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Cost statin utilization

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https://www.readbyqxmd.com/read/29261246/impact-of-statin-guidelines-on-statin-utilization-and-costs-in-an-employer-based-primary-care-clinic
#1
Holly E Gurgle, Marisa B Schauerhamer, Simón A Rodriguez, Carrie McAdam-Marx
OBJECTIVES: The purpose of this study was to describe statin utilization and costs in an employer-based patient cohort by comparing actual practice and assumed adoption of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) or 2016 US Preventive Services Task Force (USPSTF) statin recommendations versus the guidelines described in 2001 (and supplemented in 2004) in the Third Report of the National Cholesterol Education Program's Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATPIII)...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29210031/adjuvant-statin-therapy-for-esophageal-adenocarcinoma-a-cost-utility-analysis
#2
Rebekah Fong Soe Khioe, Chris Skedgel, Andrew Hart, Michael Philip Nelson Lewis, Leo Alexandre
BACKGROUND: Emerging preclinical evidence indicates statins, medications commonly used in the prevention of cardiovascular disease (CVD), inhibit proliferation, promote apoptosis and limit invasiveness of esophageal adenocarcinoma (EAC). Population-based observational data demonstrate statin treatment after diagnosis of EAC is associated with significant reductions in all-cause and cancer-specific mortality. A feasibility study of adjuvant statin therapy following potentially curative resection for EAC has been completed, with planned progression to a full phase III, randomized controlled trial...
December 5, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29181773/budget-impact-analysis-of-pcsk9-inhibitors-for-the-management-of-adult-patients-with-heterozygous-familial-hypercholesterolemia-or-clinical-atherosclerotic-cardiovascular-disease
#3
Usha G Mallya, Susan H Boklage, Andrew Koren, Thomas E Delea, C Daniel Mullins
OBJECTIVE: The aim of this study was to assess the budget impact of introducing the proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) alirocumab and evolocumab to market for the treatment of adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular (CV) disease requiring additional lowering of low-density lipoprotein cholesterol (LDL-C). METHODS: A 3-year model estimated the costs of lipid-modifying therapy (LMT) and CV events to a hypothetical US health plan of 1 million members, comparing two scenarios-with and without the availability of PCSK9i as add-on therapy to statins...
November 27, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29177971/organic-ion-transporters-and-statin-drug-interactions
#4
REVIEW
Kenneth Kellick
PURPOSE OF REVIEW: Statin drug-drug interactions (DDIs) are both troublesome to patients as well as costly to medical resources. The ability to predict and avoid these events could lead to improved outcomes as well as patient satisfaction. This review will explore efforts to better understand and predict these interactions specifically related to one drug transport system, the organic anion-transporting polypeptides (OATPs) specifically OATP1B1 and OATP1B3. RECENT FINDINGS: Since the publication of the discovery of OATPs, there have been various pharmacokinetic models that have been proposed to explain the variation in pharmacokinetic and clinical effects related to the OATPs...
November 25, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29151496/cost-effectiveness-analysis-of-cardiovascular-disease-treatment-in-japan
#5
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Hiroshi Akazawa, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29112402/combined-falling-drop-open-port-sampling-interface-system-for-automated-flow-injection-mass-spectrometry
#6
Gary J Van Berkel, Vilmos Kertesz, Matt Orcutt, Adam Bentley, Jim Glick, Jimmy Flarakos
The aim of this work was to demonstrate and to evaluate the analytical performance of a combined falling drop/open port sampling interface (OPSI) system as a simple noncontact, no-carryover, automated system for flow injection analysis with mass spectrometry. The falling sample drops were introduced into the OPSI using a widely available autosampler platform utilizing low cost disposable pipet tips and conventional disposable microtiter well plates. The volume of the drops that fell onto the OPSI was in the 7-15 μL range with an injected sample volume of several hundred nanoliters...
November 7, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28989095/risk-factors-and-prevention-of-hepatocellular-carcinoma-in-the-era-of-precision-medicine
#7
REVIEW
Naoto Fujiwara, Scott L Friedman, Nicolas Goossens, Yujin Hoshida
Chronic fibrotic liver disease caused by viral or metabolic etiologies is a high-risk condition for developing hepatocellular carcinoma (HCC). Even after complete HCC tumor resection or ablation, the carcinogenic tissue microenvironment in the remnant liver can give rise to recurrent de novo HCC tumors, which progress into incurable, advanced-stage disease in the majority of patients. Thus, early detection and prevention of HCC development is, in principle, the most impactful strategy to improve patient prognosis...
October 5, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#8
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28902603/the-utility-of-conservative-treatment-modalities-in-the-management-of-osteonecrosis
#9
Feroz Osmani, Savyasachi Thakkar, Jonathan Vigdorchik
INTRODUCTION: Osteonecrosis is an ischemic pathologic process associated with a number of conditions affecting a range of age groups. The problem faced in the management of osteonecrosis is whether conservative treatment is a viable and effective option for patients. In this systematic review, we investigated the efficacy of various nonoperative treatment modalities for hip and knee osteonecrosis, including pharmacological management and biophysical modalities. METHODS: We identified 16 studies based on electronic searches through the PubMed, Embase, CINAHL Plus, and Cochrane databases from January 2001 to November 2015...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28878673/review-of-the-reported-measures-of-clinical-validity-and-clinical-utility-as-arguments-for-the-implementation-of-pharmacogenetic-testing-a-case-study-of-statin-induced-muscle-toxicity
#10
REVIEW
Marleen E Jansen, T Rigter, W Rodenburg, T M C Fleur, E J F Houwink, M Weda, Martina C Cornel
Advances from pharmacogenetics (PGx) have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28873416/cost-effectiveness-analysis-of-use-of-a-polypill-versus-usual-care-or-best-practice-for-primary-prevention-in-people-at-high-risk-of-cardiovascular-disease
#11
Sue Jowett, Pelham Barton, Andrea Roalfe, Kate Fletcher, F D Richard Hobbs, Richard J McManus, Jonathan Mant
BACKGROUND: Clinical trials suggest that use of fixed-dose combination therapy ('polypills') can improve adherence to medication and control of risk factors of people at high risk of cardiovascular disease (CVD) compared to usual care, but cost-effectiveness is unknown. OBJECTIVE: To determine whether a polypill is cost-effective compared to usual care and optimal guideline-recommended treatment for primary prevention in people already on statins and/or blood pressure lowering therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28832867/cost-effectiveness-of-evolocumab-therapy-for-reducing-cardiovascular-events-in-patients-with-atherosclerotic-cardiovascular-disease
#12
Gregg C Fonarow, Anthony C Keech, Terje R Pedersen, Robert P Giugliano, Peter S Sever, Peter Lindgren, Ben van Hout, Guillermo Villa, Yi Qian, Ransi Somaratne, Marc S Sabatine
Importance: The proprotein convertase subtilisin/kexin type 9 inhibitor evolocumab has been demonstrated to reduce the composite of myocardial infarction, stroke, or cardiovascular death in patients with established atherosclerotic cardiovascular disease. To our knowledge, long-term cost-effectiveness of this therapy has not been evaluated using clinical trial efficacy data. Objective: To evaluate the cost-effectiveness of evolocumab in patients with atherosclerotic cardiovascular disease when added to standard background therapy...
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28744103/clinical-utility-of-evolocumab-in-the-management-of-hyperlipidemia-patient-selection-and-follow-up
#13
REVIEW
Dave L Dixon, Leo F Buckley, Cory R Trankle, Dinesh Kadariya, Antonio Abbate
Inhibition of PCSK9 is a novel therapeutic strategy aimed at reducing low-density-lipoprotein cholesterol (LDL-C) and cardiovascular risk. Evolocumab is a fully humanized monoclonal antibody that inhibits PCSK9, an enzyme that binds to LDL receptors and prevents them from recycling to the hepatocyte surface. Clinical trials have demonstrated 50%-70% reductions in LDL-C with evolocumab when used in combination with statin therapy. The recent FOURIER trial demonstrated that evolocumab further reduces cardiovascular events, but not mortality, in high-risk patients already receiving statin therapy...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28557865/the-emerging-role-of-proprotein-convertase-subtilisin-kexin-type-9-inhibition-in-secondary-prevention-from-clinical-trials-to-real-world-experience
#14
Amritanshu S Pandey, Harpreet S Bajaj, Vinay Garg, Avinash Pandey, Subodh Verma
PURPOSE OF REVIEW: The recent advent of a highly efficacious class of low-density lipoprotein cholesterol (LDL-C) lowering agents, the proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors, has transformed dyslipidaemia management in patients with cardiovascular disease as well as those with familial hypercholesterolemia. RECENT FINDINGS: Recent positive results of the landmark Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk cardiovascular outcome trial with evolocumab as an add-on to statin therapy demonstrate further reduction of cardiovascular events...
May 26, 2017: Current Opinion in Cardiology
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/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/28426345/economic-evaluation-of-ezetimibe-treatment-in-combination-with-statin-therapy-in-the-united-states
#17
Glenn M Davies, Ami Vyas, Carl A Baxter
AIMS: This study assessed the cost-effectiveness of ezetimibe with statin therapy vs statin monotherapy from a US payer perspective, assuming the impending patent expiration of ezetimibe. METHODS: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses...
July 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28366593/cost-effectiveness-of-evolocumab-in-patients-with-high-cardiovascular-risk-in-spain
#18
Guillermo Villa, Mickael Lothgren, Lucie Kutikova, Peter Lindgren, Shravanthi R Gandra, Gregg C Fonarow, Francesc Sorio, Lluis Masana, Antoni Bayes-Genis, Ben van Hout
PURPOSE: Our objective was to assess the cost-effectiveness of evolocumab in patients at high risk of cardiovascular (CV) events from the Spanish National Health System perspective. METHODS: A Markov model was used to assess the cost-effectiveness (incremental [∆] cost per ∆ quality-adjusted life-year [QALY]; or cost utility) of evolocumab plus standard of care (SoC; statins) versus SoC, assuming lifetime treatment. Cohorts with baseline LDL-C >100 mg/dL and familial hypercholesterolemia (FH) or CV event history (secondary prevention [SP]) were considered...
April 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28347513/cost-effectiveness-of-maintaining-daily-intake-of-oat-%C3%AE-glucan-for-coronary-heart-disease-primary-prevention
#19
Stephanie R Earnshaw, Cheryl L McDade, YiFang Chu, Lisa E Fleige, John L Sievenpiper
PURPOSE: Oat β-glucan reduces cholesterol levels and thus reduces the risk for coronary heart disease (CHD). However, its economic impact has not been well studied. We examined the economic impact of daily intake of ≥3 g of oat β-glucan in primary prevention of CHD in patients receiving statins or no pharmacologic treatment. METHODS: A decision model was developed to compare costs and outcomes associated with lowering cholesterol levels with no pharmacologic treatment and normal diet, no pharmacologic treatment plus ≥3 g/d of oat β-glucan, and statin therapy plus ≥3 g/d of oat β-glucan...
April 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28279072/aspirin-in-older-adults-need-for-wider-utilization-in-secondary-prevention-and-individual-clinical-judgments-in-primary-prevention
#20
Mandi Sehgal, Sarah K Wood, Joseph G Ouslander, Charles H Hennekens
In the treatment or secondary prevention of cardiovascular disease (CVD), there is general consensus that the absolute benefits of aspirin far outweigh the absolute risks. Despite evidence from randomized trials and their meta-analyses, older adults, defined as aged 65 years or older, are less likely to be prescribed aspirin than their middle-aged counterparts. In primary prevention, the optimal utilization of aspirin is widely debated. There is insufficient randomized evidence among apparently healthy participants at moderate to high risk of a first CVD event, so general guidelines seem premature...
November 2017: Journal of Cardiovascular Pharmacology and Therapeutics
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