scholarly journals Factors influencing series completion rates of recombinant herpes zoster vaccine in the United States: a retrospective pharmacy and medical claims analysis

2021 ◽  
Author(s):  
Brandon J. Patterson ◽  
Chi-Chang Chen ◽  
Catherine B. McGuiness ◽  
Siyu Ma ◽  
Lisa I. Glasser ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
The United States ◽  
Completion Rates ◽  
Claims Analysis ◽  
Zoster Vaccine ◽  
Medical Claims ◽  
Factors Influencing ◽  
Series Completion

scholarly journals 07. Recombinant Zoster Vaccine (RZV) Second-Dose Completion in Adults Age 50‒64 Years in the United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S127-S127
Author(s):  
Jessica Leung ◽  
Elizabeth B Gray ◽  
Tara Anderson ◽  
Sarah M Sharkey ◽  
Kathleen L Dooling
Keyword(s):  
The United States ◽  
Administrative Claims ◽  
Completion Rates ◽  
Medicare Beneficiaries ◽  
Medical Provider ◽  
Zoster Vaccine ◽  
National Drug ◽  
Series Completion ◽  
Recombinant Zoster Vaccine

Abstract Background In 2018, CDC recommended a highly efficacious adjuvanted recombinant zoster vaccine (RZV, Shingrix) as a 2-dose series for prevention of herpes zoster (HZ) for immunocompetent persons age ≥50 years, with the 2nd dose recommended 2–6 months after the 1st dose. Among Medicare beneficiaries, 2-dose series completion 6 months and 12 months post initiation was 78% and 86%, respectively. Here we estimate the proportion of adults age 50–64 years who completed the 2-dose RZV series within 6 or 12 months after receiving their 1st dose, by using two administrative claims databases. Methods We used medical and pharmaceutical claims data from October 2017‒March 2020 IQVIA® PharMetrics Plus and October 2017‒October 2020 IBM® MarketScan® databases. RZV vaccination was defined using Current Procedural Terminology and National Drug Codes. We allowed for sufficient follow-up time by examining 1st doses given at least 6 or 12 months prior to the end of the study period in both databases. Place of administration was available in IQVIA data. Results Among persons age 50‒64 years, in IQVIA and MarketScan, 70% and 68% received their 2nd RZV dose within 6 months, respectively, and 79% and 81% received their 2nd dose within 12 months, respectively. The median age of 1st dose of RZV vaccination was 60 years and ~60% were female [Table 1]. When the 2nd dose was administered within 12 months, the median interval between 1st and 2nd doses was 104 and 98 days in the IQVIA and MarketScan databases, respectively. Characteristics by age, sex, or region were similar in persons who received 1 RZV dose vs. 2 RZV doses [Table 1]. Among those who received only 1 RZV dose with at least 12 months of follow-up time, 55% of vaccinations occurred at ambulatory medical provider offices and 40% at pharmacies; among 2 doses recipients, 33% of vaccinations occurred at provider offices and 62% at pharmacies. Conclusion Among 50‒64-year-olds, 2-dose RZV series completion was ~70% within 6 months and 80% within 12 months of initiation. The findings were similar across two administrative claims databases. Availability of RZV at pharmacies has potentially helped to increase RZV 2nd dose completion rates. Disclosures All Authors: No reported disclosures

Herpes Zoster–Related Hospitalizations and Expenditures Before and After Introduction of the Varicella Vaccine in the United States

2008 ◽  
Vol 29 (12) ◽  
pp. 1157-1163 ◽  
Author(s):  
Mitesh S. Patel ◽  
Achamyeleh Gebremariam ◽  
Matthew M. Davis
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
Nationwide Inpatient Sample ◽  
The United States ◽  
Hospital Charges ◽  
Varicella Vaccination ◽  
Severe Illness ◽  
Zoster Vaccine ◽  
Hospital Discharges ◽  
Total Charges

Objective.With childhood varicella vaccination in the United States have come concerns that the incidence of herpes zoster may increase, because of diminishing natural exposure to varicella and consequent reactivation of latent varicella zoster virus. We wanted to estimate the rate of herpes zoster-related hospitalizations and the associated hospital charges before and during the promotion of varicella vaccination in the United States.Design.A retrospective study of patients from the Nationwide Inpatient Sample for the years 1993–2004 who were hospitalized due to herpes zoster infection.Methods.We searched for diagnoses of herpes zoster (using the International Classification of Diseases, Ninth Revison, Clinical Modification codes starting with 053) in all 15 diagnostic-code fields included for hospital discharges in the Nationwide Inpatient Sample during 1993–2004. We designed our analysis to examine the rates of severe illness due to herpes zoster that resulted in hospitalization, as measured by the rates of herpes zoster-related hospital discharges (HZHDs). The annual population-adjusted rate of HZHDs (per 10,000 US population) and the annual inflation-adjusted total charges for HZHDs were the primary outcomes. Secondary outcomes included mean charges for HZHDs and the distribution of total charges for HZHDs by expected primary payer. Varicella-related hospital discharges (VRHDs) were identified by use of similar diagnosis-based methods, which were described in our previous study.Results.Population-adjusted rates of HZHDs did not change significantiy from the prevaccination years (1993–1995) through the initial 5 years of the varicella vaccination period. Beginning in 2001, however, the rate of HZHDs overall began to increase, and by 2004 the overall rate was 2.5 HZHDs (95% confidence interval, 2.38–2.62) per 10,000 US population, significantly higher than any of the rates calculated during the years prior to 2002. Hospital charges for HZHDs overall increased by more than $700 million annually by 2004; in particular, we found that the herpes zoster vaccine–eligible population (ie, persons aged 60 years or older) accounted for 74% of the total annual hospital charges in 2004. The annual rate of VRHDs and the associated hospital charges decreased significantly from 1993 through 2004, but the decrease in hospitalizations and charges for VRHDs was less than the increase in hospitalizations and charges for HZHDs.Conclusions.AS the rates of VRHDs and the associated charges have decreased, there has been a significant increase in HZHDs and associated charges, disproportionately among older adults. Herpes zoster vaccine may mitigate these trends for HZHDs.

scholarly journals 20. Cost-Effectiveness of Recombinant Zoster Vaccine for Vaccinating Immunocompromised Adults Against Herpes Zoster in the United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S134-S134
Author(s):  
Desmond Curran ◽  
Ahmed Salem ◽  
Stéphane Lorenc ◽  
Brandon Patterson ◽  
Justin Carrico ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
Cost Effectiveness ◽  
The United States ◽  
Hypothetical Cohort ◽  
Cell Transplant ◽  
Renal Transplant Recipients ◽  
Zoster Vaccine ◽  
Scenario Analyses ◽  
Recombinant Zoster Vaccine

Abstract Background Individuals who are immunocompromised (IC) due to disease or therapy are at increased risk of herpes zoster (HZ), with HZ cases in IC populations also resulting in increased health care resource use and costs as compared with the immunocompetent population. This study assesses the cost-effectiveness of recombinant zoster vaccine (RZV) versus no vaccine for the prevention of HZ in IC adults aged ≥ 18 years in the United States (US). Methods A Markov model with a one-year cycle length was developed to follow a hypothetical cohort of one million IC individuals for a 30-year time horizon. The model estimates health and cost outcomes associated with RZV versus no vaccine. The base-case analysis considered hematopoietic stem cell transplant (HSCT) recipients who were assumed to remain IC for five years post-transplant. Second-dose compliance was assumed to be 100%, with efficacy and waning inputs based on clinical trial data. Epidemiological, cost, and utility inputs were obtained from standard US sources and published literature. Costs and quality-adjusted life-years (QALYs) were discounted at 3% per year. Sensitivity, threshold, and scenario analyses were conducted, including scenarios of four other IC conditions. Results In the modeled hypothetical cohort of one million HSCT recipients, RZV resulted in 116,790 fewer HZ cases and 21,446 fewer postherpetic neuralgia cases versus no vaccine, 5,545 fewer QALYs lost and a societal cost-savings of &5.4 million. The number needed to vaccinate to prevent one HZ case was estimated to be 9. HSCT population results were shown to be robust in sensitivity and threshold analyses. In scenario analyses, RZV was cost saving for renal transplant recipients. Incremental cost-effectiveness ratios for other IC populations were &33,268 per QALY gained for human immunodeficiency virus, &67,682 for breast cancer, and &95,972 for Hodgkin lymphoma. Conclusion Results suggest that RZV is a cost-effective option for vaccinating US IC adults for the prevention of HZ and associated complications. Disclosures Desmond Curran, PhD, The GSK group of companies (Employee, Shareholder) Ahmed Salem, MSc, The GSK group of companies (Employee) Stéphane Lorenc, NA, GSK group of companies (Consultant) Brandon Patterson, PharmD, PhD, GSK group of companies (Shareholder) Justin Carrico, BS, GSK group of companies (Consultant)RTI Health Solutions (Employee) Katherine A. Hicks, MS, BSPH, GSK group of companies (Consultant)RTI Health Solutions (Employee) Elizabeth M. La, PhD, The GSK group of companies (Employee, Shareholder) Sara Poston, PharmD, The GSK group of companies (Employee, Shareholder) Christopher F. Carpenter, MD, MHSA, GSK group of companies (Consultant)

scholarly journals 17. Assessment of Recombinant Zoster Vaccine Second Dose Completion in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S31-S31
Author(s):  
Brandon J Patterson ◽  
Chi-Chang Chen ◽  
Catherine B McGuiness ◽  
Lisa I Glasser ◽  
Kainan Sun ◽  
...  
Keyword(s):  
United States ◽  
Sensitivity Analysis ◽  
Initial Dose ◽  
The United States ◽  
Zoster Vaccine ◽  
Medical Claims ◽  
Time To Completion ◽  
Primary Sample ◽  
Recombinant Zoster Vaccine ◽  
Research Grant

Abstract Background Recombinant Zoster Vaccine (RZV) was licensed in the United States (US) in October 2017 for the prevention of herpes zoster in adults ≥ 50 years of age (YOA). The vaccine is administered in a two-dose sequence with a 2- to 6-month interval; however, the Center for Disease Control & Prevention has advised against restarting a series after the prescribed window. This study describes an assessment of 2nd dose completion and compliance of RZV in the US. Methods Primary analysis was conducted on a cohort ≥ 50 YOA who received an initial RZV dose between October 2017 and September 2018 as indicated in the IQVIA longitudinal prescription claims or medical claims databases. Subjects were required to have ≥ 1 year of observable time post initial dose. A sensitivity analysis was conducted using all eligible subjects regardless of observable time post initial dose. Endpoints of analyses were monthly and cumulative 2nd dose label-compliant proportions at 6 months and completers by 12-month intervals and time to completion from initial RZV vaccine administration with stratifications by age, sex, claim source and payer type. Results The primary sample included 1,225,088 subjects, while the sensitivity analysis included 7,097,441 (Table 1). Overall, 2nd RZV dose completion was 70.4% within 6 months and 81.8% within 12 months. Minimal variation for 12-month completion was demonstrated across age (77.2–84.5%), sex (81.7–81.9%), and Commercial vs. Medicare (80.9–83.0%). However, larger variations were seen across claim sources and other payer type, with medical claims (64.9%), Medicaid patients (72.8%) and Cash patients (74.7%) having lower rates at 12 months (Table 2). Overall, the average time to completion was around 4 months regardless of stratification except by claims source, with medical claims taking 5 months on average to complete. The sensitivity analysis of the variable follow-up cohort demonstrated findings consistent with that of the primary sample. Conclusion Assessment of RZV suggests high levels of completion across age, sex, payer type and claim sources. More effort is needed to understand barriers to completion rates in Medicaid patients and settings where vaccination claims are processed outside of the vaccine recipient’s pharmacy benefit. Disclosures Brandon J. Patterson, PharmD, PhD, GSK (Employee, Shareholder) Chi-Chang Chen, PhD, MSPharm, GSK (Research Grant or Support) Catherine B. McGuiness, MA, MS, GSK (Research Grant or Support)Pfizer (Shareholder) Lisa I. Glasser, MD, GSK (Employee, Shareholder) Kainan Sun, MS, PhD, GSK (Research Grant or Support) Philip O. Buck, PhD, MPH, ORCID: 0000-0002-3898-3669, GSK (Employee, Shareholder)

scholarly journals Factors Influencing Land Values in the Presence of Suburban Sprawl

1974 ◽  
Vol 3 (1) ◽  
pp. 112-124 ◽  
Author(s):  
Bruce E. Lindsay ◽  
Cleve E. Willis
Keyword(s):  
United States ◽  
Rural Areas ◽  
The United States ◽  
Land Values ◽  
Suburban Sprawl ◽  
Factors Influencing ◽  
Definition Of

The spread of suburbs into previously rural areas has become commonplace in the United States. A rather striking aspect of this phenomenon has been the discontinuity which results. This aspect is often manifest in a haphazard mixture of unused and densely settled areas which has been described as “sprawl”. A more useful definition of suburban sprawl, its causes, and its consequences, is provided below in order to introduce the econometric objectives of this paper.

Promoting divergent leadership philosophies to improve student success outcomes for black and brown students in higher education

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nicholas Petty ◽  
Dakota King-White ◽  
Tachelle Banks
Keyword(s):  
Higher Education ◽  
United States ◽  
Student Success ◽  
Baccalaureate Degree ◽  
The United States ◽  
Retention Rates ◽  
Completion Rates ◽  
Marginalized Groups ◽  
Support Students

Abstract Throughout the United States there are millions of Black and Brown students starting the process of attending college. However, research indicates that students from traditionally marginalized groups are less likely than their counterparts to complete the process and graduate college (Shapiro et al., 2017). While retention rates for students from traditionally marginalized backgrounds continue to decline, universities are beginning to pay attention to the needs of this population in search of ways of better supporting them. The examination of these factors may also inform programmatic adjustments, leadership philosophies, and future practices to help retain students and lead to eventual completion of a baccalaureate degree. In this article, the authors review the literature to explore factors that can affect Black and Brown students’ completion rates in higher education. By reviewing the literature and the factors impacting Black and Brown students, the authors share with readers initiatives at one university that are being used to support students from a strengths-based approach.

scholarly journals Neurofibromatosis type 1 and chronic neurological conditions in the United States: an administrative claims analysis

2014 ◽  
Vol 17 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Chinwe C. Madubata ◽  
Margaret A. Olsen ◽  
Dustin L. Stwalley ◽  
David H. Gutmann ◽  
Kimberly J. Johnson
Keyword(s):  
United States ◽  
Neurofibromatosis Type 1 ◽  
Neurofibromatosis Type ◽  
The United States ◽  
Administrative Claims ◽  
Claims Analysis ◽  
Neurological Conditions
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