Implementation of standards. Explaining translation of the Common Language Standard in the Danish municipalities

There is an abundance of standards in the local policy area. Such standards include: The Balanced Scorecard, LEAN Management, Common Language just to mention a few. Standards are characterised by being well-defined formulas to be used by many actors within a field. However, standards are not necessarily being used in the same way everywhere. Standards are translatable. The article contributes with empirical knowledge about the implementation of the Common Language Standard that is used in the senior-citizen area in the Danish municipalities. It is shown that organizational as well as actor based resources can explain the translation processes. Theoretically the explanation is build on sociological new-institutional theory and insights from actor-centred institutionalism. Methodologically the analysis builds on quantitative data in the form of a questionnaire survey among Danish municipalities

Is dabigatran considered a cost-effective alternative to warfarin treatment: a review of current economic evaluations worldwide

Abstract Objective: Dabigatran was the first of a new generation of anticoagulation drugs for the indication of non-valvular atrial fibrillation (AF) to be approved. Evidence show that dabigatran 150 mg twice daily significantly reduces the risk of stroke and systemic embolism (RR = 0.65; p  73%. Three evaluations concluded that dabigatran was a cost-effective alternative to warfarin in patient sub-groups; TTR ≤ 64%, congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke or transient ischemic attack (CHADS2 score) ≥3, or a CHADS2 score = 2 unless international normalized ratio (INR) control was excellent, and with high risk of stroke or in a low-quality warfarin treatment. Dabigatran 110 mg twice daily was in general dominated by dabigatran 150 mg twice daily. Limitations: The evaluations were not fully homogeneous, as some did not include loss of productivity, costs of dyspepsia, and annual costs of dabigatran patient management. Conclusions: In the majority of the economic evaluations, dabigatran is a cost-effective alternative to warfarin treatment. In some evaluations dabigatran is only cost-effective in sub-groups, such as patients with a low TTR-value in warfarin treatment and a CHADS2 score ≥2