Long-term cost effectiveness of ticagrelor in patients with acute coronary syndromes in Thailand

Objectives: To evaluate the long-term cost-effectiveness of ticagrelor and ASA versus generic and branded clopidogrel and ASA in patients with ACS based on a Thai cost database. Methods: A one-year decision tree and a long-term Markov model were constructed to estimate lifetime costs and quality-adjusted life years (QALYs). For the first year, data from PLATO (NCT00391872) were used to estimate the rate of cardiovascular events, resource use, and QALYs. For year 2 onwards, clinical effectiveness was estimated conditional on individual health states that occurred during the first year. Results: In the base-case analysis, the incremental cost-effectiveness ratio (ICER) with ticagrelor was 292,504 ($9,476) and 60,055 ($1,946) THB($)/QALY compared with generic and branded clopidogrel, respectively. The probability of ticagrelor being cost-effective was above 99% at a threshold of 160,000 THB/QALY compared with branded clopidogrel. Conclusions: This health economic analysis provides cost effectiveness data for ticagrelor compared with both generic and branded clopidogrel in Thailand. Based on this analysis, it appears that ticagrelor is an economically valuable treatment for ACS compared with branded clopidogrel within the Thai context

Differentiated and intercultural indigenous school education in the context of the Kiriri in the Bahian Sertão

This monograph is the result of research on the Intercultural and Differentiated Indigenous School Education Modality, which aimed to understand the Intercultural and Differentiated Indigenous School Education Modality that has been created and developed by the Kiriri indigenous peoples, and some characteristics that correspond to this modality. The methodological path taken was a qualitative approach of a bibliographic-interpretive nature. To carry out data analysis and information processing, we used the content analysis technique, which helped us present the bibliographic material since the focus of this analysis was on what the text conveyed about to the phenomenon studied. This was developed in two stages: the initial phase involves familiarization with the Kiriri context, and then this ethnic group and its historical trajectory were presented in the bibliography used. The third chapter brings up some concepts and thoughts that contributed to the comprehension of what can be understood by Intercultural and Differentiated Education, and its application in education, and in Indigenous School Education. In the last section, we analyzed and interpreted the information contained in the research documentary corpus, from the perspective of content analysis. The thematic categories that we established to analyze the results were: School; Education; Context; Culture; Knowledge; Autonomy. Relationships were established between our subject and issues relating to education, legislation, and education in the context of the Kiriri in the Bahian Sertão, and the national society in which they are inserted.Esta Monografia é o resultado da pesquisa sobre a Modalidade de Educação Escolar Indígena Intercultural e Diferenciada, que teve como objetivo conhecer a modalidade de Educação Escolar Indígena Diferenciada e Intercultural que vem sendo construída e desenvolvida pelos povos indígenas Kiriri, e algumas das características que correspondem a essa Modalidade. O caminho metodológico percorrido foi a abordagem qualitativa de natureza bibliográfica-interpretativa. Para realização da análise dos dados e tratamento das informações, fizemos uso da técnica de análise do conteúdo, que nos ajudou a apresentar o material bibliográfico, uma vez que o foco dessa análise é no que o texto está expressando em relação ao fenômeno estudado. Estruturamos seu desenvolvimento em duas etapas: a fase inicial compreende a familiarização com o contexto Kiriri, e na sequência apresentamos essa etnia e seu percurso histórico, conforme nos foi apresentado na bibliografia utilizada. No terceiro capítulo trazemos alguns conceitos e concepções que contribuíram na compreensão do que pode ser entendido por Educação Diferenciada e por interculturalidade, e sua aplicação na educação, e na Educação Escolar Indígena. Na última etapa realizamos a análise e interpretação das informações contidas no corpus documental da pesquisa, na perspectiva da análise de conteúdo. As categorias temáticas que estabelecemos para análise dos resultados foram: Escola; Educação; Contexto; Cultura; Conhecimentos; Autonomia. Através das quais estabelecemos relações entre nosso objetivo e as questões referentes às educações, às legislações e a escola no contexto Kiriri do sertão baiano, e a sociedade nacional na qual estão inseridos