The financial impact of maintenance treatment in heroin addictive behavior: the case of Subutex

BACKGROUND: The development of maintenance treatment for subjects with addictive behavior is an important public health issue. As such, the social effectiveness of maintenance products must be examined from an economical and social point of view. This paper aims at presenting the financial costs involved in the use of Subutex, a product commercialized since 1996. METHODS: A complete typology of costs related to drug addiction and its consequences was set up. Some of these costs were estimated on the basis of data drawn from the literature. The cost of Subutex use for maintenance treatment was assessed and compared with the financial stakes including the potential reduction of the economic and social cost of drug addiction. RESULTS: Monthly treatment cost of Subutex was 1252 FrF per drug abuser on maintenance treatment. By extrapolation, for a population of 40,000 drug abusers, the direct medical cost of Subutex during a course of maintenance treatment with general practitioner follow-up was estimated at 600 millions FrF. US data sources were applied to France to assess the cost of illnesses attributable to drug addiction. The cost reached 4.8 billions FrF. The cost of delinquency associated with drug addiction, which mostly concerns money laundered to purchase substances was an estimated 6.4 billions FrF. Finally, the cost of public anti-drug abuse programs was nearly 4.7 billions FrF. Thus, the direct cost of drug addiction consequences reached 15.6 billions FrF. This cost should be compared with the annual cost of Subutex for public organizations which was an estimated 600 millions FrF. CONCLUSIONS: The "profit" threshold of maintenance treatment with Subutex in terms of direct costs is very low. A decrease of only 4% of the costs associated with drug addiction would make it possible to balance the financial budget for the community. Our analysis does not take into acount absolutely all the public health and safety aspects involved in the use of Subutex. It does however provide a useful assessment of the financial aspects of the question and justification for this therapeutic strategy from a budgetary point of view.     

A potential immunotherapy approach: mucosal immunization with an IL-13 peptide-based virus-like particle vaccine in a mouse asthma model

Interleukin (IL)-13 is critical in asthma pathogenesis. Previously, we have developed an IL-13 peptide-based vaccine and confirmed that subcutaneous immunization with the vaccine suppressed airway allergic inflammatory responses in a mouse asthma model. In the present study, we sought to test if mucosal immunization with the vaccine could be a potential approach, by inducing specific autoantibodies of both local IgA in the airway and systemic IgG in serum, to provide an overall suppression of redundant IL-13 effects. The results show that intranasal vaccination induces IL-13-specific IgA responses in multiple mucosal tissues and higher titers of IgG in serum than subcutaneous vaccination. This approach leads to a more effective suppression of ovalbumin-driven Th2 patterns of antibody responses and airway IL-13 and eosinophil accumulation than subcutaneous immunization, even when the induced IL-13 IgG responses were at a similar level. In conclusion, mucosal vaccination may be an innovative potential approach in the treatment of asthma.     

中药柴胡的药源调查及商品鉴定

通过对全国27个省区的药源调查和商品鉴定,较系统地整理了我国中药柴胡使用的原植物:共19种、5变种、1变型。并通过对102件柴胡商品的鉴定,发现其主流品种为:北柴胡、小叶黑柴胡、红柴胡和窄竹叶柴胡。     

不同剂量5－氟尿嘧啶对淋巴细胞转化及肿瘤细胞DNA合成的影响

不同剂量５－氟尿嘧啶对淋巴细胞转化及肿瘤细胞ＤＮＡ合成的影响彭贵勇，蔡景修（重庆西南医院６３００３８）袁爱力（广州南方医院）Ｅｆｆｅｃｔｓｏｆｄｉｆｆｅｒｅｎｔｄｏｓｅｓｏｆ５－ＦｕｏｎＤＮＡｓｙｎｔｈｅｓｉｓｏｆｔｕｍｏｒｃｅｌｌｓａｎｄｌｙｍｐｈ...     

络泰及KMG对离体豚鼠心脏的影响

目的：观察络泰及ＫＭＧ对脑垂体后叶素所致离体豚鼠心肌损伤的保护作用。方法：采用Ｌａｎｇｅｎｄｏｆ法进行研究。结果：络泰及ＫＭＧ可拮抗脑垂体后叶素所致冠脉流量及心肌收缩力减少（Ｐ＜００５,００１）,呈剂量依赖趋势,高剂量组略能增加冠脉流量。结论：络泰及ＫＭＧ对脑垂体后叶素所致心肌缺血有一定防治作用。     

单硝酸异山梨酯药动学和药效学特点及机制探讨

目的：对单硝酸异山梨酯药动学和药效学作用特点及其机制等方面进行评价,为该类药物的开发利用提供理论参考。方法：收集有关该药的国内外近期资料加以综合归纳。结果：较为系统的阐明了该药作用及作用机制在目前国内外研究状况,并提出将来的研究动态。结论：单硝酸异山梨酯具有疗效肯定、用途广泛、毒副作用小等特点     

厄贝沙坦、黄芪注射液和胰岛素治疗早期糖尿病肾病的疗效观察

目的探讨厄贝沙坦、黄芪注射液和胰岛素联合治疗早期糖尿病肾病的疗效。方法采用回顾性分析的方法,选取我院2005年1月至2008年1月收治的80例2型糖尿病患者,依据治疗方式的不同将患者随机分为治疗Ⅰ组（25例）、治疗Ⅱ组（25例）、治疗Ⅲ组（30例）。结果三组治疗前UAER、HbAIc、BUN、TC、TG、LDL-C比较无显著性差异（P〉0.05）;各组组内治疗后与治疗前比较均有明显差异（P〈0.05）;Ⅲ组的治疗后效果均显著优于Ⅰ组、Ⅱ组治疗后的指标（P〈0.05）;三组治疗前sICAM-1和sVCAM-1比较无显著性差异（P〉0.05）;各组组内治疗后与治疗前比较均有明显差异（P〈0.05）;Ⅲ组的治疗后效果均显著优于Ⅰ组、Ⅱ组治疗后的指标（P〈0.05）。结论通过厄贝沙坦、黄芪注射液和胰岛素联合治疗早期糖尿病肾病取得了良好的效果,值得临床推广使用。     

31例肺大出血型钩端螺旋体病治疗分析

通过对31例肺大出血型钓端螺旋病的临床分析认为:降低该病死亡率,应将病情及时有效的控制在先兆期或出血期.吸净口鼻涌血,保持呼吸道畅通是垂危期的治疗关键,应用电吸引器吸净口鼻涌血,保持呼吸道畅通,疗效可靠.     

Determination of plasma fibronectin and serum C-reactive protein in patients with cerebrovascular events

The relationship between the levels of C-reactive protein (CRP) and fibronectin (FN) and atherosclerotic diseases such as coronary heart disease has already been studied, but their relationship with cerebrovascular events has not. The aim of this study was to determine the levels of plasma FN and serum CRP in cerebrovascular events, and their relationship with the outcome of the disease. CRP and FN levels were analysed in 133 patients with acute cerebrovascular disease, together with 66 healthy controls. Cerebrovascular event patients were divided into subgroups according to disease severity. FN and CRP levels in patients with cerebrovascular disease were found to be significantly elevated compared with the control group (p<0.001). CRP levels correlated with disease severity, in contrast to FN levels. We conclude that FN is not a clinically useful marker in patients with acute differentiative cerebrovascular events, in contrast to CRP which may be useful in such cases.