Stockholm County Council

About: Stockholm County Council is a government organization based out in Stockholm, Sweden. It is known for research contribution in the topics: Population & Poison control. The organization has 1410 authors who have published 2429 publications receiving 78936 citations.

Dabigatran - a continuing exemplar case history demonstrating the need for comprehensive models to optimize the utilization of new drugs.

Abstract: Background: There are potential conflicts between authorities and companies to fund new premium priced drugs especially where there are effectiveness, safety and/ or budget concerns. Dabigatran, a new oral anticoagulant for the prevention of stroke in patients with non-valvular atrial fibrillation (AF), exemplifies this issue. Whilst new effective treatments are needed, there are issues in the elderly with dabigatran due to variable drug concentrations, no known antidote and dependence on renal elimination. Published studies showed dabigatran to be cost-effective but there are budget concerns given the prevalence of AF. These concerns resulted in extensive activities pre- to post-launch to manage its introduction. Objective: To (i) review authority activities across countries, (ii) use the findings to develop new models to better manage the entry of new drugs, and (iii) review the implications based on post-launch activities. Methodology: (i) Descriptive review and appraisal of activities regarding dabigatran, (ii) development of guidance for key stakeholder groups through an iterative process, (iii) refining guidance following post launch studies. Results: Plethora of activities to manage dabigatran including extensive pre-launch activities, risk sharing arrangements, prescribing restrictions and monitoring of prescribing post launch. Reimbursement has been denied in some countries due to concerns with its budget impact and/or excessive bleeding. Development of a new model and future guidance is proposed to better manage the entry of new drugs, centring on three pillars of pre-, peri- and post-launch activities. Post-launch activities include increasing use of patient registries to monitor the safety and effectiveness of new drugs in clinical practice. Conclusion: Models for introducing new drugs are essential to optimise their prescribing especially where concerns. Without such models, new drugs may be withdrawn prematurely and/ or struggle for funding.

Outcome of Rubella during Pregnancy with Special Reference to the 17th-24th Weeks of Gestation

Abstract: The consequences of rubella during pregnancy were studied with special reference to infections occurring during the 17th to 24th weeks of gestation. Laboratory confirmed rubella infected pregnancies were followed and the infants were examined clinically and serologically at a mean age of 20 months. In addition children born to mothers with verified rubella in earlier epidemics were examined clinically at the age of 4 or 7 yr. 491 cases of rubella in pregnant women from 1978–1980 were reported and 118 children were followed-up. Intrauterine transmission occurred in >50% during the 16 first weeks of pregnancy compared to in 17% during the 21st to 24th weeks. Rubella defects appeared in a declining rate from 5/6 congenitally infected during the first 12 weeks to 1/7 at weeks 15 and 16. Three cases with deafness were found among the 65 children from earlier epidemics. Only 1 child with hearing impairment was found among children whose mothers were infected after the 16th week. Although rubella infections duri...

Experiences of living with asthma – a focus group study with adolescents and parents of children with asthma

Abstract: Objective: The goal for asthma treatment is that every individual, so far as possible, shall live without symptoms and exacerbations. Patients and health care professionals sometimes have different ...