Cost effectiveness of ulcerative colitis treatment in Germany: a comparison of two oral formulations of mesalazine

<p>Abstract</p> <p>Background</p> <p>The treatment of ulcerative colitis (UC) can place a substantial financial burden on healthcare systems. The anti-inflammatory compound 5-aminosalicylic acid (5-ASA; mesalazine) is the recommended first-line treatment for patients with UC. In this analysis, the incremental cost effectiveness ratio (ICER) of two oral formulations of 5-ASA (Mezavant^®and Asacol^®) is examined in the treatment of patients with mild-to-moderate, active UC in Germany.</p> <p>Methods</p> <p>A Markov cohort model was developed to assess the cost effectiveness of Mezavant compared with Asacol over a 5-year period in the German Statutory Health Insurance (SHI). Drug pricing details for 2009 were applied throughout the model, and overall resource use was determined and also fitted to 2009 from published results of a large cross sectional study of German SHI patients. Cost per quality adjusted life year (QALY) was the primary endpoint for this study. Remission rates were obtained using data from a randomised, phase III trial of Mezavant with an active Asacol reference arm and a long-term, open label, safety and tolerability trial of Mezavant. Uncertainty in the study model was assessed using one-way and probabilistic sensitivity analyses applying a Monte Carlo simulation.</p> <p>Results</p> <p>Over a 5-year period, healthcare costs for patients receiving Mezavant were 624 Euro lower than for patients receiving Asacol. Additionally, patients receiving Mezavant gained 0.011 QALYs or 18 more days in remission compared with Asacol. One-way sensitivity analyses suggest that these results are driven by both differences in the acquisition cost between mesalazine formulations and differences in treatment efficacy. Furthermore, sensitivity analyses suggest a probability of 76% for cost savings and higher QALYs with Mezavant compared with Asacol. If adherence and its influence on the remission rates and the risk of developing colorectal cancer were included in the model, the results might have even been more favorable to Mezavant due to its once daily dosing regimen.</p> <p>Conclusions</p> <p>This model suggests that patients treated with Mezavant may achieve increased time in remission and higher QALYs, with lower direct costs to the SHI when compared with Asacol. Mezavant may therefore be a suitable first-line option for the induction and maintenance of remission in UC.</p

Using Penggunaan Alat Permainan Edukatif (APE) Kartu Kata dalam Meningkatkan Kemampuan Membaca Permulaan pada Anak Taman Kanak-Kanak (TK) Pembina di Beabunta, Kabupaten Luwu Utara

ABSTRAK INEKE ALRIANI. Using Penggunaan Alat Permainan Edukatif (APE) Kartu Kata dalam Meningkatkan Kemampuan Membaca Permulaan pada Anak Taman Kanak-Kanak (TK) Pembina di Beabunta, Kabupaten Luwu Utara. (dibimbing oleh Mansyur Hamid dan Sulaiman Samad). Penelitian tentang penggunaan Alat Permainan Edukatif dengan menggunakan kartu kata. Rumusan masalah dari penelitian ini adalah (1) Bagaimana gambaran pelaksanaan penggunaan alat permainan edukatif (APE) kartu kata pada Anak Taman Kanak-kanak (TK) Pembina Beabunta, Kabupaten Luwu Utara?, (2) Bagaimana gambaran kemampuan membaca permulaan pada Anak Taman Kanak-kanak (TK) Pembina Beabunta, Kabupaten Luwu Utara?, (3) Apakah penggunaan alat permainan edukatif (APE) kartu kata dapat meningkatkan kemampuan membaca permulaan pada Anak Taman Kanak-kanak (TK) Pembina Beabunta, Kabupaten Luwu Utara? Metode penelitian ini adalah pre-experimental dengan one group pretest and posttest one group design. Pengumpulan data digunakan dengan cara observasi, test, dan teknik dokumentasi. Dalam penelitian ini, yang menjadi populasi dan sampel penelitian adalah anak usia dini yang berjumlah 25 anak . Hasil penelitian ini menunjukkan bahwa (1) Gambaran pengelolaan penggunaan alat permainan edukatif (APE) dengan menggunakan kartu kata pada anak Taman Kanak-kanak Pembina di Beabunta Kabupaten Luwu Utara digambarkan dalam tiga tahap yaitu tahap perencanaan, penyajian, dan pelaksanaan kegiatan; metode/teknik yang digunakan pada pelaksanaan kegiatan dengan menggunakan alat permainan edukatif (APE), dan waktu pelaksanaan kegiatan dengan menggunakan alat permainan edukatif (APE;(2) Gambaran kemampuan membaca permulaan anak usia dini di Taman Kanak-Kanak Pembina Beabunta, Kabupaten Luwu Utara sebelum diberi perlakuan yaitu pada pretest berada pada kategori tinggi dan sedang. Sendangakan setelah pembelajaran melalui Alat Permainan Edukatif dengan menggunakan kartu kata nilai anak pada posttest meningkat dan nilai anak seluruhnya berada dalam kategori tinggi, (3) Penggunaan Alat Permainan Edukatif (APE) dengan menggunakan kartu kata dapat meningkatkan kemampuan permulaan membaca anak. Ini berarti kemampuan membaca permulaan anak seteleh diberi perlakuan meningkat dibandingkan sebelum diberi perlakuan. ABSTRACT INEKE ALRIANI. Using Educational Games Tools through Word Cards to Improve Children’s Begining Reading Ability at Kindergarten Pembina in Beabunta , North Luwu. (Guided by Mansyur Hamid and Sulaiman Samad). This research was about the use of Educational Games Tools with word cards. The problem statements of this study were (1) How is the description of using Educational Games tools through word card at Kindergarten Pembina in Beabunta, Luwu Utara?, (2) How is the description of children’s beginning reading ability at Kindergarten Pembina in Beabunta North Luwu?, (3) Is the use of Educational Games Tools can improve children’s beginning reading ability at Kindergarten Pembina in Beabunta North Luwu? The research method used pre-experimental design with a one group pretest and posttest design. The data collection used observation, testing, and documentation techniques. In this study, the population and sample were early childhood, which numbered 25 children. The results of this study indicated that (1) The description of using Educational Games Tools through word cards for children Kindergarten Pemnina in Beabunta, North Luwu described in three phases, namely planning, presentation, and implementation of activities; methods / techniques used in the implementation of activities by using Educational Games Tools, and the time of activities implementation in using Educational Games Tools, (2) The description of children’s beginning reading ability to Kindergarten Pembina in Beabunta, North Luwu before being treated pretest were at high and medium categories. While, after learning through games Educational Tool using the word cards on the posttest increased and the children entirely within the high category, (3) The use of Educational Games Tools through word cards can improve children beginning reading skills. This means that the beginning of the children reading ability improved after be being treated of Educational Games Tools through word cards