scholarly journals Potential and Realized Cost Savings with the Use of the Biosimilar Grastofil Vs Neupogen

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2126-2126
Author(s):  
Hishaam Bhimji ◽  
Dean Eurich ◽  
Kerry Mansell ◽  
Holly Mansell
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Cost Savings ◽  
Cost Effective ◽  
Potential Cost ◽  
Significant Cost ◽  
Term Care ◽  
Time Period ◽  
The Cost ◽  
Care System

Background: Filgrastim was first introduced to the Canadian marketplace as Neupogen® in 1992 to treat neutropenia caused by chemotherapy regimens. In 2009, the first biosimilar drug was approved for use in Canada, and in March 2016, a biosimilar for filgrastim (Grastofil®) became available. Biosimilars represent safe, effective, and cost effective alternatives to originator biologic medications. However, although biosimilar medications present opportunities for significant cost savings to the health care system, overall uptake and use of biosimilar medications in North America has been low. The aim of this study was to describe the overall use of the filgrastim products Grastofil® and Neupogen® in Canada. Methods: A retrospective analysis of Canadian drug purchases between July 2016 and June 2018 was performed for the drug filgrastim (Neupogen®, Grastofil®). The data used to estimate drug purchases were obtained from IQVIA™, a multi-national healthcare analytics company. Samples from the IQVIA™ Canadian Drugstore and Hospital Purchases (CDH) audit covered greater than 88% of the hospital market and one-third of the retail market. Samples were stratified by region, market size, and type of outlet (e.g. cancer centers, long-term care). For each drug, the total purchase dollar amounts were provided by province on a month by month basis. Potential cost-savings were calculated as a product between the units of each product purchased and the cost difference between Neupogen® and the biosimilar Grastofil® on a quarterly basis for each province. Results: Between July 1st, 2016 and June 30th, 2018, Grastofil® accounted for 27.0% (382,254/1,415,762 units) of filgrastim purchases. During this time period, $62,061,576 was spent on Grastofil® purchases and $204,152,590 was spent on Neupogen® purchases. Through use of the biosimilar Grastofil®, $13,443,873 (37.0%) in savings were realized. Had there been 100% use of the biosimilar Grastofil®, it would have resulted in $36,348,476 in cost savings. In the first quarter (July to September 2016) Grastofil® accounted for 1.5% of filgrastim purchases, whereas in the April to June 2018 quarter it increased to 43.6% of filgrastim purchases. The overall percentage of filgrastim units purchased by Canadian province varied substantially. The market share captured by Grastofil® ranged from a low of 0.08% ($4007/$5,189,623) in the province of Nova Scotia, to a high of 81.62% ($932,864/$1,142,905) in the province of Saskatchewan. Canada's largest province, Ontario, saw Grastofil® account for 44.7% ($9,047,489/$20,229,421) of purchases during this time period. Discussion: Although the biosimilar Grastofil® only accounted for 27% of filgrastim purchases between 2016 and 2018, there was substantial growth over this time period. By the end of June 2018, Grastofil® accounted for approximately 44% of filgrastim purchases, which is substantially higher than other biosimilar medications currently available in Canada. There are also stark differences between each province, whereas some had little to no use of the biosimilar, whereby in other provinces the purchases of Grastofil® outnumbered the purchases of Neupogen®. Had there been exclusive use of the biosimilar, an additional $23 million dollars in savings could have been realized. Conclusions: The use of biosimilars represents an opportunity for cost savings to be realized in an over-extended health care system. Although there appears to be acceptance for the use of Grastofil® as the overall purchases trended up from 2016 to 2018, there are still significant cost savings that could be realized by greater use of biosimilar drugs. Disclosures Mansell: Apobiologix: Research Funding.

Replacing Liquid Antibiotics With Cheaper Pill Equivalents: An Opportunity for Substantial Savings

2018 ◽  
Vol 57 (11) ◽  
pp. 1294-1299 ◽  
Author(s):  
Kristen S. Hori ◽  
Andrea M. Siu ◽  
Loren G. Yamamoto
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Pediatric Patients ◽  
Antibiotic Prescription ◽  
Cost Savings ◽  
Substantial Cost ◽  
Potential Cost ◽  
System A ◽  
Cost Reductions ◽  
Care System

Liquid antibiotics are often substantially more expensive than their pill counterparts, representing an opportunity for substantial cost reductions. Children can be taught to swallow pills at about age 6 years. The objective of this study was to calculate the potential cost saved by replacing liquid antibiotics with cheaper pill equivalents for pediatric patients for the antibiotic prescriptions written by a health care system. A retrospective smart cost analysis was performed of pediatric patients within a health care system, age 6 to less than 18 years of age receiving a liquid antibiotic prescription. The estimated cost savings over the span of 2 years for 15 161 prescriptions was $1 million. In order to achieve these substantial savings, pediatricians could encourage parents to teach their children to swallow pills at a young age and prescribe cheaper pill equivalents over liquid medications at an earlier age.

scholarly journals Systematic Review of Cost-Effectiveness of Injury Prevention Interventions in Soccer—Evidence Why Health Agencies Should Address It

2021 ◽  
Vol 18 (22) ◽  
pp. 11901
Author(s):  
Monika Grygorowicz ◽  
Martyna Wiernicka ◽  
Marzena Wiernicka
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Injury Prevention ◽  
Health Care System ◽  
Peer Review Process ◽  
Cost Effective ◽  
Prevention Interventions ◽  
The Cost ◽  
Care System

Soccer injuries are a recognized problem worldwide. Several injury prevention programs have been confirmed to reduce the number of injuries in female and male players. Unfortunately, there is a lack of data about their cost, burden, and benefit for the health care system. In this paper we aim to systematically review the literature and critically evaluate the economic quality of injury prevention interventions implemented across different populations of soccer players. Web of Science, Medline, SPORTDiscus, Ovid, and other databases were searched from January 2011 through July 2021. Research articles were only selected for analysis if they focused on the cost-effectiveness of injury prevention, were experimental papers written in English, and were published following the peer-review process. Three cluster RCT and one retrospective study met the criteria. Cost data on incremental cost-effectiveness ratios (ICERs) were extracted. The included studies had a good/average quality of economic evaluation. Based on ICERs, injury prevention interventions were cost-effective in three out of the three comparisons. One study did not report the ICER value. However, since economic analyses were reported with varying methodological approaches and results, more data are required to recognize the cost-effectiveness of soccer-specific injury prevention interventions and their benefit for the health care system.

Teletinnitus Program at the VA Gulf Coast Veterans Health Care System

2014 ◽  
Vol 4 (1) ◽  
pp. 23-29
Author(s):  
Constance Hilory Tomberlin
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Patient Care ◽  
Health Care System ◽  
Gulf Coast ◽  
New Technology ◽  
Cost Effective ◽  
Veterans Health ◽  
Potential Benefits ◽  
Care System

There are a multitude of reasons that a teletinnitus program can be beneficial, not only to the patients, but also within the hospital and audiology department. The ability to use technology for the purpose of tinnitus management allows for improved appointment access for all patients, especially those who live at a distance, has been shown to be more cost effective when the patients travel is otherwise monetarily compensated, and allows for multiple patient's to be seen in the same time slots, allowing for greater access to the clinic for the patients wishing to be seen in-house. There is also the patient's excitement in being part of a new technology-based program. The Gulf Coast Veterans Health Care System (GCVHCS) saw the potential benefits of incorporating a teletinnitus program and began implementation in 2013. There were a few hurdles to work through during the beginning organizational process and the initial execution of the program. Since the establishment of the Teletinnitus program, the GCVHCS has seen an enhancement in patient care, reduction in travel compensation, improvement in clinic utilization, clinic availability, the genuine excitement of the use of a new healthcare media amongst staff and patients, and overall patient satisfaction.

scholarly journals A113 COST SAVINGS OF SEROLOGIC VERSUS BIOPSY PROVEN DIAGNOSIS OF PEDIATRIC CELIAC DISEASE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 131-132
Author(s):  
M Wiepjes ◽  
H Q Huynh ◽  
J Wu ◽  
M Chen ◽  
L Shirton ◽  
...  
Keyword(s):  
Health Care ◽  
Celiac Disease ◽  
North America ◽  
Cost Saving ◽  
Health Care System ◽  
Cost Savings ◽  
Serologic Diagnosis ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Care System

Abstract Background Celiac disease (CD) affects approximately one percent of the population in Canada and the United States. At present, endoscopic diagnosis (ED) of CD remains the gold standard in North America, despite mounting evidence and validated European guidelines for serologic diagnosis (SD). Within publicly funded healthcare systems there is pressure to ensure optimal resource utilization and cost efficiency, including for endoscopic services. At Stollery Children’s Hospital, Edmonton, Canada, we have adopted serologic diagnosis as routine practice since 2016. Aims The aim of this study is to estimate cost savings, i.e. hard dollar savings and capacity improvements, to the health care system as well as impacts on families in regard to reduced work days lost and missing child school days for SD versus ED. Initial cost saving data is presented. Methods Micro-costing methods were used to determine health care resource use in patients undergoing ED or SD from 2017–2018. SD testing included anti-tissue glutaminase antibody (aTTG) ≥200IU/mL (on two occasions), human leukocyte antigen (HLA) DQA5/DQ2, blood sampling, transport and laboratory costs. ED diagnosis included gastroenterologist, anesthetist, OR equipment, staff, overhead and histopathology. Cost of each unit of resource was obtained from the schedule of medical benefits (Alberta) and reported average ambulatory cost for day hospital endoscopy for Stollery Children’s Hospital determined in 2016; reported in CAN$. Results Between March 2017-December 2018, 473 patients were referred for diagnosis of CD; 233 had ED and 127 SD. Estimated cost for ED was $1240 per patient; for SD was $85 per patient (6.8% of ED cost). Based on 127 patients not requiring endoscopy and a cost saving of $1155 per patient there was a total cost savings of $146,685 over 22 months. Conclusions A SD approach presents a significant cost savings to the public health care system. It also frees up valuable endoscopic resources, and limits exposure of children to the immediate and long-term risks associated with anesthesia and biopsy. SD also decreases time to diagnosis and the cost of the process to families (lost days of school/work, travel costs etc.). Our costing data can be used in combination with mounting evidence on the test performance of SD versus ED to determine cost-effectiveness of serological diagnosis for pediatric CD. Given the potential for cost saving and more efficient operating room utilization, SD for pediatric CD warrants further investigation in North America. Funding Agencies None

scholarly journals Reoperation costs in attempted breast-conserving surgery: a decision analysis

2016 ◽  
Vol 23 (5) ◽  
pp. 314 ◽  
Author(s):  
R. Pataky ◽  
C.R. Baliski
Keyword(s):  
Health Care ◽  
Breast Reconstruction ◽  
Patient Care ◽  
Health Care System ◽  
Early Stage ◽  
Treatment Options ◽  
Breast Conserving Surgery ◽  
Reoperation Rate ◽  
The Cost ◽  
Care System

Background Breast-conserving surgery (bcs) is the preferred surgical approach for most patients with early-stage breast cancer. Frequently, concerns arise about the pathologic margin status, resulting in an average reoperation rate of 23% in Canada. No consensus has been reached about the ideal reoperation rate, although 10% has been suggested as a target. Upon undergoing reoperation, many patients choose mastectomy and breast reconstruction, which add to the morbidity and cost of patient care. We attempted to identify the cost of reoperation after bcs, and the effect that a reduction in the reoperation rate could have on the B.C. health care system.Methods A decision tree was constructed to estimate the average cost per patient undergoing initial bcs with two reoperation frequency scenarios: 23% and 10%. The model included the direct medical costs from the perspective of the B.C. health care system for the most common surgical treatment options, including breast reconstruction and postoperative radiation therapy.Results Costs ranged from a low of $8,225 per patient with definitive bcs [95% confidence interval (ci): $8,061 to $8,383] to a high of $26,026 for reoperation with mastectomy and delayed reconstruction (95% ci: $23,991 to $28,122). If the reoperation rate could be reduced to 10%, the average saving would be $1,055 per patient undergoing attempted bcs (95% ci: $959 to $1,156). If the lower rate were to be achieved in British Columbia, it would translate into a savings of $1.9 million annually.Summary The implementation of initiatives to reduce reoperation after bcs could result in significant savings to the health care system, while potentially improving the quality of patient care.

scholarly journals Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

2015 ◽  
Vol 4 (6) ◽  
pp. 82 ◽  
Author(s):  
Julie M. Mhlaba ◽  
Emily W. Stockert ◽  
Martin Coronel ◽  
Alexander J. Langerman
Keyword(s):  
United States ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Waste Reduction ◽  
Significant Cost ◽  
Instrument Type ◽  
Hospital Revenue ◽  
Potential Strategy ◽  
The Cost

Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

Outside Looking In: A Pharmacist's Personal Journey With Family Elders

2019 ◽  
Vol 34 (3) ◽  
pp. 156-167
Author(s):  
Jeannette Y. Wick
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Transitions Of Care ◽  
Clinical Inertia ◽  
Older Individuals ◽  
Care Providers ◽  
Term Care ◽  
Personal Journey ◽  
Care System

Pharmacists who work in long-term care—or in any area of health care—are exposed to the health care system on a daily basis. While most of us recognize that the health care system has problems, especially at transitions of care, few of us appreciate fully how serious these problems can be. Certifying and accrediting agencies have encouraged health care providers to step out of their silos and work more collaboratively, and educators have emphasized understanding geriatric syndromes. A description of a personal journey through the health system—for both the patient and the caregiver—with two older individuals, this narrative discusses how difficult it is for patients to understand what's happening around them. It also discusses the clinical inertia in addressing geriatric issues and offers suggestions to health care providers facing similar situations.

scholarly journals Cost effectiveness of bilateral risk-reducing mastectomy and salpingo-oophorectomy

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Michael G. Schrauder ◽  
Lisa Brunel-Geuder ◽  
Lothar Häberle ◽  
Marius Wunderle ◽  
Juliane Hoyer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Cost Effective ◽  
University Hospital ◽  
Inherited Susceptibility ◽  
Combined Operations ◽  
Deep Inferior Epigastric Perforator ◽  
Small Benefit ◽  
Risk Reducing ◽  
Care System

Abstract Background Growing demand for risk-reducing surgery in individuals with inherited susceptibility to cancer leads to the question whether these procedures are cost effective for the executing hospitals. This study compared the clinical costs for bilateral risk-reducing mastectomy (BRRM) with and without different types of reconstruction, risk-reducing salpingo-oophorectomy (RRSO), and their combinations with corresponding reimbursements in the statutory health-care system in Germany. Patients and methods Real total costs of care for BRRM with and without reconstruction, RRSO, and their combinations were calculated as the sum of all personnel and technical costs. These costs calculated in a German University hospital were compared with the sum of all reimbursements in the German DRG-based health-care system. Results While sole RRSO, BRRM without reconstruction, and BRRM with secondary DIEP (deep inferior epigastric perforator)—reconstruction still result in a small benefit, we even found shortfalls for the hospital with all other prophylactic operations under consideration. The calculated deficits were especially high for BRRM with implant-based breast reconstruction and for combined operations when the risk reduction is achieved with a minimum of separate operations. Conclusions Risk-reducing surgery in BRCA-mutation carriers is frequently not cost-covering for the executing hospitals in the German health-care system. Thus, appropriate concepts are required to ensure a nationwide care.

scholarly journals Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

2012 ◽  
Vol 4 (1) ◽  
pp. 41-46 ◽  
Author(s):  
James Coyle
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Aspiration Pneumonia ◽  
Hospital Admissions ◽  
Cost Savings ◽  
Advanced Training ◽  
Number Of Patients ◽  
Management Of Dysphagia ◽  
University Training ◽  
Care System

Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

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