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Pharmacoeconomic and Pharmacoepidemiology Aspects of Allergy Rhinitis Treatment and Prevention
Pokladníková, Jitka ; Vlček, Jiří (advisor) ; Švihovec, Jan (referee) ; Beran, Jiří (referee)
7 SUMMARY Rational pharmacotherapy should ensure a safe and cost-effective treatment of patients with allergic rhinitis (AR). Two main aspects of treatment of AR were addressed (1) comparative benefits and costs of subcutaneous and sublingual allergen immunotherapy in patients with allergic rhinitis, and (2) systemic adverse events - neuropsychiatric disorders and gynaecomastia - during intranasal corticosteroid use. (1) Allergen specific immunotherapy: benefits and costs Our pharmacoeconomic study on allergen specific immunotherapy showed that sublingual and subcutaneous immunotherapy reduced clinical symptoms and the need for symptomatic medication in adults with grass pollen induced rhinoconjunctivitis compared to standard pharmacological treatment. The clinical efficacy of the sublingual and subcutaneous immunotherapy was not significantly different in the third year of specific immunotherapy. Nevertheless, the SCIT group exhibited slightly better improvement in visual analogue scale and a greater reduction of systemic antihistamines versus SLIT in the third year compared to the baseline year. Overall, SLIT showed a better cost profile from all three perspectives. SCIT was financially favorable from a patient perspective where no loss of income and travel costs were present. Larger comparative studies...
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Health Economy and Outcomes Research in the Health Technology Assessment in the Czech Republic
Klimeš, Jiří ; Vlček, Jiří (advisor) ; Foltán, Viliam (referee) ; Švihovec, Jan (referee)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Candidate Jiří Klimeš, PharmD Supervisor Prof. RNDr. Jiří Vlček, CSc.; MUDr. Tomáš Doležal, PhD (consultant) Title of Doctoral Thesis Health Economy and Outcomes Research in the Health Technology Assessment in the Czech Republic The aim of PhD thesis was to present on practical examples of cost-of-illness (COI), cost- effectiveness (CEA), cost-utility (CUA) and outcomes research analyses their application within current HTA (Health Technology Assessment) process of drug technologies in the Czech Republic. HTA cover complex assessment of medicinal technologies/ interventions in terms of relative effectiveness, safety, health economic aspects (cost-effectiveness and budget impact) and ethical, social and legal aspects. It was presented a methodology of COI studies and their practical application (as the inputs) into CEA, CUA analyses within selected diseases - rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Moreover, it was presented concept of Markov cohort models used in CEA, CUA analyses in area of cardiovascular diseases, post-transplantation care, intensive care medicine and therapy of dementia. Within the CUA, it was interpreted a Probabilistic Sensitivity Analysis in...
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Hypoglycaemia as Acute Complication of Diabetes Mellitus
Krnáčová, Veronika ; Macek, Karel (advisor) ; Rybka, Jaroslav (referee) ; Švihovec, Jan (referee)
Title of thesis: Hypoglycaemia as acute complication of diabetes mellitus Author of thesis: Mgr. Veronika Krnáčová (roz. Vlčková) This thesis was focused on hypoglycaemia as adverse drug reaction of rosiglitazone, pioglitazone, nateglinide and repaglinide, which have been launched to the UK market and on severe hypoglycaemia (SH) requiring the assistance of Emergency medical service (EMS) in region of Hradec Králové. Observed factors were described in two separate sections. Hypoglycaemia as adverse drug reaction of selected oral antidiabetics Aim The aim of this study was to quantify the incidence of hypoglycaemic events during the first nine months of treatment with newly launched oral antidiabetics, rosiglitazone, pioglitazone, nateglinide or repaglinide, prescribed by general practitioners in England, to observe pattern of these events over time, to look for patients' characteristics which could influence the incidence of hypoglycaemia and to analyse the relationship between use of concomitant anti-diabetic therapies and the incidence of hypoglycaemia in patients treated with pioglitazone. Methods We used data collected for prescription-event monitoring (PEM) studies of rosiglitazone, pioglitazone, nateglinide and repaglinide. PEM is an observational, non-interventional, cohort study. Incidence...
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Pharmacoeconomic and Pharmacoepidemiology Aspects of Allergy Rhinitis Treatment and Prevention
Pokladníková, Jitka ; Vlček, Jiří (advisor) ; Švihovec, Jan (referee) ; Beran, Jiří (referee)
7 SUMMARY Rational pharmacotherapy should ensure a safe and cost-effective treatment of patients with allergic rhinitis (AR). Two main aspects of treatment of AR were addressed (1) comparative benefits and costs of subcutaneous and sublingual allergen immunotherapy in patients with allergic rhinitis, and (2) systemic adverse events - neuropsychiatric disorders and gynaecomastia - during intranasal corticosteroid use. (1) Allergen specific immunotherapy: benefits and costs Our pharmacoeconomic study on allergen specific immunotherapy showed that sublingual and subcutaneous immunotherapy reduced clinical symptoms and the need for symptomatic medication in adults with grass pollen induced rhinoconjunctivitis compared to standard pharmacological treatment. The clinical efficacy of the sublingual and subcutaneous immunotherapy was not significantly different in the third year of specific immunotherapy. Nevertheless, the SCIT group exhibited slightly better improvement in visual analogue scale and a greater reduction of systemic antihistamines versus SLIT in the third year compared to the baseline year. Overall, SLIT showed a better cost profile from all three perspectives. SCIT was financially favorable from a patient perspective where no loss of income and travel costs were present. Larger comparative studies...
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Pharmacoepidemiology of medicines by cardiovascular diseases
Górecká, Květoslava ; Tilšer, Ivan (advisor) ; Suchopár, Josef (referee) ; Švihovec, Jan (referee)
11. SUMMARY Introduction Increasing prevalence of chronic forms of cardiovascular diseases, theirs treatment is lifelong in majority of patients, causes considerable increase of the utilisation of cardiovascular drugs. Considering the fact that healthcare financial resources are restricted, it is necessary to use the drugs effectively and rationally. That is why it is important to study the trends in pharmacotherapy and drug prescribing in the real practice and consequently evaluate the drug use from the epidemiological, economic or social point of view. Objectives The objective of this work was to evaluate several aspects of the cardiovascular drug utilization on the basis of use of several large drug databases and different pharmacoepidemiologic attitudes. Specific issues were addressed in four independent studies: 1) A comparison of cardiovascular drug utilization in selected districts of the Czech Republic and Great Britain. 2) Cardiovascular drug utilisation, mortality and socio-economic inequalities: An ecological study in 20 districts of the Czech Republic. 3) An analysis of the hypertension treatment in general practitioners in the Czech Republic in the 90's. 4) Pleiotropic effects of statins and prevention of diabetes mellitus type 2. 1) A comparison of cardiovascular drug utilization in selected...
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