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.
A297 respectively (P< .05 vs placebo). CONCLUSIONS: These findings suggest that PHEN/ TPM ER-enhanced WL is associated with a reduction in annual medication costs vs placebo in patients with MetS.
cine for use in immunocompetent adults aged 60 years and older, HZ continues to impact the American public and a better understanding of its current incidence is needed. METHODS: This was a retrospective analysis using the Truven Health MarketScan® databases from 2011. Cases were identified by a diagnosis code for HZ (ICD-9-CM: 053.xx) and must have been enrolled as of January 1, 2011, lacked a claim for shingles vaccination or HZ in the 90 days prior to this date, and been deemed immunocompetent according to the study criteria. Annual incidence rates were calculated for the entire population observed in the database as well as by gender and age group; standardized incidence rates were also produced using the 2010 U.S. Census data. RESULTS: The annual incidence rate of HZ across all ages of the study population in 2011 was 4.47 per 1000 person-years (95% CI: 4.45, 4.50). This rate increased monotonically with age, ranging from 0.86 (95% CI: 0.84, 0.88) for those aged ≤ 19 to 12.78 (95% CI: 12.49, 13.07) for immunocompetent enrollees aged 80 and older. The incidence rate was 8.46 (95% CI: 8.39, 8.52) among adults 50 years and older and 10.46 (95% CI: 10.35, 10.56) among those aged 60 years and older. The annual incidence rate of HZ was higher in women than men ((5.25, 95% CI: 5.21, 5.29 and 3.66, 95% CI: 3.62, 3.69), respectively) and was seen across all age groups. When standardized using 2010 U.S. Census data, the annual incidence rate was 4.63 per 1000 person-years (95% CI: 4.61, 4.66). CONCLUSIONS: Herpes zoster remains common among immunocompetent adults with incidence rates of HZ observed to increase with age and be higher in women than men.
To perform a treatment cost comparison of pirfenidone versus nintedanib on the treatment of idiopathic pulmonary fibrosis (IPF) under the Brazilian private healthcare system perspective. MethOds: Both treatment's ex-factory prices were obtained from official published lists, by the Brazilian Ministry of Health, considering the incidence of taxes (ICMS 18%). Annual treatment cost was calculated based on the dosage of pirfenidone (2.403 mg/day) and nintedanib (150 mg BID) obtained from their respective Brazilian labels. A year was assumed to be 12 months with 30 days each. Results were shown for 2 scenarios: first year (including initial dose ramp up for pirfenidone) and maintenance phases. Results: Pirfenidone and nintedanib unitary costs were BRL 9,144 (BRL 33.87 per 267 mg tablet) and BRL 14,916 (BRL 248.60 per 150 mg tablet), respectively, according to their list prices. Pirfenidone showed an annual treatment cost of BRL 107,591 and BRL 109,724 on the first year and subsequent years of treatment, respectively. Nintedanib incurred an annual cost of BRL 178,988 independent of year of treatment. Those results led to savings of approximately BRL 70,000 per year per patient treated with pirfenidone compared to those treated with nintedanib (a relative reduction of approximately 40%). Pirfenidone's dose ramp up, on the first year of treatment, did not decrease significantly the treatment cost, implying on a reduction of just 2% when compared to subsequent years. cOnclusiOns: Pirfenidone was lower than the cost of nintedanib.
period evaluated, admissions of elderly (older than 60 years) were the most frequent, accounting for 74% of the total. In addition, men were the majority, with 2.38 times more admissions for men than women. There were 4,311 deaths for the period. The total admissions cost was 120,108,156 BRL. There has also been an annual growth trend in total costs with hospital admissions. Mean cost per admission was 1,990 BRL over the four year period. ConClusions: These results suggest an increasing impact of urothelial carcinoma on SUS admissions costs, especially affecting older men. This pathology has high morbidity and mortality rates if not treated optimally, and investigational immunotherapies that train the immune system to recognize cancer cells may improve outcomes for these patients.
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