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91.
Access to Cytotoxic Medicines by Children With Cancer: A Focus on Low and Middle Income Countries 下载免费PDF全文
Background
The Essential Medicines Working Group of the International Society of Pediatric Oncology (SIOP) has proposed a list of antineoplastic drugs that should be available in low and middle income countries.Procedure
Data were extracted on the listing of 18 essential and 8 ancillary antineoplastic medicines in the national essential medicines lists (NEMLs) or national reimbursable medicines lists (NRMLs) of 135 countries with gross national income (GNI) per capita of less than US $25,000. Correlations between numbers of medicines listed and GNI per capita, annual government health expenditure (AGHE) per capita, and the number of physicians per million people were examined.Results
Listing of the 18 essential antineoplastic drugs ranged from 27% (thioguanine) to 95% (methotrexate). The median number of medicines listed was 7 (0–18) in low income countries (n = 26) and 14 in lower‐middle (n = 42), upper‐middle (n = 44), and high income countries (n = 20). For the ancillary eight medicines, the median was one (0–8) across the 135 countries. Correlations with GNI per capita (r = 0.17, P = 0.0266) and physician density (r = 0.25, P = 0.0017) were statistically significant; not so for AGHE per capita (r = 0.00, P = 0.5000).Conclusions
There was large variability within income groups in numbers of antineoplastic agents identified as essential in NEMLs and NRMLs. While not a direct measure of availability, listing is an important step, guiding procurement for the public sector. These results focus attention on deficits in NEMLs and NMRLs as a step to improving access to effective antineoplastic medicines for cancers in children in low and middle income countries. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc. 相似文献92.
93.
AbstractAims: The Internet has marked a revolution in the supply of illegal drugs, while at the same time, new types of illegal and semilegal drugs increasingly are becoming available. In order to deepen our understanding of the demand and supply of these new drugs on the Internet, this study focuses on the demographic characteristics, methods and preferences of people who purchase ‘lifestyle drugs’ through the surface web.Methods: Data were obtained through the following two surveys: a prevalence study of 50,848 Dutch respondents and an in-depth study of 153 people who have purchased lifestyle drugs online.Findings: At least 10.2% of the Dutch adult population has bought medicines online; the majority being lifestyle drugs (5.2%). In addition, an estimated 1.6% of the Dutch population has purchased medicines illicitly, with the majority of products concerning lifestyle drugs (0.9%). Illicit lifestyle drugs are primarily purchased through e-commerce sites and online pharmacies, and users report high satisfaction rates.Conclusion: Purchasing lifestyle drugs is characterised by specific online dynamics, as the drugs are often openly accessible and the boundaries between legal and illegal sale blurred. As new types of drugs become available, it is important to further monitor customers’ preferences and experiences. 相似文献
94.
目的 评估基本药物制度下上海青浦区口服抗高血压药物的可负担性,为促进社区慢性病基本药物价格合理性提供实证依据。方法 采用WHO/HAI标准化法和贫化法对该地区口服抗高血压药物的可负担性进行评价。结果 用WHO/HAI标准化法评价结果显示,医疗保险患者对原研药和仿制药的可负担性都较好,而自费患者对原研药的可负担性较差。贫化法结果显示,使用同一通用名的5种原研药和仿制药的致贫人口数量差距较小。厄贝沙坦原研药的可负担性高于仿制药。结论 医疗保险对提高基本药物可负担性作用明显,同时要对一些具有明确循证学证据和使用人群广泛的药物给予合理的定价,以提高治疗高血压药物的可负担性。 相似文献
95.
96.
Alessandra Ferrario 《Value in health》2018,21(7):809-821
Objectives
First, to quantify the median time from European Union (EU)-wide approval to first use (launch) for a sample of cancer medicines and number of launches in Belgium, Estonia, Scotland, and Sweden as of June 2015. Second, to assess whether longer times to launch or lack of launches affected medicines with high or low expected additional clinical benefit. Third, to identify possible determinants of the probability of a cancer medicine to be launched.Methods
Correlation between time to launch and a set of variables hypothesized to affect launch was tested using a complementary log-log model for a sample of 46 cancer medicines that obtained EU-wide marketing authorization between 2000 and 2014.Results
In median, for a sample of 24 cancer medicines that obtained marketing authorization between 2010 and 2014, the expected time from EU-wide marketing authorization to first use of a medicine was shortest in Sweden, 3.1 months, followed by Scotland (9.3 months), Belgium (14.8 months), and Estonia (27.8 months). Median times to launch were longer for the entire sample of 46 cancer medicines that obtained marketing authorization between 2000 and 2014. In the all-country model, medicines with shorter times to submission for reimbursement, local manufacturers headquarter (or local sales representative), and a Food and Drugs Administration priority review or a combination of expedited approval programs and medicines launched in Scotland and Sweden were associated with a higher hazard of launch. Longer times since EU-wide approval initially correlate with an increased hazard but as time further elapses they negatively affect the hazard of launch.Conclusions
Median times from marketing authorization to first use of cancer medicines were shorter for medicines launched between 2010 and 2014 versus sample-wide (2000–2014). In Estonia, more medicines than in the other countries were not yet launched at the end of the observation period. There was no correlation between Prescrire and European School of Medical Oncology Magnitude of Clinical Benefit Scale ratings of added clinical value and time to launch. 相似文献97.
98.
复方阿胶浆质量标准提升研究 总被引:2,自引:2,他引:0
目的提升复方阿胶浆质量标准。方法基于中药复方制剂"整体鉴别"新模式,对复方阿胶浆中植物来源中药采用一板多鉴法,红参、党参使用同一供试品溶液、同一展开剂,采用对照品和对照药材双对照(红参使用人参皂苷Rg_1对照品和红参对照药材;党参使用党参炔苷对照品和党参对照药材)进行鉴别;熟地黄、山楂使用2种供试品溶液、同一展开剂,采用对照品和对照药材双对照(熟地黄使用毛蕊花糖苷对照品和熟地黄对照药材;山楂使用牡荆素鼠李糖苷对照品和山楂对照药材)进行鉴别。对复方阿胶浆中动物药阿胶建立L-羟脯氨酸、甘氨酸、丙氨酸、脯氨酸4种氨基酸含量测定。并采用一测多评法,以L-羟脯氨酸为内标,确定甘氨酸、丙氨酸、脯氨酸的相对校正因子并计算含量。结果建立了复方阿胶浆中植物药鉴别的"4-3-2-2"模式,即4味中药,3种供试品溶液制备方法、2种展开剂,2种对照物的双对照方法,斑点清晰且专属性强。建立了复方阿胶浆中动物药阿胶一测多评法含量测定,15批样品中L-羟脯氨酸、甘氨酸、丙氨酸、脯氨酸的质量浓度分别为2.73~3.37、4.61~6.99、2.64~3.97、3.58~4.46 mg/mL。以L-羟脯氨酸为内标建立的甘氨酸、丙氨酸、脯氨酸的相对校正因子分别为0.651、0.958、0.857。采用t检验、相对偏差法和Pearson相关系数法对2种方法的含量测定结果进行比较分析,15批复方阿胶浆一测多评法计算值与外标法实测含量值无显著差异。结论建立了复方阿胶浆中植物药来源中药鉴别的"4-3-2-2"模式。对处方中动物来源中药阿胶建立了4种氨基酸的一测多评法含量测定。通过"一板、一测",达到"多鉴、多评"整体药味质量控制的目的,科学合理地提升复方阿胶浆的质量标准。 相似文献
99.
100.
Vincent Maida Runjie B. Shi Francesco G. T. Fazzari Lydia Zomparelli 《International wound journal》2020,17(5):1508-1516
Non‐Uremic Calciphylaxis (NUC) is a rare condition that often manifests as intractable and painful integumentary wounds, afflicting patients with a high burden of co‐morbidity. The Endocannabinoid System (ECS) is a ubiquitous signalling system that is theorised to be dysregulated within wound beds and associated peri‐wound tissues. Preclinical research has shown that the dominant chemical classes derived from the cannabis plant, cannabinoids, terpenes, and flavonoids, interact with the integumentary ECS to promote wound closure and analgesia. This is a prospective open label cohort study involving two elderly Caucasian females with recalcitrant NUC leg ulcers of greater than 6 months duration. Topical Cannabis‐Based Medicines (TCBM) composed of cannabinoids, terpenes, and flavonoids were applied daily to both the wound bed and peri‐wound tissues until complete wound closure was achieved. Wounds were photographed regularly, and the digital images were subjected to planimetric analysis to objectively quantify the degree of granulation and epithelization. Analgesic utilisation, as a surrogate/proxy for pain scores, was also tracked. The cohort had a mean M3 multimorbidity index score of 3.31. Complete wound closure was achieved in a mean of 76.3 days. Additionally, no analgesics were required after a mean of 63 days. The treatments were well tolerated with no adverse reactions. The positive results demonstrated in very challenging wounds such as NUC, among highly complex patients, suggest that TCBM may have an even broader role within integumentary and wound management. This treatment paradigm warrants being trialled in other wound types and classes, and ultimately should be subjected to randomised controlled trials. 相似文献