تالیفات

 

Cost-EffectivenessAnalysisofTocilizumabinComparisonwith Infliximab inIranianRheumatoidArthritisPatientswith Inadequate ResponsetotDMARDs:AMultistageMarkovModel

Authers: Amir Hashemi-Meshkini, PharmD1, ShekoufehNikfar, PharmD, PhD1, ElizabethGlaser, MS, MA2, Ahmadreza Jamshidi, MD3, SeyedAlirezaHosseini, PharmD, PhD1, 4, *

Abstract: To analyzethecost-effectivenessoftwocommontreat- ment strategiesinIran,comparinginfliximab plusmethotrexatewith tocilizumab plusmethotrexateinpatientswithrheumatoidarthritis with inadequateresponsetotraditionaldisease-modifyinganti- rheumatic drugs. Methods: A multistageMarkovdecisionmodel was appliedtoassesstheincrementalcost-effectivenessratio(ICER) of atocilizumab-containingregimenversusaninfliximab-containing regimen overa5-yeartimeperiod.Inthecaseofnoresponse,we assumed thatpatientsswitchedtothenexttreatment(adalimumab, rituximab, orsupportivecare)insequenceforeachstrategy.We consideredmajorcostitems,suchasdirectmedicalcostsanddirect nonmedical costs,fromapayer(patientsandthird-partypayers) perspective.Adeterministicsensitivityanalysiswasconductedto assess therobustnessofthemodelresultsovertheuncertaintyofkey parameters. Results: In thebase-caseanalysis,theICERofthe tocilizumab-containingregimenwasUS$60,800perquality-adjusted life-year ascomparedtotheinfliximab-containingregimen.In the sensitivityanalysis,changesinthepriceofthedrugsby generic substitution,inutilityscores,andindiscountratedidnot change ouroverallconclusions.Amongallinputstotheprimary study andthesensitivityanalyses,however,thepriceoftocili- zumab hadthemostimpactontheICER. Conclusions: Although tocilizumab andmethotrexateprovidealargergaininquality- adjusted life-years,theircurrentpriceisquitehighascomparedwith those ofourotherinterventions.Therefore,aregimencontaining tocilizumab isnotcost-effectiveascomparedwithaninfliximab- containingregimenforpatientswithrheumatoidarthritisinIran. Keywords: cost-effectiveness,infliximab, Iran,rheumatoidarthritis, tocilizumab. سال انتشار: 2015
 

Cost-EffectivenessAnalysisofTocilizumabinComparisonwith Infliximab inIranianRheumatoidArthritisPatientswith Inadequate ResponsetotDMARDs:AMultistageMarkovModel

Authers: Amir Hashemi-Meshkini, PharmD1, ShekoufehNikfar, PharmD, PhD1, ElizabethGlaser, MS, MA2, Ahmadreza Jamshidi, MD3, SeyedAlirezaHosseini, PharmD, PhD1, 4, *

Abstract: To analyzethecost-effectivenessoftwocommontreat- ment strategiesinIran,comparinginfliximab plusmethotrexatewith tocilizumab plusmethotrexateinpatientswithrheumatoidarthritis with inadequateresponsetotraditionaldisease-modifyinganti- rheumatic drugs. Methods: A multistageMarkovdecisionmodel was appliedtoassesstheincrementalcost-effectivenessratio(ICER) of atocilizumab-containingregimenversusaninfliximab-containing regimen overa5-yeartimeperiod.Inthecaseofnoresponse,we assumed thatpatientsswitchedtothenexttreatment(adalimumab, rituximab, orsupportivecare)insequenceforeachstrategy.We consideredmajorcostitems,suchasdirectmedicalcostsanddirect nonmedical costs,fromapayer(patientsandthird-partypayers) perspective.Adeterministicsensitivityanalysiswasconductedto assess therobustnessofthemodelresultsovertheuncertaintyofkey parameters. Results: In thebase-caseanalysis,theICERofthe tocilizumab-containingregimenwasUS$60,800perquality-adjusted life-year ascomparedtotheinfliximab-containingregimen.In the sensitivityanalysis,changesinthepriceofthedrugsby generic substitution,inutilityscores,andindiscountratedidnot change ouroverallconclusions.Amongallinputstotheprimary study andthesensitivityanalyses,however,thepriceoftocili- zumab hadthemostimpactontheICER. Conclusions: Although tocilizumab andmethotrexateprovidealargergaininquality- adjusted life-years,theircurrentpriceisquitehighascomparedwith those ofourotherinterventions.Therefore,aregimencontaining tocilizumab isnotcost-effectiveascomparedwithaninfliximab- containingregimenforpatientswithrheumatoidarthritisinIran. Keywords: cost-effectiveness,infliximab, Iran,rheumatoidarthritis, tocilizumab. Copyright & 2015, سال انتشار: 2016
 

The Effects of Isolated Hip Abductor and External Rotator Muscle Strengthening on Pain, Health Status, and Hip Strength in Females With Patellofemoral Pain: A Randomized Controlled Trial

Authers: KHALIL KHAYAMBASHI, PT, PhD1 • ZEYNAB MOHAMMADKHANI, MS2 • KOUROSH GHAZNAVI, MD3, MARK A. LYLE, PT, OCS4 • CHRISTOPHER M. POWERS, PT, PhD5

Abstract: TTSTUDY DESIGN: Randomized controlled trial. TTOBJECTIVES: To examine the effectiveness of isolated hip abductor and external rotator strengthening on pain, health status, and hip strength in females with patellofemoral pain (PFP). TTBACKGROUND: Altered hip kinematics resulting from hip muscle weakness has been proposed as a contributing factor in the development of PFP. To date, no study has examined clinical outcomes associated with isolated hip muscle strengthening in those with PFP. TTMETHODS: Twenty-eight females with ... سال انتشار: 2012