In Mexico, both doses of canagliflozin are likely to be cost-effective versus sitagliptin in patients with T2DM who have inadequate glucose control on metformin, primarily because of better biomarker control and higher QALYs.
Background: In developing countries rotavirus is the leading cause of severe diarrhoea and diarrhoeal deaths in children under 5. Vaccination could greatly alleviate that burden, but in Mexico as in most lowand middle-income countries the decision to add rotavirus vaccine to the national immunisation program will depend heavily on its cost-effectiveness and affordability. The objective of this study was to assess the cost-effectiveness of including the pentavalent rotavirus vaccine in Mexico's national immunisation program.
BackgroundAntiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs.MethodsAn ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs.ResultsThree key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief.ConclusionOne of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.
RESUMENObjetivo Estimar el resultado inicial del Seguro Popular de Salud (SPS) sobre el gasto catastrófico en salud (GC) de los hogares. Adicionalmente se estimó la relación de otros factores de importancia sobre el GC. Material y métodos Estudio transversal a partir de la Encuesta de Evaluación del Seguro Popular levantada en los estados de Colima y Campeche en el segundo semestre del año 2002. El estudio se llevó a cabo en el primer semestre del año 2005. Se estimó primero la relación del SPS y otras covariables con el GC mediante un modelo probit. Después se estimó nuevamente la relación de las covariables y el GC tomando en cuenta la endogeneidad del GC con la afiliación al SPS, utilizando para ello un modelo probit bivariado. Finalmente, se realizaron algunas simulaciones para ver con más detalle la influencia de la utilización por tipo de servicio sobre el GC. Resultados Para los hogares afiliados al SPS la probabilidad de incurrir en GC fue casi 8 % menor, en comparación con los hogares no afiliados, controlando por las demás covariables y se corrigió por la endogeneidad. La probabilidad de GC siempre fue menor para los afiliados, independientemente del tercil económico al que pertenecían y del tipo de servicio utilizado. Conclusiones Los resultados del estudio sugieren que el SPS está protegiendo financieramente a los hogares; sin embargo, aún constituye un reto llegar a la meta de reducción del 75 % del GC.Palabras Clave: Inversiones en salud, Seguridad Social, Sistemas de salud,México
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