ClinicoEconomics and Outcomes Research最新文献

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Timeliness of Health Technology Assessments and Price Negotiations for Oncology Drugs in Canada 加拿大肿瘤药物卫生技术评估和价格谈判的及时性
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-05-01 DOI: 10.2147/ceor.s462872
Nigel Rawson, David Stewart
{"title":"Timeliness of Health Technology Assessments and Price Negotiations for Oncology Drugs in Canada","authors":"Nigel Rawson, David Stewart","doi":"10.2147/ceor.s462872","DOIUrl":"https://doi.org/10.2147/ceor.s462872","url":null,"abstract":"","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":" 21","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-Utility Analysis Comparing Pegcetacoplan to Anti-C5 Monoclonal Antibodies in the Treatment of Paroxysmal Nocturnal Hemoglobinuria. 在治疗阵发性夜间血红蛋白尿中比较培加氯普兰和抗 C5 单克隆抗体的成本效用分析。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-04-11 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S442906
Sergio Di Matteo, Roberto Freilone, Giacomo Matteo Bruno, Rosario Notaro, Sabrin Moumene, Nicoletta Martone, Cristina Teruzzi, Antonio Ciccarone, Giorgio Lorenzo Colombo
{"title":"Cost-Utility Analysis Comparing Pegcetacoplan to Anti-C5 Monoclonal Antibodies in the Treatment of Paroxysmal Nocturnal Hemoglobinuria.","authors":"Sergio Di Matteo, Roberto Freilone, Giacomo Matteo Bruno, Rosario Notaro, Sabrin Moumene, Nicoletta Martone, Cristina Teruzzi, Antonio Ciccarone, Giorgio Lorenzo Colombo","doi":"10.2147/CEOR.S442906","DOIUrl":"https://doi.org/10.2147/CEOR.S442906","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal nocturnal hemoglobinuria is a rare, acquired disease characterized by hemolytic episodes and associated with significant clinical burden. The introduction of C5 inhibitory monoclonal antibodies (C5i) represented a major breakthrough in PNH treatment, effectively reducing intravascular hemolysis (IVH) but showing limited impact on extravascular hemolysis (EVH). In 2021, the C3 inhibitor pegcetacoplan was approved by EMA and recently reimbursed in Italy, which also has the advantages in the reduction of both IVH and EVH, increasing hemoglobin values and simultaneously improving the quality of life and fatigue of patients. A cost-utility analysis was developed to compare pegcetacoplan to C5i (eculizumab and ravulizumab) in the PNH population who remain anemic after treatment with C5i for at least 3 months.</p><p><strong>Materials and methods: </strong>The analysis employed a Markov model with a 5-year time horizon whereby patients can transition among 3 PNH health states, adopting the perspective of the Italian NHS. Efficacy data were sourced from the PEGASUS study, with drug prices reflecting ex-factory costs. Additionally, costs associated with resource utilization, adverse events, and complications were estimated based on outpatient and hospital care rates, excluding indirect expenses. Utility and disutility values related to transfusions were also considered, with pegcetacoplan allowing for dose escalation.</p><p><strong>Results: </strong>The cumulative cost of treatment per individual patient at 5 years was estimated to be €1,483,454 for pegcetacoplan, €1,585,763 for eculizumab, and €1,574,826 for ravulizumab. Pegcetacoplan demonstrated a superior increase in quality-adjusted life years (QALYs) compared to both eculizumab (0.51 increase) and ravulizumab (0.27 increase). Furthermore, pegcetacoplan showed a reduction in complication management costs (€22,891 less compared to eculizumab and €22,611 less compared to ravulizumab) and lower transfusion-related expenses (€14,147 less than both C5i treatments).</p><p><strong>Conclusion: </strong>Pegcetacoplan emerged as the dominant strategy in this analysis, being more effective, less expensive and improves quality of life in the analyzed population affected by PNH.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"225-232"},"PeriodicalIF":2.1,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862689","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}
引用次数: 0
Cost-Savings Associated with Multi-Disciplinary Team Approach for Reducing Macrovascular and Microvascular Complications in Patients with Type 2 Diabetes: A Predictive Model. 多学科团队减少 2 型糖尿病患者大血管和微血管并发症的成本节约:预测模型。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-04-04 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S451739
Abdulmajeed Alshowair, Saleh Altamimi, Faisal A Alruhaimi, Saad Alshahrani, Fatima Alsuwailem, Mona Alkhaldi, Haiam Abdalla, Fahad Hamad Alkhuraiji, Montaser Saad Alaqeel, Salman Sulaiman Almureef, Salman Alhawasy, Amro Abdel-Azeem
{"title":"Cost-Savings Associated with Multi-Disciplinary Team Approach for Reducing Macrovascular and Microvascular Complications in Patients with Type 2 Diabetes: A Predictive Model.","authors":"Abdulmajeed Alshowair, Saleh Altamimi, Faisal A Alruhaimi, Saad Alshahrani, Fatima Alsuwailem, Mona Alkhaldi, Haiam Abdalla, Fahad Hamad Alkhuraiji, Montaser Saad Alaqeel, Salman Sulaiman Almureef, Salman Alhawasy, Amro Abdel-Azeem","doi":"10.2147/CEOR.S451739","DOIUrl":"https://doi.org/10.2147/CEOR.S451739","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to predict the expected cost savings associated with implementing a multidisciplinary team (MDT) approach to reduce macrovascular and microvascular complications among patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>This economic evaluation study was conducted in Riyadh First Health Cluster, Saudi Arabia as a predictive model conceptualized by the authors based on models used in previous studies, particularly the CORE Diabetes Model. Our model was designed based on 1) the level of glycemic control among 24,755 T2DM patients served by MDTs; 2) the expected incidence of diabetes-related complications without intervention; 3) the predicted risk reduction of developing diabetes-related complications with MDTs. Costs of complications and cost savings were then calculated and expressed as mean incremental annual cost savings adjusted for a 1% reduction in HbA1c, and a 10 mmHg reduction in systolic blood pressure (SBP).</p><p><strong>Results: </strong>Along with the expected reduction in all diabetes-related complications, the average incremental cost savings per diabetic patient is predicted to be ($38,878) with approximately ($11,108) in the year of complication onset and ($27,770) over the subsequent post-index 10-years. On adjustment of cost savings, the average incremental cost savings are predicted to be ($22,869) for each 1% reduction in HbA1c per diabetic patient and ($27,770) for every 10 mmHg reduction in SBP per diabetic patient.</p><p><strong>Conclusion: </strong>MDT as a model of care is effective in glycemic control among T2DM patients with a predicted significant reduction of all diabetes-related complications and in turn, a predicted significant cost savings.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"211-223"},"PeriodicalIF":2.1,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872681","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}
引用次数: 0
Willingness to Pay for Social Health Insurance Among Health Care Professionals in North Wollo Zone, Amhara Region, Ethiopia: Mixed Method Study [Retraction]. 埃塞俄比亚阿姆哈拉地区北沃洛区医护人员的社会医疗保险支付意愿:混合方法研究[撤回]。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-04-03 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S471182
{"title":"Willingness to Pay for Social Health Insurance Among Health Care Professionals in North Wollo Zone, Amhara Region, Ethiopia: Mixed Method Study [Retraction].","authors":"","doi":"10.2147/CEOR.S471182","DOIUrl":"https://doi.org/10.2147/CEOR.S471182","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.2147/CEOR.S421461.].</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"209-210"},"PeriodicalIF":2.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10999210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855551","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}
引用次数: 0
Racial and Ethnic Differences in Initiation and Discontinuation of Antiarrhythmic Medications in Management of Atrial Fibrillation. 在心房颤动治疗中开始和停用抗心律失常药物的种族和民族差异。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-03-27 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S457992
Ryan Kipp, Lee-Or Herzog, Rahul Khanna, Dongyu Zhang
{"title":"Racial and Ethnic Differences in Initiation and Discontinuation of Antiarrhythmic Medications in Management of Atrial Fibrillation.","authors":"Ryan Kipp, Lee-Or Herzog, Rahul Khanna, Dongyu Zhang","doi":"10.2147/CEOR.S457992","DOIUrl":"10.2147/CEOR.S457992","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with considerable morbidity and mortality. Timely management and treatment are critical in alleviating AF disease burden. There is significant heterogeneity in patterns of AF care. It is unclear whether there are racial and ethnic differences in treatment of AF following antiarrhythmic drug (AAD) prescription.</p><p><strong>Methods: </strong>Using the Optum Clinformatics Data Mart-Socioeconomic Status database from January, 2009, through March, 2022, multivariable logistic regression techniques were used to examine the impact of race and ethnicity on rate of AAD initiation, as well as receipt of catheter ablation within two years of initiation. We compared AAD discontinuation rate by race and ethnicity groups using Cox regression models. Log-rank analyses were used to examine the rate of AF-related hospitalization.</p><p><strong>Results: </strong>Among 143,281 patients identified with newly diagnosed AF, 30,019 patients (21%) were initiated on an AAD within 90 days. Patients identified as Non-Hispanic Black (NHB) were significantly less likely to receive an AAD compared to Non-Hispanic White patients (NHW) (Odds Ratio [OR] 0.90, 95% confidence interval [CI] 0.85-0.94). Compared to NHW, Hispanic (Hazard Ratio [HR] 1.08, 95% CI 1.02-1.14) and Asian patients (HR 1.17, 95% CI 1.06-1.29) have a higher rate of AAD discontinuation. Following AAD initiation, NHB patients were significantly more likely to have an AF-related hospitalization (p < 0.01). However, NHB patients were significantly less likely to receive ablation compared to NHW (HR 0.83, 95% CI 0.70-0.97), and less likely to change AAD (p < 0.01).</p><p><strong>Conclusion: </strong>Patients identified as NHB are 10% less likely to receive an AAD for treatment of newly diagnosed AF. Compared to NHW, Hispanic and Asian patients were more likely to discontinue AAD treatment. Once initiated on an AAD, NHB patients were significantly more likely to have an AF -related hospitalization, but were 17% less likely to receive ablation compared to NHW patients. The etiology of, and interventions to reduce, these disparities require further investigation.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"197-208"},"PeriodicalIF":2.1,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337167","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}
引用次数: 0
Evaluating Health Expenditure Trends and Disease Burden in India: A Cost per DALY Approach. 评估印度的卫生支出趋势和疾病负担:每 DALY 成本法》。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-03-26 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S452679
Bhavani Shankara Bagepally, Sajith Kumar S, Akhil Sasidharan
{"title":"Evaluating Health Expenditure Trends and Disease Burden in India: A Cost per DALY Approach.","authors":"Bhavani Shankara Bagepally, Sajith Kumar S, Akhil Sasidharan","doi":"10.2147/CEOR.S452679","DOIUrl":"10.2147/CEOR.S452679","url":null,"abstract":"<p><strong>Background: </strong>Efficient allocation of healthcare resources requires a comprehensive evaluation of healthcare spending and its impact on disease burden. This study aims to estimate the costs-per disability-adjusted life years (DALY) in India. Data from 2010 to 2019 on DALYs and health expenditure per capita (HEp) for individual states in India were utilised.</p><p><strong>Design and methods: </strong>We followed the CHEERS statement 2022 to present our study's methodology and outcomes. Pearson's product-moment correlations were used to analyse associations between DALYs and HEp. A panel regression analysis was conducted using a log regression model to estimate changes in DALYs due to health expenditure changes. All costs are reported in Indian rupee (₹) along with its 95% CI, with a conversion factor of 1 US$ = ₹82.4 applied.</p><p><strong>Results: </strong>The costs-per-DALY were estimated for each state and India. DALY was negatively correlated with HEp. The estimated mean cost-per-DALY for India was ₹82,112 (₹55,810 to ₹1,08,413) [$997 ($667 to $1316)]. The mean cost per-DALY varied across states, with value of ₹27,058 (₹22,250 to ₹31,866) [$328 ($270 to $387)] for states in the first quartile based on Human Development Index (HDI) and ₹2,69,175 (₹1,05,946 to ₹4,32,404) [$3267 ($1286 to $5248)] for those in fourth HDI quartile. States such as Gujarat (0.16), Karnataka (0.17) and Maharashtra (0.22) have lower, and Arunachal Pradesh has the highest cost-per-DALY to Gross state domestic product per-capita ratio (2.41), followed by Nagaland (1.45).</p><p><strong>Conclusion: </strong>Higher healthcare investment has a lower disease burden; however, reduction in DALY varies across states. Study findings provide evidence to aid the setting up of differential willingness-to-pay thresholds across Indian states for efficient and equitable healthcare resource allocation.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"187-196"},"PeriodicalIF":2.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337165","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}
引用次数: 0
Key Performance Indicators: A Framework for Allied Healthcare Educational Institutions. 关键绩效指标:联合医疗保健教育机构框架》。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-03-26 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S446614
Jithin Sreedharan, Arun Vijay Subbarayalu, Ajayan Kamalasanan, Ibrahim Albalawi, Gokul G Krishna, Ayedh Dhafer Alahmari, Jihad A Alsalamah, Mohammed G Alkhathami, Meshal Alenezi, Abdullah S Alqahtani, Mohammed Alahmari, Michael R Phillips, JoAnne MacDonald
{"title":"Key Performance Indicators: A Framework for Allied Healthcare Educational Institutions.","authors":"Jithin Sreedharan, Arun Vijay Subbarayalu, Ajayan Kamalasanan, Ibrahim Albalawi, Gokul G Krishna, Ayedh Dhafer Alahmari, Jihad A Alsalamah, Mohammed G Alkhathami, Meshal Alenezi, Abdullah S Alqahtani, Mohammed Alahmari, Michael R Phillips, JoAnne MacDonald","doi":"10.2147/CEOR.S446614","DOIUrl":"10.2147/CEOR.S446614","url":null,"abstract":"<p><strong>Background: </strong>Performance evaluation in the allied healthcare education sector is complex, making it essential for policymakers and managers to approach it comprehensively and thoughtfully to understand their performance. Hence, the development and monitoring of Key Performance Indicators (KPIs) in this domain must be considered one of the key priorities for the policymakers in AHIs.</p><p><strong>Aim: </strong>This study aims to develop a framework for the AHIs to extract and profile the indicators, measure, and report the results appropriately.</p><p><strong>Methods: </strong>The authors adopted a general review of the literature approach to study the primary goals of the institutional KPI framework, emphasizing the need for benchmarking while implementing KPIs and how to track performance using a KPI dashboard.</p><p><strong>Results: </strong>The study provides the scope, relevant KPI categories, and a list of KPIs for evaluating the effectiveness of allied healthcare programs. The study findings also emphasized the need for benchmarking the KPIs and establishing a KPI dashboard while measuring and monitoring performance.</p><p><strong>Conclusion: </strong>KPIs are considered an invaluable tool that contributes immensely to the performance monitoring process of AHIs, irrespective of the specialties. This helps to identify and guide AHIs for developing KPIs and the associated minimum data set to measure organizational performance and monitor the quality of teaching and learning. In addition, the KPI framework reported in this study is a tool to assist performance monitoring that can subsequently contribute to the overall quality of AHIs.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"173-185"},"PeriodicalIF":2.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337166","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}
引用次数: 0
The Economic Burden of Diabetic Retinopathy in Jordan: Cost Analysis and Associated Factors. 约旦糖尿病视网膜病变的经济负担:成本分析及相关因素。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-03-15 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S454185
Rami A Al-Dwairi, Abdelwahab Aleshawi, Laith Abu-Zreig, Wafa Al-Shorman, Seren Al Beiruti, Ali Omar Alshami, Mohammed Z Allouh
{"title":"The Economic Burden of Diabetic Retinopathy in Jordan: Cost Analysis and Associated Factors.","authors":"Rami A Al-Dwairi, Abdelwahab Aleshawi, Laith Abu-Zreig, Wafa Al-Shorman, Seren Al Beiruti, Ali Omar Alshami, Mohammed Z Allouh","doi":"10.2147/CEOR.S454185","DOIUrl":"https://doi.org/10.2147/CEOR.S454185","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic retinopathy (DR) is the leading cause of visual loss worldwide in patients with diabetes mellitus (DM). The aims of our study are to describe the costs associated with (DR) and to evaluate its economic impact in Jordan.</p><p><strong>Methods: </strong>Retrospectively, we included all patients with DM and classified them according to the severity of DR. Data regarding medical history, ophthalmic history, stage of DR, presence of DME, and the ophthalmic procedures and operations were collected. The total DR-related cost was measured as a direct medical cost for the outpatient and inpatient services.</p><p><strong>Results: </strong>Two hundred and twenty-nine patients were included in the study. Only 49.7% of the patients presented without DR, and 21% presented with diabetic macular edema (DME) unilaterally or bilaterally. The DR-related cost was significantly associated with insulin-based regimens, longer duration of DM, higher HbA1c levels, worse stage of DR at presentation, the presence of DME at presentation, the presence of glaucoma, and increased mean number of intravitreal injections, laser sessions, and surgical operations. Multivariate analysis should the presenting stage of DR, presence of DME, and the presence of DME be the independent factors affecting the DR-related cost.</p><p><strong>Conclusion: </strong>This study is the first study to be conducted in Jordan and encourages us to establish a screening program for DR for earlier detection and treatment. DM control and treatment compliance will reduce the heavy costs of the already exhausted healthcare and financial system.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"161-171"},"PeriodicalIF":2.1,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10950089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177074","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}
引用次数: 0
Analysis of Medicare Patients Treated with Pimavanserin versus Other Atypical Antipsychotics: A Cost-Offset Model Evaluating Skilled Nursing Facility Stays and Long-Term Care Admissions in Parkinson's Disease Psychosis. 使用 Pimavanserin 与其他非典型抗精神病药物治疗的医疗保险患者分析:评估帕金森氏症精神病患者入住专业护理机构和长期护理的成本抵消模型。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-03-11 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S452162
Krithika Rajagopalan, Nazia Rashid, Vinod Yakkala, Dilesh Doshi
{"title":"Analysis of Medicare Patients Treated with Pimavanserin versus Other Atypical Antipsychotics: A Cost-Offset Model Evaluating Skilled Nursing Facility Stays and Long-Term Care Admissions in Parkinson's Disease Psychosis.","authors":"Krithika Rajagopalan, Nazia Rashid, Vinod Yakkala, Dilesh Doshi","doi":"10.2147/CEOR.S452162","DOIUrl":"10.2147/CEOR.S452162","url":null,"abstract":"<p><strong>Background: </strong>Patients with Parkinson's disease psychosis (PDP) treated with pimavanserin (PIM) versus other atypical antipsychotics (AAPs) including quetiapine (QUE) may have health-care cost savings due to fewer skilled nursing facility-stays (SNF-stays) and long-term care admissions (LTCA).</p><p><strong>Methods: </strong>A decision analytic model was developed using the 2019 Medicare Patient Driven Payment Model (PDPM) to estimate SNF-stays and LTCA associated per-patient- per-year (PPPY) facility and rehabilitation costs among patients that initiated PIM vs QUE or vs other-AAPs (i.e, quetiapine, risperidone, olanzapine, aripiprazole). Model inputs were derived for: (i) annual SNF-stay and LTCA rates from an analysis of Medicare beneficiaries with PDP, and (ii) annual mean rehabilitation and resident care-stay costs from PDPM case-mix adjusted value-based payment rates for 5 rehabilitation components (ie, physical-therapy, occupational-therapy, nursing, speech-language pathology, non-therapy ancillary), and an additional variable-per-diem for room/board services. PPPY costs were estimated from (i) SNF-stay and (ii) LTCA rates multiplied by annual mean costs of stay in 2022 USD. Probabilistic sensitivity analysis (PSA) was performed using 1000 Monte Carlo simulations.</p><p><strong>Results: </strong>Overall SNF-stay rates of 20.2%, 31.4%, and 31.7%, and LTCA rates of 23.2%, 33.8%, 34.6% were observed for PIM, QUE, and other-AAPs, respectively. Based on annual mean costs, PPPY SNF-stay rehabilitation and resident related costs for PIM ($41,808) vs QUE ($65,172) or vs other-AAPs ($65,664), resulted in $23,364 and $23,856 PPPY cost savings, respectively. Similarly, PPPY LTCA rehabilitation and resident related costs for PIM ($47,957) vs QUE ($70,091) or vs other-AAPs ($71,566) resulted in $22,134 and $23,609 PPPY cost-savings for PIM, respectively. PSA suggested PIM would provide cost-savings vs QUE or other-AAPs in >99% of iterations.</p><p><strong>Conclusion: </strong>In this analysis, PIM demonstrated nearly 36% and 32% lower PPPY SNF-stays and LTCA costs, respectively, vs QUE or other-AAPs. Research examining additional cost-offsets (i.e., fewer falls/fractures) associated with SNF-stay or LTCA may be needed.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"149-159"},"PeriodicalIF":2.1,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144290","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}
引用次数: 0
Medical Costs Associated with High/Moderate/Low Likelihood of Adult Growth Hormone Deficiency: A Healthcare Claims Database Analysis. 与成人生长激素缺乏症高/中/低可能性相关的医疗费用:医疗索赔数据库分析》。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-03-08 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S445495
Kevin C J Yuen, Lewis S Blevins, David R Clemmons, Mads Faurby, Andrew R Hoffman, Nicky Kelepouris, Janice M Kerr, Jens Magelund Tarp, Maria Fleseriu
{"title":"Medical Costs Associated with High/Moderate/Low Likelihood of Adult Growth Hormone Deficiency: A Healthcare Claims Database Analysis.","authors":"Kevin C J Yuen, Lewis S Blevins, David R Clemmons, Mads Faurby, Andrew R Hoffman, Nicky Kelepouris, Janice M Kerr, Jens Magelund Tarp, Maria Fleseriu","doi":"10.2147/CEOR.S445495","DOIUrl":"10.2147/CEOR.S445495","url":null,"abstract":"<p><strong>Purpose: </strong>Adult growth hormone deficiency (AGHD) is often underdiagnosed and undertreated, leading to costly comorbidities. Previously, we developed an algorithm to identify individuals in a commercially insured US population with high, moderate, or low likelihood of having AGHD. Here, we estimate and compare direct medical costs by likelihood level.</p><p><strong>Patients and methods: </strong>Retrospective, observational analysis using the Truven Health MarketScan database to analyze direct medical costs relating to inpatient and outpatient claims, outpatient prescription claims, medication usage, clinical utilization records, and healthcare expenditures. Patients were categorized into groups based on algorithmically determined likelihoods of AGHD. Likelihood groups were further stratified by age and sex. Trajectories of annual costs (USD) by likelihood level were also investigated.</p><p><strong>Results: </strong>The study cohort comprised 135 million US adults (aged ≥18 years). Individuals ranked as high-likelihood AGHD had a greater burden of comorbid illness, including cardiovascular disease and diabetes, than those ranked moderate- or low-likelihood. Those in the high-likelihood group had greater mean total direct medical monthly costs ($1844.51 [95% confidence interval (CI): 1841.24;1847.78]) than those in the moderate- ($945.65 [95% CI: 945.26;946.04]) and low-likelihood groups ($459.10 [95% CI: 458.95;459.25]). Outpatient visits accounted for the majority of costs overall, although cost per visit was substantially lower than for inpatient services. Costs tended to increase with age and peaked around the time that individuals were assigned a level of AGHD likelihood. Total direct medical costs in individuals with a high likelihood of AGHD exceeded those for individuals with moderate or low likelihood.</p><p><strong>Conclusion: </strong>Understanding the trajectory of healthcare costs in AGHD may help rationalize allocation of healthcare resources.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"133-147"},"PeriodicalIF":2.1,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111762","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}
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