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Filename: controllers/Detail.php
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Filename: controllers/Detail.php
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Background: Generalized Anxiety Disorder (GAD) is a common chronic disease with a lifetime prevalence estimated to range from 4.2% to 12.7%. GAD places a substantial burden upon patients and healthcare resources.
Objective: To determine the cost-effectiveness of escitalopram for GAD in a Canadian primary care setting from two perspectives [Ministry of Health (MoH) and society (SOC)].
Methods: A 24-week decision-analytic model was constructed using Data/TreeAge software. Patients were treated with escitalopram or generic paroxetine. Clinical rates were determined from the literature; expert opinion guided model pathway development. Effectiveness was measured as 'symptom-free days' (SFDs). Analyses from MoH perspective focused on direct costs of treatment (drugs, physician visits), while SOC also accounted for indirect costs associated with workdays lost due to GAD. Unit costs of healthcare services and wage rates were obtained from standard Canadian sources (2005 Canadian $ values). Cost-effectiveness was expressed as the incremental cost-effectiveness ratio (ICER). Extensive one-way and probabilistic sensitivity analyses were conducted.
Results: Escitalopram was associated with higher expected number of SFDs than paroxetine (86.4 vs. 77.0 SFD, respectively). From the MoH perspective, expected costs were Can$724 and Can$663 for escitalopram and paroxetine arms, respectively, resulting in the ICER for escitalopram vs. paroxetine of Can$6.56/SFD (Can$2362/symptom free year). From the SOC perspective, escitalopram dominated paroxetine as more effective on SFDs and less costly. Sensitivity analyses demonstrated robustness of the model. Limitations include the absence of comorbidities, which are common in practice, lack of long-term data, and assuming that dropouts in trials reflect those in practice.
Conclusion: Escitalopram was found to be cost-effective compared with paroxetine in treatment of GAD from the Canadian MoH perspective, and dominating paroxetine from the SOC perspective. Therefore, a possible advantage may exist at the population level in the treatment of GAD with escitalopram in Canada.
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http://dx.doi.org/10.1185/030079908x297277 | DOI Listing |
Adv Mater
December 2024
Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119074, Singapore.
The unprecedented success of mRNA vaccines against COVID-19 has inspired scientists to develop mRNA vaccines for cancer immunotherapy. However, using nucleoside modified mRNA as vaccine, though evading innate immune toxicity, diminishes its therapeutic efficacy for cancers. Here, we report a polyvalent stimulator of interferon genes (STING) activating polymer (termed as PD) to bolster the immunogenicity of mRNA vaccine.
View Article and Find Full Text PDFJ Healthc Leadersh
December 2024
Office of Faculty, JHUSOM, Baltimore, MD, USA.
Background: Gender inequity persists in high-level leadership within academic medicine. Understanding the perspectives of early career women faculty could clarify how to recruit and support women who pursue high-level leadership. This study explored the specific priorities and concerns that may influence the recruitment of women leaders in the future.
View Article and Find Full Text PDFHealth SA
November 2024
Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, South Africa.
Background: Rising cases of non-communicable diseases (NCDs), poor health choices, mistrust of the health system, self-medication, resistance of diseases to medication and dissatisfaction with the service experience serve as red flags on the path to Universal Health Coverage (UHC).
Aim: This study explored the importance of patient-centred care (PCC) and patient empowerment (PE) within the context of healthcare service delivery in Ghana.
Setting: The study considered PCC and PE from the perspective of three public healthcare facilities within the Greater Accra region.
Reprod Health
December 2024
Faculté de Médecine Purpan, CERPOP, Inserm, Université Paul Sabatier Toulouse 3, 37 Allées Jules Guesde, 31073, Toulouse Cedex 7, France.
Introduction: Adolescents face unique challenges in accessing appropriate information and services regarding sexuality and reproductive health (SRH). This poor access can lead to sexual behaviours that could put them at risk of unintended pregnancies and sexually transmitted infections. Adolescents living with HIV (ALHIV) have specific SRH needs that remain unmet.
View Article and Find Full Text PDFBMC Health Serv Res
November 2024
Division of Global Health Protection, Global Health Center, Centers for Disease Control and Prevention, Atlanta, USA.
Background: In 2016, Uganda introduced services for hypertension and diabetes in selected HIV clinics. We evaluated the costs associated with scaling up these services in HIV clinics in Mbarara and Ibanda districts, Uganda.
Methods: We estimated the annual costs of providing hypertension and diabetes services using an activity-based costing approach from the health system perspective in ten randomly selected HIV clinics in Mbarara and Ibanda districts.
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