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https://www.readbyqxmd.com/read/29033060/a-review-of-international-coverage-and-pricing-strategies-for-personalized-medicine-and-orphan-drugs
#1
REVIEW
Irina Degtiar
BACKGROUND: Personalized medicine and orphan drugs share many characteristics-both target small patient populations, have uncertainties regarding efficacy and safety at payer submission, and frequently have high prices. Given personalized medicine's rising importance, this review summarizes international coverage and pricing strategies for personalized medicine and orphan drugs as well as their impact on therapy development incentives, payer budgets, and therapy access and utilization...
September 29, 2017: Health Policy
https://www.readbyqxmd.com/read/29019295/exploring-values-of-health-technology-assessment-agencies-using-reflective-multicriteria-and-rare-disease-case
#2
Mireille M Goetghebeur, Monika Wagner, Dima Samaha, William O'Neil, Danielle Badgley, Hector Castro-Jaramillo, Payam Abrishami, Antonio Sarria-Santamera, Irina Cleemput, Michele Tringali
OBJECTIVES: Tackling ethical dilemmas faced by reimbursement decision makers requires deeper understanding of values on which health technology assessment (HTA) agencies are founded and how trade-offs are made. This was explored in this study including the case of rare disease. METHODS: Representatives from eight HTA explored values on which institutions are founded using a narrative approach and reflective multicriteria (developed from EVIDEM, criteria derived from ethical imperatives of health care)...
October 11, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29017488/understanding-collaborative-care-implementation-in-the-department-of-veterans-affairs-core-functions-and-implementation-challenges
#3
Jessica M Lipschitz, Justin K Benzer, Christopher Miller, Siena R Easley, Jenniffer Leyson, Edward P Post, James F Burgess
BACKGROUND: The collaborative care model is an evidence-based practice for treatment of depression in which designated care managers provide clinical services, often by telephone. However, the collaborative care model is infrequently adopted in the Department of Veterans Affairs (VA). Almost all VA medical centers have adopted a co-located or embedded approach to integrating mental health care for primary care patients. Some VA medical centers have also adopted a telephone-based collaborative care model where depression care managers support patient education, patient activation, and monitoring of adherence and progress over time...
October 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28993805/addressing-pressing-needs-in-the-development-of-advanced-therapies
#4
David Morrow, Anton Ussi, Giovanni Migliaccio
The commercial development of advanced therapy medicinal products (ATMPs) represents great opportunity for therapeutic innovation but is beset by many challenges for its developers. Although the ATMP field continues to progress at a rapid pace, evidenced by the increasing number of clinical trials conducted over the past few years, several factors continue to complicate the introduction of ATMPs as a curative treatment for multiple disease types, by blocking their translational pathway from research to the patient...
2017: Frontiers in Bioengineering and Biotechnology
https://www.readbyqxmd.com/read/28991558/lung-cancer-screening-why-when-and-how
#5
REVIEW
Florian J Fintelmann, Ravi V Gottumukkala, Shaunagh McDermott, Matthew D Gilman, Inga T Lennes, Jo-Anne O Shepard
This article explains the rationale of lung cancer screening with low-dose computed tomography and provides a practical approach to all relevant aspects of a lung cancer screening program. Imaging protocols, patient eligibility criteria, facility readiness, and reimbursement criteria are addressed step by step. Diagnostic criteria and Lung-RADS (Lung Computed Tomography Screening Reporting and Data System) nodule management pathways are illustrated with examples. Pearls and pitfalls for interpretation of lung cancer screening low-dose chest computed tomography are discussed...
November 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28982611/nurse-driven-protocols-and-the-prevention-of-catheter-associated-urinary-tract-infections-a-systematic-review
#6
Danielle J Durant
BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-acquired conditions and no longer reimbursable from Medicare as of 2008. Nurse-driven protocols (NDPs), which provide a medically approved rubric for professional nurses to make autonomous care decisions, can facilitate appropriate catheter use and timely removal, as advised in the Centers for Disease Control and Prevention's 2009 CAUTI prevention guidelines. However, little attempt has been made to systematically evaluate their effect on clinical outcomes...
October 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28975568/modeled-health-economic-impact-of-a-hypothetical-certolizumab-pegol-risk-sharing-scheme-for-patients-with-moderate-to-severe-rheumatoid-arthritis-in-finland
#7
Erkki Soini, Christian Asseburg, Maarit Taiha, Kari Puolakka, Oana Purcaru, Riitta Luosujärvi
PURPOSE: To model the American College of Rheumatology (ACR) outcomes, cost-effectiveness, and budget impact of certolizumab pegol (CZP) (with and without a hypothetical risk-sharing scheme at treatment initiation for biologic-naïve patients) versus the current mix of reimbursed biologics for treatment of moderate-to-severe rheumatoid arthritis (RA) in Finland. METHODS: A probabilistic model with 12-week cycles and a societal approach was developed for the years 2015-2019, accounting for differences in ACR responses (meta-analysis), mortality, and persistence...
October 3, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28975428/a-new-efficient-method-to-monitor-precocious-puberty-nationwide-in-france
#8
Annabel Rigou, Joëlle Le Moal, Juliane Léger, Alain Le Tertre, Jean-Claude Carel
Clinical precocious puberty (PP) is a disease, reputed to be on the increase and suspected to be linked to endocrine disrupting chemicals (EDC) exposure. Population-based epidemiological data are lacking in France and scarce elsewhere. We accessed the feasibility of monitoring PP nationwide in France in this context, using a nationwide existing database, the French National Health Insurance Information System. Here, we present the method we used with a step-by-step approach to build and select the most suitable indicator...
October 3, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28974481/lack-of-adoption-of-a-mobile-app-to-support-patient-self-management-of-diabetes-and-hypertension-in-a-federally-qualified-health-center-interview-analysis-of-staff-and-patients-in-a-failed-randomized-trial
#9
Kathleen Thies, Daren Anderson, Benjamin Cramer
BACKGROUND: Thousands of mobile health (mHealth) apps have been developed to support patients' management of their health, but the effectiveness of many of the apps remains unclear. While mHealth apps appear to hold promise for improving the self-management of chronic conditions across populations, failure to balance the system demands of the app with the needs, interests, or resources of the end users can undermine consumers' adoption of these technologies. OBJECTIVE: The original aim of this study was to evaluate the effectiveness of a commercial mHealth app in improving clinical outcomes for adult patients in a Federally Qualified Health Center (FQHC) with uncontrolled diabetes and/or hypertension...
October 3, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28971347/effects-of-the-personalized-recovery-oriented-services-pros-program-on-hospitalizations
#10
Candace White, Eric Frimpong, Steve Huz, Adrienne Ronsani, Marleen Radigan
Though the recovery model has been implemented widely in outpatient mental health settings, there are no large sample evaluations of recovery oriented psychiatric rehabilitation programs that address both serious mental illness (SMI) and co-occurring disorders (COD) using a more comprehensive Medicaid reimbursable approach. This study examined preliminary hospitalization outcomes, for adults with SMI and COD enrolled in the NYS Personalized Recovery Oriented Services (PROS) program. McNemar's chi-square test was used to examine changes in hospitalization rates from pre-PROS admission to post-PROS discharge in a sample of 12,006 adults discharged from PROS...
October 2, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28965738/post-acute-care-setting-facility-characteristics-and-post-stroke-outcomes-a-systematic-review
#11
REVIEW
Matthew Alcusky, Christine M Ulbrict, Kate L Lapane
OBJECTIVE: To synthesize research comparing post-stroke health outcomes between patients rehabilitated in skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs). Secondly, to evaluate relationships between facility characteristics and outcomes. DATA SOURCES: PubMed and CINAHL searches spanned January 1, 1998 to October 6, 2016 and encompassed MeSH and free-text keywords for stroke, IRF/SNF, and study outcomes. Human and English limits were used...
September 28, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28965319/digitally-driven-integrated-primary-care-and-behavioral-health-how-technology-can-expand-access-to-effective-treatment
#12
REVIEW
Lori Raney, David Bergman, John Torous, Michael Hasselberg
PURPOSE OF REVIEW: Widespread implementation of integrated primary care and behavioral health is possible, but workforce shortages, competencies to deliver evidence-based approaches, and sufficient reimbursement are lacking. There are numerous telehealth solutions that could be utilized to assist with integration efforts that have the potential to be successfully used alone or in combination. This will require that the developers of such technologies understand the current evidence base for effective integration efforts and apply this knowledge to new solutions...
September 30, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28952508/so-you-think-you-have-an-idea-a-practical-risk-reduction-conceptual-model-for-academic-translational-research
#13
REVIEW
John Schwartz, Christopher Macomber
Translational research for new drugs, medical devices, and diagnostics encompasses aspects of both basic science and clinical research, requiring multidisciplinary skills and resources that are not all readily available in either a basic laboratory or clinical setting alone. We propose that, to be successful, "translational" research ought to be understood as a defined process from basic science through manufacturing, regulatory, clinical testing all the way to market. The authors outline a process which has worked well for them to identify and commercialize academic innovation...
April 4, 2017: Bioengineering
https://www.readbyqxmd.com/read/28946800/the-value-of-innovation-in-decision-making-in-health-care-in-central-eastern-europe-the-sixth-international-conference-the-value-of-innovation-in-decision-making-in-health-care-in-central-eastern-europe-2-june-2017-belgrade-serbia
#14
Tanja Novakovic, Antony P Martin, Mark Parker, Alessandra Ferrario, Simo Vukovic, Krzysztof Łanda, Jaroslav Duba, Dávid Dankó, Nikolaos Kotsopoulos, Brian Godman, Jelena Ristic, Danka Stefanovic, Danka Tesic
The Pharmacoeconomics Section of the Pharmaceutical Association of Serbia organised a one day international conference on the value of innovation in decision-making in health care in Central and Eastern Europe. The focus of the conference was on reimbursement decisions for medicines using health technology assessment and the use of managed entry agreements (MEAs). The objectives of this conference were firstly to discuss the challenges and opportunities with the use of MEAs in Central and Eastern European countries; secondly the role of patient registries especially with outcome based schemes, and finally new approaches to improve accessibility to new medicines including better managing their entry...
September 26, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28946711/health-care-payments-in-vietnam-patients-quagmire-of-caring-for-health-versus-economic-destitution
#15
Andre Pekerti, Quan-Hoang Vuong, Tung Manh Ho, Thu-Trang Vuong
In the last three decades many developing and middle-income nations' health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam's current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment)...
September 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28944593/fifty-years-of-behavioral-lifestyle-interventions-for-overweight-and-obesity-where-have-we-been-and-where-are-we-going
#16
REVIEW
Donald A Williamson
OBJECTIVE: This paper reviews the literature pertaining to the structure and content of intensive lifestyle interventions (ILIs) for overweight/obesity since Richard Stuart described this new treatment approach in 1967. A consensus opinion has formed that behavioral/lifestyle treatment of overweight and obesity should be viewed as a mainstream intervention for the treatment and prevention of type 2 diabetes and medical complications associated with obesity. METHODS: The development of modern ILIs and demonstration of their efficacy are compared by structure, content, and efficacy of four major randomized controlled trials: Diabetes Prevention Program (DPP), Look AHEAD, POUNDS Lost, and CALERIE...
September 25, 2017: Obesity
https://www.readbyqxmd.com/read/28925041/patterns-of-collaboration-among-health-care-and-social-services-providers-in-communities-with-lower-health-care-utilization-and-costs
#17
Amanda L Brewster, Marie A Brault, Annabel X Tan, Leslie A Curry, Elizabeth H Bradley
OBJECTIVE: To understand how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older adults. STUDY SETTING: Sixteen Hospital Service Areas (HSAs) in the United States. STUDY DESIGN: We conducted a qualitative study of HSAs with performance in the top or bottom quartiles nationally across three key outcomes: ambulatory care sensitive hospitalizations, all-cause risk-standardized readmission rates, and average reimbursements per Medicare beneficiary...
September 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28916895/the-cost-of-conversion-in-robotic-and-laparoscopic-colorectal-surgery
#18
Robert K Cleary, Andrew J Mullard, Jane Ferraro, Scott E Regenbogen
BACKGROUND: Conversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments. METHODS: This is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916017/payment-for-integrated-care-challenges-and-opportunities
#19
REVIEW
Katherine Hobbs Knutson
A multidisciplinary team approach to care and robust care coordination services are primary components of almost all integrated care delivery systems. Given that these services have limited reimbursement in fee-for-service payment arrangements, integrating care in a fee-for-service environment is almost impossible. Capitated payment models hold promise for supporting integrated behavioral and physical health services. There are multiple national examples of integrated care delivery systems supported by capitated payment arrangements...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28900839/behavioral-health-integration-into-primary-care-a-microsimulation-of-financial-implications-for-practices
#20
Sanjay Basu, Bruce E Landon, John W Williams, Asaf Bitton, Zirui Song, Russell S Phillips
BACKGROUND: New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. OBJECTIVE: To evaluate the financial impact for primary care practices of integrating behavioral health services. DESIGN: Microsimulation model. PARTICIPANTS: We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey...
September 12, 2017: Journal of General Internal Medicine
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