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J. Nazir 《Journal of medical economics》2014,17(6):408-414
Objective:To carry out a cost–utility analysis comparing initial treatment of patients with overactive bladder (OAB) with solifenacin 5?mg/day versus either trospium 20?mg twice a day or trospium 60?mg/day from the perspective of the German National Health Service.Methods:A decision analytic model with a 3 month cycle was developed to follow a cohort of OAB patients treated with either solifenacin or trospium during a 1 year period. Costs and utilities were accumulated as patients transitioned through the four cycles in the model. Some of the solifenacin patients were titrated from 5?mg to 10?mg/day at 3 months. Utility values were obtained from the published literature and pad use was based on a US resource utilization study. Adherence rates for individual treatments were derived from a United Kingdom general practitioner database review. The change in the mean number of urgency urinary incontinence episodes/day from after 12 weeks was the main outcome measure. Baseline effectiveness values for solifenacin and trospium were calculated using the Poisson distribution. Patients who failed second-line therapy were referred to a specialist visit. Results were expressed in terms of incremental cost–utility ratios.Results:Total annual costs for solifenacin, trospium 20?mg and trospium 60?mg were €970.01, €860.05 and €875.05 respectively. Drug use represented 43%, 28% and 29% of total costs and pad use varied between 45% and 57%. Differences between cumulative utilities were small but favored solifenacin (0.6857 vs. 0.6802 to 0.6800). The baseline incremental cost–effectiveness ratio ranged from €16,657 to €19,893 per QALY.Limitations:The difference in cumulative utility favoring solifenacin was small (0.0055–0.0057 QALYs). A small absolute change in the cumulative utilities can have a marked impact on the overall incremental cost-effectiveness ratios (ICERs) and care should be taken when interpreting the results.Conclusion:Solifenacin would appear to be cost-effective with an ICER of no more than €20,000/QALY. However, small differences in utility between the alternatives means that the results are sensitive to adjustments in the values of the assigned utilities, effectiveness and discontinuation rates. 相似文献
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通过单一硫酸盐环境以及氯盐和硫酸盐共同环境中混凝土的浸泡腐蚀试验,研究腐蚀环境中氯盐的存在及其浓度变化对硫酸根离子在混凝土内部扩散性能的影响。结果表明,氯盐的存在可延缓硫酸根离子在混凝土内部的扩散;氯盐的存在能够降低硫酸根离子含量随时间增长的幅度,且氯离子浓度越大,这种降低作用越明显。 相似文献
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在氯化物体系中,Cu^+、Cu^2+均能与Cl^-形成多种形态的配合物,存在形态及分布与溶液中各离子浓度有关。由于各种配合物的稳定性不同,致使Cu^+、Cu^2+氯化物的溶解度及电极电位也不同。对酸性蚀刻废液中铜的存在形态、电化学行为、以及采用隔膜电解法回收工艺的可行性进行了分析。 相似文献
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新型高效破乳剂的研制及性能研究 总被引:1,自引:0,他引:1
制备了不同Al/Si摩尔比的聚硅氯化铝(PASC),实验考察了成分摩尔比、废水pH值、药剂投加量对除油效果的影响。结果表明:Al与Si的摩尔比对除油效率有较大的影响,最佳摩尔比为:n(Al)/n(Si)=3:1;废水pH=4~10时,处理效果都较好;随着投药量的增加,油的去除率增加,PASC适宜的投药量(以Al^3+浓度计)为800mg/L。用其来处理实际废水时,效果很好,残余油量低于国家排放标准。PASC的的除油机理是电中和、压缩双电层、吸附架桥等多重作用的结果。 相似文献
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试验表明,聚丙烯纤维能够增加低强度混凝土和低流动性混凝土的抗氯离子性能,但同时会降低高强度混凝土的抗氯离子渗透性能和大流动性混凝土的抗氯离子性能,文章分析了其作用机理。 相似文献
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