康瑞保凝胶治疗增生性瘢痕疙瘩的疗效观察

目的观察康瑞保凝胶预防及治疗增生性瘢痕疙瘩的疗效及安全性。方法随机抽取39例病例,其中男性16例,女性23例,年龄为12~62岁。观察总有效率及不良反应。结果39例增生性瘢痕疙瘩使用康瑞保凝胶每日1次,连续6个月。结果显效率74.36%,有效率20.51%.总有效率94.87%。此药无明显不良反应。结论康瑞保凝胶预防及治疗增生性瘢痕疙瘩疗效显著。     

加强政府、企业和学术界合作,促进我国药物流行病学的发展

目的:探讨政府、企业和学术界三方合作促进中国药物流行病学发展的必要性和可行性。方法和结果:讨论政府、企业、学术界在药物流行病学研究领域合作的重要性,介绍世界范围内可借鉴的合作经验,商榷我国开展药物流行病学研究三方合作的机遇与挑战以及需要注意的问题。结论:欧美国家在药物流行病学研究中,三方合作合理运用药物流行病学进行药物疗效和安全评价工作发挥了积极作用。针对我国特定的机遇和挑战,政府、企业和学术界三方的有效合作可充分发挥各自的优势,从而促进药物流行病学研究人才培养,医疗信息资源开发和制定有关的法律法规,并最终推动这一学科在中国的进一步发展。     

非霍奇金淋巴瘤三种化疗方案成本 效果分析

目的:探讨治疗非霍奇金淋巴瘤联合化疗最佳方案及用药合理性.方法:根据文献选择68例患者,随机分为3组,分别给予以吡喃阿霉素(THP)、表阿霉素(E ADM)、阿霉素(ADM)为主的联合化疗方案,运用药物经济学成本 效果分析方法进行评价.结果:3组不同化疗方案中完全缓解率(CR%)以E ADM组最高,不良反应发生总例次THP组最低,心脏毒性及脱发3组间差异有显著性.结论:应根据患者体质、经济条件等具体情况,适宜地制订给药方案.     

多中心评价银杏内酯注射液治疗重症缺血性脑卒中药物经济学

目的 研究多中心银杏内酯注射液治疗重症缺血性脑卒中的临床疗效、经济性、安全性,评价药物经济价值。方法 采用前瞻性队列研究方法,纳入了2013年8月-2013年12月各中心重症缺血性脑卒中患者共119例,以银杏内酯注射液加常规治疗的患者为治疗组,共78例;对照组41例,患者在常规治疗基础上可使用其他活血化瘀类药物。在出院后3、6、12个月对两组患者进行电话随访,获取药效指标：日常生活活动能力评价（ADL）评分、生活自理患者比例、痊愈率、复发率、全因死亡率;经济学指标：成本效果比（CER）;以及不良事件发生情况,评估患者采用不同治疗方案的远期获益差异。结果 出院后3、6、12个月,治疗组ADL评分、痊愈率和自理率均优于对照组,且差异显著（P<0.05）;出院后6个月,治疗组复发率优于对照组,且差异显著（P<0.05）;出院后12个月,治疗组复发率和死亡率优于对照组,且差异显著（P<0.05）;出院后3、6、12个月,治疗组的CER均明显小于对照组;两组不良反应发生率均较低。结论 远期评估发现,经银杏内酯注射液治疗患者较未接受其治疗患者临床效果更佳,CER更优,证明了银杏内酯注射液治疗重症脑卒中的有效性及经济性。     

Modelling the cost-utility of bio‑electric stimulation therapy compared to standard care in the treatment of elderly patients with chronic non-healing wounds in the UK

ABSTRACT

Objective: To estimate the cost-utility of bio-electric stimulation therapy (Posifect^*) compared to standard care in elderly patients with chronic, non-healing wounds of > 6 months duration, from the perspective of the National Health Service (NHS) in the UK.

Methods: Clinical and resource use data from a 16 week clinical evaluation of bio-electric stimulation therapy among patients who had recalcitrant wounds were combined with utility data obtained from a standard gamble analysis to construct a 16 week Markov model. The model considers the decision by a clinician to continue with a patient's previous care plan or treat with bio-electric stimulation therapy. Unit resource costs at 2005/2006 prices were applied to the resource utilisation estimates within the model, enabling the cost-utility of bio-electric stimulation therapy compared to standard care to be estimated. The acquisition cost of Posifect had not been decided at the time of performing this study. Hence, the base case analysis used a cost of £50 per dressing.

Results: 33% of all wounds are expected to heal within 16 weeks after the start of bio-electric stimulation therapy. Consequently, using bio-electric stimulation therapy is expected to lead to a 51% decrease in the number of domiciliary clinician visits, from 4.7 to 2.3 per week. The model also showed that using bio-electric stimulation therapy instead of patients’ standard care is expected to reduce the NHS cost of managing them by 16% from £2287 (95% CI: £1838; £2735) to £1921 (95% CI: £1609; £2233) and result in a health gain of 0.023 QALYs over 16 weeks. Hence, bio-electric stimulation therapy was found to be a dominant treatment. Sensitivity analyses demonstrated that the cost-utility of using bio-electric stimulation therapy relative to standard care is very sensitive to the acquisition cost of the therapy, the acquisition cost of patients’ drugs and the number of clinician visits and less sensitive to utility values and the acquisition cost of other dressings.

Conclusion: Within the limitations of the model, bio-electric stimulation therapy is expected to afford the NHS a cost-effective dressing compared to standard care in the management of chronic non-healing wounds of > 6 months duration. Bio-electric stimulation therapy's acquisition cost is expected to be offset by a reduction in the requirement for domiciliary clinician visits, leading to a release of NHS resources for use elsewhere in the system, thereby generating an increase in NHS efficiency.     

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.     

运用Markov模型进行药物经济学评价的方法概述及国外研究实例分析

目的:了解国外进行药物经济学评价研究的方法,促进我国药物经济学发展,为临床合理用药提供科学依据。方法:以国外最新乳腺癌治疗方案的药物经济学研究论文为实例,阐述运用Markov模型进行药物经济学评价的方法。结果与结论:借鉴国外分析方法,运用决策分析模型进行药物经济学研究,有利于我国药物经济学的发展。     

Comparative effectiveness of everolimus and axitinib as second targeted therapies for metastatic renal cell carcinoma in the US: a retrospective chart review

Background Second targeted therapies for metastatic renal cell carcinoma (mRCC) include mammalian target of rapamycin inhibitors (mTORis) and tyrosine kinase inhibitors (TKIs). This observational study compares overall survival (OS) and progression-free survival (PFS) of patients treated with everolimus (an mTORi) and axitinib (a TKI) following first TKI, and assesses the impact of type and duration of first TKI on the relative effectiveness of these second targeted therapies.

Methods Retrospective reviews of medical records were conducted by medical oncologists or hematologists/oncologists recruited from a nationwide panel. Included patients with mRCC were required to have discontinued a first TKI (sunitinib, sorafenib, or pazopanib) for medical reasons, and to have initiated everolimus or axitinib as second targeted therapy between February 2012 and January 2013. OS and PFS were compared between patients treated with everolimus vs. axitinib using multivariable Cox proportional hazards regression models. Comparative results were also stratified by type and duration of first TKI.

Results Included patients (n?=?325 for everolimus and n?=?127 for axitinib) had a mean age of 61 years and 31% were female. Sunitinib was the most commonly used first TKI (73%). After adjusting for patient characteristics, no statistically significant differences were observed in OS or PFS between everolimus and axitinib. When stratifying by type and duration of first TKI, there was no statistically significant difference in OS between everolimus and axitinib in all subgroups except for patients with?<6 months on sunitinib or sorafenib as first TKI. No significant difference in PFS was observed in any subgroup.

Limitations Important limitations include potential missing or inaccurate data in medical charts, and confounding due to unobserved factors.

Conclusions In this retrospective chart review, no significant differences were detected in OS or PFS between axitinib and everolimus as second targeted therapy. Longer duration of first TKI was not associated with increased effectiveness of subsequent axitinib compared to everolimus.     

Novel Electromagnetic Characterization Methods for New Materials and Structures in Aerospace Platforms

The tendency over the last decades in the aerospace industry is to substitute classic metallic materials with new composite materials such as carbon fiber composites (CFC), fiber glass, etc., as well as adding electronic devices to ensure the safety and proper platform operation. Due to this, to protect the aircraft against the Electromagnetic Environmental Effects (E3), it is mandatory to develop accurate electromagnetic (EM) characterization measurement systems to analyze the behavior of new materials and electronic components. In this article, several measurement methods are described to assess the EM behavior of the samples under test: microstrip transmission line for a surface current analysis, free space to obtain intrinsic features of the materials and shielding effectiveness (SE) approaches to figure out how well they isolate from EM fields. The results presented in this work show how the different facilities from the National Institute of Aerospace Technology (INTA) are suitable for such purposes, being capable of measuring a wide variety of materials, depending on the type of test to be carried out.