Background and Objective Teriflunomide is a once-daily oral immunomodulatory agent approved in 80 countries for the treatment of patients with relapsing multiple sclerosis (RMS). The study objective was to estimate the cost effectiveness of teriflunomide (14 mg tablet, daily) versus interferon beta-1b (250 mcg subcutaneous injection, every other day) among RMS patients from the Chinese healthcare system perspective. Methods A Markov model with annual cycles and a lifetime horizon was utilized to assess cost-effectiveness of teriflunomide in comparison with interferon beta-1b in RMS patients. Treatment effects, including 3-month confirmed disability worsening and annualized relapse rate, were derived from a network meta-analysis. Cost inputs included costs related to treatment acquisition, administration, monitoring, natural disease management through Expanded Disability Status Scale states, relapse treatment, and adverse event management. These costs were calculated as the product between unit costs from published sources and healthcare resource utilization patterns identified in a survey conducted among 11 neurologists across different areas in China. Health effects were expressed as quality-adjusted life years (QALYs) with costs in local currency (¥) and US dollars (US$), 2018. Results Teriflunomide dominated interferon beta-1b and was associated with lower total costs (teriflunomide ¥1,887,144 vs interferon beta-1b ¥2,061,393) and higher QALYs (teriflunomide 9.60 QALYs vs interferon beta-1b 8.88 QALYs). In probabilistic sensitivity analysis, teriflunomide was dominant in 62.2% of model runs. Conclusion Teriflunomide is a cost-effective therapy over a lifetime time horizon compared to interferon beta-1b in the treatment of RMS patients in China. Results should be interpreted with caution as head-to-head comparisons are not available. Electronic supplementary material The online version of this article (10.1007/s40261-019-00750-3) contains supplementary material, which is available to authorized users.

Background: Cambodia garment industry is one of the leading economic sector and offering many job to labor market. However, it has attracted much attention due to a poor nutritional status among workers. Method: The study obtains with the secondary research data, multiple methods were applied including data from the better factories Cambodia project of International Labor Organization (ILO) corporate with Agence Francaise de Development (AFD),

The structural indicators and process indicators have a significant impact on outcome indicators, and they also have correlations. That is, the formulation and implementation of the national drug policy and related supporting measures play an important role in improving the accessibility of essential medicines.

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has indicated that cladribine tablets reduce the frequency and severity of relapses and delay disability progression compared to current standard of care. OBJECTIVES: To evaluate the cost-effectiveness of cladribine tablets compared to alternative options in the treatment of RRMS patients with high disease activity (HDA) and patients with rapidly evolving severe (RES) MS, in the Netherlands. METHODS: A Markov model was developed simulating costs and effects of RRMS treatment. For HDA, alemtuzumab and fingolimod were used as comparators; natalizumab was used for the RES sub-population. The analysis includes a full societal perspective, including indirect medical costs, productivity costs, costs for informal care and a value-of-information (VOI) analysis. RESULTS: For the HDA sub-population, treatment with cladribine tablets was the dominant strategy compared to alemtuzumab and fingolimod with respectively 50.9% and 98.2% probability of being cost-effective at a threshold of V50,000 per QALY gained and a net monetary benefit (NMB) of V3,860 and V150,255, respectively. For the RES subpopulation, treatment with cladribine tablets dominated treatment with natalizumab with 94.1% probability of being cost-effective at a threshold of V50,000 per QALY gained and a NMB of V123,048. The probabilistic sensitivity analyses showed significant overlap in the credible intervals for total lifetime QALY outcomes and costs of cladribine and all relevant comparators. The population-level VOI amounts to V19,295,441. CONCLUSIONS: Treatment of RRMS with cladribine tablets is cost-effective versus alemtuzumab and fingolimod in HDA patients, and cost-effective versus natalizumab in RES patients compared with current standard of care in the Netherlands, at a QALY threshold of V50,000. Cladribine tablets was dominant in all base case analyses. The probabilistic sensitivity analyses outcomes indicated that outcomes for cladribine tablets versus the comparators are surrounded by uncertainty.