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https://www.readbyqxmd.com/read/27919186/economic-evaluation-for-the-us-of-nab-paclitaxel-plus-gemcitabine-versus-folfirinox-versus-gemcitabine-in-the-treatment-of-metastatic-pancreas-cancer
#1
Mahdi Gharaibeh, Ali McBride, J Lyle Bootman, Hitendra Patel, Ivo Abraham
BACKGROUND: Nab-paclitaxel plus gemcitabine (NAB-P+GEM) and FOLFIRINOX have shown superior efficacy over gemcitabine (GEM) in the treatment of metastatic pancreatic ductal adenocarcinoma (mPDA). Though the incremental clinical benefits are modest, both treatments represent significant advances in the treatment of a high-mortality cancer. In this independent economic evaluation for the US, we aimed to estimate the comparative cost-utility and cost-effectiveness of these three regimens from the payer perspective...
December 6, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27878051/anticholinergics-for-overactive-bladder-temporal-trends-in-prescription-and-treatment-persistence
#2
Christopher J D Wallis, Colin Lundeen, Nicole Golda, Hilary Brotherhood, Peter Pommerville, Lesley Carr
INTRODUCTION: We sought to understand the contemporary pharmacologic management of overactive bladder (OAB) in a single-payer system. We examined temporal trends in the use of anticholinergic medications and assessed whether the likelihood of patients changing their anticholinergic therapy was predicted by their current therapy. METHODS: We conducted a retrospective, population-based analysis of prescription records from the PharmaNet database in BC, Canada. We identified patients treated with one or more anticholinergic prescriptions between 2001 and 2009...
August 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/27864782/the-cost-of-inpatient-management-of-heart-failure-patients-a-microcosting-study-in-the-irish-healthcare-setting
#3
R B Morgan, L McCullagh, M Barry, C Daly
AIMS: To formally assess the resource use and cost of the inpatient treatment of heart failure (HF) from the health-payer's perspective. In addition, to compare costs in our cohort to (a) locally derived patient-level costs (PLC) and (b) national costs as per disease-related group (DRG). METHODS AND RESULTS: Study population Demographics and resource utilisation data were obtained from a cohort of 30 patients (57% male, mean age 70 years) admitted into a single tertiary centre with heart failure...
November 19, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27837044/development-of-a-systematic-approach-to-pharmaceutical-industry-s-patient-assistance-programs-on-accessing-unfunded-cancer-drugs
#4
Victoria Kletas, Mario de Lemos
BACKGROUND: New oncology drugs usually become commercially available several months before the funding decisions are made by provincial public payers. Increasingly, patient assistance programs are being set up by pharmaceutical companies in order to facilitate access of their new cancer drugs before public funding decisions are finalized. We discovered that there is a need to keep this information up to date and available in a central repository, thus we have created a centralized patient assistance chart for use by all who require information on accessing unfunded drugs in our province...
November 10, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27810890/the-new-frontier-in-health-services-research-a-behavioural-paradigm-guided-by-genetics
#5
Kyle Fluegge
The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insurer selection, coverage therein and especially the subsequent use of health services is a necessary step forward, especially given the increasing prevalence of multimorbidity. Such a novel advancement in health services research may eventually propel public and private insurers to redesign their infrastructure to more accurately reflect the behavioural inclinations of their beneficiary populations...
November 2, 2016: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/27803598/predictors-of-adjuvant-treatment-for-pancreatic-adenocarcinoma-at-the-population-level
#6
D J Kagedan, M E Dixon, R S Raju, Q Li, M Elmi, E Shin, N Liu, A El-Sedfy, L Paszat, A Kiss, C C Earle, N Mittmann, N G Coburn
BACKGROUND: In the present study, we aimed to describe, at the population level, patterns of adjuvant treatment use after curative-intent resection for pancreatic adenocarcinoma (pcc) and to identify independent predictors of adjuvant treatment use. METHODS: In this observational cohort study, patients undergoing pcc resection in the province of Ontario (population 13 million) during 2005-2010 were identified using the provincial cancer registry and were linked to administrative databases that include all treatments received and outcomes experienced in the province...
October 2016: Current Oncology
https://www.readbyqxmd.com/read/27793955/colorado-s-bid-to-create-first-single-payer-system-in-us-faces-uphill-fight
#7
Michael McCarthy
No abstract text is available yet for this article.
October 28, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27793760/surgery-for-degenerative-cervical-myelopathy-a-patient-centered-quality-of-life-and-health-economic-evaluation
#8
Christopher D Witiw, Lindsay A Tetreault, Fabrice Smieliauskas, Branko Kopjar, Eric M Massicotte, Michael G Fehlings
BACKGROUND CONTEXT: Degenerative Cervical Myelopathy (DCM) represents the most common cause of non-traumatic spinal cord impairment in adults. Surgery has been shown to improve neurological symptoms and functional status, but it is costly. As sustainability concerns in the field of healthcare rise, the value of care has come to the forefront of policy decision-making. Evidence for both health related quality of life outcomes and financial expenditures are needed to inform resource allocation decisions...
October 25, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27761958/validity-of-administrative-data-for-identification-of-obstructive-sleep-apnea
#9
Cheryl R Laratta, Willis H Tsai, James Wick, Sachin R Pendharkar, Kerri A Johannson, Paul E Ronksley
Obstructive sleep apnea (OSA) is a common condition associated with significant morbidity and health-care utilization. We determined the validity of an algorithm derived from administrative data for identifying OSA using the respiratory disturbance index (RDI) as the reference standard. We conducted a retrospective cohort study of adults in Alberta, Canada referred for facility and community-based sleep diagnostic testing between July 2005 and August 2007. Validity indices were estimated for several case definitions of OSA derived from outpatient physician billing claims and hospital discharge codes...
October 20, 2016: Journal of Sleep Research
https://www.readbyqxmd.com/read/27742603/weighting-primary-care-patient-panel-size-a-novel-electronic-health-record-derived-measure-using-machine-learning
#10
Alvin Rajkomar, Joanne Wing Lan Yim, Kevin Grumbach, Ami Parekh
BACKGROUND: Characterizing patient complexity using granular electronic health record (EHR) data regularly available to health systems is necessary to optimize primary care processes at scale. OBJECTIVE: To characterize the utilization patterns of primary care patients and create weighted panel sizes for providers based on work required to care for patients with different patterns. METHODS: We used EHR data over a 2-year period from patients empaneled to primary care clinicians in a single academic health system, including their in-person encounter history and virtual encounters such as telephonic visits, electronic messaging, and care coordination with specialists...
October 14, 2016: JMIR Medical Informatics
https://www.readbyqxmd.com/read/27734785/what-can-we-learn-from-the-uk-s-natural-experiments-of-the-benefits-of-regions
#11
Gwyn Bevan
Marchildon highlights the lack of evidence on policies of regionalization in Canada: with regionalization being in favour in the 2000s followed by disillusion and the abolition of regions by some provincial governments. This paper looks at evidence from the UK's single-payer system of the impacts of regions on the performance of the delivery of healthcare. In England, regions were an important part of the hierarchical structure of the National Health Service (NHS) from its beginning, in 1948, to the introduction of provider competition, in the 1990s...
2016: HealthcarePapers
https://www.readbyqxmd.com/read/27702963/controlled-substance-lock-in-programs-examining-an-unintended-consequence-of-a-prescription-drug-abuse-policy
#12
Andrew W Roberts, Joel F Farley, G Mark Holmes, Christine U Oramasionwu, Chris Ringwalt, Betsy Sleath, Asheley C Skinner
Controlled substance lock-in programs are garnering increased attention from payers and policy makers seeking to combat the epidemic of opioid misuse. These programs require high-risk patients to visit a single prescriber and pharmacy for coverage of controlled substance medication services. Despite high prevalence of the programs in Medicaid, we know little about their effects on patients' behavior and outcomes aside from reducing controlled substance-related claims. Our study was the first rigorous investigation of lock-in programs' effects on out-of-pocket controlled substance prescription fills, which circumvent the programs' restrictions and mitigate their potential public health benefits...
October 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27695077/meta-review-of-the-quantity-and-quality-of-evidence-for-knee-arthroplasty-devices
#13
Anna R Gagliardi, Ariel Ducey, Pascale Lehoux, Sue Ross, Patricia Trbovich, Anthony Easty, Chaim Bell, Julie Takata, Christof Pabinger, David R Urbach
INTRODUCTION: Some cardiovascular devices are licensed based on limited evidence, potentially exposing patients to devices that are not safe or effective. Research is needed to ascertain if the same is true of other types of medical devices. Knee arthroplasty is a widely-used surgical procedure yet implant failures are not uncommon. The purpose of this study was to characterize available evidence on the safety and effectiveness of knee implants. METHODS: A review of primary studies included in health technology assessments (HTA) on total (TKA) and unicompartmental knee arthroplasty (UKA) was conducted...
2016: PloS One
https://www.readbyqxmd.com/read/27647784/pulmonary-artery-pressure-guided-heart-failure-management-us-cost-effectiveness-analyses-using-the-results-of-the-champion-clinical-trial
#14
Melissa Martinson, Rupinder Bharmi, Nirav Dalal, William T Abraham, Philip B Adamson
AIMS: Haemodynamic-guided heart failure (HF) management effectively reduces decompensation events and need for hospitalizations. The economic benefit of clinical improvement requires further study. METHODS AND RESULTS: An estimate of the cost-effectiveness of haemodynamic-guided HF management was made based on observations published in the randomized, prospective single-blinded CHAMPION trial. A comprehensive analysis was performed including healthcare utilization event rates, survival, and quality of life demonstrated in the randomized portion of the trial (18 months)...
September 19, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27643536/pipelines-creating-comparable-clinical-knowledge-efficiently-by-linking-trial-platforms
#15
M R Trusheim, A A Shrier, Z Antonijevic, R A Beckman, R K Campbell, C Chen, K T Flaherty, J Loewy, D Lacombe, S Madhavan, H P Selker, L J Esserman
Adaptive, seamless, multisponsor, multitherapy clinical trial designs executed as large scale platforms, could create superior evidence more efficiently than single-sponsor, single-drug trials. These trial PIPELINEs also could diminish barriers to trial participation, increase the representation of real-world populations, and create systematic evidence development for learning throughout a therapeutic life cycle, to continually refine its use. Comparable evidence could arise from multiarm design, shared comparator arms, and standardized endpoints-aiding sponsors in demonstrating the distinct value of their innovative medicines; facilitating providers and patients in selecting the most appropriate treatments; assisting regulators in efficacy and safety determinations; helping payers make coverage and reimbursement decisions; and spurring scientists with translational insights...
September 19, 2016: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27642178/potential-economic-burden-of-carbapenem-resistant-enterobacteriaceae-cre-in-the-united-states
#16
S M Bartsch, J A McKinnell, L E Mueller, L G Miller, S K Gohil, S S Huang, B Y Lee
The Centers for Disease Control and Prevention considers carbapenem-resistant Enterobacteriaceae (CRE) an urgent public health threat; however, its economic burden is unknown. We developed a CRE clinical and economics outcomes model to determine the cost of CRE infection from the hospital, third-party payer, and societal, perspectives and to evaluate the health and economic burden of CRE to the USA. Depending on the infection type, the median cost of a single CRE infection can range from $22 484 to $66 031 for hospitals, $10 440 to $31 621 for third-party payers, and $37 778 to $83 512 for society...
September 15, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27613084/beyond-the-randomized-controlled-trial-a-review-of-alternatives-in-mhealth-clinical-trial-methods
#17
Quynh Pham, David Wiljer, Joseph A Cafazzo
BACKGROUND: Randomized controlled trials (RCTs) have long been considered the primary research study design capable of eliciting causal relationships between health interventions and consequent outcomes. However, with a prolonged duration from recruitment to publication, high-cost trial implementation, and a rigid trial protocol, RCTs are perceived as an impractical evaluation methodology for most mHealth apps. OBJECTIVE: Given the recent development of alternative evaluation methodologies and tools to automate mHealth research, we sought to determine the breadth of these methods and the extent that they were being used in clinical trials...
September 9, 2016: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/27598230/high-throughput-measurement-of-single-cell-growth-rates-using-serial-microfluidic-mass-sensor-arrays
#18
Nathan Cermak, Selim Olcum, Francisco Feijó Delgado, Steven C Wasserman, Kristofor R Payer, Mark A Murakami, Scott M Knudsen, Robert J Kimmerling, Mark M Stevens, Yuki Kikuchi, Arzu Sandikci, Masaaki Ogawa, Vincent Agache, François Baléras, David M Weinstock, Scott R Manalis
Methods to rapidly assess cell growth would be useful for many applications, including drug susceptibility testing, but current technologies have limited sensitivity or throughput. Here we present an approach to precisely and rapidly measure growth rates of many individual cells simultaneously. We flow cells in suspension through a microfluidic channel with 10-12 resonant mass sensors distributed along its length, weighing each cell repeatedly over the 4-20 min it spends in the channel. Because multiple cells traverse the channel at the same time, we obtain growth rates for >60 cells/h with a resolution of 0...
October 2016: Nature Biotechnology
https://www.readbyqxmd.com/read/27593475/contemporary-practice-patterns-of-voiding-cystourethrography-use-at-a-large-tertiary-care-center-in-a-single-payer-health-care-system
#19
Linda C Lee, Armando J Lorenzo, Rakan Odeh, Michelle Falkiner, Dawn-Ann Lebarron, Jeffrey Traubici, Erika Mann, Paul R Bowlin, Martin A Koyle
PURPOSE: Voiding cystourethrogram involves radiation exposure and is invasive. Several guidelines, including the 2011 AAP (American Academy of Pediatrics) guidelines, no longer recommend routine voiding cystourethrogram after the initial urinary tract infection in children. The recent trend in voiding cystourethrogram use remains largely unknown. We examined practice patterns of voiding cystourethrogram use and explored the impact of these guidelines in a single payer system in the past 8 years...
September 2, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27579830/estimated-budget-impact-of-increased-use-of-mirabegron-a-novel-treatment-for-overactive-bladder
#20
Sinem Perk, Ronald C Wielage, Noll L Campbell, Timothy M Klein, Anthony Perkins, Linda M Posta, Thomas Yuran, Robert W Klein, Daniel B Ng
BACKGROUND: Oral pharmacological treatment for overactive bladder (OAB) consists of antimuscarinics and the beta-3 adrenergic agonist mirabegron. Antimuscarinic adverse events (AEs) such as dry mouth, constipation, and blurry vision can result in frequent treatment discontinuation rates, leaving part of the OAB population untreated. Antimuscarinics also contribute to a patient's anticholinergic cognitive burden (ACB), so the Beers Criteria recommends cautious use of antimuscarinics in elderly patients who take multiple anticholinergic medications or have cognitive impairment...
September 2016: Journal of Managed Care & Specialty Pharmacy
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