Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

Psychometric validation of anti-clot treatment scale and treatment satisfaction questionnaire for medication version II in Japanese patients with atrial fibrillation

Aims: The Anti-Clot Treatment Scale (ACTS) and Treatment Satisfaction Questionnaire for Medication version II (TSQM-II) are validated treatment satisfaction patient-reported outcome (PRO) instruments. The ACTS includes two domains: Burdens and Benefits; the TSQM-II includes four: Effectiveness, Side Effects, Convenience, and Global Satisfaction. Japanese-language versions of the ACTS and TSQM-II have been developed and linguistically validated. This study aimed to assess their psychometric properties in Japanese patients with atrial fibrillation (AF).

Materials and methods: ACTS and TSQM-II data from 534 patients with AF were collected in a Japanese post-marketing surveillance study of a direct oral-anticoagulant, rivaroxaban. Four key psychometric properties, in line with best practice guidelines from the US Food and Drug Administration, were examined using traditional psychometric methods: acceptability, scaling assumptions, reliability (i.e. internal consistency reliability, test-retest reliability), and construct validity (i.e. convergent validity and known groups).

Results: ACTS Burdens and Benefits and TSQM-II Effectiveness, Convenience, and Global Satisfaction scales were found to be acceptable (e.g. item-level missing data at baseline <4%), with all scales having good internal consistency (Cronbach’s alpha > 0.80). test-retest reproducibility intraclass correlation coefficients for the ACTS Burdens and Benefits were 0.59 and 0.65, respectively, and between 0.54–0.61 for the TSQM-II scales. Known-groups validity for the ACTS and TSQM-II was supported by differences in scale scores by positive and negative impact (p?<?0.05). Correlations between the ACTS and TSQM-II (convergent validity) were lower than expected (range r?=?0.09–0.48), but in line with the original ACTS development study.

Limitations: Evaluation of test-retest reproducibility was limited by assessment period, which was longer (3 months) than recommended guidelines (usually up to 2 weeks).

Conclusions: Overall, Japanese versions of ACTS and TSQM-II scales satisfied internal consistency reliability and traditional validity criteria. Our study supports the ACTS and TSQM-II as appropriate PRO instruments to measure satisfaction with anticoagulant treatment in Japanese patients with AF.

Trial registration: NCT01598051, clinicaltrials.gov; registered April 20, 2012.     

Discussion on the Benefits Distributing Structure in Village Land Deal

According to everyone average welfare value of land resources; this paper constitutes the base line of glebe usufruct deal value by analyzing the factors, which are affecting glebe usufruct deal value. Having adopted share＇s quotient of ownership and contracting power, the paper erects assigning mechanism to the income of glebe deal. Because of the share dynarnicity being adopted which shows the flexible strong points, the shares of ownership and contracting power avoid many unnecessary otiose disputes on income of glebe deal, adding the stability to the glebe usufruct deal. It is beneficial to the freedom flow and validity manufacture factor installment and also to the nonagricultural changing course.     

以创新创业基地建设促进物流实验室发展

该文主要阐述了怎样通过建设一个创新创业基地的架构,即管理思路、组织原则、创新流程等一系列实验室管理模式,来提供给管理类大学生一个得到实践锻炼的良好平台,同时也促进管理类专业实验室合理有效的管理。     

存款保险制度的产生发展及其理论基础

本文通过对存款保险制度在国际上产生发展的背景分析 ,发现该制度在实践中有内在的必然性 ,在理论上有坚实的基础 ,银行的存在是金融效率所在 ,尽管挤兑可能会发生甚至迅速演化为银行危机 ,但不能否定银行的客观必要性。相反 ,需要防止挤兑和银行危机发生的制度安排 ,其中没有任何一种安排能够取代存款保险制度。中国现在比以往任何时候都需要采纳这一制度以适应市场化金融改革开放的需要 ,当然相应的技术问题仍需要解决。     

几种希夫碱的合成及其异构体的表征

研究了由水杨醛与甘氨酸、L-异亮氨酸和 L-苯丙氨酸反应制得 3种希夫碱的合成方法及性质。红外光谱、氢核磁共振谱证明所合成的希夫碱中存在酚亚胺和酮烯胺的互变异构物。     

债务重组的会计问题研究

本文根据新会计制度的规定,就债务重组的基本原理五种债务重组方式的会计处理事项分别作了说明,并对中外关于债务重组的处理方法进行了比较,找出了其中的差异。为了寻找更为完善的对债务重组的会计处理方法,本文对新会计制度关于债务重组的某些不足之处进行了讨论,提出了相应的意见和建议。     

Comparing the True Cost of Living Indices of Demographically Different Households

The comparison of true cost of living indices between demographically different households (relative equivalence scale) is argued to be sensitive to the way demographic characteristics enter demand analysis. In particular, parameters reflecting the cost of demographic characteristics at base prices, though themselves do not have welfare (equivalence scale) interpretation, can alter the benchmark from which demographically varying inflation effects are measured. The empirical analysis, based on a rank‐3 demand system applied to UK individual household data, shows that the inflation adjustment of child benefits can vary with the way demographic costs at base period prices are specified.     

谈以人为本的薪酬管理

今天的企业能否在激烈的竞争中站稳脚跟 ,关键在于是否能够留住人才 ,而能否留住人才的关键又取决于企业建立一种什么样的薪酬制度。以人为本的薪酬管理是指把以人为本的思想贯穿到企业的薪酬管理当中 ,从而真正发挥激励人才的作用。建立以人为本的薪酬制度 ,要在真正了解员工需求的基础上 ,充分挖掘企业的薪酬资源 ,并结合企业的实际大胆创新     

钢筋混凝土现浇楼板裂缝成因分析及防治措施

文章对某工业厂房现浇楼板产生裂缝进行调查,分析了裂缝的特征和产生的原因,介绍了防治裂缝的措施以及修补裂缝的方法。