Chinese Clinical Studies for Pharmacological Treatments of Coronavirus Disease 2019 (COVID-19)
2020 Preprintshttps://www.doi.org/ 10.20944/preprints202004.0279.v1 preprint, COVID-19, clinical studies, China, clinical trials, observational studies,
Typology of decision analytics models – review of pros and cons and acceptability by HTA agencies
2019 2nd HTA Academy
President Trump’s prescription to reduce drug prices: from the campaign trail to American Patients First
2019 Journal of market access & health policyhttps://www.doi.org/10.1080/20016689.2019.1579597 American Patients First (APF), President Trump, Trump administration, campaign, drug prices,
Background: Drug prices in the United States are the highest in the world, restricting access to the domestic lower income population. President Trump campaigned heavily on promises to reduce drug prices.Methods: A literature review was conducted through PUBMED, EMBASE, Media and grey literature to consolidate and analyze publications addressing President Trump’s promises from the campaign trail as well as the shortcomings and achievements of the Trump administration.Results: Major promises ranged from repealing and replacing Obamacare, expanding coverage, allowing cross-state insurance purchasing, and reducing drug prices. Main accomplishments of the Trump administration have been two executive orders (13765 and 13813), the proposition of the American Health Care Act, and the passing of the Tax Cuts and Jobs Act of 2017. The American Patients First blueprint further revealed the administration’s strategies for lowering drug prices. The administration has also engaged in unconventional strategies, such as via bilateral leverage directly with trade partners.Conclusion: The Trump administration has not yet been able to fulfill the major campaign promises, primarily the ones requiring legislative and/or administrative action. If enough legislative action is accomplished to implement the Trump administration’s promises, the effects on the pharmaceutical industry could be direct, yet minimal, unless Medicare can directly negotiate with manufacturers.
[PIN4] A Network Meta-Analysis of the Efficacy and Safety of Baloxavir Marboxil Versus Neuraminidase Inhibitors in the Treatment of Influenza Virus Infection in Otherwise Healthy and High-Risk Adults
2019 Value in HealthI,
Drug utilization patterns and healthcare resource use and costs in patients with neurogenic bladder in the United Kingdom: A retrospective primary care database study
2019 Neurourology and Urodynamicshttps://www.doi.org/10.1002/nau.23981 cholinergic antagonists, comorbidity, healthcare costs, healthcare resources, neurogenic, retrospective studies, urinary bladder,
Abstract Aim To characterize patients with neurogenic bladder (NGB), their treatment patterns, healthcare resource utilization, and associated costs based on records from a primary care database in the United Kingdom. Methods This was a retrospective, descriptive, observational study of anonymized data from the Clinical Practice Research Datalink and Hospital Episode Statistics databases (selection period, 1 January 2004 to 31 December 2016). Adults with a definitive or probable diagnosis of NGB and ≥1 referral to a urologist were included. Results The study cohort included 3913 patients with definitive (n?=?363) or probable (n?=?3550) NGB. Patients had a mean of 8.6 (standard deviation [SD], 7.6) comorbidities, and mean Anticholinergic Cognitive Burden Scale score of 6.6 (SD, 5.9). During 12 months? follow-up, urinary tract infection (UTI) and urinary incontinence were the most common complications. Most patients (92.2%) received ≥1 prescription for an antimuscarinic agent or mirabegron, and 53.9% of patients received prescriptions for UTI-specific antibiotics. The mean number of visits to a general practitioner for any cause was 67.7 (SD, 42.6) per individual. Almost half (46.7%) of the study cohort visited a specialist during the 12-month follow-up period, and 11.0% had ≥1 hospital admission. Total mean per patient costs for healthcare resource utilization was £2395. Conclusions The burden of illness, healthcare resource needs, and associated costs among patients with NGB are considerable. Drug prescribing patterns are consistent with the symptoms and complications of NGB, although increased awareness of drugs with anticholinergic activity among prescribers may help to reduce the cumulative anticholinergic burden in this vulnerable population.
Common mistakes when running systematic and targeted literature reviews
2019 2nd HTA Academy
A systematic literature review identifying associations between outcomes and quality of life (QoL) or healthcare resource utilisation (HCRU) in schizophrenia
2019 J Med Econhttps://www.doi.org/10.1080/13696998.2019.1576694 I10, I11, associations, functioning, healthcare resource utilization, outcomes, quality of life, relapse, remission, schizophrenia, systematic literature review,
AIMS: There have been no systematic literature reviews (SLRs) evaluating the identified association between outcomes (e.g. clinical, functional, adherence, societal burden) and Quality of Life (QoL) or Healthcare Resource Utilization (HCRU) in schizophrenia. The objective of this study was to conduct a SLR of published data on the relationship between outcomes and QoL or HCRU. MATERIALS AND METHODS: Electronic searches were conducted in Embase and Medline, for articles which reported on the association between outcomes and QoL or HCRU. Inclusion and exclusion criteria were applied to identify the most relevant articles and studies and extract their data. A summary table was developed to illustrate the strength of associations, based on p-values and correlations. RESULTS: One thousand and two abstracts were retrieved; 5 duplicates were excluded. 997 abstracts were screened and 95 references were retained for full-text screening. 31 references were included in the review. The most commonly used questionnaire, which also demonstrated the strongest associations (defined as a p < 0.0001 and/or correlation +/- 0.70), was the Positive and Negative Syndrome Scale (PANSS) associated with HCRU and QoL (the SF-36, the Schizophrenia Quality of Life questionnaire [S-QOL-18], the Quality of Life Scale [QLS]). Other robust correlations included the Clinical Global Impression - Severity (CGI-S) with QoL (EQ5D), relapse with HCRU and remission with QoL (EQ5D). Lastly, functioning (Work Rehabilitation Questionnaire [WORQ] and Personal and Social Performance Scale [PSP]) was found to be associated to QoL (QLS and Subjective Well-being under Neuroleptics Questionnaire [SWN]). LIMITATIONS: This study included data from an 11-year period and other instruments less frequently used may be further investigated. CONCLUSIONS: The evidence suggests that the PANSS is the clinical outcome that currently provides the most frequent and systematic associations with HCRU and QoL endpoints in schizophrenia.
The mediating role of depression in pathways linking positive and negative symptoms in schizophrenia. A longitudinal analysis using latent variable structural equation modelling
2019 Psychol Medhttps://www.doi.org/10.1017/s0033291719000321 Depression, longitudinal studies, negative symptoms, positive symptoms, schizophrenia,
BACKGROUND: The interaction between positive, negative and depressive symptoms experienced by people with schizophrenia is complex. We used longitudinal data to test the hypothesis that depressive symptoms mediate the links between positive and negative symptoms. METHODS: We analyzed data from the European Schizophrenia Cohort, randomly sampled from outpatient services in France, Germany and the UK (N = 1208). Initial measures were repeated after 6 and 12 months. Depressive symptoms were identified using the Calgary Depression Scale for Schizophrenia (CDSS), while positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Latent variable structural equation modelling was used to investigate the mediating role of depression assessed at 6 months in relation to the longitudinal association between positive symptoms at baseline and negative symptoms at 12 months. RESULTS: We found longitudinal associations between positive symptoms at baseline and negative symptoms at 12 months, as well as between both of these and CDSS levels at 6 months. However depression did not mediate the longitudinal association between PANSS scores; all the effect was direct. CONCLUSIONS: Our findings are incompatible with a mediating function for depression on the pathway from positive to negative symptoms, at least on this timescale. The role of depression in schizophrenic disorders remains a challenge for categorical and hierarchical diagnostic systems alike. Future research should analyze specific domains of both depressive and negative symptoms (e.g. motivational and hedonic impairments). The clinical management of negative symptoms using antidepressant treatments may need to be reconsidered.