相关实验视频
Updated: Jun 26, 2025

05:10
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
954
在英格兰处方Liothyronine (LT3):成本限制是否阻碍了指南的实施?
Adrian Heald1,2, Lakdasa D Premawardhana3, Peter N Taylor3
1The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
Clinical endocrinology
|May 16, 2024
概括
利沃甲状腺素仍然是甲状腺功能低下症的主要治疗方法. 尽管在CMA裁决后降低了成本,并转向更低剂量,但甲酸氨酸治疗仍然要贵得多,这影响了患者的获取.
科学领域:
- 内分泌学 在内分泌学.
- 药物经济学 药物经济学
- 公共卫生 公共卫生
背景情况:
- 甲状腺功能低下症影响3%的欧洲人,通常用levothyroxine治疗.
- 英国甲状腺协会 (BTA) 最近的指导和竞争和营销管理局 (CMA) 的裁决影响了甲状腺药物处方.
- 分析的重点是levothyroxine,自然干燥甲状腺 (NDT) 和liothyronine从2016-2022年处方趋势.
研究的目的:
- 检查对levothyroxine,NDT和liothyronine的处方模式和成本的变化.
- 评估2020年CMA裁决和2023年BTA处方指南对处方的影响.
- 评估不同类型的甲状腺功能减退治疗的成本效益和可获得性.
主要方法:
- 分析英国每月的初级保健处方数据 (BNF代码) 关于levothyroxine,liothyronine和NDT.
- 使用12个月的滚动总额来识别处方量和成本的变化.
- 计算了处方数量,总成本和每微克处方成本.
主要成果:
- 到2022年,甲氨酸的处方转向较低剂量 (5mcg和10mcg),每处方的成本大幅下降,但仍然很高.
- 尽管每年总成本降低了70% (每年900万英),但甲氨酸仍然比levothyroxine更昂贵.
- 较低剂量的甲氨酸 (5mcg,10mcg) 的每微克价格比以前占主导地位的20mcg剂量要贵得多.
结论:
- 在CMA裁决后,氨酸的成本下降,但与levothyroxine相比仍然不成比例地高.
- 尽管仅占患者的0.2%,但甲氨酸占药费的16%.
- 高昂的甲氨酸定价,特别是BTA推的较低剂量,可能会限制患者获得有益的治疗方法.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
4.6K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.6K
Antiasthma Drugs: Leukotriene Modifiers
281
Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Leukotriene modifiers work through two distinct mechanisms:
281
Functions of Thyroid Hormones
2.7K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.7K
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
978
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
978
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
157
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
157
Drugs for Treatment of Constipation-Predominant IBS
160
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
160

