is a modality of renal replacement therapy that depends on a viable vascular access. The temporary double-lumen catheter (TBLC) provides immediate management; however, its use implies complications. This research aimed to calculate the average cost of TBLC use in chronic renal failure patients undergoing HD. Methods: It was an observational cost assessment study, with quantitative approach, performed in the HD unit of a University Hospital in Rio de Janeiro, Brazil in the period from April to September 2015. The sample consisted of 20 patients using TBLC who started dialysis. Data were analyzed using the statistical program Epi Info and Excel® 2010. Ethics Committee approved the study with
A931system. Methods: A cost-effectiveness analysis was performed considering six subgroups within the target population (three age groups and two risk groups) and a time horizon of twenty years. A single-dose of PCV13 was compared to a PPSV23 scheme with a reinforcing dose every five years. The model considers two forms of pneumococcal infection: invasive pneumococcal disease (bacteremia and meningitis) and community acquired pneumonia. Subject to availability, the model was mainly fed with inputs based on published local epidemiology data. The vaccine efficacy rates were estimated for each subgroup based on available clinical trials on the target population. The costs considered within the model are based on the local costs published by institutions of the Mexican public health system. Results: Considering a time horizon of twenty years: PCV13 yielded 0.6484 additional life years per patient over PPSV23 and PCV13 yielded savings of $525.39 MNX per patient over PPSV23. Hence, PCV13 is a dominant immunization strategy over PPSV23. ConClusions: Choosing PCV13 as an immunization strategy for adults over 65 years with low or moderate risk of pneumococcal infection would significantly reduce the number of community acquired pneumonia events. Hence, the use of PCV13 would reduce the clinical and economic burden associated with pneumococcal infections expected on the target population. Sensibility analyses considering the lowest possible healthcare costs and a single dose scheme of PPSV23 did not modify the results of the model.
reported in favor of OACDs. Decision analytic modeling was used in the majority of studies, mostly constituting Markov modeling. Sensitivity analyses were conducted in most studies, constituting one-way sensitivity analysis. The types of cancers, where the effect of OACDs was studied, were the metastatic renal carcinoma, gastrointestinal tumors, colon cancer, chronic myeloid leukemia and non-small cell lung cancer. Most included articles were published during the last seven years. Most studies were only conducted in the UK, US and Europe. ConClusions: This is first systematic review of the economic methods used in the evaluation of OACDs. Most important, is that despite the higher acquisition cost, OACDs were demonstrated to be mostly superior over the parenteral alternatives. The pharmacoeconomics studies are difficult to generalize, whereby published economic evaluations are locally specific, especially for the purpose of practical interpretation.
Objectives: Assess the cost-effectiveness of tiotropium bromide for severe obstructive pulmonary disease (COPD) versus indacaterol in Mexican institutions. MethOds: Cost-effectiveness analysis using a decision tree model to assess the risk of exacerbations considering the use of either tiotropium or indacaterol. A Delphi Panel with several expert pulmonologists was performed in order to calculate the cost of medical resources used by EPOC patients, especially when suffering from exacerbations. All results are presented in 2015 Mexican Pesos. A probabilistic sensitivity analysis was conducted on number of exacerbations. Hospitalizations due to exacerbations were considered when a patient suffered from 3 or more events reported on the INVIGORATE study and simulated with a Beta distribution. Results: Assuming that every time a patient suffers an exacerbation his condition worsens, the next exacerbation will require more medical attention.. We consider a cohort of 1,000 patients, a time horizon of 52 weeks and adjusted according to the INVIGORATE study. We observed that 35% of tiotropium patients had at least one exacerbation compared to 40% of the indacaterol patients.. Average cost for tiotropium patients was $55,337,159 MXP and $81,029,630 MXP for indacaterol patients. A 32% increment on treatment cost for the indacaterol patients vs. the tiotropium subjects. cOnclusiOns: Using the results of the Invigorate study the use of tiotropium in COPD treatment from the perspective of the public health system in Mexico represents a potential cost-saving alternative vs. indacaterol. Because tiotropium reduces the number of exacerbations patients might suffer, then there is decreased economic impact with the use of tiotropium.Objectives: Asthma is a progressive inflammatory disease that affects greatly patients' quality of life and demands for aggressive management early on during the course of the disease. The emergence of humanized antibody has equipped pulmonologists with evolutionary treatment tools but it has also influenced the costs of the disease, thus highlighting the necessity of cost-effectiveness data. The purpose of this study was to conduct a systematic review of cost-effectiveness data for omalizumab in the treatment of severe persistent allergic asthma. MethOds: We searched Medline, Embase and Cochrane from inception to the end of December 2016 for cost-effectiveness data for omalizumab in the treatment of severe persistent allergic asthma. An initial search using the keywords "omalizumab, cost effectiveness, and severe asthma" was followed by a search of related citations. References of the included studies were screened for additional studies. Two reviewers independently searched and extracted data with differences adjudicated via consensus discussion. Results: A total 612 studies were identified and six met the inclusion criteria. The majority of rejected studies were due to lack of cost data, failure to include omalizumab as an intervention or comparator, and failure to include severe persistent allergic ...
was conducted from 2006 -2014 comparing the observed impact of PCVs on incidence of disease compared to the pre-PCV level of disease to estimate the cumulative impact of vaccination. Epidemiological databases were revised for incidence of invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM). Vaccination and direct clinical costs were obtained from public tabulators from 2018. Given the retrospective analysis, a prospective cost-benefit analysis was calculated based on continued use of PCV13. Results: When considering the hypothetical scenario of non-immunization vs immunization the use of PCVs in Mexico is estimated to have prevented approximately 1.5 million cases of pneumococcal disease and 1,840 deaths over the past 10 years. This reduction corresponds to over a $33 billion MXN costsavings since the introduction of PCVs. Prospectively, over a one year period continued PCV13 in Mexico provides a return on investment of $2.1 MXN for each peso invested in the program. ConClusions: PCVs in Mexico have resulted in a significant impact on PD incidence and a net economic benefit. PCVs in the current schedule should be maintained in order to maximize the total benefits of vaccination.
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