OBJECTIVETo perform a pharmacoeconomic evaluation of the efficacies of therapeutic schemes involving four hepatoprotective drugs for the treatment of drug-induced liver injury (DILI).

METHODSThe principle of decision tree analysis in pharmacoeconomics was applied to perform a retrospective analysis using a meta-analyses approach to evaluate the data from randomized controlled trials of four common therapeutic schemes.The key parameters for evaluating efficacy and safety of each were identified by searching the official data, relevant literature and expert opinions, and included the parameters of consumption and unit cost with respect to a variety of health resources.

RESULTSThe hepatoprotective drug showing the greatest efficacy (4.5118) and safety for treating DILI was bicyclol; this drug also had a lower incremental cost-effectiveness ratio (ICER; 245.0118) than the other three therapeutic schemes.The tioproninenteric-coated tablet had the lowest cost (296.9536) among the four, but also had the worst efficacy (4.1352). Bicyclol had the lowest cost/benefit ratio (5.32) and ICER (4.93) among all the therapeutic schemes evaluated.Sensitivity analyses confirmed the robustness of these results.

CONCLUSIONAccording to this pharmacoeconomic evaluation, the bicyclol therapeutic strategy is the most cost-effective choice for DILI.

Chemical and Drug Induced Liver Injury ; drug therapy ; economics ; Cost-Benefit Analysis ; Cytoprotection ; Economics, Pharmaceutical ; Humans ; Retrospective Studies

Occupational diseases may be defined only medically or scientifically, and even then, their definition is not simple. However, compensable occupational diseases involve the additional layer of legal systems and social welfare policies as well. Their multifaceted nature makes determining the work-relatedness of these diseases more complex. Korea has established standards for the recognition of occupational diseases in Schedule 5 of the Enforcement Decree of the Labor Standards Act, and specific criteria for the recognition of occupational diseases are listed in Schedule 3 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act. The new list of compensable occupational diseases comprises 13 articles as an open-ended system. The newly added articles pertain to lymphohematopoietic (Article 5) and infectious diseases (Article 9), as well as diseases of other target organs. Furthermore, the article on liver diseases (Article 8) has been partially revised. The new act has been changed to clarify the meaning as it has been presented in recent research. It is necessary to achieve agreement among concerned parties, including experts from the legal, medical, and social domains to resolve the issues of work-relatedness, causation, notion of aggravation, and so on for preparing a list and a process that are more reasonable.
Adult ; Benzene/toxicity ; Communicable Diseases/*economics ; Dimethylformamide/toxicity ; Drug-Induced Liver Injury/economics ; Female ; Hematologic Diseases/chemically induced/*economics ; Humans ; Lead/toxicity ; Liver Diseases/*economics ; Male ; Middle Aged ; Occupational Diseases/*economics ; Republic of Korea ; Trichloroethylene/toxicity ; Vinyl Chloride/toxicity ; Workers' Compensation/*economics