PubMed · 7962231
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H J Morowitz. 1994-11-15. Less is more.. https://doi.org/10.1080/21548331.1994.11443099
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A pharmacoeconomic model for evaluating antiplatelet therapies is described. In order to conduct a pharmacoeconomic analysis, it is important to understand the course of the disease under study and the prevention and treatment options, identify the associated economic consequences, develop concomitant strategies, and target high-yield decisions. The steps of a pharmacoeconomics-based decision are defining the pharmacoeconomic problem, creating a cross-functional team, determining the study's perspective, determining the treatment alternatives and outcomes, selecting the appropriate pharmacoeconomic method, placing a monetary value on outcomes, identifying resources and data sources, establishing probabilities of outcomes, using decision analysis, undertaking a cost or sensitivity analysis, presenting the results, developing and implementing a policy or clinical intervention based on the results, educating health care professionals about the new policy or intervention, and documenting the quality of care and potential cost savings through follow-up. Clopidogrel is given as an example. The composite endpoint of myocardial infarction, stroke, or vascular death has been shown to be 8.7% lower with clopidogrel than with aspirin in patients with recent myocardial infarction, recent ischemic stroke, or symptomatic peripheral arterial disease. Clopidogrel costs more than aspirin but may be considered as first-line therapy for high-risk patients, patients who are allergic to aspirin, or patients who cannot tolerate the gastrointestinal effects of aspirin. Cost-effectiveness analyses can be used to support formulary decisions about which antiplatelet agent should be used; the use of a particular agent ultimately also depends on efficacy, safety, pharmacodynamics, patient-specific factors, and relative direct and indirect costs.
The objective of the article is to make readers familiar with contemporary methods of research and development of original drugs and elucidate economic aspects of pharmaceutical research. The contemporary strategy of research and development in the Research Institute for Pharmacy and Biochemistry is discussed in relation to general trends. Pharmaceutical research and development are characterized by high costs which vary in the majority of pharmaceutical companies engaged in the development of new drugs between 12-16% of the total turnover. The author discusses problems associated with the return rate of these investments in conjunction with patent protection and the time taken to develop original drugs. Expedient use of the large financial funds calls for rational management of research and development. The author therefore pays attention to an analysis of rational methods of management of research and development which are applied in the selection of a research programme and of research projects, to modern methods of research and to the organization of research and development. The author deals subsequently in more detail with contemporary methods of research focused on the detection of leading structures, where molecular modelling and technology of combinatorial chemistry are used. By their combination with optimization procedures using statistical data analysis rational design of molecules is made possible.
Bisphosphonate compounds have been studied as a class of potential drugs for the treatment of various bone diseases. However, the analyses of these compounds are problematic because most of them do not contain strong chromophores. Based on the unique structures of these compounds, we have employed a capillary electrophoresis (CE) technique for the characterization of these compounds in pharmaceutical dosage formulations. In this study, two CE methods were developed for the determination of a bisphosphonate compound, 2-thioethane-1,1-bisphosphonic acid. The first method involved the use of an uncoated column, a phosphate buffer, and hydrostatic injection with direct UV absorbance detection. The method showed excellent resolution and precision with a reasonable detection limit of 30 microg/ml. Sensitivity was further improved using a glycerol-coated column, together with a phosphate buffer of higher concentration and electrokinetic injection under sample stacking conditions. This modified method revealed a significant improvement in sensitivity with a detection limit of about 50 ng/ml. Both methods demonstrated high simplicity and excellent reproducibility and were successfully applied to the quantitative analyses of pharmaceutical dosing solutions.