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- de Bruijn, Winnie, et al.
(författare)
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Introduction and Utilization of High Priced HCV Medicines across Europe : Implications for the Future
- 2016
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Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Infection with the Hepatitis C Virus (HCV) is a widespread transmittable disease with a diagnosed prevalence of 2.0%. Fortunately, it is now curable in most patients. Sales of medicines to treat HCV infection grew 2.7% per year between 2004 and 2011, enhanced by the launch of the protease inhibitors (Hs) boceprevir (BCV) and telaprevir (TVR) in addition to ribavirin and pegylated interferon (pegIFN). Costs will continue to rise with new treatments including sofosbuvir, which now include interferon free regimens. Objective: Assess the uptake of BCV and TVR across Europe from a health authority perspective to offer future guidance on dealing with new high cost medicines. Methods: Cross-sectional descriptive study of medicines to treat HCV (pegIEN, ribavirin, BCV and TVR) among European countries from 2008 to 2013. Utilization measured in defined daily doses (DDDs)/1000 patients/quarter (DIOs) and expenditure in Euros/DDD. Health authority activities to influence treatments categorized using the 4E methodology (Education, Engineering, Economics and Enforcement). Results: Similar uptake of BCV and TVR among European countries and regions, ranging from 0.5 DIQ in Denmark, Netherlands and Slovenia to 1.5 DIQ in Tayside and Catalonia in 2013. However, different utilization of the new Pls vs. ribavirin indicates differences in dual vs. triple therapy, which is down to factors including physician preference and genotypes. Reimbursed prices for BCV and TVR were comparable across countries. Conclusion: There was reasonable consistency in the utilization of BCV and TVR among European countries in comparison with other high priced medicines. This may reflect the social demand to limit the transmission of HCV. However, the situation is changing with new curative medicines for HCV genotype 1 (GT1) with potentially an appreciable budget impact. These concerns have resulted in different prices across countries, with their impact on budgets and patient outcomes monitored in the future to provide additional guidance.
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| 2. |
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Grammatik, kritik, didaktik. Nordiska studier i systemisk-funktionell lingvistik och socialsemiotik
- 2018
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Proceedings (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Systemisk-funktionell lingvistik (SFL) och socialsemiotik är teoretiska och metodologiska program och perspektiv som kan tillämpas på ett vitt fält av språkvetenskapligt arbete. I den här volymen presenteras utvalda bidrag från Trettonde nordiska konferensen för systemisk-funktionell lingvistik och socialsemiotik (NSFL 13), som hölls vid Göteborgs universitet 11–12 oktober 2017. I enlighet med volymens titel, Grammatik, kritik, didaktik, som också var konferensens, visar bidragen på SFL:s och socialsemiotikens tillämpbarhet i och relevans för i huvudsak tre områden: grammatisk forskning, språkvetenskaplig analys med en kritisk ansats och didaktisk forskning. De sju publicerade artiklarna täcker in en lång rad av undersökningsobjekt och rör sig i rummet mellan flera olika språk och länder, från lärargrupper på svenskspråkiga Facebook via texter om Gud på norska till återvunna föremål i Sydafrika. Volymen visar på bredden och djupet i systemisk-funktionell och socialsemiotisk språkanalys.
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| 3. |
- Kalkan, Almina, et al.
(författare)
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Physician Preferences and Variations in Prescription of Biologic Drugs for Rheumatoid Arthritis: A Register-Based Study of 4,010 Patients in Sweden
- 2015
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Ingår i: Arthritis care & research. - : WILEY-BLACKWELL. - 2151-464X .- 2151-4658. ; 67:12, s. 1679-1685
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The prescription of biologic drugs for rheumatoid arthritis (RA) patients has varied considerably across different regions. Previous studies have shown physician preferences to be an important determinant in the decision to select biologic disease-modifying antirheumatic drugs (bDMARDs) rather than nonbiologic, synthetic DMARDs (sDMARDs) alone. The aim of this study was to test the hypothesis that physician preferences are an important determinant for prescribing bDMARDs for RA patients in Sweden. Methods. Using data from the Swedish Rheumatology Quality Register, we identified 4,010 RA patients who were not prescribed bDMARDs during the period 2008-2012, but who, on at least 1 occasion, had an sDMARD prescription and changed treatment for the first time to either a new sDMARD or a bDMARD. Physician preference for the use of bDMARDs was calculated using data on each physicians prescriptions during the study period. The relationship between prescription of a bDMARD and physician preference, controlling for patient characteristics, disease activity, and the physicians local context was evaluated using multivariate logistic regression. Results. When adjusting for patient characteristics, disease activity, and the physicians local context, physician preference was an important predictor for prescription of bDMARDs. Compared with patients of a physician in the lowest preference tertile, patients of physicians in the highest and middle tertiles had an odds ratio for receiving bDMARDs of 2.8 (95% confidence interval [95% CI] 2.13-3.68) and 1.28 (95% CI 1.05-1.57), respectively. Conclusion. Physician preference is an important determinant for prescribing bDMARDs.
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