Abstract:
BACKGROUND:Trastuzumab has a large financial impact on the average cost of breast cancer treatment. This study reassessed the cost-effectiveness of listing the drug on the subsidised Australian Pharmaceutical Benefits Scheme. METHODS:Using a continuous-time, discrete-event microsimulation model, we examined the effect of 1-year trastuzumab on the total number of disability-adjusted life-years (DALYs) averted among Australian women with human epidermal growth factor receptor-2 (HER2) positive early breast cancer. Target population was women aged 30–100 years and newly diagnosed with the disease in 2003. The model adjusted for tumour size and followed the women up until death or age 100 years. Uncertainty was examined in univariate and probabilistic multivariate sensitivity analyses. RESULTS:The incremental cost-effectiveness ratio (ICER) was A$132,537 (95% confidence interval 91,172–200,485) per DALY averted. Results were sensitive to restriction of trastuzumab to high-risk (large tumour) and/or high-benefit (young) patients. Suitable combinations of tumour size and age restrictions would improve the cost-effectiveness of trastuzumab. Specifically, restricting trastuzumab to women aged 40 years or younger with tumour sizes 40+ mm reduced the ICER to A$35,290 per DALY averted. CONCLUSION:Trastuzumab for HER2-positive early breast cancer had a high ICER. It is unclear why the Pharmaceutical Benefits Scheme listing does not use restrictions to improve the cost-effectiveness of the drug.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Doan TN,Barendregt Jdoi
10.4414/smw.2019.20082subject
Has Abstractpub_date
2019-05-19 00:00:00pages
w20082eissn
1424-7860issn
1424-3997pii
Swiss Med Wkly. 2019;149:w20082journal_volume
149pub_type
杂志文章,meta分析abstract::The awareness of Cheyne-Stokes respiration (CSR) and of the co-existence of the obstructive sleep apnoea syndrome and central breathing disturbances has rapidly grown in recent years. CSR is defined by a waxing and waning pattern of the breathing amplitude. Sleep related breathing disorders in patients with heart fail...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:smw-12425
更新日期:2009-03-07 00:00:00
abstract:QUESTION UNDER STUDY:Type 2 diabetes mellitus (T2Dm) is a chronic disease with great economic impact. In 2009, the Swiss Society for Endocrinology and Diabetes (SSED) published recommendations for treatment of T2Dm. In Switzerland, few data are currently available on metabolic control and physician compliance with trea...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2013.13871
更新日期:2013-10-25 00:00:00
abstract:BACKGROUND:The past 25 years have seen the increased use of minimally invasive surgery. The development of these techniques has impacted the domain of liver surgery. This study aimed to describe the safety, feasibility, benefits and results of laparoscopic liver resection in a single tertiary care centre. METHODS:We r...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2021.20391
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:Although most experts recommend empirical antibiotic treatment, covering also atypical bacteria, for patients admitted to an intensive care unit (ICU), the data are not clear for patients admitted to a general ward. European guidelines recommend starting empirical treatment with a beta-lactam antibiotic with...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2013.13870
更新日期:2013-09-19 00:00:00
abstract:PRINCIPLES:A decrease in plasma lipids occurs during severe sepsis and has prognostic implications in critical illness. Whether lipids have prognostic implications or could help to differentiate community-acquired pneumonia from other lower respiratory tract infections remains unknown. METHODS:We analysed data from pa...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12494
更新日期:2009-03-21 00:00:00
abstract:AIMS OF THE STUDY:Healthy adults have had the option to receive prescriptionless vaccination against influenza in pharmacies of several Swiss cantons since the 2015/16 influenza season. We aimed to assess in a cost-benefit analysis the resulting net benefits for the Swiss economy and public health, and the benefits tha...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2019.20161
更新日期:2019-12-17 00:00:00
abstract::With regard to HCV elimination in opioid agonist therapy patients by 2030, case finding and regular screening for new and re-infections remain a challenge, especially for non-cohort patients in a decentralised setting. Documentation of the HCV sero- and RNA status of each opioid agonist therapy patient by the ca...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2020.20317
更新日期:2020-08-06 00:00:00
abstract:OBJECTIVES:Women are still underrepresented in the senior ranks of medical school faculties. Thus far information has been lacking on gendersensitive career paths for professorial and nonprofessorial staff of Swiss medical schools. The aim of this study was to survey faculty members of all Swiss medical schools on soci...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2003/21/smw-10230
更新日期:2003-05-31 00:00:00
abstract:STUDY/PRINCIPLES:Physical activity improves the clinical course of the metabolic syndrome and its risk factors. The aim of this study was to investigate the physical activity behaviour in patients with metabolic syndrome in regard to the recommendation of the Federal Offices of Public Health (BAG) and Sports (BASPO): "...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2012.13691
更新日期:2012-10-25 00:00:00
abstract::Coronavirus disease 2019 (COVID-19) is primarily a pulmonary disease, but also affects the cardiovascular system in multiple ways. In this review, we will summarise and put into perspective findings and debates relating to the diverse aspects of cardiovascular involvement of COVID-19. We will review evidence for the r...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2020.20417
更新日期:2020-12-31 00:00:00
abstract:BACKGROUND:Thyroid hemiagenesis (TH) is a rare congenital abnormality of the thyroid gland, characterised by the absence of one lobe. The true prevalence of this congenital abnormality is not known because the absence of one thyroid lobe usually does not cause clinical symptoms by itself. This study aims to identify th...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12956
更新日期:2010-02-20 00:00:00
abstract:BACKGROUND:In contrast to quality of life, patient satisfaction on chronic haemodialysis (HD) and peritoneal dialysis (PD) has only rarely been studied. PATIENTS AND METHODS:All chronic HD and PD patients of the 19 centres located in western Switzerland were asked to complete a specific questionnaire, assessing dialys...
journal_title:Swiss medical weekly
pub_type: 杂志文章,多中心研究
doi:2006/13/smw-11180
更新日期:2006-04-01 00:00:00
abstract:STUDY OBJECTIVES:we performed an open-label national study to evaluate the effects of Bosentan on haemodynamics, exercise capacity, quality of life, safety and tolerability in patients with chronic thromboembolic pulmonary hypertension (CTEPH). PATIENTS AND METHODS:fifteen patients with CTEPH not eligible or waiting f...
journal_title:Swiss medical weekly
pub_type: 临床试验,杂志文章
doi:2007/41/smw-11819
更新日期:2007-10-20 00:00:00
abstract:PURPOSE:Stress ulcer prophylaxis prescriptions might not be sufficiently challenged throughout a patient's stay in an intensive care unit (ICU) and might be erroneously maintained after ICU discharge. This study aimed to determine (1) stress ulcer prophylaxis adequacy in ICU and (2) the proportion of patients recei...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2020.20322
更新日期:2020-08-24 00:00:00
abstract::In this review article, we aim at analysing the role of stress in addiction and relapse. In order to do so, we first offer a summary of the findings from affective neuroscience trying to understand compulsive reward-seeking behaviours. These behaviours are characterised by an imbalance between the considerable amount ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2019.20151
更新日期:2019-11-29 00:00:00
abstract:OBJECTIVE:To assess outcomes 24 months after treatment start for multidrug-resistant tuberculosis (MDR-TB). METHODS:Cohort study of all culture-positive MDR-TB cases notified in Switzerland from 01/2003 to 07/2010. RESULTS:Fifty-one cases were observed, with a median age of 26 years (range 2-56). Twenty-seven were ma...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.14053
更新日期:2014-12-04 00:00:00
abstract:OBJECTIVE:To provide population-based, gestational age (GA) stratified incidence of mortality and morbidities. METHODS:Population-based prospective observational study of infants born between 23 0/7 and 31 6/7 weeks GA in the years 2000-2004 in all Swiss neonatal intensive care units. Outcomes measured were: mortality...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2011.13212
更新日期:2011-06-24 00:00:00
abstract:QUESTIONS UNDER STUDY:Deep brain stimulation (DBS) has become a standard therapy for some forms of severe movement disorders and is investigated for other neurological and psychiatric disorders, although many scientific, clinical and ethical issues are still open. We analyse how the Swiss DBS community addresses these ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2012.13570
更新日期:2012-04-05 00:00:00
abstract::Invasive fungal infections have emerged as important causes of morbidity and mortality in immunocompromised patients. In response to this challenge, the field of antifungal chemotherapy has considerably expanded. Fluconazole and itraconazole, introduced in the late 1980s, were the first durably useful alternatives to ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2002/23/smw-09729
更新日期:2002-06-15 00:00:00
abstract::Osteoarticular infections remain a significant cause of morbidity worldwide in young children. They can have a devastating impact with a high rate of serious and long-lasting sequelae, especially on remaining growth. Depending on the localisation of infection, they manifest as osteomyelitis, septic arthritis, a combin...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2014.13971
更新日期:2014-06-12 00:00:00
abstract:QUESTION UNDER STUDY:To assess clinical reactions, immune responses and adverse events to undiluted, three- and sixfold diluted Lister strain vaccine stockpiled in Switzerland. METHODS:A prospective, triple-blinded, randomised, parallel group clinical trial was performed. RESULTS:From 2001 to 2007 104 persons with an...
journal_title:Swiss medical weekly
pub_type: 杂志文章,随机对照试验
doi:2008/27/smw-11966
更新日期:2008-07-12 00:00:00
abstract::Giant cell arteritis (GCA) is the most common of the vasculitis syndromes and, being a disease of the elderly, its incidence is increasing with the general ageing of the population. GCA is most feared for its early complications, namely blindness and stroke, resulting from inflammation and subsequent occlusion of ocul...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2011.13272
更新日期:2011-09-28 00:00:00
abstract:QUESTIONS UNDER STUDY/PRINCIPLES:We describe the proportion of severely depressed outpatients reaching complete remission at the different stages of a drug treatment algorithm. We compare several treatment options for SSRI (selective serotonin reuptake inhibitor) non-responders and test the feasibility of the algorithm...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/05/smw-11267
更新日期:2006-02-04 00:00:00
abstract:PRINCIPLES:Heart failure is associated with a grim prognosis. Disease management programmes can improve prognosis in heart failure patients but the applicability to the general population remains limited. We aimed to compare the outcome, pharmacological therapy, and quality of life in unselected heart failure patients ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/17/smw-11274
更新日期:2006-04-29 00:00:00
abstract:QUESTIONS UNDER STUDY/PRINCIPLES:A retrospective assessment of long-term results on a single centre, single author experience in treating prostate cancer with high dose curative radiotherapy (RT) with or without androgen deprivation (AD). METHODS:Between 1991 and 2004, 408 patients with clinically localised prostate c...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12604
更新日期:2009-09-05 00:00:00
abstract::Better recipient selection, sophisticated postoperative surveillance and new immunosuppressive and anti-infective regimens can improve the results of lung transplantation. We compared the results of lung transplants performed between 1992 and 1996 (early period; 47) and between 1997 and 2000 (recent period; 46) in a c...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2001/17/smw-09718
更新日期:2001-05-05 00:00:00
abstract::The differential diagnosis for children with diabetes includes a group of monogenic diabetic disorders known as maturity-onset diabetes of the young (MODY). So far, six underlying gene defects have been identified. The most common subtypes are caused by mutations in the genes encoding the transcription factor HNF-1a (...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2005/23/smw-11030
更新日期:2005-06-11 00:00:00
abstract:AIMS:This study evaluated the evolution of the prenatal diagnosis of congenital heart disease (CHD) between 2003 and 2008 and its repercussion for the CHD prevalence rate at birth in a well-defined population (Canton of Vaud, Switzerland). METHODS AND RESULTS:All 572 cases of CHD reported in the Eurocat Registry of Va...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.14068
更新日期:2014-12-04 00:00:00
abstract::Over the last few years atypical antipsychotics have been used increasingly in the pharmacological treatment of schizophrenia. This review provides an overview of the pharmacological and clinical characteristics of atypical antipsychotics. In particular we discuss their efficacy in treating psychotic and negative symp...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2003/05/smw-10003
更新日期:2003-02-08 00:00:00
abstract:QUESTIONS UNDER STUDY:To evaluate the diagnostic value of serum Cystatin C and urine neutrophil gelatinase-associated lipocalin (NGAL) for the detection of acute kidney injury in patients undergoing congenital heart surgery. METHODS:Serial samples of serum Cystatin C and urine NGAL were collected from 139 consecutive ...
journal_title:Swiss medical weekly
pub_type: 临床试验,杂志文章
doi:10.4414/smw.2013.13744
更新日期:2013-01-17 00:00:00