جستجوی مقالات مرتبط با کلیدواژه "pharmacoeconomics" در نشریات گروه "پزشکی"

Branded generics are off-patent medications with proprietary names which are bioequivalent to the innovator medications. Cardiovascular diseases, driven by diabetes, hypertension, and dyslipidemia, are major health concerns, where patient compliance is crucial for long-term management. This analysis investigates cost variations of first-line branded generics for these conditions in Indian primary care settings.

First-line medications preferred for type 2 diabetes, hypertension, and dyslipidemia were identified through an online survey of prescribers. Data from 1mg.com, an Indian online pharmacy, was used to compile a list of available brands for each medication. The study compared the prices of the five most prescribed brands, the three lowest-cost and one highest-cost brand per medication, and calculated the percentage cost difference.

First-line medications preferred for type 2 diabetes, hypertension, and dyslipidemia in India include Metformin 500mg, Enalapril 5mg, Telmisartan 40mg, Amlodipine 5 mg, and Atorvastatin 20mg. The analysis reveals significant cost disparities among commonly prescribed brands, with Metformin, Enalapril, Telmisartan, and Atorvastatin being notably more expensive (up to 1177%) than lower-cost alternatives, potentially placing a financial burden on patients. Amlodipine, however, exhibits modest cost variation (26-113%), with commonly prescribed brands leaning toward lower-cost options.

Cost disparities among commonly prescribed brands could harm patient compliance and outcomes, emphasizing the need for cost-effective medication selection. This study offers crucial insights into cost variations in India's treatment of Type 2 Diabetes, Hypertension, and Dyslipidemia, underscoring the importance of cost awareness for improved patient compliance and healthcare system sustainability.

Hypertension is a chronic disease that cannot be cured and can only be controlled but requires long-term treatment, even for life. The variety of antihypertensive treatments makes it necessary to adjust the choice of treatment not only in terms of effectiveness, but also in terms of cost. Therefore, a pharmacoeconomic approach is needed, namely Cost Effectiveness Analysis (CEA) to compare the effectiveness of therapy and costs of several alternative therapies used.

This research is observational using a descriptive research design through a pharmacoeconomic analysis approach, namely Cost-Effectiveness Analysis. The data collection technique was retrospective by accessing data from medical records of outpatient hypertension patients who met the inclusion criteria. Data taken for cost-effectiveness analysis are data on antihypertensive effectiveness and direct medical costs.

The combination of two antihypertensive drugs Calcium Channel Blocker (CCB) and Angiotensin II Receptor Blocker (ARB) with an ACER value of IDR 2,996 is the most cost-effective compared to the other combination groups.

The combination of two antihypertensive drugs Calcium Channel Blocker (CCB) and Angiotensin II Receptor Blocker (ARB) with an ACER value of IDR 2,996 is the most cost-effective compared to the other combination groups.

Oral anticancer drugs (OACDs) have been used since the 1950s and are expected to be linked with enhanced life quality which helps patients receive treatment at home. Although more convenient in use than intravenous or other infused drugs, the high costs of these OACDs have been proven controversial.

The literature was searched systematically from PubMed, Cochrane, Embase, and Scopus according to the PRISMA guidelines. The inclusion criteria included studies in the English language, evaluating Pharmacoeconomics, and evaluating cost-utility and cost-effectiveness related to OACDs. The information on the included studies was synthesized in the form of summary tables.

Thirteen studies were included for quantitative analysis, which evaluated the costs or cost-effectiveness of different OACDs used for various types of cancer. It was found that the average cost for the OACDs was $80979/year in attaining (quality-adjusted life per year) QALY across different countries. The costs of different OACDs were highly varied alone in the US. The included studies' results were highly varied, limiting the findings' interpretations.

Various studies about cost-effectiveness persist insufficiently represented in the literature regarding OACDs, suggesting the requirement of more cost-effectiveness analysis shortly. The increased costs of these OACDs require careful evaluation of the cost-effectiveness studies.

Inequitable distribution of health resources leads to high costs and sustainable poverty for households. Therefore, it is necessary to study distribution in health. The most common indicator for measuring inequality is the Gini coefficient. Therefore, the present study was conducted to measure and analyze inequality in the distribution of various pharmacies using the Gini coefficient and the Lorenz curve in Iran. This research was a retrospective cross-sectional study that looked at the state and trend of inequality in the distribution of various types of pharmacies in 11 Lorestan cities from 2016 to 2021. Data was gathered from various data centers. Finally, the Gini coefficient and the Lorenz curve were determined. Excel was utilized in this project. The results study showed an increase in the Gini coefficient of the total pharmacies in Lorestan province (0.436) which is relatively indicative of the unfair distribution of the pharmacies but this value is higher for private pharmacies (0.545). The Gini coefficient of public pharmacies was (0.377) and for rural pharmacies was (0.282). So, to achieve an appropriate level of justice in the distribution of pharmaceuticals and pharmacies, resources should be distributed according to the requirements of city residents. Different kinds of pharmacies should be considered for different population groups when developing policies.

 Overactive bladder (OAB) is a symptomatic condition characterized by urinary urgency with or without incontinence, usually associated with frequent daytime urination, enuresis, and nocturia.

 This economic evaluation was aimed at assessing the cost-effectiveness of mirabegron versus solifenacin in the treatment of OAB patients from a payer’s perspective in Iran.

 A Markov model with a 5-year time horizon was used. The model consisted of five health states, and OAB patients with an average age of 60 years entered the cycle from the persistent state. Transition probabilities were based on published trials, clinical judgments, and expert opinions. Resource use and costs, including those for medications and adverse events, were extracted from the literature and tariff book, and all costs are presented in 2019 US dollars with a 5% discount rate for the costs and utilities. The incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALYs) were computed for medications, and sensitivity analyses were used to test the robustness of the results.

 Average per-patient treatment costs were 24,720.724,668.6 for mirabegron and solifenacin, respectively. Mirabegron was expected to produce higher QALYs than solifenacin (3.20 vs. 3.19). Mirabegron had an ICER of 531.3802709/QALY.

 Compared to solifenacin, mirabegron was more cost-effective in OAB patients in the Iranian healthcare system.

The administration of chemotherapy positively correlates with diverse adverse drug reactions, including the significant impact of hematological hazards such as anemia, leukopenia-neutropenia, thrombocytopenia, and pancytopenia. This pilot pharmacoeconomic study aimed to estimate the total direct costs of treating hematological toxicity induced by chemotherapy and its main determinants.

The study was conducted as a retrospective cost of illness study using the ''from bottom to the top'' approach from the perspective of the Republic Health Insurance Fund. This study included 88 patients treated due to developing at least one episode of one of the types of hematological complications of cytostatics in 2018 at the Oncology Clinic of the University Clinical Center Kragujevac, Kragujevac, the Republic of Serbia.

Among cancer patients who developed haematological toxicity, treating pancytopenia was most demanding in a pharmacoeconomic manner compared to neutropenia and thrombocytopenia, with an estimated value of direct costs of 264,14, 178,19 and 157,76 euros per patient per year respectively. Regarding total direct costs, the main determinants were the costs of drugs, their parenteral administration, and costs due to hospitalization.

Due to the rising cancer incidence and obligatory hospital treatment of hematological toxicity induced by chemotherapy, the identification of the pharmacoeconomic aspects of the treatment of these complications is needed. Future research should focus on the development of new modalities of treatment regarding patient characteristics anticipating high costs.

Proton pump inhibitors (PPIs) are one of the most frequently prescribed class of drugs worldwide contributing to the increase in economic burden on the healthcare system. To study the utilization of intravenous proton-pump-inhibitors (PPIs) according to its indications, comorbidities and related pharmacoeconomics in a tertiary care teaching hospital 

A prospective-observational study was conducted over 3 months. Case-records of 300 indoor patients were reviewed for IV (intravenous) pantoprazole prescription, as it was the only PPI available at the hospital in IV as well as oral formulations and relevant data was procured. 

Amongst 300 patient records, 72% were males whereas 28% were females and mean age was 41.18 years (S.D. ± 15.91). 37.33% of the patients were prescribed PPIs for Stress ulcer prophylaxis and 62.66% for non-stress ulcer prophylaxis. 62.66% patients were prescribed IV PPIs inappropriately and 74% were found to be potential candidates for oral pantoprazole therapy without affecting patient outcomes. Utilisation of PPIs was found to be 0.87 defined daily dose (DDD)/100 bed days. The cost of administration for intravenous pantoprazole therapy per patient per day accounted to INR 64.34 and that for oral formulation of the same summed up to INR 1.36. The percentage reduction in the cost of administration of PPI therapy per patient in potential candidates for oral PPI therapy was found to be 97.8%. Antimicrobials (36%) were the most common drugs prescribed concomitantly followed by antiemetics (25%). 

Subtle changes like shifting the patient to oral formulations when clinically permissible can make a significant positive contribution in resource limited settings without negatively impacting patient outcomes. This will effectively reduce the economic burden on the patients and the healthcare system which is of utmost importance in a resource limited setting like tertiary care hospitals.

Improving good governance in the pharmaceutical sector is a valuable priority for improving access to essential medicines. Transparency as a means for good governance was the focus of this study. The objective was to evaluate different sectors of the pharmaceutical regulatory sector of Iran from the aspect of transparency. Awareness of the current situation may assist policymakers in making the right decisions.

The aim of this methodology was to present only quantitative measurement but to gather qualitative information as well. The study was carried from November 2016 to July 2017. The questionnaires of the assessment instrument, which the World Health Organization (WHO) produced for measuring transparency in the public pharmaceutical sector, was used. The interviewees were among managers and staff at different levels of the Food and Drug Administration (IFDA) of Iran and its clients.

Medicines registration and distribution of medicines’ scores in the 10-point rating system means that they are minimally vulnerable to corruption. Besides, medicine promotion control and procurement of medical products got an acceptable score, which means that they are marginally vulnerable to corruption. On the other hand, qualitative findings and observation of the evidence presented by key informants proved the sufficient legal capacity for transparency in almost all sections. The controversial issue was the ‘conflict of interests,’ which was not anticipated in some cases.

It is valuable to know if Iran’s medicine regulatory sector is transparent In order to improve good governance, transparency should be maximized in all sectors, and this is possible by implementing mechanized actions and online tools.

Asthma as the most common chronic disease in childhood reduces the quality of life of children and their families. We aimed to estimate the cost of managing childhood asthma in Iran and to examine its variability depending on asthma severity.

The cost of asthma was estimated by building a cost assessment model regarding the factors that influence the cost of asthma in children including age and sex distribution, prevalence of disease severity, level of resource utilization depending on disease severity (3 groups of controlled, partly controlled and uncontrolled were defined). The model was comprised of both medical (cost of medication, physician visit and respiratory tests) and non-medical (transportation and hoteling) costs. Furthermore, the average family income in each category was figured and the share of asthma managing costs from the average income was calculated in different groups.

According to model, the total cost of childhood asthma in Iran was around 516.5 million dollars. Moreover, direct medical cost represented 49% of the total costs, among which 66% accounting for medication cost. Direct non-medical costs were estimated 51% with the majority (93%) expended on transportation. In addition, the mean annual cost per child was approximately 466 dollars. In addition, the results indicate the vast majority of patients (46%) are categorized in the uncontrolled group.

The cost of childhood asthma in Iran is extremely high comparing to the average income of Iranian families in all categories of asthma severity. Considering the high amount of transportation cost, the accessibility of asthma treatment does not appear to be acceptable. The major source of costs is found to be related to medicine expenditure. Since it has been proven that using medicine does not necessarily result in a well-controlled disease status, alternative approaches should be considered in asthma management.

Phamacoeconomics can aid the policy makers and the healthcare providers in decision making in evaluating the affordability of and access to rational drug use. Efficiency is a key concept of pharmacoeconomics, and various strategies are suggested for buying the greatest amount of benefits for a given resource use. Phamacoeconomic evaluation techniques such as cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utilization analysis, which support identification and quantification of cost of drugs, are conducted in a similar way, but vary in measurement of value of health benefits and outcomes. This article provides a brief overview about pharmacoeconomics, its utility with respect to the Indian pharmaceutical industry, and the expanding insurance system in India. Pharmacoeconomic evidences can be utilized to support decisions on licensing, pricing, reimbursement, and maintenance of formulary procedure of pharmaceuticals. For the insurance companies to give better facility at minimum cost, India must develop the platform for pharmacoeconomics with a validating methodology and appropriate training. The role of clinical pharmacists including PharmD graduates are expected to be more beneficial than the conventional pharmacists, as they will be able to apply the principles of economics in daily basis practice in community and hospital pharmacy.

Diabetes is on rapid increase in third world countries undergoing rapid transition in terms of development particularly in India, which is often being referred as Diabetic capital. It is a disease more prevalent at latter part of life of human beings when finances dwindle and social care gets neglected. The medication continues till the whole life on a regular basis. In present study, the objective has been to provide pharmacoeconomic medication to the diabetic pensioners in the backdrop as mentioned in above background. The data was collected at the medical reimbursement section of pensioners of the University. The data was examined to answer issues of therapeutic decisions in the light of the pharmacoeconomic considerations. In this paper essentially data on choice of prescriptions with the angle of pharmacoeconomic prudence were included. The dichotomy of specialist versus non specialist prescribers at the tertiary center (i.e. medical college hospital) was compared. Effort was made to define merit of the prescription based on comprehensive considerations of patient profile, disease profile and therapeutic choice. Total 72 prescriptions were analyzed for the study in which 475 drugs were prescribed to the patients. Total antidiabetic drugs prescribed to the patients were 169. Out of 72 cases 39 were males and 33 were females with mean age 66.04 ± 5.80 (Mean ± SEM). The average number of drugs per prescription was 6.59 which was very high as per guidelines. Most commonly prescribed antidiabetic drug was Metformin (63.89%) followed by Glimepiride (31.95%). This study reflects that there is need to make available the standard therapeutic option at University Health Care Facility based upon pharmacoeconomic considerations.

Like many other developing countries pharmacoeconomics and outcome research and its applications in national health system is a new but promising filed in Iran. Although decision makers of Iran national health system decided to use pharmacoeconomics in the decision making approach several hurdles including lack of reliable national data, lack of expertise and local experience are the main challenges in this filed. Recent activities in training graduate students in the field of health technology assessment in the universities could play a major role in advancing this field in Iran.