Losartan 25 mg cost $20.00/mg as a single-dose treatment, while the 2.5-mg pill cost $7.00/mg, only a fraction of the cost two tablets being offered in the emergency setting (assuming no co-payment due). This discrepancy may or not account for the apparent cost where to buy losartan 50 mg savings attributable to the "faster" single-dose approach. A total of four tablets cost $36.00. The cost-value analysis showed that initial emergency-use dose of 15 mg salbutamol resulted in an additional cost for the patient of $18.00 (30%) versus what it would have cost the patient if had taken two tablets in the emergency setting ($7.00/tablet) [22]. Table 2 summarizes patients receiving an emergency-use dose with no co-payment and patients who were paying for two or more co-payments. In total, a total of 13 patients receiving an emergency-use dose paid for one tablet each and losartan generic cost 11 patients who received two tablets each paid for tablets. Most (65%) patients receiving two or more co-payments were found to have paid only one co-payment, a significant best cheap drugstore eyebrow pencil (but not significantly more than expected) proportion (21%) would not have been expected to pay any co-payments even if the drug had been made available through the VA private pay system [22]. Table Safest site for viagra online 2 Patients with and without co-payments Source of Funding Per Visit Total Cost month $100 x 6 months Monthly Cost $19.85 $39.35 $71.00 Time in office, no co-pay 25 mg $19.65 $35.90 $68.60 Time in office, co-pay $10.65 20.05 0.25 $13.08 Time after office, no co-pay 25 mg $711.64 $638.84 $12,541.20 Time after office, co-pay $10.65 20.05 0.25 $13.08 Time after office, co-pay 25 mg $711.64 $ 6,073.00 $3,984.48 Time after office, co-pay $10.65 20.05 0.25 $13.08 Time after office, no co-pay 25 mg $711.64 $ 726.08 $2,024.64 Time after office, co-pay $10.65 20.05 0.25 $13.08 Time after office, Valtrex order online uk no co-pay 25 mg $711.64 $ 702.08 $2,735.80 Time after office, co-pay $10.65 20.05 0.25 $13.08 Time after office, co-pay 25 mg $711.64 $ 835.30 $3,634.40 Time after office, co-pay $10.65 20.05 0.25 $13.08 Total cost to date $3,878.64 $2,099.40 $5,378.84 Net Cost to date $3,878.64 $2,099.40 $5,378.84 Savings $16.96 1,024.78 2,256.35
Conclusion Patients with life-threatening hypertension are being treated with salmeterol even though two-thirds of patients experience severe adverse events. The cost to government for use of salmeterol, even under a single-dose emergency service, is more than three times higher that of two active monitoring studies in which it is recommended that all patients be given a double-blind placebo during similar emergency-department visit. There are two primary problems associated with the drug: first, cost to government would be three times higher if non-VA institutions purchased it, and second, the vast majority of patients will not have any co-payment, as the program is being implemented under a mandate of federal legislation. There are several factors that may address these issues: open public source drug purchasing (that is, "buying at scale"), increased public awareness of the program and cost, and/or new insurance plans. In order to achieve adequate resources for this new program the VA should require that drug be available through the VA or be a cost-reduced benefit available through private insurance as a single-dose-only drug. Because salmeterol is not routinely prescribed for the treatment of hypertension, it is difficult to evaluate its appropriateness in this setting. Additionally, without an effective non-opioid alternative to prevent water retention, the cost savings that may be achieved through other methods, such as improved hypertension management (such better of hypoalbuminemia and renal function with more aggressive therapy) or the provision of non-retaining hypertension medications (such as phenasone), is unlikely to be large enough justify the cost of salmeterol for general population.
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