Biomedical subjects

E Soler Company

Publications and source records attributed to E Soler Company.

5 recordsLinked to original sources

PubMed2005

[Antiretroviral pharmaceutical expenditure and possibilities for optimization].

INTRODUCTION: A lack of treatment compliance, resistances and non-advanced stages of the disease are the reasons why not all HIV-infected patients benefit from the demonstrated efficacy of antiretroviral drug combinations--with the consequent important increase in costs. A prospective cohort follow-up study is conducted to analyze the distribution of antiretroviral pharmaceutical expenditure in a district hospital, and the possibilities for improving its efficiency. MATERIAL AND METHODS: The study comprised 128 HIV-infected patients seen for 12 consecutive weeks (September to November, 2004). The characteristics of previous follow-up were analyzed, and the patients were divided into groups according to the course over the following weeks and the results of prescribed treatment: group 1 (effective treatment), group 2 (ineffective treatment), and group 3 (treatment dropout). Based on the prescription history, corroborated with drug retrieval and the acquisition costs (FARMASYS software), the cost of antiretroviral medication was calculated for each of the 108 patients receiving highly active antiretroviral therapy (HAART). The statistical analysis was carried out with the SPSS version 11.5 statistical package, and considering statistical significance for p < 0.05. RESULTS: The cost generated by the 108 patients included during the study period who received HAART was 232,366 euros, with an average of 2,151 euros per patient and 19,363 euros per day of consultation. The distribution of patients and of the costs generated by the above defined groups was as follows: group 1: 79 patients (80.6%); group 2: 11 patients (10.6%); group 3: 18 patients (8.8%). In the group 1 patients, 15.2% of the antiretroviral expenditure corresponded to patients who had started therapy with a CD4+ count of > 350 cells/ml, while 45% had > 350 cells/ml at the present time, and 25.9% had > 500 cells/ml. Previous medication dropout was identified as a predictor of new dropouts and treatment failures. COMMENT: While the cost generated by antiretroviral medication is high, 19.4% is administered to patients who do not benefit from such treatment due to a lack of efficacy or dropouts, and in another 40-60% of cases the need for such treatment could be subject to consideration in view of the good immune status of the patients.

Adult↗

PubMed2004

[Cost distribution of highly active antiretroviral therapy].

UNLABELLED: The efficacy of highly active antiretroviral therapy (HAART) implies a high pharmaceutical cost. Deficient patient adhesion to therapy means that not all individuals benefit from treatment, while some patients are in non-advanced stages of the disease where such management may not be necessary. A study is made of the cost distribution of HAART. MATERIAL AND METHODS: An analysis was made of 199 HIV-infected adults subjected to HAART at least once during 2001. The medication history was used to calculate the cost of HAART in the global group, in the patients who abandoned treatment (group A), in the group in which viral load was not controlled (group B), and in the patients starting with or reaching a CD4+ count > 500 cells/mm3 (groups C1 and C2, respectively). RESULTS: The global annual cost of HAART (discounting returned medication) was 961,720 Euro (21.3% of the global hospital pharmacological expenditure), group A accounting for 6.3%, group B 14.26%, and subgroups C1 and C2 for 12.1 and 8.1, respectively. COMMENTS: In our center, almost 40% of antiretroviral drug expenditure may be considered of little use.

Adult↗

PubMed2004

[Generic drugs in a district hospital. Intervention strategies].

OBJECTIVE: To know the prescription of generic drugs in specialized attention and the impact of two different intervention strategies: MATERIAL AND METHODS: Intervention trial with evaluation and later comparison. The data on the use of generic drugs are obtained from the medical reports. After an informative note of general character we repeated the taking of data one month later. In the service of Medicine we also analysed each doctor's profile prescriptions and a personalized informative note was edited and accompanied by a brief verbal explication of the campaign. Then repeated the collection of data to the week and the month. RESULTS: 1545 reports were revised (3460 prescribed drugs). 42% of the medication could be prescribed as generic but it was only made in 10% (21% in Internal Medicine). After the informative note no significant variations were observed. Only in Internal Medicine an initial increment was obtained (21 to 56%, RR 0.38, IC 0.26-0.55) that it disappeared at month. COMMENTS: The utility of the intervention to generic promotion is limited and transitory. Besides improve the information, seems necessary the implication of the physician in the promotion campaigns.

Drug Utilization↗

PubMed2001

[Factors affecting postoperative pain].

OBJECTIVE: To determine the influence on the intensity of postoperative pain of the following variables: sex, age, type of surgery, surgical approach, anesthetic technique and analgesia administered. PATIENTS AND METHODS: Six hundred twenty-three hospitalized patients were enrolled from the units of general and digestive surgery, gynecology and obstetrics, ophthalmology, otorhinolaryngology, traumatology and orthopedics, and urology. Pain intensity was measured on a visual analog scale (VAS) when the patient left the post-anesthesia recovery ward (PARU) and 24 and 48 h after surgery, and on a verbal evaluation scale (VES) during the first and second days after surgery. RESULTS: Gynecology is the department where the most pain is reported, both when the patient leaves the PARU (>= 4 for 56.6% of patients) and during the first day on the ward (71.3% of patients suffer pain of moderate or high intensity). The correlation of pain with duration of procedure was strongest in the urology and surgery units, with common variances of 32.3% and 23.4%, respectively. More pain is felt during open procedures in the traumatology and urology units, which is not the case in gynecology and surgery. Patients receiving general anesthesia leave the PARU with pain at 3.4 +/- 1.8 cm on the VAS scale, versus 1.3 +/- 1.6 cm for patients receiving locoregional anesthesia. Patients who received only ketorolac for pain in the PARU generally experienced less intense pain (2.5 +/- 2.0 cm) than did those who received metamizol (3.3 +/- 1.5 cm), morphine (4.0 +/- 1.8 cm) or tramadol (4.5 +/- 1.8 cm). CONCLUSIONS: Surgical department, surgical approach, anesthetic technique and, finally, analgesic administered are the factors that determine the intensity of postoperative pain. These factors should therefore be taken into account when establishing treatment protocols to assure adequate control of postoperative pain. Neither sex nor age were determining factors for the intensity of postoperative pain.

Adolescent↗

PubMedDate not supplied

[Cost-minimization study on the prescription of intravenous proton pump inhibitors: pantoprazole versus omeprazole].

OBJECTIVE: To compare and quantify intravenous omeprazole versus intravenous pantoprazole prescription habits in common acid-related diseases such as gastro-esophageal reflux disease, duodenal ulcer, and gastric ulcer. MATERIAL AND METHODS: We designed an observational, longitudinal prospective and multicenter cost-minimization study to be carried out in Spanish hospitals. RESULTS: The pantoprazole regimen consisted of 40 mg/day (median), one half of that of omeprazole with 80 mg/day overall for these conditions (p < 0.05). This dosage was significantly different for duodenal ulcer (40.0 +/- 0.0 versus 90.6 +/- 22.5 mg/day, p < 0.05), and gastric ulcer (50.3 +/- 17.8 versus 85.8 +/- 39 mg/day, p < 0.05), but not for gastro-esophageal reflux disease (50.9 +/- 18.7 versus 62.2 +/- 21.1, p > 0.05). Costs for these regimens make treatments using pantoprazole 54% less expensive than treatments using omeprazole. By indication, the cost of duodenal ulcer treatment was 65% less expensive, and that of gastric ulcer 53% less expensive. CONCLUSIONS: Cost differences amount to approximately one half in treatments using pantoprazole, which is primarily due to the use of doses higher than indicated in treatments using intravenous omeprazole. To reduce expenses stemming from the inadequate use of intravenous proton pump inhibitors the use of pantoprazole is brought forward as a valid option.

2-Pyridinylmethylsulfinylbenzimidazoles↗