scholarly journals Clinically Useful and Cost-Effective of Recombinant Human Thrombopoietin in Treatment of Chemotherapy Induced Thrombocytopenia

2020 ◽  
Author(s):  
Wenxian Wang ◽  
Yibing Xu ◽  
Lan Shao ◽  
Zhengbo Song ◽  
Yiping Zhang
Keyword(s):  
Malignant Tumors ◽  
Treatment Plan ◽  
Cost Effective ◽  
Blood Platelet ◽  
Chemotherapy Drugs ◽  
Hospitalization Period ◽  
Critical Organ ◽  
The Difference ◽  
The Cost ◽  
Recombinant Human Thrombopoietin

Abstract BackgroundThe bone marrow suppression during chemotherapy will cause severe platelet decline in the human body, resulting in critical organ hemorrhage and intracranial hemorrhage. Therefore, the efficacy and economics of recombinant human thrombopoietin (rhTPO) in treating different degrees of thrombocytopenia caused by chemotherapy were analyzed. MethodsFrom January 2018 to July 2019, 233 with diagnosed lung cancer treated with the course of chemotherapy or chemoradiotherapy were enrolled. After treatment with chemotherapy or chemoradiotherapy, they all happened thrombocytopenia and received rhTPO. We divided patients into three groups according to the level of platelet decline. Changes in blood platelet count, treatment plan and cost performance between them were analyzed. ResultsOf all the included patients, 39.5% was undergoing concurrent radiotherapy or chemotherapy; 42.9% had thrombocytopenia of grade II; 40.3% had thrombocytopenia of grade III; 16.7% had thrombocytopenia of grade IV; 52.8% postponed the next cycle of chemotherapy or radiotherapy due to platelet decline; 12.0% changed the treatment plan for malignant tumors due to severe platelet decline; 15.5% reduced the dose of chemotherapy drugs due to thrombocytopenia; 23.6% had platelet transfusions during this period. During the extended hospitalization period caused by thrombocytopenia, the medical expenses of patients would increase significantly, which was dominated by the cost of rhTPO. ConclusionsFor different degrees of thrombocytopenia, the treatment of rhTPO could increase platelet counts effectively. During the treatment, patients might have varying degrees of economic and the difference between the treatment duration of different patients.

Are SSRIs a Cost-Effective Alternative to Tricyclics?

1996 ◽  
Vol 168 (4) ◽  
pp. 404-409 ◽  
Author(s):  
Matthew Hotopf ◽  
Glyn Lewis ◽  
Charles Normand
Keyword(s):  
Cost Effectiveness ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Cost Effective ◽  
Drop Out ◽  
Attrition Rates ◽  
The Difference ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Cost ◽  
Effectiveness Studies

BackgroundSelective serotonin reuptake inhibitors (SSRIs) are more expensive than tricyclics. Reports have suggested that SSRIs are cost-effective because they are better tolerated and safer in overdose.MethodA systematic review of all randomised controlled trials (RCTs), meta-analyses, and cost-effectiveness studies comparing SSRIs and tricyclic antidepressants (TCAs).ResultsNone of the RCTs provided an economic analysis and there were methodological problems in the majority which would preclude this approach. Meta-analyses suggest that clinical efficacy is equivalent but slightly fewer patients prescribed SSRIs drop out of RCTs. Cost-effectiveness studies have been based on crude ‘modelling’ approaches and over-estimate the difference in attrition rates and the cost of treatment failure. It appears impossible to evaluate the economic aspects of suicide because of its rarity.ConclusionsThere is no evidence to suggest that SSRIs are more cost-effective than TCAs. The debate will only be concluded when a prospective cost-effectiveness study is done in the setting of a large primary care based RCT.

Impact and Cost Effectiveness of Videonystagmography

2020 ◽  
pp. 000348942096887
Author(s):  
Garrett Ni ◽  
Christine Kim ◽  
Lakshmi Nair ◽  
Alexander G. Bien ◽  
Daohai Yu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Treatment Plan ◽  
Cost Effective ◽  
Diagnosis And Treatment ◽  
Medicare Reimbursement ◽  
Treatment Plans ◽  
Vestibular Symptoms ◽  
The Cost ◽  
Evidence Based Guidelines ◽  
The Impact

Objective: Videonystagmography (VNG) is a commonly ordered test to evaluate patients with vestibular complaints. To date, there are no evidence-based guidelines for evaluating patients presenting with vestibular symptoms. This study evaluates the cost effectiveness of VNG and the impact of VNG findings on patient management. Methods: Patient charts were reviewed from 3 institutions to collect the pre- and post-VNG ICD-9/10 diagnosis and treatment plan. VNG findings were recorded to calculate the incidence of abnormal findings and the incidence of change in diagnosis and/or treatment plan. The cost effectiveness of VNG was estimated based on these calculations. Results: A total of 120 patient charts were reviewed. 69/120 (57.5%; 95% CI: 48.2%-66.5%) patients had abnormal findings on their VNG. A change in diagnosis was noted in 24/120 (20.0%; 95% CI: 13.3%-28.3%) patients. A change in treatment plan was noted in 62/120 (51.7%; 95% CI: 42.4%-60.9%) patients, and 11/120 (9.2%; 95% CI: 4.7%-15.8%) had a change in diagnosis that led to change in treatment plan. Using the average Medicare reimbursement for VNG, the cost effectiveness analysis showed a cost of $869.57 per VNG with abnormal findings and a cost of $5454.55 per VNG that lead to a change in diagnosis and treatment plan. Conclusions: VNG findings may not result in changes in clinical diagnosis. However, VNG is impactful at influencing treatment plan changes. VNG results are beneficial for counseling patients, guiding treatment plans, and managing patient expectations. When there is a clear indication, VNG testing can be cost effective in managing patients presenting with vestibular symptoms.

Home-based versus hospital-based care for serious mental illness

1998 ◽  
Vol 172 (6) ◽  
pp. 506-512 ◽  
Author(s):  
Martin R. J. Knapp ◽  
Isaac M. Marks ◽  
Jane Wolstenholme ◽  
Jennifer K. Beecham ◽  
Jack Astin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Controlled Study ◽  
Sample Attrition ◽  
Home Based ◽  
The Difference ◽  
Randomised Controlled ◽  
The Cost ◽  
Home Based Care

BackgroundThe Daily Living Programme (DLP) offered intensive home-based care with problem-centred case management for seriously mentally ill people facing crisis admission to the Maudsley Hospital, London. The cost-effectiveness of the DLP was examined over four years.MethodA randomised controlled study examined cost-effectiveness of DLP versus standard in/out-patient hospital care over 20 months, followed by a randomised controlled withdrawal of half the DLP patients into standard care. Three patient groups were compared over 45 months: DLP throughout the period, DLP for 20 months followed by standard care, and standard care throughout. Bivariate and multivariate analyses were conducted (the latter to standardise for possible inter-sample differences stemming from sample attrition and to explore sources of within-sample variation).ResultsThe DLP was more cost-effective than control care over months 1–20, and also over the full 45-month period, but the difference between groups may have disappeared by the end of month 45.ConclusionsThe reduction of the cost-effectiveness advantage for home-based care was perhaps partly due to the attenuation of DLP care, although sample attrition left some comparisons under-powered.

Cost-effective analysis of conventional and nurse-led clinics for common otological procedures

2004 ◽  
Vol 118 (3) ◽  
pp. 189-192 ◽  
Author(s):  
S. Uppal ◽  
J. Jose ◽  
P. Banks ◽  
E. Mackay ◽  
A. P. Coatesworth
Keyword(s):  
Cost Effective ◽  
Access Time ◽  
Patient Visit ◽  
Complex Patients ◽  
The Difference ◽  
The Cost ◽  
Mean Cost ◽  
Effective Health Care ◽  
Effective Analysis

The need to reduce costs while providing a first-class service has led to the expansion in the role of nurses in recent years. We present results of a comparison of the cost-effectiveness of conventional and nurse-led out-patient ear clinics. Our results indicate that cost-effective health care is a distinct competitive advantage for nurses taking up some roles conventionally performed by doctors. The difference in mean cost of out-patient visit per patient between the two groups is £75.28. This is equivalent to a reduction in cost to the hospital of more than £47000 for the 626 patients seen in a nurse-led ear clinic in a year. The nurse-led service is thus more cost-effective and presents an opportunity by freeing up otolaryngologists’ time to see more complex patients and has the potential for reducing out-patient access time in the NHS.

scholarly journals Comparing the Estimated and Actual Cost of Disposable Surgical Equipment

2012 ◽  
Vol 94 (3) ◽  
pp. 1-3 ◽  
Author(s):  
P Vasudev ◽  
R Lowe ◽  
C Maxwell-Armstrong
Keyword(s):  
Cost Effective ◽  
Actual Cost ◽  
Budget Cuts ◽  
Surgical Equipment ◽  
Real Cost ◽  
Financial Climate ◽  
The Difference ◽  
Cost Efficient ◽  
The Cost ◽  
Disposable Equipment

In the current financial climate the NHS faces budget cuts. A good knowledge of the costs of the equipment used in theatres will allow more cost-efficient allocation of resources. The equipment used is dependent on the consultant surgeon leading the operation, with individual surgeons having their own preferences. For the efficient running of a department one would assume that the surgeons would have a working knowledge of the cost of equipment. This study looked at the awareness of surgeons of the cost of disposable equipment. It aimed to highlight the difference between the estimated and actual cost of disposable items, providing feedback to the surgeons so they become more aware of the real cost of their choices in order to help optimise use of equipment. This will hopefully lead to more cost-effective theatres.

scholarly journals The effectiveness of ozone therapy in goats with mastitis

2021 ◽  
Vol 9 (1) ◽  
pp. 24-29
Author(s):  
P. M. Skliarov ◽  
S. Y. Fedorenko ◽  
O. V. Onyshchenko ◽  
А. М. Pasternak ◽  
M. A. Lieshchova ◽  
...  
Keyword(s):  
Corn Oil ◽  
Treatment Plan ◽  
Cost Effective ◽  
Ozone Therapy ◽  
Negative Effects ◽  
Duration Of Treatment ◽  
Key Issues ◽  
Livestock Products ◽  
The Cost ◽  
Effective Drugs

One of the key issues in solving the problem of mastitis is the therapy efficacy. It is important to find such treatments for animals that, along with pronounced antibacterial and other therapeutic properties, have no negative effects. Therefore, the aim of the work was to develop a method for treating goats with mastitis using ozonized materials – highly effective, environmentally friendly, and cost-effective drugs that have a positive effect on animal’s body and have no side effects. The treatment was carried out with a targeted program motivated by the principle of drug action. The item of the program «Antibiotic therapy» has been replaced by the use of ozone-containing preparations «OKO» (ozonated corn oil) and «Prozon» (ozonated corn oil + alcohol solution of propolis). It was found that for the treatment of goats using «Мastilex», the effectiveness of the therapy was 86.7%, its duration was 5.2 days, and the cost per animal was 55.38 UAH. When using «OKO» treatment efficacy was at the same level – 86.7%, its duration - longer by 0.4 days, and the cost of treating one animal was lower by 31.88 UAH. The use of «Prozon» made it possible to obtain a higher efficiency of treatment – 93.3%, to reduce its duration by 0.6 days and the cost per animal – by 31.3 UAH. The use of «Prozon» with ultraphonophoresis, provided a high therapeutic effect – at the level of 93.3%, a decrease in the duration of treatment – up to 3.7 days and the cost of treating one animal – up to 25.18 UAH. Thus, ozone therapy is becoming increasingly common in veterinary practice, including reproductive pathologies and, in particular, for the treatment of animals with mastitis. Ozone does not affect the quality of livestock products and therefore is safe for humans. Hence, the use of ozone makes it possible to replace antibiotics in the treatment plan of goats with mastitis without reducing the therapeutic and cost-effectiveness and can be recommended for practice.

scholarly journals Comparative clinical and economic evaluation of pharmacogenetic testing application for dabigatran in patients with atrial fibrillation

2019 ◽  
Vol 91 (8) ◽  
pp. 22-27
Author(s):  
Sh P Abdullaev ◽  
K B Mirzaev ◽  
D A Sychev
Keyword(s):  
Atrial Fibrillation ◽  
Adverse Reactions ◽  
Standard Treatment ◽  
Cost Effective ◽  
Economic Feasibility ◽  
Pharmacogenetic Testing ◽  
Pharmacoeconomic Model ◽  
The Difference ◽  
The Cost ◽  
Ces1 Gene

Aim. To evaluate the clinical and economic feasibility of pharmacogenetic testing (PGT) for dabigataran etexilate administration in the treatment of atrial fibrillation (AF) without valve in comparison with tactics without pharmacogenetic testing. Materials and methods. The pharmacoeconomic model was done using generalized data from published clinical, epidemiological and clinical - economic studies. Results and discussion. Application of PGT on the carrier of allelic variant rs2244613 of CES1 gene for adjustment of dabigatrane etexilate dosage in patients with non - valve AF may be more cost - effective strategy for prevention of thromboembolic complications in patients with non - valve AF. Thus, due to the decrease in the number of undesirable drug reactions in the form of minor and major bleedings, the difference in treatment costs in the group with PGT compared to the group with standard pharmacotherapy tactics per 100 patients was 11 827.65 rubles. The expected cost per patient per year for standard treatment was 36 051.35 rubles, while in the group with PGT it was 35 933.07 rubles. The difference was 1182.76 rubles in favor of the pharmacogenetic approach Conclusion. A PGT approach to correct dabigatrane dosage can reduce the cost of pharmacotherapy by reducing the risk of adverse reactions of minor and major bleeding.

scholarly journals ANALISA BIAYA DAN WAKTU DENGAN MENGGUNAKAN METODE TIME COST TRADE OFF PADA PROYEK PEMBANGUNAN HOTEL ASTON PARAMOUNT MALANG

2014 ◽  
Vol 12 (1) ◽  
Author(s):  
Iktiva Sani ◽  
Zamzami Septiropa
Keyword(s):  
Treatment Plan ◽  
Sewage Treatment ◽  
Time Cost ◽  
Project Schedule ◽  
Trade Off ◽  
Tower Crane ◽  
Original Plan ◽  
Speed Up ◽  
The Difference ◽  
The Cost

ANALISA BIAYA DAN WAKTU DENGAN MENGGUNAKANMETODE TIME COST TRADE OFF PADA PROYEKPEMBANGUNAN HOTEL ASTON PARAMOUNT MALANGIktiva Sani1, Zamzami Septiropa21,2Jurusan Teknik Sipil Fakultas Teknik – Universitas Muhammadiyah MalangAlamat korespondensi : Jalan Raya Tlogomas 246 Malang 65144ABSTRACTImplementation of Development Projects Aston Paramount delayed completion time causedby the discharge of water continuously from the underground, thus flooding the area GWT (GroundWater Tank), STP (Sewage Treatment Plan) and the destruction of Tower Crane. It can be based ontime schedulle project in November 2012 or at the time the project reaches 17 weeks, the progressof the plan should reach 28.648%, but the reality on the ground has reached 24.194%, so it can beknown deviation -4.454%.The method applied in this thesis Time Cost Trade Off (TCTO) to speed up implementation ofthe project in order to achieve the optimum time in the rest of the work project. TCTO a time andBiya exchanges with a view to speeding up the duration.Acceleration time is done by holding the shift work. Of the project schedule has been delayed,the rest of the project is completed within 180 days for a total cost of Rp. 32,679,810,571.24.However if the project accelerated by using TCTO to return to the original plan schedule is 162days obtained a fee of Rp. 33,462,446,260, the difference between the cost of Rp. 782,635,689.88.Keywords: Time and Cost

scholarly journals Thalassemia prevention program in Iraq: Will it be cost-effective and applicable?

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mustafa Majid ◽  
Mohammed Mutar
Keyword(s):  
Cost Effectiveness ◽  
Prevention Program ◽  
Autosomal Recessive ◽  
Single Case ◽  
Cost Effective ◽  
Therapeutic Abortion ◽  
Number Of Patients ◽  
Treatment Facilities ◽  
The Difference ◽  
The Cost

Thalassemia is an inherited autosomal recessive hemoglobinopathy which has a prevalence of 35.7/100000 and incidence of 4.5 per 100000 in Iraq. The disease is totally preventable as many countries succeeded in accomplishing this. Many domains included in the prevention program ranging from education, carrier detection, molecular diagnosis, genetic counselling prenatal diagnosis and therapeutic abortion. The last option may find difficulties in its accomplishment in Arabic countries as it finds contradictions to some religious and tradition habits.  In Iraq it does cause burden on health budget as a report from the federal board of supreme audit in 2016 revealed that the cost of management of each patient is 1428.00-3785.00 US$/month, this include blood transfusion, drugs and other treatment facilities. As this calculated for the life expectancy for thalassemic major patient and number of patients in Iraq, the pattern of Burden will be identified clearly. Comparing this pattern to that of single case prevention calculations may show the cost effectiveness of thalassemia prevention. The aim of this study is to assess the cost-effectiveness of applying a prevention program and the difference in expenditure between case prevention and management per year and to see the extent of applicability of the prevention program.   Key words: Thalassemia, Prevention, Cost, applicability

The application of electron microscopy to diagnosis in gynecologic neoplasms and tumor-like conditions

1984 ◽  
Vol 42 ◽  
pp. 102-105
Author(s):  
Lawrence M. Roth
Keyword(s):  
Electron Microscopy ◽  
Reproductive Tract ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Cost Effective ◽  
Female Reproductive Tract ◽  
Ultrastructural Examination ◽  
Specific Diagnosis ◽  
Potential Value ◽  
Gynecologic Neoplasms

The female reproductive tract may be the site of a wide variety of benign and malignant tumors, as well as non-neoplastic tumor-like conditions, most of which can be diagnosed by light microscopic examination including special stains and more recently immunoperoxidase techniques. Nevertheless there are situations where ultrastructural examination can contribute substantially to an accurate and specific diagnosis. It is my opinion that electron microscopy can be of greatest benefit and is most cost effective when applied in conjunction with other methodologies. Thus, I have developed an approach which has proved useful for me and may have benefit for others. In cases where it is deemed of potential value, glutaraldehyde-fixed material is obtained at the time of frozen section or otherwise at operation. Coordination with the gynecologic oncologist is required in the latter situation. This material is processed and blocked and is available if a future need arises.

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