PharmacoEconomics
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Randomized Controlled Trial Multicenter Study Comparative Study
Economic evaluation of weekly epoetin alfa versus biweekly darbepoetin alfa for chemotherapy-induced anaemia: evidence from a 16-week randomised trial.
A 16-week, open-label, multicentre, randomised trial of weekly epoetin alfa 40 000 units versus biweekly darbepoetin alfa 200microg among 358 patients with solid-tumour cancers and chemotherapy-induced anaemia demonstrated superior haematological outcomes with epoetin alfa. We sought to compare resource use, costs and clinical outcomes between treatment groups and report the results using a cost-consequences framework. ⋯ Most clinical outcome measures suggested greater improvement with epoetin alfa relative to darbepoetin alfa, but most costs for both agents appeared similar. Decision makers must evaluate the differences in costs and efficacy measures that are most relevant from their perspectives.
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Comparative Study
Association of co-morbidities with prescribing patterns and cost savings: olanzapine versus risperidone for schizophrenia.
Olanzapine and risperidone are two commonly prescribed atypical antipsychotics for schizophrenia. Prior studies have shown inconsistent results in terms of advantage in cost saving in prescribing these agents. Our preliminary analysis showed that a small percentage of intensive healthcare utilizers had substantial impact on healthcare costs. This study analysed the cost effects of olanzapine and risperidone among those who had intensive utilisation of medical care prior to drug initiation, and the relationship between the choice of the two drugs and patients' co-morbid condition. ⋯ Among the top 10% most expensive patients, olanzapine and risperidone treatments were associated with comparable cost reductions in inpatient care. The choice of agent was associated with patients' co-morbid condition and was correlated with cost reduction in inpatient medical/surgical or psychiatric care.
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The positive results of a randomised clinical trial of rivastigmine in patients with dementia associated with Parkinson's disease have been published recently. Patient-level healthcare utilisation data were also collected, and this report is the economic evaluation based on these data. ⋯ Although no between-treatment differences in cost were seen, the small sample size, highly variable cost distributions and short time horizon prevent us from making strong conclusions with regard to the effect of rivastigmine on total costs and, by inference, on cost effectiveness.
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Health-related quality of life (HR-QOL) is an important outcome in the treatment of chronic childhood diseases such as asthma. However, this measure is rarely used in young children in Asia because of the difficulty of obtaining valid, reliable instruments that are developmentally and culturally suitable. ⋯ The children and parents/caregivers in this study found CAQ-B to be a simple and acceptable questionnaire with some evidence of content validity. While two of the domains did not meet internal consistency standards expected of HR-QOL instruments for adults (Cronbach's alpha = 0.70), they were acceptable for children of this age. The patterns of correlation also suggest that parent/caregivers' perception of the severity of a young child's asthma may be a better indicator of a child's HR-QOL than clinical diagnosis of severity. However, further investigation is recommended to improve and validate the internal structure of the scale.
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Comparative Study
Post-exposure influenza prophylaxis with oseltamivir: cost effectiveness and cost utility in families in the UK.
To assess the cost effectiveness and cost utility of preventing post-exposure influenza infection using the neuraminidase inhibitor oseltamivir from a healthcare payer's perspective in the UK. ⋯ PEP with oseltamivir is likely to be a cost-effective strategy for family contacts in the UK from a healthcare payer perspective when influenza-like illness contact attack rates are 8% or higher and the only treatment given is 'usual care'.