The cost and revenue situation of intravenous administration versus subcutaneous application of Herceptin and MabThera in Switzerland

In Switzerland, every year about 5’500 women are diagnosed with breast cancer and 1’500 people with non-Hodgkin's lymphoma. The targeted therapy with MabThera® is the standard of care for many patients with Non-Hodgkin’s lymphoma, whereas Herceptin® is approved for the treatment of a certain type of breast cancer. Currently both drugs are administered intravenously (IV), yet a subcutaneous application (SC) is in development. Assuming the same price for the future subcutaneous formulation, this study compared the cost and revenue situation of both application forms. The analysis was performed both in hospital outpatient- and resident oncologists-settings in Switzerland

SpitalPuls 2012: Prozess- und Changemanagement in Schweizer Spitälern

StudieDie Studie SpitalPuls 2012 untersuchte bei vier Schweizer Spitälern, wie die Einstellung, die Fähigkeiten und die Voraussetzungen bzgl. Prozess- und Changemanagement ausgestaltet sind. Die Ergebnisse zeigen in gewissen Bereichen deutliche Unterschiede zwischen den Spitälern auf. Im Bericht werden auf der Basis der Ergebnisse konkrete Empfehlungen für Spitäler abgeleitet

Quality assessment of a randomly selected sample of Swiss medical expertises : a pilot study

Background: Considerable criticism has lately been raised by the media regarding the quality of Swiss medical expertises. The present investigation was therefore undertaken to assess the professional quality of Swiss medical expertises. The study was part of a market analysis of medical expertises (MGS study). Methods: A sample of 97 anonymised expertises randomly chosen from a total of 3165, collected in the MGS study over a period of 3 months, were evaluated by an international board of medical experts and reviewers, using a stepwise developed questionnaire. Each expertise was independently evaluated by two experts. Data were then tested for plausibility (obvious errors and misunderstandings). The main outcome was the overall quality rating of the expertise that was graded from 1 (very poor) to 6 (excellent) in analogy to the Swiss school grading system. For analysis and interpretation the grades were divided into sufficient (grades >= 4) and insufficient (grades <4). Results: Overall 19.6% (95% confidence interval: 13.1%; 28.3%) of the expertises were rated to be of insufficient quality. The quality was inversely related to the number of involved medical disciplines, the time relapsed since injury and positively related to the difficulty of the expertise. In addition, expertises in the French and Italian languages were rated superior to those in German. Conclusions: Our results confirm recent criticisms that the professional quality of expertises does not suffice. This is hardly acceptable in face of the financial and personal consequences. There is an obvious need for further research using larger samples and for educational programmes on all levels

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned.</p> <p>Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal.</p> <p>Findings</p> <p>We analysed 3165 medical appraisals, 2444 (77%) of them from the public disability insurance, 678 (22%) from private accident, liability and loss of income insurances and 43 (1%) from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3).</p> <p>Conclusions</p> <p>From the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.</p

Microscopic modelling of doped manganites

Colossal magneto-resistance manganites are characterised by a complex interplay of charge, spin, orbital and lattice degrees of freedom. Formulating microscopic models for these compounds aims at meeting to conflicting objectives: sufficient simplification without excessive restrictions on the phase space. We give a detailed introduction to the electronic structure of manganites and derive a microscopic model for their low energy physics. Focussing on short range electron-lattice and spin-orbital correlations we supplement the modelling with numerical simulations.Comment: 20 pages, 10 figs, accepted for publ. in New J. Phys., Focus issue on Orbital Physic