Abstract:
:Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of the symptoms of osteoarthritis (OA), rheumatoid arthritis (RA), sprains and strains, sports injuries and menstrual disorders, and have a small role in the management of patent ductus arteriosus in the neonate. In patients with RA, symptom relief through use of NSAIDs is firmly established, although it remains unclear whether they influence the course and outcome of the disease. For the average patient with RA taking NSAIDs, the attributable risk of hospitalisation with gastrointestinal problems related to NSAIDs is 1.3 to 1.6% annually and risk of death is 0.15%. Associations of therapy with risk are greatest with age, corticosteroid use and previous NSAID-related gastrointestinal adverse effects, and less marked with disability and high NSAID dose. These are important data in attempting to balance risk of therapy with clinical efficacy in an individual patient, and assessing the cost-effectiveness of prophylaxis. Although half of all NSAID consumption is for control of pain associated with degenerative conditions, their superiority over simple analgesics in osteoarthritis is poorly documented. This finding supports the use of the simple analgesic paracetamol (acetaminophen) as the preferred therapy of osteoarthritis, especially when its lower cost and low incidence of adverse effects are taken into consideration. Consistent differences in clinical effectiveness of individual NSAIDs have not been demonstrated, although unpredictable interpatient variation in response to individual agents is of considerable clinical importance, and a more expensive NSAID may prove cost effective for some patients. Cost effectiveness can be improved by a self-adjusted dosage regime which also leads to lower overall drug consumption. The adverse gastrointestinal effects of these drugs account for about 30% of the overall cost of arthritis treatment, and although studies to date have been too limited to assess the relative risk of gastrointestinal toxicity of the different NSAIDs reliably, ibuprofen appears to be one of the least hazardous, and azapropazone one of the most hazardous. Although the effectiveness of prophylaxis with H 2-antagonists and with prostaglandin E 1 analogues (prostaglandin-E 1 analogues) has been established, estimates of cost-benefit ratios are widely divergent. To establish the most cost-effective therapy with NSAIDs, more data are required to establish multivariable risk profiles for identification of patients at particular risk, the optimal drug, and its optimal dosage and duration of treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Wynne HA,Campbell Mdoi
10.2165/00019053-199303020-00004subject
Has Abstractpub_date
1993-02-01 00:00:00pages
107-23issue
2eissn
1170-7690issn
1179-2027journal_volume
3pub_type
杂志文章,评审abstract:BACKGROUND:Probabilistic sensitivity analysis (PSA) in cost-effectiveness analysis involves sampling a large number of realisations of an economic model. For some parameters, we may be uncertain around the true mean values of the variables, but the ordering of the values is known. Typical sampling approaches lack eithe...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0584-3
更新日期:2018-03-01 00:00:00
abstract::Variable compliance with prescribed drug regimens is a leading source of variability in drug response. Specifics differ by drug and disease. The role of variable compliance was clearly defined in 2 trials of lipid-lowering agents, cholestyramine and gemfibrozil, in which exceptionally careful measurements of complianc...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199915030-00002
更新日期:1999-03-01 00:00:00
abstract::The progressive increase in the prevalence of obesity and aging in the population is resulting in increased healthcare and disability spending. The burden of obesity is particularly relevant in old age, due to accumulating co-morbidities and changes in body composition. Sarcopenic obesity, a mix of over- and under-nut...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0237-8
更新日期:2015-07-01 00:00:00
abstract::Recombinant human erythropoietin (rHuEpo) has been increasingly used in preterm infants in the last 3 to 4 years. Recent studies have indicated a reduction in blood transfusion requirements in infants receiving rHuEpo. No significant adverse effects have emerged, apart from iron deficiency (if iron supplementation is ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199712040-00002
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) is a well-recognized public health concern and imposes high economic and societal costs. Decision analytic models exist for evaluating the economic ramifications associated with HF. Despite this, studies that appraise these modelling approaches for augmenting best-practice decisions remain...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0755-x
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:Patients with cancer-associated neutropenia are at high risk of developing severe infections which can be fatal if treatment is not promptly administered. For this reason, fever is treated as soon as possible with broad spectrum antibacterial therapy. The objective of this study was to conduct a cost analysis...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199915010-00006
更新日期:1999-01-01 00:00:00
abstract::Which costs and benefits to consider in economic evaluations of healthcare interventions remains an area of much controversy. Unrelated medical costs in life-years gained is an important cost category that is normally ignored in economic evaluations, irrespective of the perspective chosen for the analysis. National gu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200826100-00003
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Recent clinical trial results have demonstrated that, in patients with type 2 diabetes, second-line treatment of rosiglitazone in combination with metformin can lead to significant improvements in the control of fasting plasma glucose/ glycosylated haemoglobin A1c (HbA1c) after the failure of metformin mon...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624001-00003
更新日期:2006-01-01 00:00:00
abstract::Answering the demanding questions asked of pharmacotherapy in the 21st century will require more reliance on the disciplines of pharmacoepidemiology and pharmacoeconomics. Pharmacoepidemiology can help assess patterns and appropriateness of drug utilisation, provide explanations for poor compliance, quantify the frequ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422002-00009
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To estimate savings in the cost of caring for patients with Alzheimer's disease (AD) during 6 months, 1 year and 2 years of treatment with rivastigmine. An intermediate objective was to estimate the relationship between disease progression and institutionalisation. DESIGN AND SETTING:We assessed the relation...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200017040-00005
更新日期:2000-04-01 00:00:00
abstract::Germany is in a period of transition with regard to healthcare reform. The number and intensity of cost control interventions increased during the last decade in an attempt to contain healthcare expenditure. The German legislature has implemented long term macroeconomic measures such as contribution rate stability and...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199600102-00013
更新日期:1996-01-01 00:00:00
abstract::The original article can be found online. ...
journal_title:PharmacoEconomics
pub_type: 已发布勘误
doi:10.1007/s40273-020-00950-2
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:In the Netherlands, decisions about the reimbursement of new pharmaceuticals are based on cost effectiveness, as well as therapeutic value and budget impact. Since 1 January 2005, drug manufacturers are formally required to substantiate the cost effectiveness of drugs that have therapeutic added value in com...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11539850-000000000-00000
更新日期:2012-03-01 00:00:00
abstract::There is an inevitable tension between robust reimbursement processes and providing speedy access to new and novel technologies, given uncertainties about key pieces of evidence and subsequent concerns regarding their overall efficiency. The public perception of these treatments as 'breakthrough', combined with substa...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11530850-000000000-00000
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:In many healthcare systems, affordability concerns can lead to restrictions on the use of expensive efficacious therapies. However, there does not appear to be any consensus as to the terminology used to describe affordability, or the thresholds used to determine whether new drugs are affordable. OBJECTIVES...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-017-0514-4
更新日期:2017-08-01 00:00:00
abstract::About one-quarter of men aged 50 years and older experience voiding problems due to benign prostatic hyperplasia (BPH). Until about 10 years ago, surgery (particularly transurethral resection of the prostate) was the only effective treatment for symptomatic BPH. Over the last decade, several new treatments have been i...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119020-00003
更新日期:2001-01-01 00:00:00
abstract::Weight Reduction is Cost-Effective for the Treatment of Non-alcoholic Fatty Liver Disease in Thailand. ...
journal_title:PharmacoEconomics
pub_type: 已发布勘误
doi:10.1007/s40273-018-0754-y
更新日期:2019-02-01 00:00:00
abstract::As a consequence of its prevalence, early onset and chronicity, schizophrenia imposes clinical and economic impediments to healthcare practitioners and society alike. Among the many antipsychotics available to treat the symptoms of this devastating illness, clozapine has emerged and differentiated itself from the othe...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200321010-00001
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To estimate indirect costs in Spanish ambulatory patients with HIV/AIDS and to identify changes in employment status and their current QOL. METHOD:Information was obtained through 32 interviews/enquiries carried out with ambulatory patients receiving medical attention at Gregorio Marañón and Puerta de Hierro...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200321150-00005
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adher...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0554-9
更新日期:2017-12-01 00:00:00
abstract::Decision makers increasingly request evidence on the real-world cost effectiveness of a new treatment. There is, however, a lack of practical guidance on how to conduct an economic evaluation based on registry data and how this evidence can be used in actual decision making. This paper explains the required steps on h...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0260-4
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The symptoms of attention-deficit hyperactivity disorder (ADHD) are associated with impairment in multiple domains of health-related quality of life (HR-QOL). HR-QOL of children with ADHD has been assessed by relatively long multidimensional questionnaires. A review of the literature found no studies using t...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523080-00004
更新日期:2005-01-01 00:00:00
abstract::Potential conflict between the goals of the investigators and the sponsors of pharmacoeconomic and clinical research has been well documented. Although there have been efforts to formalise relationships between sponsors and investigators in some areas of clinical research, no set of guidelines or standardised contract...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199507030-00004
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Candidaemia and other forms of invasive candidiasis (C/IC) are serious and costly events for hospitalized patients, particularly those in the ICU. Both fluconazole and the echinocandins are recommended as first-line therapy for C/IC. Resource use and cost considerations are important in selecting appropriate...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11584810-000000000-00000
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:The study objective was to evaluate and compare quality-of-life (QOL) parameters between patients with type 2 (non-insulin-dependent) diabetes mellitus who changed therapy from an oral hypoglycaemic agent (OHA) to insulin and those who remained on an OHA. DESIGN:The World Health Organization Quality of Life ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199814020-00008
更新日期:1998-08-01 00:00:00
abstract::Published estimates for the treatment costs of breast cancer vary widely in methodology, perspective, patient populations and time horizon. We systematically summarized and analysed the published literature on per-patient costs of breast cancer, and highlight the perspectives, populations studied, time horizons and fu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/00019053-200927030-00003
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Cost is an issue when prescribing two drugs with equivalent efficacy. We compared the direct medical costs of topical brinzolamide 1% (twice a day or three times daily) with topical dorzolamide 2% (twice a day or three times daily) in France, Italy, Portugal and Spain in patients with ocular hypertension or p...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200321030-00005
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To assess the economic efficiency of meloxicam, a cyclo-oxygenase (COX)-2 selective inhibitor, versus diclofenac and piroxicam in the UK for the treatment of patients with osteoarthritis and the impact on the NHS budget of substituting nonselective NSAIDs with meloxicam. Methods and perspective: A decision an...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200321060-00007
更新日期:2003-01-01 00:00:00
abstract::In this paper we consider the evolving American healthcare landscape and what it means for the use of economic evaluation of health interventions. We emphasise that use of economic evaluation in the US is unlikely to follow the European, Canadian or Australian models, which use cost effectiveness openly and explicitly...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624110-00012
更新日期:2006-01-01 00:00:00
abstract::Pharmacoeconomic data may be obtained within the context of randomised clinical trials (RCTs) and from effectiveness studies in the 'real world'. The differences between the 2 types of study design have implications for the types of data that can be obtained and the interpretation of the resulting findings. Because RC...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199915050-00001
更新日期:1999-05-01 00:00:00