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American Journal of Managed Care

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https://www.readbyqxmd.com/read/30452214/optimizing-use-and-addressing-challenges-to-uptake-of-biosimilars
#1
Molly Billstein Leber
With the passing and implementation of the Biologics Price Competition and Innovation Act in 2010, biosimilars became a new classification of FDA-approved drugs. The biosimilar classification, created with a streamlined drug approval process, was intended to spur competition and reduce the cost of biological product therapies. Since the first FDA-approved biosimilar in 2015, the impact of biosimilars on the US biological product market remains to be seen. As more biosimilar products are approved and marketed, cost-savings are expected with predictions ranging from $54 billion to $250 billion by the mid-2020s...
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452213/current-market-and-regulatory-landscape-of-biosimilars
#2
Valkal Bhatt
The introduction of biologic therapies has improved the treatment landscape for multiple diseases, particularly in the areas of oncology, rheumatology, and endocrinology. Although they are effective, biologics are associated with increased costs that result in economic burden for healthcare professionals and patients. Biosimilars are biologic medical products that are almost an identical copy of the original product. There are differences in the regulatory requirements for the original biologic product and a biosimilar, as biosimilars gain FDA approval through an abbreviated approval pathway...
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452210/overdose-risk-for-veterans-receiving-opioids-from-multiple-sources
#3
Guneet K Jasuja, Omid Ameli, Donald R Miller, Thomas Land, Dana Bernson, Adam J Rose, Dan R Berlowitz, David A Smelson
OBJECTIVES: The aim of this study was to evaluate whether veterans in Massachusetts receiving opioids and/or benzodiazepines from both Veterans Health Administration (VHA) and non-VHA pharmacies are at higher risk of adverse events compared with those receiving opioids at VHA pharmacies only. STUDY DESIGN: A cohort study of veterans who filled a prescription for any Schedule II through V substance at a Massachusetts VHA pharmacy. Prescriptions were recorded in the Massachusetts Department of Public Health Chapter 55 data set...
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452209/cost-of-pharmacotherapy-for-opioid-use-disorders-following-inpatient-detoxification
#4
Kathryn E McCollister, Jared A Leff, Xuan Yang, Joshua D Lee, Edward V Nunes, Patricia Novo, John Rotrosen, Bruce R Schackman, Sean M Murphy
OBJECTIVES: To estimate the costs of providing extended-release injectable naltrexone (XR-NTX) and buprenorphine-naloxone (BUP-NX) following inpatient detoxification using data derived from a multisite randomized controlled trial at 8 US community-based treatment programs. STUDY DESIGN: Cost data were collected for 3 intervention phases: program start-up, inpatient detoxification, and up to 24 weeks of medication induction and management visits (post detoxification)...
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452208/a-randomized-pragmatic-pharmacist-led-intervention-reduced-opioids-following-orthopedic-surgery
#5
David H Smith, Jennifer L Kuntz, Lynn L DeBar, Jill Mesa, Xiuhai Yang, Jennifer Schneider, Amanda Petrik, Katherine Reese, Lou Ann Thorsness, David Boardman, Eric S Johnson
OBJECTIVES: To determine whether a pharmacist-led, patient-directed intervention can reduce opioid use following total hip arthroplasty (THA) or total knee arthroplasty (TKA). STUDY DESIGN: Randomized trial. METHODS: Patients scheduled to undergo THA or TKA (during 2015 and 2016) were randomized to usual care or intervention. We ranked patients according to predicted risk of persistent opioid use and selected the top 60% for inclusion (n = 561); all contributed to the analysis...
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452207/understanding-and-improving-value-frameworks-with-real-world-patient-outcomes
#6
Anupam B Jena, Jacquelyn W Chou, Lara Yoon, Wade M Aubry, Jan Berger, Wayne Burton, A Mark Fendrick, Donna M Fick, David Franklin, Rebecca Killion, Darius N Lakdawalla, Peter J Neumann, Kavita Patel, John Yee, Brian Sakurada, Kristina Yu-Isenberg
OBJECTIVES: To provide recommendations that will improve approaches to measuring the value of new medical technologies to patients. STUDY DESIGN: Informed discussion by experts after literature review. METHODS: A working group was formed, and participants discussed how value frameworks should incorporate key features important to patients in evaluating new medical technologies, particularly for chronic diseases. RESULTS: The working group suggests that new value frameworks should integrate real-world evidence to complement randomized controlled trials, incorporate the ways in which real-world behavior mediates outcomes, and explicitly discuss how therapies affect real-world equity and disparities in care...
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452206/a-narrow-view-of-choosing-wisely
#7
Daniel B Wolfson
This letter argues that an editorial published in the August 2018 issue provides an unduly limited perspective of the impact of Choosing Wisely.
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452205/effects-of-a-community-based-care-management-model-for-super-utilizers
#8
Purvi Sevak, Cara N Stepanczuk, Katharine W V Bradley, Tim Day, Greg Peterson, Boyd Gilman, Laura Blue, Keith Kranker, Kate Stewart, Lorenzo Moreno
OBJECTIVES: Medicare, Medicaid, and commercial plans have all explored ways to improve outcomes for patients with high costs and complex medical and social needs. The purpose of this study was to test the effectiveness of a high-intensity care management program that the Rutgers University Center for State Health Policy (CSHP) implemented as an adaptation of a promising model developed by the Camden Coalition of Healthcare Providers. STUDY DESIGN: We estimated the impact of the program on 6 utilization and spending outcomes for a subgroup of beneficiaries enrolled in Medicare fee-for-service (n = 149) and a matched comparison group (n = 1130)...
November 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452204/predicting-30-day-emergency-department-revisits
#9
Kelly Gao, Gene Pellerin, Laurence Kaminsky
OBJECTIVES: To develop a predictive model that hospitals or healthcare systems can use to identify patients at high risk of revisiting the emergency department (ED) within 30 days and thus reduce unnecessary ED use through proactive interventions. STUDY DESIGN: A retrospective analysis of fiscal years (FYs) 2013 and 2014 data from 4 Veterans Affairs hospitals in upstate New York. METHODS: This study developed a predictive model based on administrative data, a publicly available patient classification system, and logistic regression...
November 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452203/patients-adoption-of-and-feature-access-within-electronic-patient-portals
#10
Jennifer Elston Lafata, Carrie A Miller, Deirdre A Shires, Karen Dyer, Scott M Ratliff, Michelle Schreiber
OBJECTIVES: We describe online portal account adoption and feature access among subgroups of patients who traditionally have been disadvantaged or represent those with high healthcare needs. STUDY DESIGN: Retrospective cohort study of insured primary care patients 18 years and older (N = 20,282) receiving care from an integrated health system. METHODS: Using data from an electronic health record repository, portal adoption was defined by 1 or more online sessions...
November 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452202/impact-of-dementia-on-costs-of-modifiable-comorbid-conditions
#11
Patricia R Salber, Christobel E Selecky, Dirk Soenksen, Thomas Wilson
OBJECTIVES: To use the CMS 5% data sample to explore the impact of Alzheimer disease and other dementias (ADOD) on individual and population costs of certain potentially modifiable comorbid conditions, in order to assist in the design of population health management (PHM) programs for individuals with ADOD. STUDY DESIGN: A cross-sectional retrospective analysis was performed on parts A and B claims data of 1,056,741 Medicare beneficiaries 65 years and older with service dates in 2010...
November 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452201/hospital-cancer-pain-management-by-electronic-health-record-based-automatic-screening
#12
Jinyoung Shin, Hyeonyoung Ko, Jeong Ah Kim, Yun-Mi Song, Jin Seok An, Seok Jin Nam, Jungkwon Lee
OBJECTIVES: A cancer pain clinic (CPC) service is a thorough, comprehensive consultation service for patients with uncontrolled cancer pain. The aim of this study was to determine the success of a new CPC service with enrollment via electronic health record-based automatic screening at 1 cancer center in Korea. STUDY DESIGN: A case-control study and a satisfaction survey. METHODS: The intervention group (n = 158) was enrolled in the CPC service, whereas the control group (n = 158), which was matched using propensity scores, did not participate in the service...
November 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452200/best-practices-for-implementing-venous-thromboembolism-prophylaxis-across-the-continuum-of-care
#13
Paul P Dobesh, Tania Ahuja, George A Davis, Hugh Fatodu, William H Francis, Frank P Hull, Gary L Johnson, Joshua D Lenchus, Jacqueline Glee Lenoir, Claudette McPherson, Jeffrey Nemeth, Ralph J Riello
No abstract text is available yet for this article.
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452199/the-use-of-betrixaban-for-extended-prophylaxis-of-venous-thromboembolism-events-in-hospitalized-high-risk-patients
#14
Paul P Dobesh, Tania Ahuja, George A Davis, Hugh Fatodu, William H Francis, Frank P Hull, Gary L Johnson, Joshua D Lenchus, Jacqueline Glee Lenoir, Claudette McPherson, Jeffrey Nemeth, Ralph J Riello
No abstract text is available yet for this article.
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30452198/venous-thromboembolism-in-acute-medically-ill-patients-identifying-unmet-needs-and-weighing-the-value-of-prophylaxis
#15
Paul P Dobesh, Tania Ahuja, George A Davis, Hugh Fatodu, William H Francis, Frank P Hull, Gary L Johnson, Joshua D Lenchus, Jacqueline Glee Lenoir, Claudette McPherson, Jeffrey Nemeth, Ralph J Riello
No abstract text is available yet for this article.
November 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30427646/the-economic-impact-of-peanut-allergies
#16
H Eric Cannon
The prevalence of peanut allergies, the most common food allergy in children, has tripled in the past 2 decades. Today, up to 2.5% of the pediatric population has been diagnosed with a peanut allergy. Peanut allergies result in significant medical, out-of-pocket, and opportunity costs to payers, parents, and employers. They are also a leading cause of food allergy-related deaths in children. Although there is evidence that peanut oral immunotherapy may be effective in reducing the severity of the allergy, such approaches require a long intervention with no standardized protocol available...
October 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30427645/management-of-peanut-allergy-a-focus-on-novel-immunotherapies
#17
Christopher P Parrish
The management of peanut allergy involves strict avoidance, prompt recognition of allergic reactions, and rapid initiation of epinephrine and other supportive therapy for anaphylaxis. Avoidance presents several challenges and burdens to quality of life and daily activities. Currently, no treatment options are available for peanut allergy apart from epinephrine, which is the treatment of choice for severe allergic reactions. In recognition of the need for improved treatment options among patients with peanut allergy, several novel immunotherapies are undergoing clinical development, and clinicians must be knowledgeable about the safety and efficacy of these agents...
October 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30427644/severity-of-peanut-allergy-and-the-unmet-gaps-in-care-a-call-to-action
#18
Jay A Lieberman
Peanut allergy is one of the most common food allergies in children, with a prevalence that has been increasing over the past several decades. The allergy is a type I, immunoglobulin E (IgE)-mediated reaction that commonly presents in childhood and can be associated with an anaphylactic response. There are many theories that attempt to explain the increasing prevalence, including dietary changes, improvements in hygiene, and intentional allergen avoidance. Diagnosis is made through a combination of a thorough patient history, peanut-specific serum-specific IgE levels, peanut skin-prick test, and, if necessary, an oral food challenge...
October 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30362811/understanding-total-cost-of-care-in-advanced-non-small-cell-lung-cancer-pre-and-postapproval-of-immuno-oncology-therapies
#19
Beata Korytowsky, Janna Radtchenko, Esmond D Nwokeji, Kenneth W Tuell, Jonathan K Kish, Bruce A Feinberg
This study assesses resource utilization and total direct medical cost among patients in the United States starting systemic antineoplastic therapy (ST) pre- and postapproval of immuno-oncology (IO) agents for advanced non-small cell lung cancer. Adults diagnosed with lung cancer initiating first-line ST within 6 months of diagnosis during either the pre- (March 2013-March 2014) or post-IO (March 2015-December 2016) approval period were identified in a US-based multipayer administrative claims database. Excluded were patients with small cell lung cancer, secondary malignancies, less than 1 month follow-up, and those in clinical trials...
October 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/30328691/strategies-to-improve-cinv-outcomes-in-managed-care
#20
Scott A Soefje
Managing chemotherapy-induced nausea and vomiting (CINV) is an opportunity for better clinical, economic, and humanistic outcomes. Clinicians working in managed care settings must understand background information about CINV's causes, likelihood, and treatment. They need to understand how CINV creates collateral damage (eg, psychological effects, electrolyte disturbances, dehydration, malnutrition, and esophageal injury). Patients with CINV are costly to treat and may be unable or unwilling to continue chemotherapy at doses needed...
October 2018: American Journal of Managed Care
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