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1.
Anales de la Real Academia Nacional de Farmacia ; 88(3):323-335, 2022.
Article in Spanish | EMBASE | ID: covidwho-2172099
2.
Asian Journal of Pharmaceutical and Clinical Research ; 15(12):192-196, 2022.
Article in English | EMBASE | ID: covidwho-2205061

ABSTRACT

Objectives: The main objectives of the study are to identify the socio-economic characteristics of lay persons who engage in self-medication activities, to determine the economic aspects of self-medication, to conduct cost minimization analysis, and to determine the consequences of self-medication. Method(s): A cross-sectional survey was conducted in community pharmacies throughout Northern Kerala for a period of 6 months from April 2021 to September 2021. A total of 300 participants were selected through consecutive sampling. Result(s): 117 people were from upper middle class families based on Kuppuswamy's scale. A majority of participants considered self-medication for economic benefits which confirmed that self-medication is closely related to the financial background of the respondents. The costs saved were measured by calculating the costs associated with hospital visits by them or family in the past 6 months for similar manifestations. During the study, the cost of branded drugs prescribed was determined as 70-1498.78% more than the generic versions. Hence, patients are spending much more on their treatment unaware about other alternative options. 117 participants experienced an adverse drug reaction after taking the medication, and 134 participants responded that their symptoms were not improving and 99 entrants had to visit the hospital who had an economic burden due to delay in detection of the disease. Conclusion(s): Thus, the study concluded that there is a strong relationship between pharmacoeconomics and self-medication behavior. Copyright © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

3.
Farmacia Hospitalaria ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165297

ABSTRACT

Objective: To describe the marginal cost and survival of patients treated with tocilizumab in a university hospital under real-life conditions and to evaluate factors that could influence costs and health outcomes will be evaluated. Methods: Observational, single-center, retrospective study of a cohort of adult patients infected with SARS-COV2 treated with tocilizumab. The 1 year restricted mean survival time was analyzed in life-years gained (LYG). The influence of sex, age and severity on patient survival was evaluated. The marginal cost/LYG and marginal cost/survivor ratios were calculated. Results: 508 patients (66 ± 13 years;32% women) were included. Seventeen percent were admitted to the ICU. Overall survival was 77%. Age older than 71.5 years (HR = 1.08;95%CI 1.07–1.10;p < 0.001) and ICU admission at initiation of treatment (HR = 2.01;95%CI 1.30–3.09;p = 0.002) were identified as risk factors. The total budgetary impact of tocilizumab in the period analyzed was 206,466 euros. The patients with the highest cost per unit of health outcome were those admitted to the ICU and those over 71.5 years, with a marginal cost/LYG of €966 and a marginal cost/survivor of €1136. Conclusion: The efficiency of treatment with tocilizumab is associated with the age and severity of the patients. The figures are lower in all subgroups than the thresholds usually used in cost-effectiveness evaluations. The results of the present study suggest that early first dose of tocilizumab is an efficient strategy. RESUMEN Objetivo: Describir el coste marginal y la supervivencia de los pacientes tratados con tocilizumab en un hospital universitario en condiciones de vida real. Y evaluar los factores que podrían influir los costes y los resultados en salud. Metodología: Estudio observacional, retrospectivo y unicéntrico de una cohorte de pacientes adultos infectados con SARS-COV2 tratados con tocilizumab. Se analizó, en años de vida ganados (AVG), la media de supervivencia restringida a 1 año. Se evaluó la influencia del sexo, la edad y la gravedad en la supervivencia de los pacientes. Se calcularon el ratio coste marginal/AVG y coste marginal/superviviente. Resultados: Se incluyeron 508 pacientes (66 ± 13 años;32% mujeres). Un 17% ingresó en UCI. La supervivencia global fue del 77%. Se identificaron como factores de riesgo la edad mayor de 71,5 años (HR = 1,08;IC95% 1,07–1,10;p < 0,001), y el ingreso en UCI al iniciar el tratamiento (HR = 2,01;IC95% 1,30–3,09;p = 0,002). El impacto presupuestario total de tocilizumab en el periodo analizado ascendió a 206.466€. Los pacientes con mayor coste por unidad de resultado en salud son los pacientes ingresados en UCI y mayores de 71,5 años, que presentan un coste marginal/AVG de 966 € y un coste marginal/superviviente de 1.136€. Conclusión: La eficiencia del tratamiento con tocilizumab se asocia a la edad y a la gravedad de los pacientes. Las cifras son inferiores en todos los subgrupos a los umbrales habitualmente utilizados en las evaluaciones coste-efectividad. Los resultados del presente estudio sugieren que el inicio precoz de tocilizumab es una estrategia eficiente.

4.
Farmacia Hospitalaria ; 2022.
Article in Spanish | ScienceDirect | ID: covidwho-2158844

ABSTRACT

Resumen Objetivo: Describir el coste marginal y la supervivencia de los pacientes tratados con tocilizumab en un hospital universitario en condiciones de vida real. Y evaluar los factores que podrían influir los costes y los resultados en salud. Metodología: Estudio observacional, retrospectivo y unicéntrico de una cohorte de pacientes adultos infectados con SARS-COV2 tratados con tocilizumab. Se analizó, en años de vida ganados (AVG), la media de supervivencia restringida a 1 año. Se evaluó la influencia del sexo, la edad y la gravedad en la supervivencia de los pacientes. Se calcularon el ratio coste marginal/AVG y coste marginal/superviviente. Resultados: Se incluyeron 508 pacientes (66 ± 13 años;32% mujeres). Un 17% ingresó en UCI. La supervivencia global fue del 77%. Se identificaron como factores de riesgo la edad mayor de 71,5 años (HR = 1,08;IC95% 1,07–1,10;p < 0,001), y el ingreso en UCI al iniciar el tratamiento (HR = 2,01;IC95% 1,30–3,09;p = 0,002). El impacto presupuestario total de tocilizumab en el periodo analizado ascendió a 206.466€. Los pacientes con mayor coste por unidad de resultado en salud son los pacientes ingresados en UCI y mayores de 71,5 años, que presentan un coste marginal/AVG de 966 € y un coste marginal/superviviente de 1.136€. Conclusión: La eficiencia del tratamiento con tocilizumab se asocia a la edad y a la gravedad de los pacientes. Las cifras son inferiores en todos los subgrupos a los umbrales habitualmente utilizados en las evaluaciones coste-efectividad. Los resultados del presente estudio sugieren que el inicio precoz de tocilizumab es una estrategia eficiente. Objective: To describe the marginal cost and survival of patients treated with tocilizumab in a university hospital under real-life conditions and to evaluate factors that could influence costs and health outcomes will be evaluated. Methods: Observational, single-center, retrospective study of a cohort of adult patients infected with SARS-COV2 treated with tocilizumab. The 1 year restricted mean survival time was analyzed in life-years gained (LYG). The influence of sex, age and severity on patient survival was evaluated. The marginal cost/LYG and marginal cost/survivor ratios were calculated. Results: 508 patients (66 ± 13 years;32% women) were included. Seventeen percent were admitted to the ICU. Overall survival was 77%. Age older than 71.5 years (HR = 1.08;95%CI 1.07–1.10;p < 0.001) and ICU admission at initiation of treatment (HR = 2.01;95%CI 1.30–3.09;p = 0.002) were identified as risk factors. The total budgetary impact of tocilizumab in the period analyzed was 206,466 euros. The patients with the highest cost per unit of health outcome were those admitted to the ICU and those over 71.5 years, with a marginal cost/LYG of €966 and a marginal cost/survivor of €1136. Conclusion: The efficiency of treatment with tocilizumab is associated with the age and severity of the patients. The figures are lower in all subgroups than the thresholds usually used in cost-effectiveness evaluations. The results of the present study suggest that early first dose of tocilizumab is an efficient strategy.

5.
Pharmaceutical Journal ; 307(7952), 2022.
Article in English | EMBASE | ID: covidwho-2064995
6.
Pharmaceutical Journal ; 306(7950), 2022.
Article in English | EMBASE | ID: covidwho-2064968
7.
Pharmaceutical Journal ; 306(7949), 2022.
Article in English | EMBASE | ID: covidwho-2064963
8.
Journal of Clinical Outcomes Management ; 29(4):155, 2022.
Article in English | ProQuest Central | ID: covidwho-1988535

ABSTRACT

An interview with Dr George Sakoulas, an infectious diseases clinician at Sharp Memorial Hospital in San Diego CA, is presented. Sakoulas talks about work around COVID-19 management, the economics of inpatient care, and connection between the medical outcomes and pharmacoeconomics findings from his article and link it to the bedside and treatment of their patients.

9.
Revista Cubana de Salud Publica ; 48(2), 2022.
Article in Spanish | EMBASE | ID: covidwho-1976042

ABSTRACT

Introduction: Cuba is a country with development in the biotechnology and medicines field, where pharmacoeconomic studies provide significant evidence for decision-making;mainly at present when the country is immersed in the "Task of Ordering" and at the same time is affected by the pandemic of the new coronavirus. Objective: Characterize pharmacoeconomic studies in Cuba in the last 20 years. Methods: A bibliometric research was carried out for which the Cuban scientific production on pharmacoeconomics was recovered in the Scopus database for the period 2001-2020. Bibliometric indicators were used to obtain the number of documents, years of publication, sources, collaboration, type and patterns of institutional and country collaboration, as well as co-occurrence of keywords. Results: 648 documents were retrieved. The most productive year was 2010. The documents were published in 273 journals, 17 (6.2%) Cuban ones and 256 (93.8%) foreign. There were 449 documents (69.3%) in institutional collaboration and 199 (30.7%) without collaboration. The most productive institutions were the Center for Genetic Engineering and Biotechnology with 82 (12.7%) and the Center of Molecular Immunology, with 77 (11.9%). The collaboration network between countries showed three defined areas: Latin America, North America-Europe-India and Spain. The most published topics were effectiveness and safety of drugs, vaccines, and those related to cancer. Conclusions: The publications were characterized by being collaborative, with a slight predominance of national over international ones. Comprehensive economic assessments need to be expanded.

10.
European Journal of Clinical Pharmacology ; 78:S32, 2022.
Article in English | EMBASE | ID: covidwho-1955962

ABSTRACT

Introduction: Antimicrobial resistance is recognized as one of the top 10 threats to public health.Due to recent circumstanceswith the 2019 Covid pandemic worldwide, the urgency of monitoring antibiotic consumption and rational use of medications has increased. According to WHO recommendations, countries should aim to increase the proportion of Access group antibiotics consumption to 60% and higher in AWaRe classification system (Access,Watch and Reserve). The ABC/VEN analysis (80%, 15%, 5% of spending) is the simplest and most relevant method for evaluating the effectiveness of antibiotic therapy expenditures. Objectives: Evaluating the cost-effectiveness of antibiotic therapy in the Department of Pulmonology. Methods: ABC/VEN analysis was performed with data on antibiotic costs in the pulmonology department (30 beds) of a multidisciplinary regional hospital (844 beds in total) with 1 full-time clinical pharmacologist for no clinical pharmacy or pharmacology service. To analyze antibiotic consumption patterns according to the AWaRe 2021 classification, we used data on the number of antibiotics procured. Results: The results of the antibiotics spending analysis from 2019-2021 showed that all antibiotics from the most costly group A (80% of total spending) are in the Watch group (J01DH Carbapenems - Ertapenem, Doripenem, Meropenem;J01MA Fluoroquinolones - Levofloxacin;J01DD Third-generation-cephalosporins - Ceftazidime, Ceftriaxone and J01DE Fourth-generation-cephalosporins: Cefepime). Meanwhile, there has been an increase in the share of spending on the most consumed group of antibiotics, J01DH Carbapenems, from 42.9% in 2019 to 62.8% by 2021. On the contrary, there is downward trend in spending on the third-generation-cephalosporins which was 35.6% in 2019 and only 6.7% by 2021. Assessment of antibiotic prescription patterns in the pulmonology department based on classification AWaRe 2021 and WHO Model List of Essential Medicines (EML) 2021 (22nd edition) revealed a negative trend in the use of the most costly group (A) of antibiotics with a low level of evidence of efficiency or safety in pulmonology: Doripenem, Ertapenem, Levofloxacin, Cefepime. However, there is a positive result in the work of the clinical pharmacology service - the drugs mentioned above were moved into group B (medium-cost) by 2021, except for Cefepim, which was not purchased at all. Conclusion: Despite the positive trend in antibiotic consumption patterns (transfer of antibiotics with efficiency proof from gr A to gr B), current antibiotic therapy in the pulmonology department needs comprehensive optimization of approach to rational antibiotic use, strengthening pharmaceutical care by implementing a clinical pharmacy service that will conduct regular systematic evaluation and contribute to the pharmacoeconomic expediency of antibiotic therapy. Suchmeasures lead to an improvement of the quality of medical care for the population and reduce the cost of this nosology, which proves that there is a need for a comprehensive detailed analysis.

11.
Int J Environ Res Public Health ; 19(13)2022 06 27.
Article in English | MEDLINE | ID: covidwho-1934047

ABSTRACT

The world is facing a continuous increase in medical costs. Due to the surge in disease prevalence, medical science is becoming more sensitive to the economic impact of medications and drug therapies. This brings about the importance of pharmacoeconomics, which is concerned with the effective use of health resources to optimize the efficiency and costs of medications of treatment for the best outcomes. This review was conducted to find out the potential barriers and facilitators to implementing pharmacoeconomic studies in the Middle Eastern region having both high- and low-income countries. The varying economies in the region depict diverse healthcare systems where implementation of pharmacoeconomics faces a large number of challenges and is also aided by numerous facilitators that contribute to the growth of its implementation. In this context, we have reviewed the status of pharmacoeconomics in Middle Eastern countries in research databases (Google Scholar, MEDLINE, Science Direct and Scopus) using keywords ("pharmacoeconomics", "barriers", "facilitators", "Middle East"). The study reported that Yemen, Syria, Palestine, Iran, Iraq, Jordan and Lebanon are the lowest-income countries in the Middle East and the implementation of pharmacoeconomics is the poorest in these states. The UAE, Saudi Arabia and Israel are high-income rich states where economic aspects were comparatively better but still a large number of barriers hinder the way to its effective implementation. These include the absence of national governing bodies, the lack of data on the effectiveness of medications, the absence of sufficient pharmacoeconomic experts and the lack of awareness of the importance of pharmacoeconomics. The main facilitators were the availability of pharmacoeconomic guidelines, the encouragement of pharmacoeconomic experts and the promotion of group discussions and collaborations between researchers and policymakers. Cost-benefit analysis is still evolving in Middle Eastern countries, and there is a great need for improvement so that states can effectively benefit from cost analysis tools and utilize their health resources. In this regard, governments should develop national governing bodies to evaluate, implement pharmacoeconomics at the local and state levels and bring about innovation in the field through further research and development incorporating all sectors of pharmacy and pharmaceutics. The data presented in this research can further be extended in future studies to cover the various domains of pharmacoeconomics including cost-minimization analysis, cost-effectiveness analysis and cost-benefit analysis and their applications within the healthcare sectors of Middle Eastern countries.


Subject(s)
Economics, Pharmaceutical , Research Personnel , Cost-Benefit Analysis , Humans , Lebanon , Syria
12.
BMC Health Serv Res ; 21(1): 986, 2021 Sep 18.
Article in English | MEDLINE | ID: covidwho-1840980

ABSTRACT

BACKGROUND: Sars-Cov-2 is a novel corona virus associated with significant morbidity and mortality. Remdesivir and Dexamethasone are two treatments that have shown to be effective against the Sars-Cov-2 associated disease. However, a cost-effectiveness analysis of the two treatments is still lacking. OBJECTIVE: The cost-utility of Remdesivir, Dexamethasone and a simultaneous use of the two drugs with respect to standard of care for treatment Covid-19 hospitalized patients is evaluated, together with the effect of Remdesivir compared to the base model but based on alernative assumptions. METHODS: A decision tree for an hypothetical cohort of Covid-19 hospitalized patients, from an health care perspective and a one year horizon is specified. Efficacy data are retrieved from a literature review of clinical trials, whilst costs and utility are obtained from other published studies. RESULTS: Remdesivir, if health care costs are related to the days of hospitalization, is a cost saving strategy. Dexamethasone is cost effective with an ICER of 5208/QALY, and the concurrent use of Remdesivir and Dexamethasone is the most favorable strategy for higher level of willingness to pay thresholds. Moreover, if Remdesivir has a positive effect on mortality the utility is three times higher respect to base case. Whereas, if health care costs are not related to the length of patient hospitalization Remdesivir has an ICER respect to standard of care of 384412.8/QALY gained, which is not cost effective. We also find that Dexaamethasone is cost effective respect to standard care if we compute the cost for live saved with an ICER of 313.79 for life saved. The uncertainty of the model parameters is also tested through both a one-way deterministic sensitivity analysis and a probabilistic sensitivity analysis. CONCLUSION: We find that the use of Remdesivir and/or Dexamethasone is effective from an economic standpoint.


Subject(s)
COVID-19 , Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , COVID-19/drug therapy , Cost-Benefit Analysis , Dexamethasone , Humans , SARS-CoV-2
13.
Vaccines (Basel) ; 10(1)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1614022

ABSTRACT

(1) Background: In epidemiological terms, it has been possible to calculate the savings in health resources and the reduction in the health effects of COVID vaccines. Conducting an economic evaluation, some studies have estimated its cost-effectiveness; the vaccination shows highly favorable results, cost-saving in some cases. (2) Methods: Cost-benefit analysis of the vaccination campaign in the North Metropolitan Health Region (Catalonia). An epidemiological model based on observational data and before and after comparison is used. The information on the doses used and the assigned resources (conventional hospital beds, ICU, number of tests) was extracted from administrative data from the largest primary care provider in the region (Catalan Institute of Health). A distinction was made between the social perspective and the health system. (3) Results: the costs of vaccination are estimated at 137 million euros (€48.05/dose administered). This figure is significantly lower than the positive impacts of the vaccination campaign, which are estimated at 470 million euros (€164/dose administered). Of these, 18% corresponds to the reduction in ICU discharges, 16% to the reduction in conventional hospital discharges, 5% to the reduction in PCR tests and 1% to the reduction in RAT tests. The monetization of deaths and cases that avoid sequelae account for 53% and 5% of total savings, respectively. The benefit/cost ratio is estimated at 3.4 from a social perspective and 1.4 from a health system perspective. The social benefits of vaccination are estimated at €116.67 per vaccine dose (€19.93 from the perspective of the health system). (4) Conclusions: The mass vaccination campaign against COVID is cost-saving. From a social perspective, most of these savings come from the monetization of the reduction in mortality and cases with sequelae, although the intervention is equally widely cost-effective from the health system perspective thanks to the reduction in the use of resources. It is concluded that, from an economic perspective, the vaccination campaign has high social returns.

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