Ivacaftor for cystic fibrosis: An evaluation of real world utilisation and expenditure in the Irish Healthcare Setting.

In Ireland, Ivacaftor is reimbursed, on the High-Tech Drug Scheme, for the treatment of cystic fibrosis in patients age 6 years and older who have the G551D mutation. The aim of this study was to analyse the utilisation and expenditure of Ivacaftor on this scheme in the 12 month period post-reimbursement. All patients who had received Ivacaftor (regardless of General Medical Services Scheme eligibility/ineligibility) were included. A total of 140 individuals (male=74; 53%) received Ivacaftor over the defined 12 month study period (from January 2015 to December 2015 inclusive). The cohort ranged in age from 6 years to 61 years. The mean age was 22 years; a positive skew in age distribution indicated that a greater number of the cohort were in the younger age groups. No statistically significant difference was detected in the mean ages of the male and female subgroups. Drug acquisition expenditure by the Health Services Executive on Ivacaftor over the 12 month study period was €29.81 million.

Assessing the need for anesthesia and sedation in the general population.

The authors used a national telephone survey to examine the relationship between dental anxiety and the use of pain and anxiety control measures in the general population. Nearly 30 percent of respondents reported being somewhat nervous, very nervous or terrified about going to the dentist. There was a threefold difference between the reported use of anesthesia and sedation and respondents' preference for these treatment modalities. These data suggest that fear of dentistry is still prevalent and that patients who are fearful would seek oral health care more regularly if general anesthesia or conscious sedation were more readily available.