Out-of-pocket costs for PARP inhibitor treatment: Are ovarian cancer patients at risk for financial toxicity?

2020 ◽  
Vol 159 ◽  
pp. 21
Author(s):  
R.F. Harrison ◽  
S. Fu ◽  
C.C. Sun ◽  
H. Zhao ◽  
K.H. Lu ◽  
...  
2004 ◽  
Vol 93 (1) ◽  
pp. 164-169 ◽  
Author(s):  
Elizabeth A Calhoun ◽  
David A Fishman ◽  
John R Lurain ◽  
Emily E Welshman ◽  
Charles L Bennett

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S67-S68
Author(s):  
Jeffrey Berinstein ◽  
Shirley Cohen-Mekelburg ◽  
Calen Steiner ◽  
Megan Mcleod ◽  
Mohamed Noureldin ◽  
...  

Abstract Background High-deductible health plan (HDHP) enrollment has increased rapidly over the last decade. Patients with HDHPs are incentivized to delay or avoid necessary medical care. We aimed to quantify the out-of-pocket costs of Inflammatory Bowel Disease (IBD) patients at risk for high healthcare resource utilization and to evaluate for differences in medical service utilization according to time in insurance period between HDHP and traditional health plan (THP) enrollees. Variations in healthcare utilization according to time may suggest that these patients are delaying or foregoing necessary medical care due to healthcare costs. Methods IBD patients at risk for high resource utilization (defined as recent corticosteroid and narcotic use) continuously enrolled in an HDHP or THP from 2009–2016 were identified using the Truven Health MarketScan database. Median annual financial information was calculated. Time trends in office visits, colonoscopies, emergency department (ED) visits, and hospitalizations were evaluated using additive decomposition time series analysis. Financial information and time trends were compared between the two insurance plan groups. Results Of 605,862 with a diagnosis of IBD, we identified 13,052 patients at risk for high resource utilization with continuous insurance plan enrollment. The median annual out-of-pocket costs were higher in the HDHP group (n=524) than in the THP group (n=12,458) ($1,920 vs. $1,205, p<0.001), as was the median deductible amount ($1,015 vs $289, p<0.001), without any difference in the median annual total healthcare expenses (Figure 1). Time in insurance period had a greater influence on utilization of colonoscopies, ED visits, and hospitalization in IBD patients enrolled in HDHPs compared to THPs (Figure 2). Colonoscopies peaked in the 4th quarter, ED visits peaked in the 1st quarter, and hospitalizations peaked in the 3rd and 4th quarter. Conclusion Among IBD patients at high risk for IBD-related utilization, HDHP enrollment does not change the cost of care, but shifts healthcare costs onto patients. This may be a result of HDHPs incentivizing delays with a potential for both worse disease outcomes and financial toxicity and needs to be further examined using prospective studies.


2021 ◽  
Author(s):  
Sofiana Mootassim‐Billah ◽  
Gwen Van Nuffelen ◽  
Jean Schoentgen ◽  
Marc De Bodt ◽  
Tatiana Dragan ◽  
...  

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23010-e23010
Author(s):  
Vanessa Carranza ◽  
Bryan Carson Taylor ◽  
Susan H. Gitzinger ◽  
Joan B. Fowler ◽  
Jessica Hall

e23010 Background: About a third of ovarian cancer patients in the US have limited access to a gynecologic oncologist (GO) due to geographic disparities. A survey by The Society of Gynecologic Oncology (SGO) found that the majority of GOs found it was vital to coordinate local access to care, from diagnosis to survivorship, for patients living in areas of disparity. This allows rural/underserved patients broader access to novel therapies, as they increasingly become standard of care. It is critical for not only GOs to be current on the latest ovarian cancer data, but all clinicians who care for these patients. Methods: CEC Oncology developed two educational initiatives focused on PARP inhibitor therapy in ovarian cancer, which was targeted to all US healthcare professionals caring for ovarian cancer patients. Evaluations were collected from attendees attending an SGO Symposium and Ground Round (GR) series to assess impact on practice, increased competency, and intent to make a change in practice. Learning, knowledge, and competence was objectively assessed by analyzing pre-test, post-test, and follow-up survey data (sent 4-6 weeks post-activity). Chi-square analysis was conducted with a priori significance set at 0.05. Results: A total of 830 clinicians were educated, with SGO attendees primarily practicing in academic settings and GR attendees mostly from community practices. SGO attendees were asked case questions at baseline, immediately after the activity, and 4-6 weeks after the activity. Knowledge increased from pre- to post-test regarding current genetic testing recommendations (23% increase; P= .004) and appropriate selection of PARP inhibitor therapy (25% increase; P= .017). Knowledge was sustained at follow-up analysis. At follow-up, 90% of SGO and 84% of GR attendees made a change as a result of attending the activities. More attendees were able to incorporate germline multigene testing into practice, than originally intended; increase of 29% for SGO and 7% for GR audiences. All attendees experienced the barrier lack of patient education about the importance of genetic testing/counseling more than anticipated; increase of 7% for SGO and 13% for GR audiences. At follow-up, there was a 9% increase in GR attendees listing staying current with trial data and practice guidelines as a barrier. Conclusions: There were some notable differences seen in competence/performance among attendees of the two ovarian cancer educational initiatives. Differences may be attributed to practice setting (SGO primarily academic; GR primarily community.) Overall, GR attendees were more likely to face barriers, suggesting that community-based clinicians have fewer resources and experience more barriers to implementing best practices. Thus, it is vital to offer education for clinicians in community-based practices, particularly in areas that are considered ‘geographically disparate’.


2003 ◽  
Vol 1 (4) ◽  
pp. 331-335 ◽  
Author(s):  
KENNETH L. KIRSH, ◽  
CHRISTINE DUGAN ◽  
DALE E. THEOBALD ◽  
STEVEN D. PASSIK

Objective: Cachexia is a problematic wasting syndrome experienced by some cancer patients that can lead to early death in these patients. The purpose of the present study was to examine the criterion validity and sensitivity and specificity of two single items from a depression scale to rapidly screen patients in ambulatory oncology clinics for cancer-related nutritional risk and cachexia.Methods: A chart review was conducted of 50 randomly selected patient profiles. Patients' responses to item 5 (“I eat as much as I used to”) and item 7 (“I notice I am losing weight”) of the Zung Self Rating Depression Scale (ZSDS) were compared against the Scored Patient-Generated Subjective Global Assessment (PG-SGA) as well as to Body Mass Index (BMI) scores and weight at two time periods.Results: Item 5 of the ZSDS was significantly related to initial weight (F3,45 = 6.06, p < 0.001), weight at 6-month follow-up (F3,27 = 4.16, p < 0.05), BMI score (F3,46 = 2.89, p < 0.05), and nutritional risk on the PG-SGA (F3,45 = 5.80, p < 0.01). Item 7 of the ZSDS was only a significant predictor of nutritional risk as measured by the PG-SGA (F3,46 = 6.01, p < 0.01). When the two items were combined to form a two-item scale, it maintained the individual items' significant relationship to the PG-SGA (F1,48 = 13.99, p < 0.001). Using this as the criterion for identifying nutritionally at-risk patients, the two-item screen yields a sensitivity of 50% and specificity of 88%.Significance of the research: It is concluded that a single item or a combination of two items can yield a reliable initial screen for identifying patients who might be at nutritional risk for the development of cachexia. Further study is needed in prospective trials to further explore the utility of these items.


2020 ◽  
Vol 191 ◽  
pp. S31-S36
Author(s):  
Anton Ilich ◽  
Vaibhav Kumar ◽  
Michael Henderson ◽  
Ranjeeta Mallick ◽  
Philip Wells ◽  
...  

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