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https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#1
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28095170/financial-burden-for-patients-with-chronic-myeloid-leukemia-enrolled-in-medicare-part-d-taking-targeted-oral-anticancer-medications
#2
Chan Shen, Bo Zhao, Lei Liu, Ya-Chen Tina Shih
PURPOSE: The number of targeted oral anticancer medications (TOAMs) has grown rapidly in the past decade. The high cost of TOAMs raises concerns about the financial aspect of treatment, especially for patients enrolled in Medicare Part D plans because of the coverage gap. METHODS: We identified patients with chronic myeloid leukemia (CML) who were new TOAM users from the SEER registry data linked with Medicare Part D data, from years 2007 to 2012. We followed these patients throughout the calendar year when they started taking the TOAMs and examined their out-of-pocket (OOP) payments and gross drug costs, taking into account their benefit phase, plan type, and cost share group...
January 17, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28079594/impact-of-concurrent-medication-use-on-pancreatic-cancer-survival-seer-medicare-analysis
#3
Muhammad S Beg, Arjun Gupta, David Sher, Sadia Ali, Saad Khan, Ang Gao, Tyler Stewart, Chul Ahn, Jarett Berry, Eric M Mortensen
OBJECTIVES: Preclinical studies have suggested that non-antineoplastic medication use may impact pancreatic cancer biology. We examined the association of several medication classes on pancreatic cancer survival in a large medical claims database. MATERIALS AND METHODS: Histologically confirmed pancreatic adenocarcinoma diagnosed between 2006 and 2009 were analyzed from the Surveillance, Epidemiology, and End Results-Medicare database with available part D data...
January 10, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28060052/evaluating-the-effects-of-pioneer-accountable-care-organizations-on-medicare-part-d-drug-spending-and-utilization
#4
Yuting Zhang, Kadin J Caines, Christopher A Powers
BACKGROUND: The improvement of medication use is a critical mechanism that accountable care organization (ACO) could use to save overall costs. Currently pharmaceutical spending is not part of the calculation for ACO-shared savings and risks. Thus, ACO providers may have strong incentives to prescribe more medications hoping to avoid expensive downstream medical costs. METHODS: We designed a quasinatural experiment study to evaluate the effects of Pioneer ACOs on Medicare Part D spending and utilization...
January 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28060051/e-prescribing-and-adverse-drug-events-an-observational-study-of-the-medicare-part-d-population-with-diabetes
#5
Meghan Hufstader Gabriel, Christopher Powers, William Encinosa, Julie P W Bynum
BACKGROUND: Although the adoption of e-prescriptions among physicians has increased substantially under the Medicare Improvements for Patients and Providers Act and Meaningful Use programs, little is known of its impact on patient outcomes. OBJECTIVE: To examine the impact of e-prescribing on emergency visits or hospitalizations for diabetes-related adverse drug events (ADEs) including hypoglycemia. DESIGN: This is a prospective, observational cohort study with patient fixed effects...
January 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28046001/the-diagnosis-and-management-of-patients-with-renal-colic-across-a-sample-of-us-hospitals-high-ct-utilization-despite-low-rates-of-admission-and-inpatient-urologic-intervention
#6
Elizabeth M Schoenfeld, Penelope S Pekow, Meng-Shiou Shieh, Charles D Scales, Tara Lagu, Peter K Lindenauer
OBJECTIVES: Symptomatic ureterolithiasis (renal colic) is a common Emergency Department (ED) complaint. Variation in practice surrounding the diagnosis and management of suspected renal colic could have substantial implications for both quality and cost of care as well as patient radiation burden. Previous literature has suggested that CT scanning has increased with no improvements in outcome, owing at least partially to the spontaneous passage of kidney stones in the majority of patients...
2017: PloS One
https://www.readbyqxmd.com/read/28038389/adherence-to-antiepileptic-drugs-among-diverse-older-americans-on-part-d-medicare
#7
Kendra Piper, Joshua Richman, Edward Faught, Roy Martin, Ellen Funkhouser, Jerzy P Szaflarski, Chen Dai, Lucia Juarez, Maria Pisu
INTRODUCTION: Older minority groups are more likely to have poor AED adherence. We describe adherence to antiepileptic drugs (AEDs) among older Americans with epilepsy. METHODS: In retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries augmented by minority representation, epilepsy cases in 2009 were those with ≥1 claim with ICD-9345.x or ≥2 with 780.3x, and ≥1 AED. New-onset cases had no such claims or AEDs in the year before the 2009 index event...
December 27, 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28034069/association-between-out-of-pocket-costs-race-ethnicity-and-adjuvant-endocrine-therapy-adherence-among-medicare-patients-with-breast-cancer
#8
Albert J Farias, Xianglin L Du
Purpose Previous studies suggest that adherence to adjuvant endocrine therapy (AET) for patients with breast cancer is suboptimal, especially among minorities, and is associated with out-of-pocket medication costs. This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to AET and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. Methods This retrospective cohort study used the SEER-Medicare linked database to identify patients ≥ 65 years of age with hormone receptor-positive breast cancer who were enrolled in Medicare Part D from 2007 to 2009...
January 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28030476/socioeconomic-disparities-in-mortality-among-women-with-incident-breast-cancer-before-and-after-implementation-of-medicare-part-d
#9
Ann B Nattinger, Erica M Wozniak, Emily L McGinley, Jianing Li, Purushottam Laud, Liliana E Pezzin
BACKGROUND: Breast cancer patients exhibit survival disparities based on socioeconomic status (SES). Disparities may be attributable to access to expensive oral endocrine agents. OBJECTIVES: Define recent socioeconomic disparities in breast cancer survival and determine whether these improved after implementation of the Medicare Part D program. DESIGN: Difference-in-difference natural experiment of women diagnosed and treated before or after implementation of Medicare Part D...
December 27, 2016: Medical Care
https://www.readbyqxmd.com/read/28025930/cost-effectiveness-of-treatment-sequences-of-chemotherapies-and-targeted-biologics-for-elderly-metastatic-colorectal-cancer-patients
#10
Rohan C Parikh, Xianglin L Du, Morgan O Robert, David R Lairson
BACKGROUND: Treatment patterns for metastatic colorectal cancer (mCRC) patients have changed considerably over the last decade with the introduction of new chemotherapies and targeted biologics. These treatments are often administered in various sequences with limited evidence regarding their cost-effectiveness. OBJECTIVE: To conduct a pharmacoeconomic evaluation of commonly administered treatment sequences among elderly mCRC patients. METHODS: A probabilistic discrete event simulation model assuming Weibull distribution was developed to evaluate the cost-effectiveness of the following common treatment sequences: (a) first-line oxaliplatin/irinotecan followed by second-line oxaliplatin/irinotecan + bevacizumab (OI-OIB); (b) first-line oxaliplatin/irinotecan + bevacizumab followed by second-line oxaliplatin/irinotecan + bevacizumab (OIB-OIB); (c) OI-OIB followed by a third-line targeted biologic (OI-OIB-TB); and (d) OIB-OIB followed by a third-line targeted biologic (OIB-OIB-TB)...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28025927/the-effect-of-medicare-part-d-on-prescription-drug-spending-and-health-care-use-6-years-of-follow-up-2007-2012
#11
Taehwan Park, Jeah Jung
BACKGROUND: Previous studies have shown that Medicare Part D was associated with a reduction in out-of-pocket expenditures for Medicare beneficiaries during the early years of its implementation (2006 and 2007). However, a question remains regarding the effect of Part D on out-of-pocket expenditures in the longer term. OBJECTIVE: To evaluate the effects of Part D on prescription drug expenditures and certain health care use for a longer time period using a large, nationally representative sample of Medicare beneficiaries...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28025924/improving-comprehensive-medication-review-acceptance-by-using-a-standardized-recruitment-script-a-randomized-control-trial
#12
Alexander Miguel, Anna Hall, Wei Liu, Jeremy Garrett, Angel Ballew, Tsu-Hsaun Yang, Richard Segal
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) require prescription drug plan sponsors to offer a comprehensive medication review (CMR) annually to eligible beneficiaries through the plans' Medication Therapy Management Programs (MTMPs). In 2011, the Pharmacy Quality Alliance endorsed the CMR completion rate as a quality measure for MTMPs, and CMS has adopted the measure into the 2016 CMS star ratings. CMS star ratings are used to describe the quality of plans to assist Medicare plan enrollees in choosing a plan and to determine quality bonus payments for Medicare Advantage plans...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28025599/disparity-implications-of-proposed-2015-medicare-eligibility-criteria-for-medication-therapy-management-services
#13
Junling Wang, Yanru Qiao, Christina A Spivey, Christine Li, Caroline Clark, Yuewen Deng, Flora Liu, Jeffrey Tillman, Marie Chisholm-Burns
OBJECTIVES: Previous studies found that racial and ethnic minorities may be less likely than non-Hispanic Whites (Whites) to meet existing Medicare medication therapy management (MTM) eligibility criteria. To address these issues, the Centers for Medicare & Medicaid Services (CMS) proposed alternative Medicare MTM eligibility criteria for 2015. Due to opposition to other Part D reforms proposed simultaneously by various stakeholders, CMS rescinded all proposed reforms. This study was conducted to determine whether non-Hispanic Blacks (Blacks) and Hispanics have lower likelihood of meeting the proposed 2015 Medicare MTM eligibility criteria...
December 2016: Journal of Pharmaceutical Health Services Research
https://www.readbyqxmd.com/read/28008353/impact-of-medicare-part-d-on-racial-and-ethnic-minorities
#14
JoEllen Jarrett Jamison, Junling Wang, Satya Surbhi, Samantha Adams, David Solomon, Kenneth C Hohmeier, Sharon McDonough, James C Eoff
OBJECTIVES: Prior to the implementation of Medicare Part D in the United States, inequalities were found to exist in the use of medications between minority and white beneficiaries. Despite improvements in medication affordability after Medicare Part D implementation, it is still not clear whether the characteristics of the program have improved drug utilization patterns among minorities to the same degree as whites. This review aims to determine whether there were barriers for Medicare Part D to realize its potential to improve prescription drug utilization patterns among minorities...
2016: Diversity and Equality in Health and Care
https://www.readbyqxmd.com/read/28005571/long-term-exposure-to-pm2-5-and-mortality-among-older-adults-in-the-southeastern-us
#15
Yan Wang, Liuhua Shi, Mihye Lee, Pengfei Liu, Qian Di, Antonella Zanobetti, Joel D Schwartz
BACKGROUND: Little is known about what factors modify the effect of long-term exposure to PM2.5 on mortality, in part because in most previous studies certain groups such as rural residents and individuals with lower socioeconomic status (SES) are under-represented. METHODS: We studied 13.1 million Medicare beneficiaries (age ≥65) residing in seven southeastern US states during 2000-2013 with 95 million person-years of follow-up. We predicted annual average of PM2...
December 21, 2016: Epidemiology
https://www.readbyqxmd.com/read/27998232/medicare-d-subsidies-and-racial-disparities-in-persistence-and-adherence-with-hormonal-therapy
#16
Alana Biggers, Yushu Shi, John Charlson, Elizabeth C Smith, Alicia J Smallwood, Ann B Nattinger, Purushottam W Laud, Joan M Neuner
Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined...
December 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27998230/high-cost-high-value-oral-specialty-drugs-more-evidence-on-the-impact-of-cost-sharing-in-medicare-part-d
#17
Scott F Huntington, Amy J Davidoff
No abstract text is available yet for this article.
December 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27991746/rural-medicare-advantage-market-dynamics-and-quality-historical-context-and-current-implications
#18
Leah Kemper, Abigail R Barker, Lyndsey Wilber, Timothy D McBride, Keith Mueller
Purpose. In this policy brief, we assess variation in Medicare’s star quality ratings of Medicare Advantage (MA) plans that are available to rural beneficiaries. Evidence from the recent Centers for Medicare & Medicaid Services (CMS) quality demonstration suggests that market dynamics, i.e., firms entering and exiting the MA marketplace, play a role in quality improvement. Therefore, we also discuss how market dynamics may impact the smaller and less wealthy populations that are characteristic of rural places...
2016: Rural Policy Brief
https://www.readbyqxmd.com/read/27990073/medicare-names-six-plans-for-part-d-mtm-demo-starting-in-january
#19
Stephen Barlas
Medicare names plans for Part D MTM demo.
December 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/27956005/differences-between-access-to-follow-up-care-and-inappropriate-shocks-based-on-insurance-status-of-implantable-cardioverter-defibrillator-recipients
#20
Solomon J Sager, Chris Healy, Archana Ramireddy, Harold Rivner, Juan F Viles Gonzalez, James O Coffey, Natalia Rossin, Ka M Lo, Jeffrey J Goldberger, Robert J Myerburg, Raul D Mitrani
Differences in implantable cardioverter defibrillator (ICD) utilization based on insurance status have been described, but little is known about postimplant follow-up patterns associated with insurance status and outcomes. We collected demographic, clinical, and device data from 119 consecutive patients presenting with ICD shocks. Insurance status was classified as uninsured/Medicaid (uninsured) or private/Health Maintenance Organization /Medicare (insured). Shock frequencies were analyzed before and after a uniform follow-up pattern was implemented regardless of insurance profile...
November 16, 2016: American Journal of Cardiology
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