Long-Term Cost-Effectiveness Analysis of Etanercept and Adalimumab for Plaque Psoriasis not Associated with Arthritis.

INTRODUCTION: Pharmacoeconomic studies examining the cost-effectiveness of biological agents to treat moderate-to-severe psoriasis in real-life clinical practice are scarce. The aim of this study was to assess the efficiency, in terms of incremental cost-effectiveness, of etanercept and adalimumab in a real clinical setting. METHODS: Direct and indirect costs were assessed from a Spanish societal perspective in a historical hospital cohort of patients with moderate-to-severe psoriasis attending a tertiary referral hospital over a 1-year period. The data examined included drug-related variables, use of health-care resources, transportation and work productivity losses. Effectiveness was measured as the proportion of patients achieving a reduction of at least 75% with respect to the baseline value for the Psoriasis Area Severity Index (PASI 75) during the first 52 weeks of treatment. RESULTS: No statistically significant differences in effectiveness between etanercept (n = 135) and adalimumab (n = 48) were found (PASI 75 80% vs. 85.7%; RR = 1.07 [0.90, 1.27]; RRA = 5.7 [-8.9, 20.2]; p = 0.943). There were no significant differences in total cost per patient with etanercept as compared to adalimumab (14,843.73 ± 6,178.98  vs. 15,405.91 ± 9,106.50 ; p = 0.768). CONCLUSION: Under conditions of daily clinical practice in our hospital, total health-care costs associated with the treatment of moderate-to-severe psoriasis with etanercept appear to be equivalent to those with adalimumab in the first year of treatment.

Un sistema económico de fluoruración del agua en communidades rurales / An economic system of water fluoridation in rural communities

A gravity-operated mechanism for measuring fluoride dosage is described. It would be suitable for rural areas and communities which lack the funds to purchase an electric mechanism, or which have not electricity

The fluoridator described has functioned with proved accuracy for the four years of the test, in a community whose aqueduct has a constant flow of 12 liters per second and whose population is 4,500 inhabitants

The cost of the accessories and tanks which make up the fluoridator is only 2,420 Colombian pesos, or US$138.28

The fluoridator parts are simple, easy to obtain, economical and safe. These qualities make it feasible to build and use in any area. Moreover, because of its simplicity, and ordinary workman can operate it with easily understood instructions and with the assurance that there is no risk of any kind(AU)

Un sistema económico de fluoruración del agua en communidades rurales / An economic system of water fluoridation in rural communities

A gravity-operated mechanism for measuring fluoride dosage is described. It would be suitable for rural areas and communities which lack the funds to purchase an electric mechanism, or which have not electricity

The fluoridator described has functioned with proved accuracy for the four years of the test, in a community whose aqueduct has a constant flow of 12 liters per second and whose population is 4,500 inhabitants

The cost of the accessories and tanks which make up the fluoridator is only 2,420 Colombian pesos, or US$138.28

The fluoridator parts are simple, easy to obtain, economical and safe. These qualities make it feasible to build and use in any area. Moreover, because of its simplicity, and ordinary workman can operate it with easily understood instructions and with the assurance that there is no risk of any kind(AU)