Abstract 275: Concomitant Statin Use With Ezetimibe Or Colesevelam For Treatment Of Hypercholesterolemia

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Xin Ye ◽  
Harold Bays ◽  
Philip Schwab
Keyword(s):  
Index Date ◽  
Claims Data ◽  
Study Objective ◽  
Factors Associated ◽  
Patient Demographics ◽  
Pharmacy Claims ◽  
Before And After ◽  
Charlson Comorbidity Score ◽  
Claims Data Analysis ◽  
Statin Use

OBJECTIVES: Ezetimibe or colesevelam are often used for treating hypercholesterolemia when statin therapy is insufficient or not well tolerated. Our study objective was to examine prevalence of concomitant statin use and associated factors among hypercholesterolemia patients newly treated with ezetimibe or colesevelam. METHODS: This analysis evaluated a large health plan’s Commercial and Medicare Advantage claims data from 1/1/08 to 7/31/12. The first ezetimibe (excluding fixed combination therapy of ezetimibe/simvastatin) or colesevelam prescription fill date during this period was identified as the index date. Patients were assigned to either ezetimibe or colesevelam cohort based on the index drug and were required to have ≥ 2 consecutive prescriptions for the index drug and have at least 6 months and 12 months continuous enrollment before and after the index date, respectively. Prevalence of concomitant statin use was identified based on pharmacy claims. Patient demographics and clinical characterisitics were explored to examine the factors associated with concomitant statin use using multivariate logistic regression. RESULTS: A total of 679 colesevelam and 1439 ezetimibe patients were included in this study. The concomitant use of statins was 24% among colesevelam and 50% among ezetimibe patients, respectively. After adjustment for patient demographics and comorbidities, ezetimibe patients were 3.2 times more likely than colesevelam patients to have concomitant statin use (OR= 3.168, 95% CI: 2.573, 3.900, P<0.001). Other significant factors associated with higher concomitant statin use include: male gender (OR= 1.296, 95%: 1.079, 1.558, P=0.006), presence of diabetes mellitus (OR=1.262, 95% CI: 1.035, 1.539, P=0.021) and higher Charlson comorbidity score (OR=1.114, 95% CI: 1.046, 1.187, P<0.001) CONCLUSIONS: In this claims data analysis, statins were administered along with ezetimibe more frequently than administered with colesevelam, which should be taken into account when evaluating effectiveness of ezetimibe vs. colesevelam in the real-world treatment of hypercholesterolemia.

A 10-Year Trend in Statin Use Among Older Adults in Australia: an Analysis Using National Pharmacy Claims Data

2018 ◽  
Vol 32 (3) ◽  
pp. 265-272 ◽  
Author(s):  
Richard Ofori-Asenso ◽  
Jenni Ilomäki ◽  
Ella Zomer ◽  
Andrea J. Curtis ◽  
Sophia Zoungas ◽  
...  
Keyword(s):  
Older Adults ◽  
Claims Data ◽  
Pharmacy Claims ◽  
Statin Use

Glyburide Use in Older Adults: Pharmacy Claims Data Analysis of a Regional Healthcare Organization

2020 ◽  
Vol 68 (10) ◽  
pp. 2354-2358
Author(s):  
Kristen A. Herzik ◽  
Mitchell J. Barnett ◽  
Danielle M. Thanh ◽  
Shadi Doroudgar ◽  
Eric J. Ip
Keyword(s):  
Older Adults ◽  
Data Analysis ◽  
Claims Data ◽  
Healthcare Organization ◽  
Pharmacy Claims ◽  
Claims Data Analysis

“Imiglucerase Treatment Associated with Reduction of Bone Claims in Gaucher Patients: Analysis of US Claims Data”

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4837-4837
Author(s):  
Lubomyra Nalysnyk ◽  
Martin Selzer ◽  
Alaa Hamed ◽  
Neal J. Weinreb
Keyword(s):  
Index Date ◽  
Pediatric Patients ◽  
Claims Data ◽  
Treatment Initiation ◽  
Statistical Significance ◽  
Medical Claims ◽  
Number Of Patients ◽  
Before And After ◽  
Pre Treatment ◽  
Average Bone

Abstract BACKGROUND: Gaucher disease type 1 (GD1) is a rare, genetic, multisystemic disorder caused by a deficiency of acid ß-glucosidase and characterized by an accumulation of lipid glucosylceramide in organs such as the spleen, liver and bone marrow. The key clinical features include anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. Bone involvement is one of the most frequent, debilitating complications of GD1 that can have significant negative impact on patients’ quality of life due to pain, disability, and need for orthopedic intervention. Several studies have shown that treatment with imiglucerase improves bone density, decreases the occurrence of bone crisis, and ameliorates bone pain. OBJECTIVE: To examine the impact of treatment with imiglucerase on bone claims in Gaucher patients before and after initiation of treatment using US administrative claims data. METHODS: A retrospective study of medical claims data was conducted using Optum’s Clinformatics Data Mart database. Gaucher patients treated with imiglucerase between January 1, 1997 and June 30, 2013 were identified. Adult and pediatric patients were eligible for this study and were required to have at least 3 months continuous insurance coverage prior to their first treatment with imiglucerase (index date), at least 3 months follow-up post-index date, and at least 4 imiglucerase administrations within the first 3 months. The number of claims associated with bone disease and number of patients reporting these claims before and after treatment initiation with imiglucerase were assessed. The percentage of patients with bone claims and the average bone claims per patient were used to compare pre- and post-treatment data. Bone claims with the following treatment diagnoses were included: osteoporosis, pathological fracture, joint pain, necrosis, and unspecified bone problems. RESULTS: A total of 107 GD patients were evaluated in the pre-treatment period; 59 (55%) were male and 48 (45%) were female; there were 85 (79%) adults (18 years and older) and 22 (21%) pediatric patients. Among the 107 GD patients, 31 patients (29%) reported bone claims within 3 months prior to treatment initiation with imiglucerase. During the first year of post-treatment initiation, a significant reduction in the number of patients with bone claims was observed in all 3-month intervals when compared to the pre-treatment period. The same results were observed for the average bone claims per patient, except it did not reach statistical significance for the 6-9 month period. Results for all patients are presented in the Table below. Table: Bone Claims Before and After Treatment Initiation with Imiglucerase Time interval N evaluated N (%) of patients with bone claims Total # of bone claims Average # of bone claims per patient (SD) Baseline/3 months prior to treatment 107 31 (29%) 99 0.93 (1.922) 0-3 months after treatment 105 10 (9.5%*) 32* 0.3 (1.161)* 3-6 months after treatment 98 12 (12.2%)* 30* 0.31 (1.04)* 6-9 months after treatment 80 7 (8.8%)* 49* 0.61 (2.447) 9-12 months after treatment 72 7 (9.7%)* 14* 0.19 (0.685)* N = Number of patients * Statistically significant compared to baseline at a cumulative probability level > 0.95. Note: Statistical significance for % of patients is evaluated as a difference in proportions. Data has been adjusted for outliers. When data were analyzed separately for adult and pediatric populations, similar trends were observed with more pronounced results among pediatric patients. For pediatric patients, 5 patients reported bone claims prior to initiation of treatment and no bone claims in the first 6 months after treatment initiation. CONCLUSION: A reduction in the number of bone claims and number of patients with bone claims was observed after initiation of treatment with imiglucerase in Gaucher patients in the US. These results suggest that imiglucerase treatment is associated with a reduction of bone complaints in both adult and pediatric patients. Differences in bone claim frequencies between adult and pediatric patients after treatment initiation with imiglucerase also suggest that early treatment can mitigate the development of chronic bone disease and can result in a reduction of associated medical claims. Disclosures Nalysnyk: Genzyme, a Sanofi Company: Employment. Selzer:Genzyme, a Sanofi Company: Employment. Hamed:Genzyme, a Sanofi Company: Employment. Weinreb:Genzyme, A Sanofi Company: Consultancy, Honoraria, Speakers Bureau.

Patient out-of-pocket payments for oral oncologic therapies: Updated results from a U.S. claims data analysis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6582-6582
Author(s):  
E. Pelletier ◽  
J. Tierce ◽  
Y. Yim ◽  
C. Reyes
Keyword(s):  
Health Plan ◽  
Claims Data ◽  
Treatment Options ◽  
Care Plans ◽  
Pharmacy Claims ◽  
Out Of Pocket Payments ◽  
Nationally Representative ◽  
Dollar Amount ◽  
Claims Data Analysis ◽  
Insured Patients

6582 Background: Oral oncologic therapies are increasingly becoming part of treatment options for cancer. These agents often fall within the pharmacy benefit, with the potential for increased out-of-pocket (OOP) cost burden to patients. The objective of this study is to evaluate patient OOP payments for oral oncologic therapies in U.S. managed care plans. Methods: Patients aged 18+ years with 1 of 13 oral oncologics (bexarotene, capecitabine, dasatinib, erlotinib, gefitinib, imatinib, lapatinib, lenalidomide, sorafenib, sunitinib, temozolomide, thalidomide, vorinostat) were identified in 2007 from a nationally representative database of medical and pharmacy claims from over 90 U.S. health plans. OOP payments were calculated as the allowed amount (dollar amount a health plan allows for a therapy, including any member liability) minus the paid amount (dollar amount paid by a health plan for a therapy). Results: 10,400 patients with evidence of at least 1 of 13 oral oncologic therapies were identified in 2007. The mean age was 59.2 years, 48% were male, and 83% had a commercial payer; 26% of patients were diagnosed with lung cancer, 14% with breast cancer, and 13% with colorectal cancer at the time of the first evidence of therapy use in 2007. Mean and median OOP payments for the 13 oral oncologic therapies are provided in the table below. Medicare Advantage and Medicaid had higher mean OOP payments for most therapies compared to commercial payers and self-insured patients. Conclusions: This study evaluated OOP payments for oral oncologic therapies using current claims data. Among the 13 oral oncologics studied, the average OOP costs ranged from $117 to $1,014. As costs for therapy become a greater part of treatment decisions, an understanding of patient OOP costs will be critical in informing choices. [Table: see text] [Table: see text]

The Probability of A1C Goal Attainment in Patients with Uncontrolled Type-2 Diabetes in a Large Integrated Delivery System: A Prediction Model

2020 ◽  
Author(s):  
Kevin M Pantalone ◽  
Anita D Misra-Hebert ◽  
Todd M Hobbs ◽  
Sheldon X Kong ◽  
Xinge Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Goal Attainment ◽  
Index Date ◽  
Cleveland Clinic ◽  
Patient Characteristics ◽  
Psychiatric Disease ◽  
Lower Probability ◽  
Factors Associated ◽  
One Year

<b>Objective:</b> To assess patient characteristics and treatment factors associated with uncontrolled type 2 diabetes (T2D) and the probability of A1C goal attainment. <p><b>Research Design and Methods</b>: Retrospective cohort study using the electronic health record at Cleveland Clinic. Patients with uncontrolled T2D (A1C>9%) were identified on the index date of 12/31/2016 (n=6,973), grouped by attainment (n=1,653 [24.7%) or non-attainment (n=5,320 [76.3%]) of A1C<8% by 12/31/2017, and subgroups compared on a number of demographic and clinical variables. Based on these variables, a nomogram was created for predicting probability of A1C goal attainment. </p> <p><b>Results:</b> For the entire population, median age at index date was 57.7 years (53.3% male), and the majority were white (67.2%). Median A1C was 10.2%. Obesity (50.6%), cardiovascular disease (46.9%) and psychiatric disease (61.1%) were the most common comorbidities. Metformin (62.7%) and sulfonylureas (38.7%) were the most common anti-diabetes medications. Only 1,653 (24%) patients achieved an A1C <8%. Predictors of increased probability of A1C goal attainment were older age, white/non-Hispanic race/ethnicity, Medicare health insurance, lower baseline A1C, higher frequency of endocrinology/primary care visits, DPP-4i use, thiazolidinedione use, metformin use, GLP-1RA use, and fewer classes of anti-diabetes drugs. Factors associated with lower probability included insulin use and longer time in the T2D database (both presumed as likely surrogates for duration of T2D). </p> <p><b>Conclusions:</b> A minority of patients with an A1C>9% achieved an A1C<8% at one year. While most identified predictive factors are non-modifiable by the clinician, pursuit of frequent patient engagement and tailored drug regimens may help improve A1C goal attainment. </p>

Trends in Craniofacial Injuries Associated with the Introduction of Electric Scooter Sharing Services

FACE ◽  
2021 ◽  
pp. 273250162199244
Author(s):  
Elizabeth M. Boudiab ◽  
Thomas D. Zaikos ◽  
Christopher Issa ◽  
Kongkrit Chaiyasate ◽  
Stephen M. Lu
Keyword(s):  
Maxillofacial Surgery ◽  
Age Groups ◽  
Injury Surveillance System ◽  
Patient Demographics ◽  
Time Period ◽  
Electric Scooter ◽  
Before And After ◽  
Trends Over Time ◽  
Patterns Of Injury ◽  
Craniofacial Fractures

Electric scooters are an increasingly common and convenient mode of transportation worldwide and have effectively revolutionized the shared micromobility industry. As electric scooter sharing companies have increased in popularity there has been a concomitant increase in the frequency of all electric scooter-related injuries. The purpose of this study is to describe the most up-to-date trends in craniofacial fractures and lacerations related to electric scooter use among all age groups. We queried the National Electronic Injury Surveillance System (NEISS) for craniofacial fractures and lacerations related to e-scooters between 2010 and 2019. We then compared injury trends over time and between time periods before and after 2017 when electric scooter share apps revolutionized micromobility. We compared incidence of injury overall and by day of the week, patient demographics, and case severity based on clinical disposition. We identified an increase in the frequency of craniofacial lacerations and fractures in the 3 years following the introduction of electric scooter share services in 2017 (2017 and 2019), compared to the 3 years before this time (2014-2016). Young adults (18-39 years) were the age group with the greatest interval increase in craniofacial injuries. There was also an increase in number of craniofacial injuries occurring on Mondays and a decrease number occurring on Fridays in the later time period. Finally, patients who presented with electric scooter-related craniofacial injuries in this later time period showed a higher frequency of overnight observation and hospital admission for their injuries. The number of craniofacial injuries secondary to electric scooter use has increased dramatically since the introduction of share services. Craniofacial fractures and lacerations are a common reason for craniofacial or maxillofacial surgery consultation and understanding these patterns of injury will help prepare surgeons for patient care, preventative education, and public advocacy.

scholarly journals OP0073 RISK OF DEVELOPING RHEUMATIC DISEASES IN PATIENTS WITH PALINDROMIC RHEUMATISM IN SOUTH KOREA: A NATION-WIDE POPULATION-BASED STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 49.2-49
Author(s):  
J. K. Ahn ◽  
J. Hwang ◽  
J. Lee ◽  
H. Kim ◽  
G. H. Seo
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Rheumatic Diseases ◽  
Index Date ◽  
Claims Data ◽  
Population Based ◽  
Palindromic Rheumatism ◽  
Psoriatic Arthropathy ◽  
Increased Risk ◽  
The Mean

Background:Palindromic rheumatism (PR) has known to be three patterns of disease course: clinical remission of attacks, persistent attacks, and evolution to chronic arthritis or systemic disease. The spectrum in progression to chronic diseases of PR, however, is quite variable; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren’s syndrome (SjS), ankylosing spondylitis (AS), relapsing polychondritis (RP), Behçet’s disease (BD), sarcoidosis, and psoriatic spondylitis and arthropathy. Because of the small numbers in case-control studies and too aged investigations, now we needs to shed new light on the fate of PR.Objectives:The aim was to investigate the epidemiology of PR and the risk of developing various rheumatic diseases compared with non-PR individuals, employing the National Health Insurance Service (NHIS) medical claims data, which covers all medical institutions of South Korea.Methods:The study used 2007-2018 claims data from the Korean Health Insurance Review and Assessment Service (HIRA). The identified 19,724 PR patients from 2010 to 2016 were assessed for the incidence rate (IR) compared with the population in the given year by 100,000 person-year (py). The date of diagnosis was the index date. After matching with non-PR individuals (1:10) for age, sex and the year of index date, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs). The risk of developing the various rheumatic diseases and adult immunodeficiency syndrome (AIDS) as the outcome diseases in PR cohort was estimated. This risk was compared with that of matched non-PR cohort.Results:Of 19,724 PR patients (8,665 males and 11,059 females), the mean age was 50.2 ± 14.9 years (47.7 ± 14.4 years in males and 52.6 ± 14.9 years in females,p< 0.001). The ratio of male to female patients with PR was approximately 1:1.28. The annual IR of PR was 7.02 (6.92-7.12) per 100,000 py (6.22 (6.09-6.35) and 7.80 (7.66-7.95) per 100,000 py in males and females, respectively). The mean duration to develop the outcome diseases was significantly shorter in PR cohort compared that of non-PR cohort (19.4 vs. 35.8 months,p< 0.001). The most common outcome disease was RA (7.34% of PR patients; 80.0% of total outcome diseases), followed by AS, SLE, BD, SjS, MCTD, DM/PM, SSc, RP, psoriatic arthropathy, and AIDS in PR cohort. The patients with PR had an increased risk of RA (HR 46.6, 95% CI [41.1-52.7]), psoriatic arthropathy (44.79 [15.2-132.4]), SLE (24.5 [16.2-37.2]), MCTD (22.0 [7.7-63.3]), BD (21.0 [13.8-32.1]), SjS (12.4 [8.5-17.9]), AS (9.0 [6.7-12.2]), DM/PM (6.1 [2.6-14.8]), and SSc (3.8 [1.5-9.6]) but not of AIDS. The risk of developing RA was greater in male patients (HR 58.9, 95% CI [45.6-76.2] vs. 43.2 [37.4-49.8],pfor interaction = 0.037) while female patients encountered a higher risk of developing AS (15.8 [8.9-28.1] vs. 7.2 [5.0-10.3],pfor interaction = 0.023). The risk of developing RA, SLE, SjS, and BD were significantly more highly affected in younger age (pfor interaction < 0.001, = 0.003, 0.002, and 0.017, at each).Conclusion:This nationwide, population-based cohort study demonstrated that patients with PR had an increased risk of developing various rheumatic diseases, not only RA but also psoriatic arthropathy. Therefore, patients with PR needs to be cautiously followed up for their potential of diverse outcome other than RA: RA, SLE, SjS, and BD in younger patients, RA in males, and AS in females, in particular.Disclosure of Interests:None declared

Factors associated with demoralisation syndrome in patients before and after cardiac surgery

2017 ◽  
Vol 27 (3-4) ◽  
Author(s):  
Hsiu‐Yun Liao ◽  
Chaw‐Chi Chiu ◽  
Ying‐Ying Ko ◽  
Hsing‐Mei Chen
Keyword(s):  
Cardiac Surgery ◽  
Factors Associated ◽  
Before And After
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