indexed prices were lower than their respective reference biologics (86.5 vs. 110.8). Conclusions: The price of biologics paid by the Medicare Part B increased more than the consumer price index in the period of analysis. Prices of reference biologics with biosimilar competition increased at a lower rate than biologics without biosimilar competition.
A 1 -A 3 1 8 A241 fatality, serious adverse events,and hospitalization. ConClusions: There are sizable adverse events associated with antiobesity medication use.Drug safety about antiobesity medication should be warrant.
4 ufrgs -universidade federal do rio grande do sul (Brazil), porto alegre, Brazil Objectives: Healthcare studies contemplating the TDABC method have increased in recent years, mainly driven by the need for greater precision in cost estimation. Although several organizations are already implementing the method, some issues still lie in the estimation of cost capacities rate (CCR) and in consideration of indirect costs. This review analyzed if the researchers, when performing TDABC studies, are applying specific methods to estimate CCRs and distribute indirect costs. Methods: Pubmed/Medline and Scopus databases were used to conduct the search in October 2019 by the string: "time-driven activity-based costing" and "healthcare." One researcher reviewed the title and abstracts, using as selection criteria papers that applied TDABC in a healthcare organization. In sequence, the same researcher reviewed the full texts and using as criteria the confirmation of TDABC use and detailed information about the resources, their capacity estimation, and the indirect costs consideration, included the studies in the sample to be evaluated. Results: 88 studies were identified, and 37 were included in the sample. The key resources considered are labor cost (100%), equipment (57%), supplies (54%), and space (43%). The majority of organizations (70%) estimated the CCRs using an analytically calculated practical capacity, and a few using an arbitrary practical (19%) or theoretical capacity (11%). None of the organizations used more than one capacity estimation. For the indirect costs, most organizations (65%) didn't consider them during the application of the method. Among those who used, "overhead costs" expression was pointed to explain what was considered by the distribution that traditional cost systems already do. Conclusions: The practical capacity is a positive calculation being applied by healthcare organizations, but the non-consideration of different capacities makes it challenging to identify cost-saving opportunities. There is no exploration of overhead costing accurate methods, which represents an issue to be studied to increase the quality of TDABC in healthcare.
Objetivo: dado que en este momento está disponible a nivel de la Seguridad Social Costarricense tanto trastuzumab para administración intravenosa como para administración subcutánea, y que la presentación para administración subcutánea ha documentado ser no inferior a la intravenosa, resulta pertinente contar con un estudio de minimización de costes que permita documentar cuál de las formulaciones resulta más conveniente mantener en el sistema público de salud, con base en criterios de eficiencia de la intervención.Métodos: se desarrolló un estudio que evaluó desde la perspectiva financiera de la Seguridad Social de Costa Rica, dos opciones diferentes de aplicación del trastuzumab en pacientes con cáncer de mama. Los procedimientos relacionados fueron identificados y documentados para los dos tipos de aplicación del tratamiento intravenosa y subcutánea. Ambas opciones de tratamiento se basaron en esquemas de diecisiete dosis, con la estimación de los suministros y el tiempo del profesional sanitario para cada posibilidad. El análisis incluyó la evaluación desde la perspectiva del paciente.Resultados: la evaluación económica del procedimiento de administración para ambas alternativas evidenció que la opción subcutánea tenía un costo de aplicación de $ 78,6 y $ 467,34 para la opción intravenosa. Desde la perspectiva financiera, la opción subcutánea constituye la alternativa con un costo menor: $ 4000,00 por tratamiento por paciente, y desde la perspectiva de este, implica un 45,0 % menos de tiempo por sesión de tratamiento por paciente, que en la opción intravenosa.Conclusiones: la formulación de trastuzumab subcutánea evidenció una reducción sustancial de tiempo y costo en comparación con la presentación intravenosa en el sistema de Seguridad Social Costarricense.
Objectives: Erlotinib, a representative of targeted therapy, has been approved by FDA for first-line therapy in EGFR-mutations positive NSCLC. However the high price of drug created a large barrier in practice especially in Vietnam. The aim of this study is to estimate the cost-utility of erlotinib versus the standard chemotherapy as firstline therapy in advanced EGFR mutation-positive NSCLC in Vietnam. MethOds: A 3-state Markov model was developed to evaluate the cost-utility of erlotinib versus the standard chemotherapy over life-time horizon. The discount rate of 3% has been evaluated for both cost and QALY. One-way sensitivity analysis was performed to evaluate uncertainties of parameters. Results: Compared with standard therapy, erlotinib regimen in first-line therapy in EGFR-mutations positive NSCLC resulted in the increase of 439.02 million VND treatment cost (534.16 million and 95.14 million VND, respectively) with the increase of 0,11 QALY (1.38 vs 1.27, respectively). The ICUR of erlotinib versus standard chemotherapy was 4.1 billion VND/QALY, which is 34 times higher than the willingness-to-pay of Vietnam (around 120 million VND). One-way sensitivity analysis showed such influencing factors on ICUR as drug price, price of medical services, discount rate, from which price of erlotinib was the most influencing factor. cOnclusiOns: Erlotinib was not cost-effective compared with standard chemotherapy in first-line therapy in EGFR-mutations positive NSCLC.
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