Abstract:
OBJECTIVE:To investigate adherence to dornase alfa therapy among commercially-insured patients with cystic fibrosis (CF) and to examine the impact of adherence on health and economic outcomes. METHODS:This retrospective cohort analysis included CF patients with ≥1 dornase alfa (Pulmozyme) pharmacy claim between 1 October 2006 and 30 September 2008 and with continuous enrollment in the health insurance plan at least 1 year before and 1 year after their index dornase alfa claim. Adherence was measured with the medication possession ratio (MPR). Multivariate models were used to estimate the relationship between adherence and exacerbations, utilization, and cost. RESULTS:Nine hundred and seven patients met the inclusion criteria. The mean age was 19.5 years (SD = 11.5) and 49.1% were female. Overall MPR was 0.59 and by age was 0.66 for patients of 5-12 years, 0.57 for 13-20 years, 0.54 for 21-30 years, and 0.56 for patients ≥31 years. Adherence was better in fall and winter than in spring and summer. There was no statistically significant difference in the proportion of patients with inpatient respiratory exacerbations across groups with low (<0.5), moderate (0.5-0.79), and high (≥0.8) adherence (24.5%, 22.3%, and 19.1%, respectively, p = 0.250). There was a trend toward higher total charges in more-adherent patients (mean $58,612 in the least-adherent group and mean $69,427 in the most adherent group, p = 0.107). In multivariate models, MPR was not significantly associated with the risk of inpatient respiratory exacerbations (hazard ratio = 1.16 for MPR <0.5 vs ≥0.8; 95% CI = 0.83-1.61). LIMITATIONS:Study data were derived from insurance claims; adherence measures were based on prescription fills, not observed medication use. CONCLUSION:Adherence to dornase alfa was generally low, but varied by age and season. Adherence was not found to be significantly associated with respiratory exacerbations or total charges, but was associated with shorter hospital length of stay.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Nasr SZ,Chou W,Villa KF,Chang E,Broder MSdoi
10.3111/13696998.2013.787427subject
Has Abstractpub_date
2013-01-01 00:00:00pages
801-8issue
6eissn
1369-6998issn
1941-837Xjournal_volume
16pub_type
杂志文章abstract:AIMS:Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients' health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to asse...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1572015
更新日期:2019-04-01 00:00:00
abstract::Aims: OnabotulinumtoxinA is recommended by NICE for the treatment of chronic migraine. This economic evaluation provides updated estimates of the cost-effectiveness of onabotulinumtoxinA for chronic migraine using new utility estimates in an existing model structure.Methods: A previously published model was revised to...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1675417
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Two human papillomavirus (HPV) vaccines are on the market. Based on expected differences in sustained- and cross-protection between the two vaccines, their long-term economic value is modelled and compared for France, Ireland and Italy. METHODS:A Markov cohort model reproducing the natural history of HPV inf...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.490481
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:The past few decades have been marked by a bold increase in national health spending across the globe. Rather successful health reforms in leading emerging markets such as BRICS reveal a reshaping of their medical care-related expenditures. There is a scarcity of evidence explaining differences in long-term m...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1093493
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:Atazanavir (ATV) and darunavir (DRV) are protease inhibitors approved for HIV treatment in combination with ritonavir (/r). The objectives of this study were to compare persistence (time to treatment discontinuation/modification), adherence, and healthcare costs among patients with human immunodeficiency vir...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1128942
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Neuroblastoma (NB) is notorious in childhood cancer because of its high incidence and poor prognosis. The Children's Oncology Group reported that the 3-year OS in the high-risk (HR) group is 50%, and the HR-NB with bone marrow metastasis in our center is 43.1%. Thousands of families in China suffer from the ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1786392
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:To assess the cost effectiveness of palivizumab, a humanised monoclonal antibody, used as prevention against severe respiratory syncytial virus (RSV) infection requiring hospitalisation, in infants with haemodynamically significant congenital heart disease (CHD) in the German healthcare setting. STUDY DESIG...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990903347172
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Until recently, standard treatment of venous thromboembolism (VTE) concerned a combination of short-term low-molecular-weight heparin (LMWH) and long-term vitamin-K antagonist (VKA). Risk of bleeding and the requirement for regular anticoagulation monitoring are, however, limiting their use. Rivaroxaban is a...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.1080/13696998.2017.1331912
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Allergic rhinitis (AR) is a chronic disease with a substantial clinical and economic burden. This study estimated the potential budget impact (BI) associated with market entry of Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract Tablet for Sublingual Use ('5...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1061533
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To critically evaluate published cost-effectiveness studies of novel drug products requiring less-frequent medication dosing compared to conventional formulations of the same drug substance. METHODS:A search was conducted in the Medline and Embase databases for cost-effectiveness studies published before May...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.3111/13696991003757500
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To quantify and compare hospital length of stay (LOS) and costs between hospitalized non-valvular atrial fibrillation (NVAF) patients treated with either apixaban or warfarin via a large claims database. METHODS:Adult patients hospitalized with AF were selected from the Premier Perspective Claims Database (0...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2016.1171774
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Compare long-term costs and outcomes of lurasidone to aripiprazole among adults with schizophrenia in the US who previously failed ≥1 atypical antipsychotic (olanzapine, risperidone, quetiapine, or ziprasidone) based on an indirect comparison of outcomes data from clinical trials. METHODS:A 5-year Markov coh...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.807813
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To carry out a cost-utility analysis comparing initial treatment with solifenacin 5 mg/day vs oxybutynin immediate-release (IR) 15 mg/day for the treatment of patients with overactive bladder (OAB) from the perspective of the U.K. National Health Service (NHS). METHODS:A Markov model with six health states w...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.829079
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To estimate the lifetime economic consequences of glaucoma in France. METHODS:A Markov model estimated the average discounted outcome and cost of glaucoma treatment over a patient's lifetime. Clinical states were defined as first- to fourth-line drugs, no treatment, laser therapy, surgery, blindness and deat...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990902728729
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To estimate direct medical costs and resource use for commercially-insured patients within two pulmonary hypertension sub-groups: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). RESEARCH DESIGN AND METHODS:Using a retrospective cohort design, subjects (≥18 yea...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.665109
更新日期:2012-01-01 00:00:00
abstract:AIMS:Six Delta is a six-dimensional independent platform for outcome-based pricing/contracting. The six dimensions have been described separately: (δ1) cost-effectiveness analysis and cost-utility analysis-based pricing; (δ2) willingness-to-pay-based pricing; (δ3) reference-based pricing; (δ4) safety-based pricing; (δ5...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1815031
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:In the last decade, the number of new agents, including monoclonal antibodies, being developed to treat metastatic colorectal cancer (mCRC) increased rapidly. While improving outcomes, these new treatments also have distinct and known safety profiles with toxicities that may require hospitalizations. However...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.610394
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Alemtuzumab and natalizumab are approved as second-line therapies for relapsing-remitting multiple sclerosis (RRMS) patients in Iran who have shown an inadequate response to other disease-modifying therapy (DMT). In the absence of head-to-head trials, evaluations based on decision analytic modeling may be a ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1543189
更新日期:2019-01-01 00:00:00
abstract:AIMS:Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and th...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1426591
更新日期:2018-04-01 00:00:00
abstract:AIMS:Tuberous sclerosis complex (TSC) is a multi-organ autosomal-dominant, genetic disorder with incomplete penetrance. The multiple manifestations of TSC and impacts to numerous organ systems represent significant disease, healthcare, and treatment burden. The economic and employment burden of the disease on individua...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1487447
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Triple therapy using a protease inhibitor (PI) with peginterferon and ribavirin (PR) is increasingly used in patients with chronic hepatitis C virus (HCV) infection. The most recently introduced PI, simeprevir (SMV), offers high levels of viral eradication combined with a reduced overall duration of therap...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1044457
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Basal insulin analogs are well established in the treatment of type 1 diabetes in Germany. However, little is known about their economic impact. The aim of this study for an adult population was to compare, from the perspective of the Statutory Health Insurance (SHI), the cost effectiveness of the long-acting...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.713879
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Validation of overall survival (OS) extrapolations of immune-checkpoint inhibitors (ICIs) during the National Institute for Health and Care Excellence (NICE) Single Technology Assessment (STA) process is limited due to data still maturing at the time of submission. Inaccurate extrapolation may lead to inappr...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2018.1547303
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:This retrospective study aims to examine the association between prescribing information (PI)-concordant oral antidiabetic drug (OAD) treatment and clinical and economic outcomes in patients with type 2 diabetes mellitus and stages 3-5 chronic kidney disease (CKD). METHODS:The study used a large, national a...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.775135
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:The use of hemostatic agents has increased over time for all surgical procedures. The purpose of this study was to evaluate the newer topical absorbable hemostat products Surgicel * Fibrillar † and Surgicel SNoW ‡ (Surgicel advanced products, abbreviated as SAPs) compared to the older product Surgicel Origina...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1017503
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The cost effectiveness of pregabalin as an add-on to the standard treatment of Belgian patients with post-herpetic neuralgia (PHN) had been demonstrated in a previously published Markov model. The purpose of this study was to update that model with more recent cost data and clinical evidence, ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.773333
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate medication adherence and persistence of patients treated with Etanercept and Adalimumab for Rheumatoid Arthritis, also giving economic evaluations on therapy costs for Received Daily Dose (RDD). MATERIALS AND METHODS:This retrospective study took into account 6 years fro...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.902844
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:This study evaluated the overall burden of illness of chemotherapy-induced nausea and vomiting (CINV) and associated all-cause costs from a hospital's perspective (costs to the hospital) in patients with cancer treated with chemotherapy (CT) in the US hospital outpatient setting. METHODS:Patients with a canc...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.547237
更新日期:2011-01-01 00:00:00
abstract::Objectives: To describe the clinical characteristics, treatment pattern, and medical costs associated with metastatic castration-resistant prostate cancer (mCRPC) in Chinese patients. Methods: This retrospective study identified a group of patients with newly-developed mCRPC from 2012 to 2016 to extract information fr...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1600524
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To describe costs, healthcare resource utilization, and adherence of US patients receiving human regular U-500 insulin (U-500R), compared to patients receiving high-dose (>200 units/day) U-100 insulins (U-100) by subcutaneous injection for the treatment of diabetes. METHODS:A retrospective analysis of data f...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.772059
更新日期:2013-01-01 00:00:00