scholarly journals Pharmacoeconomic analysis of long term use of darbepoetin-α in treating chronic nephropathy-induced anemia in dialysed patients

2007 ◽  
Vol 8 (2) ◽  
pp. 61-69
Author(s):  
Nicola Giotta ◽  
Ercole Biamino ◽  
Mario Eandi
Keyword(s):  
Health System ◽  
National Health ◽  
Average Cost ◽  
Conversion Factor ◽  
Pharmacoeconomic Analysis ◽  
National Health System ◽  
Chronic Nephropathy ◽  
Italian National Health

The main aim of this retrospective study was to perform a pharmacoeconomic analysis of long term use of darbepoetin-α (DARB) after switch from erythropoietin-ß (EPO-ß) in treating chronic nephropathy-induced anemia in dialysed patients. Secondary objective was the assessment of the actual EPO-ß-to-DARB dose conversion factor. We extracted data of 78 patients who have been treated with EPO-ß for at least 6 months and then switched to DARB from the database of the dialysis center of the Asti (Piedmont, Italy) hospital. From these, we selected 47 patients (23 males and 24 females) who completed a 120-weeks follow-up treatment with DARB.
All patients were treated with a dose adjustment schedule to keep haemoglobin levels in the range 11-12g/dl. Pre-switch EPO-ß administration was thrice a week, while DARB was administered once a week, both via intravenous. Initial DARB dose has been calculated on the basis of the theoretical 200:1 conversion factor. Actual cumulative EPO and DARB consumption was recorded for all patients. Drug costs were valued according to purchasing prices for the Italian National Health System (October 2006).
In the 24 pre-switch weeks the average cost (±SD) per patient for EPO-ß was € 2,309.86 (±1,434.78). In the 120 weeks of follow-up the average cost (±SD) per patient for DARB/24 weeks ranged from a minimum of € 1,487.09 (±1,125.51) to a maximum of € 2,125.73 (±1,546.85). 
The switch of 47 patients to DARB produced an overall net saving for the dialysis centre estimated in 119,540.72 Euro/120 weeks, under the hypothesis that EPO-ß semester costs remain constant: the conversion from EPO-ß to DARB has the potential to maintain long term good haemoglobin control and induces significant savings for the National Health System.
However the dosage should be adjusted on an individual basis in order to avoid excessive fluctuation of Hb concentrations. The actual conversion factor resulted on average higher than theoretical factor settling to 240-280:1.


scholarly journals Effectiveness of Maintenance Immunosuppression Therapies in a Matched-Pair Analysis Cohort of 16 Years of Renal Transplant in the Brazilian National Health System

2020 ◽  
Vol 17 (6) ◽  
pp. 1974 ◽  
Author(s):  
Rosângela Maria Gomes ◽  
Wallace Breno Barbosa ◽  
Brian Godman ◽  
Juliana de Oliveira Costa ◽  
Nélio Gomes Ribeiro Junior ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Health System ◽  
National Health ◽  
Real World ◽  
Graft Loss ◽  
National Health System ◽  
Treatment Regimens

The maintenance of patients with renal transplant typically involves two or more drugs to prevent rejection and prolong graft survival. The calcineurin inhibitors (CNI) are the most commonly recommended medicines in combinations with others. While immunosuppressive treatment regimens are well established, there is insufficient long-term effectiveness data to help guide future management decisions. The study analyzes the effectiveness of treatment regimens containing CNI after renal transplantation during 16 years of follow-up with real-world data from the Brazilian National Health System (SUS). This was a retrospective study of 2318 SUS patients after renal transplantion. Patients were propensity score-matched (1:1) by sex, age, type and year of transplantation. Kaplan–Meier analysis was used to estimate the cumulative probabilities of survival. A Cox proportional hazard model was used to evaluate factors associated with progression to graft loss. Multivariable analysis, adjusted for diabetes mellitus and race/color, showed a greater risk of graft loss for patients using tacrolimus plus mycophenolate compared to patients treated with cyclosporine plus azathioprine. In conclusion, this Brazilian real-world study, with a long follow-up period using matched analysis for relevant clinical features and the representativeness of the sample, demonstrated improved long-term effectiveness for therapeutic regimens containing cyclosporine plus azathioprine. Consequently, we recommend that protocols and clinical guidelines for renal transplantation should consider the cyclosporine plus azathioprine regimen as a potential first line option, along with others.

scholarly journals Time trends in physical activity of adult users of the Brazilian National Health System: 2010-2014. Longitudinal study

2017 ◽  
Vol 135 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Rômulo Araújo Fernandes ◽  
Kyle Robinson Lynch ◽  
Eduardo Kokubun ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Study ◽  
Health System ◽  
National Health ◽  
Time Trends ◽  
Economic Status ◽  
National Health System ◽  
Sports Participation ◽  
Male Sex

ABSTRACT CONTEXT AND OBJECTIVE: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.

scholarly journals Budget Impact Analysis of Xydalba from the Perspective of Italian National Health System

2016 ◽  
Vol 19 (7) ◽  
pp. A564-A565
Author(s):  
A Marcellusi ◽  
C Bini ◽  
N Petrosillo ◽  
FS Mennini ◽  
P Sciattella
Keyword(s):  
Health System ◽  
National Health ◽  
Impact Analysis ◽  
Budget Impact ◽  
National Health System ◽  
Budget Impact Analysis ◽  
Italian National Health

scholarly journals Reflections on Health Management from a Systems Perspective: A Reinterpretation of the Italian National Health System

2021 ◽  
Vol 16 (5) ◽  
pp. 79
Author(s):  
Armando Masucci ◽  
Antonietta Megaro
Keyword(s):  
Health System ◽  
National Health ◽  
Systems Approach ◽  
Health Management ◽  
Health Sector ◽  
National Health System ◽  
Well Being ◽  
Economic Activities ◽  
Viable Systems ◽  
Italian National Health

The provision of health services represents a set of central activities in the social context since, through the offer of prevention, diagnostic, treatment, care and rehabilitation services, they allow the pursuit of the ultimate goal of any health system, the well-being of the population and public health. The considerable relevance of the topic, supported by the ethical-social purposes that the health system ultimately assumes, make it an important field of analysis in business studies in general, and in management in particular, considering the economic activities developed by the many actors involved in the dispensing process. The importance of these activities and their strategic nature make them a highly regulated context, in which over time the reference legislative framework has developed and articulated for the determination of reciprocal relations between the actors, for the regulation of the flow of resources, for the control of medical activities to protect citizens. However, the proliferation of laws and regulations at the various levels of government (community, national and regional) has contributed to increasing the interpretative complexity of the health system. This work proposes the use of the Viable Systems Approach (VSA) for the interpretation and management of complex phenomena in the health sector, concerning the Italian National Health System (NHS). The deepening of the implications arising from the analysis enables the VSA as a useful approach to the advancement of research in health management, through the understanding of complexity, stimulating the observer with analysis methodologies capable of better understanding the health context under exam.

scholarly journals Deprescribing in elderly patients: new challenges to the Italian National Health System

2016 ◽  
Vol 26 (suppl_1) ◽  
Author(s):  
V Amprino ◽  
E Azzan ◽  
MR Gualano ◽  
R Siliquini ◽  
P Varese ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Italian National Health ◽  
New Challenges
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