甘草酸制剂预防肺癌化疗所致肝损伤的药物经济学评价

目的:研究3种甘草酸制剂对非小细胞肺癌患者化疗药物致肝损伤的预防作用及安全性,并进行药物经济学评价,为临床合理选用甘草酸制剂提供参考.方法:回顾性收集2018年1月～2019年12月本院非小细胞肺癌化疗适应证的患者176例,分为A组(预防性使用异甘草酸镁,45例)、B组(预防性使用复方甘草酸苷组,44例)、C组(预防性使用复方甘草酸单铵S,45例)与D组(未预防性使用保肝药,42例),运用成本-效果与增量成本-效果比分析评价药物经济学,并对其敏感性分析.结果:A、B、C、D组4种预防方案总有效率及显效率分别为95.56％、86.36％、75.56％、69.05％及86.67％、75.00％、66.67％、28.57％;A、B、C、D组4种预防方案的成本分别为1705.84元、1651.38元、1682.39元、2837.87元;A、B、C、D组4种预防方案的总有效率及显效率的C/E值分别为1785.10、1912.20、2226.56、4109.88及1968.20、2201.84、2523.46、9933.04;C组与D组为绝对劣势方案.如果决策者认为平均增加一个患者达到治疗总有效及显效的最大支付意愿值分别大于591.96元、466.67元是值得的,则A方案最经济,反之则B方案最经济,敏感性分析与结果保持一致.结论:在非小细胞肺癌患者化疗预防药物致肝损伤时,可以依据患者的支付意愿来选择保肝药,鼓励选择异甘草酸镁.     

左氧氟沙星仿制药与原研药用于非重症社区获得性肺炎的疗效及安全性回顾性对比研究

目的探讨左氧氟沙星仿制药和原研药治疗非重症社区获得性肺炎(CAP)的疗效和安全性。方法回顾性分析124例非重症CAP患者的病历资料,根据用药种类不同分为仿制组和原研组,各62例。仿制组采取仿制盐酸左氧氟沙星注射液治疗,原研组采取原研左氧氟沙星氯化钠注射液治疗。对比两组患者临床疗效、痰培养转阴率、退热时间、住院时间、炎性因子水平、安全性和治疗成本。结果仿制组总有效率与痰培养转阴率分别为95.16%、93.33%,与原研组的98.39%、97.06%对比,差异无统计学意义(P>0.05)。仿制组退热时间为(51.54±38.94)h,首次及末次降钙素原(PCT)水平分别为(1.31±2.40)、(0.54±0.38)ng/ml,与原研组的(96.50±75.11)h、(2.16±2.21)ng/ml、(0.96±1.20)ng/ml对比差异有统计学意义(P<0.05)。两组住院时间、首次及末次血清C反应蛋白(CRP)水平对比,差异无统计学意义(P>0.05)。仿制组成本效果比(C/E)0.16低于原研组的6.56,增量成本效果比(△C/△E)为195.07。原研组不良反应发生率为1.61%,低于仿制组的17.74%,差异有统计学意义(P<0.05)。结论左氧氟沙星仿制药与原研药治疗非重症CAP的疗效相近,仿制药的不良反应风险更高,以皮肤及其附件损害为主,可见史蒂文斯-约翰逊综合征(SJS)等严重药品不良反应(ADR)报道,但仿制药治疗费用更低,可减少患者医疗成本。     

Pricing and Reimbursement of Pharmaceuticals. A New Culture for the Community Pharmacist.

Pricing and reimbursement of pharmaceuticals are of concern for pharmacists. Different countries have different ways of organising their health care systems. The place for pharmaceuticals within these systems also differ. This article looks into the price and reimbursement systems for medicinal products in Germany, Sweden, the UK and Norway. Various ways of organising the pharmaceutical market emerge. Some existing measures have been in place for a long time while others have been introduced more recently. A common goal for the four countries seems to be the drive to cut costs, and attempts to do this can be directed through various reimbursement systems, by focusing on prices or by influencing the physicians' prescribing behaviour, either through the use of advice or through the use of budgets. It is important for the pharmacists to have indepth knowledge of the price and reimbursement system they have to work within in order to be of full service to their customers.     

止嗽理肺汤治疗社区获得性肺炎的药物经济学评价

目的：止嗽理肺汤治疗非重症社区获得性肺炎（CAP）的临床有效性及经济性。方法：将73例CAP患者随机分为治疗组37例、对照组36例,治疗组予基础治疗+止嗽理肺汤;对照组予基础治疗。结果：治疗组与对照组初始治疗有效率比较,无明显差异（P>0.05);但愈显率比较,差异明显（P<0.05）,治疗组抗生素静脉内使用时间少于对照组,生活质量改善情况优于对照组（P<0.05）。治疗组与对照组的总成本比较,无明显差异（P>0.05）;但治疗组西药成本明显少于对照组,成本-效果比明显低于对照组（P<0.05）。结论：止嗽理肺汤配合西药常规治疗对CAP疗效肯定,能减少抗生素的使用时间和使用量,改善患者的生活质量;中药早期介入治疗CAP具有经济性。     

药物经济学在中医“治未病”中的应用

目的:探讨药物经济学在中医"治未病"中的应用。方法:通过对药物经济学及中医"治未病"理论的简单介绍,并以活血化瘀药预防脑梗死为例,分析以药物经济学方法研究中医"治未病"的可行性及必要性。结果与结论:应用药物经济学方法评价中医"治未病",将建立更加客观的中药评价体系,更好地指导临床合理用药。     

Physician treatment preferences in rheumatoid arthritis of differing disease severity and activity: The impact of cost on first‐line therapy

Objective

To conduct a pilot study to identify rheumatologists' treatment preferences for first‐line rheumatoid arthritis (RA) therapy and determine whether pharmacoeconomic variables modify physician choice(s).

Methods

A questionnaire describing 3 different RA scenarios was mailed to American College of Rheumatology members within 4 geographic regions of the US. Physicians were asked to identify their choice(s) of first‐line therapy for each of the cases, first taking cost into consideration, second without considering the influence of cost, and third identifying the therapy that would be chosen for either themselves or a family member.

Results

Three hundred seventy‐five questionnaires out of a total of 994 (37.7%) were returned between 3/12/00 and 4/25/00. Hydroxychloroquine was the most commonly cited medication for a mild disease activity/severity presentation, and methotrexate for a moderate‐to‐severe disease activity/severity presentation. For the severe disease activity/severity presentation, when cost was not considered, 217 (65%) rheumatologists included new disease‐modifying antirheumatic drugs (leflunomide, etanercept, and infliximab) in their choice of first‐line agents; this number decreased to 47 (14%) when cost was a consideration.

Conclusion

Pharmacoeconomics appear to play a dominant role in rheumatologists' choice of treatment regimens, at times contrary to the physician's perception of the effectiveness of a drug. Future studies should address physician preferences in more depth with respect to cost and its various components.

     

The Predictors study: Development and baseline characteristics of the Predictors 3 cohort

Introduction

The Predictors study was designed to predict the length of time to major disease outcomes in Alzheimer's disease (AD) patients. Here, we describe the development of a new, Predictors 3, cohort.

中药配方颗粒发展现状与临床推广应用面临的主要问题分析

通过文献研究和市场调查,阐明中药配方颗粒国内外市场获得了较好发展,产业的规模和效益都在提高,产品逐步得到医生和患者接受,在医院诊疗中占据了越来越重要的地位.与国外市场相比,国内市场的发展相对缓慢,原因主要包括对中药配方颗粒与饮片是否等效的质疑和价格比较高等问题,进而提出加强临床应用研究以检验其疗效、加快推行电子调配方式...     

Pharmacoeconomics in COPD and inappropriateness of diagnostics, management and treatment

Chronic respiratory disorders (CRDs) concern many people and generate important health and social costs. Their global impact (particularly that of COPD) has been the subject of numerous pharmacoeconomic studies published in recent years. These studies confirm the growing impact of COPD in all countries, in terms of the patient and patient's family, and that of society as a whole. The attitude towards COPD management is still largely inadequate, from prevention to diagnosis to drug and non-pharmacologic long-term treatment. The pulmonary specialist, in cooperation with other health professionals, can play a fundamental role in detecting inappropriateness in the clinical course of COPD and provide the basis for a correct assessment of pharmacoeconomic issues. Given the increasing social impact of COPD, the meeting inspiring this review, "COPD a social disease: inappropriateness and pharmacoeconomics. The role of the specialist: present and future", Venice, Italy, 21-22 April 2010, fits in perfectly with the goals and recommendations of GARD (Global Alliance against chronic Respiratory Diseases) of the WHO. GARD has formulated working recommendations: (i) to develop national programs of prevention and control of CRDs, starting from health education campaigns and better knowledge of epidemiology, impact, and relative risk factors; (ii) to provide training and continuing education on prevention and treatment of CRDs, disseminating the existing guidelines; and (iii) to facilitate access to essential treatments and favour adherence to long-term treatment, including drug treatment and pulmonary rehabilitation, particularly amongst disadvantaged sectors of the population.     

两种耐甲氧西林凝固酶阴性葡萄球菌感染药物治疗方案的药物经济学分析

目的：分析万古霉素单用及其与蒲公英伍用治疗耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）感染的药物经济学效果。方法：用随机平行对照法将60例MRCNS感染患者分为A、B两组,分别静滴万古霉素并同期服用蒲公英汤、仅静滴万古霉素治疗,比较两组药物治疗方案的疗效和经济学效果。结果：两组的有效率、细菌清除率、不良反应发生率比较,均无显著性差异（P〉0.05）; A组的实际用药天数明显少于B组（P〈0.05）; A组成本低于B组,A组单位有效率所需成本（C/E1）和单位细菌清除率所需成本（C/E2）均低于B组。结论：A组治疗方案药物经济学效果优于B组。