Cost-effectiveness of Viridal Duo compared to MUSE and Viagra in the treatment of erectile dysfunction in the UK - a preliminary model

Summary

This study estimated the cost-effectiveness of starting erectile dysfunction (ED) treatment with Viridal Duo relative to MUSE and Viagra over one year, from the perspective of the National Health Service. Decision analysis techniques were used to estimate the expected costs and consequences of managing ED, stratified by initial treatment. The model was based on estimates of clinical outcome and resource use obtained from published literature and a Delphi panel.

Viridal Duo is a registered trademark of Schwarz Pharma;

MUSE is a registered trademark of Astra Pharmaceuticals;

Viagra is a registered trademark of Pfizer Consumer Healthcare

Starting ED treatment with Viridal Duo instead of Viagra leads to an average 0.8 additional months during which a man can achieve successful erections (from 6.5 to 7.3 months) over one year, for an additional cost of £106 per patient (from £369 to £475). Starting ED treatment with Viagra instead of MUSE leads to an average 1.1 additional months during which a man can achieve successful erections (from 5.4 to 6.5 months) over one year and reduces the cost per patient by £85 (from £454 to £369).

Fifty-two percent of patients who start treatment with Viridal Duo continue successfully over one year. This compares to 38% and 18% of patients who start treatment with Viagra and MUSE respectively. Eighty-seven percent of the total success with Viridal Duo can be directly attributed to this treatment when used first-line. In contrast, 68% and 44% of the total success attributed to Viagra and MUSE respectively can be attributed to these treatments when chosen first-line. Moreover, an additional 44% and 27% of the expected total success with MUSE and Viagra is attributable to Viridal Duo.

Starting ED treatment with Viridal Duo rather than MUSE, when Viagra is either unavailable or contraindicated, increases the period during which a man can achieve successful erections by 1.8 months (from 5.5 to 7.3 months) for an additional cost of £14 per patient (from £460 to £474). Additionally, in patients who have previously failed Viagra, starting second-line treatment with Viridal Duo rather than MUSE leads to an average 1.6 additional months during which a man can achieve successful erections (from 4.0 to 5.6 months) over one year and reduces the cost per patient by £15 (from £493 to £478).

In conclusion, Viridal Duo is clinically more effective than Viagra and MUSE. Therefore, starting ED treatment with Viridal Duo instead of Viagra or MUSE increases the period during which a man can achieve successful erections, albeit for an additional cost. In patients who have previously failed first-line treatment with Viagra, starting second-line treatment with Viridal Duo instead of MUSE increases the period during which a man can achieve successful erections (by 40% at one year) and reduces healthcare costs (by £15 per patient).     

立足实践的文献检索课程教学研究——我院数字资源知识技能竞赛报告分析

文献检索课是一门工具课、技能课、实践课。对这门课的教学应立足于实践,要不断改进教学方法,规范教学模式,完善教学内容,使之顺应时代的要求。     

A preliminary theoretical examination of the targeted public distribution system in India

A theoretical model of targeting in the public distribution system is set out. In any system of targeting there could be inclusion and exclusion errors. These errors could be reduced by search by the state. The state aims to minimise the costs of food administration subject to keeping the magnitude of the exclusion error bounded. Targeting involves a consideration of the objective poverty level, the official poverty level and the targeted poverty level by the state. The targeted poverty level could be less than the official poverty level if the extent of search is not adequate. The objective poverty level is an increasing function of the above poverty line issue price of food due to exclusion errors, a decreasing function of the procurement price of food and by definition the below poverty line issue price of food. The instruments in the hands of the state are the official poverty level, the above poverty line issue price for food, the procurement price of food and the extent of search. The comparative static implications of the model are set out.     

浅析我国高速公路成本控制的措施

高速公路成本控制是系统的全程控制,降低成本,发挥成本优势,是高速公路企业在市场竞争中处于有利地位的重要措施。本文介绍了高速公路成本控制的内容,通过对高速公路成本控制的分析,阐述了高速公路成本控制的原则,并从高速公路的进度成本,质量成本,风险成本以及采购成本的控制四个方面对高速公路的成本控制的措施进行了说明。高速公路成本的控制对于提高高速公路企业的经济效益和社会效益有着非常重要的作用和意义。     

Erin Anderson and the Path Breaking Work of TCE in New Areas of Business Research: Transaction Costs in Action

This review article synthesizes Erin Anderson's academic contribution, with an emphasis on two path breaking aspects of her work, namely the operationalization of TCA in different contexts and the refinement of the theory. We review the measures that she developed to reflect key TCE constructs, and identify five contexts in which Erin Anderson's application of TCE concepts broke new paths. These are employee or representative salesforces, choice of foreign entry mode, new market entry and innovation, countertrade, and ethics. We highlight a number of ways in which her research integrates other theories to transaction cost economics, thereby deepening our understanding of key issues involving make or buy decisions. Finally, we draw attention to directions for future research identified through her work.     

Cost-effectiveness implications of increased survival with anastrozole in the treatment of advanced breast cancer

Summary

Anastrozole (Arimidex*) has a survival benefit compared with megestrol acetate in postmenopausal women with advanced breast cancer who have failed on tamoxifen. It was felt appropriate that such a clinical finding should be subjected to economic evaluation.

A cost-effectiveness analysis was undertaken from the viewpoint of a third-party payer, of the data from a combined analysis of two clinical studies. The outcome measures were duration of drug treatment and life years gained. The incremental cost effectiveness ratio (ICER) of anastrozole was £1,608 per life year gained based on UK NHS drug prices in April 1998. Sensitivity analysis showed that the ICER could vary between £5 and £1,643, depending on relative drug costs in a number of countries, between £1,056 and £1,761, depending on the method used to calculate duration of treatment and survival, and could increase to £3,730, based on treatment provided during the extra period of survival.

Anastrozole is a highly cost-effective alternative to megestrol acetate for postmenopausal women with advanced breast cancer.     

物流运输运作成本控制研究分析——以某化工公司为例

从运输成本的构成入手,分析了影响运输成本因素、物流成本与运输成本之间的关系,在此基础之上,以上海某化工企业为例,分析研究了进行物流系统优化过程中运输成本控制的方法和采取的具体策略。     

电子期刊数据库的检索策略

本文从参考咨询人员工作实践出发,通过信息检索的几个环节,以实例分析的方式,论述了实施成功检索的检索策略,并以检索结果的评估强调了检索策略的意义。     

Downward wage rigidity and business cycle asymmetries

The growth rates of wages, unemployment and output of a number of OECD countries have a strongly skewed distribution. In this paper we analyze to what extent downward wage rigidities can explain these empirical business cycle asymmetries. To this aim, we introduce asymmetric wage adjustment costs in a New-Keynesian DSGE model with search and matching frictions in the labor market. Increasing wages is less costly than cutting them. It follows that wages increase relatively fast and thus limit vacancy posting and employment creation, but they decline more slowly, leading to a strong reduction in vacancies and employment. The presence of downward wage rigidities strongly improves the fit of the model to the observed skewness of labor market variables and the relative length of expansions and contractions in the output and the employment cycles. The asymmetry also explains the differing transmission of positive and negative monetary policy shocks from wages to inflation.     

Choice modelling with search and sort data from an interactive choice experiment

We present a highly structured, online, interactive choice environment containing a large number of alternatives, a search tool that eliminates alternatives that fail specified criteria, and a sort tool. A conceptual framework is developed that links tool usage and preference heterogeneity, and tested in the context of long-haul flight choice. Individuals who sort on price are more price sensitive; individuals who search on certain attributes have a greater marginal (dis)utility for that attribute; and individuals who perform certain non-price searches have a lesser price disutility. The method shows promise as a means for providing a richer picture of preference heterogeneity.