Cost-effectiveness and budget impact of saxagliptine as additional therapy to metformin for the treatment of diabetes mellitus type 2 in the Brazilian private health system

Cost-effectiveness and budget impact of saxagliptine as additional therapy to metformin for the treatment of diabetes mellitus type 2 in the Brazilian private health system Objectives: To compare costs and clinical benefits of three additional therapies to metformin (MF) for patients with diabetes mellitus type 2 (DM2). Methods: A discrete event simulation model seas built to estimate the cost-utility ratio (cost per quality-adjusted life years [QALY)) of saxagliptine as an additional therapy to MF when compared to rosiglitazone or pioglitazone. A budget impact model (BIM) was built to simulate the economic impact of saxagliptine use in the context of the Brazilian private health system. Results: The acquiring medication costs for the hypothetical patient group analyzed in a time frame of three years, were R$ 10,850,185, R$ 14,836,265 and R$ 14,679,099 for saxagliptine, pioglitazone and rosiglitazone, respectively. Saxagliptine showed lower costs and greater effectiveness in both comparisons, with projected savings for the first three years of R$ 3,874 and R$ 3,996, respectively. The BIM estimated cumulative savings of R$ 417,958 with the repayment of saxagliptine in three years from the perspective of a health plan with 1,000,000 covered individuals. Conclusion: From the perspective of private paying source, the projection is that adding saxagliptine with MF save costs when compared with the addition of rosiglitazone or pioglitazone in patients with DM2 that have not reached the HbA1c goal with metformin monotherapy. The BIM of including saxagliptine in the reimbursement lists of health plans indicated significant savings on the three-year horizon.

An initial proposal for PDP of smes developing hospital furniture

A large percentage of the industrial SMEs has an organizational structure for product development too far from the adequate practices and models, elaborated by renowned authors with expertise in the theme of product development. On the other hand, the authors state that SMEs obtain considerable advantages by adopting a model of product development process (PDP) management. Healt is one of the most innovative sectors in the world, and countries like Brazil and Colombia are transitioning from a system that cares for contagious infecttions diseases where the drug product is the main form of treatment - to a system that cares for chronic degenerative conditions - where the equipment, including hospital furniture, has more relevance to the treatment. This change is offering better opportunities of specialized markets to hospital furniture SMEs that adopt an adquate PDF model. The present study proposes a first outline of a model of PDP management for industrial metal-mechanical SMEs that develop and manufacture hospital furniture, from a review of models proposed for great mechanical area.