Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece

BACKGROUND: Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. PURPOSE: To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. METHODS: A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). RESULTS: The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. CONCLUSIONS: PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes

Detection and extraction of road network in object-oriented analysis of quickbird's multispectral images

80 σ.Στην παρούσα μελέτη σκοπός είναι η διερεύνηση των δυνατοτήτων που παρέχει η αντικειμενοστραφής ανάλυση τηλεπισκοπικών απεικονίσεων υψηλης χωρικής διακριτικής ικανοτητας στην ανίχνευση και στην εξαγωγή του οδικού δικτύου. Αρχικά παρουσιάζεται μια σύντομη βιβλιογραφική ανασκόπηση των μεθόδων αλλά και των τεχνικών που εφαρμόζονται κατά την Αντικειμενοστραφή Ανάλυση, και οι οποίες χρησιμοποιήθηκαν με σκοπό να αναπτυχθεί η ιδανικότερη μεθοδολογία για την ανίχνευση και εξαγωγή του οδικού δικτύου Το πλήθος των επιλογών που υπάρχουν κατά την αντικειμενοστραφή ανάλυση έδωσε την δυνατότητα να αναπτυχθούν διαφορετικές μεθοδολογικές προσεγγίσεις για την ανάλυση της απεικόνισης, ανάλογα με τις παραμέτρους, τον τρόπο ταξινόμησης, ή τα εισαγόμενα δεδομένα κατά την εκάστοτε προσέγγιση. Παρατίθενται εφτά προσεγγίσεις ενώ αναλυτικότερα όλων αναλύεται η έκτη προσέγγιση που έδωσε και τα καλύτερα αποτελέσματα. Για την καλύτερη παρουσίαση των αποτελεσμάτων καθώς και για την ευκολότερη κατανόηση της μεθοδολογίας που χρησιμοποιείται περιλαμβάνονται αρκετές εικόνες και πίνακες. Στο επόμενο κεφάλαιο παρουσιάζεται η αξιόλογηση των αποτελεσμάτων που προέκυψαν. Αξιολογήθηκε η ευστάθεια της ταξινόμησης μεσω του λογισμικού eCognition ενώ εφαρμόστηκε και μια μέθοδος σύγκρισης των ταξινομήσεων με το υφιστάμενο οδικό δίκτυο για να εξαχθούν τα σφάλματα παράλειψης και συμπερίληψης τους. (ιερευνήθηκε επίσης η δυνατότητα εφαρμογής των αποτελεσμάτων της καλύτερης ταξινόμησης και σε άλλη τηλεπισκοπική απεικόνιση αντίστοιχης ραδιομετρικής και χωρικής διακριτικής ικανότητας. Τέλος παρατίθενται τα συμπεράσματα που εξήχθησαν από την παρούσα διπλωματική εργασία.The purpose of this study was to explore the possibilities offered by object-oriented analysis of high spatial resolution remote sensing images for the detection and extraction of roads. Initially, a short literature review of methods and techniques applicable to the Object Based Image Analysis was presented, which are used to develop the ideal methodology for the detection and extraction of road network. The number of options that exist in object-oriented analysis provided an opportunity to develop different methodological approaches to the analysis of images, depending on configuration, the assignments, or inputs on each approach. Out of seven approaches the sixth approach, which gave the best results is discussed in greater detail. For better presentation of results and an easier understanding of the methodology used, several images and tables are included. The next chapter presents the evaluation of the results. The stability of the classification was assessed using the software eCognition and a method of comparing classifications with the existing road network to extract the omission and the commission errors was applied. Furthermore, the best classification approach was applied to other remote sensing images with similar radiometric and spatial resolution capability. Finally the conclusions drawn from this study are given.Περικλής Ι. Πατεράκη

Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece

Abstract Background Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. Purpose To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. Methods A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). Results The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. Conclusions PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes.</p

Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece

Abstract Background Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. Purpose To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. Methods A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). Results The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. Conclusions PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes