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J Soto Alvarez

Publications and source records attributed to J Soto Alvarez.

At least 19 recordsLinked to original sources
PubMed2006

[Cost-effectiveness analysis of the use of atorvastatin in patients with type 2 diabetes mellitus: a pharmacoeconomic model of the CARDS study].

BACKGROUND AND OBJECTIVE: To perform a cost-effectiveness analysis of the use of Atorvastatin 10 mg in the primary prevention of cardiovascular disease in patients with type 2 diabetes (DM2). METHOD: A deterministic and retrospective model by a decision analysis based on CARDS study (Collaborative Atorvastatin Diabetes Study) was performed. In the CARDS study, a significant reduction in cardiovascular morbimortality by the use of Atorvastatin 10 mg versus placebo (5.8 vs. 9.0%, p=0.001) in DM2 patients with an additional condition, had previously been demonstrated. In the present cost-effectiveness analysis, effectiveness units were life years gained (LYG) and quality adjusted life years (QALY), obtained from differences in morbimortality and life expectancy in DM2 patients, with and without previous cardiovascular events. Costs of the evaluated alternatives were obtained from the CARDS results. RESULTS: Incremental cost-effectiveness ratio of using Atorvastin 10 mg versus placebo was 5,886 euro per LYG and 8,046 euro per QALY. Sensitivity analyses confirmed the model stability. CONCLUSIONS: In the primary prevention of the cardiovascular disease in type 2 diabetic patients, the use of Atorvastatin 10 mg is cost-effective, with a cost per LYG and per QALY below that of other alternatives widely used in the Spanish National Health System, and also below a value considered as a reasonable threshold for our country, which might unofficialy be around 30,000 euro/ QALY.

Adult↗
PubMed2001

[Cost effectiveness of the use of spironolactone in the treatment of chronic heart failure].

BACKGROUND: Chronic heart failure (CHF) is the first cause of hospitalization in elderly patients. The use of spironolactone in patients with CHF (degree III-IV) reduces their mortality and the rate of hospitalization. The aim of this study has been to assess the efficiency of using spironolactone in the treatment of CHF when compared with the use of conventional treatment alone. MATERIAL AND METHODS: The study has been performed through the design of a decision analytic model. A cost-effectiveness analysis was carried out by doing a simulation of 2 hypothetic cohorts of 1000 patients with CHF. It was evaluated the costs of each extra life year gained with each alternative under study. Data included have been obtained from Rales and the mean survival time for these patients has been considered of 4.3 years. Only direct medical costs have been included into this analysis. The chosen perspective has been the society and the time horizon included has been of 4.3 years. RESULTS: The cost/effectiveness ratio has been better in the spironolactone group (1,961,214) than in the standard treatment alone (2,242,912) and each extra life year gained when adding spironolactone to the conventional treatment yielded an additional cost of 591,457 ptas. The sensitivity analysis performed has shown that the option of using spironolactone presents always a better cost/effectiveness ratio even in the worst scenarios. CONCLUSIONS: The association of 25 mg/day of spironolactone to the conventional treatment of CHF is going to get more life years gained for these patients with a reasonable cost and clearly affordable by our National Health Service.

Cost-Benefit Analysis↗
PubMed2000

[Economic evaluation of the use of diclofenac/misoprostol in the treatment of osteoarticular diseases].

OBJECTIVE: To carry out a economic evaluation of diclofenac/misoprostol in the treatment of rheumatoid arthritis and osteoartritis when comparing with diclofenac alone, diclofenac + omeprazol, and diclofenac + ranitidine. DESIGN: Cost effectiveness analysis using a decision analytic model, where the effectiveness unit was defined as the patient free of gastro-intestinal toxicity. MATERIAL AND METHODS: The effectiveness data of the four alternatives under evaluation have been obtaining from published clinical trials. In this analysis only direct medical costs have been included without incorporating indirect costs or intangible costs. The perspective chosen has been a primary care area and the time horizon 6 months. All costs are expressed in monetary units of 1998. MEASUREMENTS AND RESULTS: The cost/effectiveness ratio obtained with diclofenac/misoprostol has been a 37% lower compared with diclofenac alone (42,238 vs 67,214 ptas), a 39% compared with diclofenac + omeprazol (42,238 vs 69,058 ptas) and a 50% compared with diclofenac + ranitidine (42,238 vs 85,198 ptas). The sensitivity analysis performed has shown that diclofenac/misoprostol is the therapeutic alternative more efficient even when most influential variables are modified. CONCLUSIONS: Diclofenac/misoprostol has demonstrated to be an alternative with a better cost/effectiveness ratio, and therefore more efficient than diclofenac alone or the concomitant use of diclofenac either with omeprazol or ranitidine. The routinary use of this association will save important resources to the National Health Service.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

[Oxidative hepatic metabolism in chronic alcoholics during the acute abstinence period: evaluation with antipyrine elimination].

In chronic alcoholics, while they consume ethanol, an increase in the oxidative hepatic metabolism is produced by means of an increment of microsomal enzymes induced by ethanol. In our study we have appraised this hepatic metabolism during the period of acute ethilic abstinence. This study has been performed in 20 chronic alcoholics without clinical symptoms, after five days free of ethanol drinks. The assessment of oxidative hepatic metabolism was realized by means of the measuring of corporal antipyrine clearance (by saliva elimination), being compared to those performed in a control group of ten healthy adults. Antipyrine clearance (5.5 +/- 2 l/h) is increased significatively in chronic alcoholics respect to the control group value (3.4 +/- 1 l/h) (p < 0.01). Elimination half-life of antipyrine in chronic alcoholic groups (7.6 +/- 3 h) is decreased significatively respect to the control group value (11.2 +/- 2 h) (p < 0.01). During the period of acute abstinence, the oxidative hepatic metabolism persists increased. In these patients, when we administer drugs with hepatic metabolism following the same metabolic way that antipyrine, it will be necessary to readjust the maintenance dose to attain its therapeutic effect.

Adult↗