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https://www.readbyqxmd.com/read/29731350/the-cost-effectiveness-of-pcsk9-inhibitors-the-australian-healthcare-perspective
#1
Radya Kumar, Andrew Tonkin, Danny Liew, Ella Zomer
BACKGROUND: For patients in whom statins are not tolerated or effective as monotherapy, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) represent a new class of lipid lowering therapies that may reduce low-density lipoprotein cholesterol (LDL-C) levels by up to 50% and lower cardiovascular events. While an important treatment option, the cost-effectiveness of PCSK9i in Australia remains unknown. This study aimed to determine the cost-effectiveness of PCSK9i compared to placebo in the prevention of atherosclerotic cardiovascular disease (CVD)...
April 26, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29651791/a-discrete-event-simulation-model-to-assess-the-economic-value-of-a-hypothetical-pharmacogenomics-test-for-statin-induced-myopathy-in-patients-initiating-a-statin-in-secondary-cardiovascular-prevention
#2
Dominic Mitchell, Jason R Guertin, Anick Dubois, Marie-Pierre Dubé, Jean-Claude Tardif, Ange Christelle Iliza, Fiorella Fanton-Aita, Alexis Matteau, Jacques LeLorier
BACKGROUND: Statin (HMG-CoA reductase inhibitor) therapy is the mainstay dyslipidemia treatment and reduces the risk of a cardiovascular (CV) event (CVE) by up to 35%. However, adherence to statin therapy is poor. One reason patients discontinue statin therapy is musculoskeletal pain and the associated risk of rhabdomyolysis. Research is ongoing to develop a pharmacogenomics (PGx) test for statin-induced myopathy as an alternative to the current diagnosis method, which relies on creatine kinase levels...
April 12, 2018: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/29622506/cost-effectiveness-of-a-fixed-dose-combination-polypill-in-secondary-prevention-of-cardiovascular-diseases-in-india-within-trial-cost-effectiveness-analysis-of-the-umpire-trial
#3
Kavita Singh, Catriona Crossan, Tracey-Lea Laba, Ambuj Roy, Alison Hayes, Abdul Salam, Stephen Jan, Joanne Lord, Nikhil Tandon, Anthony Rodgers, Anushka Patel, Simon Thom, Dorairaj Prabhakaran
BACKGROUND: The Use of Multidrug Pill In Reducing cardiovascular Events (UMPIRE) trial, showed that access to a cardiovascular polypill (aspirin, statin and two blood pressure lowering drugs) significantly improved adherence, lowered systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDLc) in patients with or at high risk of cardiovascular disease (CVD). We aimed to analyze the within-trial cost-effectiveness of the polypill strategy versus usual care in India. METHODS: Relative effectiveness and costs of polypill versus usual care groups in UMPIRE were estimated from the health sector perspective...
March 21, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29440909/clinical-characteristics-patterns-of-lipid-lowering-medication-use-and-health-care-resource-utilization-and-costs-among-patients-with-atherosclerotic-cardiovascular-disease
#4
Thomas P Power, Xuehua Ke, Zhenxiang Zhao, Nicole Gidaya Bonine, Mark J Cziraky, Michael Grabner, John J Barron, Ralph Quimbo, Burkhard Vangerow, Peter P Toth
Purpose: The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment. Patients and methods: This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29401328/implications-of-new-cholesterol-treatment-guidelines-on-statin-utilization-intensity-and-costs-in-active-duty-service-members
#5
Michael S Cahill, Rebecca M Seifried, Julia H Cheringal, Nicholas R Fiacco, Patrick S Moon, Michael K Cheezum, Todd C Villines
Background: The recommendations in the 2013 American College of Cardiology/American Heart Association (ACC/AHA) blood cholesterol guidelines expanded the indications and level of intensity of statin therapy for the primary prevention of cardiovascular disease. We assessed the treatment and cost implications of theseguidelines within a cohort of active duty service members. Methods: Using the military electronic medical record system, the Armed Forces Health Longitudinal Technology Application, we randomly selected 1,000 active duty persons aged 40 yr or older and reviewed their lipid profiles and medical records to identify risk factors for atherosclerotic cardiovascular disease...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29358195/national-trends-in-nonstatin-use-and-expenditures-among-the-us-adult-population-from-2002-to-2013-insights-from-medical-expenditure-panel-survey
#6
Joseph A Salami, Haider J Warraich, Javier Valero-Elizondo, Erica S Spatz, Nihar R Desai, Jamal S Rana, Salim S Virani, Ron Blankstein, Amit Khera, Michael J Blaha, Roger S Blumenthal, Barry T Katzen, Donald Lloyd-Jones, Harlan M Krumholz, Khurram Nasir
BACKGROUND: Evidence supporting nonstatin lipid-lowering therapy in atherosclerotic cardiovascular disease risk reduction is variable. We aim to examine nonstatin utilization and expenditures in the United States between 2002 and 2013. METHODS AND RESULTS: We used the Medical Expenditure Panel Survey database to estimate national trends in nonstatin use and cost (total and out-of-pocket, adjusted to 2013 US dollars using a gross domestic product deflator) among adults 40 years or older...
January 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29261246/impact-of-statin-guidelines-on-statin-utilization-and-costs-in-an-employer-based-primary-care-clinic
#7
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
#8
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...
March 2018: 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
#9
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...
January 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29177971/organic-ion-transporters-and-statin-drug-interactions
#10
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
#11
REVIEW
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...
December 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29112402/combined-falling-drop-open-port-sampling-interface-system-for-automated-flow-injection-mass-spectrometry
#12
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
#13
REVIEW
Naoto Fujiwara, Scott L Friedman, Nicolas Goossens, Yujin Hoshida
Patients who develop chronic fibrotic liver disease, caused by viral or metabolic aetiologies, are at a high risk of developing hepatocellular carcinoma (HCC). Even after complete HCC tumour resection or ablation, the carcinogenic tissue microenvironment in the remnant liver can give rise to recurrent de novo HCC tumours, which progress into incurable, advanced-stage disease in most patients. Thus, early detection and prevention of HCC development is, in principle, the most impactful strategy to improve patient prognosis...
March 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#14
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
#15
REVIEW
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
#16
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
#17
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
#18
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
#19
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
#20
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
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