Quantification of the potential impact of cost-effectiveness thresholds on dutch drug expenditures using retrospective analysis.

Background: Other than the UK, The Netherlands has no formal threshold for cost-per-QALY values defined yet. For example, a cutoff value at €20,000 per QALY is sometimes mentioned in various discussions, however it has no formal status at all. Yet, since 2005, all new innovative do have to go through a cost-effectiveness evaluation though, with the assessment being focused on the methodology rather than on the exact cost-per-QALY outcome.

Effects of L-arginine and L-NAME on the renal function in hypertensive and normotensive subjects.

Background/aim: Renal vasodilation in response to L-arginine has been reported to be diminished in hypertensive (HT) subjects. If this diminished renal vasodilator response indicates disturbance of the renal NO pathway, a diminished renal vasoconstrictor response to NO synthase inhibition may be present in HT subjects as well. The present study was conducted to compare the effects of L-arginine and N(G)-nitro-L-arginine methyl ester (L-NAME) on renal and systemic hemodynamics between HT and normotensive (NT) subjects.

Human renal and systemic hemodynamic, natriuretic, and neurohumoral responses to different doses of L-NAME.

Experimental evidence indicates that the renal circulation is more sensitive to the effects of nitric oxide (NO) synthesis inhibition than other vascular beds. To explore whether in men the NO-mediated vasodilator tone is greater in the renal than in the systemic circulation, the effects of three different intravenous infusions of NG-nitro-L-arginine methyl ester (L-NAME; 1, 5, and 25 microg. kg-1.