scholarly journals Treatment journey in rheumatoid arthritis with biosimilars: from better access to good disease control through cost savings and prevention of nocebo effects

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001637
Author(s):  
Josef S Smolen ◽  
Roberto Caporali ◽  
Thomas Doerner ◽  
Bruno Fautrel ◽  
Fabrizio Benedetti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Price Competition ◽  
Imaging Techniques ◽  
Cost Savings ◽  
Healthcare Systems ◽  
Nocebo Effect ◽  
Good Disease Control ◽  
Negative Perceptions ◽  
The Cost

Early diagnosis and treatment of rheumatoid arthritis (RA) are of critical importance to halt the progression of the disease. Optimal use of advanced imaging techniques or biomarkers may facilitate early diagnosis of RA. Even though many disease-modifying anti-rheumatic drugs (DMARDs) are available for RA treatment, biological DMARDs (bDMARDs) offer expanding therapeutic options and good outcomes in patients with RA who do not have a sufficient response to conventional synthetic DMARDs. However, high costs of bDMARDs have limited patient access to optimised disease management and increased the cost burden for healthcare systems. The advent of biosimilars led to significant cost savings driven by price competition among the reference products, which could be beneficial for healthcare systems. Healthcare provider (HCP)–patient communication and informed shared decision-making are crucial to prevent the occurrence of a nocebo effect, which results from negative perceptions that patients may have and could lead to less effective outcomes. Research has demonstrated that effective communication between HCPs and patients utilising positive framing can improve acceptance by patients to be initiated on or switched to a biosimilar and can help to integrate biosimilars into routine clinical practice to maximise benefits for patients with RA.

How will the cost of biosimilars affect patients’ willingness to receive them?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18338-e18338
Author(s):  
R Donald Harvey ◽  
Megan McGrath ◽  
John W. Cook ◽  
Margie D Dixon ◽  
Rebecca D. Pentz
Keyword(s):  
Financial Burden ◽  
Cost Savings ◽  
Drug Market ◽  
Oncology Patients ◽  
Convenience Sample ◽  
Anti Cancer ◽  
Negative Perceptions ◽  
Oncology Care ◽  
The Cost ◽  
Patients Experience

e18338 Background: The cost of oncology care is increasing. The NIH projects that the oncology drug market will reach $111.9 billion by 2020. Studies show that oncology patients experience considerable financial burden, regardless of insurance status and in general believe that oncology medications are too expensive. However, there is some evidence outside of oncology that suggests patients may not trust generics or cheaper medications. Therefore, there is a need to assess oncology patients’ views of a biosimilars and their potential to reduce costs. Methods: We surveyed a convenience sample of 79 oncology patients in clinics and the infusion center. The survey consisted of five questions on cost and patient participation in decision making. Results: Of 79 patients approached, 75 (95%) completed the survey. Fifty (66%) believed that expensive medications do not work better than less costly ones for the same disease; yet only 30 of those 50 (60%) and 44% overall (33/75) would prefer that their doctor prescribe them the cheaper version of their anti-cancer medication. Of the 20 respondents who believed that expensive drugs do not work better but still wanted the more expensive drugs for themselves, 8 believed cancer was too serious of an illness to take any chances with a cheaper medication, 5 wanted the most expensive that insurance would cover and 2 wanted the best possible medication. 90.67% respondents (68/75) wanted to know if their physician was prescribing a cheaper version of their drug. Conclusions: Our results show that, overall, oncology patients agree that cheaper medications work as well as more expensive ones, but there are definite concerns among some patients that drug price may be a proxy for quality, particularly in cancer. Overcoming these negative perceptions among patients will be important if optimal cost savings are going to be realized with expanded biosimilar use.

scholarly journals A Five-Year Model to Assess The Cost-Effectiveness of New Diagnostic Tests In The Early Diagnosis of Rheumatoid Arthritis

2015 ◽  
Vol 18 (7) ◽  
pp. A358-A359
Author(s):  
LR Buisman ◽  
JJ Luime ◽  
M Oppe ◽  
JM Hazes ◽  
MP Rutten-van Mölken
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Early Diagnosis ◽  
Diagnostic Tests ◽  
The Cost

scholarly journals Will savings from biosimilars offset increased costs related to dose escalation? A comparison of infliximab and golimumab for rheumatoid arthritis

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeffrey R. Curtis ◽  
Fenglong Xie ◽  
Jonathan Kay ◽  
Joel D Kallich
Keyword(s):  
Rheumatoid Arthritis ◽  
Dose Escalation ◽  
Cost Savings ◽  
Least Square ◽  
Physician Ownership ◽  
High Adherence ◽  
Adjusted Logistic Regression ◽  
Current Price ◽  
Break Even Point ◽  
The Cost

Abstract Introduction Biosimilar infliximab has the potential for appreciable cost savings compared to its reference biologic, but dose escalation is common and increases costs. We compared frequency of dose escalation and associated Medicare-approved amount so as to determine the break-even point at which infliximab dose escalation would offset the cost savings of using a biosimilar, referent to alternatively using golimumab. Methods We studied Medicare enrollees with rheumatoid arthritis (RA) initiating infliximab or golimumab. Frequency of dose escalation was summarized descriptively over 18 months, as were Medicare-approved amounts for reimbursement. Analyses were repeated conditioning on high adherence (i.e., non-discontinuation, > 10-week gap). Multivariable-adjusted logistic regression and mixed models evaluated factors associated with infliximab dose escalation. Results A total of 5174 infliximab and 2843 golimumab initiators were observed. Dose escalation was rare for golimumab (5%) but common for infliximab (49%), and was even more common (72%) for infliximab among patients who persisted on treatment. Regardless of dose escalation, the adjusted least square mean dollar amounts were appreciably higher for golimumab ($28,146) than for infliximab ($21,216) and greater among persistent patients (cost difference $9269, favoring infliximab). Only when patients escalated infliximab to ≥ 8 mg/kg every 6 weeks was golimumab IV at break-even or less expensive. After controlling for multiple factors, physician ownership of the infusion center was associated with greater likelihood of infliximab dose escalation (odds ratio = 1.25, 95% CI 1.09–1.44). Conclusion Despite frequent dose escalation with infliximab that often increase its dose by threefold or more, the savings from the current price of its biosimilar substantially offsets the costs of an alternative infused TNFi biologic for which no biosimilar is available.

Uncovering Hidden Costs in R&D Outsourcing: A Case Study

2017 ◽  
Author(s):  
Richard Gruszewski ◽  
Bruce H. Smith ◽  
Donald E. Thresh ◽  
James Van Bortel ◽  
Marcos Esterman
Keyword(s):  
Cost Savings ◽  
Fortune 500 ◽  
Development Project ◽  
Unintended Consequences ◽  
Knowledge Loss ◽  
Product Features ◽  
Global Corporations ◽  
Negative Perceptions ◽  
The Cost

Global corporations are facing competitive pressures and as result are outsourcing products or services to improve profitability, reduce delivery schedules, increase product features, and increase value to their shareholders. However hidden or unexpected costs can come with these benefits that erode the expected profits and outweigh the cost savings. This includes unintended consequences that arise from employee lay-offs and knowledge loss. This can result in negative perceptions on the value of outsourcing within the firm. This paper will report on a study of an outsourced development project at a Fortune 500 company that examined the drivers that impede accurate cost estimates used to assess the viability of outsourcing R&D activities. A result of the case study was that while there was hidden costs uncovered, significant misperceptions within the firm initially eroded the value of the outsourced activities.

Exploration-Stage Implementation Variation

2014 ◽  
Vol 222 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Stephanie Romney ◽  
Nathaniel Israel ◽  
Danijela Zlatevski
Keyword(s):  
Parent Training ◽  
Average Cost ◽  
Cost Savings ◽  
Training Group ◽  
Group Differences ◽  
Triple P ◽  
Community Based ◽  
Parent Training Program ◽  
A Site ◽  
The Cost

The present study examines the effect of agency-level implementation variation on the cost-effectiveness of an evidence-based parent training program (Positive Parenting Program: “Triple P”). Staff from six community-based agencies participated in a five-day training to prepare them to deliver a 12-week Triple P parent training group to caregivers. Prior to the training, administrators and staff from four of the agencies completed a site readiness process intended to prepare them for the implementation demands of successfully delivering the group, while the other two agencies did not complete the process. Following the delivery of each agency’s first Triple P group, the graduation rate and average cost per class graduate were calculated. The average cost-per-graduate was over seven times higher for the two agencies that had not completed the readiness process than for the four completing agencies ($7,811 vs. $1,052). The contrast in costs was due to high participant attrition in the Triple P groups delivered by the two agencies that did not complete the readiness process. The odds of Triple P participants graduating were 12.2 times greater for those in groups run by sites that had completed the readiness process. This differential attrition was not accounted for by between-group differences in participant characteristics at pretest. While the natural design of this study limits the ability to empirically test all alternative explanations, these findings indicate a striking cost savings for sites completing the readiness process and support the thoughtful application of readiness procedures in the early stages of an implementation initiative.

Methods and clinical applications in nuclear cardiology: a position statement

2002 ◽  
Vol 41 (01) ◽  
pp. 3-13 ◽  
Author(s):  
M. Schäfers
Keyword(s):  
Nuclear Cardiology ◽  
Clinical Medicine ◽  
Imaging Techniques ◽  
Cost Savings ◽  
Cost Benefit ◽  
Position Statement ◽  
Electron Beam Tomography ◽  
Partial Functions ◽  
Cost Benefit Ratio ◽  
Medicine Today

SummaryNuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e. g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio.Our current understanding shows that effective, targeted nuclear cardiology diagnosis – in particular for high-risk patients – can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures.In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging.

‘I’m an expert in me and I know what I can cope with’: Patient expertise in rheumatoid arthritis

2014 ◽  
Vol 10 (3) ◽  
pp. 249-261 ◽  
Author(s):  
Tessa Sanderson ◽  
Jo Angouri
Keyword(s):  
Rheumatoid Arthritis ◽  
Meta Analysis ◽  
Healthcare Systems ◽  
Specific Knowledge ◽  
Active Involvement ◽  
Domain Specific ◽  
Access To Health ◽  
Patient Expertise ◽  
Domain Specific Knowledge ◽  
The Uk

The active involvement of patients in decision-making and the focus on patient expertise in managing chronic illness constitutes a priority in many healthcare systems including the NHS in the UK. With easier access to health information, patients are almost expected to be (or present self) as an ‘expert patient’ (Ziebland 2004). This paper draws on the meta-analysis of interview data collected for identifying treatment outcomes important to patients with rheumatoid arthritis (RA). Taking a discourse approach to identity, the discussion focuses on the resources used in the negotiation and co-construction of expert identities, including domain-specific knowledge, access to institutional resources, and ability to self-manage. The analysis shows that expertise is both projected (institutionally sanctioned) and claimed by the patient (self-defined). We close the paper by highlighting the limitations of our pilot study and suggest avenues for further research.

REKAYASA NILAI HARGA PEMBUATAN TERHADAP EFEKTIFITAS PENGGUNAAN BAHAN PADA PEMBANGUNAN PERUMAHAN TIRTO PENATARAN ASRI TIPE 70/135 KECAMATAN NGLEGOK KABUPATEN BLITAR

2017 ◽  
Vol 7 (1) ◽  
pp. 43-52
Author(s):  
Mochamad Tamim Ma’ruf
Keyword(s):  
Engineering Application ◽  
Cost Savings ◽  
Comparison Method ◽  
Value Engineering ◽  
Design Work ◽  
Housing Projects ◽  
Initial Design ◽  
A Value ◽  
The Cost ◽  
Design Proposal

One-solving methods and techniques necessary to avoid inefficiencies and not economic costs as well as reduce the cost of housing construction is the method of Value Engineering. Value engineering is a method and cost control techniques to analyze a function to its value at the lowest cost alternative (most economical) without reducing the quality desired.At the writing of this study used a comparison method by comparing the initial design to the design proposal of the author. In the housing projects Upgrading Tirto Penataran Asri type 70, the application of Value Engineering conducted on the job a couple walls and roofs pair by replacing some work items with a more economical alternative but does not change the original function and high aesthetic level and still qualify safe. For that performed the step of determining a work item, the alternative stage, the analysis stage, and the stage of recommendations to get a Value Engineering application and cost savings against the wall a couple of work items and partner roof.The proposed design as compared to the initial design. Work items discussed was the work of a couple wall having analyzed obtained savings of Rp. 2,747,643.56 and the work of the roof pair obtained savings of Rp. 2,363,446.80. Thus the total overall savings gained is Rp 5,111,090.36 or savings of 0048%.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.

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