Abstract:
:It is a continual challenge trying to improve the quality of prescribing while concurrently trying to address increasing pharmaceutical development, utilization and expenditure. National and regional reforms and initiatives in Sweden have moderated growth in ambulatory drug expenditure to 2.7% per annum in recent years despite increasing volumes. National reforms include mandatory generic substitution and value-based pricing alongside devolution of drug budgets to the regions. Regional initiatives include strengthening the role of the regional Drug and Therapeutic Committees, further budget devolution as well as strategies incorporating prescribing guidance and monitoring coupled with financial incentives. The extent and nature of the regional initiatives vary depending on their characteristics. In this article, we compare initiatives undertaken in two major counties, Stockholm and Ostergötland, and their outcomes. Outcomes include annual drug budget savings while achieving agreed quality as well as increased adherence to prescribing targets and guidance; the latter associated with savings. Appraising these multifaceted reforms can provide guidance to other countries and regions in view of their diversity. Future steps must incorporate measures to improve the utilization of new expensive drugs, which should include horizon scanning and forecasting activities as well as post-launch activities involving monitoring of prescribing and registries. This may well require cooperation with other European countries.
journal_name
Expert Rev Pharmacoecon Outcomes Resjournal_title
Expert review of pharmacoeconomics & outcomes researchauthors
Godman B,Wettermark B,Hoffmann M,Andersson K,Haycox A,Gustafsson LLdoi
10.1586/14737167.9.1.65subject
Has Abstractpub_date
2009-02-01 00:00:00pages
65-83issue
1eissn
1473-7167issn
1744-8379journal_volume
9pub_type
杂志文章,评审abstract::A comprehensive literature search identified seven instruments, of which three had psychometric data available. These were the 'Sawicki instrument', the Duke Anticoagulation Satisfaction Scale (DASS) and Deep Vein Thrombosis Quality of Life (DVTQoL). Sawicki assessed five domains with acceptable internal reliability. ...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.8.3.291
更新日期:2008-06-01 00:00:00
abstract::Interest is rising in measuring subjective health outcomes, such as treatment outcomes that are not directly quantifiable (functional disability, symptoms, complaints, side effects and health-related quality of life). Health economists in particular have applied probabilistic choice models in the area of health evalua...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/erp.12.85
更新日期:2013-02-01 00:00:00
abstract::Evaluation of: Levin LA, Wallentin L, Bernfort L et al. Health-related quality of life of ticagrelor versus clopidogrel in patients with acute coronary syndromes results from the PLATO trial. Value Health 16(4), 574-580 (2013). Antiplatelet therapy is considered essential treatment for acute coronary syndromes with or...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 评论,杂志文章
doi:10.1586/14737167.2014.861743
更新日期:2014-02-01 00:00:00
abstract::Despite the intense debates over state or private sector dominance in healthcare finance and provision, there are no clear winners. Failed models exist on either end of the ideological spectrum and no country in the world has one that is purely public or purely private. Neither does a perfect public-private mix exist;...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.6.6.647
更新日期:2006-12-01 00:00:00
abstract::Nursing homes are facing increased environmental pressures to improve quality of care. However, this increased emphasis on quality comes at a time when nursing homes are facing revenue constraints as a result of the repeal of the Boren amendment, increased reimbursement based on prospective payment systems and widespr...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.4.1.99
更新日期:2004-02-01 00:00:00
abstract:INTRODUCTION:This article is part of the series "How to Prepare a Systematic Review (SR) of Economic Evaluations (EE) for Informing Evidence-based Healthcare Decisions" in which a five-step-approach for conducting a SR of EE is proposed. Areas covered: This paper explains the data extraction process, the risk of bias a...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1080/14737167.2016.1246961
更新日期:2016-12-01 00:00:00
abstract::Cancer patient satisfaction assessment is increasingly considered, owing to the need to assess evolving patterns of care organization and delivery or to test new cancer treatments and interventions. This article reviews cancer patient satisfaction questionnaires using key methodological criteria. In total, 17 patient ...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/erp.10.7
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:Breast cancer, the second most common cancer in women, exerts a multidimensional grave effect on affected women. Among the several subtypes of breast cancer, the overexpression of the human epidermal growth factor receptor-2 gene is associated with poorer survival and higher relapse rates. Trastuzumab, a m...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1080/14737167.2019.1536549
更新日期:2019-04-01 00:00:00
abstract::Fondaparinux sodium is the first in a new class of anticoagulants that selectively inhibits Factor Xa. It produces a predictable pharmacologic response, obviating the need for coagulation monitoring. Additionally, this agent does not bind to platelet Factor 4, thereby reducing the risk of thrombocytopenia. Clinical tr...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.7.3.227
更新日期:2007-06-01 00:00:00
abstract::Healthcare reform in any nation is an evolving process. Brought about by demographic, technological, social, cultural, economic and political factors, all healthcare systems are continually confronting issues related to cost, access and quality. This paper examines other countries' approaches to healthcare in the ongo...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.2.3.279
更新日期:2002-06-01 00:00:00
abstract::The second symposium of the European Organisation for Research and Treatment of Cancer took place in September 2011 at the European Parliament in Brussels (Belgium). The aim of the symposium was to discuss a wide range of topics in health-related quality of life, symptom research and cancer clinical trials, including ...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type:
doi:10.1586/erp.11.84
更新日期:2011-12-01 00:00:00
abstract::Smoking cessation is the only strategy that has shown a lasting reduction in the decline of lung function in patients with chronic obstructive pulmonary disease. This study aims to evaluate the cost-effectiveness of smoking cessation interventions in patients with chronic obstructive pulmonary disease, to assess the q...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/14737167.2015.1001976
更新日期:2015-04-01 00:00:00
abstract:AIM:To evaluate patient perception of the onset of action and overall satisfaction with a fast-dissolving tablet (FDT) formulation of ebastine in patients with intermittent or persistent allergic rhinitis. PATIENTS AND METHODS:This was a cross-sectional, multicenter, pharmacy-based survey involving adult patients (>18...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.8.4.337
更新日期:2008-08-01 00:00:00
abstract::Given growing interest in multicriteria decision making and multiple cost-effectiveness thresholds' approach, it was decided to investigate its usefulness in Poland. The pricing and reimbursement (P&R) regulations were reviewed and a cross-sectional survey was conducted amongst nurses. The study investigated whether P...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.2014.940903
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:Alcohol use is a major risk factor for mortality and morbidity burden, and alcohol use disorders contribute markedly to this burden. Effective interventions for alcohol use disorders improve health, and are potentially cost-effective or even cost saving. AREAS COVERED:We searched the literature for the co...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1080/14737167.2018.1392241
更新日期:2018-02-01 00:00:00
abstract::The Dutch basic health insurance is based on the principles of regulated competition. This implies that insurers and providers compete on price and quality while the regulator sets certain rules to achieve public objectives such as solidarity. Two regulatory aspects of this scheme are that insurers are not allowed to ...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/14737167.2013.841546
更新日期:2013-12-01 00:00:00
abstract::Chronic obstructive pulmonary disease is a major cause of morbidity and mortality throughout the world. Standard management includes avoidance of causative factors such as smoking, and pharmacological therapy with combinations of inhaled and/or oral bronchodilators and corticosteroids. Lung transplantation is an estab...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.3.6.729
更新日期:2003-12-01 00:00:00
abstract::This review considers some of the broad principles that concern quality of life assessment. These are discussed in relation to health-related quality of life (HRQOL) and the measurement of subjective well-being. It is argued that there are serious logical and methodological issues concerning HRQOL measurement, to the ...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.4.4.413
更新日期:2004-08-01 00:00:00
abstract::This review examines the national trends in out-of-pocket and high economic burden of prescription drug expenditures by elderly people aged 65 years and older. From 1992 to 2000, prescription out-of-pocket drug expenditures increased at an annual rate of 7%. During this period the proportion of elderly without prescri...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.5.3.297
更新日期:2005-06-01 00:00:00
abstract::Treatment switching has become an important issue in the development and approval of new drugs, particularly in oncology. Randomized controlled trials (RCTs) represent the gold standard for evaluating the effectiveness of interventions, but often patients randomized to the control group are permitted to switch onto th...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 社论
doi:10.1586/14737167.2015.1037835
更新日期:2015-01-01 00:00:00
abstract::In this article, we will focus on how preferences and utilities are measured, including the strengths and limitations of various approaches, discuss their use in estimating quality-adjusted life-years (QALYs) and make some recommendations for further research. Preferences are either measured using direct (visual analo...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/erp.11.100
更新日期:2012-02-01 00:00:00
abstract::Chronic obstructive pulmonary disease is a progressive disease of the airways in which respiratory symptoms aggravate transitorily during disease exacerbations. The treatment of the disease in its stable state is the most important factor in reducing related morbidity, but exacerbation therapy might also impact on sub...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/erp.09.33
更新日期:2009-08-01 00:00:00
abstract:AIM:Limitations of vitamin K antagonists (VKAs) include frequent monitoring, dietary restrictions and drug interactions. This study conducted an indepth exploration of perspectives of VKA therapy in respondents with atrial fibrillation or venous thromboembolism. METHODS:A total of 60 respondents, recruited from the UK...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/erp.09.48
更新日期:2009-10-01 00:00:00
abstract::Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. The burden of skin disease is a multidimensional concept that encompasses psychological, social and financial consequences of the skin disease on the patients, their families and on society. Chronic and inc...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/erp.09.23
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:During the past few years, medical-economic evaluation of lung cancers (LCs) has become unavoidable. Total management costs have been rising constantly, with values almost doubling every 10 years. The financial impact will be even greater with the new molecules now marketed. The methodology for these studi...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1080/14737167.2018.1485099
更新日期:2018-10-01 00:00:00
abstract::The 10th consecutive World Health Economics conference was organized jointly by International Health Economics Association and European Conference on Health Economics Association and took place at The Trinity College, Dublin, Ireland in July 2014. It has attracted broad participation from the global professional commu...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type:
doi:10.1586/14737167.2014.967220
更新日期:2014-12-01 00:00:00
abstract::A systematic review was conducted of the full economic evaluations of the cost-effectiveness of peginterferon alfa-2b (PEG-IFN alfa-2b) plus ribavirin (RBV) in the treatment of chronic hepatitis C (CHC). A total of 439 references were screened and 11 studies were included. The studies employed decision analytic Markov...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.7.6.577
更新日期:2007-12-01 00:00:00
abstract::Osteoporosis is a public health threat to approximately 44 million individuals in the USA, or 55% of men and women over the age of 50 years. The primary goal of osteoporosis management is to prevent fracture, the most devastating consequence. Risk factors and bone mineral density can be assessed to determine appropria...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章
doi:10.1586/14737167.6.5.525
更新日期:2006-10-01 00:00:00
abstract::Asthma is an inflammatory disorder with increasing prevalence and significant morbidity worldwide. Inhaled steroids improve asthma symptoms, reduce exacerbations number and severity, and the need for oral steroids. Due to their potent anti-inflammatory effect, inhaled steroids represent the most effective maintenance ...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 评论,杂志文章
doi:10.1586/14737167.3.3.223
更新日期:2003-06-01 00:00:00
abstract::Differential item functioning (DIF) analyses are used to determine whether certain groups respond differently to a particular item of a test or questionnaire; however, these do not explain the reasons for observed response differences. Many studies have used external reviews of items, sometimes using blinded reviewers...
journal_title:Expert review of pharmacoeconomics & outcomes research
pub_type: 杂志文章,评审
doi:10.1586/erp.10.22
更新日期:2010-06-01 00:00:00