scholarly journals Drug Utilization Pattern, Cost of Illness and Cost-Effective Analysis of Antihypertensive Drugs in a Tertiary Hospital- A Cross-Sectional Study

2021 ◽  
pp. 15-23
Author(s):  
K. V. Ramanath ◽  
Brijin Thomas Biju ◽  
Imad Ahmed ◽  
Mandapati Veera Venkata Haritha ◽  
K. S. Kishore
Keyword(s):  
Cost Effectiveness ◽  
Combination Therapy ◽  
Cost Of Illness ◽  
Antihypertensive Drugs ◽  
Cost Effective ◽  
Prescribing Patterns ◽  
Antihypertensive Medications ◽  
Public Health Burden ◽  
Cost Effective Treatment ◽  
The Cost

Background: Hypertension is a condition with a substantial public health burden and a high risk of cardiovascular disease. The increasing prevalence of hypertension requires the use of cost-effective treatment and effective management of a disease. Hence, this study aims to assess the cost-effectiveness of antihypertension drugs in patients with hypertension and other co- morbidities. Methods: The study was designed as prospective and interventional, with objectives to evaluate the cost of illness, prescribing patterns of different classes of antihypertensive drugs alone or in combination, and cost-effectiveness evaluation of other groups of antihypertensive drugs prescribed. Provided About 40 patients were with antihypertensive drugs of various classes whose health scores were calculated using the EQ-5D-5L questionnaire and calculated the total cost of treatment. Also calculated Most common Prescribe antihypertensive medications and the cost-effectiveness of each drug. Results: This study showed that 58% of patients received combination therapy, 42% received monotherapy. Metoprolol was most cost-effective, followed by Carvedilol, which was in the case of monotherapy. Concerning combination therapy, Amlodipine + Bisoprolol proved to be the most cost-effective. ARBs were the most commonly prescribed class of antihypertensive drugs. Conclusion: The study provided significant improvement in the health score of patients concerning the cost-effective antihypertensive treatment, showing an effective reduction in BP/ Helped in the management of hypertension and helped reduce risk factors associated with various cardiovascular diseases.

scholarly journals The Cost-effectiveness of Initial Immunomodulators or Infliximab Using Modern Optimization Strategies for Crohn’s Disease in the Biosimilar Era

2019 ◽  
Author(s):  
Abhinav Vasudevan ◽  
Francis Ip ◽  
Danny Liew ◽  
Daniel R Van Langenberg
Keyword(s):  
Crohn’S Disease ◽  
Cost Effectiveness ◽  
Crohn's Disease ◽  
Combination Therapy ◽  
Cost Effective ◽  
Extended Model ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Therapy Costs ◽  
The Cost

Abstract Background Treatment cost, efficacy, and safety are integral considerations when optimizing management of Crohn’s disease (CD). This study assessed the cost-effectiveness of initial immunomodulator and anti–tumor necrosis factor (anti-TNF) agents for the treatment of CD from a US third-party perspective, incorporating current treatment algorithms, optimization strategies, and reduced costs availed by biosimilars. Method A 1-year Markov model was developed to simulate the cost and quality-adjusted life-years (QALYs) of initial azathioprine, infliximab, and combination therapy for moderate to severe CD. Treatment was changed based on tolerability and clinical disease activity at 3-monthly intervals. Efficacy data were based on published literature. Results Initial azathioprine had the lowest cost and utility ($35,337 and 0.63 QALYs), whereas combination therapy was the costliest yet conferred the highest health benefits ($57,638 and 0.67 QALYs). The incremental cost-effectiveness of infliximab and combination therapy compared with azathioprine were both in excess of $500,000 per QALY gained. Initial azathioprine remained the most cost-effective treatment on sensitivity analysis compared with infliximab and combination therapy, with 90% reductions in anti-TNF therapy costs and a 5-year time horizon, although combination therapy had an acceptable cost-effectiveness when costs were reduced in the extended model. Initial infliximab, ustekinumab, and vedolizumab were dominated by combination therapy. Conclusions In the biosimilar era, initial azathioprine with escalation to infliximab appeared more cost-effective in the short term compared with infliximab or combination therapy, although initial combination therapy yields acceptable ICERs in the long term with continued reductions in anti-TNF therapy costs and will likely be the preferred treatment strategy in the future.

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 The Cost-effectiveness of Biological Therapy Cycles in the Management of Crohn’s Disease

2019 ◽  
Vol 13 (10) ◽  
pp. 1323-1333 ◽  
Author(s):  
Kristian Bolin ◽  
Erik Hertervig ◽  
Edouard Louis
Keyword(s):  
Crohn’S Disease ◽  
Cost Effectiveness ◽  
Crohn's Disease ◽  
Combination Therapy ◽  
Willingness To Pay ◽  
Cost Effective ◽  
Treatment Intensification ◽  
Tree Model ◽  
Necrosis Factor Alpha ◽  
The Cost

Abstract Objectives To examine the cost-effectiveness of continued treatment for patients with moderate-severe Crohn’s disease in clinical remission, with a combination of anti-tumour necrosis factor alpha [anti-TNFα] [infliximab] and immunomodulator therapy compared with two different withdrawal strategies: [1] withdrawal of the anti-TNFα therapy; and [2] withdrawal of the immunomodulator therapy, respectively. Methods A decision-tree model was constructed mimicking three treatment arms: [1] continued combination therapy with infliximab and immunomodulator; [2] withdrawal of infliximab; or [3] withdrawal of the immunomodulator. Relapses in each arm are managed with treatment intensification and re-institution of the de-escalated drug according to a prespecified algorithm. State-dependent relapse risks, remission probabilities, and quality of life weights were collected from previous published studies. Results Combination therapy was less costly and more efficient than the withdrawal of the immunomodulator, and more costly and more efficient than withdrawal of infliximab. Whether or not combination therapy is cost-effective, compared with the alternatives, depends primarily on current pharmaceutical prices and the willingness-to-pay per additional quality-adjusted life-year [QALY]. Conclusions Combination therapy using a combination of anti-TNFα [infliximab] and an immunomodulator is cost-effective in the treatment of Crohn’s disease compared with treatment cycles in which the immunomodulator is withdrawn. Combination treatment is cost-effective compared with treatment cycles in which infliximab is withdrawn, at prices of infliximab below€192/100 mg, given a willingness-to-pay threshold at€49 020 [Sweden] per additional QALY.

Cost-Effectiveness of Migraine Prevention: The Case of Topiramate in the UK

Cephalalgia ◽  
2006 ◽  
Vol 26 (12) ◽  
pp. 1473-1482 ◽  
Author(s):  
JS Brown ◽  
G Papadopoulos ◽  
PJ Neumann ◽  
M Price ◽  
M Friedman ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Preventive Treatment ◽  
Cost Effective ◽  
Health Utility ◽  
Quality Adjusted Life Year ◽  
Migraine Prevention ◽  
Migraine Frequency ◽  
Cost Effective Treatment ◽  
The Uk ◽  
The Cost

The aim of this study was to assess the cost-effectiveness of topiramate vs. no preventive treatment in the UK. Model inputs included baseline migraine frequency, treatment discontinuation and response, preventive and acute medical cost per attack [2005 GBP (£)] and gain in health utility. Outcomes included monthly migraines averted, acute and preventive treatment costs and cost per quality-adjusted life year (QALY). Topiramate was associated with 1.8 fewer monthly migraines and a QALY gain of 0.0384. The incremental cost of topiramate vs. no preventive treatment was about £10 per migraine averted and £5700 per QALY. Results are sensitive to baseline monthly migraine frequency, triptan use rate and the gain in utility. Incorporating savings from reduced work loss (about £36 per month) suggests that topiramate would be cost saving compared with no preventive treatment. This analysis suggests that topiramate is a cost-effective treatment for migraine prevention compared with no preventive treatment.

scholarly journals A study of the cost analysis of various oral antihypertensive drugs available in Indian market

2019 ◽  
Vol 8 (8) ◽  
pp. 1850
Author(s):  
Neelesh Arya ◽  
Shweta Agrawal ◽  
Mehul Agrawal
Keyword(s):  
Public Health ◽  
Effective Treatment ◽  
Antihypertensive Drugs ◽  
Public Health Problem ◽  
Price Variation ◽  
Medical Specialties ◽  
Average Percentage ◽  
Public Health Burden ◽  
Cost Effective Treatment ◽  
The Cost

Background: Hypertension is a serious global public health problem. It accounts for 10% of all deaths in India and is the leading non-communicable disease. Recent studies have shown that the prevalence of hypertension is 25% in urban and 10% in rural people in India. It exerts a substantial public health burden on cardiovascular health status and health care systems in India. Antihypertensive treatment effectively reduces hypertension related morbidity and mortality. The cost of medications has always been a barrier to effective treatment. The increasing prevalence of hypertension requires use of cost effective treatment for the effective management of the disease.Methods: Cost of a particular drug (cost per 10 tablets) in the same strength and dosage forms being manufactured by different companies was obtained from Current Index of Medical Specialties, Jan‑April 2019 and “Indian Drug Review” (IDR) September 2018. Difference between the maximum and minimum cost of the same drug manufactured by different pharmaceutical companies was calculated and percentage cost variation was calculated.Results: The prices of a total of 24 drugs (15 single and 9 combination preparations), available in 59 different formulations were analysed. These 62 formulations are manufactured by different pharmaceutical companies.Conclusions: The average percentage price variation of different brands of the same oral antihypertensive drug manufactured in India is very wide. The appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences.

scholarly journals ANALISIS EFEKTIVITAS BIAYA PASIEN PNEUMONIA BALITA RAWAT INAP DI RUMAH SAKIT BHAYANGKARA MANADO

PHARMACON ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 968
Author(s):  
Monica D. Lestari ◽  
Gayatri Citraningtyas ◽  
Hosea Jaya Edi
Keyword(s):  
Cost Effectiveness ◽  
Effective Treatment ◽  
Treatment Options ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Cost Effective Treatment ◽  
Retrospective Data Collection ◽  
Keywords Antibiotics ◽  
The Cost

ABSTRACTPneumonia is an infectious disease in the lower respiratory tract that affects the lung tissue. Ceftriaxone and Gentamicin antibiotics are the most numerous and good for use in the treatment of pneumonia, but of the two antibiotics is not yet known the options for more cost effective treatment, so it needs to be done the cost effectiveness analysis in order to facilitate the selection of more cost-effective treatment options especially in toddler. This study aims to determine which therapies are more cost-effective than the use of antibiotics Ceftriaxone and Gentamicin in pneumonia patients in the January-December 2018 period in the Bhayangkara Manado Hospital using descriptive research methods with retrospective data collection. The sample in this study were 22 patients, 12 patients using ceftriaxone antibiotics and 10 patients using gentamicin antibiotics. The results showed that pneumonia treatment in infants using Ceftriaxone antibiotics was more cost-effective with ACER ceftriaxone value of Rp. 503,872 / day and ICER value of Rp. 145,588 / day. Keywords : Antibiotics, CEA (Cost-Effectiveness Analysis), Pharmacoeconomy, Toddler Pneumonia. ABSTRAKPneumonia merupakan penyakit infeksi pada saluran pernapasan bagian bawah yang mengenai jaringan paru. Antibiotik Seftriakson dan Gentamisim yang paling banyak dan baik untuk digunakan dalam pengobatan pneumonia, namun dari kedua antibiotik tersebut belum diketahui pilihan terapi yang lebih cost-effective, sehingga perlu dilakukan analisis efektivitas biaya agar dapat mempermudah dalam pemilihan alternatif pengobatan yang lebih cost-effective khususnya pada balita. Penelitian ini bertujuan untuk menentukan terapi yang lebih cost-effective dari penggunaan antibiotik Seftriakson dan Gentamisin pada pasien pneumonia rawat inap periode Januari-Desember 2018 di Rumah Sakit Bhayangkara Manado dengan menggunakan metode penelitian deskriptif dengan pengambilan data secara retrospektif. Sampel pada penelitian ini sebanyak 22 pasien yaitu 12 pasien menggunakan antibiotik Seftriakson dan 10 pasien menggunakan antibiotik Gentamisin. Hasil penelitian menunjukkan pengobatan pneumonia pada balita menggunakan antibiotik Seftriakson lebih cost-effective dengan nilai ACER seftriakson sebesar Rp. 503,872/hari dan nilai ICER sebesar Rp. 145.588/hari. Kata Kunci : Pneumonia Balita, Antibiotik, CEA (Cost-Effectiveness Analysis), Farmakoekonomi

scholarly journals Pegylated versus non-pegylated interferon beta 1a in patients with relapsing-remitting multiple sclerosis: A cost-effectiveness analysis

2019 ◽  
Author(s):  
Amir Hashemi-Meshkini ◽  
Hedieh Sadat Zekri ◽  
Hasan Karimi-Yazdi ◽  
Pardis Zaboli ◽  
Mohammad Ali Sahraian ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cost Effectiveness ◽  
Interferon Beta ◽  
Cost Effective ◽  
Pegylated Interferon ◽  
The United States ◽  
Health States ◽  
Payer Perspective ◽  
Cost Effective Treatment ◽  
The Cost

Background: Pegylated (PEG) interferon beta 1a has been approved by the United States Food and Drug Administration (USFDA) as an alternative to interferon beta 1a for multiple sclerosis (MS). Due to its higher price, this study aimed to evaluate the cost-effectiveness of PEG-interferon beta 1-a compared with interferon beta 1a from an Iranian payer perspective. Methods: A Markov model was designed according to health states based on Expanded Disability Status Scale (EDSS) and one-month cycles over a 10-year time horizon. Direct medical and non-medical costs were included from a payer perspective. Results: The incremental cost-effectiveness ratio (ICER) was estimated around 11111 US dollars (USD) per quality-adjusted life-year (QALY) gained for the PEG-interferon versus interferon regimen [with currency rate of 29,000 Iranian Rial (IRR) to 1 USD in 2016]. Conclusion: Considering the cost-effectiveness  threshold in Iran [three times of gross domestic product (GDP) per capita or 15,945 USD], PEG-interferon beta 1-a could be considered as a cost effective treatment for Iranian patients with MS.

Cost-effectiveness of using intermittent pneumatic compression to manage hard-to-heal venous leg ulcers in the UK

2021 ◽  
Vol 30 (7) ◽  
pp. 544-552
Author(s):  
Julian F Guest ◽  
Karen Staines ◽  
Nina Murphy
Keyword(s):  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Intermittent Pneumatic Compression ◽  
Quality Adjusted Life Year ◽  
Controlled Study ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Cost Effective Treatment ◽  
The Cost

Objective: To estimate whether thigh-administered intermittent pneumatic compression (IPC) could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of hard-to-heal venous leg ulcers (VLUs). Method: A Markov model was constructed depicting the management of hard-to-heal VLUs with IPC plus standard care or standard care alone over a period of 24 weeks. The model estimated the cost-effectiveness of the two interventions in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2019/20 prices. Results: Treatment of hard-to-heal VLUs with IPC plus standard care instead of standard care alone is expected to increase the probability of healing by 58% (from 0.24 to 0.38) at 24 weeks and increase health-related quality of life over 24 weeks from 0.32 to 0.34 QALYs per patient. Additionally, the cost of treating with IPC plus standard care (£3,020 per patient) instead of standard care alone (£3,037 per patient) has the potential to be cost-neutral if use of this device is stopped after 6 weeks in non-improving wounds. Sensitivity analysis showed that the relative cost-effectiveness of IPC plus standard care remains <£20,000 per QALY with plausible variations in costs and effectiveness. Conclusion: Within the limitations of this study, the addition of IPC to standard care potentially affords a cost-effective treatment to the NHS for managing hard-to-heal VLUs. However, a controlled study is required to validate the outcomes of this analysis.

Cost-Effectiveness Analysis of Treatment for Esophageal Varices in Japan

1987 ◽  
Vol 3 (4) ◽  
pp. 575-586 ◽  
Author(s):  
Akira Sasaki ◽  
John M. Eisenberg
Keyword(s):  
Cost Effectiveness ◽  
Esophageal Varices ◽  
Ethical Issues ◽  
Japanese Literature ◽  
Cost Effective ◽  
Injection Sclerotherapy ◽  
Endoscopic Injection ◽  
Trade Offs ◽  
Cost Effective Treatment ◽  
The Cost

AbstractWe analyzed the cost-effectiveness of nonemergent treatment for esophageal varices commonly used in Japan (endoscopic injection sclerotherapy, nonshunting direct interruption procedure, and selective shunt). We assessed the cost per survivor from the perspective of the Japanese government and other payors. Epidemiologic and economic data from published Japanese literature and from Japanese hospital-cost information were applied in decision analysis. While sclerotherapy is the most cost-effective treatment, the popular surgical procedures save the most lives, thus raising difficult ethical issues regarding trade-offs of cost and quality.

scholarly journals Cost–effectiveness of tacrolimus for the treatment of moderate-to-severe lupus nephritis in China

2019 ◽  
Vol 8 (13) ◽  
pp. 1125-1141
Author(s):  
Soyoung Kim ◽  
Adrian Yit Reen Ooi ◽  
Thomas Stephens ◽  
Hongsi Jiang
Keyword(s):  
Cost Effectiveness ◽  
Lupus Nephritis ◽  
Cost Effective ◽  
Original Form ◽  
Health States ◽  
Effectiveness Model ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Tacrolimus Therapy ◽  
The Cost

Aim: Therapy for lupus nephritis (LN) requires treatment with immunosuppressive regimens, often including intravenous cyclophosphamide (IVCY), mycophenolate mofetil (MMF) or azathioprine. Additionally, tacrolimus (original form or generic) is recommended to treat LN patients in Asia, including China. However, the cost–effectiveness of tacrolimus therapy has not previously been assessed. We aimed to estimate the cost–effectiveness of tacrolimus in the treatment of moderate-to-severe LN versus standard therapies in China. Materials & methods: This cost–effectiveness model combined a decision-tree/Markov-model structure to map transitions between health states during induction and maintenance treatment phases. Induction with tacrolimus, IVCY or MMF, was followed by tacrolimus, MMF or azathioprine maintenance. Results: According to the model, during induction, complete remission rates were higher with tacrolimus versus IVCY (relative risk 1.40 vs IVCY [deterministic sensitivity analysis minimum 0.92, maximum 2.13]) and time to response was shorter. Relapse rates were lower with tacrolimus versus azathioprine or MMF during maintenance. Tacrolimus induction and maintenance was the most cost-effective regimen, incurring the lowest total costs (CN¥180,448) with the highest quality-adjusted life-years. Conclusion: The model demonstrated that tacrolimus use in both induction and maintenance therapy may be an efficacious and cost-effective treatment for LN in China.

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