Use of drospirenone/ethinyl estradiol (DRSP/EE) among women with acne reduces acne treatment-related resources

Abstract

Background and objective:

Acne is a common dermatologic condition that extends into middle age, particularly among women, and is associated with substantial healthcare resource utilization. Drospirenone (DRSP), a synthetic progestin, has anti-androgenic activity, and women using DRSP 3.0?mg/ethinyl estradiol (EE) 0.02?mg as a 24/4 regimen (DRSP/EE-24/4) for contraception also may use it for treatment of moderate acne. The study used a US national healthcare database to assess acne-related healthcare resource utilization among women aged 18–45 years before (pre-index) and after (post-index) initiation of DRSP/EE-24/4.

Methods:

Resource utilization and costs were evaluated by age group (18–25, 26–35, or 36–45 years) and by type of acne medication (systemic antibiotic, topical, or anti-androgen).

Results:

Data for 1340 women were evaluated. Overall, drug costs, medical costs, and total costs were decreased by 38%, 37%, and 37%, respectively (p?<?0.0001 for all) between the pre-index and post-index periods; significant differences were evident across age groups and acne medication categories. Total costs were significantly decreased for patients (41%) and healthcare plans (36%; p?<?0.0001 for both) overall and across age groups and drug classes. Acne-related claims and number of days using acne medication were reduced (by 37% each; p?<?0.0001 for both).

Study limitations:

The study was retrospective in design and had a limited follow-up period. Database limitations restricted assessment of medication compliance and adherence.

Conclusion:

DRSP/EE-24/4 use was associated with substantial reductions in acne-related healthcare resource utilization, and reductions occurred regardless of age or type of acne medication. DRSP/EE-24/4 therefore represents a cost-effective option for the treatment of acne among women using DRSP/EE-24/4 for oral contraception.     

流程型企业SCM/ERP/MES/PCS集成系统研究

流程型行业是国民经济发展的重要支柱性产业，如何将先进的过程控制技术与现代管理技术相结合，如何实现跨企业经营管理，是当前流程工业迫切需要解决的问题。提出了流程型企业SCM／ERP／MES／PCS集成框架，阐述了各系统间集成的方法。     

Evolution of Smartn Players

To model the evolution of strategic intelligence, player types are drawn from a hierarchy of "smartness" analogous to the levels of iterated rationalizability. Nonrationalizable strategies die out, but when higher levels of smartness incur maintenance costs, being right is always as good as being smart. Moreover, if a manifest way to play emerges, then dumb players never die out, while smarter players with positive maintenance costs vanish. These results call to question the standard game-theoretic assumption of super-intelligent players. Journal of Economic Literature Classification Numbers: B40, C70, C72, C73.     

INCOME AND THE HAMILTONIAN1

Among the many interpretations of real national income are (i) the return to national wealth and (ii) the Hamiltonian of an appropriately-chosen dynamic model of the economy. These interpretations are sometimes alleged to be equivalent and to constitute the self-evidently ideal definition to which statistics of real national income should conform as closely as possible., The allegation is correct on some very restrictive assumptions about technology and taste. Otherwise, these interpretations are inconsistent, inexpedient as definitions of real national income and significantly at variance with the usage in the national accounts. The return to wealth is unmeasurable with the currently-available data. The Hamiltonian is typically in the wrong units. It is an accurate reflection of neither productive capacity nor welfare in an intertemporal context. It is not well-defined in a tax-distorted economy. It is rarely an indicator of the return to wealth.

A personn's income is "the maximum value he can consume during a week and still be as well off at the end of the week as he was at the beginning"

J. R. Hicks²