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Yang J, Wei Q, Yang X, Jiao J, Yang Z, Li F. Assessment and predictive analysis of health professions students' proficiency in health economics and pharmacoeconomics in Southwest China: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:1239. [PMID: 39482631 PMCID: PMC11526572 DOI: 10.1186/s12909-024-06214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 10/17/2024] [Indexed: 11/03/2024]
Abstract
OBJECTIVES This study addresses the growing importance of health economics and pharmacoeconomics in preparing healthcare professionals for economic decision-making, particularly in China's evolving healthcare system. Despite their significance, these subjects are inconsistently included in health education in Southwest China, making it crucial to assess students' proficiency and educational needs. METHODS A cross-sectional study was conducted from July to October 2023, involving medical and pharmaceutical programs across universities in Sichuan, Chongqing, Guizhou, and Yunnan. Data on students' knowledge, attitudes, and proficiency were captured using a structured questionnaire. Advanced statistical methods, including descriptive analysis, ANOVA, regression analysis, PCA, and Spearman correlation heatmaps, were employed for data analysis using IBM SPSS and Python. The sample consisted of 781 students, with the survey facilitated via the Questionnaire Star platform. RESULTS The survey revealed moderate comprehension of health economics and pharmacoeconomics among 781 health-related students, with an average knowledge score of 2.9. The majority were pharmacy students (45.58%) and aged 21-24 years (65.81%) with a significant female majority (64.92%). Academic year significantly influenced understanding, while gender differences were minimal. Spearman correlation indicated a strong linkage (0.78) between Supply and Demand and Cost Effectiveness, with minimal correlations between knowledge and attitudes towards the educational importance of health economics. Multiple regression analysis highlighted the impact of gender and academic progression on students' comprehension of Supply and Demand concepts, as well as the influence of knowledge levels on their attitudes towards the importance of health economics education. PCA indicated the complex structure of knowledge and attitudes. CONCLUSIONS The study found moderate knowledge levels in health economics among health professions students in Southwest China, with academic year affecting comprehension and minimal gender differences. Pharmacy students had higher proficiency in pharmaceutical-related areas, but gaps in complex topics like 'Economic Evaluation' highlight the need for targeted educational improvements to better prepare students for healthcare economic decision-making.
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Affiliation(s)
- Jian Yang
- School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
- Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan, 650500, People's Republic of China
- College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
| | - Quanzhi Wei
- Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan, 650500, People's Republic of China
- College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
- The Third Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
| | - Xin Yang
- School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
- Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan, 650500, People's Republic of China
- College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
| | - Jingyi Jiao
- School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
- Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan, 650500, People's Republic of China
- College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
| | - Zaixian Yang
- School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
- College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
- Technology Transfer Center, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China
| | - Fan Li
- Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan, 650500, People's Republic of China.
- College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China.
- Technology Transfer Center, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China.
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Edwards A, Oestreich JH. A novel game to review pharmacoeconomic content in a pharmacy program. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1193-1198. [PMID: 36154965 DOI: 10.1016/j.cptl.2022.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 07/04/2022] [Accepted: 07/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND PURPOSE This study reports on the development of a new game designed specifically for a pharmacoeconomics course to meet three objectives: (1) identify four main types of pharmacoeconomic analyses, (2) understand different outcomes for each analysis, and (3) interpret findings of pharmacoeconomic analyses. EDUCATIONAL ACTIVITY AND SETTING The game simulated real-world applicability of pharmacoeconomic analyses in a classroom setting using a candy theme. Groups of pharmacy students (N = 62) competed by building formularies that incorporated a minimum number of medications (candies) from each outcome category and at least two specialty services. Each medication and service were assigned a cost and rating according to the outcome associated with each analysis type. The following class session served as a debriefing to assess student perceptions using a written survey. Survey responses ranged from a score of 1 (strongly agree) to 5 (strongly disagree). A separate open-ended question collected feedback on the strengths and weaknesses of the game and analyzed into themes. FINDINGS Student responses averaged 1.96 (SD = 1.1) for all questions. The highest rated question, "I attained the stated goals/objectives of this activity," scored 1.81 (SD = 1.1). Four overall themes emerged: engaging (n = 10), valuable (n = 19), confusing (n = 17), and disconnected (n = 8). Students highlighted the value of the gaming activity for providing practical, real-life examples to increase their understanding. SUMMARY The design and application of gaming in a pharmacoeconomics course proved practical and valuable for student learning.
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Affiliation(s)
- Akesha Edwards
- Pharmaceutical Sciences, Department of Pharmaceutical Sciences, College of Pharmacy, University of Findlay, 1000 N Main St, Findlay, OH 45840, United States.
| | - Julie H Oestreich
- Pharmaceutical Sciences, Department of Pharmaceutical Sciences, College of Pharmacy, University of Findlay, 1000 N Main St, Findlay, OH 45840, United States.
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Pizzi LT, Onukwugha E, Corey R, Albarmawi H, Murray J. Competencies for Professionals in Health Economics and Outcomes Research: The ISPOR Health Economics and Outcomes Research Competencies Framework. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1120-1127. [PMID: 32940228 DOI: 10.1016/j.jval.2020.04.1834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/11/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
The need for Health Economics and Outcomes Research (HEOR) has expanded globally, fueling demand for professionals trained in the discipline. By leveraging the expertise and perspectives of its members, the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) established a set of competencies for HEOR professionals. The resulting 41 competencies were organized into 13 topic domains that collectively comprise the ISPOR Health Economics and Outcomes Research Competencies Framework. In this article, we explain the collaborative process used by the ISPOR Institutional Council and Faculty Advisor Council to identify and validate the framework. This process entailed expertise from the council members combined with natural language processing to examine competencies included in ISPOR Career Center HEOR job postings, qualitative input from a focused Institutional Council-Faculty Advisor Council workgroup, and quantitative input from 3 surveys of mutually exclusive member groups: a general member survey to assess importance and relevance of each competency, a faculty member survey to assess the extent to which HEOR graduate degree programs cover each of the competencies, and a student member survey to assess exposure to each of the competencies. Organization of the competencies into topic domains was achieved by engaging the Education Council, which applied a taxonomy consistent with ISPOR's educational programming. The resulting ISPOR Health Economics and Outcomes Research Competencies Framework has the important potential of serving as a tool to guide academic curricula, fellowships, and continuing education programs, and assessment of job candidates. As the HEOR field advances, so do the job types and the breadth of topics in which professionals must demonstrate competence. Future work will entail revisiting the competencies to ensure their currency and comprehensiveness, and tailoring the framework according to major specialty areas.
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Affiliation(s)
- Laura T Pizzi
- Center for Health Outcomes, Policy, and Economics, Rutgers University Ernest Mario School of Pharmacy, Piscataway, NJ, USA.
| | - Ebere Onukwugha
- Pharmaceutical Research Computing, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | | | - Husam Albarmawi
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - James Murray
- Global Patient Outcomes and Real-World Evidence, Eli Lilly and Company, Indianapolis, IN, USA
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AlRuthia Y, Al-Washali NY, Aljuhani R, Sales I, Balkhi B, Alghaiheb A, Arafah A, Almalag HM, Alsultan A, Alqahtani SA, Alwhaibi M. Exploring the value of a Doctor of Philosophy program in Pharmaceutical Outcomes and Policy Research in Saudi Arabia. Saudi Pharm J 2020; 28:107-115. [PMID: 31920437 PMCID: PMC6950942 DOI: 10.1016/j.jsps.2019.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background The need for graduate education in Pharmaceutical Outcomes and Policy Research (POPR) is becoming increasingly apparent worldwide. However, the number of professionals in this field is inadequate in the Middle East. Therefore, this study aimed at gaining insight into the perceived value of a potential Doctor of Philosophy (Ph.D.) program in POPR among different stakeholders in Saudi Arabia. Methods Following the development of a Ph.D. program structure in POPR, a questionnaire was created to explore the perception of its value among decision-makers in different healthcare and governmental institutions. An email with detailed information on the proposed program was sent to 131 identified individuals along with an online link to the questionnaire. Results Responses were provided by 107 (81.67%) individuals. The majority of respondents (53.3%) represented large organizations with more than 500 workers; hospitals and academia were the most represented types of institutions. More than 85% of the participants strongly agreed that the program will meet the needs of the healthcare market in Saudi Arabia and that there will be a demand for graduates of the program over the next 5–10 years. However, only 28.04% of the participants declared that they would definitely recommend the program to their colleagues and employees, and 49.53% would consider employing its graduates. Conclusions The obtained results indicate a significant interest among different stakeholders in introducing a Ph.D. program in POPR in Saudi Arabia.
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Affiliation(s)
- Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Corresponding author at: Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia.
| | - Nasser Yahya Al-Washali
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Raneem Aljuhani
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Sales
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Bander Balkhi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdlatif Alghaiheb
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Azher Arafah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Haya M. Almalag
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alsultan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Saeed A. Alqahtani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Monira Alwhaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Health Economics and Outcomes Research Knowledge Needs Assessment for Latin America. Value Health Reg Issues 2019; 20:2-6. [PMID: 30634087 DOI: 10.1016/j.vhri.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND An increasing awareness of the importance of health economics and outcomes research (HEOR) skills has been reported in Latin America. There is, however, no published study directly assessing perceived knowledge levels and knowledge gaps on specific HEOR topics among professionals and students in the region. OBJECTIVES To assess perceived HEOR knowledge levels and identify knowledge gaps in Latin America. METHODS An online needs assessment survey was developed to quantify perceived HEOR knowledge levels and identify knowledge gaps. Members of the International Society for Pharmacoeconomics and Outcomes Research in the Latin American region, regional chapters, and student chapter presidents were invited to participate in the survey. The survey, developed using the SurveyMonkey tool, was distributed to participants electronically. Data were extracted from the survey and analyzed using Microsoft Excel. Data analysis was conducted using descriptive statistics to summarize the survey respondents' demographic information, current and desired knowledge levels, and preferred method/format for delivery of educational training. RESULTS Survey responses were collected from 106 participants. The largest knowledge gap was calculated for methods for integrating medication adherence and persistence in health economic evaluations (mean = 2.30 ± 1.48). The smallest knowledge gap was calculated for types of healthcare costs (mean = 1.01 ± 1.17). Most respondents (74% [n = 66]) preferred to receive educational materials related to HEOR topics through online learning and continuing education programs. CONCLUSIONS The knowledge gap assessment provided current knowledge gap perceptions among members of the International Society for Pharmacoeconomics and Outcomes Research in Latin America. The survey data collected support a need for developing educational programs for topics with the highest perceived knowledge gap.
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Catić T, Skrbo S. Pharmacoeconomic education for pharmacy students in bosnia and herzegovina. Mater Sociomed 2013; 25:282-5. [PMID: 24511276 PMCID: PMC3914744 DOI: 10.5455/msm.2013.25.282-285] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/25/2013] [Indexed: 11/29/2022] Open
Abstract
Pharmacoeconomic (PE) is becoming more important in pharmaceutical reimbursement decision and drug evaluation. To ensure its appropriate application, conduction and assessment of studies it is important to have well trained and educated professionals. Pharmaceutical faculties all over the world have established PE in under- and post-graduate curricula's. In this pilot research we examine situation in B&H. In Bosnia-Herzegovina, education in this field is poor and only one faculty for pharmacy has introduced PE as subject in its program. Objective of this study is to explore understanding of PE and its concept and analysis and to evaluated adopted knowledge among graduate (fifth year/tenth semester) pharmacy students who have listened subject "pharmacoeconomics" in previous semester. A self-administered questionnaire was developed consisted of 12 questions and survey was conducted among students. Results are analyzed in MS Excel and we used descriptive statistics. Even graduate students have lessons from PE they understand its scope and definition, but do not feel capable for conducting PE studies, but show interest in additional education and getting competencies in this field finding it applicable in their future professional engagements.
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Affiliation(s)
- Tarik Catić
- Society for Pharmacoeconomics and Outcomes Research in Bosnia and Herzegovina - ISPOR BH, Sarajevo, Bosnia and Herzegovina
| | - Selma Skrbo
- Faculty for Pharmacy University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Makhinova T, Rascati K. Pharmacoeconomics education in US colleges and schools of pharmacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2013; 77:145. [PMID: 24052648 PMCID: PMC3776899 DOI: 10.5688/ajpe777145] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/13/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To determine the extent of pharmacoeconomics education in US colleges and schools of pharmacy provided to doctor of pharmacy (PharmD) students in 2011. METHODS E-mails requesting syllabi and information about courses covering pharmacoeconomic topics were sent to all US colleges and schools of pharmacy from which PharmD students had graduated in 2011 (n=103). RESULTS Of 87 responding pharmacy colleges and schools, 85 provided pharmacoeconomics education in 2011. The number of hours dedicated to pharmacoeconomic-related topics varied from 2 to 60 per year (mean=20). CONCLUSIONS. Pharmacoeconomics education is provided at almost all US colleges and schools of pharmacy; however, variation in the number of teaching hours and topics covered demonstrates a lack of standardization in the PharmD curriculum. Pharmacy administrators and educators should invest more resources and tools to standardize training in this area.
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Soliman AM, Hussein M, Abdulhalim AM. Pharmacoeconomic education in Egyptian schools of pharmacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2013; 77:57. [PMID: 23610475 PMCID: PMC3631732 DOI: 10.5688/ajpe77357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 10/28/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE. To investigate the status of pharmacoeconomics education in Egyptian schools of pharmacy and compile and construct recommendations on how Egypt and similar countries could improve their educational infrastructure in pharmacoeconomics. METHODS. A modified version of a published survey instrument was sent to all schools of pharmacy in Egypt (n= 24). The data were assessed to identify associations between offering pharmacoeconomics education and school characteristics. RESULTS. Usable responses were obtained from 20 schools (response rate: 83%). Only 7 schools offered pharmacoeconomics education, with a median of 20 teaching hours per semester. Among respondents, 4 schools had instructors with some training in pharmacoeconomics and only 1 school had a faculty member with PhD-level training. Only 4 schools offered graduate-level courses in pharmacoeconomics. Eight additional schools expressed interest in teaching pharmacoeconomics in the near future. Having 1 or more faculty members with training in pharmacoeconomics was significantly associated with offering pharmacoeconomics education (p = 0.03). CONCLUSIONS. Pharmacoeconomics education in Egypt is still in its infancy and there exists a unique opportunity for well-trained instructors and researchers to fill this gap. Providing structured pharmacoeconomics education to student pharmacists, researchers, and stakeholders can help countries establish an integrated scientific community that can start applying pharmacoeconomic evidence to healthcare decision-making.
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Affiliation(s)
- Ahmed M Soliman
- The University of Minnesota College of Pharmacy, 308 Harvard St SE,Minneapolis, MN 55455, USA.
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Slejko JF, Libby AM, Nair KV, Valuck RJ, Campbell JD. Pharmacoeconomics and outcomes research degree-granting PhD programs in the United States. Res Social Adm Pharm 2012; 9:108-13. [PMID: 22554392 DOI: 10.1016/j.sapharm.2012.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 03/09/2012] [Accepted: 03/12/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Evidence is missing on showcasing current practices of degree programs specific to the field of pharmaceutical outcomes research. OBJECTIVES To measure current practices of pharmacoeconomics and outcomes research PhD programs in the United States and synthesize recommendations for improving the success of programs and prospective students. METHODS A 23-question online survey instrument was created and distributed to 32 program directors identified in the International Society for Pharmacoeconomics and Outcomes Research educational directory. Descriptive statistics summarized both the program characteristics (including observed and desired number of faculty and students) and training recommendations (traits of program and student success). RESULTS Of 30 eligible programs that conferred a PhD in pharmacoeconomics, pharmaceutical outcomes research, or a related field, 16 respondents (53%) completed the survey. Seventy-five percent of respondents were located in a school of pharmacy. The average observed number of faculty (7.5) and students (11.5) was lower than the average desired numbers (8.1) and (14.7), respectively. Reputation of faculty research and a collaborative environment with other disciplines were rated highest for a program's success. Faculty's mentoring experience and reputation and student funding opportunities were rated highest for prospective students' success. CONCLUSIONS Existing and emerging programs as well as prospective students can use these findings to further their chances of success.
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Affiliation(s)
- Julia F Slejko
- Department of Clinical Pharmacy, Center for Pharmaceutical Outcomes Research, University of Colorado Aschutz Medical Campus, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO 80045, USA.
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Abstract
Outcome research focusing on the economics of the medical field began in the mid-1990s and has included studies about costs, cost effectiveness, and policies. According to the American Diabetes Association, the total estimated cost of diabetes in 2007 was $174 billion. The economic burden of patients with diabetes in Canada is expected to be about $12.2 billion in 2010. Recent Korean studies have analyzed the expenses associated with type 2 diabetes for patients in selected general hospitals. Type 2 diabetic patients without complications cost approximately 1,184,563 won (the equivalent of US $1,184) per patient for healthcare annually. In contrast, patients with microvascular disease due to diabetic complications cost up to 4.7 times that amount, and patients with macrovascular disease incur up to 10.7 times the annual costs for patients without diabetic complications. Diabetic complications ultimately impact the quality of life for patients and patient mortality, and are associated with higher direct medical expenses for patients. To avoid increased medical costs, appropriate management techniques must be implemented to ensure timely care for patients with diabetes.
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Affiliation(s)
- Kwan Woo Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
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Brunoni AR, Fraguas R, Fregni F. Pharmacological and combined interventions for the acute depressive episode: focus on efficacy and tolerability. Ther Clin Risk Manag 2009; 5:897-910. [PMID: 19956554 PMCID: PMC2781064 DOI: 10.2147/tcrm.s5751] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Use of antidepressants is the gold standard therapy for major depression. However, despite the large number of commercially available antidepressant drugs there are several differences among them in efficacy, tolerability, and cost-effectiveness. In addition the optimal augmentation strategy is still not clear when dealing with treatment-resistant depression, a condition that affects 15% to 40% of depressed patients. METHODS We therefore reviewed the main characteristics of these drugs regarding their efficacy, tolerability, side effects and cost-effectiveness, by accessing all meta-analyses and systematic reviews published from 2004 to 2009. In addition, we reviewed the augmentation strategy of associated antidepressants with neurostimulation therapies (such as transcranial magnetic stimulation [TMS] and transcranial direct current stimulation [tDCS]). A search was undertaken in MEDLINE, Web of Science, Cochrane, and Scielo databases. We included: 21 meta-analyses of antidepressant trials, 15 neurostimulation clinical trials and 8 studies of pharmacoeconomics. We then performed a comprehensive review on these articles. RESULTS AND CONCLUSION Although recent meta-analyses suggest sertraline and escitalopram might have increased efficacy/tolerability, other studies and large pragmatic trials have not found these to be superior to other antidepressant drugs. Also, we did not identify any superior drug in terms of cost-effectiveness due to the different designs observed among pharmacoecomics studies. Side effects such as sexual dysfunction, gastrointestinal problems and weight gain were common causes of discontinuation. Tolerability was an important issue for novel neurostimulation interventions, such as TMS and tDCS. These therapies might be interesting augmentation strategies, considering their benign profile of side effects, if proper safety parameters are adopted.
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Affiliation(s)
- Andre R Brunoni
- Department and Institute of Psychiatry, University of Sao Paulo, Brazil
| | - Renerio Fraguas
- Department and Institute of Psychiatry, University of Sao Paulo, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Spaulding Rehabilitation Center, Harvard Medical School and Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
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Reddy M, Rascati K, Wahawisan J, Rascati M. Pharmacoeconomic education in US colleges and schools of pharmacy: an update. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2008; 72:51. [PMID: 18698384 PMCID: PMC2508714 DOI: 10.5688/aj720351] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 12/13/2007] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To determine the extent of pharmacoeconomics education at US pharmacy colleges and schools in 2007. METHODS An e-mail survey was developed and sent to pharmacoeconomics instructors at all US colleges of pharmacy. RESULTS Of the 90 colleges and schools of pharmacy that completed the survey, 7 colleges and schools did not currently have someone teaching pharmacoeconomics (eg, new school or looking for instructor). For the 83 colleges and schools that had an instructor who taught pharmacoeconomics, 69 covered pharmacoeconomic-related topics in a required course only; 5, in an elective course only; and 9, in both a required and elective course. The number of hours of pharmacoeconomic-related topics presented in required courses ranged from 1 to 48 hours (mean = 21 +/- 14; median = 19). CONCLUSIONS Pharmacoeconomics education courses are offered at the majority of US colleges and schools of pharmacy. There was a wide range of hours devoted to pharmacoeconomic-related topics and the topics covered in these colleges and schools varied. Although the majority of US colleges and schools of pharmacy offer pharmacoeconomics courses, official guidelines are needed for the specific aspects and topics that should be covered in the classroom.
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Tonon LM, Tomo TT, Secoli SR. Farmacoeconomia: análise de uma perspectiva inovadora na prática clínica da enfermeira. TEXTO & CONTEXTO ENFERMAGEM 2008. [DOI: 10.1590/s0104-07072008000100020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo desse artigo é abordar conceitos e métodos de avaliação farmacoeconômica, analisar e discutir as limitações e perspectivas do uso da farmacoeconomia. Trata-se de um estudo analítico e reflexivo cujo objeto é a aplicabilidade da farmacoeconomia no âmbito da enfermagem. No contexto atual, esta disciplina vem se tornando instrumento essencial, viabilizando tomada de decisões fundamentadas em desfechos e custos. Todavia, o seu uso exige conhecimento atualizado acerca da terminologia e da metodologia das análises, no intuito de assegurar a aplicação e a interpretação correta dos resultados. O grande desafio das enfermeiras é aplicar os instrumentos da farmacoeconomia às questões cotidianas da prática clínica e superar as dificuldades metodológicas relativas à identificação, cálculo e comparação dos custos e desfechos.
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Maio V, Lofland JH. Outcome measures for pharmacoeconomics education. PHARMACOECONOMICS 2004; 22:549-550. [PMID: 15217310 DOI: 10.2165/00019053-200422080-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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