Physician-pharmacy integration and oral cancer drug use and quality.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 39-39
Author(s):  
Pragya Kakani
Keyword(s):  
Oral Cancer ◽  
Drug Use ◽  
Economic Research ◽  
Cancer Drug ◽  
National Bureau ◽  
Fee For Service ◽  
Early Discontinuation ◽  
Part D ◽  
Oral Oncolytics ◽  
The Impact

39 Background: Public reports suggest increasing integration of in-house specialty pharmacies by independent and system-based oncology practices. Understanding the impact of such integration has important implications for state-level regulations limiting physicians’ ability to launch pharmacies in certain states and policies governing pharmacy network design. In this analysis, I document the growth of in-house pharmacies and estimate the impact of this growth on oral cancer drug use and quality. Methods: I used 2006-2017 data from Medicare Fee-for-Service and Part D claims, pharmacy names and characteristics from health plan pharmacy network lists and the National Plan and Provider Enumeration System, and a unique Health System and Practice Dataset, developed by National Bureau of Economic Research and Harvard University researchers, that tracks practice ownership relationships. I first linked physician organizations and pharmacies that they operate using a novel claims-based algorithm combining information on pharmacy characteristics, similarities in names of practices and pharmacies, and the share of total pharmacy spending attributable to a single practice or system. I then used an event study approach to compare oral oncolytic use and quality at practices launching a pharmacy between 2009 to 2014 compared with matched controls. Outcomes included total spending on oral oncolytics, use of oral drugs when an intravenous equivalent exists (capecitabine and 5-fluoruracil), timeliness of new prescription fills (# days from first fill to last office visit), medication adherence, and early discontinuation of lenalidomide, tyrosine kinase inhibitors, aromatase inhibitors, tamoxifen, enzalutamide, and abiraterone. Results: The number of independent or system-based oncology practices with an in-house pharmacy filling any oncology prescriptions increased from 135 in 2006 to 442 in 2017. In that time, the share of Medicare Part D spending on oral oncolytics filled at in-house pharmacies increased from 4% in 2006 to 27% in 2017. The launch of an in-house pharmacy was not associated with an overall increase in spending on oral oncolytics, but was associated with a 4.5 percentage point (p =.01) increase in the use of capecitabine relative to 5-fluorouracil, within 2 years of launch. In-house pharmacies were associated with a modest decrease in the time to fill an initial prescription (2.4 days, p <.001) within 2 years of launch, but no improvements in adherence or reductions in early discontinuation. Conclusions: There has been substantial growth in the use of in-house pharmacies in oncology in recent years. Having an in-house pharmacy only had modest effects on cost and quality. Policymakers should therefore approach claims that in-house pharmacies meaningfully impact cost and quality with caution.

The Impact Of Medicare Part D On Prescription Drug Use By The Elderly

2007 ◽  
Vol 26 (6) ◽  
pp. 1735-1744 ◽  
Author(s):  
Frank R. Lichtenberg ◽  
Shawn X. Sun
Keyword(s):  
Drug Use ◽  
Prescription Drug ◽  
Medicare Part D ◽  
The Elderly ◽  
Medicare Part ◽  
Part D ◽  
Prescription Drug Use ◽  
The Impact

scholarly journals Prospects of China-Mongolia-Russia trade in the light of the COVID-19 pandemic

R-Economy ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 192-199
Author(s):  
Xiujie Zhang ◽  
Keyword(s):  
Northeast Asia ◽  
Economic Research ◽  
National Bureau ◽  
Republic Of China ◽  
Economic Statistics ◽  
Before And After ◽  
Trade Turnover ◽  
The Impact ◽  
Trade Partners ◽  
Volume Of Trade

Relevance. China, Mongolia, and Russia are among each other’s major trade partners. The COVID-19 pandemic has had a large impact on global trade, which creates the need to analyze further prospects of the trilateral cooperation between China, Mongolia and Russia. Research objective. This study aims to analyze China-Mongolia-Russia trade cooperation in the context of the COVID-19 pandemic. Data and methods. This article applies a comparative analysis method to examine the development and changes in import and export trade between China, Mongolia, and Russia before and after the beginning of the project of the China-Mongolia-Russia Economic Corridor, from 2014 to 2020. The research relies on the data from the China Trade and Foreign Economy Statistical Yearbook, Northeast Asia Economic Statistics of Sea of Japan Economic Research Institute, Ministry of Commerce of the People's Republic of China, Russian Customs, and National Bureau of Statistics of Mongolia. Results. Along with the realization of the medium and short-term goal of raising the volume of trade turnover within the Corridor, the three countries seek to play more and more important roles as each other’s trade partners. It is observed that the impact of the COVID-19 pandemic on the volume of trade has not been significant, and thus the fundamental premises of trilateral trade cooperation have remained largely unchanged. Conclusions. To increase the volume of trade between China, Mongolia and Russia, it is necessary to improve the trade structure, reduce tariffs, establish free trade areas and actively promote the diversification of trade cooperation.

Family planning improves global development outlook

2015 ◽  
Keyword(s):  
Family Planning ◽  
Child Survival ◽  
Survival Rates ◽  
Economic Research ◽  
National Bureau ◽  
Maternal Deaths ◽  
Content Type ◽  
Rapid Economic Growth ◽  
Contraception Use ◽  
The Impact

Subject The impact of contraception use in countries. Significance The growing use of contraception worldwide has had major effects on economic development and maternal and child survival. According to a 2012 comprehensive study from Johns Hopkins University, contraception use has cut maternal deaths by 44% since 2008, and could lead to an additional reduction of 29% if the current levels of unmet contraceptive need were met. The US National Bureau of Economic Research assessed in 1997 that fertility declines contributed significantly to rapid economic growth in East Asia. However, with growing inequity and government austerity measures, many nations in Latin America, Africa, and Europe are stagnating in their progress to improve contraception rates. Impacts Improved access to contraception will decrease maternal deaths related to unwanted pregnancies. Families can better support fewer children, so falling birth rates would also improve child survival rates. This would also lead to more children in school, improving national rates of universal education. However, family planning programmes perceived to be anti-poor will prove politically controversial.

Cost of oral cancer drugs: Trends in the United States Medicare population in 2013 and 2015.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6631-6631
Author(s):  
Kira Rose-Madison Seiger ◽  
Emily S Ruiz
Keyword(s):  
Oral Cancer ◽  
Consumer Price Index ◽  
The United States ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Part D ◽  
Tamoxifen Citrate ◽  
Medicare Costs ◽  
Bureau Of Labor Statistics ◽  
Utilization Cost

6631 Background: Rising pharmaceutical costs threaten affordability and access to cancer care. Methods: The 2013 and 2015 Medicare Part D claims databases were queried for CareFirst’s 2017 list of oral cancer drugs. Drugs with on-label indications for conditions other than cancer were excluded. Cost in 2013 were adjusted for inflation to 2015 dollars according to the Bureau of Labor Statistics consumer price index. Results: The total cost of oral cancer drugs paid by Medicare nearly doubled from 2013 to 2015, rising from over $4.8 billion to over $9.1 billion. The number of prescriptions increased by 21.6% from 640,193 to 778,357, suggesting that increased spending is driven more by rising drug prices than by increased utilization. Cost per patient increased for 81% (46) of the 57 drugs prescribed in both years and decreased for the remaining 19% (11). While only seven drugs cost more than $50,000 per patient in 2013, more than fifteen drugs cost more than $50,000 per patient in 2015. The overall average cost per beneficiary increased by 56% from $7,521.64 to $11,734.68, and seven drugs more than doubled in per patient cost. Cost per patient increased by 4.5 times for imbruvica (ibrutinib), 3.5 times for targretin (bexarotene), 3.2 times for soltamox (tamoxifen citrate), 3.1 times for nilandron (nilutamide), 2.6 times for gilotrif (afatinib dimaleate), 2.6 times for cyclophosphamide, and 2.5 times for iclusig (ponatinib hydrochloride). Conclusions: Medicare costs for oral cancer drug nearly doubled from 2013 to 2015, largely due to increased per patient costs. [Table: see text]

Book Reviews

2013 ◽  
Vol 51 (1) ◽  
pp. 208-209
Keyword(s):  
Scientific Knowledge ◽  
Innovation Policy ◽  
50Th Anniversary ◽  
Economic Research ◽  
London School ◽  
National Bureau ◽  
Massachusetts Institute Of Technology ◽  
Inventive Activity ◽  
Institute Of Technology ◽  
The Impact

David Grover of London School of Economics reviews, “The Rate and Direction of Inventive Activity Revisited” edited by Josh Lerner and Scott Stern. The EconLit abstract of this book begins: “Thirteen papers, based on the proceedings of the National Bureau of Economic Research 50th Anniversary Conference in honor of the 1962 volume The Rate and Direction of Inventive Activity: Economic and Social Factors, held in Warrenton, Virginia, in the Fall of 2010, plus thirteen comments, present theoretical and empirical contributions to fundamental questions relating to the economics of innovation and technological change, while revisiting the findings of the 1962 work. Papers discuss funding scientific knowledge—selection, disclosure, and the public-private portfolio; the diffusion of scientific knowledge across time and space—evidence from professional transitions for the scientific elite; the effects of the Foreign Fulbright Program on knowledge creation in science and engineering; Schumpeterian competition and diseconomies of scope—illustrations from the histories of Microsoft and IBM; how entrepreneurs affect the rate and direction of inventive activity; diversity and technological progress; how competition policy best promotes innovation; the effects of the Plant Patent Act on biological innovation; the rate and direction of invention in the British Industrial Revolution—incentives and institutions; the confederacy of heterogeneous software organizations and heterogeneous developers—field experimental evidence on sorting and worker effort; the consequences of financial innovation—a counterfactual research agenda; the adversity/hysteresis effect— Depression-era productivity growth in the U.S. railroad sector; and the recombination and reuse of key general purpose technologies. Includes three panel discussions from the 2010 conference that discuss the impact of the 1962 Rate and Direction volume—a retrospective; innovation incentives, institutions, and economic growth; and the art and science of innovation policy. Lerner is Jacob H. Schiff Professor of Investment Banking in the Harvard Business School at Harvard University. Stern is School of Management Distinguished Professor of Technological Innovation, Entrepreneurship, and Strategic Management in the Sloan School of Management at the Massachusetts Institute of Technology. Author and subject indexes.””

scholarly journals The Impact of the Medicare Part D Prescription Benefit on Generic Drug Use

2008 ◽  
Vol 23 (10) ◽  
pp. 1673-1678 ◽  
Author(s):  
James X. Zhang ◽  
Wesley Yin ◽  
Shawn X. Sun ◽  
G. Caleb Alexander
Keyword(s):  
Drug Use ◽  
Generic Drug ◽  
Medicare Part D ◽  
Medicare Part ◽  
Part D ◽  
The Impact

Commentary: Assessing the Benefits and Costs of the Doha Development Agenda Negotiations -- a Labor Perspective

2005 ◽  
Vol 5 (4) ◽  
pp. 1850077 ◽  
Author(s):  
Thea Lee
Keyword(s):  
International Economic ◽  
Economic Policy ◽  
International Trade ◽  
Advisory Committee ◽  
Wage Inequality ◽  
Global Economy ◽  
Economic Research ◽  
National Bureau ◽  
Smith College ◽  
The Impact

A commentary on the Doha Development Round by a representative of the AFL-CIO. Thea Lee is Policy Director at the AFL-CIO in Washington, D.C., where she oversees research and strategies on domestic and international economic policy. Previously, she worked as an international trade economist at the Economic Policy Institute in Washington, D.C. and as an editor at Dollars & Sense magazine in Boston. Lee is co-author of A Field Guide to the Global Economy, published by the New Press. Her research projects include reports on the North American Free Trade Agreement, the impact of international trade on U.S. wage inequality, and the domestic steel and textile industries. She has testified before several committees of the U.S. House of Representatives and the Senate on various trade topics. She serves on several advisory committees, including the State Department Advisory Committee on International Economic Policy and the Export-Import Bank Advisory Committee. She is also on the Board of Directors of the Worker Rights Consortium and the National Bureau of Economic Research. She received a Bachelor’s degree from Smith College and a Master’s degree in economics from the University of Michigan.

The impact of dementia on antidiabetic drug use in Medicare beneficiaries with diabetes: findings post-Medicare part D

2016 ◽  
Vol 5 (4) ◽  
pp. 383-392
Author(s):  
Z Kevin Lu ◽  
Minghui Li ◽  
Karen McGee ◽  
Cynthia M Phillips ◽  
Jing Yuan ◽  
...  
Keyword(s):  
Drug Use ◽  
Medicare Part D ◽  
Medicare Part ◽  
Medicare Beneficiaries ◽  
Antidiabetic Drug ◽  
Part D ◽  
The Impact

scholarly journals Global Economic Crisis: Impact on Higher Education in Malaysia

2010 ◽  
Author(s):  
Ramli Hassan ◽  
Mohammad Haji Alias
Keyword(s):  
Higher Education ◽  
Economic Crisis ◽  
The United States ◽  
Food Prices ◽  
Economic Research ◽  
Success Factor ◽  
National Bureau ◽  
Global Economic Crisis ◽  
The Government ◽  
The Impact

The global economy is reeling from the effects of financial crisis which led to an economic crisis triggered by the United States sub-prime mortgage crisis which started in late 2007. The sharp inflation in petroleum and food prices in the first half of 2008 also compounded the problem. The National Bureau of Economic Research (NBER) had declared that the US economy had been in recession since December 2007. Contraction in the growth rates of major developed economies thereby causing global trade in goods and services to plummet has affected open economies including Malaysia. Last year Malaysian GDP grew by about 4.6% over 2007. An ominous sign that economic growth in 2009 would be low or even negative was the 0.1% growth in GDP in the fourth quarter of 2008 compared to the same quarter in 2007. This was due mainly to a 40% drop in net exports. The slow down in growth has affected all sectors of the economy. Education in general and higher education in particular are not spared. Higher education has to compete for scarce public funds. The main objective of this paper is to understand the impact of the global economic crisis on higher education in Malaysia. A better understanding is imperative in order to prepare for the challenges ahead. The challenges ahead are within the framework of the new economic model being formulated by the government in order to lift Malaysia into a high income country within a decade. A major critical success factor is the implementation of an effective human capital development strategy.   Keywords: Economic crisis; higher education; recession.

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