Expert review of pharmacoeconomics & outcomes research
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Expert Rev Pharmacoecon Outcomes Res · Jan 2015
Multicenter Study Observational StudyThe use of adalimumab, etanercept, golimumab and infliximab in rheumatic pathologies: variation between label dosage and real-world use.
Rheumatoid arthritis (AR), psoriatic arthritis (PSA) and ankylosing spondylitis (AS) are autoimmune systemic diseases characterized by inflammation, pain and joint degeneration. The objective of this study is to evaluate, under the actual conditions of use, dosing patterns of adalimumab, etanercept, golimumab and infliximab in these pathologies, and compare them with the label regimens recommended, as well as evaluating the financial implications of these regimen modifications. The study population included all adult patients diagnosed with RA, PSA or AS who had been treated with adalimumab, etanercept, golimumab and infliximab for at least 6 months between 1 January 2011 and 31 December 2013. ⋯ By contrast, 48.5% of patients with RA treated with infliximab required dose intensification; however, infliximab dose intensification in PSA and AS is not so pronounced. The practice of optimization of dose regimens in patients with rheumatic diseases under treatment with anti-TNFα is spreading among professionals, resulting in annual cost reduction in the treatment of rheumatic arthropathies. However, long term follow-up will be necessary to assess the influence of this optimization on health outcomes.
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Expert Rev Pharmacoecon Outcomes Res · Apr 2013
Randomized Controlled Trial Multicenter Study Comparative StudyCost-effectiveness analysis comparing degarelix with leuprolide in hormonal therapy for patients with locally advanced prostate cancer.
Degarelix, approved in the USA in 2008, is a gonadotropin-releasing hormone antagonist, representing one of the latest additions to androgen deprivation therapy (ADT). ADT is used as first-line therapy for locally advanced or metastatic prostate cancer with the aim to reduce testosterone to castrate levels. ⋯ Using one registration trial for degarelix with leuprolide as the active control, a cost-effectiveness analysis with a Markov model and a 20-year time horizon found the incremental cost-effectiveness ratio for degarelix to be US$245/quality-adjusted life years. Degarelix provides a cost-effective treatment for ADT among patients with locally advanced prostate cancer.
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Expert Rev Pharmacoecon Outcomes Res · Feb 2013
Multicenter StudyMedical resource use, disturbance of daily life and burden of hypoglycemia in insulin-treated patients with diabetes: results from a European online survey.
Hypoglycemia is common in patients with diabetes, and any severe hypoglycemic event can increase the fear of future hypoglycemic events. To try to reduce hypoglycemic events, many patients with diabetes maintain their blood glucose levels with a 'safety margin' (i.e., at higher than recommended values) and maintain hyperglycemia. Following this strategy leads to raised glycated hemoglobin levels, which are, consequently, linked to an increased risk of diabetic complications and increased healthcare costs. ⋯ In addition, 10% of the patients reported that they had taken days off work because of hypoglycemia during the previous 12 months. Furthermore, 80% of diabetics in the three countries said they would value a meter that tells them when their blood glucose level is getting high/low at a particular time of the day. Thus, the survey outlines the potential scale, in a real-world setting, of 'hidden' costs associated with hypoglycemia and fear of hypoglycemia; such costs are likely to have a major detrimental impact on the overall emotional and economic burden of diabetes, which may be reduced through broader use of blood-glucose monitors for self-monitoring of blood glucose.