RESUMEN
The prescription of homeopathic remedies at the expense of the statutory health insurance (SHI) system in Germany has been criticized for years due to a lack of evidence. Now, on the planned abolition of the reimbursement of homeopathic medicines in Germany, the debate on this topic has been reignited. The aim of this paper is to show the costs and their development over time incurred by homeopathic remedies in the healthcare system from 1985 to 2021. For this purpose, 15 selected homeopathic medicines were chosen from the drug prescription report (Arzneiverordnungsreport) and analyzed with regard to their development of DDD (Defined Daily Dose) using data from the Wissenschaftliches Institut der Ortskrankenkassen (WidO, Scientific Institute of the General Local Health Insurance Funds) and compared with their respective rational pharmacological alternatives. The price comparison was based on the DDD costs and the pharmacy retail price of the smallest packaging in each case. The clinical study situation for the preparations was also analyzed. For this purpose, the clinical studies provided by the manufacturer and those on PubMed were divided into evidence levels and analyzed. In addition, the presentation of homeopathic remedies on company websites, in online pharmacies, in specialist information and package leaflets was analyzed with regard to side effects, interactions, indication, and information on the alleged effect/proof of efficacy. In many media, information on homeopathic medicines remained incomplete, and non-compliance with the Therapeutic Product Advertising Act (Heilmittelwerbegesetz) was noted. Naming of the products if often very suggestive, too. Manufacturers' claims of efficacy go far beyond what can be considered proven in terms of evidence-based medicine and the quality of most clinical studies is poor. Homeopathic remedies are on average significantly more expensive than their rational pharmacological alternatives. Furthermore, DDD costs have continued to rise over the years analyzed. In aggregate, from a pharmacoeconomic, legal, and scientific perspective, abolition of reimbursement of homeopathic medicines in Germany at the expense of the SHI system is well justified.
Asunto(s)
Homeopatía , Alemania , Humanos , Homeopatía/economía , Economía Farmacéutica , Costos de los Medicamentos/tendencias , Costos de los Medicamentos/legislación & jurisprudencia , Seguro de Salud/economía , Prescripciones de Medicamentos/economíaRESUMEN
OBJECTIVE: The aim: Pharmacoeconomic substantiation and marketing research of immunoprotective phytopreparations in Ukraine to substantiate rational pharmacotherapy of the effectiveness of immunomodulatory drugs of plant origin and pharmaceutical care of patients to strengthen individual immunity. PATIENTS AND METHODS: Materials and methods: Research materials - data from the State Register of Medicinal Products of Ukraine; information content of the Public Health Center of the Ministry of Health of Ukraine; data of the State Register of Wholesale Prices for medicines declared in Ukraine under the international non-proprietary or common name as of 01.01.2023. Research methods: theoretical analysis of scientific sources, systematic, retrospective, descriptive and frequency analysis of information resources of databases; pharmacoeconomic analysis, marketing analysis of positioning in the pharmaceutical market of Ukraine to substantiate rational pharmacotherapy and the effectiveness of immunomodulatory drugs of plant origin to strengthen individual immunity. RESULTS: Results: Theoretical analysis and pharmacoeconomic substantiation of rational pharmacotherapy of efficiency of application of drugs of immunomodulatory action of plant origin and pharmaceutical care for strengthening of individual immunity of patients is carried out. The algorithm of pharmacoeconomic analysis of the use of immunomodulatory phytopreparations to ensure rational pharmacotherapy and pharmaceutical care of outpatients is substantiated. To substantiate the availability of effective immunomodulatory phytopreparations for patients, marketing research on the use of immunomodulatory phytopreparations in Ukraine has been conducted. CONCLUSION: Conclusions: The theoretical analysis shows that the use of immunomodulatory drugs of plant origin is appropriate in rational pharmacotherapy to strengthen the individual immunity of patients, which is especially relevant in an exacerbation of the epidemic situation caused by the spread of infectious diseases of viral origin. An algorithm of pharmacoeconomic substantiation has been developed, which provides an opportunity to confirm the therapeutic efficacy and pharmacoeconomic feasibility of immunomodulatory phytopreparations for rational pharmacotherapy and pharmaceutical care of patients. The results of marketing research provide an opportunity to determine the availability (positioning and price range) for patients of effective immunomodulatory phytopreparations in Ukraine and outline the prospects for pharmaceutical development and registration on the pharmaceutical market of Ukraine of new effective immunomodulatory drugs of plant origin.
Asunto(s)
Economía Farmacéutica , Agentes Inmunomoduladores , Humanos , Estudios Retrospectivos , Mercadotecnía , Preparaciones FarmacéuticasRESUMEN
BACKGROUND: Coronary heart disease (CHD) is a cardiovascular disease caused by myocardial ischemia. In China, safflor yellow and artemisinin-based combination therapies have been extensively used to treat angina pectoris. METHODS: Efficacies were provided by a network meta-analysis following the PRISMA 2020 checklist. Cost-effectiveness analysis was based on patient perspectives. Two-way and probabilistic sensitivity analyses were conducted to assess the robustness of the study results. RESULTS: Conventional treatment combined with safflower is a better choice against angina pectoris. Sensitivity analysis showed that the model was sensitive to the treatment efficacy rather than the drug cost. CONCLUSION: Conventional treatment combined with safflower injection is suggested to treat angina pectoris. Low molecular weight heparin or compound Danshen-dropping pills can be used to increase the recovery rate of angina pectoris, according to conventional treatment combined with safflower injection.
Asunto(s)
Artemisininas , Medicamentos Herbarios Chinos , Angina de Pecho/tratamiento farmacológico , Artemisininas/uso terapéutico , Medicamentos Herbarios Chinos/uso terapéutico , Economía Farmacéutica , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Metaanálisis en RedRESUMEN
This study aims to investigate the efficacy, safety, and cost-effecctiveness of Qizhi Weitong Granules in the treatment of functional dyspepsia. Specifically, two commonly used clinical protocols for the treatment of functional dyspepsia were selected: Qizhi Weitong Granules+Mosapride vs Mosapride alone(control). Meta-analysis of previous clinical studies was performed to examine the efficacy and safety, and pharmacoeconomic evaluation was carried out according to the results of the Meta-analysis. The cost-effectiveness analysis was carried out to elucidated the incremental cost-effectiveness ratio(ICER), and the sensitivity was analyzed with tornado dia-gram and Monte Carlo simulation. The willingness-to-pay threshold of patients for functional dyspepsia was investigated and compared with the ICER to evaluate whether Qizhi Weitong Granules was cost-effective. The result showed that the effective rate of Qizhi Weitong Granules combined with Mosapride in the treatment of functional dyspepsia was 95.49%, which was higher than that of Mosapride alone(73.30%)(OR=8.52, 95%CI[4.36, 16.64])(P<0.000 1). The two groups showed no significant difference in safety. The price of Qizhi Weitong Granules+Mosapride was higher than that of Mosapride alone. The ICER was 640.29 CNY, 1 506.67 CNY lower than the willingness-to-pay threshold. The sensitivity analysis showed that the analysis results were relatively stable. Thus, Qizhi Weitong Granules+Mosapride is safe, effective, and economical in the treatment of functional dyspepsia, which should be further promoted in clinical settings.
Asunto(s)
Dispepsia , Benzamidas , Análisis Costo-Beneficio , Dispepsia/tratamiento farmacológico , Economía Farmacéutica , Fármacos Gastrointestinales/uso terapéutico , Humanos , Morfolinas , Resultado del TratamientoRESUMEN
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.
Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , Enfermedad Crónica , Economía Farmacéutica , Humanos , Pólipos Nasales/tratamiento farmacológico , Calidad de Vida , Rinitis/tratamiento farmacológico , Sinusitis/tratamiento farmacológicoRESUMEN
To evaluate the pharmacoeconomic value of Qidong Yixin Oral Liquid in the treatment of viral myocarditis(Qi-Yin deficiency syndrome) by supplementing Qi, nourishing the heart, calming the mind, and relieving palpitation, the present study performed the Meta-analysis based on the published papers on Qidong Yixin Oral Liquid by AMSTAR and carried out pharmacoeconomic evaluation using TreeAge Pro by the cost-effectiveness analysis. The results showed that the quality of the included papers was good. After four weeks of treatment, Qidong Yixin Oral Liquid combined with the conventional treatment regimen was superior to the conventional treatment in improving creatine kinase isoenzyme, and the difference was statistically significant. Furthermore, the treatment cost was also higher than that of conventional treatment, with an incremental cost-effectiveness ratio of CNY 95.89, accounting for 0.30% of per capita disposable income. The results of sensitivity analysis showed that the research results were robust. Therefore, based on the assumption that the per capita disposable income in 2020 was the threshold of patients' willingness to pay, it is more economical for patients with viral myocarditis to use Qidong Yixin Oral Liquid combined with conventional secondary prevention regimen than conventio-nal secondary prevention regimen alone. The economic evaluation of Qidong Yixin Oral Liquid in the treatment of viral myocarditis will help physicians and patients choose optimal treatment options, improve rational clinical medication, and provide references for the efficient allocation and utilization of medical resources in China.
Asunto(s)
Medicamentos Herbarios Chinos , Miocarditis , Análisis Costo-Beneficio , Medicamentos Herbarios Chinos/uso terapéutico , Economía Farmacéutica , Humanos , Miocarditis/tratamiento farmacológico , Qi , Deficiencia Yin/tratamiento farmacológicoRESUMEN
To evaluate the pharmacoeconomic value of Qidong Yixin Oral Liquid in the treatment of viral myocarditis(Qi-Yin deficiency syndrome) by supplementing Qi, nourishing the heart, calming the mind, and relieving palpitation, the present study performed the Meta-analysis based on the published papers on Qidong Yixin Oral Liquid by AMSTAR and carried out pharmacoeconomic evaluation using TreeAge Pro by the cost-effectiveness analysis. The results showed that the quality of the included papers was good. After four weeks of treatment, Qidong Yixin Oral Liquid combined with the conventional treatment regimen was superior to the conventional treatment in improving creatine kinase isoenzyme, and the difference was statistically significant. Furthermore, the treatment cost was also higher than that of conventional treatment, with an incremental cost-effectiveness ratio of CNY 95.89, accounting for 0.30% of per capita disposable income. The results of sensitivity analysis showed that the research results were robust. Therefore, based on the assumption that the per capita disposable income in 2020 was the threshold of patients' willingness to pay, it is more economical for patients with viral myocarditis to use Qidong Yixin Oral Liquid combined with conventional secondary prevention regimen than conventio-nal secondary prevention regimen alone. The economic evaluation of Qidong Yixin Oral Liquid in the treatment of viral myocarditis will help physicians and patients choose optimal treatment options, improve rational clinical medication, and provide references for the efficient allocation and utilization of medical resources in China.
Asunto(s)
Humanos , Análisis Costo-Beneficio , Medicamentos Herbarios Chinos/uso terapéutico , Economía Farmacéutica , Miocarditis/tratamiento farmacológico , Qi , Deficiencia Yin/tratamiento farmacológicoRESUMEN
Objectives: This study was aimed to find and appraise the available published pharmacoeconomic research on Traditional Chinese Medicine (TCM), to identify related issues and make suggestions for improvement in future research. Methods: After developing a search strategy and establishing inclusion and exclusion criteria, pharmacoeconomic studies on TCM were sourced from seven Chinese and English databases from inception to April 2020. Basic information about the studies and key pharmacoeconomic items of each study were extracted. The quality of each study was evaluated by using the British Medical Journal economic submissions checklist for authors and peer reviewers, focusing on factors such as study design, research time horizon, sample size, perspective, and evaluation methods. Results: A total of 431 published pharmacoeconomic articles with 434 studies on topics including cost-effectiveness, cost-benefit, cost-minimization, cost-utility, or combination analyses were identified and included in this review. Of these, 424 were published in Chinese and 7 in English. These studies conducted economic evaluations of 264 Chinese patent medicines and 70 types of TCM prescriptions for 143 diseases, including those of the central nervous, cardiovascular, respiratory, gynecologyical, and other systems. The studied TCMs included blood-activating agents (such as Xuesaitong tablet, Fufant Danshen tablet, and Danhong Injection), blood circulation promoting agents (such as Shuxuetong injection, Rupixiao tablet, and Fufang Danshen injection), and other therapeutic agents. The overall quality score of the studies was 0.62 (range 0.38 to 0.85). The mean quality score of studies in English was 0.72, which was higher than that of studies in Chinese with 0.62. Conclusions: The quality of pharmacoeconomic studies on TCM was relatively, generally low. Major concerns included study design, inappropriate pharmacoeconomic evaluation, insufficient sample size, or non-scientific assessment. Enhanced methodological training and cooperation, the development of a targeted pharmacoeconomic evaluation guideline, and proposal of a reasonable health outcome index are warranted to improve quality of future studies.
Asunto(s)
Economía Farmacéutica , Medicina Tradicional China , China , Economía Médica , Proyectos de InvestigaciónRESUMEN
This research was to evaluate the economics of Shexiang Tongxin Dropping Pills combined with conventional therapy for patients with coronary heart disease(CHD) in Chinese medical environment. From the perspective of medical insurance, a Markov model was established in this study based on the results of Meta-analysis comparing the effectiveness and safety of Shexiang Tongxin Dripping Pills combined with conventional treatment and conventional treatment alone. The experimental group was treated with She-xiang Tongxin Dropping Pills combined with conventional Western medicine treatment, while the control group was treated with conventional Western medicine treatment alone. The cost-utility analysis and sensitivity analysis were performed for the two regimens using Treeage pro. After 30 cycles of model simulation, according to the results of Markov model, the total cost and health output were CNY 237 795.73 and 16.36 QALYs(the quality adjusted life years, QALYs), respectively for Shexiang Tongxin Dropping Pills combined with conventional Western medicine treatment, CNY 247 396.55 and 16.36 QALYs respectively for the conventional Western medicine treatment alone. Compared with the conventional treatment alone, the Shexiang Tongxin Dropping Pills combined with conventional treatment had lower long-term cost and higher health output, with advantages of cost-utility and pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is considered that compared with the conventional Western medicine alone, Shexiang Tongxin Dropping Pill combined with conventional Western medicine is a treatment regimen with pharmacoeconomic advantages for the treatment of CHD.
Asunto(s)
Enfermedad Coronaria , Medicamentos Herbarios Chinos , Enfermedad Coronaria/tratamiento farmacológico , Economía Farmacéutica , Femenino , HumanosRESUMEN
To evaluate the economics of Suhuang Zhike Capsules in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) for inpatients. Based on the published clinical research data, cost-utility analysis was used in this study to evaluate the pharmacoeconomics of Suhuang Zhike Capsules in treatment of AECOPD inpatients from the perspective of medical insu-rance. The test group was treated with Suhuang Zhike Capsules combined with conventional Western medicine, and the control group was treated with conventional Western medicine alone. Treeage software was used to construct a pharmacoeconomic model and perform simulation analysis. The results showed that the cost and output of Suhuang Zhike Capsules combined with the conventional Western medicine were 60 010.18 yuan and 1.92 quality adjusted life year(QALYs), respectively in the simulated 3 years of disease treatment. The cost and output of the conventional Western medicine were 96 730.60 yuan and 1.90 QALYs respectively. Suhuang Zhike Capsules combined with conventional Western medicine required lower cost but achieved higher output, showing cost-utility advantages, so this drug combination was a plan with pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is believed that as compared with the conventional Western medicine, Suhuang Zhike Capsules combined with conventional Western medicine have lower cost and higher output for the treatment of AECOPD inpatients, and it is a treatment plan with pharmacoeconomic advantages.
Asunto(s)
Medicamentos Herbarios Chinos , Enfermedad Pulmonar Obstructiva Crónica , Cápsulas , Medicamentos Herbarios Chinos/uso terapéutico , Economía Farmacéutica , Humanos , Pacientes Internos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológicoRESUMEN
BACKGROUND: Without the needed medical support, bariatric surgery can be associated with post-operative malnutrition and associated nutrient deficiencies. We aimed to evaluate the cost difference of perioperative infusion requirements and TPN between GBP and BPD-DS. METHODS: All patients undergoing GBP or BPD-DS procedures between August 2015 and June 2018 were included. Information was collected to standardize the nutritional information into two categories: (1) oral supplementation and standard intravenous infusions, as predicted costs forming part of preoperative quote and (2) infusions prescribed for malnutrition, based on blood biochemistry, caterized as unexpected costs. RESULTS: A total of 573 patients over 3 years (GBP 60%, BPD-DS 40%) were included in the analysis. The average predicted costs from oral supplementation for both surgery groups and prophylactic infusions for BPD-DS were GBP (46.90USD) vs. BPD-DS (154.13 USD) (p-value = NS). Unexpected costs for infusions to correct nutritional deficiencies were GBP (199.14 USD) vs. BPD-DS (127.29 USD) (p-value = NS). TPN incidence rate was GBP (2.1%) and BPD-DS (12.7%) (p-value < 0.001) and admission rate per patient was GBP (0.9) and BPD-DS (0.63) (p-value < 0.05). Costs for acquiring TPN were GBP (153.58 USD) vs. BPD-DS (268.76 USD). Total unexpected costs were GBP (352.72 USD) vs. BPD-DS (396.05 USD) (p-value = NS). CONCLUSION: Nutrient deficiencies are known to occur within both GBP and BPD-DS surgeries, even up to 3 years. The admission rate/patient, requiring TPN, was higher in the GBP group, indicating that BPD-DS surgery can be efficient and cost-effective with holistic and multitherapeutic post-surgery care. BPD-DS procedures should be reserved for centers with a comprehensive and experienced multidisciplinary team enforcing stringent follow-up regimes.
Asunto(s)
Desviación Biliopancreática , Derivación Gástrica , Obesidad Mórbida , Suplementos Dietéticos , Duodeno/cirugía , Economía Farmacéutica , Derivación Gástrica/efectos adversos , Humanos , Nutrientes , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/prevención & controlRESUMEN
OBJECTIVES: The pharmacoeconomic studies of traditional Chinese medicine (TCM) are still in its infancy. Assessing the quality of pharmacoeconomic studies of TCM to improve the efficiency of health resource allocation and guide the rational use of medicine. METHODS: Four databases were searched from inception to January 2018. The Consolidated Health Economic Evaluation Reporting Standards statement (CHEERS) and the Quality of Health Economic Studies (QHES) were used to assess the reporting quality and methodological quality. STATA 12.0 and Meta analyst 3.13 were used to analyze the related data. RESULTS: A total of 178 studies were included. The methodological evaluation of the study found that the total score of QHES was 47.85 ± 8.09. The report quality evaluation results found that many studies did not report comprehensive information, such as lack of detailed reports on abstracts, study perspectives, time frames, discount rates, model selection, but the titles, study background and location, and health results, resource and cost estimates, analysis methods, and heterogeneity analysis are reported in more detail. Six of the ten stratification factors have statistically significant differences. CONCLUSION: The overall quality of pharmacoeconomic studies of TCM is low, and further standardization and improvement are needed to obtain reliable study results.
Asunto(s)
Economía Farmacéutica/normas , Medicina Tradicional China/economía , Proyectos de Investigación/normas , China , Bases de Datos Factuales , Economía Médica , Humanos , Modelos Teóricos , Informe de Investigación/normas , Asignación de Recursos/economíaRESUMEN
Osteoarthritis (OA) is the most prevalent musculoskeletal disease and a major cause of negative relevant outcomes, associated with an ever-increasing societal burden. Pharmaceutical-grade chondroitin sulfate (CS) was repeatedly reported to reduce pain and improve function in patients with OA. This article aims to review the evidence for the role of highly purified (hp) CS (Condrosulf®, IBSA) in the treatment of OA. We collected and reported evidence concerning (1) efficacy of hpCS 800 mg/day in the treatment of OA affecting the knee, hand and hip; (2) efficacy and safety of hpCS 1200 mg/day also in the oral gel formulation; (3) the safety profile of hpCS; (4) the difference of hpCS and pharmaceutical-grade formulations versus food supplements; (5) pharmacoeconomic added value of hpCS. The data support that hpCS is an effective and safe treatment of OA, with its effect already evident at 30 days; in addition, its beneficial action is prolonged, being maintained for at least 3 months after the drug is discontinued. Full safety reports' analyses confirm that CS is safe to use and has almost no side effects, in particular, it showed better gastrointestinal tolerance if compared with non-steroidal anti-inflammatory drugs (NSAIDs). Moreover, the therapeutic strategy has proved to be cost-effective: treatment with CS reduced the use of NSAIDs and their side effects.
Asunto(s)
Osteoartritis de la Rodilla , Osteoartritis , Antiinflamatorios no Esteroideos/uso terapéutico , Sulfatos de Condroitina/uso terapéutico , Economía Farmacéutica , Humanos , Articulación de la Rodilla , Osteoartritis/tratamiento farmacológico , Osteoartritis de la Rodilla/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Objective: This study aims to provide an up-to-date analysis of the current state of patient access to new drugs in South Korea, focusing on the effect of new review pathways for reimbursement. Methods: We analyzed patients' access to new drugs, listing rate and lead time until listing from marketing authorization. New pathways were defined as 'price negotiation waiver,' 'risk-sharing agreements,' and 'pharmacoeconomic evaluation exemption.' Results: The listing rate for drugs increased after the introduction of the new pathways (93.7% vs. 77.9%, p < 0.001). Before the new pathways, the median lead time for listing was 21.0 months (95% CI: 16.9-25.0), while afterward it was shortened to 10.9 months (95% CI: 10.2-11.7) (p < 0.001). Conclusion: Although it has strengthened national health insurance coverage by positively impacting the rate and lead time, the lead time for the oncology and orphan drugs is substantially longer as compared to other drugs. Expanding the eligibility criteria to include non-life-threatening but rare or intractable diseases, and resolving the system's operational issues are still necessary.
Asunto(s)
Aprobación de Drogas , Economía Farmacéutica , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Preparaciones Farmacéuticas/provisión & distribución , Antineoplásicos/economía , Antineoplásicos/provisión & distribución , Accesibilidad a los Servicios de Salud/economía , Humanos , Reembolso de Seguro de Salud/economía , Programas Nacionales de Salud/economía , Producción de Medicamentos sin Interés Comercial/economía , Preparaciones Farmacéuticas/economía , Mecanismo de Reembolso , República de Corea , Factores de TiempoRESUMEN
This research was to evaluate the economics of Shexiang Tongxin Dropping Pills combined with conventional therapy for patients with coronary heart disease(CHD) in Chinese medical environment. From the perspective of medical insurance, a Markov model was established in this study based on the results of Meta-analysis comparing the effectiveness and safety of Shexiang Tongxin Dripping Pills combined with conventional treatment and conventional treatment alone. The experimental group was treated with She-xiang Tongxin Dropping Pills combined with conventional Western medicine treatment, while the control group was treated with conventional Western medicine treatment alone. The cost-utility analysis and sensitivity analysis were performed for the two regimens using Treeage pro. After 30 cycles of model simulation, according to the results of Markov model, the total cost and health output were CNY 237 795.73 and 16.36 QALYs(the quality adjusted life years, QALYs), respectively for Shexiang Tongxin Dropping Pills combined with conventional Western medicine treatment, CNY 247 396.55 and 16.36 QALYs respectively for the conventional Western medicine treatment alone. Compared with the conventional treatment alone, the Shexiang Tongxin Dropping Pills combined with conventional treatment had lower long-term cost and higher health output, with advantages of cost-utility and pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is considered that compared with the conventional Western medicine alone, Shexiang Tongxin Dropping Pill combined with conventional Western medicine is a treatment regimen with pharmacoeconomic advantages for the treatment of CHD.
Asunto(s)
Femenino , Humanos , Enfermedad Coronaria/tratamiento farmacológico , Medicamentos Herbarios Chinos , Economía FarmacéuticaRESUMEN
To evaluate the economics of Suhuang Zhike Capsules in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) for inpatients. Based on the published clinical research data, cost-utility analysis was used in this study to evaluate the pharmacoeconomics of Suhuang Zhike Capsules in treatment of AECOPD inpatients from the perspective of medical insu-rance. The test group was treated with Suhuang Zhike Capsules combined with conventional Western medicine, and the control group was treated with conventional Western medicine alone. Treeage software was used to construct a pharmacoeconomic model and perform simulation analysis. The results showed that the cost and output of Suhuang Zhike Capsules combined with the conventional Western medicine were 60 010.18 yuan and 1.92 quality adjusted life year(QALYs), respectively in the simulated 3 years of disease treatment. The cost and output of the conventional Western medicine were 96 730.60 yuan and 1.90 QALYs respectively. Suhuang Zhike Capsules combined with conventional Western medicine required lower cost but achieved higher output, showing cost-utility advantages, so this drug combination was a plan with pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is believed that as compared with the conventional Western medicine, Suhuang Zhike Capsules combined with conventional Western medicine have lower cost and higher output for the treatment of AECOPD inpatients, and it is a treatment plan with pharmacoeconomic advantages.
Asunto(s)
Humanos , Cápsulas , Medicamentos Herbarios Chinos/uso terapéutico , Economía Farmacéutica , Pacientes Internos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológicoRESUMEN
This paper describes the reimbursement policy for immune checkpoint inhibitors in Taiwan and provides a perspective to improve the quality, consistency, and transparency of decision making. Global trends for cancer treatment have shifted from chemotherapies to targeted therapies and immuno-oncology (IO) medicine, leading to significant increases in treatment costs. To enhance the accessibility of advanced therapy, the Taiwan National Health Insurance Administration announced two pathways for high-cost medicine: the managed entry agreement and a set of general rules of reimbursement submission for high-cost drugs. To further manage the financial burden on Taiwan's national health insurance system, the policy makers introduced novel inhibitory drugs for cancer immune checkpoints, subject to a maximum annual budget of NT$800 million (≈US$26.7 million). In April 2019, a national registry was established for patients undergoing cancer immunotherapy. Clinical characteristics, treatment duration, toxicity, and the outcome of the postcheckpoint inhibitor treatments were recorded. By analyzing real-world data, we assess the therapeutic effect of IO treatment in Taiwanese patients, thereby enabling payers to adjust payment regulations and rules for reimbursement. The Health Technology Assessment Team plays an important role in drawing upon the evidence to support policy making. Under an implemented cost-management mechanism, Taiwan's high-cost drug policy has enabled patients to access new medicines and maximized patient benefits.
Asunto(s)
Economía Farmacéutica , Inhibidores de Puntos de Control Inmunológico/economía , Reembolso de Seguro de Salud , Política Organizacional , Humanos , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Programas Nacionales de Salud , Taiwán , Evaluación de la Tecnología BiomédicaRESUMEN
BACKGROUND: An important contribution to well-being of human beings can be observed by the use of self-medication products that is reflected in the constantly growing volume of over-the-counter (OTC) drugs. The aim of the current study was to extend the measurement concept for OTCs by exploring the relevance of the peripheral assortment provided by the widely accepted framework of the Anatomical Therapeutical and Chemical (ATC) classification of the WHO. METHODS: The focus was on the prescriptions and drug-related receipts submitted by privately insured persons to 18 private health insurers (PHIs) in Germany from the year 2016. The age- and gender-specific average claims amount per risks of outpatient drug expenditure were used as weights to scale up the relative distributions of the item amounts. The ATC-classification defines the commodity groups and discriminates between the main and the peripheral assortment. A descriptive analysis assessed the OTC frequencies and sum scores of the product groups within the main and peripheral assortment whereby the study group explored and assessed the relevance of each category independently according to the OTCs and integrative medicines. RESULTS: The analysis included 22.1 Mio. packages from the main assortment and examined 10.1 Mio. packages from the peripheral assortment. The latter was examined thoroughly and the commodity groups "Pharmaceutical food products", "Medicinal products for special therapy options" and particular "Hygiene and body care products" meet the defined requirements for OTCs relevant for integrative medicines. A high proportion of OTC products from the peripheral assortment was associated with the categories "medicinal products for special therapy options". Homeopathy and anthroposophy present two special therapy options, which are relevant for the extended OTC measurement. CONCLUSIONS: The analysis of OTC drugs is feasible when the main and the peripheral assortment is available and enable to integrate about 18% of all OTCs, which are neglected by the common ATC-based approach. The presented extended approach may help to identify potential users of OTCs or people in need of OTC use. In case of the highly disputed homeopathy and anthroposophy products, more research among interactions with prescriptions drugs (Rx), nutrition's and other potentially harmful exposures is recommended.
Asunto(s)
Terapias Complementarias , Seguro de Salud , Medicamentos sin Prescripción/uso terapéutico , Sector Privado , Medicina Antroposófica , Terapias Complementarias/estadística & datos numéricos , Análisis de Datos , Prescripciones de Medicamentos , Economía Farmacéutica , Femenino , Alemania , Humanos , Revisión de Utilización de Seguros , Masculino , Medicamentos bajo Prescripción , AutomedicaciónRESUMEN
Objectives: The South African Guidelines for Pharmacoeconomic Submissions (SAGPS) were compared with other African pharmacoeconomic guidelines and the National Institute of Health and Care Excellence Methods Guide (NICE MG) to make recommendations for evidence generation and further development thereof.Methods: The European Network for HTA Core Model (version 3.0) (the Model) provided the comparative framework, using three criteria: completely, partly, or not completely requiring the same/similar information.Results: Of 45 African countries reviewed, only Egypt had a publicly accessible pharmacoeconomic guideline (EPG). The guidelines were different in respect to their intended audience, size, and content but for all the main focus are the economic evaluation, and health problem and current treatment domains. The SAGPS and EPG had few requirements for a medicine's safety, organizational, ethical, and legal aspects. The SAGPS completely or partly required the same/similar information as the Model for 41.2% of total issues, the EPG 33.3%, and the NICE MG 63.2%.Conclusions: The SAGPS was similar to the EPG, but not as comprehensive as the NICE MG and could be strengthened for decision-making and priority setting. Evidence generation should focus on describing the medicine's targeted disease and current treatment options, and associated cost and outcomes data.