Hiteksha S. Panchal
Raul Montalvo Otivo*, Salome Ochoa, JF Quispe-Pari, Jorge De La Cruz, Julio Rosales and Angela Gomez
Background: Since the emergence of the pandemic caused by Coronavirus disease-19 (COVID-19), Social isolation is one of the measures adopted by the countries in order to flatten the curve, thus reducing the productive capacity of the affected cities, while allowing health systems to manage care capacity. The objective of this study was to estimate the economic losses due to COVID-19 in Peru. Methods: To estimate the economic loss, direct and indirect costs were determined from the health system perspective. The direct cost was represented by the expenses caused by the care provided by the health facility to the patient and the indirect cost is represented by the loss of economic production. Results: Of a total of 363 confirmed cases of COVID-19 in Peru, the percentage of patients requiring hospitalization was 12.3%, and those requiring admission to Intensive Care was 3.9%. The direct cost was $1708 for each patient who received care in a hospital of the Ministry of health through the comprehensive health insurance (SIS); $2,300 if the patient received treatment from Social Security (EsSalud) and US $ 3,192 if he went to a private clinic. In relation to the indirect cost, it ranged from $1447.0 in the patients that are treated by the SIS to $4102.0 for each patient that is attended in private institutions. Conclusion: Our findings indicate that caring for a patient with COVID-19 imposes a heavy economic burden on Peru.
Rasmus Vinther Russell*, MJG Dunn
Background: Bronchoscopy procedures are conventionally associated with complex supporting processes, large capital investments and inevitable repairs. Cost-comparison analysis with the single-use bronchoscope Ambu® aScope™4 Broncho within a UK intensive care unit have never been done before.
Materials and Methods: We conducted a cost-comparison analysis of reusable vs single-use bronchoscopes within the intensive care unit of the Royal Infirmary of Edinburgh via a micro-costing method.
Results: At the current split between reusable and single-use bronchoscopes, the incremental cost of using single-use vs. reusable bronchoscopes was £111. In a binary setup with either reusable or single-use bronchoscopes, the incremental procedure cost was£90. Singleuse bronchoscopes were cost-minimising up to 75 annual procedures per reusable bronchoscope. When including a 0.72% and 2.8% risk of cross-infection the incremental cost of was £159 and £352.
Conclusion: Single-use is cost-effective compared with reusable bronchoscopes within the ICU setting.
Martin Connock*, Mubarak Patel, Daniel Gallacher and Aileen Clarke
Background: Most Health Technology Appraisals (HTA) model survival data using a conventional set of six parametric distributions. Alternative and potentially useful distributions exist and could also be exploited. Rayleigh 2 parameter (R2P) and Weibull models are both defined with two parameters and exhibit monotonic hazard; the Rayleigh model is relatively unused in HTA and should not be regarded as just a special case of the Weibull model.
Aim: To explore circumstances where the predictions from R2P and Weibull models may differ or coincide.
Method: Stata software was used to model sample survival data with R2P and Weibull models and to compare the predicted hazard and survival from each parametric.
Results: R2P models generate different predictions to Weibull models except in the special case where the Weibull shape parameter equals or closely approaches two and the Weibull hazard prediction is linearly increasing. When compared to Weibull models R2P models may generate a better fit to observed data according to conventionally used indicators of goodness of fit.
Conclusion: Rayleigh modelling of survival warrants inclusion in the survival modelling undertaken in Health Technology Appraisals.
In 15–35% of cases, depending on the specifics of the traumatic event and the subject's subjective experience, a scenario or stressful occurrence that is extraordinarily threatening or catastrophic and could result in clear distress symptoms in the majority of people "causes" PTSD.
Based on the analysis of objective and subjective parameters as well as the influence of the fractured side on the final results, the purpose of this study was to assess patients' quality of life after treatment for a distal radius fracture (at least six months but no more than ten years after the treatment).Thirty women, all of whom claimed to be right-handed and were divided according to the side of the fracture (left limb or right limb), were included in the study sample. A goniometer was used to check for active wrist movement, elbow joint pronation, and supination. In addition, a dynamometer made by Biometrics Ltd. was used to measure the upper limb's global grip strength. After that, patients were given the PRWE wrist evaluation questionnaire and the Polish version of the SF-36 questionnaire that measured quality of life.
Pharmacopoeias have a rich and diverse history dating back to ancient times. The earliest known pharmacopoeia is the Chinese Shennong Benaco Jing, which was written in the 3rd century BCE and contains descriptions of hundreds of medicinal plants and their uses. The Greeks and Romans also had their own pharmacopoeias, which included descriptions of herbal remedies and other medicinal substances. In the middle Ages, Arab scholars built upon the Greek and Roman pharmacopoeias and developed their own systems of medicine, which included a focus on pharmacology and pharmacy. One of the most influential works from this period was the Canon of Medicine by Avicenna, which was written in the 11th century and remained a standard medical text for centuries. During the Renaissance, the study of medicine and pharmacy was further advanced in Europe, with the publication of several important pharmacopoeias. One of the most significant was the Pharmacopoeia. Which was published in 1618 and remained the official pharmacopoeia of England until the 19th century? This pharmacopoeia contained descriptions of medicinal substances, along with recipes for preparing medicines and instructions for quality control.
Pharmacopoeia is a comprehensive guide to the identification, quality control, and therapeutic use of medicinal substances. It is a critical reference tool for healthcare professionals, pharmacists, regulators, and manufacturers to ensure that medicines are safe, effective, and of high quality. Pharmacopoeias have a long history, dating back to ancient civilizations, and have evolved into international standards that govern the development and regulation of pharmaceuticals worldwide. This essay will explore the history and evolution of pharmacopoeias, the role of pharmacopoeias in modern healthcare, and the importance of pharmacopoeias in quality control of medicines. The history of pharmacopoeias can be traced back to ancient civilizations such as Egypt, Greece, and China. The earliest known pharmacopoeia is the Ebers Papyrus, which was written in Egypt around 1550 BCE and contained information on over 700 medicinal substances. The Greeks also produced several pharmacopoeias, including the Hippocratic Corpus, which contained descriptions of hundreds of medicinal plants and their therapeutic uses. In China, the earliest known pharmacopoeia is the Shen Nong Ben Cao Jing, which was written around 100 BCE and contained information on over 350 medicinal substances.
Günther Krumpl and Evelyn Walter*
Background: Sepsis and septic-shock are associated with cardiovascular problems, including tachyarrhythmia, myocardial injury, and changes in vascular endothelial function that might affect cardiac output with potential fatal outcome. The consequences of sepsis extend well beyond the acute illness. Tachycardia and new-onset atrial-fibrillation (AF), often treated with less effective agents such as amiodarone, are key prognostic factors for sepsis and associated with increased use of health-care resources and costs. Early decrease of heart-rate is associated with improved outcome. The use of β-blockers for managing acute arrhythmias in patients with septic-shock has been described in the literature. Landiolol, an ultra-short-acting β1-selective adrenergic-receptor-antagonist, is used specifically for the acute management of atrial-fibrillation and atrial-flutter in critically ill patients with/without cardiac-dysfunction.
Methods: A decision-model was developed to reflect the cost-effectiveness of landiolol in addition to conventional-therapy vs. standard-of-care (SoC) to manage sepsis-related tachyarrhythmia. The model combines a short-term decision tree to describe the time span of the sepsis related hospitalization over 28 days. The endpoint of the decision tree was then combined with a Markov model to simulate a life-long time horizon, as AF and post discharge mortality occurrence following sepsis hospitalization was more common among patients with new-onset AF during sepsis. The model calculates total costs (incl. hospital-stay, ICU and ventilation, AF costs) quality-adjusted life-years/QALYs and life-years/LYs over life-time.
Results: Manage sepsis related tachyarrhythmia with landiolol led to estimated lifetime costs of 59.130.79 € (95%-CI=53,436-64,901) per patient and 4.02 QALYs (5.56 LYs) over a life-time horizon. SOC was associated with 60.935.11 € (95%-CI=47,928-73,124) and 3.55 QALYs (5.01 LYs). Landiolol yields cost savings of about 1,804.31 € per patient and a QALY gain of 0.47 or 5.63 months in perfect health. Landiolol resulted in a life year gain of 0.54 LYs.
Conclusion: The economic analysis shows that the use of landiolol is associated with costs saving from the payer’s perspective.
Pharmacoeconomic studies provide valuable information for healthcare decision-makers by assessing the economic impact of pharmaceutical interventions. Despite their importance, such studies face several challenges and barriers that may hinder their conduct and implementation. This review aims to explore the barriers and facilitators of pharmacoeconomic studies in Middle Eastern countries and suggest potential solutions to overcome these challenges.A systematic review was conducted by searching PubMed, Embase, and Scopus databases for relevant articles published from January 2010 to December 2021. The search was limited to studies conducted in Middle Eastern countries and those reporting on barriers and facilitators of pharmacoeconomic studies. The quality of the included studies was assessed using the Critical Appraisal Skills Program tool. A total of 25 studies were included in this review. The main barriers to conducting pharmacoeconomic studies in Middle Eastern countries included limited funding, lack of trained personnel, inadequate data availability, and cultural barriers. On the other hand, the main facilitators of conducting such studies were the presence of supportive policies and regulations, collaborations between academia and industry, and the availability of skilled researchers. Moreover, the use of modeling techniques and the development of local pharmacoeconomic guidelines were suggested as potential solutions to overcome the identified barriers.
Pharmacoeconomics: Open Access received 85 citations as per Google Scholar report