紫杉醇的不良反应及其合理应用

目的：探讨紫杉醇应用于癌症治疗期间的不良反应发生情况及防治办法。方法对100例应用紫杉醇治疗的癌症患者出现的不良反应进行分析。结果患者使用抗肿瘤药物紫杉醇治疗后出现较多的不良反应,主要有消化道反应、神经毒性、骨髓抑制以及过敏反应等。结论通过控制给药时间及在化疗前预防性用药,可明显减少紫杉醇不良反应的发生。     

Treatment patterns and resource utilization and costs among patients with pulmonary arterial hypertension in the United States

Abstract

Objective:

To explore treatment patterns and resource utilization and cost for subjects with pulmonary arterial hypertension (PAH).

Research design:

Retrospective claims database analysis of 706 patients with PAH enrolled in a large, geographically diverse US managed-care organization.

Results:

In the final sample of PAH patients treated with bosentan (n?=?251) or sildenafil (n?=?455), average age was 57 years, 86% of patients were commercially insured, and 52% of patients were male. Gender distribution varied significantly across subgroups, with a lower proportion of males in the bosentan (30%) subgroup compared with the sildenafil group (64%) (p?<?0.001). Average baseline Charlson comorbidity score was 2.4. Average numbers of fills per month were 0.8 and 0.4 for bosentan and sildenafil patients, respectively (p?<?0.001). Over 80% of patients received only one PAH treatment in the first 90 days following the index date, with 28% of bosentan and 13% of sildenafil patients receiving combination therapy (p?<?0.001). Over one-third of bosentan patients and one-quarter of sildenafil patients experienced a dose increase in the follow-up period (p?=?0.009). Sixteen percent of sildenafil patients experienced a dose decrease in the follow-up period, while a smaller proportion of patients receiving bosentan (4%) experienced a dose decrease (p?<?0.001). On average, number of PAH-related per subject per month (PSPM) inpatient stays and emergency department visits and PSPM length of inpatient stays were statistically similar between the subgroups. PAH-related PSPM healthcare costs were high for both subgroups, with average monthly costs of $5,332 and $3,632 among bosentan and sildenafil patients, respectively (p?=?0.003). Differences in total costs were driven mainly by differences in pharmacy expenditures.

Conclusions:

Of the oral agents approved for treating PAH at the time of this study, sildenafil was most commonly prescribed as index therapy and was also associated with the lowest costs, largely due to significantly lower pharmacy costs. This study is characterized by limitations inherent to claims database analyses, such as the potential for coding errors and lack of information on whether a drug was taken as prescribed. Furthermore, PAH severity (WHO functional class) was not assessed.     

药价昂贵:究竟谁惹的祸

药品价格昂贵、药费负担沉重已成为制约和谐社会构建的严重社会问题,本文从表里两个层面分析了造成药价昂贵的原因和运行机理,指出药价昂贵的表层原因主要是药品收入加成制度滞后、医德医风滑坡、药品生产流通秩序混乱、政府价格管理失控和虚假药品广告泛滥,而深层原因主要体现为国家卫生资源总体匮乏、结构布局失衡、管理部门角色缺失和社会医疗保障体系的残缺不全。     

渔药对水产品质量安全的影响

渔药的不规范使用和残留已经成为影响水产品质量安全的重要问题。论文通过对渔药使用现状、存在的主要问题进行梳理,分析了药物残留对水产品质量安全造成的危害,并对此提出了对策和建议。     

我国在合理用药中的问题与对策

目的探讨促进合理用药的有效措施,为药品使用管理提供参考。方法结合实际,通过对影响因素及原因进行具体分析,提出有针对性的建议。结果与结论我国药品使用环节的制度尚不完善,建议通过制度完善限制医生处方权,提高药品自身各方面水平,提高社会对药品合理使用的认识,以促进合理用药。     

浅谈我国非处方药的市场营销策略

本文从现阶段我国非处方药的市场现状入手,从产品、价格、渠道、促销四个方面研究了跨国药企和本土制药企业的市场营销策略,提出企业应严把质量关,健全营销渠道,避免渠道冲突,构建新型营销网络,同时选择有效媒介,突出产品的定位,将产品的品牌深入到消费者心中,满足消费者的需求。     

中医药品集中招标采购制度的缺失与完善研究

历时多年的中医药品集中招标采购的确发挥了一定的积极成效,但是由于中医药品集中招标采购制度仍存在的种种问题使得中医药品集中招标采购还无法完全发挥其威力。     

Comparing approval procedures for new drugs

We analyse how drug approval procedures influence the incentives of pharmaceutical firms to commercialise new drugs in the presence of international reference pricing. Since 1995, the European Medicines Agency (EMA) coordinates a centralised approval procedure for specific new drugs in the EU. With such a centralised procedure, the EMA grants simultaneous drug approvals for all EU countries. Alongside, non‐centralised procedures coexist for approvals of other new drugs and approvals can be sequential. We focus on the effects of the exogenous timing of drug approvals, either simultaneous or sequential, and we compare the effects of centralised versus non‐centralised procedures on the firms’ incentives to commercialise new drugs in different markets. In a context of international reference pricing, we show that a centralised procedure limits the number of countries where the firm commercialises new drugs, compared to a non‐centralised procedure. We also show in a simplified framework that countries are better off with non‐centralised procedures, while pharmaceutical firms in theory prefer the drug to be approved everywhere as soon as possible, as in an early centralised procedure. This is in line with the stated objective of the EMA to generate savings for the pharmaceutical firms.     

四川凉山州失依儿童现象及对策研究——基于社会管理创新的思考

随着《新闻1＋1》、《走基层》等栏目的报道,四川省凉山州失依儿童这一群体开始引起社会各界越来越多的关注,这一社会最大弱势群体,一直以来都是社会管理的盲点、弱点和难点,也是党、政府和社会各界近年来共同关注的热点、焦点和重点。如何加强对该群体的管理,改善该群体的生活现状,使他们尽快得到有效救助走出困境,这无疑成为当下创新社会管理的重点之一。     

反义核酸技术及其应用

反义核酸作为一种新的抗病毒、抗肿瘤药物,它的应用受到越来越多的重视,但反义核酸技术的研究也面临一些挑战。相信伴随这些问题的解决,反义药物能够被广泛应用,给疾病的治疗带来益处。文章对反义核酸、反义药物及反义核酸技术的应用进行了综述。