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High Price Drugs

Paolo Vercellini, Paola Viganò, Giussy Barbara, Laura Buggio, Edgardo Somigliana
Elagolix, an orally active non-peptidic GnRH antagonist, has been approved by the Food and Drug Administration for the management of moderate to severe pain associated with endometriosis. As the degree of ovarian suppression obtained with elagolix is dose-dependent, pain relief may be achieved by modulating the level of hypo-oestrogenism while limiting side effects. Elagolix may thus be considered a novelty in terms of its endocrine and pharmacological properties but not for its impact on the pathogenic mechanisms of endometriosis, as the target of this new drug is, yet again, alteration of the hormonal milieu...
December 14, 2018: Human Reproduction
Frederick W Thielen, Nasuh C Büyükkaramikli, Rob Riemsma, Debra Fayter, Nigel Armstrong, Ching-Yun Wei, Vanesa Huertas Carrera, Kate Misso, Gill Worthy, Jos Kleijnen, Isaac Corro Ramos
The National Institute for Health and Care Excellence (NICE), as part of the institute's single technology appraisal (STA) process, invited the company that makes obinutuzumab (Roche Products Limited) to submit evidence of the clinical and cost effectiveness of the drug in combination with chemotherapy, with or without obinutuzumab as maintenance therapy for adult patients with untreated, advanced follicular lymphoma (FL) in the UK. Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Erasmus University Rotterdam, was commissioned to act as the Evidence Review Group (ERG)...
December 13, 2018: PharmacoEconomics
Patricia M Danzon
This paper first reviews the evidence on price levels, price growth, and value for cancer drugs. The available evidence suggests that prices for originator (brand-name) drugs are rising significantly more rapidly than general inflation, but the available data are inadequate for robust comparisons between cancer and other categories of specialty drugs. We then examine the factors contributing to high and rising prices for cancer drugs. This analysis focuses mainly on the USA, which accounts for 46% of global expenditures on cancer drugs...
2019: Recent Results in Cancer Research
Clement Francois, Junwen Zhou, Michał Pochopien, Leila Achour, Mondher Toumi
In this chapter, we will present and discuss the challenges of assessing oncology products from a health economic perspective. We will provide a brief introduction on the need for economic evaluation in health care and focus on cost-effectiveness and comparative aspects of the evaluation of oncology products, which are of paramount interest to HTA decision-making bodies using economic evaluation in their decision-making framework. As the burden of oncology is well-documented, we do not discuss it in detail here...
2019: Recent Results in Cancer Research
Terry Cothran, Bethany Holderread, Melissa Abbott, Nancy Nesser, Shellie Keast
OBJECTIVES: To describe roles for pharmacists to facilitate payer-initiated value-based contracts within state Medicaid programs. SUMMARY: According to the Centers for Medicare and Medicaid Services, prescription drug expenditures are expected to see the fastest annual growth in the health care sector over the next decade owing to a greater number of costly specialty medications and overall higher drug prices. Increased prescription costs make value-based contracts particularly compelling opportunities for payers...
December 4, 2018: Journal of the American Pharmacists Association: JAPhA
Joel Sim, Andrew Hill
Objectives: Differences in marketed prices of antiretrovirals raises questions about the fairness of pricing medicines of significant public health importance such as dolutegravir (DTG). In view of the reduced prices of generically available efavirenz (EFV), there is a need to determine if previous conclusions on DTG's cost-effectiveness need to be re-assessed. Methods: Lowest list prices of DTG were extracted from national drug price or reimbursement databases for 52 countries...
October 1, 2018: Journal of Virus Eradication
Olivier J Wouters, Dale M Sandberg, Anban Pillay, Panos G Kanavos
OBJECTIVE: We investigated the South African tendering system for medicines to (a) evaluate its impact on prices and market concentration over a 14-year period and (b) analyze the accuracy of government forecasts of drug demand. METHODS: We calculated Herfindahl-Hirschman indexes to measure market concentration levels based on all pharmaceutical tender contracts issued by the South African government between 2003 and 2016 (n = 8701). We estimated price indexes to track changes in medicine costs over this period...
November 23, 2018: Social Science & Medicine
Tania Jain, Mark R Litzow
Therapeutic options for acute lymphoblastic leukemia, especially in the relapsed/refractory setting, have expanded significantly in recent times. However, this comes at the cost of toxicities: medical as well as financial. We highlight some of the unique toxicities associated with the novel agents to apprise our readers about what to expect, how to recognize them, and how to manage these toxicities. One of the toxicities seen with inotuzumab, a CD22 antibody drug conjugate, is sinusoidal obstruction syndrome, which can be fatal in >80% of patients if associated with multiorgan failure...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Solomon Abrha, Ebisa Tadesse, Tesfay Mehari Atey, Fantahun Molla, Wondim Melkam, Birhanetensay Masresha, Solomon Gashaw, Abrham Wondimu
BACKGROUND: In developing countries, child health outcomes are influenced by the non-availability of priority life-saving medicines at public sector health facilities and non-affordability of medicines at private medicine outlets. This study aimed to assess availability, price components and affordability of priority life-saving medicines for under-five children in Tigray region, Northern Ethiopia. METHODS: A cross-sectional study was conducted in Tigray region from December 2015 to July 2016 using a standard method developed by the World Health Organization and Health Action International (WHO/HAI)...
November 29, 2018: BMC Pregnancy and Childbirth
Simon Schäfermann, Emmanuel Wemakor, Cathrin Hauk, Lutz Heide
Substandard and falsified medicines represent a serious threat for public health and patient safety. Especially in low and middle-income countries, the prevalence of substandard and falsified medicines is reportedly high. However, reliable information on the prevalence of poor-quality medicines is scarce. In this study, 12 essential medicines, including antibiotics, antidiabetics, cardiac drugs and antiasthmatic drugs, were collected from six informal vendors and six licensed pharmacies in the southern part of Togo (regions Maritime and Plateaux)...
2018: PloS One
Tanya M Horacek, Elif Dede Yildirim, Erin Kelly, Adrienne A White, Karla P Shelnutt, Kristin Riggsbee, Melissa D Olfert, Jesse Stabile Morrell, Anne E Mathews, Terezie T Mosby, Tandalayo Kidd, Kendra Kattelmann, Geoffrey Greene, Lisa Franzen-Castle, Sarah Colby, Carol Byrd-Bredbenner, Onikia Brown
Background This paper describes the development, reliability, and convergent validity of a practical tool-the Convenience Store Supportive Healthy Environment for Life-Promoting Food (SHELF) Audit. Methods Audit items included: a variety of fresh, processed, and frozen fruits and vegetables; low-fat dairy products; healthy staples and frozen meals; healthy food incentive programs; items sold in check-out areas; portion/cup sizes; and pricing. Each audit item was scored using a five-point semantic-differential scale (1 = provides little or no support for healthful foods to 5 = provides high support for healthful foods)...
November 28, 2018: International Journal of Environmental Research and Public Health
Tania Jain, Mark R Litzow
Therapeutic options for acute lymphoblastic leukemia, especially in the relapsed/refractory setting, have expanded significantly in recent times. However, this comes at the cost of toxicities: medical as well as financial. We highlight some of the unique toxicities associated with the novel agents to apprise our readers about what to expect, how to recognize them, and how to manage these toxicities. One of the toxicities seen with inotuzumab, a CD22 antibody drug conjugate, is sinusoidal obstruction syndrome, which can be fatal in >80% of patients if associated with multiorgan failure...
November 27, 2018: Blood Advances
Lixian Zhong, Anh Thu Tran, Taylor Tomasino, Elizabeth Nugent, Judith A Smith
BACKGROUND: The recent approval of olaparib and niraparib as maintenance therapy can significantly affect the management of ovarian cancer. Clinical benefits, however, come with trade-offs in adverse events and costs. OBJECTIVE: To evaluate the cost-effectiveness of new ovarian cancer poly-ADP ribose polymerase (PARP) inhibitor therapies, olaparib and niraparib, as maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer. METHODS: A decision tree model was constructed to evaluate the costs and effectiveness of olaparib and niraparib compared with placebo from a U...
December 2018: Journal of Managed Care & Specialty Pharmacy
Roger Williams, Graeme Alexander, Richard Aspinall, Rachel Batterham, Neeraj Bhala, Nick Bosanquet, Katherine Severi, Anya Burton, Robyn Burton, Matthew E Cramp, Natalie Day, Anil Dhawan, John Dillon, Colin Drummond, Jessica Dyson, James Ferguson, Graham R Foster, Ian Gilmore, Jonny Greenberg, Clive Henn, Mark Hudson, Helen Jarvis, Deirdre Kelly, Jake Mann, Neil McDougall, Martin McKee, Kieran Moriarty, Joanne Morling, Philip Newsome, John O'Grady, Liz Rolfe, Peter Rice, Harry Rutter, Nick Sheron, Douglas Thorburn, Julia Verne, Jyotsna Vohra, John Wass, Andrew Yeoman
This report presents further evidence on the escalating alcohol consumption in the UK and the burden of liver disease associated with this major risk factor, as well as the effects on hospital and primary care. We reiterate the need for fiscal regulation by the UK Government if overall alcohol consumption is to be reduced sufficiently to improve health outcomes. We also draw attention to the effects of drastic cuts in public services for alcohol treatment, the repeated failures of voluntary agreements with the drinks industry, and the influence of the industry through its lobbying activities...
November 21, 2018: Lancet
Lei Zhang, Ziyi Lin, Hongjun Yin, Jing Liu, Jianwei Xuan
PURPOSE: Monotherapy with either aspirin or clopidogrel is recommended for long-term use after discontinuation of dual-antiplatelet therapy (DAPT) for acute coronary syndrome (ACS) management after percutaneous coronary intervention (PCI). The present study is to evaluate the cost-effectiveness of clopidogrel versus aspirin after 12-month DAPT for patients with ACS who underwent PCI in China. METHODS: A 2-part model was developed to estimate the cost-effectiveness of clopidogrel compared with aspirin...
November 20, 2018: Clinical Therapeutics
Xiaomeng Yue, Jeff Jianfei Guo, Patricia R Wigle
Background: Smoking remains the single largest preventable cause of death and disease. Smoking-cessation medications provide patients a multitude of benefits and can prevent certain diseases, including some cancers. Because of the limited amount of studies on smoking-cessation medications, we wanted to find general trends about the use of these medications. Objective: To examine trends in the utilization, pharmacy reimbursement, and prices of smoking-cessation medications and nicotine replacement therapy in the US Medicaid-covered population...
September 2018: American Health & Drug Benefits
Shuyang Xie, Min Xie
Dexmedetomidine is a highly selective central α2 adrenergic receptor agonist, which has anti sympathetic, sedative and analgesic effects. The aim of this study was to investigate the effect of dexmedetomidine on postoperative delirium in elderly patients undergoing hip fracture surgery. The results showed that the dosage of sufentanil and propofol decreased significantly in the experimental group (P<0.05). The price-henry pain scores of 10min, 1H and 6h in the experimental group were significantly reduced after the operation...
September 2018: Pakistan Journal of Pharmaceutical Sciences
Yuan Ping, Chen Jing, Jia Qing
Narcotic analgesics play an important role in the treatment of pain. If the drug is not standardized, it is easy to cause tolerance and addiction, so scientific management and rational application is very important. In this article, we analyzed the use of narcotic analgesics in a tertiary hospital in 2015-2017. The results showed that the top 3 drugs in DDDs (defined daily doses) were fentanyl transdermal patch (4.2 mg), fentanyl transdermal patch (8.4 mg) and morphine sulfate sustained-release tablets (30 mg)...
September 2018: Pakistan Journal of Pharmaceutical Sciences
Brian K Chen, Y Tony Yang, Charles L Bennett
Biologics and biosimilars are medicines made from living cells that treat common and serious diseases such as cancer, diabetes, rheumatoid arthritis, and other inflammatory diseases. They are highly targeted, efficacious, and represent an increasingly important part of physicians' armamentaria in the combat against these medical conditions. Yet they are extremely expensive, costing on average $10,000-$30,000 per year and exceed $500,000 for the most expensive biologics. The advent of biosimilar drugs, or high similar copies of biologics, was supposed to help reduce costs, but thus far the cost of treatment with biologics or biosimilars has not fallen sharply in the USA...
November 16, 2018: Drugs
Svetlana B Tikunova, Andres Cuesta, Morgan Price, Monica X Li, Natalya Belevych, Brandon J Biesiadecki, Peter J Reiser, Peter M Hwang, Jonathan P Davis
Despite extensive efforts spanning multiple decades, the development of highly effective Ca2+ sensitizers for the heart remains an elusive goal. Existing Ca2+ sensitizers have other targets in addition to cardiac troponin (cTn), which can lead to adverse side effects, such as hypotension or arrhythmias. Thus, there is a need to design Ca2+ -sensitizing drugs with higher affinity and selectivity for cTn. Previously, we determined that many compounds based on diphenylamine (DPA) were able to bind to a cTnC-cTnI chimera with moderate affinity (Kd ∼10-120 µM)...
November 15, 2018: Journal of General Physiology
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