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Yang Y.,REAL WORLD | Du F.,China Pharma | Ye W.,Eli Lilly and Company | Chen Y.,Lilly Suzhou Pharmaceutical Co. | And 4 more authors.
ClinicoEconomics and Outcomes Research | Year: 2015

Purpose: The objective of this study was to provide new estimates on the per-admission inpatient hospital cost and per-admission length of stay (LOS) for osteoporosis-related fractures in mainland China. Materials and methods: Data for inpatient hospitalization associated with at least one osteoporosis-related fracture were obtained from the nationwide China Health Insurance Research Association and were analyzed post hoc. Patients’ data were included if the patients were ≥50 years old and diagnosed with osteoporosis and pathologic fracture, or osteoporosis therapy and fragility fracture by an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code designation, between 2008 and 2010. Results: The analysis included 830 patients (female: 77.3%; mean age: 73.4±9.8 years). The medians of the per-admission LOS and inpatient costs were 19 days and ¥18,587, respectively. Longer LOS and higher costs per admission were associated with older patients (≥70 years) compared to younger patients (<70 years). Hip fracture had the longest median LOS (22 days) and highest median cost (¥32,594) among all fracture sites. The per-hospitalization episode and per-day costs of osteoporotic fracture increased rapidly (60% and 89%, respectively) between 2008 and 2010. Conclusion: The analysis showed that hospitalization cost increases were associated with increasing per-day hospitalization costs. The proportion of the costs reimbursed by health insurances increased, while the mean absolute patient copayment amounts decreased. The incidence and prevalence of osteoporosis and osteoporosis-related fractures may rise rapidly due to the projected growth of the aged population in mainland China. Therefore, the combination of greater anticipated total fractures and rising hospital costs may lead to a tremendously increased economic burden in the future. © 2015 Yang et al. Source


Cui Y.-M.,Peking University | Wang Z.-N.,Peking University | Chen X.-W.,Lilly Suzhou Pharmaceutical Co. | Zhang H.-L.,Peking University | And 2 more authors.
Acta Pharmacologica Sinica | Year: 2012

Aim: To characterize the pharmacokinetics (PKs), pharmacodynamics (PDs), and tolerability of different dose regimens of prasugrel in healthy Chinese subjects. Methods: This was a single-centered, open-label, parallel-design study. Subjects received a single loading dose (LD) of prasugrel followed by once-daily maintenance dose (MD) for 10 d. They were enrolled into 3 groups: 60 mg LD/10 mg MD; 30 mg LD/7.5 mg MD; 30 mg LD/5 mg MD. Blood samples were collected after the first and last dose. The serum concentration of the active metabolite of prasugrel was determined using a LC/MS/MS method. Platelet aggregation was assessed using the VerifyNow-P2Y 12 assay. Results: Thirty-six healthy native Chinese subjects (19 males) aged 18-45 were enrolled; mean age and body weight were similar across the treatment groups (n=12 for each). The metabolite AUC 0-4 and C max increased dose-proportionally across the dose range of 5 mg to 60 mg. The median T max was 0.5 h in all groups. The PD parameters, indicated by the inhibition of ADP-induced platelet aggregation, were met more rapidly in the 60 mg group than the 30 mg group after the LD (94%-98%). This high degree of inhibition of platelet aggregation was maintained following the 10 mg MD (87%-90%) and was lower in the 7.5 mg and 5 mg MD groups (79%-83% and 64%-67%, respectively). Prasugrel was well tolerated in healthy Chinese subjects for single doses up to 60 mg and a MD of 10 mg for 10 d. Conclusion: The PKs and PDs of the active metabolite of prasugrel were similar to those in Chinese subjects reported by a previous bridging study, which demonstrated that the exposure to the active metabolite in Chinese subjects was higher than in Caucasians. © 2012 CPS and SIMM All rights reserved. Source


Ye W.,Lilly Suzhou Pharmaceutical Co. | Ascher-Svanum H.,Eli Lilly and Company | Flynn J.A.,Eli Lilly and Company | Tanji Y.,Eli Lilly and Company | Takahashi M.,Eli Lilly and Company
ClinicoEconomics and Outcomes Research | Year: 2012

Purpose: Although expert guidelines for the treatment of schizophrenia recommend antipsychotic monotherapy, the use of antipsychotic polypharmacy is common. This study identified characteristics that differentiate patients with schizophrenia who are treated with olanzapine monotherapy versus polypharmacy in usual care in Japan. Patients and methods: In a large (N = 1850) prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Consistent with past research, antipsychotic polypharmacy was defined as the concurrent use of olanzapine and another antipsychotic for at least 60 days. Switching was defined as discontinuing a prior antipsychotic therapy rather than augmenting the medication regimen. Predictors of antipsychotic monotherapy were based on information available at the time of olanzapine initiation. Baseline characteristics were compared using t-tests and χ 2 tests. Stepwise logistic regression was used to identify independent predictors of monotherapy. Results: Patients treated with olanzapine monotherapy (43.2%) differed from those treated with antipsychotic polypharmacy (56.8%) on demographics, treatment history, baseline symptom levels, functional levels, and treatment-emergent adverse events. Stepwise logistic regression identified multiple variables that significantly predicted monotherapy: older age, shorter duration of schizophrenia, outpatient status, comorbid medical conditions, lower body mass index, no prior anticholinergic use, no prior mood stabilizer use, and switching from a previous antipsychotic (typical or atypical). Conclusion: Consistent with prior research in Japan, antipsychotic polypharmacy appears to be common in the treatment of schizophrenia. Patients treated with monotherapy could be differentiated from those treated with antipsychotic polypharmacy based on a specific set of demographic and baseline clinical characteristics. © 2012 Ye et al. Source


Ye W.,Lilly Suzhou Pharmaceutical Co. | Ascher-Svanum H.,Eli Lilly and Company | Tanji Y.,Eli Lilly and Company | Flynn J.A.,Eli Lilly and Company | And 2 more authors.
Neuropsychiatric Disease and Treatment | Year: 2012

Purpose: Antipsychotic monotherapy is often recommended over antipsychotic polypharmacy because of fewer adverse events, reduced treatment complexity, and lower medication cost. This study compared the rate and the duration of antipsychotic monotherapy following initiation of olanzapine or risperidone in the treatment of outpatients with schizophrenia in Japan. Methods: Outpatients diagnosed with schizophrenia in the Japan Medical Data Center database were identified using International Statistical Classification of Diseases and Related Health Problems, 10th Revision, diagnosis codes. Patients were between 20 and 65 years old, initiated on olanzapine or risperidone therapy between August 2003 and July 2008, and continuously enrolled during the 6 months prior to and the 12 months following the initiation date. Antipsychotic polypharmacy was defined as concurrent use of two or more antipsychotics. The probability of monotherapy during the 12-month follow-up period was assessed using a propensity score-adjusted generalized estimating equation model. Duration of monotherapy was contrasted using a propensity score-adjusted bootstrapping model. Results: After applying all inclusion and exclusion criteria, the final analytic sample consisted of 332 olanzapine- and 496 risperidone-treated outpatients. At treatment initiation, 61.5% of the olanzapine-treated patients and 45.6% of the risperidone-treated patients received antipsychotic monotherapy (P, 0.001). After correcting for background differences, monotherapy was more common among olanzapine-treated patients (P = 0.001). In addition, olanzapine was used as monotherapy for a longer duration (P = 0.006). Conclusion: Consistent with prior global research, this retrospective naturalistic study of schizophrenia outpatients in Japan found that olanzapine is more likely to be used as monotherapy and to be used as monotherapy for a longer duration than risperidone. © 2012 Ye et al. Source


Wang Y.,Peking Union Medical College | Chen J.,Central South University | Wu S.,Central South University | Hu C.,Central South University | And 6 more authors.
BMC Cancer | Year: 2015

Background: Real-world evidence lacks for clinical effectiveness and clinical toxicity associated with platinum-based doublets in the first-line setting for advanced non-squamous non-small cell lung cancer (advNS-NSCLC) in Chinese patients. Methods: Patients receiving first-line chemotherapy for advNS-NSCLC in four Chinese tertiary care hospitals from 2007 to 2012 were retrospectively identified for chart review. Propensity score methods created best matched pairs for platinum/pemetrexed versus other platinum-based doublets for head-to-head comparisons of early treatment discontinuation (completed treatment cycles <4), treatment failure (progressive disease or early treatment discontinuation), and adverse events (AE). Conventional multiple logistic regression analyses were also performed to confirm the impact of the studied platinum-based doublets on early treatment discontinuation, treatment failure, and hematological AE using vinorelbine/platinum as reference. Results: 1,846 patients were included to create propensity score matched treatment groups for platinum/pemetrexed versus docetaxel (95 pairs), paclitaxel (118 pairs), gemcitabine (199 pairs), and vinorelbine (72 pairs)-contained doublet, respectively. Platinum/pemetrexed was associated with significantly lower risks of early treatment discontinuation (odds ratio (OR) ranged from 0.239, p = 0.001 relative to platinum/docetaxel to 0.389, p = 0.003 relative to platinum/paclitaxel) and treatment failure (OR ranged from 0.257, p < 0.001 relative to platinum/paclitaxel to 0.381, p < 0.001 relative to platinum/gemcitabine) than the other four studied doublets. Platinum/pemetrexed was also associated with several significantly lower hematological AE rates, such as versus platinum/paclitaxel (any hematological AE: OR 0.508, p = 0.032), platinum/gemcitabine (i.e., any hematological AE: OR 0.383, p < 0.001; anemia: OR 0.357, p < 0.001; thrombocytopenia: OR 0.345, p < 0.001) or platinum/vinorelbine (i.e., neutropenia: OR 0.360, p = 0.046; anemia: OR 0.181, p = 0.014) in matched patients. Further conventional logistic regression analyses indicated that pemetrexed/platinum was ranked lowest for the risks of early treatment discontinuation (OR 0.326, p < 0.001), treatment failure (OR 0.460, p < 0.001), and any hematological AE (OR 0.329, p < 0.001). Conclusions: Pemetrexed plus platinum had significantly superior clinical effectiveness as compared to the other platinum-based doublets with third-generation cytotoxic agents and was also associated with several lower hematological toxicity rates than gemcitabine or vinorelbine-based doublet in the first-line setting for advNS-NSCLC in Chinese patients. © 2014 Wang et al.; licensee BioMed Central Ltd. Source

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