ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

Migraine is a remarkably disabling condition, although unpredictable and heterogeneous in frequency, duration and severity. It can be difficult to manage in primary care where it is under-recognised, underdiagnosed and undertreated. Proposals have been made that migraine care could be improved by incorporating assessments of migraine impact into management strategies, and measuring headache-related disability can be used to assess the impact of migraine on people’s lives and society. The Migraine Disability Assessment (MIDAS) questionnaire was developed from this research. MIDAS is a scientifically reliable and valid measure of migraine disability that can improve communication between patients and physicians, assess migraine severity and act as an outcome measure to monitor treatment efficacy. Perhaps the most important use of MIDAS is as an aid to public health initiatives on headache. MIDAS can be used to screen populations for headache-related disabilities and medical needs and be part of generalised migraine management guidelines in primary care in order to produce an individualised treatment plan for each patient. MIDAS can be used by physicians, pharmacists, nurses and patients.

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

ObjectiveTo evaluate whether the trend in adults seeking medical care for the treatment of attention-deficit hyperactivity disorder (ADHD) reflects the upward pattern seen among children.MethodsData from the US National Ambulatory Medical Care Survey were utilised for this analysis. The number and rate of office-based physician visits resulting in a diagnosis of ADHD (International Classification of Diseases, 9th Revision, Clinical Modificationcode 314.00 or 314.01) among patients aged ≥20 years were discerned for the years 1995−2000. Trend analyses were conducted using three time intervals: 1995−96, 1997−98 and 1999−2000.ResultsOver the 6 years examined, national estimates of the number of annualised office-based physician visits documenting a diagnosis of ADHD among adults increased: 582 728 (95% CI 328 937, 836 518) in 1995−96; 611 703 (95% CI 348 475, 874 931) in 1997−98; and 1 049 486 (95% CI 518 776, 1 580 196) in 1999−2000. Adjusted for population growth, the rate per year of office-based visits per 1000 US population aged ≥20 years resulting in a diagnosis of ADHD was 3.1 in 1995−96, 3.2 in 1997−98 and 5.4 in 1999−2000. The majority of visits over the three time intervals documented a prescription for stimulant pharmacotherapy (61.0−69.6%). The mean age was 38 years, men accounted for 55.4% of the office visits and 75.1% of the visits were reported by psychiatric specialists.ConclusionAs with children, the rate of adults seeking medical care for ADHD increased between 1995 and 2000, with adults being treated predominantly with stimulant pharmacotherapy. Although this disorder was previously thought to be nonexistent in adults, by 1999−2000 adults accounted for nearly one in five (19.4%) US office visits resulting in a diagnosis of ADHD.

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

摘要:

Despite the significant increase in spending on pharmaceutical research and development that we have seen in real terms over the past 20 years, this has not been matched by an increase in new chemical entities (NCEs). Therefore, each NCE has to produce ever-increasing financial returns to the company in order to fund further research to maintain the viability of the industry. However, the payers in the marketplace have limited pharmaceutical budgets and have introduced various cost containment strategies to limit access to all new pharmaceuticals until they are proven to be a cost-effective replacement to the current treatments. The impact of these cost containment strategies is seen at the national, regional and/or local (formulary) approval level. Therefore, for companies to ensure rapid market access with an NCE that will be reimbursed at a suitable level, and take market share from a current market leader, they must have proof of comparative cost effectiveness at launch. To achieve this goal, companies need to address the pricing and reimbursement strategy at each stage of development to ensure that they have the critical data collected to prove comparative value in use. In reality, however, not all potential NCEs will have the ability to deliver the comparative level of improvement over available treatments needed to achieve the required price, at the necessary level of reimbursement and at sufficient volume to satisfy the financial targets. Therefore, companies need to invest in collecting and analysing market data at each stage of development, from project selection through to phase III, to ensure that they can make informed decisions. This market place data will help to determine the returns that can be achieved from different product profiles, thereby enabling ‘go/no go’ decisions to be put in place. The indication, subpopulation and launch sequencing are other critical factors that need to be addressed by the company.To make these significant improvements it is not a simple investment in market research alone. The whole of the research and development function need to accept that they have to address the pricing and reimbursement data requirements in the same way as the collection of regulatory safety and efficacy.

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS

ISSN:1364-9027    

出版商:ADIS    

年代:2004

数据来源: ADIS