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American Health & Drug Benefits

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https://www.readbyqxmd.com/read/28465768/comparing-healthcare-costs-associated-with-oral-and-subcutaneous-methotrexate-or-biologic-therapy-for-rheumatoid-arthritis-in-the-united-states
#1
Joseph Lee, Ryan Pelkey, Julieanna Gubitosa, Michael F Henrick, Michael L Ganz
BACKGROUND: Methotrexate (MTX) is the primary disease-modifying antirheumatic drug used for the treatment of rheumatoid arthritis (RA). Optimizing the use of oral and subcutaneous MTX may delay the use of expensive biologic therapies; the effect of such a delay on overall medical costs is currently unknown. OBJECTIVE: To compare the 5-year healthcare costs of treatment pathways for patients with RA who initiate oral MTX in the United States. METHODS: We identified patients with RA in the Symphony Health Solutions database (Integrated Dataverse) who initiated treatment with oral MTX in 2009 and had RA-related claims for each year through 2014...
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465767/top-10-healthcare-market-trends-in-2017
#2
John Santilli, F Randy Vogenberg
No abstract text is available yet for this article.
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465766/biologic-disease-modifying-antirheumatic-drugs-in-a-national-privately-insured-population-utilization-expenditures-and-price-trends
#3
Christopher B Atzinger, Jeff J Guo
BACKGROUND: Spending on biologic drugs is a significant driver of drug expenditures for payers in private health plans. Biologic disease-modifying antirheumatic drugs (DMARDs) are some of the most effective and costly treatments in a physician's arsenal. Understanding the total annual expenditure, the average cost per prescription, and the impact of cost-sharing is important for drug benefit managers. OBJECTIVE: To assess drug utilization, expenditures, out-of-pocket (OOP) cost, and price trends of biologic DMARDs in patients with rheumatoid arthritis (RA) in a large managed care organization...
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465765/pharmaceutical-patent-litigation-and-the-emerging-biosimilars-a-conversation-with-kevin-m-nelson-jd
#4
Stanton R Mehr
No abstract text is available yet for this article.
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465764/sociodemographic-determinants-of-out-of-pocket-expenditures-for-patients-using-prescription-drugs-for-rheumatoid-arthritis
#5
Kumar Mukherjee, Khalid M Kamal
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease that has a substantial economic impact on patients. Patients with RA are at an increased risk for disability and for loss of income. The inclusion of biologic drugs in RA therapy has increased the cost of treatment. Little is known about the relationship between sociodemographic characteristics and the out-of-pocket (OOP) expenditures for prescription drugs for patients with RA, including biologics, disease-modifying antirheumatic drugs (DMARDs), nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and analgesics...
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465763/the-dream-of-value-based-care
#6
EDITORIAL
David B Nash
No abstract text is available yet for this article.
February 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465779/is-a-biologic-produced-15-years-ago-a-biosimilar-of-itself-today
#7
Stanton R Mehr, Marj P Zimmerman
Much of the testing required for the regulatory approval of a biosimilar is focused on proving that the new drug is sufficiently similar to the reference biologic in structure, pharmacokinetics or pharmacodynamics, clinical efficacy, and safety. However, the reference drug may itself have gone through some changes in the years since its approval, including those caused by alterations in the manufacturing process. Do these changes increase the risk that the reference drug may cause unexpected outcomes? It is up to the US Food and Drug Administration to decide whether the changes merit the need for additional studies to confirm that the drug meets the structural or clinical outcomes standard for the reference agent...
December 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465778/the-challenge-of-managing-psoriasis-unmet-medical-needs-and-stakeholder-perspectives
#8
REVIEW
Steven R Feldman, Bernard Goffe, Gary Rice, Matthew Mitchell, Mandeep Kaur, Debbie Robertson, Debra Sierka, Jeffrey A Bourret, Tamara S Evans, Alice Gottlieb
BACKGROUND: Psoriasis is a debilitating chronic inflammatory autoimmune disease affecting approximately 7.4 million adults in the United States. Plaque psoriasis is the most common form, affecting 80% to 90% of patients. OBJECTIVES: To describe the impact and challenges that psoriasis presents for various stakeholders, and to provide nondermatologist healthcare decision makers with information to enhance their contributions to drug and pharmacy benefit design discussions...
December 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465777/use-of-the-prostate-core-mitomic-test-in-repeated-biopsy-decision-making-real-world-assessment-of-clinical-utility-in-a-multicenter-patient-population
#9
Lorena Legisi, Elise DeSa, M Nasar Qureshi
BACKGROUND: Prostate cancer is the most common cancer diagnosed in men in developed countries. Using molecular testing may help to improve outcomes in this clinically challenging group. Since 2011, the Prostate Core Mitomic Test (PCMT), which quantifies a 3.4-kb mitochondrial DNA deletion strongly associated with prostate cancer, has been used by more than 50 urology practices accessing pathology services through our laboratory in New Jersey. However, the use of a molecular test can only be beneficial if it affects patient management and improves outcomes...
December 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465776/bundled-payments-value-based-care-implications-for-providers-payers-and-patients
#10
Byron C Scott, Tricia L Eminger
No abstract text is available yet for this article.
December 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465775/leveraging-real-world-evidence-in-disease-management-decision-making-with-a-total-cost-of-care-estimator
#11
Thanh-Nghia Nguyen, Jeffrey Trocio, Stacey Kowal, Cheryl P Ferrufino, Julie Munakata, Dell South
BACKGROUND: Health management is becoming increasingly complex, given a range of care options and the need to balance costs and quality. The ability to measure and understand drivers of costs is critical for healthcare organizations to effectively manage their patient populations. Healthcare decision makers can leverage real-world evidence to explore the value of disease-management interventions in shifting total cost trends. OBJECTIVE: To develop a real-world, evidence-based estimator that examines the impact of disease-management interventions on the total cost of care (TCoC) for a patient population with nonvalvular atrial fibrillation (NVAF)...
December 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465774/the-price-of-peace
#12
EDITORIAL
David B Nash
No abstract text is available yet for this article.
December 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465773/treatment-patterns-and-outcomes-in-patients-with-varicose-veins
#13
Rajiv Mallick, Aditya Raju, Chelsey Campbell, Rashad Carlton, David Wright, Kimberly Boswell, Michael Eaddy
BACKGROUND: Approximately 24% of adults in the United States have visible varicose veins, and an estimated 6% have evidence of advanced chronic venous disease. The majority of individuals with varicose veins seek treatment because of symptoms, such as aching, throbbing, fatigue, pruritus, ankle swelling, and tenderness, rather than cosmetic reasons. Furthermore, varicose veins are a manifestation of chronic venous insufficiency, which can progress to leg pain, leg edema, chronic skin changes, and nonhealing ulcers...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465772/healthcare-spending-plenty-of-blame-to-go-around
#14
Gary Branning, Martha Vater
No abstract text is available yet for this article.
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465771/clinical-characteristics-and-unmet-need-among-patients-with-atherosclerotic-cardiovascular-disease-stratified-by-statin-use
#15
Qing Huang, Michael Grabner, Robert J Sanchez, Vincent J Willey, Mark J Cziraky, Swetha R Palli, Thomas P Power
BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) 2013 guidelines for blood cholesterol treatment recommend high-intensity statins for adults with atherosclerotic cardiovascular disease (ASCVD). Currently, little is known about the real-world patient characteristics of ASCVD, as well as the clinical and economic consequences of different treatment options for this disease. OBJECTIVES: To compare the demographic, clinical, and economic characteristics of patients with clinical ASCVD who started therapy with high-intensity statins, low-/moderate-intensity statins, or no statins in usual-care settings based on data primarily before the release of the ACC/AHA 2013 guidelines...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465770/effects-of-specialty-pharmacy-care-on-health-outcomes-in-multiple-sclerosis
#16
Jun Tang, James Bailey, Cyril Chang, Richard Faris, Song Hee Hong, Michael Levin, Junling Wang
BACKGROUND: Increasingly, third-party payers are requiring patients with multiple sclerosis (MS) to participate in specialty pharmacy management programs to improve their adherence to their prescribed medications. The effects of specialty pharmacy care on MS clinical outcomes have not yet been comprehensively examined in the literature. OBJECTIVE: To compare the effectiveness of specialty pharmacy care and usual community pharmacy care MS outcomes. METHODS: Inpatient, outpatient, and pharmacy claims for patients with MS were extracted from a major national pharmacy benefit management company's databases for this retrospective cohort study...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465769/from-cells-to-society
#17
EDITORIAL
David B Nash
No abstract text is available yet for this article.
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27994714/factors-associated-with-adherence-to-the-hedis-quality-measure-in-medicaid-patients-with-schizophrenia
#18
Marie-Hélène Lafeuille, Christian Frois, Michel Cloutier, Mei Sheng Duh, Patrick Lefebvre, Jacqueline Pesa, Zoe Clancy, John Fastenau, Mike Durkin
BACKGROUND: Treatment continuity is a major challenge in the long-term management of patients with schizophrenia; poor patient adherence to antipsychotic drugs has been associated with negative clinical outcomes. Long-acting injectable therapies may improve adherence and lessen the risk for psychiatric-related relapse, often leading to rehospitalization and higher healthcare costs. Therefore, understanding the determinants of adherence to antipsychotics is critical in the management of patients with schizophrenia...
October 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27994713/evaluating-adherence-to-dilated-eye-examination-recommendations-among-patients-with-diabetes-combined-with-patient-and-provider-perspectives
#19
Maxine D Fisher, Yamina Rajput, Tao Gu, Joseph R Singer, Amanda R Marshall, Seonyoung Ryu, John Barron, Catherine MacLean
BACKGROUND: Diabetes mellitus remains the leading cause of new cases of blindness among US adults. Routine dilated eye examinations can facilitate early detection and intervention for diabetes-related eye disease, providing an opportunity to reduce the risk for diabetes-related blindness in working-aged Americans. The Healthcare Effectiveness Data and Information Set (HEDIS) established criteria for performing dilated eye examination in patients with diabetes. OBJECTIVES: To obtain information about adherence and nonadherence to diabetic eye examinations among insured patients to understand the barriers to routine dilated eye examinations, and to identify ways to improve the quality of care for these patients...
October 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27994712/examining-the-value-of-subsidies-of-health-plans-and-cost-sharing-for-prescription-drugs-in-the-health-insurance-marketplace
#20
Surachat Ngorsuraches, Jane R Mort
BACKGROUND: The Affordable Care Act (ACA) initiated federally and state-run health insurance exchanges, or marketplaces, with health plans offering subsidies for plan members as well as coverage for essential health benefits, to help individuals, families, and small businesses find health plans that fit their specific needs. A recent study found that the value of these healthcare subsidies varied with the number of health plans in the different geographic rating areas, but that study only examined the premiums and the deductibles of those health plans...
October 2016: American Health & Drug Benefits
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