Abstract:
OBJECTIVE:Research indicates that insomnia may contribute significantly to healthcare costs; however, information on the effects of treatments on costs has not been thoroughly published. This study presents predictive models that forecast, from the perspective of commercial managed care, the effects of insomnia medications in reducing overall medical costs. The main objectives of this study were to predict the level of cost savings associated with insomnia treatments, illustrate the variation in outcomes given underlying model assumptions, and assist managed-care policy-makers with the evaluation of medications routinely administered for insomnia. METHODS:Data on four primary-efficacy measures: wake after sleep onset (WASO), sleep efficiency (SE), sleep onset latency (SOL) and total sleep time (TST) were abstracted from published clinical trial data for eszopiclone, indiplon, low-dose trazodone, ramelteon, zaleplon, zolpidem and zolpidem extended-release. Change in per-patient per-year (PPPY) healthcare costs in a single claims database was calculated for subjects taking zolpidem, zaleplon and low-dose trazodone using generalized linear model (GLM) techniques, controlling for baseline demographics and baseline costs. Change in costs for emerging insomnia medications was forecasted by imputing efficacy values for these drugs into the regressions. RESULTS:Using the accepted efficacy measure, WASO, zolpidem extended-release had the overall forecasted savings of -$1253 (CI: -$1404 to -$1404) PPPY compared to remaining treatments, whereas ramelteon cost an additional $348 (-$1280 to $584) PPPY. In three out of four cost-efficacy models, zolpidem extended-release had higher mean forecasted PPPY savings. CONCLUSION:This study examined cost effects of existing and emerging insomnia medications using models integrating clinical literature and medical claims within a statistical framework. The use of a single database may limit generalizability and models only address a 1-year period. Results suggest treatments can offer health plans direct cost savings, with amounts sensitive to variable and efficacy measures, potentially limited by those variables available in the claims database. Compared to other evaluated treatments, zolpidem extended-release produced consistently higher predicted cost savings.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Jhaveri M,Seal B,Pollack M,Wertz Ddoi
10.1185/030079907X199619subject
Has Abstractpub_date
2007-06-01 00:00:00pages
1431-43issue
6eissn
0300-7995issn
1473-4877journal_volume
23pub_type
杂志文章abstract::Poor nutritional status may impair well being indirectly as a consequence of increased morbidity and decline in functional status. The aim of this study was to examine the independent effect of body mass index on the well being of older people. Thirty one hospital-based patients over 65 years of age were studied. Well...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::This commentary critically evaluates the limitations of genetic risk predictions in multifactorial disease, with specific reference to age-related macular degeneration (AMD). AMD is a common blinding disease with 33 million people worldwide experiencing vision impairment. Although gene polymorphism combinations infer ...
journal_title:Current medical research and opinion
pub_type: 社论
doi:10.1185/03007995.2011.603301
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Control of arterial hypertension in obese or overweight patients is complicated since obesity directly contributes to increased blood pressure, requiring new, highly effective antihypertensive drugs. This study evaluates the efficacy of azilsartan medoxomil in real clinical practice. METHODS:An internationa...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1844647
更新日期:2020-12-07 00:00:00
abstract::A double-blind, parallel group study was carried out in 50 patients with an anxiety disorder to compare the anxiolytic efficacy and tolerability of a recently developed benzodiazepine, metaclazepam, with that of bromazepam. Patients were allocated at random to receive treatment for 2 weeks with either 15 mg metaclazep...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998809111129
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVES:To describe multiple myeloma (MM) treatment patterns and comorbidities over time in the US. RESEARCH DESIGN AND METHODS:Study patients were newly diagnosed with MM (ICD-9-CM 203.0x) between 1 July 2006 and 31 March 2014 and had ≥6 months of data prior to the initial MM diagnosis in MarketScan Research Datab...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2015.1105202
更新日期:2016-01-01 00:00:00
abstract::Objective: To evaluate the safety and efficacy of fulranumab as adjunct or monotherapy in patients with knee or hip pain related to moderate-to-severe osteoarthritis.Methods: Osteoarthritic patients (aged ≥18 years) from four phase 3 randomized, double-blind (DB), placebo-controlled studies were randomized to receive ...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1080/03007995.2019.1653068
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:A novel preoperative procedure From Home To Operation (FHTO) seeks to combat increasing operation and infection rates. This is the first prospective randomized controlled trial (RCT) comparing the cost-effectiveness and cost-utility of FHTO and conventional ward procedures for standardized Laparoscopic Cholec...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/030079907x233223
更新日期:2007-11-01 00:00:00
abstract::Two hundred and two patients with symptoms, signs and mycological evidence of Candida vaginitis were entered in a single-blind trial comparing 6-day clotrimazole therapy with a control group receiving 6 days' nystatin therapy. Adequate data was collected on 69 clotrimazole and 72 nystatin treated patients for analysis...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007997509113652
更新日期:1975-01-01 00:00:00
abstract:INTRODUCTION:This brief review describes conservative treatment methods for pelvic venous congestion. Therapy options: The authors present an analysis of the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), ergot alkaloid derivatives, hormonal agents, venoprotective agents, and compression therapy in the trea...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1080/03007995.2017.1302414
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Healthcare organizations must evaluate the cost effectiveness of the alternative therapies that are available to treat anemia and improve quality of life (QoL) of patients with cancer, that is, erythropoietic protein therapy and blood transfusion. METHODS:Pharmacoeconomic studies that evaluated the cost of ...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079906X167282
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To review clinical trial evidence supporting treatment of patients to a near-normal HbA(1c) target level and outline therapeutic strategies that optimize glycemic control. RESEARCH DESIGN AND METHODS:The current MEDLINE database and bibliographies were searched for literature relevant to diabetic complicatio...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079904X6291
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:To derive current real-world data on the rates and costs of severe hypoglycemia (SH) for people with type 2 diabetes mellitus (T2D) who have initiated basal insulin therapy and to examine differences in SH rates and costs stratified by history of prior SH events. METHODS:We used a nation-wide electronic hea...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2014.936930
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:To compare 1-year direct healthcare costs and utilization among children and adolescents initiating non-stimulant medications atomoxetine (ATX) or extended-release guanfacine (GXR). METHODS:In this retrospective, observational cohort study, children and adolescents aged 6-17 years with attention deficit/hyp...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1421918
更新日期:2018-04-01 00:00:00
abstract::Nine patients with persistently elevated diastolic blood pressure, exceeding 130 mmHg, received an oral dose of labetalol ranging from 200 mg to 400 mg. In all patients, this produced a significant and gradual decline in recumbent systolic and diastolic blood pressure, unaccompanied by symptoms or complications, with ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007997709110155
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:Poor quality has been reported for some generics and other copies of original products. We performed a pilot study to compare the disintegration/dissolution profiles of FOSAMAX (alendronate) 70 mg tablets with those of copies of FOSAMAX that were manufactured outside the United States. RESEARCH DESIGN AND ME...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079903125002577
更新日期:2003-01-01 00:00:00
abstract::Although the statistical strength of direct comparative randomized controlled trials is generally acknowledged, the particular demands of therapeutic decision making will often require indirect comparisons to be made, based on pooled data from multiple trials. As for all post-hoc analyses, the process of indirect comp...
journal_title:Current medical research and opinion
pub_type: 社论
doi:10.1185/03007995.2014.1002559
更新日期:2015-02-01 00:00:00
abstract::Evidence is needed to guide therapeutic decisions on patients who had ischaemic cerebral events. The recently published European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT), an open-label randomised controlled study, compared long-term treatment of patients randomised to aspirin 30-325 mg dai...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/030079906X167291
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:The objectives were to estimate the prevalence of self-treated hypoglycaemia in patients using basal insulin analogues; identify demographic, treatment related and behavioural risk factors; and describe patient and physician responses to these events. RESEARCH DESIGN AND METHODS:The GAPP2 (Global Attitude o...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1185/03007995.2012.743457
更新日期:2012-12-01 00:00:00
abstract::Background: Actinic keratosis (AK) is considered an "in situ" non-melanoma skin cancer induced by ultraviolet chronic exposure. Sunscreen and topical anti-inflammatory agents like diclofenac could improve the evolution of this kind of lesions. A topical product containing piroxicam 0.8% and sun filters (50 SPF) (ACTX)...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1080/03007995.2019.1626227
更新日期:2019-10-01 00:00:00
abstract:UNLABELLED:The occurrence of intestinal bacterial overgrowth in patients with Crohn's Disease (CD) has been described and antimicrobial treatment has been shown to be effective in reversing this condition. However, the mechanisms underlying the efficacy of antimicrobial therapy are still only partially known. The aim o...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/0300799009117003
更新日期:2000-01-01 00:00:00
abstract::The efficacy and side-effect profiles of two formulations of indomethacin were compared in a multi-centre, double-blind, crossover study in 77 patients with osteoarthritis. Patients were allocated at random to receive 75 mg indomethacin per day either as 1 controlled-release tablet at night or as 1 immediate-release c...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/03007999009110481
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:In treating migraine sufferers, physicians can choose from among seven triptans with different attributes. OBJECTIVE:To develop a system for selecting an oral triptan based on treatment priorities of migraine sufferers, neurologists, and primary care physicians (PCPs) in the United States, and evidence-base...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/030079905X36387
更新日期:2005-03-01 00:00:00
abstract::An open study was carried out in 41 children with mild to moderate psoriasis to assess the effectiveness and tolerance of treatment with a 0.1% dithranol plus 17% urea preparation applied twice daily. Thirty-four patients completed 6-weeks' treatment and 8 of them continued for a further 4 to 6 weeks. The results show...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007998309111752
更新日期:1983-01-01 00:00:00
abstract::A double-blind trial was carried out in 45 anxious out-patients to compare the effectiveness and tolerance of clobazam and diazepam. The severity of each patient's symptoms was assessed before, during and at the end of the trial period using the Hamilton Anxiety Rating Scale, and a note kept of any side-effects. The r...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998009109494
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:Generic drugs are identical or bioequivalent versions of the brand name drugs. They are the economic alternative of the costlier brand name drugs. This article presents a general overview of the procedure and regulatory aspects relating to generic drug approval in the US. METHODS:A computerized search was co...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2010.548374
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:For the prevention of chemotherapy-induced febrile aplasia, a single injection of pegfilgrastim per cycle has the same efficacy as six to ten injections of conventional granulocyte colony-stimulating factor (G-CSF). However, there are few data on the economic impact of pegfilgrastim use, especially in the co...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007990902918156
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Ramelteon is an MT(1)/MT(2) melatonin receptor agonist indicated for the treatment of insomnia characterized by difficulty with sleep onset. In previous clinical studies, ramelteon reduced latency to persistent sleep (LPS) in subjects with chronic insomnia. The goal of the current analysis was to determine th...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/03007990902858527
更新日期:2009-05-01 00:00:00
abstract::Two double-blind randomised trials are reported comparing the effectiveness of the antihistamines, clemastine and chlorpheniramine in comparable doses, in relieving the symptoms of allergic rhinitis. In the first trial, treating 58 adults seen in a general practice, both drugs were prescribed in tablet form; l mg. cle...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007997509113659
更新日期:1975-01-01 00:00:00
abstract:OBJECTIVE:Although a reduced aflibercept (2.0 mg) injection frequency relative to the approved dosing posology is included in national treatment guidelines for wet age-related macular degeneration (AMD), there is limited evidence of its comparative efficacy. The objective was to compare the efficacy and safety of reduc...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
doi:10.1185/03007995.2015.1084909
更新日期:2015-11-01 00:00:00
abstract::The glomerular and tubular function of 7 patients with a spectrum of renal impairment was measured before, during and after 4-days' treatment with cefuroxime and gentamicin. Neither the mean plasma urea nor creatinine concentrations of the group increased after combined treatment, nor was the excretion of cefuroxime s...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998009109458
更新日期:1980-01-01 00:00:00