Ziyad S. Almalki

Off-label use of oral fluoroquinolone antibiotics in outpatient settings in the United States, 2006 to 2012

The aim of this study was to evaluate the practice pattern of off‐label use of fluoroquinolones (FQs) in ambulatory settings and to identify the related risk factors.

Cost-effectiveness of Simvastatin Plus Ezetimibe for Cardiovascular Prevention in Patients with a History of Acute Coronary Syndrome: Analysis of Results of the IMPROVE-IT Trial

BACKGROUND Simvastatin plus ezetimibe reduced the risk of cardiovascular events in the IMProved Reduction of Outcomes: Vytorin Efficacy International (IMPROVE-IT) study. The aim of this study is to investigate the cost-effectiveness of adding ezetimibe to simvastatin treatment for patients with ACS based on the recently completed IMPROVE-IT trial. METHODS We constructed a Markov state-transition model to evaluate the costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness (ICER) associated with co-therapy compared with simvastatin alone from a health care perspective. We ran separate base-case analyses assuming a trial-length and longer term follow-up. One-way sensitivity analyses were used to explore uncertainty in model parameters. RESULTS In the trial-length model, the ICERs compared with simvastatin alone were

Access to orphan drugs in the Middle East: Challenge and perspective

114,400 per QALY for the combination therapy. In 5- and 10-year time horizons, the ICERs remained above the cost-effectiveness threshold of

Cardiovascular Events and Safety Outcomes Associated with Azithromycin Therapy: A Meta-Analysis of Randomized Controlled Trials

50,000 per QALY. In the lifetime horizon model, The ICER was

Thromboembolic Events Associated with Bevacizumab plus Chemotherapy for Patients with Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials

45,046 per QALY for combination treatment compared with simvastatin alone. The combination therapy is cost-effective at an 80% decrease in the current branded simvastatin and ezetimibe cost. Probabilistic sensitivity analysis suggested simvastatin and ezetimibe co-therapy would be a cost-effective alternative to simvastatin monotherapy 60.7% of the time. CONCLUSIONS In our trial-length, 5-year, and 10-year models, the co-therapy was not a cost-effective alternative; however, as follow-up was extended to lifetime, the co-therapy became a cost-effective treatment compared with the simvastatin monotherapy in patients with histories of ACS.

Utilization, Spending, and Price Trends for Quinolones in the US Medicaid Programs: 25 Years’ Experience 1991–2015

An orphan drug is a drug developed specifically to treat a rare medical condition. With a combined population of less than 400 million, about 2.8 million patients are estimated to be suffering from a rare disease in the Middle East. Some disorders such as hemoglobinopathy, glucose-6-phosphate dehydrogenase deficiency, autosomal recessive syndromes, and several metabolic disorders have a presence throughout the Middle East. In order to promote the treatment of these diseases, Middle Eastern governments need to facilitate education and training of healthcare personnel; develop and execute a method for obtaining and paying for orphan drugs; and, finally, provide tax, marketing, and other incentives to domestic and international firms to develop drugs specifically for the diseases of most importance to Middle Eastern patients.