PharmacoEconomics
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5-Hydroxytryptamine3 (5-HT3) receptor antagonists are a major breakthrough in the prevention of nausea and vomiting induced by cancer chemotherapy. The acquisition cost of these drugs is considerably higher than for more conventional antiemetics. In this study, the authors reported on the economic consequences of giving ondansetron in Thomas Jefferson University Hospital, Philadelphia, USA. ⋯ In the retrospective study, costs were evaluated for patients who never received ondansetron, those who always received it, and those who received ondansetron during at least 1 hospital stay. In the prospective study, the costs associated with vomiting were nursing time, time required to obtain antiemetic therapy from the pharmacy, telephone calls to contact physicians, additional use of ancillary services, and laundry costs for soiled items. In the retrospective analysis, it was found that the average length of hospital stay for patients who were always given ondansetron was significantly shorter than for those who never received it.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Cost and cost-effectiveness analysis of ondansetron versus metoclopramide regimens: a hospital perspective from Italy.
In a large double-blind study of antiemetic therapy conducted in Italy, 289 patients underwent 3 consecutive cycles of cisplatin chemotherapy. Antiemetic treatment with ondansetron plus dexamethasone was more efficacious and better tolerated, but also more expensive, than treatment with metoclopramide plus both dexamethasone and diphenhydramine. To evaluate the different costs of the 2 antiemetic regimens, we conducted a retrospective cost-effectiveness analysis from a hospital perspective. ⋯ Corresponding figures for the metoclopramide regimen were 59.5 and 50.4%, 53.6 and 37.1%, and 46.8 and 27.3%, respectively. Thus, the cost per successfully treated (completely protected) patient was 2.43- and 2.34-fold higher, respectively, for ondansetron at the first cycle, 2.23- and 1.99-fold higher, respectively, at second cycle, and 1.82- and 1.36-fold higher, respectively, at third cycle. In conclusion, the study demonstrates that, while ondansetron has a greater acquisition cost than metoclopramide, the ondansetron regimen costs per successfully-treated patient substantially decrease when all direct hospital costs are taken into account.
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The need to treat obesity successfully can be measured by the medical penalty paid by the obese individual and the financial price paid by society in general. The management of obesity has 2 objectives: first, to produce significant weight reduction (10% of pretreatment bodyweight) and, second, to maintain this weight reduction. For the purpose of this paper, we have defined successful treatment as that maintaining significant weight loss for at least 5 years. A review of the literature confirms that there is no single outstanding treatment for obesity, and that clinicians must consider an individual's needs before selecting a particular method of weight reduction. The main determinants of suitability of any specific treatment are degree of obesity, concomitant medical disorders, urgency of treatment, and the individual's willingness to undergo the programme prescribed.
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The influence of the Patented Medicine Prices Review Board in restraining the prices of patented drugs has been established over the past 6 years. Recent legislative and policy changes now in place may result in the Board assuming a more influential, public, and activist posture. This article reviews the way in which the Board carries out its mandate to ensure that patented medicines sold in Canada are not 'excessive'. The Board represents one segment of Canada's ongoing effort to balance what often appear to be irreconcilable tasks-the promotion of an increased domestic research and development investment by the pharmaceutical industry, and the control of expenditures for pharmaceuticals in response to the escalating concerns of the provincial health authorities and consumers.