These findings suggest that there is no single WTP value for a quality-adjusted life-year. The CE threshold estimated for Malaysia was found to be lower than the threshold value recommended by the World Health Organization.

IntroductionThe incremental cost-effectiveness ratio (ICER) is typically compared with a reference value to support the cost-effectiveness of a decision. One method for estimating this value is to estimate the willingness-to-pay (WTP) for a quality-adjusted life-year (QALY). This study was conducted to explore the WTP for a QALY in the Malaysian population.MethodsA cross-sectional, contingent valuation study was conducted in Penang, Malaysia. Respondents were selected from randomly chosen geographical grids of Penang. Respondents’ sociodemographic information, qualities of life, and WTP for one additional QALY were collected using predesigned questionnaires in face-to-face interviews. WTP values were elicited using a double-bound dichotomous choice via a bidding game approach. The Heckman selection model was applied to the analysis of the mean WTP/QALY values, where the “protest zero” values, which may contribute to selection bias, were excluded.ResultsThe mean value of WTP for an additional QALY gained was estimated to be MYR (Malaysian Ringgit) 29,080 (~USD 9,000). Key factors that affected the WTP include ethnicity and estimated monthly household income.ConclusionThe study findings suggested that the cost-effectiveness threshold value as studied in Penang, Malaysia was estimated to be MYR 29,080.

Continuous cold crystalloid perfusion in a canine model of DCD: (1) facilitates aerobic metabolism and resuscitates the DCD heart, (2) provides functional and metabolic recovery superior to cold storage, (3) shows promise for improved clinical preservation of DCD and marginal donor hearts.

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for new drugs and new indications for existing drugs were identified from the European Medicines Agency (EMA) website. The decision to undertake an appraisal was obtained from the NICE website and NIHR Horizon Scanning Centre records, and the associations between this and characteristics of the drug and intended patient population were then determined. Results: For 2005-2011, we identified 134 MAs granted by the EMA (116 new drugs and 18 new indications) of which 72 (54%) were selected for appraisal. The decision to undertake an appraisal was significantly associated with an MA granted 2009-2011 (OR= 2.3, p< 0.01), the drug being a biological agent (OR= 3.9, p< 0.01), administered on a long-term basis (OR= 1.8, p< 0.05), indicated for a patient population < 1 in 1,000 (OR= 2.1, p< 0.05), or for malignant disease (OR= 5.1, p< 0.01). It was not associated with an indication for more severe disease (OR= 2.0, p= 0.06), an MA issued for a new indication (OR= 1.4, p= 0.50), or whether a drug was first-of-kind (OR= 1.8, p= 0.10). ConClusions: We identified several characteristics associated with the decision to undertake an appraisal relating to both the drug and intended patient population that do not completely match published topic selection criteria (e.g. severity). Further analyses are required to determine which are the most relevant factors in this decision.

BackgroundThe proposed Pharmacy Bill of Malaysia which served to consolidate and harmonise the existing pharmacy legislation which has been used for more than 60 years. This new Pharmacy Bill contains 17 parts and a total of 170 legislative sections covering laws governing pharmacy practice, medicinal products classification, registration, sale, supply, licensing etc. Our article could serve as a case study on pharmacy jurisprudence and drug regulation as well as the governance for medicines.DiscussionChanges to the colonial era legislation are long overdue as the present pharmaceutical and medical controls are not integrated and various overlaps exist in terms of roles of control. However, various organisations of private general practitioners strongly opposed this Pharmacy Bill and lobbied for a revised version that greatly favours themselves. Thus, the latest revision of this Pharmacy Bill renders the power to medical doctors to not only continue selling and supplying medications but also compound medication.SummaryA complete overhaul of pharmacy legislation in view of the current challenges faced in providing efficient and comprehensive health services in Malaysia is necessary. For the sake of patients’ safety and good governance for medicines, the private general practitioners should empower the patients with their needs for prescription and itemised billing. The proposed Pharmacy Bill could make the whole mechanism of managing and controlling the use of medicines more transparent and synchronised.

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for use in diabetes (n = 11; 13%) ), then 7 pain instruments (8%), 5 respiratory questionnaires (6%), 2 urological questionnaires (2%) and 2 treatment specific instruments (2%). The remaining 30 (34%) instruments covered individual conditions ranging from anaemia to osteoporosis. ConClusions: There are at least 88 patient's treatment satisfaction/preference instruments published for possible use in clinical trials; 31 of which are useful for evaluating satisfaction / preference for drug therapies without reference to a specific therapy area. For those disease-specific measures, assessment of content validity and psychometric properties should be assessed before chosing the most appropriate measure for a given study.