, disease outcomes, and the prescribed treatment. The cost of b/tsDMARDs was calculated based on the drug price given in the annual tender process. Results The number of registered RA patients increased from 4909 in 2010 to 9335 in 2019. The percentage of patients receiving a b/tsDMARD was 39% in 2010 and 45% in 2019. The proportion of b/tsDMARDs treated patients achieving DAS28 remission increased from 42 to 67%. The estimated mean annual cost to treat a patient on b/tsDMARDs fell by 47%, from 13.1 thousand euros (EUR) in 2010 to 6.9 thousand EUR in 2019. The mean annual cost to treat b/tsDMARDs naïve patients was reduced by 75% (13.0 thousand EUR in 2010 and 3.2 thousand EUR in 2019). Conclusions In the period 2010–2019, b/tsDMARD treatment costs for Norwegian RA patients were significantly reduced, whereas DAS28 remission rates increased. Our data may indicate that the health authorities’ intention to reduce treatment costs by implementing a tender system has been successful.

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