RESUMO
INTRODUCTION AND OBJECTIVES: Treatment of chronic hepatitis B (CHB) with nucelos(t)ide analogues (NA) can improve outcomes, but NA treatment is expensive for insurance plans. MATERIALS AND METHODS: The Centers for Medicare & Medicaid Services database was assessed from 2012 to 2021 to assess the use of NA for CHB in patients on Medicaid. Data extracted included the number of claims, units, and costs of each agent stratified by originator and generic. RESULTS: Over the study period, 1.9 billion USD was spent on NA, with spending peaking in 2016 at $289 million US, which has subsequently decreased. Lower expenditures since 2016 have been associated with increased use of generics. The use of generic tenofovir or entecavir led to savings of $669 million US over the study period. CONCLUSIONS: Increased generic use has significantly reduced expenditures for NA drugs; policy shifts towards generic drug use may help with sustainability.
Assuntos
Antivirais , Custos de Medicamentos , Medicamentos Genéricos , Gastos em Saúde , Hepatite B Crônica , Medicaid , Humanos , Estados Unidos , Medicaid/economia , Antivirais/uso terapêutico , Antivirais/economia , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/economia , Medicamentos Genéricos/economia , Medicamentos Genéricos/uso terapêutico , Nucleosídeos/uso terapêutico , Nucleosídeos/economia , Tenofovir/uso terapêutico , Tenofovir/economia , Guanina/análogos & derivados , Guanina/uso terapêutico , Guanina/economiaRESUMO
BACKGROUND: Canine distemper (CD) is a widespread infectious disease that can severely impact a variety of species in the order Carnivora, as well as non-carnivore species such as non-human primates. Despite large-scale vaccination campaigns, several fatal outbreaks have been reported in wild and domestic carnivore populations. This, in association with expansion of the disease host range and the development of vaccine-escape strains, has contributed to an increased demand for therapeutic strategies synergizing with vaccine programs for effectively controlling canine distemper. 6-methylmercaptopurine riboside (6MMPr) is a modified thiopurine nucleoside with known antiviral properties against certain RNA viruses. METHODS: We tested the inhibitory effects of 6MMPr against a wild-type CDV strain infection in cell culture. We measured infectious particle production and viral RNA levels in treated and untreated CDV-infected cells. Ribavirin (RIB) was used as a positive control. RESULTS: Here, we report for the first time the antiviral effects of 6MMPr against canine distemper virus (CDV) in vitro. 6MMPr was able to reduce viral RNA levels and to inhibit the production of infectious CDV particles. The therapeutic selectivity of 6MMPr was approximately six times higher than that of ribavirin. CONCLUSION: Our results indicate that 6MMPr has high anti-CDV potential and warrants further testing against other paramyxoviruses, as well as clinical testing of the compound against CDV.
Assuntos
Antivirais/farmacologia , Vírus da Cinomose Canina/efeitos dos fármacos , Vírus da Cinomose Canina/fisiologia , Metiltioinosina/farmacologia , Viabilidade Microbiana/efeitos dos fármacos , Animais , Linhagem Celular , CãesRESUMO
Es un análogo nucleósido de guanosina con actividad selectiva contra hepatitis B, que ha surgido como una opción terapéutica en pacientes que desarrollan resistencia a la lamivudina con un perfil de seguridad similar a esta, encontrándose prácticamente ausencia de resistencia en casos de tratamiento por 1 año con una dosis de 1mg/día.
It is a nucleoside analogue of guanosine with selective activity against hepatitis B. It has come out as a therapeutic option for patients who develop resistance to Lamivudine with a security profile similar to this medicine. There is absence of resistance in case of 1 year treatments with a dosage of 1mg/day.
Assuntos
Humanos , Guanosina Difosfato/administração & dosagem , Vírus da Hepatite BRESUMO
Es un análogo nucleósido sintético de la timidina, cuyo nombre químico es 1-( 2-deoxy-ß-L-ribofuranosyl)-5metiluracil, y ejerce su acción a través de la inactivación de la ADN polimerasa del virus de la Hepatitis B, mediante la inhibición competitiva de su sustrato natural , el 5-trifosfato timidina. Fue recientemente aprobado por el FDA para el tratamiento de la hepatitis B.
Telbivudine´s chemical name is 1-(2-deoxy-ß-Lribofuranosyl)-5-metiluracil. It is a synthetic nucleoside analogue of timidine with activity against HBV DNA Polymerase by competing with the natural substrate, timidine 5-triphosphate. It was recently approved by the FDA for hepatitis B treatment.