Abstract:
BACKGROUND:The apparent decrease in the rate of approval of new molecular entities has provoked extensive discussion and fears that the productivity of biopharmaceutical research and development has severely declined in recent years. OBJECTIVE:To investigate the extent to which traditional measures of innovative output neglect important innovations that occur after a drug receives initial market approval. METHODS AND RESULTS:Data on drug utilisation by diagnosis for the period 1999-2004 were combined with data on the approval histories of three important classes of drugs: ACE inhibitors, histamine H(2)-antagonists/proton-pump inhibitors, and selective serotonin/norepinephrine reuptake inhibitors. Counts of new drug approvals by the FDA were classified as new indications, new dosages, new combinations, new formulations, and labeling for expanded populations. Large numbers of such "supplemental" approvals were obtained. The share of drug utilisation in indications other than that specified in the initially approved labeling was computed, and found to be very substantial in two out of the three drug classes considered. CONCLUSIONS:Significant incremental innovation to existing pharmaceutical products has been occurring in the form of supplementary approvals for new dosages, formulations, and indications. These innovations account for a substantial share of drug utilisation and associated economic and medical benefits. Productivity trends for research and development based on counts of new molecular entities alone have therefore overlooked an important source of innovation in biopharmaceuticals.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Berndt ER,Cockburn IM,Grépin KAdoi
10.2165/00019053-200624002-00008subject
Has Abstractpub_date
2006-12-01 00:00:00pages
69-86eissn
1170-7690issn
1179-2027journal_volume
24 Suppl 2pub_type
杂志文章abstract:BACKGROUND:Assessment of health state and health-related quality of life (HR-QOL) are limited by a child's age and cognitive ability. Parent-proxy reports are known to differ from children's reports. Simultaneous assessment using a parent-child dyad is an alternative approach. OBJECTIVE:Our objective was to assess the...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11597890-000000000-00000
更新日期:2012-08-01 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
abstract::To review and critically evaluate published cost-utility analyses (CUAs) pertaining to pharmaceuticals for the past 3 decades. We examined data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), which contains detailed information on English-language CUAs and their ratios (in $US...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11312720-000000000-00000
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:Discrete choice experiments (DCEs) are increasingly advocated as a way to quantify preferences for health. However, increasing support does not necessarily result in increasing quality. Although specific reviews have been conducted in certain contexts, there exists no recent description of the general state ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0734-2
更新日期:2019-02-01 00:00:00
abstract::Economic analysis of healthcare interventions is increasingly reliant on decision models to estimate the long-term costs and benefits of new therapies. Models permit analysts to take short-term clinical data to forecast long-term costs and benefits. Models should follow certain basic principles and can be appraised in...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200220001-00002
更新日期:2002-01-01 00:00:00
abstract::A number of recent findings from the literature imply that the value of a QALY varies depending on the concentration or dispersion of that QALY over treated individuals. Given that funding decisions are currently made under either the assumption of distributive-neutrality or some combination of explicit decision crite...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624090-00003
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:The National Cholesterol Education Program recommends regular physician follow-up and lipid testing to promote adherence with lipid-lowering medications. The objective of this study was to determine whether lipid tests and physician visits after treatment initiation are indeed associated with...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-200422003-00003
更新日期:2004-01-01 00:00:00
abstract::Most countries have healthcare resource constraints and it is easy to identify new health technologies as an area in need of resource management, particularly given that new health technologies usually increase rather than save costs. Resource constraints are even more noticeable in Asia than in other regions, with a ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11310280-000000000-00000
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The process of "mapping" is increasingly being used to predict health utilities, for application within health economic evaluations, using data on other indicators or measures of health. Guidance for the reporting of mapping studies is currently lacking. OBJECTIVE:The overall objective of this research was ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0312-9
更新日期:2015-10-01 00:00:00
abstract::The recent licensing of interferon-beta for use in patients with multiple sclerosis has caused concern, in view of the equivocal evidence of efficacy, pressure of public expectation towards its use and the high expected cost if widespread use were to be sanctioned. Whether such alarm is justified remains a moot point....
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199711030-00002
更新日期:1997-03-01 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:BACKGROUND:Lung cancer is among the top causes of cancer-related deaths. Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors can increase progression-free survival compared with standard chemotherapy in patients with EGFR mutation-positive advanced non-small cell lung cancer (NSCLC). OBJECTIVE:The aim o...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0305-8
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The COUGAR-02 trial recently showed survival and quality-of-life benefits of docetaxel and active symptom control (DXL + ASC) over active symptom control (ASC) alone in patients with refractory oesophagogastric adenocarcinoma. AIM:The aim of this study was to conduct an economic evaluation conforming to Nat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0324-5
更新日期:2016-01-01 00:00:00
abstract::The objective of this study was to demonstrate the cost effectiveness of long term maintenance treatment with citalopram versus standard therapy (defined as short term antidepressant treatment) in patients with major depression in Germany. We chose doxepin, amitriptyline and trimipramine as standard therapy because th...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199508020-00007
更新日期:1995-08-01 00:00:00
abstract::This study evaluated the cost of sequential treatment with once-daily ofloxacin or twice-daily ciprofloxacin in 474 hospitalised patients in different countries. The patients were treated intravenously for at least 3 days, then orally for 7 to 10 days or for 3 days beyond the disappearance of infection-related symptom...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199711040-00007
更新日期:1997-04-01 00:00:00
abstract::Constipation is one of the most common digestive complaints. It is a symptom, not a disease. The subjectivity that this involves means that assessments of clinical epidemiology, socioeconomic costs and pharmacotherapy are difficult, since there is no definition of 'normal' bowel habit. Although constipation can affect...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199507010-00003
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Cost-effectiveness analyses worldwide assume that the price of any single drug increases with inflation. New guidance from the Pharmaceutical Management Agency in New Zealand suggests that, when it is known that a generic drug will be available in the near future, a best estimate of the lower price of the ge...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200826070-00006
更新日期:2008-01-01 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:INTRODUCTION:Mixture modelling is increasingly being considered where a potential cure leads to a long life. Traditional methods use relative survival models for frail populations or cure models that have improper survival functions with theoretical infinite lifespans. Additionally, much of the work uses population dat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-019-00867-5
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Healthcare resource use data were collected for 1 year as part of the CAESAR (Canada, Australia, Europe, South Africa) clinical trial, which evaluated the effect of adding lamivudine to treatment regimens containing zidovudine in patients with HIV infection. This study showed that lamivudine-containing regim...
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:10.2165/00019053-199915001-00003
更新日期:1999-01-01 00:00:00
abstract::Vaccination is an underutilised, low cost and effective method of preventing illness. Cost-effectiveness analysis discloses a beneficial role of influenza vaccination in preventing illness especially in patients over 65 years of age and in high risk patients. In one large study, when 150 million doses of influenza v...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199202030-00003
更新日期:1992-09-01 00:00:00
abstract::Community-acquired pneumonia (CAP) is a common diagnosis and care of CAP is responsible for significant healthcare expenditures, the majority of which are for patients who require hospitalisation. Studies have shown that significant variation exists among institutions with respect to antibacterial costs and length of ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422070-00001
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:Pertussis is a highly contagious infection affecting mainly children. Acellular pertussis vaccines were recently introduced in Canada based on evidence of improved safety and efficacy over whole cell vaccines, the current standard of care. The following study reports the economic impact of replacing the whole...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200119050-00009
更新日期:2001-01-01 00:00:00
abstract::In the current climate of cost containment and quality control, nosocomial infection is a worrisome adverse event in hospital care. Hospitalised patients require care for increasingly severe illnesses, and are therefore more susceptible to infection, especially by opportunistic micro-organisms. It is thus necessary to...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199507020-00005
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to determine the costs and effects associated with a community pharmacy-based smoking-cessation programme in Northern Ireland, using the perspective of the payer in the main analysis. DESIGN AND SETTING:Data from a pilot study conducted in 2 community pharmacies in Northern Ireland w...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199814030-00008
更新日期:1998-09-01 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 (Sanofi Genzyme) of sarilumab (SAR; Kevzara®) to submit evidence of its clinical effectiveness and cost-effectiveness for previously treated moderate or severe rheumatoid arth...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-018-0677-7
更新日期:2018-12-01 00:00:00
abstract:AIM:To determine the economic impact (cost-benefit analysis) of childhood varicella vaccination, with the Oka/Merck varicella zoster virus vaccine live (Varivax) in Italy. METHODS:This analysis is based on an epidemiological model of varicella zoster virus (VZV) dynamics adapted to the Italian situation. Cost data (Eu...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422130-00003
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:The reliability and validity of generic utility measures have not yet been summarized in people with multiple sclerosis (MS). It is important to assess the psychometric properties of these measures, to ensure that the values obtained by the scoring system are valid for interpretation and utilization by clinic...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0167-5
更新日期:2014-08-01 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:OBJECTIVE:Our objective was to identify, among the information routinely collected on patients in intensive care units (ICUs), data that determine the total cost for a given patient. DESIGN:We developed a model that could help physicians in medical ICUs to estimate the cost of care for their patients when no cost data...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-199915060-00005
更新日期:1999-06-01 00:00:00