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dermatology cost

Jose-Manuel Carrascosa, Ira Jacobs, Danielle Petersel, Robert Strohal
Psoriasis is a chronic, inflammatory, lifelong disease with a high prevalence (afflicting approximately 1-5% of the population worldwide) and is associated with significant morbidity. The introduction of biologic therapies has improved the management of this disease. Multiple biologic medicines that block cytokine signaling, including tumor necrosis factor (TNF) antagonists (adalimumab, etanercept, and infliximab) and inhibitors of interleukin (IL)-17 (brodalumab, ixekizumab, and secukinumab), IL-23 (guselkumab), or IL-12/23 (ustekinumab), are approved for the treatment of psoriasis...
March 16, 2018: Dermatology and Therapy
Jill M Bowman Peterson, Briar Duffy, Alisa Duran, Sophia P Gladding
BACKGROUND: Current health care costs are unsustainable, with a large percentage of waste attributed to doctor practices. Medical educators are developing curricula to address value-based care (VBC) in education. There is, however, a paucity of curricula and assessments addressing levels higher than 'knows' at the base of Miller's pyramid of assessment. Our objective was to: (1) teach residents the principles of VBC using active learning strategies; and (2) develop and pilot a tool to assess residents' ability to apply principles of VBC at the higher level of 'knows how' on Miller's pyramid...
March 6, 2018: Clinical Teacher
Jean Yoon, Ciaran S Phibbs, Adam Chow, Martin A Weinstock
BACKGROUND: It is unknown whether treatment costs of Keratinocyte Carcinoma (KC) and Actinic Keratosis (AK) can be lowered by spending more on chemoprevention. OBJECTIVE: We examine the impact of one-course treatment of topical fluorouracil on the face and ears on KC and AK treatment costs over three years. METHODS: The VAKCC trial compared the efficacy of topical fluorouracil cream, 5%, vs vehicle control cream for reducing KC risk. Trial data and administrative data on costs and utilization were analyzed to measure post-randomization encounters and treatment costs for KC and AK care...
March 2, 2018: Journal of the American Academy of Dermatology
Kira L Ryskina, Erica Goldberg, Briana Lott, Davis Hermann, John S Barbieri, Jules B Lipoff
Importance: Primary nonadherence with acne medications is high but commonly underreported to prescribing physicians. Objectives: To describe patient experiences with primary nonadherence to medications for acne and to identify physician-level factors that may improve adherence in this population. Design, Setting, and Participants: A qualitative analysis was conducted from structured interviews with patients reporting nonadherence with acne medications at a large academic health system in the Philadelphia, Pennsylvania, area...
February 28, 2018: JAMA Dermatology
V Blaschke, B Brauns, N Khaladj, C Schmidt, S Emmert
BACKGROUND: Hospital revenues generated by diagnosis-related groups (DRGs) are in part dependent on the coding of secondary diagnoses. Therefore, more and more hospitals trust specialized coders with this task, thereby relieving doctors from time-consuming administrative burdens and establishing a highly professionalized coding environment. However, it is vastly unknown if the revenues generated by the coders do indeed exceed their incurred costs. METHODS: Coding data from the departments of dermatology, ophthalmology, and infectious diseases from Rostock University Hospital from 2007-2016 were analyzed for the effects of secondary diagnoses on the resulting DRG, i...
February 27, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
David G Li, Fan Di Xia, Hasan Khosravi, Anna K Dewan, Daniel J Pallin, Christopher W Baugh, Karl Laskowski, Cara Joyce, Arash Mostaghimi
Importance: Many inflammatory skin dermatoses mimic cellulitis (pseudocellulitis) and are treated with antibiotics and/or hospitalization, leading to unnecessary patient morbidity and substantial health care spending. Objective: To evaluate the impact of early dermatology consultation on clinical and economic outcomes associated with misdiagnosed cellulitis. Design, Setting, and Participants: This prospective cohort study enrolled patients with presumed diagnosis of cellulitis in the emergency department, in the emergency department observation unit, or within 24 hours of admission to an inpatient unit of a large urban teaching hospital between February and September 2017...
February 16, 2018: JAMA Dermatology
Lauren N Ko, Anna C Garza-Mayers, Jessica St John, Lauren Strazzula, Priyanka Vedak, Radhika Shah, Allison S Dobry, Sowmya R Rao, Leslie W Milne, Blair Alden Parry, Daniela Kroshinsky
Importance: Each year, cellulitis leads to 650 000 hospital admissions and is estimated to cost $3.7 billion in the United States. Previous literature has demonstrated a high misdiagnosis rate for cellulitis, which results in unnecessary antibiotic use and health care cost. Objective: To determine whether dermatologic consultation decreases duration of hospital stay or intravenous antibiotic treatment duration in patients with cellulitis. Design, Setting, and Participants: This randomized clinical trial was conducted in a large urban tertiary care hospital between October 2012 and January 2017, with 1-month follow-up duration...
February 16, 2018: JAMA Dermatology
Caitlin N Suire, Sarah Nainar, Michael Fazio, Adam G Kreutzer, Tara Paymozd-Yazdi, Caitlyn L Topper, Caroline R Thompson, Malcolm A Leissring
Insulin-degrading enzyme (IDE) is an atypical zinc-metalloendopeptidase that hydrolyzes insulin and other intermediate-sized peptide hormones, many of which are implicated in skin health and wound healing. Pharmacological inhibitors of IDE administered internally have been shown to slow the breakdown of insulin and thereby potentiate insulin action. Given the importance of insulin and other IDE substrates for a variety of dermatological processes, pharmacological inhibitors of IDE suitable for topical applications would be expected to hold significant therapeutic and cosmetic potential...
2018: PloS One
Jeffrey M Clarke, Daniel J George, Stacey Lisi, April K S Salama
Immune checkpoint blockers have revolutionized cancer treatment in recent years. These agents are now approved for the treatment of several malignancies, including melanoma, squamous and non-squamous non-small cell lung cancer, renal cell carcinoma, urothelial carcinoma, and head and neck squamous cell carcinoma. Studies have demonstrated the significant impact of immunotherapy versus standard of care on patient outcomes, including durable response and extended survival. The use of immunotherapy-based combination therapy has been shown to further extend duration of response and survival...
February 13, 2018: Targeted Oncology
Hal Lewis, Mirna Becevic, Danny Myers, Dyann Helming, Rachel Mutrux, David Fleming, Karen Edison
INTRODUCTION: The present maldistribution of dermatologists in the USA may make it difficult for patients to access timely and quality care. Access to specialty care may be even more challenging for rural and underserved patients due to geographical limitations and other socioeconomic hardships. With over one-third of primary care patients seeking care for at least one skin problem, it is important to follow the American Academy of Dermatology Special Positioning Workgroup\'s core areas of impact regarding treatment of conditions that affect millions of patients by using a team-based approach and telemedicine technologies...
February 2018: Rural and Remote Health
Brooke E Rothstein, Jessica Gonzalez, Kiera Cunningham, Ami Saraiya, Adriana C Dornelles, Bichchau M Nguyen
The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients...
December 2017: Cutis; Cutaneous Medicine for the Practitioner
M Schielein, L Tizek, M Rotter, A Konstantinow, T Biedermann, A Zink
INTRODUCTION: Psoriasis and urticaria are chronic inflammatory skin diseases, which account for a substantial socio-economic burden and severely affect patients' quality of life. According to the respective German guidelines, biologicals can be used for the treatment of severe forms of these diseases. However, only a minority of patients receive this advised treatment. OBJECTIVE: To analyse the prescription of biologicals according to German national guidelines for psoriasis and chronic spontaneous urticaria and to assess possible barriers to prescription...
January 22, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Maren C Locke, Jeremy C Davis, Ross Joseph Brothers, W Elliot Love
BACKGROUND: There is a paucity of data providing direct comparison of outcomes, complications and costs between general and local anesthesia in cutaneous surgery. OBJECTIVE: Analyze the literature from dermatologic and other specialties to compare outcomes, risks and costs of general and local anesthesia. METHODS: A retrospective analysis of case comparison studies from other specialties comparing outcomes, risks, and/or costs in local vs...
January 12, 2018: Journal of the American Academy of Dermatology
Spencer D Brodsky, Olabola D Awosika, Misty G Eleryan, Monica Rengifo-Pardo, Xiangyu Kuang, Richard L Amdur, Alison Ehrlich
<p>Background: High out-of-pocket drug expenditures are increasingly common in dermatology. Patients may not be aware that prices vary among pharmacies and consequently may not shop for the lowest cost.</p> <p>Objective: To determine what factors influence pharmacy choice and the effect of providing local prescription prices on pharmacy selection. We hypothesized that patients do not "shop around" due to lack of knowledge of price variation and would choose a pharmacy based on costs if educated on price disparity...
December 1, 2017: Journal of Drugs in Dermatology: JDD
Divya Seth, Khatiya Cheldize, Danielle Brown, Esther F Freeman
Purpose of Review: We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings. Recent Findings: The Global Burden of Disease project has shown that skin diseases continue to be the 4th leading cause of nonfatal disease burden world-wide...
September 2017: Current Dermatology Reports
Fludiona Naka, Hanspaul Makkar, Jun Lu
Teledermatology has emerged as a promising solution for pediatric and adult patients accessing dermatologic care in a health care environment fraught with barriers to access. Teledermatology has been extensively evaluated in terms of diagnostic accuracy, clinical outcomes, patient and provider satisfaction, and costs, relative to traditional health care delivery models. Current research indicates that teledermatology is effective and efficient in diagnosis and management of skin diseases. The majority of studies on the subject, however, rely on adult patient data...
November 2017: Clinics in Dermatology
Marta Pentek, Zsombor Zrubka, Laszlo Gulacsi
BACKGROUND: Biological drugs represent highly effective but costly treatments for chronic immune-mediated inflammatory diseases posing substantial burden on health care budgets. Introduction of biosimilars since 2013 has brought forward the potential of market competition, and as a societal benefit, the hope of increased access at a lower cost. OBJECTIVE: We aim to provide a descriptive review on economic aspects and market changes related to the introduction of biosimilar drugs...
November 29, 2017: Current Pharmaceutical Design
Sally Y Tan, Daphne Tsoucas, Arash Mostaghimi
Importance: The persistent shortage of dermatologists in the United States affects access to care and patient outcomes. Objective: To characterize the effect of geographic variations in dermatologist density on the provision of dermatology procedures within Medicare. Design, Setting, and Participants: This was a cross-sectional study using the 2013 Medicare Provider Utilization and Payment Database. Dermatology-related procedures were defined by the top 50 billing codes accounting for more than 95% of procedures billed by dermatologists...
January 1, 2018: JAMA Dermatology
Martha Matsumoto, Aaron Secrest, Alyce Anderson, Melissa I Saul, Jonhan Ho, John M Kirkwood, Laura K Ferris
BACKGROUND: Data on the cost and efficiency of skin cancer detection through total body skin examination are scarce. OBJECTIVE: To determine the number needed to screen (NNS) and biopsy (NNB) and cost per skin cancer diagnosed in a large dermatology practice in patients undergoing total body skin examination. METHODS: This is a retrospective observational study. RESULTS: During 2011-2015, a total of 20,270 patients underwent 33,647 visits for total body skin examination; 9956 lesion biopsies were performed yielding 2763 skin cancers, including 155 melanomas...
November 24, 2017: Journal of the American Academy of Dermatology
Yoko Komura, Takamichi Kogure, Kazuo Kawahara, Hiroo Yokozeki
Using large-scale receipt data, we analyzed the differences in the prescription of drugs and their costs between dermatology and pediatrics in the treatment of atopic dermatitis (AD) in children. Between August 2010 and July 2011, 50 706 patients were diagnosed as having AD, and the data of 21 075 (15 257 dermatology, 5818 pediatric) patients aged 0-14 years were included in this study. The use of classes I (strongest), II (very strong), and III (strong) topical corticosteroids and tacrolimus was significantly higher in dermatology than in pediatrics (class I, 2...
November 23, 2017: Journal of Dermatology
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