Skip header and navigation

Refine By

772 records – page 1 of 78.

A 10-year survey of inflammatory bowel diseases-drug therapy, costs and adverse reactions.

https://arctichealth.org/en/permalink/ahliterature71979
Source
Aliment Pharmacol Ther. 2001 Apr;15(4):475-81
Publication Type
Article
Date
Apr-2001
Author
P. Blomqvist
N. Feltelius
R. Löfberg
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Paul.Blomqvist@mep.ki.se
Source
Aliment Pharmacol Ther. 2001 Apr;15(4):475-81
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adult
Adverse Drug Reaction Reporting Systems
Aged
Anti-Inflammatory Agents - adverse effects - economics - therapeutic use
Drug Costs - statistics & numerical data
Female
Health Surveys
Humans
Inflammatory Bowel Diseases - drug therapy - economics
Male
Middle Aged
Nutritional Support
Physician's Practice Patterns
Prescriptions, Drug - economics
Retrospective Studies
Steroids
Sweden
Abstract
BACKGROUND: Drug therapy for Crohn's disease and ulcerative colitis is based on anti-inflammatory and immunodulating drugs, nutritional support and surgical resection. Recently, new drugs have been introduced. AIM: To report drug prescriptions, costs and adverse reactions among inflammatory bowel disease patients in Sweden between 1988 and 1997. METHODS: Drug use was calculated from the national Diagnosis and therapy survey and drug costs from prescriptions and drug sales. Adverse drug reactions were obtained from the Medical Products Agency's National Pharmacovigilance system. RESULTS: The annual drug exposure for Crohn's disease was 0.55 million daily doses per million population, mainly supplementation and aminosalicylic acids. Mesalazine and olsalazine had 61% within this group. For ulcerative colitis patients, drug exposure was 0.61 million daily doses per million per year and aminosalicylic acids fell from 70% to 65%. For inflammatory bowel disease patients, corticosteroids and nutritional supplementation were common. The annual average cost for inflammatory bowel disease drugs was 7.0 million US dollars. Annually, 32 adverse drug reactions were reported, mainly haematological reactions such as agranulocytosis and pancytopenia (60%), followed by skin reactions. Only two deaths were reported. Aminosalicylic acids were the most commonly reported compounds. CONCLUSIONS: Drug use for inflammatory bowel disease in the pre-biologic agent era rested on aminosalicylic acid drugs and corticosteroids with stable levels, proportions and costs. The level of adverse drug reactions was low but haematological reactions support the monitoring of inflammatory bowel disease patients.
PubMed ID
11284775 View in PubMed
Less detail

Access to medicines and global health: will Canada lead or flounder?

https://arctichealth.org/en/permalink/ahliterature181912
Source
CMAJ. 2004 Jan 20;170(2):224-6
Publication Type
Article
Date
Jan-20-2004
Author
James Orbinski
Author Affiliation
St. Michael's Hospital, Centre for International Health, University of Toronto, Toronto, Ont. james.orbinski@utoronto.ca
Source
CMAJ. 2004 Jan 20;170(2):224-6
Date
Jan-20-2004
Language
English
Publication Type
Article
Keywords
Canada
Drug Costs
Drug Industry - organization & administration
Drugs, Essential - supply & distribution
Forecasting
Health Policy
Health Services Accessibility
Humans
National health programs - organization & administration
Needs Assessment
Patents as Topic
World Health
Notes
Comment In: CMAJ. 2004 Apr 27;170(9):1374; author reply 1374-515111456
PubMed ID
14734437 View in PubMed
Less detail

Achieving optimal prescribing: what can physicians do?

https://arctichealth.org/en/permalink/ahliterature121612
Source
Can Fam Physician. 2012 Aug;58(8):820-1
Publication Type
Article
Date
Aug-2012
Author
Samuel Shortt
Ingrid Sketris
Author Affiliation
Office for Knowledge Transfer, Canadian Medical Association, Ottawa ON. sam.shortt@cma.ca
Source
Can Fam Physician. 2012 Aug;58(8):820-1
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Canada
Drug Costs
Humans
Inappropriate Prescribing - adverse effects - economics - prevention & control
Medication Errors - adverse effects - economics - prevention & control
Patient Safety
Physician's Practice Patterns - economics - standards
Physician's Role
Quality Improvement
Notes
Cites: Clin Ther. 2007 Apr;29(4):742-5017617298
Cites: CMAJ. 2008 May 20;178(11):1441-918490640
Cites: CMAJ. 2009 Dec 8;181(12):891-619969578
Cites: CMAJ. 2010 Apr 6;182(6):540-120212024
Cites: J Antimicrob Chemother. 2006 Oct;58(4):830-916921182
Cites: Can Fam Physician. 2005 Mar;51:386-716926931
Cites: CMAJ. 2004 May 25;170(11):1678-8615159366
Cites: Clin Infect Dis. 1999 Jul;29(1):155-6010433579
Cites: Can J Cardiol. 2005 Mar 15;21(4):337-4315838560
Cites: J Contin Educ Health Prof. 2006 Winter;26(1):13-2416557505
Cites: Can J Cardiol. 2004 Jan;20(1):61-714968144
PubMed ID
22893327 View in PubMed
Less detail

Acquisition cost of dispensed drugs in individuals with multiple medications--a register-based study in Sweden.

https://arctichealth.org/en/permalink/ahliterature135038
Source
Health Policy. 2011 Jul;101(2):153-61
Publication Type
Article
Date
Jul-2011
Author
Bo Hovstadius
Bengt Åstrand
Ulf Persson
Göran Petersson
Author Affiliation
eHealth Institute and School of Natural Sciences, Linnaeus University, SE-391 82 Kalmar, Sweden. bo.hovstadius@pwc.se
Source
Health Policy. 2011 Jul;101(2):153-61
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Costs and Cost Analysis
Drug Costs
Female
Humans
Infant
Male
Middle Aged
Polypharmacy
Prescription Drugs - economics
Registries
Sweden
Young Adult
Abstract
To analyse the acquisition cost of dispensed prescription drugs for individuals with multiple medications in a national population.
We collected and analysed individual based data regarding the acquisition cost of dispensed prescription drugs for all individuals with five or more dispensed drugs (DP=5) in Sweden 2006 (2.2 million).
Individuals with DP=5 (24.5% of the population) accounted for 78.8% of the total acquisition cost, and individuals with DP=10 (8.6% of the population) and DP=15 (3.0% of the population) accounted for 46.3% and 23.2%, respectively. The average acquisition cost per defined daily doses (DDD) generally decreased with increasing age. The highest average cost per DDD was observed for individuals with DP=10. The acquisition cost for women with DP=5 represented 56.0% of the total acquisition cost. Men with DP=5 represented 44.0% of the total acquisition cost.
In an entire national population, individuals with multiple medication accounted for four fifths of the total acquisition cost of dispensed drugs. Actions to reduce the number of prescription drugs for the group of patients with a number of different drugs may also result in a substantial reduction of the total acquisition cost.
PubMed ID
21514685 View in PubMed
Less detail

Adherence to statin therapy under drug cost sharing in patients with and without acute myocardial infarction: a population-based natural experiment.

https://arctichealth.org/en/permalink/ahliterature164224
Source
Circulation. 2007 Apr 24;115(16):2128-35
Publication Type
Article
Date
Apr-24-2007
Author
Sebastian Schneeweiss
Amanda R Patrick
Malcolm Maclure
Colin R Dormuth
Robert J Glynn
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Suite 3030, Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
Circulation. 2007 Apr 24;115(16):2128-35
Date
Apr-24-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
British Columbia
Cohort Studies
Cost Sharing - economics - statistics & numerical data
Deductibles and Coinsurance - economics - statistics & numerical data
Drug Costs
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - economics - therapeutic use
Insurance Coverage - economics - statistics & numerical data
Insurance, Pharmaceutical Services - classification - economics - statistics & numerical data
Male
Myocardial Infarction - drug therapy
National Health Programs - economics - statistics & numerical data
Patient Compliance - statistics & numerical data
Abstract
As medication spending grows, Medicare Part D will need to adapt its coverage policies according to emerging evidence from a variety of insurance policies. We sought to evaluate the consequences of copayment and coinsurance policies on the initiation of statin therapy after acute myocardial infarction and adherence to therapy in statin initiators using a natural experiment of all British Columbia residents aged 66 years and older.
Three consecutive cohorts that included all patients who began statin therapy during full drug coverage (2001), coverage with a $10 or $25 copay (2002), and coverage with a 25% coinsurance benefit (2003-2004) were followed up with linked healthcare utilization data (n=51,561). Follow-up of cohorts was 9 months after each policy change. Adherence to statin therapy was defined as > or = 80% of days covered. Relative to full-coverage policies, adherence to new statin therapy was significantly reduced, from 55.8% to 50.5%, under a fixed copayment policy (-5.4% points; 95% CI, -6.4% to -4.4%) and the subsequent coinsurance policy (-5.4% points; 95% CI, -6.3% to -4.4%). An uninterrupted increase in the proportion of patients initiating statin therapy after an acute myocardial infarction (1.7% points per quarter) was observed over the study period, similar to a Pennsylvania control population with full coverage. Sudden changes to full out-of-pocket spending, similar to Medicare's Part D "doughnut hole," almost doubled the risk of stopping statins (adjusted odds ratio, 1.94, 95% CI, 1.82 to 2.08).
Fixed patient copayment and coinsurance policies have negative effects on adherence to statin lipid-lowering drug therapy but not on their initiation after myocardial infarction.
PubMed ID
17420348 View in PubMed
Less detail

Adherence to weekly oral bisphosphonate therapy: cost of wasted drugs and fractures.

https://arctichealth.org/en/permalink/ahliterature153066
Source
Osteoporos Int. 2009 Sep;20(9):1583-94
Publication Type
Article
Date
Sep-2009
Author
O. Sheehy
C. Kindundu
M. Barbeau
J. LeLorier
Author Affiliation
Pharmacoeconomics and Pharmacoepidemiology, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada. odile.sheehy@umontreal.ca
Source
Osteoporos Int. 2009 Sep;20(9):1583-94
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Aged, 80 and over
Bone Density Conservation Agents - economics - therapeutic use
Diphosphonates - economics - therapeutic use
Drug Costs
Female
Fractures, Bone - economics - epidemiology - prevention & control
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Osteoporosis - drug therapy - economics - epidemiology
Quebec - epidemiology
Retrospective Studies
Risk assessment
Abstract
In an observational cohort of patients treated with biphosphonates (BP), we observed that poor adherence to these drugs causes important expenditures in terms of avoidable fractures. Of particular interest are the amounts of money wasted by patients who did not take their BPs long enough to obtain a clinical benefit.
A large proportion of patients initiated with oral weekly BP therapy stop their treatment within the first year. The objective of this study was to estimate the impact of the poor adherence to BPs in terms of drug wasted and avoidable fractures.
The study was done on primary and secondary prevention cohorts from the Régie de l'assurance maladie du Québec (Québec). The concept of the "point of visual divergence" was used to determine the amount of wasted drug. The risk of fracture was estimated using Cox regression models. The hazard ratios of compliant patients (+80%) versus non compliant patients were used to estimate the number of fractures saved.
The cost of wasted drugs was $25.87 per patient initiated in the primary prevention cohort and $30.52 in the secondary prevention cohort. If all patients had been compliant, 110 fractures would have been avoided in the primary prevention cohort and 19 fractures in the secondary prevention cohort. The cost of these avoidable fractures per patient initiated on BP therapy was $62.95 in primary prevention cohort and $330.84 in secondary prevention cohort.
This study confirms that poor adherence to oral BPs leads to a significant waste of money and avoidable fractures.
PubMed ID
19153677 View in PubMed
Less detail

Adjustment of antibiotic treatment according to the results of blood cultures leads to decreased antibiotic use and costs.

https://arctichealth.org/en/permalink/ahliterature171349
Source
J Antimicrob Chemother. 2006 Feb;57(2):326-30
Publication Type
Article
Date
Feb-2006
Author
Dag Berild
Atefeh Mohseni
Lien My Diep
Mogens Jensenius
Signe Holta Ringertz
Author Affiliation
Department of Internal Medicine, Aker University Hospital, N-0514 Oslo, Norway. dag.berild@medisin.uio.no
Source
J Antimicrob Chemother. 2006 Feb;57(2):326-30
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage - economics - therapeutic use
Bacteremia - blood - drug therapy - economics
Drug Costs
Escherichia coli - drug effects
Female
Gram-Negative Bacteria - drug effects
Gram-Positive Bacteria - drug effects
Guidelines as Topic
Hospitals, University - economics
Humans
Male
Middle Aged
Norway
Retrospective Studies
Treatment Outcome
Abstract
To avoid the use of unnecessary broad-spectrum antibiotics, empirical therapy of bacteraemia should be adjusted according to the results of blood cultures.
To investigate whether the results of blood cultures led to changes in antibiotic use and costs in a tertiary-care university hospital in Norway.
Medical records from all patients with positive blood cultures in 2001 were analysed retrospectively. Factors predisposing to infections, results of blood cultures, antibiotic use and outcome were recorded. The influence of blood culture results on antibiotic treatment and costs were analysed.
The antibiotic use in 226 episodes of bacteraemia in 214 patients was analysed. According to the guidelines empirical antibiotic treatment should be adjusted in 166 episodes. Antibiotic use was adjusted in 146 (88%) of these 166 episodes, which led to a narrowing of therapy in 118 (80%) episodes. Compared with empirical therapy there was a 22% reduction in the number of antibiotics. Adjustment of therapy was more often performed in Gram-negative bacteraemia and polymicrobial cultures than in Gram-positive bacteraemia. In bacteraemia caused by ampicillin-resistant Escherichia coli, ampicillin was mostly replaced by ciprofloxacin. The cost for 7 days adjusted therapy in 146 episodes was euro19,800 (23%) less than for 7 days of empirical therapy.
Adjustment of antibiotic therapy according to the results of blood cultures led to a reduction in the number of antibiotics and a narrowing of antibiotic therapy. The costs for antibiotics decreased.
PubMed ID
16387751 View in PubMed
Less detail

Adjuvant fluorouracil, epirubicin and cyclophosphamide in early breast cancer: is it cost-effective?

https://arctichealth.org/en/permalink/ahliterature16695
Source
Acta Oncol. 2005;44(7):735-41
Publication Type
Article
Date
2005
Author
Jan Norum
Mari Holtmon
Author Affiliation
Department of Oncology, University Hospital of North Norway, Norway. jan.norum@unn.no
Source
Acta Oncol. 2005;44(7):735-41
Date
2005
Language
English
Publication Type
Article
Keywords
Antineoplastic Combined Chemotherapy Protocols - economics - therapeutic use
Breast Neoplasms - drug therapy - economics
Chemotherapy, Adjuvant
Comparative Study
Cost-Benefit Analysis
Cyclophosphamide - economics - therapeutic use
Drug Costs
Epirubicin - economics - therapeutic use
Female
Fluorouracil - economics - therapeutic use
Humans
Medical Records
Methotrexate - economics - therapeutic use
Norway
Survival Rate
Abstract
Adjuvant chemotherapy (ACT) in breast cancer exposes patients to morbidity, but improves survival. The FEC (fluorouracil, epirubicin, cyclophosphamide) regimen has taken over the prior role of CMF (cyclophosphamide, methotrexate, fluorouracil). In this model, efficacy, tolerability and quality of life (QoL) data from the literature were incorporated with Norwegian practice and cost data in a cost-effectiveness approach. The FEC efficacy was calculated 3-7% superior CMF. There was no difference in quality of life. An 80-100% dose intensity range was employed, one Euro was calculated NOK 8.78 and a 3% discount rate was used. The total cost of FEC employing the friction cost method on production loss, including amount spent on drugs, administration and travelling ranged between 3,278-3,850 Euros (human capital approach 12,143-12,715 Euros). Money spent on drugs alone constituted 15-48%, depending on method chosen. A cost-effectiveness analysis revealed a cost per life year (LY) saved replacing FEC by CMF of 3,575-15,125 Euros. Adjuvant FEC is cost effective in Norway.
PubMed ID
16227165 View in PubMed
Less detail

Alefacept: potential new therapy for patients with moderate-to-severe psoriasis.

https://arctichealth.org/en/permalink/ahliterature185907
Source
Issues Emerg Health Technol. 2003 Apr;(45):1-4
Publication Type
Article
Date
Apr-2003
Author
Vijay K Shukla
Source
Issues Emerg Health Technol. 2003 Apr;(45):1-4
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Canada
Clinical Trials, Phase III as Topic
Drug Approval
Drug Costs
Humans
Psoriasis - drug therapy
Randomized Controlled Trials as Topic
Recombinant Fusion Proteins - adverse effects - economics - therapeutic use
T-Lymphocyte Subsets - immunology
Treatment Outcome
United States
United States Food and Drug Administration
Abstract
Alefacept is a new biotechnology product designed for the treatment of patients with chronic plaque-type psoriasis who have disease severe enough to make them eligible for phototherapy or systemic therapy. In two randomized controlled phase III trials of patients with moderate-to-severe disease, alefacept showed a modest but statistically significant increase in the number of responders compared to placebo. Alefacept's dose-dependent CD4+ T lymphocyte-depleting effect requires monitoring; however, no association has been found between this adverse effect and serious adverse events, particularly infection. Due to lack of direct comparative data, it is difficult to predict exactly how alefacept will fit into the current rotational psoriasis therapy paradigm.
PubMed ID
12680422 View in PubMed
Less detail

[Alternative drugs against Chlamydia urethritis. Tetracycline offers the most cost-effective cure].

https://arctichealth.org/en/permalink/ahliterature212831
Source
Lakartidningen. 1996 Jan 31;93(5):369-71
Publication Type
Article
Date
Jan-31-1996

772 records – page 1 of 78.