PharmacoEconomics
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
An economic analysis of the Atorvastatin Comparative Cholesterol Efficacy and Safety Study (ACCESS).
The objective of the Atorvastatin Comparative Cholesterol Efficacy and Safety Study (ACCESS) was to compare the efficacy and safety of the five 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors in a randomised, controlled, yet large-scale study. ACCESS also produced data that permitted comparative analysis of the cost to achieve National Cholesterol Education Panel (NCEP) II low density lipoprotein-cholesterol (LDL-C) targets. ⋯ Compared with the other statins studied, atorvastatin was associated with the lowest resource use and costs when used to treat patients to their NCEP II LDL-C targets. Atorvastatin was also associated with the highest percentage of patients achieving their desired clinical outcomes. Therefore, in cost-effectiveness terms, it dominated the four other statins.
-
Multicenter Study Comparative Study
Unit costs of inpatient hospital days.
Costs of inpatient days in hospitals are frequently the main drivers of total treatment costs, and their unit cost can markedly affect the outcomes of an economic evaluation. In many countries, the availability of unit cost data is limited and unit costs are often based on data from hospitals participating in clinical trials. ⋯ The results of this study were used to develop standard costs for inpatient days in The Netherlands and may contribute to the comparability and generalisability of economic evaluations.
-
Comparative Study
A cost comparison of oral tegafur plus uracil/folinic acid and parenteral fluorouracil for colorectal cancer in Canada.
Two randomised, controlled trials (n = 1396) comparing (i) intravenous fluorouracil (FU) plus oral folinic acid (leucovorin) and (ii) oral tegafur plus uracil (UFT) plus folinic acid for the treatment of metastatic colorectal carcinoma found both regimens to have equivalent efficacy in terms of survival, tumour response and time to disease progression. The UFT/folinic acid regimen was associated with a better toxicity profile than FU/folinic acid. ⋯ In regard to the two therapeutic approaches, the cost of treatment per patient and per cycle using oral UFT/folinic acid was less than that using intravenous FU/folinic acid.
-
Randomized Controlled Trial Clinical Trial
Cost effectiveness and cost utility of acetylcysteine versus dimethyl sulfoxide for reflex sympathetic dystrophy.
To determine the cost effectiveness and cost utility of acetylcysteine versus dimethyl sulfoxide (DMSO) for patients with reflex sympathetic dystrophy (RSD), from a societal viewpoint. ⋯ In general, DMSO is the preferred treatment for patients with RSD.
-
Patients who have undergone orthopaedic surgery represent a high-risk group for venous thromboembolism (VTE). Despite the routine prophylactic use of antithrombotic agents, patients still experience thrombotic events that can result in mortality and acute morbidity and, in significant numbers of patients, may lead to long-term consequences such as the post-thrombotic syndrome. Increasingly, initial VTE events occur after hospital discharge since the length of stay in hospital after major orthopaedic surgery has decreased in many countries. ⋯ Symptomatic deep vein thrombosis and pulmonary embolism, recurrent VTE, post-thrombotic syndrome, major hemorrhage and all-cause death are included. We also recommend that the relevance of quality-adjusted survival is investigated, and that economic appraisals are presented in both cost-consequence and budget-impact approaches. These recommendations are based on extensive examination of recent advances in the management of VTE combined with a greater understanding of its natural history.