Background: Human papillomavirus (HPV) vaccine may be commercially available in a few years. We explored the clinical benefits and cost-effectiveness of introducing an HPV16/18 population with organized cervical cancer screening program. Methods: A computer-based model natural history HPV was used to project incidence mortality, life expectancy (adjusted unadjusted for quality life), lifetime costs, incremental ratios (i.e., additional cost strategy divided by its benefit compared next most...

Abstract The object of our study is to project the impact a prophylactic vaccine against persistent human papillomavirus (HPV)‐16/18 infection on age‐specific incidence invasive cervical cancer. We developed computer‐based mathematical model natural history carcinogenesis incorporate underlying type‐specific HPV distribution within precancerous lesions and After defining plausible ranges for each parameter based comprehensive literature review, was calibrated best available population‐based...

The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, been the most widely used package to conduct meta-analyses. However, learning curve for WinBUGS can be daunting, especially new users. Furthermore, critical appraisal meta-analyses conducted challenging given its limited data manipulation capabilities and fact that generation graphical output from often relies on different packages than analyses themselves. We...

To determine the efficacy of immunoglobulin free light chain (FLC) removal by high cut-off haemodialysis (HCO-HD) as an adjuvant treatment to chemotherapy for patients with acute kidney injury complicating multiple myeloma (MM).Sixty-seven dialysis-dependent renal failure secondary MM were treated HCO-HD and chemotherapy.The population was predominantly male (62.7%) new presentation (75%) did not have a history chronic disease (84%). The mean serum creatinine at 662 (SD = 349) μmol/L 56.7%...

Objectives: To (i) quantify the cost of multiple sclerosis (MS) to Canadian health care system and society; (ii) measure utility in MS patients, (iii) examine influence disability on patient costs.Materials methods: A comprehensive survey chart review relapsing remission, relapse recalling a relapse.Results: Annual remission costs increased with EDSS level ($7596 at 1, $33 206 6). At all levels largest were due inability work, which EDSS. The average for was $1367. An inverse correlation...

Background and Objectives The aim of this study was to examine the cost‐effectiveness adding nucleic acid testing (NAT) serological (antibody antigen) screening protocols for donated blood in United States (US) with purpose reducing risks transfusion‐transmission hepatitis B virus (HBV), C (HCV) human immunodeficiency (HIV). Materials Methods costs, health consequences either minipool or individual‐donor NAT (SS) were estimated using a decision‐analysis model. Results With given modelling...

Aim: Evaluate the cost–effectiveness of combinatorial pharmacogenomic (PGx) testing, versus treatment as usual (TAU), to guide for patients with depression, from Canadian public healthcare system perspective. Materials & methods: Clinical and economic data associated depression were extracted published literature. (quality-adjusted life years; QALYs) (incremental ratio) outcomes modeled using PGx TAU strategies across a 5-year time horizon. Results: With strategy treatment, projected gain...

The Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) showed that tafamidis reduced all-cause mortality and cardiovascular-related hospitalizations patients with transthyretin amyloid cardiomyopathy (ATTR-CM). This study aimed to estimate the impact of on survival quality-adjusted life-years (QALYs).A multi-state, cohort, Markov model was developed simulate disease course ATTR-CM throughout a lifetime. For extrapolation, curves were fitted by treatment arm New York Heart...

Abstract Background A rise in gastrointestinal (GI) adverse events (AEs) and a decline bone mineral density (BMD) was observed patients previously tolerant to brand alendronate shortly after generic versions were introduced July 2005 the Canadian market. The objective of our study quantify changes AE rates BMD scores, as well associated discontinuation among before switch from alendronate. Methods chart review postmenopausal women 50 years age older between 2003 2007 conducted two...

Objective. To assess whether use of oral vancomycin for treatment during an outbreak Clostridium difficile infection (CDI) was associated with increased rates colonization vancomycin-resistant enterococci (VRE).. Design. A retrospective analysis hospital databases. Setting. The Jewish General Hospital in Montreal, Quebec, Canada. Methods. We collected data regarding VRE and CDI from November 1, 2000, through September 30, 2007, which policies preferential metronidazole or were implemented to...

Infections caused by multidrug-resistant organisms and

Ofatumumab is a high-efficacy disease-modifying therapy (DMT) approved for first-line treatment of relapsing-remitting multiple sclerosis (RRMS) in Canada. The aim this study was to evaluate the cost effectiveness ofatumumab from Canadian healthcare system perspective. A Markov cohort model run over 65 years using annual cycles, 1.5% discount rate, and 100% discontinuation at 10 years. British Columbia database informed natural history transition probabilities. Treatment efficacy DMTs were...

There is limited information regarding the cost-effectiveness of sevelamer for treatment hyperphosphatemia in chronic kidney disease (CKD) patients on dialysis UK. Using a UK National Health Service (NHS) perspective and final results Dialysis Clinical Outcomes Revisited (DCOR) study, an evaluation was performed to determine compared calcium-based phosphate binders first-line CKD dialysis.A Markov model developed estimate life years, quality-adjusted years (QALYs), costs, incremental cost...

Ticagrelor demonstrated a significant reduction in major cardiac events patients with acute coronary syndrome (ACS) compared clopidogrel the Platelet Inhibition and Patient Outcomes (PLATO) trial. The objective of this study was to assess cost-effectiveness ticagrelor ACS from perspective Canadian publicly funded health care system.A two-part model developed consisting 1-year decision tree lifetime Markov model. Within tree, remained event-free, experienced nonfatal myocardial infarction,...

Background:Approximately 10–20% of multiple myeloma patients experience dialysis-dependent renal failure. This is principally due to kidney, a tubulointerstitial injury caused by high circulating concentrations monoclonal free light chains. Studies have found that between 3% and 37% with kidney requiring dialysis recover function. In-vivo studies indicate extended haemodialysis using cut-off dialysers (HCO-HD) can remove significant quantities chains associated recovery rate 63–74% in these...

Introduction . Clostridium difficile -associated disease (CDAD) is treated using antibiotics, which often leads to the emergence of antibiotic-resistant bacteria such as vancomycin-resistant enterococci (VRE). This study estimated impact a non antibiotic treatment for CDAD on VRE prevalence. Methods A previously published model describing in-hospital use prevalence was adapted include treatment. Simulations compared when nonantibiotic versus therapy used. Results Nonantibiotic in 50%...

Chronic kidney disease (CKD) is a rapidly emerging global health crisis, with predictions of it being the fifth leading cause death by 2040. Its rising prevalence set to strain systems, significant economic implications; proportion healthcare budget allocated CKD treatment projected reach an average 7.3% and up 25.7% in some countries. IMPACT-CKD focuses on emphasizing advantages detecting treating early from holistic standpoint.

To assess the cost-effectiveness of treatment strategies that utilize first-line latanoprost compared to those based on initial beta-blocker therapy in patients with open-angle glaucoma (OAG) or ocular hypertension (OH) France.The study was a decision-analytic model populated data from retrospective chart review. A hypothetical cohort newly diagnosed OAG and/or OH assessed over period 2 and 3 years. For each strategy 10,000 were assumed.First-line significantly more effective than...

In recent years, the FDA has approved several 3-agent (i.e., triplet) combinations for previously treated multiple myeloma (MM), and National Comprehensive Cancer Network (NCCN) now recommends triplet regimens over doublets. Little is known about real-world cost of because limited time that they have been on market since approval. Furthermore, traditional analyses developed to support entrance rely utilization assumptions are difficult validate when numerous comparators simultaneously enter market.