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Medicare part d

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https://www.readbyqxmd.com/read/28541791/subsidies-for-oral-chemotherapy-and-use-of-immunomodulatory-drugs-among-medicare-beneficiaries-with-myeloma
#1
Adam J Olszewski, Stacie B Dusetzina, Charles B Eaton, Amy J Davidoff, Amal N Trivedi
Purpose The low-income subsidy (LIS) substantially lowers out-of-pocket costs for qualifying Medicare Part D beneficiaries who receive orally administered chemotherapy. We examined the association of LIS with the use of novel oral immunomodulatory drugs (IMiDs; lenalidomide and thalidomide) among beneficiaries with myeloma, who can receive either orally administered or parenteral (bortezomib-based) therapy. Methods Using SEER-Medicare data, we identified Part D beneficiaries diagnosed with myeloma in 2007 to 2011...
May 25, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28537963/out-of-pocket-spending-under-the-affordable-care-act-for-patients-with-cancer
#2
Matthew S Dixon, Ashley L Cole, Stacie B Dusetzina
The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patients...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28535297/antihypertensive-adherence-trajectories-among-older-adults-in-the-first-year-after-initiation-of-therapy
#3
Jennifer L Hargrove, Virginia Pate, Carri H Casteel, Yvonne M Golightly, Laura R Loehr, Stephen W Marshall, Til Stürmer
BACKGROUND: Adherence to antihypertensives is suboptimal, but previous methods of quantifying adherence fail to account for varying patterns of use over time. We sought to improve classification of antihypertensive adherence using group-based trajectory models, and to determine whether individual factors predict adherence trajectories. METHODS: We identified older adults initiating antihypertensive therapy during 2008-2011 using a 20% sample of Medicare (federal health insurance available to US residents over the age of 65) beneficiaries enrolled in parts A (inpatient services), B (outpatient services), and D (prescription medication)...
May 23, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28530467/osteoporotic-fractures-in-patients-with-systemic-lupus-erythematosus-and-end-stage-renal-disease
#4
B Le, J L Waller, R Radhakrishnan, S J Oh, M F Kheda, N S Nahman, L Carbone
Background The incidence of end stage renal disease (ESRD) in patients with systemic lupus erythematosus (SLE) is rising. However, the relationship between osteoporotic fractures and SLE in the setting of ESRD remains uninvestigated. The purpose of this study was to compare the frequency of incident osteoporotic fractures in patients with ESRD with and without SLE, to identify risk factors for fractures in patients with SLE and ESRD, and to examine the contribution of these fractures to mortality. Methods Retrospective cohort study of patients with SLE ( n = 716) and a 5% random sample of controls without SLE ( n = 4176) in the United States Renal Data System (USRDS) from years 2006-2008 enrolled in Medicare Part D...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28527969/surgically-managed-clinical-stage-iiia-clinical-n2-lung-cancer-in-the%C3%A2-society-of-thoracic-surgeons-database
#5
Daniel Boffa, Felix G Fernandez, Sunghee Kim, Andrzej Kosinski, Mark W Onaitis, Patricia Cowper, Jeffrey P Jacobs, Cameron D Wright, Joe B Putnam, Anthony P Furnary
BACKGROUND: The role of surgical resection in patients with clinical stage IIIA-N2 positive (cIIIA-N2) lung cancer is controversial, partly because of the variability in short- and long-term outcomes. The objective of this study was to characterize the management of cIIIA-N2 lung cancer in The Society of Thoracic Surgeons General Thoracic Surgery Database (STS-GTSD). METHODS: The STS-GTSD was queried for patients who underwent operations for cIIIA-N2 lung cancer between 2002 and 2012...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28515111/racial%C3%A2-differences-in-adjuvant-endocrine-therapy-use-and-discontinuation-in-association-with-mortality-among-medicare-breast-cancer-patients-by-receptor-status
#6
Albert J Farias, Xianglin L Du
BACKGROUND: There are racial disparities in breast cancer mortality. Our purpose was to determine whether racial/ethnic differences in use and discontinuation of AET differed by hormone receptor status and whether discontinuation was associated with mortality. METHODS: We conducted a retrospective cohort study with SEER/Medicare dataset of women age 65 years or older diagnosed with stage I-III breast cancer in Medicare Part-D from 2007-2009, stratified by hormone receptor status...
May 17, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28499649/a-seer-medicare-analysis-of-the-impact-of-metformin-on-overall-survival-in-ovarian-cancer
#7
Christine Garcia, Aaron Yao, Fabian Camacho, Rajesh Balkrishnan, Leigh A Cantrell
OBJECTIVE: Determine whether metformin use is associated with improved survival in patients with ovarian, fallopian tube or primary peritoneal cancer. METHODS: All patients with a diagnosis of first epithelial ovarian cancer from 2007 to 2011 in the combined SEER-Medicare database were identified from the SEER registry primary site codes. Comorbidities, procedures and cancer treatment ICD-9 and HCPCS codes were used to search the Medicare claims files. Medication use was determined with National Drug Codes using the Medicare Part D event files...
May 9, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28485111/disclosure-of-industry-payments-to-prescribers-industry-payments-might-be-a-factor-impacting-generic-drug-prescribing
#8
Jingjing Qian, Richard A Hansen, Daniel Surry, Jennifer Howard, Zippora Kiptanui, Ilene Harris
PURPOSE: Pharmaceutical companies paid at least $3.91bn to prescribers in 2013, yet evidence indicating whether industry payments shift prescribing away from generics is limited. This study examined the association between amount of industry payments to prescribers and generic drug prescribing rates among Medicare Part D prescribers. METHODS: A cross-sectional analysis was conducted among 770 095 Medicare Part D prescribers after linking the 2013 national Open Payments data with 2013 Medicare Provider Utilization and Payment data...
May 9, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28471711/rising-prices-of-targeted-oral-anticancer-medications-and-associated-financial-burden-on-medicare-beneficiaries
#9
Ya-Chen Tina Shih, Ying Xu, Lei Liu, Fabrice Smieliauskas
Purpose The high cost of oncology drugs threatens the affordability of cancer care. Previous research identified drivers of price growth of targeted oral anticancer medications (TOAMs) in private insurance plans and projected the impact of closing the coverage gap in Medicare Part D in 2020. This study examined trends in TOAM prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. Methods Using SEER linked to Medicare Part D, 2007 to 2012, we identified patients who take TOAMs via National Drug Codes in Part D claims...
May 4, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28460645/statin-use-and-hip-fractures-in-u-s-kidney-transplant-recipients
#10
Chandan Vangala, Colin R Lenihan, Maria E Montez-Rath, Sumi Sukumaran Nair, Sankar D Navaneethan, Venkat Ramanathan, Wolfgang C Winkelmayer
BACKGROUND: Basic and translational research supports beneficial effects of statins on bone metabolism. Clinical studies suggest that statin use may reduce the risk of hip fractures in the general population. Whether statin use is associated with hip fracture risk in kidney transplant recipients, a particularly high-risk group for this outcome, is unknown. METHODS: From the U.S. Renal Data System (2007-2011), we identified all hip fracture events recorded in Medicare billing claims of first-time kidney transplant recipients...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28459351/psychometric-evaluation-of-kingston-caregiver-stress-scale
#11
Tatiana Sadak, Anna Korpak, Jacob D Wright, Mee Kyung Lee, Margaret Noel, Kathleen Buckwalter, Soo Borson
OBJECTIVES: Standardized measurement of caregiver stress is a component of Medicare's new health care benefit supporting care planning for people with dementia. In this article we identify existing measures of caregiver stress, strain and burden and propose specific criteria for choosing tools that may be suitable for wide use in primary care settings. We reviewed 22 measures and identified one, the Kingston Caregiver Stress Scale (KCSS), which met all the proposed criteria but had not been studied in a U...
April 5, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28453645/medicare-part-d-payments-for-topical-steroids-rising-costs-and-potential-savings
#12
Hannah Song, Adewole Adamson, Arash Mostaghimi
Importance: Rising pharmaceutical costs in the United States are an increasing source of financial burden for payers and patients. Although topical steroids are among the most commonly prescribed medications in dermatology, there are limited data on steroid-related spending and utilization. Objective: To characterize Medicare and patient out-of-pocket costs for topical steroids, and to model potential savings that could result from substitution of the cheapest topical steroid from the corresponding potency class...
April 28, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28447106/defining-hip-fracture-with-claims-data-outpatient-and-provider-claims-matter
#13
S D Berry, A R Zullo, K McConeghy, Y Lee, L Daiello, D P Kiel
Medicare claims are commonly used to identify hip fractures, but there is no universally accepted definition. We found that a definition using inpatient claims identified fewer fractures than a definition including outpatient and provider claims. Few additional fractures were identified by including inconsistent diagnostic and procedural codes at contiguous sites. INTRODUCTION: Medicare claims data is commonly used in research studies to identify hip fractures, but there is no universally accepted definition of fracture...
April 26, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28431672/corrigendum-to-trends-in-opioid-prescriptions-among-part-d-medicare-recipients-from-2007-to-2012-the-american-journal-of-medicine-2016-129-221-e21-221-e30
#14
Yong-Fang Kuo, Mukaila A Raji, Nai-Wei Chen, Hunaid Hasan, James S Goodwin
No abstract text is available yet for this article.
May 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28429891/comparison-of-immunization-rates-of-adults-ages-65-years-and-older-managed-within-two-nurse-practitioner-owned-clinics-with-national-immunization-rates
#15
Wendy L Wright, Elise Morrell, Jennie Lee, Norma Graciela Cuellar, Patricia White
BACKGROUND AND PURPOSE: Adults ages ≥65 years are at increased risk for infectious diseases. Ensuring these individuals are fully vaccinated is imperative. The purpose of this study was to assess the immunization rates of adults ages ≥65 years managed by nurse practitioners (NPs) and compare the results with national immunization rates and Healthy People 2020 goals. METHODS: A convenience sample of adults ages ≥65 years was obtained from two NP-managed clinics...
April 21, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28428922/the-cost-benefit-balance-of-statins-in-hawai-i-a-moving-target
#16
Corey J Lum, Kazuma Nakagawa, Ralph V Shohet, Todd B Seto, Deborah A Taira
Statins are lipid-lowering medications used for primary and secondary prevention of atherosclerotic disease and represent a substantial portion of drug costs in the United States. A better understanding of prescribing patterns and drug costs should lead to more rational utilization and help constrain health care expenditures in the United States. The 2013 Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File for the State of Hawai'i was analyzed. The number of prescriptions for statins, total annual cost, and daily cost were calculated by prescriber specialty and drug...
April 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28426189/issues-confronting-rural-pharmacies-after-a-decade-of-medicare-part-d
#17
Fred Ullrich, Abiodun Salako, Keith Mueller
Purpose. The RUPRI Center for Rural Health Policy Analysis has been monitoring the status of rural independent pharmacies since the implementation of Medicare Part D in 2005. After a decade of Part D, we reassess in this brief the issues that concern rural pharmacies and may ultimately challenge their provision of services. This reassessment is based on survey responses from rural pharmacists. Key Findings: (1) Rural pharmacists indicated that two challenges--direct and indirect remuneration (DIR) fees, and delayed maximum allowable cost (MAC) adjustment--ranked highest on scales of both magnitude and immediacy...
April 2017: Rural Policy Brief
https://www.readbyqxmd.com/read/28419189/propensity-scores-with-misclassified-treatment-assignment-a-likelihood-based-adjustment
#18
Danielle Braun, Malka Gorfine, Giovanni Parmigiani, Nils D Arvold, Francesca Dominici, Corwin Zigler
Propensity score methods are widely used in comparative effectiveness research using claims data. In this context, the inaccuracy of procedural or billing codes in claims data frequently misclassifies patients into treatment groups, that is, the treatment assignment ($T$) is often measured with error. In the context of a validation data where treatment assignment is accurate, we show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis: (i) propensity score estimation; (ii) propensity score implementation; and (iii) outcome analysis conducted conditional on the estimated propensity score and its implementation...
April 17, 2017: Biostatistics
https://www.readbyqxmd.com/read/28412154/quality-indicator-for-epilepsy-treatment-15-quiet-15-intervening-after-recurrent-seizures-in-the-elderly
#19
Jerzy P Szaflarski, Roy C Martin, Edward Faught, Ellen Funkhouser, Joshua Richman, Kendra Piper, Lucia Juarez, Chen Dai, Maria Pisu
In this study, we examined the provision of care to older adults with epilepsy and compliance with the "Quality Indicator for Epilepsy Treatment 15" (QUIET-15) measure. We analyzed 2008-2010, 5% random sample of Medicare beneficiaries augmented with data from all beneficiaries who identified as a minority with claims related to seizures (780.3x) or epilepsy (345.xx). Of 36,912 identified epilepsy cases, 12.6% had ≥1 emergency room (ER) visit for seizure(s). For those who presented to ER, among those taking anti-epileptic drugs (AEDs), AED was changed in 15...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28412055/impact-of-an-open-enrollment-service-on-costs-for-medicare-part-d-beneficiaries
#20
Chelsea E Leonard, Frances V Cohenour, Lindsey A DeLoach, John A Galdo
OBJECTIVE: The primary objective was to determine total estimated cost savings based on a patient's current medication regimen after comparing available Medicare Part D plans for the upcoming year by using a plan comparison platform. The secondary objective was to determine patient-centered concerns when considering a change in Part D plans. DESIGN: Review of an Open Enrollment service that included a patient survey and a Part D plan comparison. SETTING: This study took place at a single independent community pharmacy in northwest Alabama...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
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