Ocrelizumab not recommended in France for patients with primary progressive multiple sclerosis while recommended in England : a review comparing the assessment by HAS and NICE

Peer reviewedPostprin

Cost-Effectiveness Of Treatments For Mild-To-Moderate Obstructive Sleep Apnea In France

International audienceObjectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY.Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France

Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs

<p>Abstract</p> <p>Background</p> <p>In spite of increasing efforts to enhance patient safety, medication errors in hospitalised patients are still relatively common, but with potentially severe consequences. This study aimed to assess antineoplastic medication errors in both affected patients and intercepted cases in terms of frequency, severity for patients, and costs.</p> <p>Methods</p> <p>A 1-year prospective study was conducted in order to identify the medication errors that occurred during chemotherapy treatment of cancer patients at a French university hospital. The severity and potential consequences of intercepted errors were independently assessed by two physicians. A cost analysis was performed using a simulation of potential hospital stays, with estimations based on the costs of diagnosis-related groups.</p> <p>Results</p> <p>Among the 6, 607 antineoplastic prescriptions, 341 (5.2%) contained at least one error, corresponding to a total of 449 medication errors. However, most errors (n = 436) were intercepted before medication was administered to the patients. Prescription errors represented 91% of errors, followed by pharmaceutical (8%) and administration errors (1%). According to an independent estimation, 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage, while 2.6% would have compromised the vital prognosis of the patient, with four to eight deaths thus being avoided. Overall, 13 medication errors reached the patient without causing damage, although two patients required enhanced monitoring. If the intercepted errors had not been discovered, they would have resulted in 216 additional days of hospitalisation and cost an estimated annual total of 92, 907€, comprising 69, 248€ (74%) in hospital stays and 23, 658€ (26%) in additional drugs.</p> <p>Conclusion</p> <p>Our findings point to the very small number of chemotherapy errors that actually reach patients, although problems in the chemotherapy ordering process are frequent, with the potential for being dangerous and costly.</p

Anticancéreux (les facteurs clés pris en compte dans les avis de la commission de la transparence entre 2003 et 2008)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Evaluation de la prise en charge de la mucite orale au sein du service d'hématologie de l'hôpital Debrousse (étude préliminaire et proposition d'un protocole d'étude coût-efficacité évaluant le technique laser)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Les enjeux de l'orientation client dans l'industrie pharmaceutique (analyse de la stratégie développée par MSD France et ses facteurs de succès)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Prévention de la maladie thromboembolique veineuse (étude post-AMM (autorisation de mise sur le marché) du fondaparinux aux Hospices Civils de Lyon)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Influence des micro-technologies sur le processus d'innovation pharmaceutique (définir les utilisations et les impacts des micro-technologies dans le monde de l'industrie pharmaceutique et comprendre le schéma d'acceptation de ces technologies émergentes)

LYON1-BU Santé (693882101) / SudocSudocFranceF

La Régulation des dépenses pharmaceutiques en Suisse depuis l'introduction de l'assurance-maladie obligatoire (présentation, analyse et éléments de comparaisons)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Le Dispositif médical (aspects réglementaires et économiques : évolution sur les dix dernières années)

LYON1-BU Santé (693882101) / SudocSudocFranceF