Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 17.750
Filtrar
Mais filtros

Intervalo de ano de publicação
1.
Am J Manag Care ; 28(9): 427-428, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36121356

RESUMO

In the health spending debate, what policy makers need most is an honest, realistic, and evidence-based discussion. Unfortunately, many studies in the public arena fall far short.


Assuntos
Custos de Medicamentos , Política de Saúde , Humanos
2.
Clin Adv Hematol Oncol ; 20(9): 550-551, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36125945
6.
Rev Panam Salud Publica ; 46, mayo 2022. Special Issue HEARTS
Artigo em Espanhol | PAHOIRIS | ID: phr-56414

RESUMO

[RESUMEN]. Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos. La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.


[ABSTRACT]. The objectives of this article are to describe the interventions carried out by the Strategic Fund of the Pan American Health Organization to facilitate access to and availability of antihypertensive drugs and devices for measuring blood pressure in the countries of the Region of the Americas, supporting implementation of the HEARTS initiative; and to present the preliminary results of price analyses of antihypertensive drugs. The study methodology included a review of reports made by the Strategic Fund during 2019–2020, evaluation of modalities of procurement, a review of the public procurement databases for five antihypertensive drugs, and a comparison with the price obtained by the Strategic Fund. Differences ranging from 20% to 99% were identified, indicating significant opportunities for savings. Interprogrammatic actions in support of the HEARTS initiative are also presented, such as the inclusion of antihypertensive drugs recommended by the World Health Organization; consolidation of regional demand and establishment of competitive prices with long-term agreements to manage the procurement of quality generic products; and the definition of technical specifications and regulatory requirements to support the procurement of devices to measure blood pressure. Through this mechanism, Member States can reduce their costs significantly, enabling them to extend treatment and diagnostic coverage to more people.


[RESUMO]. Os objetivos deste artigo são descrever as intervenções realizadas pelo Fundo Estratégico da Organização Pan-Americana da Saúde para facilitar o acesso e a disponibilidade de medicamentos anti-hipertensivos e aparelhos de medição de pressão arterial aos países da Região das Américas, em apoio à implementação da iniciativa HEARTS; e apresentar os resultados preliminares da análise dos preços dos medicamentos anti-hipertensivos. A metodologia do estudo incluiu a revisão de relatórios feitos pelo Fundo Estratégico durante os anos de 2019 e 2020, a avaliação das modalidades de aquisição e revisão dos dados de compras públicas de 5 medicamentos anti-hipertensivos e uma análise comparativa com o preço obtido pelo Fundo Estratégico. Foram identificadas diferenças que oscilaram entre 20% e 99%, o que evidencia oportunidades de economia significativas. Da mesma forma, são apresentadas as ações interprogramáticas desenvolvidas em apoio à iniciativa HEARTS, entre as quais se destacam a inclusão de medicamentos anti-hipertensivos recomendados pela Organização Mundial da Saúde; a consolidação da demanda regional e o estabelecimento de preços competitivos com acordos de longo prazo para gerenciar a aquisição de genéricos de qualidade; e a definição de especificações técnicas e requisitos regulatórios para subsidiar a aquisição de aparelhos de medição de pressão arterial. Por meio desse mecanismo, os Estados Membros podem reduzir seus custos significativamente, ampliando a cobertura de tratamento e diagnóstico para atingir mais pessoas.


Assuntos
Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Anti-Hipertensivos , Fundo Estratégico , Custos de Medicamentos , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Anti-Hipertensivos , Fundo Estratégico , Custos de Medicamentos , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Anti-Hipertensivos , Fundo Estratégico , Custos de Medicamentos
8.
Front Public Health ; 10: 956823, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36033763

RESUMO

The availability and affordability of medicines remain major health challenges around the world. In March 2019, the Chinese government introduced a pilot National Centralized Drug Procurement (NCDP) program in order to reduce drug prices and improve the affordability of effective and safe medicines. This study aimed to assess the impact of NCDP policy on health expenditures of cancer patients. Using inpatient discharge records from a large hospital in the pilot city, we performed a difference-in-differences design to estimate the change in health expenditures before and after the policy. We found that the implementation of NCDP was associated with a significant decrease in total expenditures (14.13%) and drug expenditures (20.75%) per inpatient admission. There were also significant reductions in non-drug-related expenditures, including a 7.65% decrease in health service expenditures, a 38.28% decrease in diagnosis expenditures, and a 25.31% decrease in consumable material expenditures per inpatient admission. However, the NCDP implementation was associated with a 107.97% increase in the traditional Chinese medicine expenditures. Overall, the study provided evidence that the NCDP policy has achieved its goals of high-quality and affordable healthcare. The drug expenditures of lung cancer patients revealed a continuous decline, and the policy may have spillover effects on other healthcare expenditures. Further studies are needed to evaluate the long-term effects of NCDP on policy-related expenditures and health outcomes.


Assuntos
Gastos em Saúde , Neoplasias Pulmonares , Custos de Medicamentos , Humanos , Pacientes Internados , Centros de Atenção Terciária
11.
JAMA Health Forum ; 3(6): e221435, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35977245

RESUMO

This cross-sectional study assesses pharmacy participation in the 340B Drug Pricing Program following the 2010 expansion and the extent to which growth has occurred in socioeconomically disadvantaged neighborhoods.


Assuntos
Farmácias , Custos e Análise de Custo , Estudos Transversais , Custos de Medicamentos , Fatores Socioeconômicos
12.
Lancet ; 400(10352): 551-552, 2022 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-35988557
17.
Front Public Health ; 10: 947375, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937220

RESUMO

Background: The treatment paradigm of unresectable malignant pleural mesothelioma (MPM) has changed in recent years. Checkmate 743 demonstrate that nivolumab plus ipilimumab showed good clinical benefits compared with chemotherapy in the treatment of MPM. The study is aim to evaluate the cost-effectiveness of Nivolumab plus ipilimumab vs. platinum plus chemotherapy for the first-line treatment of unresectable MPM. Methods: A Markov model was developed to compare the cost and quality-adjusted life-year (QALY) of nivolumab plus ipilimumab and chemotherapy over a 10-year time horizon. Clinical efficacy and safety data were extracted from the CheckMate 743 trials. Health state utilities were obtained from published literature. Costs were collected from an US payer perspective. One-way and probabilistic sensitivity analyses were conducted to explore the impact of uncertainties on the cost-effectiveness's results. Results: In the base case analysis, the incremental healthcare costs and QALYs for Nivolumab plus Ipilimumab vs. chemotherapy are $196,604.22 and 0.53, respectively, resulting an incremental cost-effectiveness ratio (ICER) of $372,414.28/QALYs for the model cohort of patients with locally advanced or metastatic MPM. However, Probabilistic sensitivity analysis showed that there was no probability that Nivolumab plus ipilimumab was cost-effective within the fluctuation range of other model parameters in first-line in unresectable MPM. The results of one-way sensitivity analysis showed that the cost of Nivolumab was the most sensitive parameter. Conclusions: The ICER of Nivolumab plus ipilimumab is above the theoretical willingness-to-pay threshold in the U.S, which suggests that first-line nivolumab plus ipilimumab for unresectable MPM may be not a cost-effective choice.


Assuntos
Antineoplásicos Imunológicos , Ipilimumab , Mesotelioma Maligno , Nivolumabe , Antineoplásicos Imunológicos/efeitos adversos , Antineoplásicos Imunológicos/economia , Antineoplásicos Imunológicos/uso terapêutico , Análise Custo-Benefício , Custos de Medicamentos , Humanos , Ipilimumab/economia , Ipilimumab/uso terapêutico , Mesotelioma Maligno/tratamento farmacológico , Nivolumabe/economia , Nivolumabe/uso terapêutico , Anos de Vida Ajustados por Qualidade de Vida , Estados Unidos
20.
BMC Health Serv Res ; 22(1): 875, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799160

RESUMO

BACKGROUND: Several measures are in force in Switzerland to control the cost of drugs, but are not effective enough. There are many determinants influencing these expenditures, related to treatments, markets, physicians, patients and regions, but their impact on costs is not clear. METHODS: We applied a Bayesian multilevel model with five levels to adjust for patients, drugs' market, and physicians 'characteristics, treatment type, and district (i.e. Swiss canton). We used data of the Swiss drugs' market in 2006, offering real choices for doctors and patients (multiple products for similar active substances), with a neutral position of pharmacists (no financial incentives). RESULTS: Variance partitioning of yearly drugs' cost per insured showed that market level (delivered substance) contributed to 76% of the variance, treatment level (delivered product) to 20%, whereas patients' and physicians' levels accounted for only 2% each, without significant differences between Swiss cantons. After adjusting for covariables at each level, the model explained about 51% of the variation at the market and 20% at the treatment levels. We found that older but substitutable drugs, generics, larger size of the market and physician's specialty were associated with lower expenditure, whereas drugs requiring a physician's prescription, the number of prescribers per patient, patient' age, male gender, and comorbidities increased expenditure. Our results show that for a specific medication the yearly cost of recently released drugs was 36 CHF higher than for similar and substitutable drugs introduced 15 years earlier, corresponding to one third of the average annual treatment cost observed in our dataset. Competition did not seem to be effective to reduce expenditure on the drug market. CONCLUSION: The main finding of this study is that recentness of drugs was associated with an increase in drug expenditure in 2006, even after adjustment for all non-controllable determinants. Further research is recommended to confirm those results with updated data.


Assuntos
Setor de Assistência à Saúde , Gastos em Saúde , Teorema de Bayes , Custos de Medicamentos , Medicamentos Genéricos/uso terapêutico , Humanos , Masculino , Suíça
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA