Evaluating the Relationship Between Diabetes Treatment and Health Care Costs - Measuring the Atom With a Yardstick?

2005 ◽  
Vol 11 (7) ◽  
pp. 588-589
Author(s):  
Joanne LaFleur
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Diabetes Treatment ◽  
The Relationship ◽  
Care Costs

Treatment Persistence with Azacitdine (Vidaza) Is Associated with Lower Inpatient Hospitalization Costs Over Time

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4231-4231
Author(s):  
B. Douglas Smith ◽  
Dalia Mahmoud ◽  
Stacey Dacosta Byfield ◽  
Henry J Henk
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Medical Costs ◽  
Sensitivity Analyses ◽  
Bleeding Complications ◽  
Inpatient Hospitalization ◽  
Treatment Persistence ◽  
Hospitalization Costs ◽  
The Relationship ◽  
Care Costs

Abstract Abstract 4231 Background: In the US, understanding the costs associated with Myelodysplastic Syndromes (MDS) is challenging given that multiple channels including pharmacy, ambulatory, and inpatient hospitalization (IPH) settings make up the total expenses to manage patients. Recent studies suggest that MDS patients under active medical management experience fewer cytopenia-related medical problems compared to untreated, transfusion dependent (TD) patients who require more medical treatments, often for recurrent infections and bleeding complications. It is clear that persistence of drug therapy is essential to achieve optimal clinical responses for MDS patients and we sought to determine if continued therapy also optimized costs related to the disease. Aim: To evaluate the relationship between treatment persistence with AZA and health care costs encountered for patients with MDS. Methods: Commercial and Medicare Advantage enrollees with a diagnosis of high grade MDS (ICD-9, 238.73) who initiated AZA with pharmacy and medical benefits in the prior 6 months and who had a variable follow up period from initiation of AZA to disenrollment or end of study were identified in a US health plan claims database (1/1/2007-6/30/2010). The number of AZA “cycles” was calculated by dividing the total number of AZA administrations by 7 days, with a sensitivity analysis for 5 day administration, - commonly utilized in the “real-world”. Persistence was defined as the number of cycles of AZA. Eligible patientshad to have at least 2 AZA cycles. An independent analysis identified health care costs for the same patients during periods of transfusion-dependence (TD) - defined as periods in which they received 2 transfusions in an 8 week period and did not receive erythropoietin-stimulating agents (ESAs) or AZA. Average Per Patient Per Month (PPPM) costs were examined among patients with various lengths of TD periods, up to 1 year. Linear models were used to examine the relationship between persistence on AZA and PPPM health care costs. Healthcare costs included both payer and patient paid amounts under the medical and pharmacy benefit. Medical costs were further broken out into IPHs, ambulatory, and other costs captured. Several sensitivity analyses were performed to confirm the robustness of the results such as excluding patients with IPH prior to AZA initiation, and including patients with <2 cycles of AZA. Results: The baseline cost breakdown for MDS patients (n=225) who were transfusion dependent and not receiving treatment are outlined in Figure 1. Interestingly, the largest proportion of the medical costs for TD patients comes from IPHs. In fact, the PPPM IPH costs among TD periods account for approximately 65–75% of total health care costs - even at one year of their diagnosis. A similar analysis was done for patients completing at least 2 cycles of AZA (n = 100) which suggested that the proportion of cost related to IPHs was closer to 40%. This cohort averaged 6.3 cycles (median = 5) with 24% of patients completing at least 8 cycles. Importantly, completion of every additional AZA cycle (baseline 7day analysis) was found to be associated with, on average, a 6% decrease in medical care costs (p=0.005) driven largely by an 18% decrease in IPH costs (p<0.001; Figure 2) due to fewer medical events. Even a single additional AZA cycle was found to be associated with 5% lower total health care cost (p=0.006). These results also hold in the sensitivity analyses. As expected, an examination of medical needs of both TD and AZA treated patients led infections as a frequent driver of IPHs. Conclusions: Patients who persist with AZA therapy have lower PPPM medical costs, driven by decreased expenditures on IPHs. This is consistent with results identified in the AZA-001 clinical trial in which patients receiving AZA experienced reduced IPHs driven by less transfusions and need for IV antibiotics, antifungals, and antivirals. These lower overall costs offset the expected increase in continuing therapy based on the cost of drug alone. Improving duration of therapy of AZA may not only optimize clinical outcomes but may decrease cumulative costs of care among high risk MDS patients. Disclosures: Smith: Celgene: Consultancy. Mahmoud:celgene: Employment. Dacosta Byfield:Celgene: Consultancy. Henk:Celgene: Consultancy.

The impact of non-compliance with imatinib (IM) therapy on health care costs

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6083-6083
Author(s):  
H. J. Henk ◽  
S. K. Thomas ◽  
W. Feng ◽  
B. Jean-Francois ◽  
G. A. Goldberg ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Medication Possession Ratio ◽  
Underlying Disease ◽  
Imatinib Therapy ◽  
First Year ◽  
The Impact ◽  
Initial Starting ◽  
The Relationship ◽  
Care Costs

6083 Background: While compliance to drug therapy is vital to receive optimal patient benefits, the costs of delivering adequate medical care for cancer patients remain an important consideration for society and payers. This study examined the relationship between compliance with IM therapy and health care costs for patients with CML and GIST. Methods: Claims data from 6/1/01–3/31/04 from a US health plan were used to identify non-Medicare IM-treated patients with a CML or GIST diagnosis who had continuous pharmacy and medical benefits in the 3 months prior and 12 months following initiation of IM therapy. Compliance was defined by medication possession ratio (MPR=total days IM supply in the first year ÷365) and patients were stratified into three segments by MPR (<50%, 50–90%, 90–100%). Total health care costs include hospital, laboratory testing, office, ER, and pharmacy charges. Disease-related health care costs were also analyzed. Multivariate analyses were used to examine the relationship between MPR and first-year health care costs, controlling for age, sex, number of medications, initial starting dose, diagnosis (CML or GIST), year of initial IM fill, and complications due to underlying disease. Results: Total 878 IM-treated patients were identified of whom 413 had at least 15 months of continuous eligibility. Of these, 307 were non-Medicare CML or GIST patients. Total health care costs per patient in the first year of therapy in MPR < 50%, 50–90%, and 90–100% groups were $163,828, $53,924, and $40,924 respectively (p < 0.001). The corresponding numbers for disease-related health care costs were $103,118, $36,436, and $34,086 (p<0.001). Controlling for the variables listed above, a 10% increase in MPR is associated with a 5% decrease in total health care costs (p=0.021). Similar association was found between MPR and disease-related health care costs. Conclusions: Improved compliance with imatinib therapy is associated with decreased total health care costs and disease-related health care costs. Improving compliance to imatinib therapy may not only optimize clinical outcomes but may also reduce the overall societal burden of health care costs associated with cancer. [Table: see text]

scholarly journals The Relationship of Vitamin D Deficiency to Health Care Costs in Veterans

2008 ◽  
Vol 173 (12) ◽  
pp. 1214-1218 ◽  
Author(s):  
Alan N. Peiris ◽  
Beth A. Bailey ◽  
Todd Manning
Keyword(s):  
Health Care ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Health Care Costs ◽  
Relationship Of ◽  
The Relationship ◽  
Care Costs

Ten Modifiable Health Risk Factors and Employees’ Medical Costs—An Update

2020 ◽  
Vol 34 (5) ◽  
pp. 490-499 ◽  
Author(s):  
Ron Z. Goetzel ◽  
Rachel Mosher Henke ◽  
Michael A. Head ◽  
Richele Benevent ◽  
Kyu Rhee
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Promotion ◽  
Health Risk ◽  
Health Care Costs ◽  
Health Risks ◽  
Modifiable Risk Factors ◽  
Full Time ◽  
The Relationship ◽  
Care Costs

Purpose: To estimate the relationship between employees’ health risks and health-care costs to inform health promotion program design. Design: An observational study of person-level health-care claims and health risk assessment (HRA) data that used regression models to estimate the relationship between 10 modifiable risk factors and subsequent year 1 health-care costs. Setting: United States. Participants: The sample included active, full-time, adult employees continuously enrolled in employer-sponsored health insurance plans contributing to IBM MarketScan Research Databases who completed an HRA. Study criteria were met by 135 219 employees from 11 employers. Measures: Ten modifiable risk factors and individual sociodemographic and health characteristics were included in the models as independent variables. Five settings of health-care costs were outcomes in addition to total expenditures. Analysis: After building the analytic file, we estimated generalized linear models and conducted postestimation bootstrapping. Results: Health-care costs were significantly higher for employees at higher risk for blood glucose, obesity, stress, depression, and physical inactivity (all at P < .0001) than for those at lower risk. Similar cost differentials were found when specific health-care services were examined. Conclusion: Employers may achieve cost savings in the short run by implementing comprehensive health promotion programs that focus on decreasing multiple health risks.

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