Abstract:
:Open-heart surgery (OHS) is performed to bypass occluded arteries, replace malfunctioning cardiac valves or correct congenital abnormalities. The average cost of OHS varies from $US25 057-$US79 795 (1997 values). The objective of this paper was to review economic studies of pharmacological strategies in open-heart surgery. Pharmacological strategies studied include the prevention of postoperative complications such as atrial fibrillation (AF), bleeding and infection. Modifications in anaesthetic technique have been attempted by using agents that promote early extubation. In addition, strategies for postoperative management of sedation, analgesia and AF and use of neuromuscular blockers have also been compared. The majority of studies in this area have been cost analyses with few cost-effectiveness studies performed. Prophylaxis against AF with amiodarone is associated with a reduction in AF and was cost-neutral compared with placebo. Compared with placebo, prevention of bleeding with antifibrinolytics reduces transfusion costs. In direct comparative studies, lysine analogues, due to lower drug acquisition costs, offset transfusion costs to a greater extent than aprotinin. However, safety concerns with the lysine analogues remain. Erythropoietin decreases transfusion requirements and is cost effective compared with no intervention when the cost of postoperative bacterial complications is included. First- and second-generation cephalosporins prevent postoperative infections. Based on drug acquisition cost, the first-generation agents are less expensive although when administration costs are included, both classes have similar costs. Modifications in anaesthetic technique with short-acting anaesthetic agents, results in higher drug costs although nursing and total hospital costs are typically reduced. For neuromuscular blockers, drug acquisition costs are lowest with pancuronium but administration costs and the cost of adverse events have not been included in existing analyses. Midazolam provides an equivalent level of postoperative sedation to propofol but the acquisition cost is lower. The combined use of propofol and midazolam warrants further investigation, as its use is associated with lower sedative agent costs compared with either agent alone. There is limited data on the economics of postoperative analgesia and the management of AF. As the majority of studies to date are partial cost analyses, additional studies that include length of stay and other hospitalisation data are warranted. In future, cost-effectiveness and cost-utility studies, which incorporate quality of life and the cost of adverse effects and other longer term costs, should be undertaken.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Reddy P,Song Jdoi
10.2165/00019053-200321040-00003subject
Has Abstractpub_date
2003-01-01 00:00:00pages
249-62issue
4eissn
1170-7690issn
1179-2027pii
210403journal_volume
21pub_type
杂志文章,评审abstract::Since the inception of the National Health Service in 1948, successive British governments have taken various measures to restrain the growth of the medicines bill. A total of 10 different measures have been introduced with very limited success. The most effective measures have been those directed at increasing the le...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199610030-00003
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To examine the relative cost effectiveness of topical calcipotriol and short-contact dithranol in the treatment of mild to moderate plaque psoriasis. DESIGN AND SETTING:This was a modelling study from the perspective of the UK National Health Service as payer. METHODS:The interventions were compared using 2...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018050-00006
更新日期:2000-11-01 00:00:00
abstract::Rheumatoid arthritis (RA) is a chronic, generally progressive autoimmune disease that causes functional disability, significant pain and joint destruction, and leads to premature mortality. It is estimated to affect between 0.5 and 1.0% of the adult population worldwide, increases in prevalence with age and affects mo...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422001-00002
更新日期:2004-01-01 00:00:00
abstract::Health economic modelling studies are of interest to many parties with different responsibilities and diverging interests. Therefore, it is obvious that recognising the relevance of statistical uncertainty and dealing with it appropriately are required to obtain unbiased results from health economic modelling studies,...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422120-00001
更新日期:2004-01-01 00:00:00
abstract::This article explores the need to perform pharmacoeconomic evaluations of herbal medicines and assesses the extent to which this approach has been applied so far to these products. There seems to be no compelling need for pharmacoeconomic analyses of herbal over-the-counter medicines, but such analyses are certainly w...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018010-00001
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To compare the cost effectiveness of sequential intravenous (i.v.) to oral ciprofloxacin plus metronidazole (CIP/MTZ i.v./PO) with that of i.v. ciprofloxacin plus i.v. metronidazole (CIP/MTZ i.v.) and i.v. imipenem-cilastatin (IMI i.v.) in patients with intra-abdominal infections. DESIGN AND PARTICIPANTS:Pat...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.2165/00019053-199916050-00011
更新日期:1999-11-01 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::A growing body of recent work has identified several problems with economic evaluations undertaken alongside controlled trials that can have potentially serious impacts on the ability of decision makers to draw valid conclusions. At the same time, the use of cost-effectiveness models has been drawn into question, due ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200017050-00007
更新日期:2000-05-01 00:00:00
abstract::For practical reasons, in order to carry out economic evaluations of collective decisions, total costs will generally be compared with total benefits; hence, individuals' willingness to pay (WTP) or quality-adjusted life-years (QALYs) have to be estimated at an aggregate level. So far, aggregation has usually been don...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119040-00001
更新日期:2001-01-01 00:00:00
abstract::Pharmacoeconomics identifies, measures, and compares the costs and consequences of pharmaceutical products and services. The cost effectiveness of a pharmacotherapy in a particular indication depends on the molecular configuration of the drug, its safety and efficacy, and local market factors such as the acquisition ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199406040-00002
更新日期:1994-10-01 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::The National Institute for Health and Care Excellence (NICE) invited GlaxoSmithKline, the manufacturer of dabrafenib, to submit evidence for the clinical and cost effectiveness of dabrafenib for the treatment of unresectable, advanced or metastatic BRAF V600 mutation-positive melanoma in accordance with the Institute'...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-015-0276-9
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Invasive fungal infections in neutropenic patients treated for haematological malignancies are associated with a high mortality rate and, therefore, require early treatment. As the diagnosis of invasive fungal infections is difficult, effective antifungal prophylaxis is desirable. So far, fluconazole has bee...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200826010-00007
更新日期:2008-01-01 00:00:00
abstract::Stroke remains the leading cause of neurological disability and the third leading cause of death worldwide, consuming a large share of total healthcare expenditures. In this review, we discuss the cost effectiveness of stroke prevention for various risk factor-modification programmes and pharmacological interventions ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199711050-00004
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Recent randomised trials have demonstrated a statistically significant effect of trastuzumab on disease-free survival when used as adjuvant therapy for human epidermal growth factor receptor 2 protein (HER2)-positive resectable early stage breast cancer, with a treatment course lasting either 9 or 52 weeks. ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725050-00006
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to develop a generic treatment algorithm for influenza and influenza-like illness (ILI) that could be used to estimate the costs and outcomes of current and new treatments for influenza in different countries for different patient subgroups. METHODS:A series of possible treatment pa...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199916001-00010
更新日期:1999-01-01 00:00:00
abstract::The purpose of this study was to estimate the direct and indirect costs of alcoholism in the Federal Republic of Germany. Direct costs comprised treatment costs, while indirect costs consisted mainly of costs incurred as a result of work time lost, as well as costs related to premature retirement and premature mortali...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610050-00006
更新日期:1996-11-01 00:00:00
abstract::Disease management is a systematic approach to a health condition or a healthcare intervention that organises preventative, interventional and care approaches throughout the continuum of care and which measures outcomes in terms of populations, not individuals. Disease management's advantage over the current component...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199814010-00002
更新日期:1998-07-01 00:00:00
abstract::As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of vedolizumab (Takeda UK) to submit evidence of the clinical effectiveness and cost effectiveness of vedolizumab for the treatment of patients with moderate-to-severe active ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0334-3
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:International phase III studies (CHIB 201 and 352) showed that basiliximab, a high affinity chimeric monoclonal antibody interleukin-2 receptor antagonist, is highly effective in preventing acute rejection when used as immunoprophylaxis in patients receiving cyclosporin (Neoral). We conducted a cost evaluati...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200321110-00003
更新日期:2003-01-01 00:00:00
abstract::Until a few years ago, griseofulvin and ketoconazole were the only 2 oral agents available for the treatment of dermatophyte onychomycosis of the toenails. With the availability of the newer antifungal agents, such as itraconazole, terbinafine and fluconazole, the armamentarium of drugs available to treat onychomycosi...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813020-00007
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Low-dose aspirin (ASA) is effective for secondary prevention of ischemic stroke but can increase the risks of hemorrhagic stroke, upper gastrointestinal bleeding (UGIB), and dyspepsia. Prophylactic administration of proton pump inhibitors (PPIs) reduces the risks of these digestive symptoms. We investigated ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0289-4
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:The objective of this article was to summarize the findings of all the available studies on alternative pharmacological treatments for asthma and assess their methodological quality, as well as to identify the main drivers of the cost effectiveness of pharmacological treatments for the disease. METHODS:A sys...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0668-8
更新日期:2018-10-01 00:00:00
abstract::The progressive disability of Parkinson's disease results in substantial burdens for patients, their families and society in terms of increased health resource use, poorer quality of life, caregiver burden, disrupted family relationships, decreases in social and leisure activities, deteriorating emotional well-being, ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119070-00003
更新日期:2001-01-01 00:00:00
abstract::There is a global perspective to the economic consequences of diabetes, which is illustrated in the many publications now being produced on this subject. Because of the higher prevalence of type II diabetes, its impact is greater than that of type I diabetes in both developed and developing countries (but particularly...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199500081-00017
更新日期:1995-01-01 00:00:00
abstract:UNLABELLED:Cyclosporin microemulsion (Neoral) is a self-emulsifying preconcentrate of cyclosporin which is more rapidly and consistently absorbed than the original oil-based formulation of cyclosporin (standard formulation; Sandimmun, Sandimmune). This superior pharmacokinetic profile suggests that cyclosporin microemu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199814060-00009
更新日期:1998-12-01 00:00:00
abstract::The elderly are a heterogeneous population group who range from well and completely independent individuals to a smaller proportion who are frail, require help and are high users of the healthcare system. Since health is a state of well-being which includes the domains of social, spiritual, psychological and physical ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199712050-00004
更新日期:1997-11-01 00:00:00
abstract::Cost-effectiveness analysis (CEA) is one of the main tools of economic evaluation. Every CEA is based on a number of assumptions, some of which may not be accurate, introducing uncertainty. Sensitivity analysis (SA) formalizes ways to measure and evaluate this uncertainty. Specific sources of uncertainty in CEA have b...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11584630-000000000-00000
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Pharmacogenetics offers the potential to improve health outcomes by identifying individuals who are at greater risk of harm from certain medicines. Routine adoption of pharmacogenetic tests requires evidence of their cost effectiveness. OBJECTIVE:The present review aims to systematically review published ec...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-016-0397-9
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:A wide variety of oral antiplatelet trials have been carried out, and a large number of cost-effectiveness estimates based on them have been published. OBJECTIVE:To assess the cost effectiveness of oral antiplatelet treatments in the prevention of cardiovascular events. METHODS:A comprehensive literature s...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/00019053-200725120-00007
更新日期:2007-01-01 00:00:00