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  • SAGE Publications  (3)
  • 1
    Online Resource
    Online Resource
    Disability compensation and responsibility
    SAGE Publications ; 2010
    In:  Politics, Philosophy & Economics Vol. 9, No. 4 ( 2010-11), p. 411-427
    Details
    In: Politics, Philosophy & Economics, SAGE Publications, Vol. 9, No. 4 ( 2010-11), p. 411-427
    Abstract: It is a central political goal to secure disabled individuals the same opportunities as others to pursue their conception of a good life. This goal reflects an ambition to combine an egalitarian and a liberal moral intuition. In this article, we analyse how disabled individuals who take part in economic activity should be compensated in order to respect these two intuitions. The article asks how a system of disability compensation should be structured and what the level of such compensation should be. It also analyses how the answers to these questions depend on whether the disabled individuals are held responsible for their choice of work effort.
    Type of Medium: Online Resource
    ISSN: 1470-594X , 1741-3060
    URL: Article
    DOI: 10.1177/1470594X09359154
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2084315-X
    SSG: 5,1
    SSG: 3,6
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Implementation of transcatheter aortic valve insertion (TAVI) in clinical practice: An ethical analysis
    SAGE Publications ; 2014
    In:  Clinical Ethics Vol. 9, No. 2-3 ( 2014-06), p. 96-103
    Details
    In: Clinical Ethics, SAGE Publications, Vol. 9, No. 2-3 ( 2014-06), p. 96-103
    Abstract: The objective of this article is to provide an ethical analysis of a high-risk, advanced treatment case where the patient received transcatheter aortic valve insertion (TAVI), for aortic valve stenosis. Particular emphasis will be placed upon the significance of evidence and the implications for priority setting. Method One paradigmatic case involving a TAVI patient from a large university hospital in Norway is described and analysed. The method used was ethical case analysis modified after Kymlicka by Miljeteig et al. Perioperative mortality risk was estimated using the Euroscore risk-logarithm and the Society of Thoracic Surgeons’ risk model, STS. These predict the risk of operative mortality and morbidity associated with adult cardiac surgery. GRADE, the Grading of Recommendations Assessment, Development and Evaluation, was used to evaluate the evidence. Results In the case analysis, we found that it would be ethically justifiable not to recommend TAVI treatment for this patient. Although the patient had a severe condition in need of treatment, the expected improvement was marginal, the quality of evidence was low and the opportunity costs for other patients and society were higher than usually deemed appropriate. Conclusions Decision-making in the absence of high quality evidence from randomized trials is a complex process involving difficult ethical judgments. Novel high-risk devices often enter the European market with limited clinical evidence. Transparency and improved clinical evaluation are required so patient safety is not jeopardized. We argue that implementation of high risk, high cost interventions should be better regulated at a national level. Background All clinical decisions imply priority setting and therefore indirectly affect other patients and other patient groups. The use of expensive, innovative health technologies has an affect on individual patients as well as on other patient groups competing for the same resources.
    Type of Medium: Online Resource
    ISSN: 1477-7509 , 1758-101X
    URL: Article
    DOI: 10.1177/1477750914546761
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2231775-2
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Cost-Effectiveness of Saxagliptin Compared With Glibenclamide as a Second-Line Therapy Added to Metformin for Type 2 Diabetes Mellitus in Ethiopia
    SAGE Publications ; 2021
    In:  MDM Policy & Practice Vol. 6, No. 1 ( 2021-01), p. 238146832110057-
    Details
    In: MDM Policy & Practice, SAGE Publications, Vol. 6, No. 1 ( 2021-01), p. 238146832110057-
    Abstract: Background. Metformin is a widely accepted first-line pharmacotherapy for patients with type 2 diabetes mellitus (T2DM). Treatment of T2DM with glibenclamide, saxagliptin, or one of the other second-line treatment agents is recommended when the first-line treatment (metformin) cannot control the disease. However, there is little evidence on the additional cost and cost-effectiveness of adding second-line drugs. Therefore, this study aimed to estimate the cost-effectiveness of saxagliptin and glibenclamide as second-line therapies added to metformin compared with metformin only in T2DM in Ethiopia. Methods. This cost-effectiveness study was conducted in Ethiopia using a mix of primary data on cost and best available data from the literature on the effectiveness. We measured the interventions’ cost from the providers’ perspective in 2019 US dollars. We developed a Markov model for T2DM disease progression with five health states using TreeAge Pro 2020 software. Disability-adjusted life year (DALY) was the health outcome used in this study, and we calculated the incremental cost-effectiveness ratio (ICER) per DALY averted. Furthermore, one-way and probabilistic sensitivity analysis were performed. Results. The annual unit cost per patient was US$70 for metformin, US$75 for metformin + glibenclamide, and US$309 for metformin + saxagliptin. The ICER for saxagliptin + metformin was US$2259 per DALY averted. The ICER results were sensitive to various changes in cost, effectiveness, and transition probabilities. The ICER was driven primarily by the higher cost of saxagliptin relative to glibenclamide. Conclusion. Our study revealed that saxagliptin is not a cost-effective second-line therapy in patients with T2DM inadequately controlled by metformin monotherapy based on a gross domestic product per capita per DALY averted willingness-to-pay threshold in Ethiopia (US$953).
    Type of Medium: Online Resource
    ISSN: 2381-4683 , 2381-4683
    URL: Article
    DOI: 10.1177/23814683211005771
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2861432-X
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