Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of pu...Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.展开更多
AIM:To analyze the costs of cancer drugs administered in a Portuguese Hospital compared with the Karolinska Institute study.METHODS:To evaluate spending on cancer drugs, we retrospectively analyzed data on the overall...AIM:To analyze the costs of cancer drugs administered in a Portuguese Hospital compared with the Karolinska Institute study.METHODS:To evaluate spending on cancer drugs, we retrospectively analyzed data on the overall costs of cancer drugs, obtained at the Department of Medical Oncology of the Centro Hospitalar de Entre Douro e Vouga, between 2004 and 2010. In this comparative study we selected only drugs belonging to the following groups:chemotherapy, targeted therapy, immunotherapy and endocrine therapy. The selected drugs were further grouped according to their market placement year:≤ 1998, 1999 to 2002, 2003 to 2005, and 2006 to 2010. Drugs used as supportive therapy and bisphosphonates were excluded.RESULTS:The overall costs of cancer drugs increased gradually between 2004 and 2008(from €1911947 to €3666284), with an increase in the number of patients treated during this period. The expenditure decreased in 2009(€3438155) and increased again in 2010(€3673116), but the costs increment was not the same as in previous years. Chemotherapy and targeted therapy were responsible for most of the expenditure. Drugs placed on the national market before 1999 accounted for more than 50% of the expenditure up to 2007. From 2008, these drugs represented less than 50% of the total expenditure. Cancer drugs placed between 1999 and 2002 accounted for 25%-35% of the costs in all the years studied, while drugs placed between 2003 and 2005 accounted for less than 30%. Drugs placed between 2006 and 2010 were responsible for less than 10% of the expenditure.CONCLUSION:In this study, older drugs were responsible for most of the expenditure up to 2007, which is in agreement with the Karolinska study.展开更多
目的在决策树模型的基础上对宫颈癌化疗的药物进行药物经济学评价,确定期望成本最低、效果最佳的宫颈癌化疗方案,以期为临床宫颈癌化疗药物的合理搭配提供决策依据。方法采用决策树模型对顺铂+紫杉醇脂质体,拓扑替康+紫杉醇脂质体和顺铂...目的在决策树模型的基础上对宫颈癌化疗的药物进行药物经济学评价,确定期望成本最低、效果最佳的宫颈癌化疗方案,以期为临床宫颈癌化疗药物的合理搭配提供决策依据。方法采用决策树模型对顺铂+紫杉醇脂质体,拓扑替康+紫杉醇脂质体和顺铂+紫杉醇脂质体+贝伐珠单抗三种用药方案治疗宫颈癌进行成本-效果分析,成本参数来源于九江市第三人民医院药品信息系统,同时根据本项目的随机对照研究所获取的化疗效果参数评估三种化疗方案短期内的经济性,决策树模型模拟的干预时间为12周。采用Treeage Pro 2011软件进行概率敏感性分析(成本-效果可接受曲线)和单因素敏感性分析(旋风图),对研究结果进行稳健性验证。结果基础分析结果表明,顺铂+紫杉醇脂质体的增量成本-效果比为12329.8,顺铂+紫杉醇脂质体+贝伐珠单抗的增量成本-效果比为36290.9,拓扑替康+紫杉醇脂质体的增量成本-效果比为19113.7。单因素敏感性分析结果显示,顺铂+紫杉醇脂质体的治疗成本和临床有效率对研究结果有最显著影响;当患者的个人意愿支付价格低于7376.6元时,顺铂+紫杉醇脂质体干预方案更具有经济性;当患者个人意愿支付价格高于7376.6元后,使用拓扑替康+紫杉醇脂质体治疗宫颈癌更具有经济性。结论若以2022年人均可支配收入作为患者个人意愿支付价格,宫颈癌患者选用顺铂+紫杉醇脂质体方案治疗最具有经济性。展开更多
目的:通过对兰州大学第一医院胰岛素带量采购前后同期半年的用药情况进行分析,了解本院胰岛素使用情况及发展趋势,为临床胰岛素合理用药及治疗方案选择提供参考,探讨胰岛素带量采购对胰岛素的采购和使用的影响。方法:调取HIS系统胰岛素...目的:通过对兰州大学第一医院胰岛素带量采购前后同期半年的用药情况进行分析,了解本院胰岛素使用情况及发展趋势,为临床胰岛素合理用药及治疗方案选择提供参考,探讨胰岛素带量采购对胰岛素的采购和使用的影响。方法:调取HIS系统胰岛素带量采购实施前(2021年7月—12月)与实施后(2022年7月—12月)胰岛素的使用数据,按照世界卫生组织官网提供的胰岛素限定日剂量及相关胰岛素的说明书,确定各种胰岛素的限定日剂量(DDD)值,分别统计和计算胰岛素的用药频度(DDDs)、日均费用(DDC)、排序比、使用金额和用量等的数据。结果:带量采购后半年使用量较带量采购前上涨了21.20%,而销售金额下降了47.69%,DDDs值带量采购后上升的有14个品规,增幅较大的(变化幅度≥50%)的是谷赖胰岛素3 mL:300 IU (赛诺菲)和精蛋白锌重组赖脯胰岛素混合注射液(25R) 3 mL:300 IU (礼来);带量采购后,我院胰岛素的DDC值全部下降,降幅大于50%的品种有7个,其他品种的降幅也均大于30%,带量采购后序号比≥1的品种占比上升了11个百分点。结论:药品带量采购政策有助于形成合理的药品价格形成机制,药费的下降可以提高慢性病患者用药的持续性、依从性,也大大减轻医保和患者的经济负担,带量采购后甘精胰岛素和德谷胰岛素成为本院胰岛素用量的增长点,而精蛋白人胰岛素用量将有大幅度下降,需在下一年度胰岛素预采购量申报工作中进行调整。新引进的品种因为临床对其疗效、安全性等认知不足,抱有疑虑,造成使用量较少,后期还需药师大力宣传。展开更多
文摘Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.
文摘AIM:To analyze the costs of cancer drugs administered in a Portuguese Hospital compared with the Karolinska Institute study.METHODS:To evaluate spending on cancer drugs, we retrospectively analyzed data on the overall costs of cancer drugs, obtained at the Department of Medical Oncology of the Centro Hospitalar de Entre Douro e Vouga, between 2004 and 2010. In this comparative study we selected only drugs belonging to the following groups:chemotherapy, targeted therapy, immunotherapy and endocrine therapy. The selected drugs were further grouped according to their market placement year:≤ 1998, 1999 to 2002, 2003 to 2005, and 2006 to 2010. Drugs used as supportive therapy and bisphosphonates were excluded.RESULTS:The overall costs of cancer drugs increased gradually between 2004 and 2008(from €1911947 to €3666284), with an increase in the number of patients treated during this period. The expenditure decreased in 2009(€3438155) and increased again in 2010(€3673116), but the costs increment was not the same as in previous years. Chemotherapy and targeted therapy were responsible for most of the expenditure. Drugs placed on the national market before 1999 accounted for more than 50% of the expenditure up to 2007. From 2008, these drugs represented less than 50% of the total expenditure. Cancer drugs placed between 1999 and 2002 accounted for 25%-35% of the costs in all the years studied, while drugs placed between 2003 and 2005 accounted for less than 30%. Drugs placed between 2006 and 2010 were responsible for less than 10% of the expenditure.CONCLUSION:In this study, older drugs were responsible for most of the expenditure up to 2007, which is in agreement with the Karolinska study.
文摘目的在决策树模型的基础上对宫颈癌化疗的药物进行药物经济学评价,确定期望成本最低、效果最佳的宫颈癌化疗方案,以期为临床宫颈癌化疗药物的合理搭配提供决策依据。方法采用决策树模型对顺铂+紫杉醇脂质体,拓扑替康+紫杉醇脂质体和顺铂+紫杉醇脂质体+贝伐珠单抗三种用药方案治疗宫颈癌进行成本-效果分析,成本参数来源于九江市第三人民医院药品信息系统,同时根据本项目的随机对照研究所获取的化疗效果参数评估三种化疗方案短期内的经济性,决策树模型模拟的干预时间为12周。采用Treeage Pro 2011软件进行概率敏感性分析(成本-效果可接受曲线)和单因素敏感性分析(旋风图),对研究结果进行稳健性验证。结果基础分析结果表明,顺铂+紫杉醇脂质体的增量成本-效果比为12329.8,顺铂+紫杉醇脂质体+贝伐珠单抗的增量成本-效果比为36290.9,拓扑替康+紫杉醇脂质体的增量成本-效果比为19113.7。单因素敏感性分析结果显示,顺铂+紫杉醇脂质体的治疗成本和临床有效率对研究结果有最显著影响;当患者的个人意愿支付价格低于7376.6元时,顺铂+紫杉醇脂质体干预方案更具有经济性;当患者个人意愿支付价格高于7376.6元后,使用拓扑替康+紫杉醇脂质体治疗宫颈癌更具有经济性。结论若以2022年人均可支配收入作为患者个人意愿支付价格,宫颈癌患者选用顺铂+紫杉醇脂质体方案治疗最具有经济性。
文摘目的:通过对兰州大学第一医院胰岛素带量采购前后同期半年的用药情况进行分析,了解本院胰岛素使用情况及发展趋势,为临床胰岛素合理用药及治疗方案选择提供参考,探讨胰岛素带量采购对胰岛素的采购和使用的影响。方法:调取HIS系统胰岛素带量采购实施前(2021年7月—12月)与实施后(2022年7月—12月)胰岛素的使用数据,按照世界卫生组织官网提供的胰岛素限定日剂量及相关胰岛素的说明书,确定各种胰岛素的限定日剂量(DDD)值,分别统计和计算胰岛素的用药频度(DDDs)、日均费用(DDC)、排序比、使用金额和用量等的数据。结果:带量采购后半年使用量较带量采购前上涨了21.20%,而销售金额下降了47.69%,DDDs值带量采购后上升的有14个品规,增幅较大的(变化幅度≥50%)的是谷赖胰岛素3 mL:300 IU (赛诺菲)和精蛋白锌重组赖脯胰岛素混合注射液(25R) 3 mL:300 IU (礼来);带量采购后,我院胰岛素的DDC值全部下降,降幅大于50%的品种有7个,其他品种的降幅也均大于30%,带量采购后序号比≥1的品种占比上升了11个百分点。结论:药品带量采购政策有助于形成合理的药品价格形成机制,药费的下降可以提高慢性病患者用药的持续性、依从性,也大大减轻医保和患者的经济负担,带量采购后甘精胰岛素和德谷胰岛素成为本院胰岛素用量的增长点,而精蛋白人胰岛素用量将有大幅度下降,需在下一年度胰岛素预采购量申报工作中进行调整。新引进的品种因为临床对其疗效、安全性等认知不足,抱有疑虑,造成使用量较少,后期还需药师大力宣传。
