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Journal of Comparative Effectiveness Research

Jessica Davies, Michael Martinec, Paul Delmar, Mathieu Coudert, Walter Bordogna, Sophie Golding, Reynaldo Martina, Gracy Crane
AIM: To compare the overall survival of anaplastic lymphoma kinase-positive non-small-cell lung cancer patients who received alectinib with those who received ceritinib. MATERIALS & METHODS: Two treatment arms (alectinib [n = 183] and ceritinib [n = 67]) were extracted from clinical trials and an electronic health record database, respectively. Propensity scores were applied to balance baseline characteristics. Kaplan-Meier and multivariate Cox regression were conducted...
June 26, 2018: Journal of Comparative Effectiveness Research
Alanzi Turki, Bah Sulaiman, Alzahrani Sara, Alshammari Sirah, Almunsef Fatima
AIM: The aim of this study is to evaluate the WhatsApp social networking application for improving knowledge, self-efficacy and awareness about diabetes management. METHODOLOGY: The study was conducted with intervention and control groups at Teaching Hospital in Al-Khobar, Saudi Arabia. The intervention group received weekly educational messages using WhatsApp, while the control group received regular care. RESULTS: Statistically, compared with the control group, the diabetes knowledge and self-efficacy of the intervention group increased significantly after the intervention with the WhatsApp application...
June 26, 2018: Journal of Comparative Effectiveness Research
Zhanglin L Cui, Lisa M Hess, Robert Goodloe, Doug Faries
AIM: A comparison of conventional pairwise propensity score matching (PSM) and generalized PSM method was applied to the comparative effectiveness of multiple treatment options for lung cancer. MATERIALS & METHODS: Deidentified data were analyzed. Covariate balances between compared treatments were assessed before and after PSM. Cox proportional hazards regression compared overall survival after PSM. RESULTS & CONCLUSION: The generalized PSM analyses were able to retain 61...
June 21, 2018: Journal of Comparative Effectiveness Research
Wen Chen, Thomas Ward, Mai Ping Tan, Jing Yan, Peter Feng Wang, Gail D Wygant, Jason Gordon
AIM: To evaluate the cost-effectiveness of the novel all-oral direct-acting antiviral regimen daclatasvir + asunaprevir (DUAL), versus interferon-based regimens for the treatment of chronic hepatitis C virus genotype 1b infection. METHODS: Inputs for a lifetime Markov model were sourced from clinical trials and published literature. Outputs include disease management costs, life expectancy, quality-adjusted life-years and cost-effectiveness. Sensitivity analyses assessed the drivers of cost-effectiveness and sustained virologic response thresholds at which DUAL is cost-saving...
June 4, 2018: Journal of Comparative Effectiveness Research
Mike Dolph, Anuja Roy, Menaka Bhor, Jaclyn Hearnden, Christina S Kwon, Anna Forsythe, Gabriel Tremblay, Andrew Briggs
AIM: Eltrombopag and romiplostim are comparable second-line therapies in chronic immune thrombocytopenia. Treatment decisions are made in different contexts. A framework was created to outline decision pathways for physicians and payers. MATERIALS & METHODS: The costs of drugs, administration, routine care, bleeding, other adverse events and mortality were included in the year-long calculation of total costs from a US private payer perspective. Treatment parameters and outcome data were obtained from relevant clinical trials...
May 31, 2018: Journal of Comparative Effectiveness Research
Michael L Sabolinski, Gary Gibbons
AIM: To compare the effectiveness of bilayered living cellular construct (BLCC) and an acellular fetal bovine collagen dressing (FBCD) for the treatment of venous leg ulcers. METHODS: Data from WoundExpert® (Net Health, PA, USA) was used to analyze 1021 refractory venous leg ulcers treated at 177 facilities. RESULTS: Kaplan-Meier analyses showed that BLCC (893 wounds) was superior to FBCD (128 wounds), p = 0.01 for: wound closure by weeks 12 (31 vs 25%), 24 (55 vs 43%) and 36 (68 vs 53%); reduction in time to wound closure of 37%, (19 vs 30 weeks); and improvement in the probability of healing by 45%...
May 29, 2018: Journal of Comparative Effectiveness Research
Kit N Simpson, Bryant A Seamon, Brittany N Hand, Courtney O Roldan, David J Taber, William P Moran, Annie N Simpson
AIM: The effects of frailty and multiple chronic conditions (MCCs) on cost of care are rarely disentangled in archival data studies. We identify the marginal contribution of frailty to medical care cost estimates using Medicare data. MATERIALS & METHODS: Use of the Faurot frailty score to identify differences in acute medical events and cost of care for patients, controlling for MCCs and medication use. RESULTS: Estimated marginal cost of frailty was US$10,690 after controlling for demographics, comorbid conditions, polypharmacy and use of potentially inappropriate medications...
May 29, 2018: Journal of Comparative Effectiveness Research
Robert W Klein, Shaum Kabadi, Frank N Cinfio, Christopher A Bly, Douglas Ca Taylor, Keith A Szymanski
AIM: Estimate budget impact of adopting lesinurad as add-on to allopurinol for urate-lowering therapy in gout. METHODS: A budget impact model was developed for a US payer perspective, using a Markov model to estimate costs, survival and discontinuation in a one-million-member health plan. The population included patients failing first-line gout therapy, followed for 5 years. RESULTS: Incremental costs of adding lesinurad versus no lesinurad were US$241,907 and US$1,098,220 in first and fifth years, respectively...
May 24, 2018: Journal of Comparative Effectiveness Research
Mustapha D Ibrahim, Mevhibe B Hocaoglu, Berna Numan, Sahand Daneshvar
AIM: Directive 2011/24/EU on patients' rights in cross-border healthcare facilitates EU citizens' access to and reimbursement for healthcare provided or prescribed in a member state other than the member state of affiliation. MATERIALS & METHODS: The efficiency of cross-border healthcare policy is evaluated using data envelopment analysis of relevant items in Eurobarometer Survey on Safety and Quality of Care and Patients' Rights in the EU. RESULTS: Our study shows policy inefficiency in 52% of the 25 EU member states included in the analysis...
May 17, 2018: Journal of Comparative Effectiveness Research
Kruti Joshi, Erik Muser, Yihua Xu, Phil Schwab, Manasi Datar, Brandon Suehs
AIM: To compare adherence, healthcare utilization and costs among real world, Medicare-eligible patients with schizophrenia using long-acting injectable paliperidone palmitate (PP) versus oral atypical antipsychotics. Patients & methods: Historical cohort study used Medicare Advantage claims data. Inverse probability of treatment weighting was applied to adjust for baseline differences. 12-month adherence, healthcare utilization and costs were compared. RESULTS: Patients using PP were more adherent (proportion of days covered ≥0...
May 3, 2018: Journal of Comparative Effectiveness Research
Daisy Ng-Mak, Vanita Tongbram, Kerigo Ndirangu, Krithika Rajagopalan, Antony Loebel
AIM: To assess the relative efficacy and metabolic effects of lurasidone and brexpiprazole in the acute treatment of schizophrenia. METHODS: Five lurasidone and three brexpiprazole trials were identified. In the absence of head-to-head trials, a Bayesian network meta-analysis comparing lurasidone and brexpiprazole was performed. RESULTS: Nonstatistically significant differences in efficacy measures were observed between lurasidone and brexpiprazole...
April 26, 2018: Journal of Comparative Effectiveness Research
Margarida Augusto, Mallik Greene, Maëlys Touya, Samantha Min Sweeney, Heidi Waters
AIM: To evaluate the cost-effectiveness of aripiprazole once-monthly 400/300 mg (AOM 400) in maintenance monotherapy treatment of bipolar I disorder (BP-I). METHODS: A de novo lifetime Markov model was developed for BP-I using available data for AOM 400 and relevant comparators. Base-case analysis considered costs and outcomes from the US payer perspective. RESULTS: The cost per quality-adjusted life year gained with AOM 400 versus comparators ranged from US$2007 versus oral asenapine to dominance (i...
April 25, 2018: Journal of Comparative Effectiveness Research
Margarida Augusto, Mallik Greene, Maëlys Touya, Samantha Min Sweeney, Heidi Waters
AIM: To estimate the budget impact (BI) of introducing aripiprazole once-monthly 400 mg/300 mg (AOM 400) in the maintenance monotherapy treatment of bipolar I disorder versus long-acting injectables, oral antipsychotics and best supportive care. METHODS: A BI model was developed from a US-payer perspective using treatment-related, hospitalization and adverse event management cost estimates for a hypothetical 1,000,000-member health plan over a 5-year period. RESULTS: Market share of AOM 400 was predicted to increase from 0...
April 25, 2018: Journal of Comparative Effectiveness Research
Enos M Rampamba, Johanna C Meyer, Brian Godman, Amanj Kurdi, Elvera Helberg
AIM: To evaluate adherence to antihypertensive treatment in rural South Africa and identify potential determinants given concerns with adherence and its impact in this priority disease area. Patients & methods: Face-to-face interviews with hypertensive patients and rating their adherence to treatment using defined categorized responses. Associations between adherence and patient characteristics assessed and sensitivity analyses performed. RESULTS: 54.6% of patients were adherent to treatment...
July 2018: Journal of Comparative Effectiveness Research
Chad G Ball, Sean C Grondin, Janice L Pasieka, Andrew W Kirkpatrick, Anthony R MacLean, Paul Cantle, Elijah Dixon, Prism Schneider, Mark Hamilton
Innovation can be variably defined, but when applied to healthcare is often considered to be the introduction of something new, whether an idea, method or device, into an unfilled void or needy environment. Despite the introduction of many positive surgical subspecialty altering concepts/devices however, epic failures are not uncommon. These failures can be dramatic in regards to both their human and economic costs. They can also be very public or more quiet in nature. As surgical leaders in our communities and advocates for patient safety and outcomes, it remains crucial that we meet new introductions in technology and patient care with a measured level of curiosity, skepticism and science-based conclusions...
July 2018: Journal of Comparative Effectiveness Research
Lin Zhang, JinKui Yang, LanTing Li, DongDong Liu, XiaoPing Xie, Peng Dong, Yong Lin
AIM: Reducing the fluctuation of blood pressure has recently been recognized as a potential target for improving management of hypertension to prevent cardiovascular events, particularly for strokes. Some randomized controlled trials demonstrated that amlodipine can effectively reduce blood pressure as a well-established, long-acting calcium channel blocker (CCB). However, few data are available for amlodipine on blood pressure variability (BPV) in China in a real-world setting. This study aimed to assess the effect of amlodipine versus other CCB antihypertensive agents on BPV...
July 2018: Journal of Comparative Effectiveness Research
Srinivas Annavarapu, Pranav K Gandhi, Yong Li, Prachi Arora, Chad Moretz, Cheng Wang, Stephen D Sander, George A Andrews
Factors influencing differences in persistence between dabigatran and warfarin in patients with nonvalvular atrial fibrillation (NVAF) remain unclear. AIM: Compare differences in persistence between new dabigatran and warfarin users in patients newly diagnosed with NVAF, adjusting for sociodemographics, clinical characteristics, patient out-of-pocket cost and other covariates. METHODS: A retrospective matched-cohort study was conducted using a US claims database of Medicare and commercially insured patients with NVAF aged≥ 18 years...
July 2018: Journal of Comparative Effectiveness Research
Greta Lozano-Ortega, Nathalie Waser, Mark E Bensink, Sarah Goring, Heather Bennett, Geoffrey A Block, Glenn M Chertow, Marie-Louise Trotman, Kerry Cooper, Adrian R Levy, Vasily Belozeroff
AIM: Randomized controlled trials (RCTs) with clinical outcomes are considered the gold standard for regulatory approval. However, by design they are only able to answer a small number of clinical questions. Other high-quality studies are required for clinical decision-making. The EVOLVE was the largest RCT, evaluating the effects of cinacalcet on clinical outcomes among adult patients receiving maintenance dialysis suffering from secondary hyperparathyroidism. While the EVOLVE trial did not reach its primary end point, imbalance in subjects' age at randomization and discontinuation rates are two of the reasons that the lack of mortality benefit is in question...
July 2018: Journal of Comparative Effectiveness Research
Antoni Sicras-Mainar, Javier Rejas-Gutiérrez, Maria Perez-Paramo, Ruth Navarro-Artieda
AIM: To analyze the cost of peripheral neuropathic pain (PNP) treatment with pregabalin or gabapentin at therapeutic doses in routine clinical practice. METHODS: Analysis of a retrospective, observational study of electronic medical records of patients treated for PNP with therapeutic doses of pregabalin or gabapentin, with 2 years' follow-up, considering PNP type, comorbidities, concomitant analgesia and resource use. RESULTS: The weighted total average cost/patient was lower for pregabalin than gabapentin (€2464 [2197-2730] vs €3142 [2670-3614]; p = 0...
July 2018: Journal of Comparative Effectiveness Research
Nicole A Brys, Jeff Whittle, Nasia Safdar
AIM: Engaging patients in the planning, implementation and dissemination of research can increase the credibility and relevance of results and lead to higher quality, more patient-centered care. Veterans have unique experiences and healthcare needs, making their input on research related to their care particularly important. However, existing veteran engagement resources primarily focus on veterans who receive care through the Veterans Health Administration (VA). This excludes those veterans - the majority - who do not use the VA for healthcare...
June 2018: Journal of Comparative Effectiveness Research
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