Expert review of pharmacoeconomics & outcomes research
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Expert Rev Pharmacoecon Outcomes Res · Apr 2010
Initiatives to enhance renin-angiotensin prescribing efficiency in Austria: impact and implications for other countries.
To assess the utilization of renin-angiotensin drugs, including combinations, in Austria in practice given the limited availability of diuretics, as well as the impact of recent reforms and initiatives on the utilization and expenditure of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs), following prescribing restrictions on ARBs immediately after their introduction. ⋯ The results confirm the successful implementation of the latest pricing policies and demand-side measures for generics and originators in Austria. We believe the prescribing restrictions for ARBs reduced their utilization in practice and offer an alternative approach to other demand-side measures.
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Expert Rev Pharmacoecon Outcomes Res · Feb 2010
ReviewModeling healthcare expenditures: overview of the literature and evidence from a panel time-series model.
The rapid growth of healthcare expenditures in the past 40 years in many industrial countries has contributed to an improvement in life expectancy and the quality of life, but has also jeopardized the sustainability of public budgets. For the future, it is important to get more insight into the determinants of this growth. ⋯ Owing to the Baumol effect, healthcare tends to become more expensive over time. How does the demand for healthcare react to this price increase?
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Expert Rev Pharmacoecon Outcomes Res · Feb 2010
Initiatives to enhance the quality and efficiency of statin and PPI prescribing in the UK: impact and implications.
To assess the impact of a range of national and regional initiatives introduced in the North Lancashire Teaching Primary Care Trust (NLTPCT) since 2004 to enhance the quality and efficiency of prescribing proton pump inhibitors (PPIs), statins and ezetimibe. In addition, to suggest additional measures that could be introduced in NLTPCT to further enhance the quality and efficiency of prescribing based on initiatives in other European countries. ⋯ The findings are in line with expectations and do provide examples to other European countries. This includes a high rate of INN prescribing, low reimbursed prices for generic simvastatin and omeprazole and growing utilization of higher strength statins. The high rate of INN prescribing reduces the need for additional measures that have been instigated in other European countries to further enhance the prescribing and dispensing of generics to fully realize the resource benefits. Additional demand side measures are feasible and have already been instigated to conserve resources.
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Expert Rev Pharmacoecon Outcomes Res · Dec 2009
ReviewAcute 'strokenomics': efficacy and economic analyses of alteplase for acute ischemic stroke.
Cerebrovascular disease is the leading cause of adult disability in Western countries and, as such, is associated with a considerable and increasing economic burden. Prevention of disability is preferable to a costly and prolonged period of rehabilitation; however, in this regard, we have only a limited number of acute treatments. Treatment of ischemic stroke with the tissue plasminogen activator alteplase has a considerable and compelling evidence base confirming its clinical efficacy. ⋯ A recurring theme in these economic analyses is of reducing healthcare costs associated with the increasing use of thrombolysis. In this regard, it is unfortunate that rates of tissue plasminogen activator utilization remain modest in most centers. This review will discuss the economics of alteplase in acute stroke, making particular reference to the current and projected economic burden of stroke, the evidence base for thrombolysis and published literature on the economics analyses of this therapy.
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Expert Rev Pharmacoecon Outcomes Res · Oct 2009
ReviewCost-effectiveness of Medicare's coverage of immunosuppression medications for kidney transplant recipients.
Kidney transplantation is the preferred method of treating patients with end-stage renal disease. Transplantation improves the quality of life of the transplant recipient and also results in reduced treatment costs owing to the cost difference between dialysis and the post-transplant immunosuppression medications. ⋯ This article reviews studies that documented the improvements in long-term transplant outcomes attributable to previous coverage extensions of immunosuppression medications, from both 1-3 years post-transplant for all transplant recipients in 1993 and the coverage extension from 3 years to lifetime for elderly and disabled patients in the year 2000. In addition, previous studies of the potential cost-effectiveness of a lifetime immunosuppression benefit for all patients are discussed.