0 1 7 ) A 8 5 3 -A 9 4 3 analysis established that the average cost of anti-TNF for acute ischemic coronary disease should be US$ 406.52 or with an incidence difference between strategies of 0.032. In addition, for cardiovascular death the average cost should be US$ 290.03 or a difference of 0.071. All the probabilistic sensitivity analyzes performed established an unfavorable relationship of the anti-TNF treatment strategy. These results are robust for deterministic and probabilistic analysis. ConClusions: The findings of the CEA among patients with rheumatoid arthritis for ischemic heart disease when compared to the anti-TNF drug treatment strategy against to the dominant strategy with Dmards after 6 months of drug exposure point to an unfavorable relationship, surpassing the Brazilian Health Ministry's willingness to pay in the year 2015.objeCtives: To estimate and compare the long-term cost per responder based on the Assessment of SpondyloArthritis international Society (ASAS) outcomes following 52 weeks of treatment of ankylosing spondylitis (AS) with secukinumab relative to adalimumab. Methods: The cost per responder for each treatment was estimated by dividing the drug acquisition cost for the course of treatment with its response rate. Drug costs were estimated using the public price approved by Brazilian health authority and the number of doses required for 52 weeks. The longterm response rates were estimated using a matching-adjusted indirect comparison (MAIC) technique based on the data from MEASURE 2 and ATLAS clinical trials of secukinumab and adalimumab, respectively. Results: MAIC analysis showed that ASAS (20, 40 and 5/6) response rates were significantly higher for secukinumab compared to adalimumab at 52 weeks. ASAS 20, ASAS 40 and ASAS 5/6 response rates were 81% vs. 65%, 62% vs. 47%, 74% vs. 55% for secukinumab vs. adalimumab, respectively. The cost per ASAS 20 responder was BRL61,852 vs. BRL147,546, cost per ASAS40 responder was BRL80,407 vs. BRL205,127, whereas, costs per ASAS 5/6 responder was BRL69,240 vs. BRL175,514 for secukinumab vs. adalimumab, respectively. The costs per ASAS (20, 40 and 5/6) responders were about 60% lower for secukinumab compared to adalimumab for all outcomes at 52 weeks. Sensitivity analyses confirmed the robustness of our analysis. ConClusions: The long-term cost per responder for all ASAS outcomes at 52 weeks were consistently lower for secukinumab vs. adalimumab. These findings indicated that it is more efficient to treat AS patients with secukinumab vs. adalimumab. In addition, more AS patients could be effectively treated in Brazil with secukinumab vs. adalimumab with a given budget, due to the cost-offsets.objeCtives: To evaluate effect of baricitinib (BARI) on patient-reported outcomes (PROs) in Latin American (LA)* patients with moderately to severely active rheumatoid arthritis (RA) with limited or no disease-modifying antirheumatic drug (DMARD) and naïve to biologic DMARDs. *LA countries: Argentina, Brazil, and Mexico. Methods: In the global 52-week, dou...
some kind of CAM for their disease. A wide range of CAM was used by patients to reduce side effects due to conventional therapies. Data analysis revealed a total of three themes: patient's understanding towards CAM, reasons of using or rejecting CAM and barriers to the CAM use. Patients recognize CAM as traditional ways of healing with not much scientific evidence. Those reported to use CAM were in favor to boost body's own resources to improve hemoglobin together with conventional therapies. Lack of scientific evidence was given as major reasons of not using CAM. Fear of CAM interaction with the conventional therapies was among other few reasons of not using CAM. Slow progression of CAM modalities and cost was given as a major barrier to CAM use. ConClusions: In conclusion, slow progression of CAM effects and treatment cost were among the major barrier to CAM use. Further investigations are required to establish the scientific evidence on the type of CAM used by Thalaseemia patients. Patients should be advised to disclose their CAM use to their health care professionals to avoid any harmful interactions.
Antecedentes: la toxoplasmosis congénita es una infección parasitaria causada por Toxoplasma gondii, la cual es adquirida por la gestante principalmente a través de la ingesta de alimentos contaminados. De acuerdo con el trimestre del embarazo en el que se adquiera la infección puede presentar manifestaciones clínicas leves o llegar a tener secuelas irreversibles que afectan la salud y calidad de vida del neonato. Reporte de caso: se presenta el caso de un recién nacido de 35 semanas con toxoplasmosis neonatal, con peso al nacer de 2 125 gramos, quien presentó hepatoesplenomegalia, lesiones equimóticas y eritematosas en piel generalizadas, cambios oftalmológicos, hiperbilirrubinemia mixta, serología de toxoplasma positiva y estudios imagenológicos compatibles con toxoplasmosis. Por lo tanto, se indicó tratamiento con pirimetamina, sulfadiazina, ácido folínico y corticoide sistémico. Conclusiones: es por este motivo que se hace hincapié en la importancia de la educación a la gestante con el fin de prevenir la infección, realizar un diagnóstico y tratamiento oportuno para disminuir las complicaciones y secuelas de la enfermedad, lo cual se puede lograr a través de los controles prenatales.
A433 20 weeks) vs. OnaBTX administered at fixed intervals (minimum 12, maximum 20 weeks); a 5-year horizon time was used. It was assumed that patients experiment a re-emergence of symptoms at some point after administration of toxins. Utilities were extracted from a published study in patients with focal dystonia. Costs (drugs acquisition and administration) were based on Spanish public databases. Efficiency outcome was expressed as the Incremental Cost Effectiveness Ratio (ICER). Deterministic and probabilistic sensitivity analyses were performed. Results: In the management of BL, patients treated with IncoBTX at flexible intervals (cost: € 3742) showed symptoms during 22.12 weeks less than those treated with OnaBTX at fixed intervals (€ 3366), leading to a QALY gain of 0.0276. In CD, patients with IncoBTX (cost: € 6673) showed symptoms during 21.34 weeks less than OnaBTX (cost: € 6419), resulting in a QALY gain of 0.0610. Estimated ICER was 13,576 and 4,158 € /QALY in BL and CD respectively ConClusions: The treatment of BL and CD with IncoBTX at flexible intervals determined by the patient needs clinically confirmed is an efficient therapeutic alternative compared to the fixed administration of OnaTBX in Spain. Patients treated at flexible intervals had fewer weeks experiencing symptoms compared to the patients treated at minimum 12-weeks intervals.objeCtives: Incobotulinumtoxin-A (Xeomin®) is a formulation of botulinum neurotoxin type A (BoNT/A) that is free of complexing proteins. The advantages of incobotulinumtoxin-A include flexible treatment intervals determined by clinically confirmed patient needs. The objective of this study was to assess the cost-effectiveness of incobotulinumtoxin-A administered with flexible treatment intervals compared to a scenario where incobotulinumtoxin-A was given at fixed doses every 12 weeks in blepharospasm (BLEPH) and cervical dystonia (CD) from the Australian healthcare providers' perspective. Methods: A Markov state transition model was developed to perform a cost-utility analysis (CUA). The CUA compared incobotulinumtoxin-A treatment, given at minimum intervals of 6 weeks and maximum intervals of 20 weeks, with incobotulinumtoxin-A treatment given at fixed 12 week intervals. The Markov model consisted of three health states and followed patients in weekly cycles for one year. Only direct healthcare costs associated with the acquisition and administration of BoNT/A's were included. Utility values were derived from a prospective, open-labelled cohort study. The primary outcome measure was the incremental cost per quality-adjusted life year (QALY). Univariate and probabilistic sensitivity analyses were conducted. Results: Incobotulinumtoxin-A flexible dosing was cost-effective compared to incobotulinumtoxin-A fixed 12 week dosing with an incremental cost per QALY gained of $20,696 in BLEPH and $4,243 in CD. Results held under sensitivity analyses. ConClusions: Incobotulinumtoxin-A administered at flexible treatment intervals, determined by patient needs, represents a more ...
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