scholarly journals Cost Minimisation Study of the Impact of Generic Drugs on Glaucoma Management: 1-year Indian Experience

1970 ◽  
Vol 12 (4) ◽  
pp. 192-196
Author(s):  
Devindra Sood ◽  
Alka Pandey ◽  
Rajeev Sood ◽  
Nagesh Gupta ◽  
Ravinder Kumar Bajaj ◽  
...  
Keyword(s):  
Generic Drugs ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Brand Name ◽  
Cost Difference ◽  
Medication Costs ◽  
Generic Medications ◽  
The Mean ◽  
The Cost ◽  
The Impact

Aim: To study the medication costs of various topical glaucoma medications using data collected from real world use by patients.Methods: Patients with primary open angle glaucoma treated at glaucoma clinics in 5 hospitals (1 rural and 4 urban) in northern India from 1 January to 30 June 2008 were enrolled. The number of days each bottle of medication lasted was recorded, and the mean cost per day was computed from the maximum retail price and mean number of days each medication lasted.Results: 790 of 801 eligible patients completed the study. The mean number of days that a bottle of medication lasted was found to be highest for Xalatan® and Xalacom® at 35.23 days and 35.00 days, respectively. The brand name prostaglandin analogues all lasted for a mean of more than 30 days: Xalatan, 35.23 days (SD, 4.14 days); Lumigan®, 31.37 days (SD, 5.31 days); and Travatan®, 34.84 days (SD, 6.51 days), while the generic eye drops lasted for about 21 days: latanoprost, 20.69 days (SD, 3.69 days) and bimatoprost, 21.39 days (SD, 4.34 days). The cost of the generic medication was less than the brand name medication in all groups (for example, bimatoprost, Indian rupees 9.76 versus Indian rupees 12.33) except for brimonidine/timolol (Indian rupees 8.73 versus Indian rupees 8.66). Further analysis in 2009 showed that, for latanoprost, brimonidine and brimonidine/timolol, the difference between the brand name and generic medications decreased in 2009 over 2008 (in the latanoprost group, the cost difference over the year reduced from Indian rupees 592 in 2008 to Indian rupees 523 in 2009); the cost difference for bimatoprost increased from 2008 to 2009.Conclusion: When both cost and number of days a bottle lasts were considered over the long term, use of generic medications might not minimise the cost of glaucoma medical management by much when compared with the brand name medication.

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.

scholarly journals Lowering drug prices and enhancing pharmaceutical affordability: an analysis of the national volume-based procurement (NVBP) effect in China

2021 ◽  
Vol 6 (9) ◽  
pp. e005519
Author(s):  
Jing Yuan ◽  
Z Kevin Lu ◽  
Xiaomo Xiong ◽  
Bin Jiang
Keyword(s):  
Multifaceted Approach ◽  
Pilot Programme ◽  
Drug Prices ◽  
Insurance Programme ◽  
The Mean ◽  
Lowering Drug ◽  
Daily Wage ◽  
The Cost ◽  
The Impact ◽  
Health Insurance Programme

To cope with the increasing healthcare costs brought about by the universal health insurance programme, national volume-based procurement (NVBP) was implemented in China to reduce drug prices. However, the impact of NVBP remains unknown. We reported the effects of the NVBP pilot programme on medication affordability and discussed the challenges and recommendations for further reforms. A total of 25 molecules won the bidding in the NVBP pilot programme, and price cuts ranged from 25% to 96%. Medication affordability was measured as the number of days’ wages needed to pay for a course of treatment, and the medication was identified as affordable if the cost of a treatment course was less than the average daily wage. After the NVBP, the proportion of affordable drugs increased from 33% to 67%, and the mean affordability improved from 8.2 days’ wages to 2.8 days’ wages. Specifically, for rural residents, the proportion of affordable drugs increased from 13% to 58%, and the mean affordability improved from 15.7 days’ wages to 5.3 days’ wages. For urban residents, the proportion of affordable drugs increased from 54% to 71%, and the mean affordability improved from 5.9 days’ wages to 2.0 days’ wages. Implementing the NVBP substantially improved medication affordability. In future reforms, a multifaceted approach addressing all issues in the health system is needed to enhance medicine access.

MODELING COST OF TREATMENT WITH NEW TOPICAL TREATMENTS FOR GLAUCOMA

1999 ◽  
Vol 15 (1) ◽  
pp. 207-219 ◽  
Author(s):  
Gisela Kobelt ◽  
Linus Jönsson
Keyword(s):  
Open Angle Glaucoma ◽  
Current Treatment ◽  
Current Therapy ◽  
New Agents ◽  
The United Kingdom ◽  
Recent Diagnosis ◽  
One Year ◽  
New Treatments ◽  
The Cost ◽  
The Impact

Several new topical agents have been introduced recently and it can be expected that the treatment of glaucoma will change, depending on how effectively these agents control intraocular pressure (IOP). IOP is considered the major risk factor in the development of glaucomatous damage. In order to estimate the impact of these new agents on the cost of treating glaucoma, a simulation model was created to estimate the cost of treating patients with a recent diagnosis of primary open-angle glaucoma or ocular hypertension in different countries. The Markov model is based on retrospective chart reviews in different countries and calculates only cost, not outcome. Results are presented for France and the United Kingdom, where current treatment appeared to be comparable. Average one-year costs per patient with current treatment were FF2,389 (US $389) and £380 (US $627), respectively. Costs with the new treatments were lower than with current therapy.

The clinical feature of myocilin Y437H mutation in a Chinese family with primary open-angle glaucoma

2019 ◽  
Vol 103 (10) ◽  
pp. 1524-1529
Author(s):  
Lei Lei ◽  
Shushan Li ◽  
Xiangyun Liu ◽  
Chun Zhang
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Clinical Feature ◽  
Visual Field Defects ◽  
Chinese Family ◽  
Eye Drops ◽  
Open Angle ◽  
Age Related ◽  
Phenotypic Characterisation ◽  
The Mean

PurposeTo characterise the genotype(s), phenotype(s) and age-related penetrance of glaucoma in a Chinese family with primary open-angle glaucoma (POAG).MethodsRecruited from a Chinese family spanning four generations, 7 individuals with POAG, 1 with ocular hypertension (OHT) and 14 unaffected individuals were included in this study. Genotypic investigation included sequencing of mutation sites using a glaucoma panel in combination with high-throughput sequencing and validated using Sanger sequencing. Phenotypic characterisation included investigation into patient medical history and physical examination.ResultsEight (36.4%) family members harboured heterozygous Y437H mutation, of whom seven (87.5%) were glaucomatous and one (12.5%) had OHT. The mean age of POAG diagnosis was 30.85±7.13 years. The mean highest recorded intraocular pressure (IOP) was 46.57±6.53 mm Hg. They all had complained of symptoms associated with vision and pain. Four (57.1%) patients presented blindness. Five eyes (62.5%) presented with severe and three eyes with moderate visual field defects. Most of them underwent surgery on average 1.29±2.36 years after diagnosis, and the mean IOP at study was 17.95±7.23 mm Hg, with an average of 0.92±0.86 eye-drops. The patient with OHT was treated with latanoprost only and her IOP was well controlled. Age-related glaucoma penetrance was 0% in individuals under the age of 20 years, 50% at ages 20–35 years, 75% at ages 31–35 years and 87.5% over 45 years.ConclusionA novel MYOC mutation (c.1309T>C, p.Y437H) in a Chinese family with POAG was identified which was associated with a phenotype characterised by severe visual impairment, frequent surgical intervention requirement and relatively high penetrance.

scholarly journals Self-report versus care provider registration of healthcare utilization: Impact on cost and cost-utility

2009 ◽  
Vol 25 (4) ◽  
pp. 588-595 ◽  
Author(s):  
Martine Hoogendoorn ◽  
Carel R. van Wetering ◽  
Annemie M. Schols ◽  
Maureen P. M. H. Rutten-van Mölken
Keyword(s):  
Resource Use ◽  
Care Provider ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Cost Utility ◽  
Self Report ◽  
Chronic Obstructive ◽  
Cost Difference ◽  
The Cost ◽  
The Impact

Objectives: This study aims to compare the impact of two different sources of resource use, self-report versus care provider registrations, on cost and cost utility.Methods: Data were gathered for a cost-effectiveness study performed alongside a 2-year randomized controlled trial evaluating the effect of an INTERdisciplinary COMmunity-based management program (INTERCOM) for patients with chronic obstructive pulmonary disease (COPD). The program was offered by physiotherapists, dieticians and respiratory nurses. During the 2-year period, patients reported all resource use in a cost booklet. In addition, data on hospital admissions and outpatient visits, visits to the physiotherapist, dietician or respiratory nurse, diet nutrition, and outpatient medication were obtained from administrative records. The cost per quality-adjusted life-year (QALY) was calculated in two ways, using data from the cost booklet or registrations.Results: In total, 175 patients were included in the study. Agreement between self-report and registrations was almost perfect for hospitalizations (rho = 0.93) and physiotherapist visits (rho = 0.86), but above 0.55, moderate, for all other types of care. The total cost difference between the registrations and the cost booklet was 464 euros with the highest difference for hospitalizations 386 euro. Based on the cost booklet the cost difference between the treatment group and usual care was 2,444 euros (95 percent confidence interval [CI], −819 to 5,950), which resulted in a cost-utility of 29,100 euro/QALY. For the registrations, the results were 2,498 euros (95 percent CI, −88 to 6,084) and 29,390 euro/QALY, respectively.Conclusions: This study showed that the use of self-reported data or data from registrations effected within-group costs, but not between-group costs or the cost utility.

scholarly journals Combined Technique for the Application of Micropulse Cyclophotocoagulation in Patients with Uncontrolled Glaucoma: Cyclo Mix

2020 ◽  
Vol 14 (3) ◽  
pp. 93-97
Author(s):  
Loayza-Gamboa Waldo ◽  
Herrera-Quiroz Julio ◽  
Chávez-Vallejos Jennifer ◽  
Valderrama-Albino Vanessa ◽  
Córdova-Crisanto Luis ◽  
...  
Keyword(s):  
Continuous Wave ◽  
Open Angle Glaucoma ◽  
Wave Mode ◽  
Cumulative Probability ◽  
Eye Drops ◽  
Change In The Mean ◽  
Surgical Failure ◽  
Continuous Wave Mode ◽  
The Mean ◽  
Combined Technique

ABSTRACT Purpose To describe the outcomes of a combined technique (Cyclo Mix) in uncontrolled glaucoma cases. Materials and methods Retrospective study. The Supra 810 nm subliminal laser (Quantel Medical, Cournon d'Auvergne, France) was used. A combined technique was performed using the subliminal mode (Subcyclo) in one hemifield (power of 2,000 mW, a duty cycle of 35%, and 80–150 seconds), and the continuous wave mode (Thermo Cyclo) on the other hemifield (power of 1,000 mW, exposure time of 2 seconds per spot). The primary endpoint was the probability of surgical failure. Mean intraocular pressure (IOP) change, best-corrected visual acuity (BCVA), number of glaucoma eye drops, and complications at 6 months postoperatively were secondary outcomes. Results Twenty-three eyes from 13 patients were included. Mean age was 61.4 ± 16.7 (range: 18–78 years), and 69% were female, with a baseline IOP of 20.3 ± 5.9 (range: 13–38 mm Hg). The cumulative probability of failure was 18 and 22% on days 90 and 180, respectively. Mean IOP reduction was −25.6 ± 20.9% at 6 months. The number of glaucoma eye drops was reduced to 1.2 ± 1 (p = 0.0024) at 6 months. No statistically significant change in the mean BCVA compared with baseline at 6 months was found (p = 0.84), and no severe complications were reported. Conclusion Cyclo Mix seems to be a safe therapy that effectively reduces the IOP and glaucoma medications in eyes with uncontrolled open-angle glaucoma for up to 6 months. How to cite this article Waldo L-G, Julio H-Q, Jennifer C-V, et al. Combined Technique for the Application of Micropulse Cyclophotocoagulation in Patients with Uncontrolled Glaucoma: Cyclo Mix. J Curr Glaucoma Pract 2020;14(3):93–97.

Economic and workload impact of therapeutic interchange of inhaler medications and nebulizer solutions

2020 ◽  
Vol 78 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Elizabeth Gonzalez ◽  
Jason Alan Glick ◽  
Guogen Shan ◽  
Jeffery N Talbot
Keyword(s):  
Hospital Stay ◽  
Community Hospital ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Medication Costs ◽  
Metered Dose ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Purpose To examine the financial impact of automatic formulary substitution of nebulization solutions for pressurized metered dose inhalers and dry powder inhalers and the effect of the automatic substitution initiative on respiratory care practitioner (RCP) workload at a community hospital. Methods A retrospective observational study was conducted in a 326-bed nonacademic community hospital. Adult patients who received respiratory medications and had an inpatient stay, were admitted for observation, or had an emergency room visit from December 2016 through February 2017 (the control group) or from December 2017 through February 2018 (the study group) were included in the analysis. The primary outcomes were the cost of respiratory medications per hospital stay and the number of RCP visits per hospital stay. The secondary outcome was the cost of wasted doses per hospital stay. Results A total of 3,766 patients were included in the study: 2,030 in the study group and 1,736 in the control group. The mean cost of respiratory medications per hospital stay was significantly lower in the study group vs the control group ($13.29 vs $36.48, P < 0.001). The mean number of RCP visits per hospital stay was also statistically lower in the study group vs the control group (11.6 vs 12.9, P = 0.04). The mean cost of wasted doses was significantly lower in study group vs the control group ($0.25 vs $22.91, P < 0.001). Conclusion Automatic formulary substitution of nebulization solutions for inhaler medications significantly decreased medication costs without increasing the average number of RCP visits per hospital stay.

Capturing the Financial Impact of Heparin-Induced Thrombocytopenia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3127-3127 ◽  
Author(s):  
Maureen A. Smythe ◽  
John M. Koerber ◽  
Joan C. Mattson
Keyword(s):  
Control Patient ◽  
Hospital Cost ◽  
Financial Impact ◽  
Case Patient ◽  
Heparin Induced Thrombocytopenia ◽  
The Mean ◽  
Cost Calculations ◽  
The Cost ◽  
And Control ◽  
The Impact

Abstract Data evaluating the financial impact of heparin-induced thrombocytopenia (HIT) (a severe adverse drug reaction which can result in life threatening thrombosis) is lacking. The goal of this case-control study was to evaluate the financial impact of HIT. Case patients were those with a new diagnosis of HIT from April 2003 to March 2004 for whom matched controls were available. Controls for each case patient were matched for the DRG under which the hospital was reimbursed, the patient’s primary diagnosis code and their primary procedure code. Case patients required identification of >1 control for inclusion. The hospital’s financial database was queried for length of stay (LOS), total cost, and reimbursement. For each case patient, the cost and reimbursement were compared to the cost and reimbursement for each group of matched controls. In an effort to eliminate the impact of variable reimbursement, a subset of only Medicare case and control patients was also evaluated. Of 72 new HIT patients, matched controls were identified for 31. The mean LOS for the case and control patients was 22.8 and 11.6 days respectively (p=0.006). The mean hospital cost of case and control patients was $55,440 and $26,505 respectively. From reimbursement minus cost calculations, our institution lost an average of $13,429 per HIT patient compared to an average of $393 per control patient (p=0.005). The mean LOS for Medicare cases (n=21) and matched Medicare controls was 26 and 14.6 days respectively (p=0.041). The mean hospital cost of Medicare case and control patients was $58,842 and $30,210 respectively. From reimbursement minus cost calculations for the Medicare subset, our institution lost an average of $20,229 per HIT case compared to $1844 per control patient (p<0.0001). Assuming 72 new cases of HIT per year, our institution incurs a projected annual financial loss of $980,000 from HIT. The use of alternate anticoagulants, although having a higher acquisition cost, may offset this loss through HIT avoidance.

Wastage of conserved fodder when feeding livestock

2010 ◽  
Vol 50 (6) ◽  
pp. 400 ◽  
Author(s):  
C. R. Stockdale
Keyword(s):  
Beef Cattle ◽  
Dairy Cattle ◽  
Present Review ◽  
Factors Affecting ◽  
Storage Method ◽  
The Mean ◽  
Main Factors ◽  
Wet Weather ◽  
The Cost ◽  
The Impact

The objective of the present review was to establish levels of conserved fodder wastage when feeding livestock (sheep, beef cattle, dairy cattle) under various conditions and using various feed-out systems, and to determine the factors affecting wastage. The mean wastage of hay recorded in the literature reviewed was 17% of the DM offered, but the range was from 4 to 77%. The main factors affecting the degree of wastage were storage method, packaging method, method of feeding out, amount of fodder on offer and its palatability and/or quality and the impact of wet weather. Although the emphasis was on hay, the principles should also apply to silage. If wastage was 40% rather than 5%, the cost of feeding conserved fodder to livestock would be a third greater than producers might expect or budget on.

The Ability of Anaesthetists to Identify Generic Medications from Trade Names

2009 ◽  
Vol 37 (4) ◽  
pp. 624-629 ◽  
Author(s):  
D. E. P. Bramley
Keyword(s):  
Generic Drug ◽  
Generic Drugs ◽  
Clinical Problem ◽  
Brand Names ◽  
Prescription Medications ◽  
Brand Name ◽  
Drug Substances ◽  
Generic Medications ◽  
Trade Names ◽  
Theoretical Test

The recent proliferation of brand names for prescription medications has made the clinician's task of identifying the corresponding generic drug substances more difficult. A survey of 86 anaesthetists and anaesthetic trainees at two Melbourne hospitals was conducted to measure the extent to which this was perceived to be a clinical problem. In addition, a theoretical test was administered to examine the ability of these anaesthetists to correctly identify generic drugs and therapeutic groups when only the brand name is provided. The results indicated this is perceived to be a genuine clinical problem, with more than 80% of respondents encountering unfamiliar trade names ‘often’ or ‘always’ and the test revealing that fewer than one third of commonly prescribed brand names were identified correctly.

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