the respective countries were elicited from local experts and clinical guidelines in addition to 1L> 2L BEV sequences obtained from the ML18147 trial. Results: When 1L> 2L BEV replaces sequences which include 1L anti-EGFR regimens, it results in an average potential cost reduction of ARS-42,796
To profile the use of an operator in immunobiological supplemental health Fortaleza -Brazil, to identify the most prescribed therapeutic regimens and costs. METHODS: Cross-sectional study in two hospitals accredited service provider, from March to November/2012. Data were recorded by medical expertise in computerized management system (Sabius ® ) performed after the medical consultation. Later, these were entered in Microsoft Excell 2007 and analyzed by pharmacists auditors. The cost was calculated from the value contained in Brasíndice Unit 765, using the Consumer Price Max. The doses used for rheumatoid arthritis Etanercept 50 mg, 40 mg Adalimumab, abatacept 750 mg, 300 mg infliximab, 560 mg Tocilizimabe, Rituximab 1g and Golimumab 50 mg based on a 70 kg adult. RESULTS: We analyzed 64 patients with a mean weight 67 kg, of which 70.31% (n = 45) were women aged 30-59 years whose most frequent indications were rheumatoid arthritis (n = 33, 51.56%) and ankylosing spondylitis (n = 19; 29.69%). The most immunobiological commonly prescribed were Infliximab (n = 36; 56.25%), Tocilizimabe (n = 11, 17.19%), abatacept, and Rituximab (n = 8; 12, 50%) and golimumab (n = 1, 1.56%). It was observed that 67% (n = 43) patients were naïve immunobiological and 33% (n = 21) initiated with anti-TNF, whereas 61.9% (n = 13) moved into one another with immunobiological mechanism of action and 38.1% (n = 8) continued with an anti-TNF, changing only the drug. The average cost of treatment/dose first line
Objectives: European registries of Rheumatoid Arthritis (RA) patients treated by biological agents suggest that 70-80% are maintained in first line at 1 year despite potential insufficient efficacy. Post hoc analyses of certolizumab pegol (CZP) studies indicate that a 3 month clinical response had a high predictive value of the 1 year outcome. The objective was to examine the efficiency of a strategy consisting of early switching from CZP to a second line TNF inhibitor in case of insufficient clinical response at 3 months (3M) in the French setting versus current clinical practices. MethOds: A decision-tree model was built to estimate the clinical outcomes (ACR50 cumulated time) and the direct costs of different cohorts of RA patients over a 2 year period. ACR50 was considered as an RA satisfying clinical outcome. The "3M tight control" strategy consisted of stopping CZP at 3 months in patients not achieving the ACR50 criterion and switching them to other biologics. Three reference cohorts treated with first line CZP, etanercept or adalimumab, respectively, according to current clinical practices were considered as comparators (reference). All TNF inhibitors were assumed to have equal efficacy in first line. Costs were estimated at 2013 French public prices. Results: The proportion of patients achieving ACR50 after a 2 year follow-up was 58% in all reference cohorts and 75% in the "3M tight control" CZP strategy cohort. The costs per patient-year in ACR50 were € 19,326 with the "3M tight control" strategy cohort and € 23,588, € 26,774 and € 30,285 for the CZP, etanercept and adalimumab reference cohorts, respectively. The strategy "3M tight control" had an incremental cost-effectiveness ratio of € 5,605/patient-year in ACR50 versus CZP reference, and was dominant versus etanercept or adalimumab reference. cOnclusiOns: A 3-month tight control management of RA patients with CZP as first line treatment is cost-effective compared to alternatives.
A7152012 el consumo de ATB aumentó un 32% (de 7.4 a 9.8 DHD). El patrón de consumo total estuvo dado principalmente por las penicilinas de amplio espectro (53%, 61.1 DHD), siendo la amoxicilina el ATB más usado (44%, 50,5 DHD). ConClusiones: Las medidas regulatorias permitieron disminuir el consumo y los costos/DDD de ATB en Chile. Sin embargo, el aumento progresivo observado indica la necesidad de revisar la calidad en la utilización de los ATB y el cumplimiento de la regulación vigente.
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