1,721,050 research outputs found
Pricing policies in the pharmaceutical sector
No full textIn this article we analyze the problem of determining the price for new drugs in a market where stringent budget constraints on public expenditure exists and we suggest an innovative methodology to set drug prices. The market is characterized by asymmetry of information and a high proportion of investment in research and development, an element that must be taken into account because it is only through research that it is possible to obtain better drugs. Our proposed method allows one to set the price of new drugs in different market contexts, that is, where less effective alternatives are already sold or in new markets. We also propose a unified methodology to evaluate the social value of drugs in different markets through the definition of a function of the cost per quality adjusted life year that society is willing to pay
Cost-effectiveness in Italy of preventive treatment with ramipril in patients at high risk of cardiovascular events
No full textOBJECTIVES: A cost-effectiveness analysis was conducted in Italy of preventive treatment with ramipril (an angiotensin converting enzyme [ACE] inhibitor) compared to no treatment in patients at high risk of cardiovascular death. The analysis was based on data extracted from the HOPE trial. METHODS: The current life table method was used in order to model a lifetime time horizon for outcomes and costs. The cohorts used were 1000 subjects on ramipril, and 1000 subjects on placebo enrolled in the HOPE trial. Kaplan-Meier curves at 5 years of the clinical study were fitted using an exponential model over a lifetime horizon, the outcome variables being myocardial infarction, stroke, revascularization and death. Total direct medical costs have been considered from a third-party payer's perspective--the Italian National Health Service. Resources involved in each event/activity were estimated using the modified Delphi technique with a panel of six clinicians. Types of resources reported included drug therapies, laboratory and imaging tests, physician visits, outpatient and inpatient rehabilitation, as well as medical and surgical hospital admissions. The incremental cost per life year gained was the main measure of the analysis. RESULTS: ICER (incremental cost-effectiveness ratio) decreases with the length of the treatment period. After the first year the ICER is 55,062 euros and subsequently decreases to about 12,770 euros at 5 years, 5945 euros at 10 years and 3726 euros at 20 years. The two ways sensitivity analysis showed that at 5 years ICERs range from a saving of 4059 euros to a cost of 22,929 euros (at 20 years they are 1814 euros and 4434 euros), mainly depending on the cost of drug and cost of events. Previous analyses in other countries based on the HOPE study obtained ICER values which are comparable with our results, when taking into account the different cost structure of the health care systems. CONCLUSIONS: On the basis of these results, the use of ramipril is likely to represent an efficient use of public health expenditure in the Italian healthcare system
Razionalizzazione della spesa farmaceutica: farmaci costo efficaci in malattie cardiovascolari
No full textExtended prophylaxis of venous thromboembolism with fondaparinux in patients undergoing major orthopedic surgery: Cost-effective analysis
No full textInternational Price Regulations in the Pharmaceutical Sector: A Common Model to Sharing the Benefits
No full textIn this paper, we analyse the market for drugs in health care markets where third payers (an insurance company or a government agency) bear the cost and we suggest a common and transparent methodology to set the price for new drugs as well as active principles for which an alternative already exists. We argue that in this context, a bargaining approach is the most suitable instrument to describe the price-setting procedure and we show how this approach can be implemented. We argue that many of the systems that are used by western countries are in fact simplified applications of our model, the main difference usually being that the actual price-setting procedure is not as transparent as the one we propose. Copyright © by The Haworth Press, Inc. All rights reserved
Extended prophylaxis of venous thromboembolism with fondaparinux in patients undergoing major orthopedic surgery: Cost-effective analysis
No full textCost-effectiveness of Pazopanib Versus Sunitinib as First-line Treatment for Locally Advanced or Metastatic Renal Cell Carcinoma from an Italian National Health Service Perspective
No full textPurpose: A prior randomized controlled trial (COMPARZ [Comparing the Efficacy, Safety and Tolerability of Pazopanib versus Sunitinib]) found non-inferior progression-free survival for pazopanib versus sunitinib as first-line therapy in patients with advanced or metastatic renal cell carcinoma. The present study evaluated the cost-effectiveness of pazopanib versus sunitinib as first-line treatment for patients with metastatic renal cell carcinoma from an Italian National Health Service perspective. Methods: A partitioned-survival analysis model with 3 health states (progression-free survival, post progression survival, and dead) was employed. The model time horizon was 5 year : For each treatment strategy, the model generated expected progression free life years, post-progression life years, overall life years, quality-adjusted life years (QALYs), and costs. Results were reported as incremental costs per QALY gained and the net monetary benefit of pazopanib versus sunitinib. Probabilistic and deterministic sensitivity analyses were conducted to assess the impact on results of methodological and parameter uncertainty. Findings: In the base case, pazopanib was associated with higher QALYs and lower costs and dominated sunitinib. Using willingness-to-pay thresholds of (sic)30,000 and (sic)50,000 per QALY, the net monetary benefits with pazopanib were 6508 and 7702 per patient, respectively, versus sunitinib. The probability that pazopanib is cost-effective versus sunitinib was estimated to be 85% at a cost-effectiveness threshold of 20,000, 86% at a threshold of 30,000, and 81% at a threshold of (sic)50,000 per QALY. Results were robust to changes in key parameter values and assumptions. Implications: These results suggest that pazopanib is likely to represent a cost-effective treatment option compared with sunitinib as first-line treatment for patients with metastatic renal cell carcinoma in Italy. (C) 2017 Published by Elsevier HS Journals, Inc
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
