Abstract:
OBJECTIVE:This study compared real-world treatment patterns and healthcare costs among biologic-naive psoriasis patients initiating apremilast or biologics. METHODS:A retrospective cohort study was conducted using the Optum Clinformatics™ claims database. Patients with psoriasis were selected if they had initiated apremilast or biologics between January 1, 2014, and December 31, 2015; had 12 months of pre-index and post-index continuous enrollment in the database; and were biologic-naive. The index date was defined as the date of the first claim for apremilast or biologic, and occurred between January 1, 2014, and December 31, 2015. Treatment persistence was defined as continuous treatment without a > 60-day gap in therapy (discontinuation) or a switch to a different psoriasis treatment during the 12-month post-index period. Adherence was defined as a medication possession ratio (MPR) of ≥ 80% while persistent on the index treatment. Persistence-based MPR was defined as the number of days with the medication on hand measured during the patients' period of treatment persistence divided by the duration of the period of treatment persistence. Because patients were not randomized, apremilast patients were propensity score matched up to 1:2 to biologic patients to adjust for possible selection bias. Treatment persistence/adherence and all-cause healthcare costs were evaluated. Cost differences were determined using Wilcoxon rank-sum tests. RESULTS:In all, 343 biologic-naive patients initiating apremilast were matched to 680 biologic-naive patients initiating biologics. After matching, patient characteristics were similar between cohorts. Twelve-month treatment persistence was similar for biologic-naive patients initiating apremilast vs biologics (32.1% vs 33.2%; p = 0.7079). While persistent on therapy up to 12 months, per-patient per-month (PPPM) total healthcare costs were significantly lower among biologic-naive cohorts initiating apremilast vs biologics ($2,214 vs $5,184; p < 0.0001). Likewise, PPPM costs while persistent on therapy were significantly lower among patients initiating apremilast vs biologics, whether they switched treatments ($2,475 vs $4,422; p < 0.0001), remained persistent ($2,279 vs $3,883; p < 0.0001), or discontinued but did not switch treatments ($2,104 vs $6,294; p < 0.0001). LIMITATIONS:Data were limited to individuals with United Healthcare commercial and Medicare Advantage insurance plans, and may not be generalizable to psoriasis patients with other insurance or without health insurance coverage. CONCLUSION:Biologic-naive patients with similar patient characteristics receiving apremilast vs biologics had significantly lower PPPM costs, even when they switched to biologics during the 12-month post-index period. These results may be useful to payers and providers seeking to optimize psoriasis care while reducing healthcare costs.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Wu JJ,Pelletier C,Ung B,Tian Mdoi
10.1080/13696998.2019.1571500subject
Has Abstractpub_date
2019-04-01 00:00:00pages
365-371issue
4eissn
1369-6998issn
1941-837Xjournal_volume
22pub_type
杂志文章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:OBJECTIVE:Iso-osmolar Iodixanol is associated with a lower rate of contrast-induced acute kidney injury (CI-AKI) in patients at increased risk compared to low-osmolar contrast media (LOCM). The aim of this study was to assess the financial consequences of CI-AKI risk reduction in patients undergoing coronary angiograph...
journal_title:Journal of medical economics
pub_type: 杂志文章,meta分析,评审
doi:10.3111/13696998.2015.1105809
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:A Phase-3 study of defibrotide compared with historical controls demonstrated a 23% improvement in 100-day survival post-hematopoietic stem cell transplantation (HSCT) among patients with veno-occlusive disease with multi-organ dysfunction (VOD with MOD). AIM:To estimate the budget impact and cost-effective...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1275652
更新日期:2017-05-01 00:00:00
abstract::Aims: To assess healthcare resource utilization (HCRU) and costs in patients with non-small cell lung cancer treated with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors afatinib or erlotinib as first-line treatment.Materials and methods: This retrospective analysis used data from three large ad...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1645681
更新日期:2020-01-01 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:INTRODUCTION:The patient cost burden of oral anticancer medicines has been associated with prescription abandonment, delayed treatment initiation, and poorer health outcomes in the US. Since 2011, several small molecule tyrosine kinase inhibitors have been approved for the treatment of non-small cell lung cancer (NSCLC...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1580200
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Bipolar 1 disorders (BPD) are a chronic disorder with prevalence rates of up to 2.6% of the adult population or higher and appreciable direct and indirect costs. As a result, these are a concern to health authorities especially given the low age of onset. Consequently, there is a need to treat BPD patients w...
journal_title:Journal of medical economics
pub_type: 评论,社论
doi:10.3111/13696998.2015.1073736
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:Two anti-cancer drugs are currently approved for the treatment of HER2-positive metastatic breast cancer (MBC): trastuzumab-based therapy (TBT) administered intravenously as first line therapy until disease progression and lapatinib, an oral self-administered dual therapy with capecitabine (L+C) as second in...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.729549
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:The economic implications from the US Medicare perspective of adopting alternative treatment strategies for acute bacterial skin and skin structure infections (ABSSSIs) are substantial. The objective of this study is to describe a modeling framework that explores the impact of decisions related to both the lo...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.941065
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:The purpose of this study was to describe the health-related quality-of-life (QoL) in patients after elective surgery for abdominal aortic aneurysm (AAA) compared to a normal population and to study the association between QoL and number of years since surgery. METHODS:All Danish men who underwent elective sur...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.626822
更新日期:2011-01-01 00:00:00
abstract::Aims: Allopurinol is the most common urate lowering therapy (ULT) used to treat gout but may cause life-threatening severe cutaneous adverse reactions (SCAR) in a small number of patients. Risk of SCAR is increased for patients with the HLA-B*58:01 genotype. When alternative ULT is required, febuxostat or probenecid a...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1757456
更新日期:2020-08-01 00:00:00
abstract::Background: Procedural efficiencies can contribute to cost reductions in transcatheter aortic valve replacement procedures (TAVR). The objective of this study is to determine operating room (OR) variable cost per minute in endovascular TAVR procedures, in a real-world hospital setting. Methods: Using Premier data from...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1627364
更新日期:2019-10-01 00:00:00
abstract:AIM:The aim of this analysis was to investigate total healthcare costs, HbA1c, and weight changes over a 36-month period in patients with type 2 diabetes initiated on NPH or long-acting insulin analogs. METHODS:Electronic patient data from 479 general practices in the UK (THIN database) were examined for new users of ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.991788
更新日期:2015-04-01 00:00:00
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:OBJECTIVE:To compare outcomes between patients with type 2 diabetes mellitus (T2DM) using fixed-dose combination (FDC) and loose-dose combination (LDC) products. METHODS:This retrospective cohort study used MarketScan Commercial and Medicare Supplemental data from January 1, 2009-December 31, 2013. The identified popu...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1109518
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To quantify the health economic impact of managing cow milk allergy (CMA) in South Africa, from the perspective of healthcare insurers in both the private and public sectors and parents/carers of CMA sufferers. METHODS:A decision model depicting the management of CMA in South Africa was constructed, using in...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.482904
更新日期:2010-01-01 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:OBJECTIVE:A new and smaller percutaneous ventricular assist device (pVAD, Impella, Abiomed, Danvers, MA) has been developed to provide circulatory support in hemodynamically unstable patients and to prevent hemodynamic collapse during high-risk percutaneous coronary interventions (PCI). The objective of the study was t...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.762004
更新日期:2013-01-01 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:OBJECTIVES:More than 1.5 million patients worldwide are affected by bone metastases. Patients with bone metastases frequently develop skeletal-related events (SREs, including radiation to bone, non-vertebral fracture, vertebral fracture, surgery to bone, and spinal cord compression) that are associated with high health...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.774279
更新日期:2013-01-01 00:00:00
abstract::Aims: Estimate the direct costs of high-risk patients presenting with coronary artery disease (CAD) or peripheral artery disease (PAD) in France.Materials and methods: This retrospective cohort study used a representative claims database, the "Echantillon Généraliste de Bénéficiaires" (EGB), to identify patients prese...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1715415
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Systemic Candida infections (SCI) occur predominantly in intensive care unit patients and are a common cause of morbidity and mortality. Recently, changes in Candida epidemiology with an increasing prevalence of SCI caused by Candida non-albicans species have been reported. Resistance to fluconazole and azol...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.839948
更新日期:2013-11-01 00:00:00
abstract::Background: Adults admitted to hospital with community-acquired pneumonia (CAP) impose significant burden upon limited hospital resources. To achieve early response and possibly early discharge, thus reducing hospital expenditure, the choice of initial antibiotic therapy is pivotal.Methods: A cost-consequences model w...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1688819
更新日期:2020-02-01 00:00:00
abstract::Background: IVF is now a wide spread procedure globally, and currently 65 countries report annually all or part of their IVF/ICSI cycles, from which the International Committee Monitoring progress in Assisted Reproduction Technology (ICMART) published its report. There is considerable variation in the utilization (num...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1609484
更新日期:2019-09-01 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
abstract:OBJECTIVE:Cost-effectiveness analyses of new treatments for cardiovascular disease frequently require input parameters whose values are known with uncertainty due to limited data. The objective of this paper is to examine the extent to which published sensitivity analyses addressing this uncertainty adhere to Health Te...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.3111/13696990903123813
更新日期:2009-06-01 00:00:00
abstract:AIM:To evaluate the cost-effectiveness of secukinumab, a fully human anti-interleukin-17A monoclonal antibody, compared to other clinically used biologics (adalimumab, infliximab, and ustekinumab) in Japan for the treatment of moderate-to-severe psoriasis from the healthcare system (total costs) and patient co-payment ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1532905
更新日期:2018-10-26 00:00:00
abstract:OBJECTIVES:To assess the costs of severe hypoglycaemic events (SHEs) in diabetes patients in Germany, Spain and the UK. METHODS:Healthcare resource use was measured by surveying 639 patients aged ≥ 16 years, receiving insulin for type 1 (n=319) or type 2 diabetes (n=320), who experienced ≥ 1 SHE in the preceding year....
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990903336597
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:To compare demographic and comorbidity profiles and healthcare costs of Medicaid patients with postherpetic neuralgia (PHN) treated with lidocaine patch 5% (lidocaine patch) versus patients not treated with the lidocaine patch. Repeat comparison for the subset of patients treated in long-term care (LTC) sett...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.499819
更新日期:2010-01-01 00:00:00
abstract::Background: Guidelines recommend febrile neutropenia (FN) prophylaxis following myelotoxic chemotherapy with either daily injections of filgrastim (Neupogen®) or biosimilar filgrastim-sndz (Zarzio/Zarxio®), single-injection pegfilgrastim (Neulasta®), or pegfilgrastim administered through an on-body injector (PEG-OBI; ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1658591
更新日期:2020-01-01 00:00:00