Pharmacoeconomics of medicines used for geriatric individuals in a tertiary care hospital in Delhi.

BACKGROUND OBJECTIVES: Expenditure on healthcare is a major concern in the geriatric age group. The current study was carried out to assess the expenditure patterns on medicines utilized in geriatric inpatients. METHODS: An observational study was conducted on 1000 geriatric inpatients, aged ≥60 yr, admitted to the medicine unit. Data were collected regarding demographic characteristics, prescribed medicines, expenditure incurred on medicines, appropriateness of medicines prescribed and adverse drug reactions (ADRs). Appropriateness of the prescribed medicines was determined using the American Geriatrics Society 2015 Updated Beers Criteria. RESULTS: Geriatric inpatients comprised 41.3 per cent of the total individuals admitted in the ward during the study period. A total of 8366 medicines were prescribed in 127 formulations. The total expenditure on prescribed medicines was INR 1,087,175 with a per capita expenditure of INR 1087.17. Parenteral medicines accounted for 91 per cent of the expenditure on medicines. Maximum expenditure (70%) was incurred on 11.9 per cent of the medicines prescribed. The per capita expenditure was significantly higher in individuals with comorbidities (P=0.03) and those who had a longer duration of hospital stay (P<0.0001). About 28.1 per cent prescriptions were inappropriate. ADRs (140) were observed in 139 (13.9%) inpatients. Individuals with inappropriate medicines prescriptions and ADRs had a longer duration of hospital stay and more number of medicines prescribed. INTERPRETATION CONCLUSIONS: Comorbidities, prolonged hospitalization, polypharmacy, inappropriate medicines and parenteral medicines being prescribed contribute to increased expenditure on medicines in geriatric inpatients. In view of the rising number of geriatric inpatients, there is a need to frame a drug policy for them along with surveillance of expenditure on prescribed medicines. This needs to be treated as a priority.

Evaluating the cost utility of estradiol plus dydrogesterone for the treatment of menopausal women in China.

AIM: Evaluate the cost utility of menopausal hormone therapy for women in China. MATERIALS AND METHODS: A bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China's Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks. RESULTS: According to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of -7,184$ (-47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China. CONCLUSION: Contingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.

Menopausal hormone therapy is publicly funded in many countries to alleviate symptoms of menopause; however, uptake has been comparatively slow in China. This has implications for the estimated 168 million menopausal-aged women. This analysis is the first to evaluate the cost effectiveness of menopausal hormone therapy in China using best practice principles and incorporating longer term disease risks. Menopausal hormone therapy is potentially cost saving in the context of China.

Comparative Pharmacoeconomic Effectiveness of Interleukin-17 Inhibitors for the Treatment of Ankylosing Spondylitis.

The objective of this study was to compare the clinical efficacy and cost-effectiveness of IL-17 inhibitors (SEC, IXE, NTK) in the treatment of adult patients with ankylosing spondylitis (AS) in the healthcare system of the Russian Federation. Materials and methods. The study is a sub-analysis of a previously published systematic review and network meta-analysis of the comparative efficacy of biologics in adult patients with AS in the Russian Federation. NNT values were calculated for BASDAI 50 and ASAS 20/40 after 16 weeks of therapy for all studied drugs. CpR was estimated for each biologic after 16 weeks and one year of therapy. Additionally, we carried out an assessment of the financial burden of the most cost-effective strategies for the treatment of AS. The use of NTK is characterized by an average of no more than three patients needed to treat to achieve one ASAS 20/40 or BASDAI 50 response, while on IXE and SEC no more than 4-5 patients need to be treated, depending on the estimated effectiveness criterion. According to CpR estimate, NTK is the most cost-effective IL-17 inhibitor for the treatment of AS, both after 16 weeks and after one year of therapy. The obtained results make it possible to compare the effectiveness of IL-17 inhibitors from a clinical and economic points of view and can be used both in decision making on treatment strategies for individual patients and at the population level when deciding on the reimbursement of drugs.

Pharmacoeconomic issues in stem cell mobilization.

BACKGROUND: recently, stem cell mobilization has made dramatic progress, that ended up in an increasing number of aphereses at target for autologous peripheral stem cell transplantation (ASCT). The aim of this research is investigating the cost-effectiveness of stem cell mobilization. METHODS: a narrative review of the literature was carried out, searching for primary contributions written in English and published during 2000-2023 on cost-effectiveness analysis (CEA) of stem cell mobilization in patients entitled to ASCT. The PubMed database was searched with the following sets of keywords: cost-effectiveness AND apheresis AND myeloma (PubMed_1); cost-effectiveness AND stem cell mobilization (PubMed_2). Articles included in the analysis were assessed via two different checklists. RESULTS: sixty-six entries were retrieved. Five out of 66 (PubMed_1: 4 out 17; PubMed_2: 1 out of 49), 4 CEAs and 1 cost-utility analysis (CUA) fit the research goal. Four out of 5 contributions proved to be in line with most of the items included in the two assessment grids. However, the most relevant missing features in some of the included contributions were: study perspective, healthcare resources valuation, and sensitivity analyses. DISCUSSION: most of the articles included in this research show that chemotherapy-free stem cell mobilization is cost-effective according to different standpoints. Future health economic research on this topic should establish local threshold values for incremental apheresis at target and explore the heterogeneity of CEA (and CUA) to determine oncohaematological diseases and patient categories for which chemotherapy-free stem cell mobilization is cost-effective in different healthcare systems, given local budget constraints.

Interventional pharmacoeconomics for immune checkpoint inhibitors through alternative dosing strategies.

Immune checkpoint inhibitors (ICIs) are approved for the treatment of a variety of cancer types. The doses of these drugs, though approved by the Food and Drug Administration (FDA), have never been optimised, likely leading to significantly higher doses than required for optimal efficacy. Dose optimisation would hypothetically decrease the risk, severity, and duration of immune-related adverse events, as well as provide an opportunity to reduce costs through interventional pharmacoeconomic strategies such as off-label dose reductions or less frequent dosing. We summarise existing evidence for ICI dose optimisation to advocate for the role of interventional pharmacoeconomics.

An Industry Survey on Unmet Needs in South Korea's New Drug Listing System.

INTRODUCTION: Since introducing the positive listing system in 2007, the South Korean government has undergone multiple changes in its drug listing system. As there is a lack of studies that evaluate the system from an industry perspective, this paper examined South Korea's new drug listing system from the suppliers' perspective. METHODS: We surveyed members of the three main pharmaceutical industry associations online. The survey (a 5-point Likert scale) covered their satisfactory levels, demands, and updates on the current new drug listing system, especially pharmacoeconomic evaluation, pharmacoeconomic evaluation exemption, and risk-sharing agreement. RESULTS: A total of 56 respondents participated in the survey. The self-reported satisfaction level for value recognition of new drugs was 1.6 (± 0.7) points (5 points = very satisfied). The most highly demanded reforms for PE, RSA, and PEE were incremental cost-effectiveness ratio threshold (92.9%), reimbursement scope expansion (91.1%), and eligible disease (83.9%). Lastly, they also claimed that the indication-based pricing system must be introduced (83.9%). CONCLUSIONS: Pricing and reimbursement policies need to improve in such a way that would enable better access to new drugs while still facilitating their development. Given the nature of the current system, some innovative rare disease treatments and anticancer drugs remain unreimbursed, resulting in low satisfaction levels across the pharmaceutical industry. Hence, pathways to speed up the reimbursement assessment process and expand the range of reimbursable diseases are required. Pharmaceutical companies are also important stakeholders, like in the case of clinicians and patients, and their opinions should also be considered in the process of pricing and reimbursement policy reforms.

Pharmacoeconomics of novel pharmacotherapies in triple-negative breast cancer.

INTRODUCTION: Triple-negative breast cancer (TNBC) represents the most aggressive breast cancer subtype carrying unfavorable clinical outcomes. Although traditionally chemotherapy has represented the only systemic treatment option available, novel drugs have changed the treatment landscape, granting approval by regulatory agencies worldwide, while determining new economic struggles on health systems for their high prices. AREAS COVERED: In this review, we provided a comprehensive analysis of pharmacoeconomic studies of drugs recently approved in the early and advanced settings of TNBC. EXPERT OPINION: Novel systemic treatment options redefined the therapeutic algorithms for TNBC by establishing new paradigms, based on substantial clinical benefits. Pembrolizumab and olaparib in the curative setting portend high value, as shown with the use of value frameworks, resulting in cost-effective interventions. In the metastatic setting, new drugs have demonstrated mixed improvements in patient-centric end-points, resulting often in interventions unlikely to have good value for money. We believe that cost-effectiveness alone is not a metric to inform the opportunity to invest on new interventions, while the intrinsic value of medicines should be the driver of the decisions. We endorse a patient-centric priority setting that can ensure health system sustainability, to timely deliver innovative cancer care to all in need and positively impact on population health.

Pharmacokinetic approach in therapeutic monitoring of antineoplastic drugs and the impact on pharmacoeconomics: A systematic review.

OBJECTIVES: Therapeutic drug monitoring aims to quantify the concentration of a drug in a biological matrix. In oncology, the therapeutic arsenal is vast and therapeutic drug monitoring optimizes treatment and reduces costs. This review will analyze the financial impact of therapeutic monitoring of anticancer drugs in healthcare institutions. METHODS: Keywords were selected using Decs (MeSH). Through the Pubmed, Scopus, and Virtual Health Library (VHL) databases, 74 articles were found, of which 4 meet the inclusion criteria. Methodological quality and risk of bias were assessed according to the Research Triangle Institute Item Bank (RTI-Item Bank) scale. KEY FINDINGS: Therapeutic drug monitoring is an important tool for dose reduction or dose increase due to toxicity and lack of response, respectively. The main barriers are associated costs and lack of cost-benefit data. An alternative is to use population pharmacokinetic models, measured plasma concentration(s) and relevant patient characteristics, estimated individual pharmacokinetic parameters, and predicted drug concentrations at any point in the dosing range. CONCLUSIONS: Therapeutic drug monitoring is understood as a technology that adds costs to payers. Future studies should generate clinical evidence of population pharmacokinetics from therapeutic drug monitoring studies.

Effect of the copayment reduction system on accessibility to orphan drugs in South Korea.

OBJECTIVE: This study aims to analyze the effect of the copayment reduction system on accessibility to orphan drugs (ODs) in South Korea. METHODS: Data on approval and reimbursement for drugs designated as ODs for the last 10 years (2012-2021) in South Korea were extracted. Among them, with 136 approved products as of 31 December 2022, the reimbursement rates and lead time to reimbursement between drugs for rare diseases (DRDs) and nondrugs for rare diseases (non-DRDs) were analyzed. The pricing and reimbursement (P&R) pathways between drugs for only rare diseases (DORDs) and drugs for rare and cancerous diseases (DRCDs) were compared. RESULTS: The reimbursement rates for DRDs and non-DRDs were 54.8% and 33.3%, respectively, and the lead time to reimbursement for DRDs and non-DRDs were 16.1 months and 31.2 months, respectively. The P&R pathways for DORDs and DRCDs were pharmacoeconomic evaluation waivers (21.7% and 52.6%), weighted average price (52.2% and 13.2%), and risk-sharing agreement (30.4% and 81.6%). CONCLUSION: The copayment reduction system may act as a driver and also barrier for the reimbursement of ODs. To expand treatment accessibility to ODs, it is necessary to consistently grants benefits in all processes from OD designation to market access.

Multinational Analysis of Estimated Health Care Costs Related to Extended-Interval Fixed Dosing of Checkpoint Inhibitors.

Importance: New dosing options for immune checkpoint inhibitors have recently been approved by the US Food and Drug Administration (FDA), including fixed dosing with extended intervals. Although the dose intensity appears the same, there is expected to be some waste with extended-interval dosing, as some drug remains in the bloodstream once a decision to stop treatment is made. The economic impact of extended-interval fixed dosing is unknown compared with standard-interval fixed dosing. Objective: To analyze the potential health care costs of using extended-interval fixed dosing instead of standard-interval fixed dosing. Design, Setting, and Participants: This economic evaluation used a pharmacoeconomic model to simulate 2 cohorts of patients with platinum-resistant metastatic urothelial cancer receiving pembrolizumab as second-line therapy at different dosing intervals using 2020 pricing data. Data were analyzed from 2020 to 2022. Exposures: The simulated patients received FDA-approved regimens of either 200 mg every 3 weeks or 400 mg every 6 weeks. Main Outcomes and Measures: The progression-free survival curve from the KEYNOTE-045 trial was used to estimate treatment duration. Drug, imaging, and administration costs were included in analyses. Sensitivity analyses were performed to assess how different imaging frequencies would affect the model results. The potential overall costs of using the 2 different dosing strategies were assessed. The base case was set in the US, while sensitivity analyses were set in several other countries. Results: In the base case analysis, dosing every 6 weeks instead of every 3 weeks resulted in an estimated 8.9% increase in pembrolizumab costs for the health care payer. Accounting for a decrease in infusion costs would result in an estimated net additional cost of $7483 per patient in the US (7.9% cost increase). In the US, this would amount to an increase of approximately $28 million annually for health care payers. Similar percentages in cost estimate increases were found for health care payers around the world, such as in Israel, where the net additional cost would be $5491 per patient. Conclusions and Relevance: This economic evaluation assessed and quantified the potential increased costs related to extended-interval fixed dosing of pembrolizumab. The model method could be applied to other diseases and other drugs for which there has been a movement toward extended-interval dosing. Results may differ in other diseases owing to differing disease courses and patient profiles.

Boletín de salud y economía. Edición N° 1 - Año 2 / Health and economy bulletin. Edition N° 2 - Year 1

La proporciona los resultados de sus estudios, trabajos de investigación, evaluaciones y similares en la que se presenten temas que vinculen la Salud y Economía, tales como: a) Producción, b) Financiamiento, c) Evaluaciones económicas, d) Inversiones, e) Costos, f) Presupuestos, g) Aseguramiento en Salud, h) Procesos, i) Tecnología en Salud, j) Atención Primaria y Hospitalaria, k) Farmacoeconomía, l) Capital Humano e Intelectual, entre otros, correspondiente a Enero 2023.

Intervenções farmacêuticas em Unidade de Pronto Atendimento: uma análise farmacoterapêutica e farmacoeconômica / Pharmaceutical interventions in Emergency Care Unit: a pharmacotherapeutic and pharmacoeconomic analysis

Objetivo: Esclarecer o impacto farmacoterapêutico e farmacoeconômico das intervenções farmacêuticas em serviços de urgência e emergência. Métodos: Estudo de intervenção conduzido em uma Unidade de Pronto Atendimento. Os pacientes admitidos na pesquisa receberam acompanhamento farmacoterapêutico por meio de avaliação e intervenção na farmacoterapia. Resultados: Participaram do estudo 197 pacientes majoritariamente feminino, comórbidos, com média de idade de 43 anos ± 13. Foram realizadas intervenções em 130 destes, com aceitação de 83% por parte da equipe de assistência. As intervenções também repercutiram na farmacoeconomia, proporcionando uma redução de custos de 35% em comparação ao semestre anterior. Conclusão: Nossos resultados expressaram que a presença do farmacêutico clínico é essencial para farmacoterapias otimizadas e redução de custos hospitalares.

Objective: To clarify pharmaceutical interventions' pharmacotherapeutic and pharmacoeconomic impact on urgent and emergency services. Methods: Intervention study conducted in an Emergency Care Unit. Patients enrolled in the research received pharmacotherapeutic follow-up through evaluation and intervention in pharmacotherapy. Results: One hundred and ninety seven patients, mostly female, with comorbid conditions, with a mean age of 43 years ± 13, participated in the study. Interventions were performed in 130 of them, with an acceptance of 83% by the care team. The interventions also impacted pharmacoeconomics, providing a cost reduction of 35% compared to the previous semester. Conclusion: Our results expressed that the presence of the clinical pharmacist is essential for optimized pharmacotherapies and hospital cost reduction.

Análise de custo-efetividade do uso de inibidores da via de sinalização mTOR x micofenolato em receptores de transplante renal sem profilaxia para citomegalovírus s / Cost-effectiveness analysis of the use of mTOR signaling pathway inhibitors x mycophenolate in kidney transplantation recipients without cytomegalovirus prophylaxis

Objetivo: Avaliar a relação de custo-efetividade dos regimes imunossupressores utilizados em pacientes receptores de transplante renal, no Hospital Santa Casa de Misericórdia de Juiz de Fora, MG, basiliximabe, micofenolato de sódio, tacrolimo e prednisona (Grupo 1 = 93 pacientes), comparados com a associação de timoglobulina, everolimo, tacrolimo e prednisona (Grupo 2 = 91 pacientes). Métodos: Para a análise farmacoeconômica, foi utilizado o modelo de Árvore de Decisão, desenvolvido no software Treeage Suite 2011. Foi considerada uma coorte real de pacientes submetidos ao transplante renal entre janeiro de 2013 e março de 2017, os quais foram acompanhados por um período de um ano, sendo mensurados os benefícios clínicos, bem como os custos associados, na perspectiva do Sistema Único de Saúde. O método de custeio utilizado foi o botton-up. Foram adotados os limiares de custo-efetividade (LCEs) equivalentes a 1 PIB per capita e 1 a 3 PIB, considerando o ano de 2017. Resultados: No que diz respeito à sobrevida, a RCEI foi de cerca de R$ 214.234,12 para 1 ano de vida ganho. Em relação aos eventos adversos, a RCEI foi de cerca de R$ 43.682,98 para 1 ano sem incidência de eventos adversos. Conclusões: Ao avaliar a sobrevida e a incidência de eventos adversos, timoglobulina+everolimo não é considerado custo-efetivo em relação ao esquema contendo basiliximabe+micofenolato de sódio diante do LCE de 1 PIB per capita. No entanto, ao adotarmos o LCE até 3 PIB per capita, o regime contendo moglobulina+everolimo é custo-efetivo, ultrapassando cerca de 38% do PIB per capita.

Objective: Evaluate the cost-effectiveness of immunosuppressive regimens used in kidney transplant recipients at the Santa Casa de Misericórdia, Hospital in Juiz de Fora, MG, compared with basiliximab, mycophenolate sodium, tacrolimus and prednisone (Group 1 = 93 patients) with the association of thymoglobulin, everolimus, tacrolimus and prednisone (Group 2 = 91 patients). Methods: For the pharmacoeconomic analysis, the Decision Tree model was used, developed in the TreeAge Suite 2011 software. A real cohort of patients undergoing kidney transplantation between January 2013 and March 2017 was considered, they were followed up for a period of 1 year, where the clinical benefits were measured, as well as the associated costs, from the perspective

Transição de via de linezolida endovenosa para via oral: uma análise de custo-minimização / Switching from intravenous to oral linezolid therapy: a cost-minimization analysis

Objetivo: Comparar custos da terapia endovenosa exclusiva com linezolida com os custos da terapia iniciada por via endovenosa com transição para via oral após 72 horas, como estratégia de intervenção em programas de gestão de antimicrobianos. Métodos: Avaliação econômica de custo-minimização comparando custos diretos da terapia endovenosa exclusiva com linezolida com a terapia endovenosa seguida de transição para via oral em cenário simulado, sob a perspectiva do Sistema Único de Saúde (SUS), com árvore de decisão como modelo para tomada de decisão. Resultados: A alternativa englobando a transição de via mostrou-se a mais econômica em todos os cenários analisados. Para 28 dias de tratamento com linezolida, houve redução de 22% nos custos, considerando o paciente internado. Ao considerar alta após o sexto dia de tratamento, a redução de custos variou de 26%, com financiamento pelo SUS do restante do tratamento, a 84%, com financiamento do tratamento pós-alta pelo paciente. Conclusão: Conclui-se que a transição de via de linezolida é uma importante estratégia nos programas de gerenciamento de antimicrobianos, capaz de gerar economia significativa para a instituição. As avaliações econômicas de custo-minimização, nesse contexto, são uma importante ferramenta para demonstrar o aspecto econômico com potencial para sensibilizar gestores e tomadores de decisão.

Objective: To compare the direct costs of linezolid intravenous therapy with the costs of intravenous therapy switching to oral therapy after 72 hours as an intervention strategy in antimicrobial stewardship programs. Methods: Economic evaluation cost-minimization comparing direct costs of exclusive linezolid intravenous therapy with intravenous therapy for 72 hours and after switching to oral therapy in a simulated scenario, from the perspective of the National Health Service, with a decision tree as a decision modeling. Results: The alternative encompassing the therapy transition proved to be the most economical in all analyzed scenarios. For 28 days of treatment with linezolid, there was a 22% reduction in costs, considering the hospitalized patient. When considering discharge after the sixth day of treatment, the cost reduction ranged from 26%, with funding from the National Health Service for the rest of the treatment, to 84%, with funding for the post-discharge treatment by the patient. Conclusion: It was concluded that the linezolid therapy transition is an important strategy in antimicrobial management programs, capable of generating significant savings for the institution. In this context, economic cost-minimization assessments are an important tool to demonstrate the economic aspect with the potential to raise awareness among managers and decision-makers.

A scoping review on patient heterogeneity in economic evaluations of precision medicine based on basket trials.

INTRODUCTION: Considerable challenges in the economic evaluation of precision medicines have been mentioned in previous studies. However, they have not addressed how an economic assessment would be conducted based on basket trials (novel studies for evaluation of precision medicine effects) in which the included populations have specific biomarkers and various cancers. Since basket trial populations have remarkable heterogeneity, this study aims to investigate the concept of heterogeneity and specific method(s) for considering it in economic evaluations through guidelines and studies that could be applicable in economic evaluation based on basket trials. AREA COVERED: We searched PubMed, Web of Science, Scopus, Google Scholar, and Google to find studies and pharmacoeconomics guidelines. The inclusion criteria included subjects of patient heterogeneity and suggested explicit method(s). Thirty-nine guidelines and 43 studies were included and evaluated. None of these materials mentioned disease types in a target population as a factor causing heterogeneity. Moreover, in economic evaluations, patient heterogeneity has been considered with four general approaches subgroup analysis, individual-based models, sensitivity analysis, and regression models. EXPERT OPINION: Type of disease is not considered a contributing factor in population heterogeneity, and the probable appropriate method for this issue could be individual-based models.

[Pharmacoeconomic evaluation of Xiangju Capsules in treatment of chronic rhinosinusitis].

Chronic rhinosinusitis refers to the non-specific inflammation that occurs in the nasal mucosa and sinuses, with clinical manifestations of mucopurulent nasal discharge, nasal congestion, hyposmia or anosmia, and head and face swelling pain.This disease has a long course and is prone to recurrence, which seriously affects the physical and mental health and quality of life of patients.Xiangju Capsules, prepared from infructescence of Platycarya strobilacea(without seeds), Prunellae Spica, Magnoliae Flos, Chuan-xiong Rhizoma, Angelicae Dahuricae Radix, Chrysanthemi Indici Flos, Astragali Radix, etc., are effective in dispelling wind by pungency and dispersing, clearing heat, and relieving orifices, and has good efficacy and safety in the clinical treatment of acute and chronic rhinosinusitis and rhinitis.From the perspective of the health system, an economic evaluation model was constructed based on the Meta-analysis of the effectiveness of Xiangju Capsules in the treatment of chronic rhinosinusitis to discuss the economic efficiency of Xiangju Capsules in combination with conventional treatment or conventional treatment alone in patients with chronic rhinosinusitis.The model simulation results showed that 53 days(average course of treatment) after treatment, Xiangju Capsules combined with conventional treatment had higher cost and higher output, with an incremental cost-effectiveness ratio of CNY 263.71, about 0.82% of per capita disposable income.As revealed by sensitivity analysis results, the research results were robust.As indicated by the findings of this study, Xiangju Capsules combined with conventional treatment for chronic rhinosinusitis patients were more economical than conventional treatment alone based on the assumption that the per capita disposable income of Chinese people in 2020 was the threshold of patients' willingness to pay.

Estudios farmacoeconómicos en Cuba en los últimos 20 años / Pharmacoeconomic studies in Cuba in the last 20 years

Introducción: Cuba es un país con desarrollo en el área biotecnológica y de medicamentos, donde los estudios farmacoeconómicos aportan evidencia significativa para la toma de decisiones, principalmente en la actualidad que el país se encuentra inmerso en la Tarea ordenamiento y a la vez es afectado por la pandemia del nuevo coronavirus. Objetivo: Caracterizar los estudios farmacoeconómicos en Cuba en los últimos 20 años. Métodos: Se realizó una investigación bibliométrica para la que se recuperó la producción científica cubana sobre farmacoeconomía en la base de datos Scopus del periodo 2001-2020. Se utilizaron indicadores bibliométricos para obtener número de documentos, años de publicación, fuentes, colaboración, tipo y patrones de colaboración institucional y de países, así como coocurrencia de palabras clave. Resultados: Se recuperaron 648 documentos. El año más productivo fue 2010. Los documentos se publicaron en 273 revistas, 17 (6,2 por ciento) cubanas y 256 (93,8 por ciento) extranjeras. Hubo 449 (69,3 por ciento) documentos en colaboración institucional y 199 (30,7 por ciento) sin colaboración. Las instituciones más productivas fueron Centro de Ingeniería Genética y Biotecnología 82 (12,7 por ciento) y Centro de Inmunología Molecular, 77 (11,9 por ciento). La red de colaboración entre países mostró tres áreas definidas, Latinoamérica, Norteamérica-Europa-India y España. Los temas más publicados fueron efectividad y seguridad de medicamentos, las vacunas y los relacionados con el cáncer. Conclusiones: Las publicaciones se caracterizaron por ser en colaboración, con ligero predominio de las nacionales sobre las internacionales. Es necesario ampliar la realización de evaluaciones económicas completas(AU)

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 (6.2percent) Cuban ones and 256 (93.8percent) foreign. There were 449 documents (69.3percent) in institutional collaboration and 199 (30.7percent) without collaboration. The most productive institutions were the Center for Genetic Engineering and Biotechnology with 82 (12.7percent) and the Center of Molecular Immunology, with 77 (11.9percent). 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(AU)

Disposição a pagar e Método de Valoração Contingente na avaliação econômica de serviços farmacêuticos / Willingness to pay and Contingent Valuation Method in the economic evaluation of pharmacy services

Objetivo: Sintetizar os principais pontos abordados em investigações de Disposição a Pagar (DAP) por serviços farmacêuticos, com foco no Método de Valoração Contingente (MVC). Métodos: Foi realizada uma revisão não sistemática com recuperação e análise de manuscritos publicados até novembro de 2020. A busca por estudos ocorreu nas bases MEDLINE, LILACS e SciELO. Resultados: Foram discutidos os fundamentos teóricos e processos metodológicos da análise, apresentando o MVC como principal perspectiva de abordagem. Enquanto delineamento do questionário, é sugerida uma estrutura que apresente, sequencialmente, os elementos: "conhecimento do participante sobre a intervenção", "apresentação da intervenção", "cenário hipotético", "pergunta DAP", "estado de saúde percebido" e "informações socioeconômicas". No mais, é enfatizada a importância da execução de etapas de validação, tanto do instrumento quanto da avaliação. Conclusão: Avaliar a preferência declarada da população por serviços farmacêuticos é uma estratégia ainda limitada. Se realizado adequadamente, esse tipo de investigação pode auxiliar gestores e tomadores de decisão no processo de implementação de novas tecnologias de cuidado.

Objective: To synthesize key points addressed in investigations of Willingness to Pay (WTP) for pharmaceutical care services, focusing on the Contingent Valuation Method (CVM). Methods: We performed a non-systematic review with recovery and analysis of manuscript published until November 2020. Three databases were majorly searched, including MEDLINE, LILACS and SciELO. Results: The theoretical foundations and methodological process were discussed, presenting the CVM as the main perspective. For questionnaire design, is suggested a structure that sequentially presents the elements: "participant knowledge on intervention", "intervention presentation", "hypothetical scenario", "WTP question", "perceived health status", and "socioeconomic information". In addition, we emphasize the importance of executing validation steps for the instrument of measurement as well as the evaluation process. Conclusion: Assessing the population's declared preference for pharmaceutical services is still a limited strategy. If carried out properly, this type of investigation can help managers and decision makers in the process of implementing technologies of care.

Policy Updates on Access to and Affordability of Innovative Medicines in China.

INTRODUCTION: In China, efforts to qualify innovative medical products for reimbursement used to be subject to substantial delays after regulatory approval due to fiscal and bureaucratic barriers. In this review, we surveyed the Chinese government's most recent initiatives to improve access to innovative medicines from both the regulatory and the reimbursement aspects, which not only accelerated the launching of drugs in the Chinese market but also expanded the reimbursement coverage of such products. We also provided a discussion of the current challenges. AREAS COVERED: We provided a comprehensive review of the updates in China's national reimbursement listing policies of medicines. EXPERT OPINION: As the most recognized regulatory shortcuts, priority and conditional approvals have expedited the authorization of many innovative medicines. In addition, the national negotiation process was institutionalized to enable timely access to innovative medicines through the National Reimbursement Drug List, leading examples of which were new anticancer drugs. Other impactful reimbursement policies in recent years included dynamic updates of the National Reimbursement Drug List, manufacturer-initiated reimbursement coverage applications, and parallel fund robustness tests and pharmacoeconomic analyses for price estimation. Recent administrative efforts have substantially improved the access to and affordability of innovative medicines in China. Nevertheless, standardized and transparent evidence appraisal processes need to be established for informed decision making in the future.