Global & Regional Health Technology Assessment最新文献

{"title":"Analisi di Budget Impact di ponatinib per il management di pazienti affetti da leucemia mieloide cronica.","authors":"Michele Basile, Filippo Rumi, Americo Cicchetti","doi":"10.33393/grhta.2021.2238","DOIUrl":"https://doi.org/10.33393/grhta.2021.2238","url":null,"abstract":"Budget Impact analysis of ponatinib for the management of patients with chronic myeloid leukemia Background: The current clinical practice for patients affected by chronic myeloid leukemia (CML) is based on the evaluation of second generation alternatives following therapeutic failure that leads to a lengthening of patients’ management times and a consequent negative impact in terms of quality of life. Objective: To determine the economic absorption of resources associated to the management of patients with CML in a scenario in which an early recourse to ponatinib is considered as compared with a scenario based on the current Italian clinical practice characterized by a cyclical recourse to the available therapies. Methods: A Budget Impact model was developed to compare the resources absorbed in the scenarios under assessment considering a 3-year time horizon and the perspective of the Italian National Health Service. Results are expressed in terms of differential resources absorbed in the alternative scenarios. Results: The increase in the recourse to ponatinib allowed a saving of resources for the Italian NHS over the 3-year time horizon of –€ 1,979,322 (€ 825,104,350 vs € 823,125,028). The parameter affecting the most of the results achieved in the base-case is the monthly cost of bosutinib used as a third-line treatment. Conclusions: The increase in the recourse to ponatinib in patients affected by CML that failed to respond to a previous pharmacological therapy resulted to be associated to a lower level of resources’ absorption in the Italian NHS allowing to re-allocate health founds to other fields of the care sector ensuring greater sustainability of the system.","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"87-95"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/3d/grhta-8-87.PMC9616198.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valutazione delle conseguenze epidemiologiche ed economiche generate dal ritardo di trattamento dei pazienti HIV-positivi causato dalla pandemia COVID-19.","authors":"Andrea Marcellusi,&nbsp;Chiara Bini,&nbsp;Massimo Andreoni,&nbsp;Andrea Antinori,&nbsp;Francesco Saverio Mennini","doi":"10.33393/grhta.2021.2279","DOIUrl":"https://doi.org/10.33393/grhta.2021.2279","url":null,"abstract":"Objective: To assess, from an epidemiological and economic point of view, the consequences of the reduction in the supply of antiretroviral drugs due to the COVID-19 pandemic.\u0000Method: The analysis was conducted by adapting a Markov model previously published in literature. The simulations were conducted considering the possibility of continuous treatment for patients already diagnosed (no therapeutic interruptions are expected) and an immediate start of patients with new diagnosis during 2021. This analysis was compared with a scenario involving a therapeutic interruption or diagnostic delay caused by COVID-19.\u0000Results: The analysis showed that the scenario characterized by a treatment delay, compared to the scenario of early resumption of therapy, could generate an increase in the number of patients with CD4 < 200 equal to 1,719 subjects (+16%) and a reduction in the number of patients with CD4 500 equal to 6,751 (−9%). A timely resumption of treatment for HIV+ patients could prevent 296, 454 and 687 deaths in the third, fifth and tenth years of analysis respectively with a potential cost reduction equal to 78,9 million at a 10 year time horizon.\u0000Conclusions: These findings show that it is essential, especially in a pandemic situation such as the present one, to introduce technological, digital and organizational solutions, aimed at promoting timely diagnosis and at accelerating the therapeutic switch for patients who are no longer targeted.","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"147-154"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/af/grhta-8-147.PMC9616186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analisi costo-efficacia di caplacizumab nel nuovo standard of care della porpora trombotica trombocitopenica immune in Italia.","authors":"Giovanni Di Minno,&nbsp;Roberto Ravasio","doi":"10.33393/grhta.2021.2191","DOIUrl":"https://doi.org/10.33393/grhta.2021.2191","url":null,"abstract":"Cost-effectiveness analysis of caplacizumab in the new standard of care for immune Thrombotic Thrombocytopenic Purpura in Italy Objectives: To evaluate the cost-effectiveness analysis (CEA) of caplacizumab in combination with plasmapheresis (PEX) and immunosuppression compared to PEX and immunosuppression in the treatment of acute episodes of iTTP. Methods: A Markov model was used to conduct the CEA from the perspective of the hospital, over a lifetime horizon. Clinical data derived from HERCULES trial and a systematic literature review. Economic input included direct costs only. Utility and disutility values were obtained from literature. Data on healthcare resources and costs were retrieved from HERCULES trial, literature, TTP guidelines and Italian tariffs. A sensitivity analysis was conducted. The cost-effectiveness probability was tested for several options of discount levels considering a suggested willingness to pay (WTP) threshold of € 60,000 in Italy. Results: The use of caplacizumab in combination with PEX and immunosuppression is associated with a positive difference in survival of 3.27 life years (24.53 vs 21.26) and in quality of life of 3.06 QALY (22.01 vs 18.96) when compared to PEX and immunosuppression. Caplacizumab leads to an ICER per life years of € 41,653 and an ICER per QALY of € 44,572. For the suggested WTP threshold, the probability of caplacizumab being cost-effective is 82.4% (no discount), 92.8% (15% discount), 95.3% (20% discount), 96.9% (25% discount) and 98.2% (30% discount). Conclusions: Caplacizumab in addition to PEX and immunosuppression is cost-effective, allowing the hospital to achieve greater efficiency in managing the burden of a life-threatening disease such as iTTP.","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"43-52"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/43/grhta-8-43.PMC9616191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuovi criteri di definizione del prezzo di un farmaco in Italia: riflessioni e proposte per supportare valore ed innovazione.","authors":"Francesca Patarnello,&nbsp;Federico Villa","doi":"10.33393/grhta.2021.2207","DOIUrl":"https://doi.org/10.33393/grhta.2021.2207","url":null,"abstract":"The definition of criteria and processes for the submission of price and reimbursement requests (P&R) of a drug in Italy cannot be separated from the definition of an overall “Pharmaceutical Policy” that includes, in an organic vision: (i) the governance related to the research, marketing and monitoring of drugs in the Italian market; (ii) the availability of drugs on the national territory as an element included in the essential levels of care (LEA) and the related conditions in terms of timing and equity of access between different regions, as well as towards other European countries; (iii) the assessment criteria used. The decree published in the Italian Official Journal in the summer of 2020, which defines the new criteria for the regulation of P&R of medicines in Italy, focuses on the final part of the process, i.e. the price negotiation. It would be necessary to frame this last step within a broader and more organic structure of drug policies aimed at: 1. optimising healthcare funding by encouraging competition between healthcare technologies; 2. reducing assessment time by simplifying processes; 3. improving early access to drugs for unmet need; 4. increasing the quality of P&R dossiers by improving interaction with the companies; 5. encouraging innovative agreements and complementary elements to the price; 6. encouraging the reproducibility of assessment methodologies in a value-based pricing system; 7. considering cost-benefit analyses as tools for the definition of price and conditions of reimbursability; 8. creating a place for discussion on drug policies.","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"131-133"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/25/grhta-8-131.PMC9616182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10513338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs of the management of hemophilia A with inhibitors in Spain.","authors":"Santiago Bonanad,&nbsp;María Teresa Álvarez,&nbsp;Ramiro Núñez,&nbsp;José Luis Poveda,&nbsp;Beatriz Gil,&nbsp;Elena Ruíz-Beato,&nbsp;Ana Durán,&nbsp;Yoana Ivanova,&nbsp;Inés Pérez-Román,&nbsp;Almudena González-Domínguez","doi":"10.33393/grhta.2021.2234","DOIUrl":"https://doi.org/10.33393/grhta.2021.2234","url":null,"abstract":"<p><strong>Introduction: </strong>Emicizumab is a first-in-class monoclonal antibody, recently authorized for the treatment of hemophilia A with inhibitors. This study aims to estimate the direct and indirect costs of the management of hemophilia A with inhibitors, in adult and pediatric patients, including the prophylaxis with emicizumab.</p><p><strong>Methods: </strong>We calculated the costs of the on-demand and prophylactic treatments with bypassing agents (activated prothrombin complex concentrate and recombinant activated factor VII) and the emicizumab prophylaxis, from the societal perspective, over 1 year. The study considered direct healthcare costs (drugs, visits, tests, and hospitalizations), direct non-healthcare costs (informal caregivers), and indirect costs (productivity loss). Data were obtained from a literature review and were validated by an expert group. Costs were expressed in 2019 euros.</p><p><strong>Results: </strong>Our results showed that the annual costs of the prophylactic treatment per patient varied between €543,062.99 and €821,415.77 for adults, and €182,764.43 and €319,826.59 for children, while on-demand treatment was €532,706.84 and €789,341.91 in adults, and €167,523.05 and €238,304.71 in pediatric patients. In relation to other prophylactic therapies, emicizumab showed the lowest costs, with up to a 34% and 43% reduction in the management cost of adult and pediatric patients, respectively. It reduced the bleeding events and administration costs, as this drug is less frequently administered by subcutaneous route. Emicizumab prophylaxis also decreased the cost of other healthcare resources such as visits, tests, and hospitalizations, as well as indirect costs.</p><p><strong>Conclusion: </strong>In comparison to prophylaxis with bypassing agents, emicizumab reduced direct and indirect costs, resulting in cost savings for the National Health System and society.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"35-42"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/66/grhta-8-35.PMC9616192.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuity of care between hospital pharmacies and community pharmacies, and costs avoided: a pilot experience in times of COVID-19 in Spain.","authors":"Néboa Zozaya,&nbsp;Almudena González-Domínguez,&nbsp;Natividad Calvente,&nbsp;Rita de la Plaza,&nbsp;Ana Herranz,&nbsp;Antonio Blanes,&nbsp;Miguel Tamayo","doi":"10.33393/grhta.2021.2215","DOIUrl":"https://doi.org/10.33393/grhta.2021.2215","url":null,"abstract":"<p><strong>Introduction: </strong>In March 2020, due to the pandemic caused by COVID-19, a pilot experience of pharmaceutical continuity of care received by hospital outpatients was launched in Cantabria, a Spanish autonomous community. Thanks to this experience, the medication was dispensed by the hospital pharmacy through the community pharmacy of the patient's choice. Our objective was to estimate the costs avoided by this practice during the months of April and May 2020.</p><p><strong>Methods: </strong>The analysis of the economic impact was carried out in terms of saved costs, from the hospital and from the social perspective. Savings associated with the avoided home delivery of medication and avoided labor productivity losses were calculated, as well as the time associated with avoided trips in monetary terms.</p><p><strong>Results: </strong>A total of 2,249 hospital-dispensed drugs were delivered through the community pharmacy in the analyzed period, with an average of 57.7 daily deliveries. The experience, which involved one hospital and 262 pharmacies of Cantabria, saved patients 93,305 km in trips to the hospital, associated with an average time saving of 1,374 hours. In terms of costs, the hospital saved on shipments by courier, estimated at €30,205, since it was the community pharmacy and the distribution warehouses that delivered the drugs. From a social perspective, this initiative saved €23,309 due to the trips (€8,907) and productivity losses (€14,402) that were avoided.</p><p><strong>Conclusions: </strong>This exceptional situation may be a good opportunity to improve the coordination between hospital pharmacies and community pharmacies in Spain, not only during the pandemic but also in the post-COVID-19 era.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"8-13"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/04/grhta-8-8.PMC9616201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costo per responder di upadacitinib e abatacept nel trattamento dell’artrite reumatoide da moderata a grave in Italia.","authors":"Roberto Caporali,&nbsp;Roberto Ravasio,&nbsp;Paola Raimondo,&nbsp;Fausto Salaffi","doi":"10.33393/grhta.2021.2267","DOIUrl":"https://doi.org/10.33393/grhta.2021.2267","url":null,"abstract":"Cost per responder for upadacitinib vs abatacept in patients with moderate-to-severe Rheumatoid Arthritis in Italy Purpose: The objective of this economic evaluation was to compare the cost per responder between upadacitinib and abatacept (intravenous [iv] or subcutaneous [sc]) in patients with moderate-to-severe Rheumatoid Arthritis (RA) in Italy. Methods: The clinical efficacy was assessed based on SELECT-CHOICE study results. The clinical efficacy of upadacitinib and abatacept (iv or sc) was measured by Clinical Remission (CR), Low Disease Activity (LDA) and American College of Rheumatology response (ACR20, 50 and 70). The treatment cost was based on the number of administrations dispensed at 12 or 24 weeks. The cost per responder was adopted as a cost-effectiveness indicator. Results: Independent of the clinical efficacy measure used and the duration of treatment considered, the cost per responder was consistently lower for upadacitinib compared to abatacept (iv or sc) across all clinical measures. For example, considering the CR at 24 weeks, the cost per responder for upadacitinib was € 9,417 compared to € 17,817 for abatacept sc or to € 23,110 for abatacept iv. The differences in the cost per responder between upadacitinib and abatacept (iv or sc) increased when higher ACR response levels were considered. Conclusions: These results suggested that upadacitinib is a cost-effectiveness option compared to abatacept (iv or sc) from the perspective of the Italian National Health Service in patients with moderate-to-severe Rheumatoid Arthritis in Italy.","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"69-79"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/e1/grhta-8-69.PMC9616195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply to comments on \"Continuity of care between hospital pharmacies and community pharmacies, and costs avoided: a pilot experience in times of COVID-19 in Spain\".","authors":"Néboa Zozaya","doi":"10.33393/grhta.2021.2272","DOIUrl":"https://doi.org/10.33393/grhta.2021.2272","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"8 ","pages":"68"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/60/grhta-8-68.PMC9616194.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10513339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards standardization of economic evaluation research in the youth psychosocial care sector: A broad consultation in the Netherlands.","authors":"Silvia M A A Evers, Carmen D Dirksen","doi":"10.33393/grhta.2020.2143","DOIUrl":"10.33393/grhta.2020.2143","url":null,"abstract":"<p><strong>Introduction: </strong>Stakeholders are increasingly interested in the societal impact of psychosocial interventions in the youth sector, in terms of costs and quality of life, as well as in outcomes research. The aim of this broad consultation was to reach consensus regarding the steps to be undertaken to set a research agenda for the Netherlands Organisation for Health Research and Development (ZonMw) programme.</p><p><strong>Methods: </strong>The broad consultation consisted of an eight-step procedure, including the conceptualization of a consultation document consisting of a scoping review of (mainly) international opinion/methodological literature and an inventory of existing Dutch guidelines and manuals for economic evaluation, a written consultation procedure among a broad range of stakeholders, and a consultation meeting with these stakeholders.</p><p><strong>Results: </strong>In total 21 documents were included in the scoping review. A total of 24 stakeholders participated in the written consultation procedure and 14 stakeholders during the consultation meeting. The methodological issues and challenges, which were ranked in the top 5 by the stakeholders, are (i) outcome measurement, (ii) outcome identification, (iii) cost valuation, (iv) outcome valuation, and (v) time horizon/analytical approach. The existing guidelines and manuals provided guidance for some, but not all, issues and challenges.</p><p><strong>Discussion and conclusion: </strong>This broad consultation has contributed to a research agenda for the ZonMw programme, which will in the long run lead to the standardization of economic evaluations in this sector in the Netherlands and methodological improvement of economic evaluations in the Dutch youth sector.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"7 ","pages":"117-123"},"PeriodicalIF":0.4,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/fb/grhta-7-117.PMC9677588.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness and budget impact of a lifestyle intervention to improve cardiometabolic health in patients with severe mental illness.","authors":"Anne Looijmans, Frederike Jörg, Richard Bruggeman, Robert A Schoevers, Eva Corpeleijn, Talitha L Feenstra, A D I Thea van Asselt","doi":"10.33393/grhta.2020.2027","DOIUrl":"10.33393/grhta.2020.2027","url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed the cost-effectiveness and budget impact of a lifestyle intervention to improve cardiometabolic health in severe mentally ill (SMI) patients in the LION trial.</p><p><strong>Methods: </strong>Patients (n = 244) were randomized to receive either care-as-usual or a lifestyle intervention in which mental health nurses coached patients in changing their lifestyle by using a web tool. Costs and quality of life were assessed at baseline and at 6 and 12 months. Incremental costs per centimeter waist circumference (WC) lost and per Quality-Adjusted Life Year (QALY) gained were assessed. Budget impact was estimated based on three intervention-uptake scenarios using a societal and a third-party payer perspective.</p><p><strong>Results: </strong>Costs and reduction in WC were higher in the intervention (n = 114) than in the control (n = 94) group after 12 months, although not statistically significant, resulting in €1,370 per cm WC lost. QALYs did not differ between the groups, resulting in a low probability of the intervention being cost-effective in cost/QALY gained. The budget impact analysis showed that for a reasonable participation of 43%, total costs were around €81 million over 5 years, or on average €16 million annually (societal perspective).</p><p><strong>Conclusions: </strong>The intervention is not cost-effective at 12 months and the budget impact over 5 years is substantial. Possibly, 12 months was too short to implement the intervention, improve cardiometabolic health, and reduce care costs. Therefore, the incentive for this intervention cannot be found in short-term financial advantages. However, there may be benefits associated with lifestyle interventions in the long term that remain unclear.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"7 ","pages":"131-138"},"PeriodicalIF":0.4,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/1a/grhta-7-131.PMC9677596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10870302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}