Nonadherence to oral linezolid after hospitalization: a retrospective claims analysis of the incidence and consequence of claim reversals.


BACKGROUND:Linezolid is available in an oral as well as an intravenous formulation. It is an oxazolidinone antibiotic and is effective in treating resistant gram-positive organisms such as methicillin-resistant Staphylococcus aureus and multidrug-resistant Streptococcus pneumoniae. OBJECTIVES:The goals of this study were to identify the incidence of claim reversals for oral linezolid in members who were recently discharged from a hospital and to study the subsequent pattern of health care utilization to quantify the consequences for members who have a reversed linezolid claim. METHODS:This study was a retrospective claims analysis of Humana Medicare Advantage Prescription Drug patients who had a claim for oral linezolid after an inpatient discharge between April 1, 2006, and June 30, 2008. The incidence of reversed claims among those with a linezolid prescription was measured as a proxy for medication adherence. Propensity scores were calculated to account for differences in patients' propensity to have a reversed claim. The association of the claim reversal with subsequent expenditures was assessed through 3 multivariate regression models wherein the dependent variables were drug, medical, and total costs for the 60-day period after discharge. The key independent variable was the occurrence of a reversed linezolid claim, and control variables included the propensity score quartiles and other clinical and demographic characteristics. All costs were provided in US dollars and from the year in which they occurred. RESULTS:Of 1046 patients identified (mean [SD] age, 69 [12] years; 51% male), 252 patients (24.1%) had a claim reversal for linezolid. Among these, 125 patients (49.6%) received linezolid within 10 days of the initial reversal, 39 patients (15.5%) received other antibiotics, and 88 patients (34.9%) did not receive any antibiotics. The unadjusted, mean outpatient drug costs were $696 and $2265 for patients with and without a reversal, respectively, whereas mean medical costs were $13,567 and $9355. Multivariable analyses revealed that members who did not receive linezolid after the claim reversal had significantly higher medical expenditures (Wald χ(2), 8.370; P = 0.004) and lower drug expenditures (Wald χ(2), 122.630; P < 0.01). The total costs did not differ significantly between the 2 groups (Wald χ(2), 1.540; P = 0.215), however, as the medical savings were partially negated by the higher drug costs. CONCLUSION:These patients with a reversed outpatient claim for linezolid had lower outpatient drug costs and higher medical costs in the 60-day period after the reversal.


Clin Ther


Clinical therapeutics


Ball AT,Xu Y,Sanchez RJ,Shelbaya A,Deminski MC,Nau DP




Has Abstract


2010-12-01 00:00:00














  • Pharmacokinetic Interaction Between Rosuvastatin, Telmisartan, and Amlodipine in Healthy Male Korean Subjects: A Randomized, Open-label, Multiple-dose, 2-period Crossover Study.

    abstract:PURPOSE:Rosuvastatin, a hydroxy methylglutaryl coenzyme A reductase inhibitor; telmisartan, an angiotensin receptor blocker; and amlodipine, a calcium channel inhibitor, are commonly prescribed together for the treatment of hypertension nonresponsive to monotherapy and accompanied by dyslipidemia. However, the pharmaco...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Son M,Guk J,Kim Y,Woo Chae D,Heo YA,Soh D,Park K

    更新日期:2016-08-01 00:00:00

  • Aripiprazole: a comprehensive review of its pharmacology, clinical efficacy, and tolerability.

    abstract:BACKGROUND:Recently approved for the treatment of schizophrenia, aripiprazole represents the sixth second-generation antipsychotic (SGA) introduced to the US market. Aripiprazole is considered a partial dopaminergic agonist, acting on both postsynaptic dopamine(2) receptors and presynaptic autoreceptors, in addition to...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: DeLeon A,Patel NC,Crismon ML

    更新日期:2004-05-01 00:00:00

  • An open-label, prospective, observational study of the incidence of coronary artery disease in patients with HIV infection receiving highly active antiretroviral therapy.

    abstract:BACKGROUND:The association of highly active antiretroviral therapy (HAART) regimens that include protease inhibitors (PIs) with metabolic and somatic disorders has raised concerns about the possibility of an increased risk of coronary artery disease (CAD) in patients with HIV infection. OBJECTIVE:The aim of this study...

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    pub_type: 临床试验,杂志文章,多中心研究


    authors: Barbaro G,Di Lorenzo G,Cirelli A,Grisorio B,Lucchini A,Hazra C,Barbarini G

    更新日期:2003-09-01 00:00:00

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    abstract::The pharmacodynamic parameter that appears to correlate best with a successful therapeutic outcome with beta-lactam antibiotics is the length of time the serum antibiotic concentration remains above the minimum inhibitory concentration (MIC) for the infecting pathogen. By maximizing this parameter, continuous administ...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Burgess DS,Summers KK,Hardin TC

    更新日期:1999-11-01 00:00:00

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    abstract::Forty women with moderate to severe primary dysmenorrhea participated in a two-month, double-blind, crossover trial comparing ketoprofen with mefenamic acid. Treatment with ketoprofen provided rapid and marked pain relief similar to that afforded by mefenamic acid. This improvement in symptoms was accompanied by an am...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章


    authors: Hébert JG,Le Morvan P,Bourgouin J

    更新日期:1986-01-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,meta分析


    authors: Nemergut C,Cheng JW

    更新日期:2000-08-01 00:00:00

  • Results of a cross-sectional survey about lipid-management practices among cardiologists in Pakistan: assessment of adherence to published treatment guidelines.

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    journal_title:Clinical therapeutics

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    authors: Gowani SA,Shoukat S,Taqui AM,Bhulani N,Khalid S,Sheikh A,Halim MS,Samreen S,Jafary FH

    更新日期:2009-07-01 00:00:00

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    pub_type: 杂志文章,meta分析,评审


    authors: Aroda VR,Henry RR,Han J,Huang W,DeYoung MB,Darsow T,Hoogwerf BJ

    更新日期:2012-06-01 00:00:00

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    journal_title:Clinical therapeutics

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    authors: Cheen HH,Lim SH,Huang MC,Bee YM,Wee HL

    更新日期:2014-07-01 00:00:00

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    authors: Aleixo GF,Fonseca MCM,Bortolini MAT,Brito LGO,Castro RA

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    authors: Zetin M,Aden G,Moldawsky R

    更新日期:1983-01-01 00:00:00

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    authors: Stubbings J,Lau DT

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    authors: Mecrow I,Miller V,Preston T

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    authors: Wong SF,Jakowatz JG,Taheri R

    更新日期:2005-12-01 00:00:00

  • Pharmacokinetics of oral cyanocobalamin formulated with sodium N-[8-(2-hydroxybenzoyl)amino]caprylate (SNAC): an open-label, randomized, single-dose, parallel-group study in healthy male subjects.

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,meta分析


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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


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    journal_title:Clinical therapeutics

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    authors: Nakagawa K,Aoki Y,Kusama T,Ban N,Nakagawa S,Sasaki Y

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    pub_type: 杂志文章


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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Mennella JA,Spector AC,Reed DR,Coldwell SE

    更新日期:2013-08-01 00:00:00

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    pub_type: 杂志文章


    authors: Cui N,Feng X,Zhao Z,Zhang J,Xu Y,Wang L,Hao G

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    journal_title:Clinical therapeutics



    authors: Summers KH

    更新日期:1996-11-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Nygaard HB

    更新日期:2013-10-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kooi GH,Pit S

    更新日期:1990-01-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Bar-Shalom D

    更新日期:2014-02-01 00:00:00