drug cost
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2021 ◽  
Author(s):  
Seung Min Chung ◽  
Ji-In Lee ◽  
Eugene Han ◽  
Hyun-Ae Seo ◽  
Eonju Jeon ◽  
...  

Abstract Background: We aimed to investigate the long-term effects of diabetes drug costs on cardiovascular (CV) events and death. Methods: This retrospective observational study used the 2009–2018 National Health Insurance data in Korea. Among patients with type 2 diabetes, those who were taking antidiabetic drugs and did not have CV events before 2009 were included. Data on the annual cost of each diabetes drug were collected. The 10-year incidence of CV events (cardiac death, non-fatal myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization) and CV death were analyzed according to the diabetes drug cost quartiles (Q1 [the lowest] – Q4 [the highest]).Results: A total of 441,914 participants were enrolled (median age, 60 years; male, 57%). CV events and death occurred in 28.1% and 8.36% of patients, respectively. The overall diabetes drug cost was USD 271/year per person (range: 1–18,921). The 10-year incidence of CV events and death was lowest in Q3 and high in Q4 and Q1. After adjusting for CV risk factors, the risk of CV events increased in the sequential order of cost quartiles (hazard ratio (HR)=1 [ref], 1.102 [95% confidence interval (CI): 1.084–1.120], 1.137 [95% CI: 1.118–1.156], and 1.323 [95% CI: 1.3011.346]). The risk of CV death showed U-shaped pattern which was lowest in the Q3 (HR=0.943, 95% CI 0.903-0.984) and highest in the Q4 (HR= 1.234, 95% CI 1.182-1.287).Conclusion: The expenditure for diabetes drug affects 10-year CV events and death. Affording an appropriate diabetes cost at a similar CV risk is an independent protective factor for CV death.Trial registration: retrospectively registered


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S768-S769
Author(s):  
Sonia S Kim ◽  
Brandon Chen ◽  
Karan Raja ◽  
Mitesh Patel ◽  
Mona Philips

Abstract Background Our institution admits 650 patients annually for acute bacterial skin and skin structure infection (ABSSSI). These patients may require intravenous antibiotics, potentially complicated by social factors and loss to follow up. Dalbavancin is a long-acting lipoglycopeptide given as a single dose regimen for ABSSSI. A previous review conducted at our institution identified 117 potential avoidable hospital days over 4 months with outpatient dalbavancin use. The objective of this prospective study was to evaluate the clinical and financial impact of avoided admissions with outpatient dalbavancin use. Methods The Institutional Review Board approved this single-site, prospective study. All patients who presented to the emergency department (ED) with ABSSSI from December 15, 2020 to April 15, 2021 were included in the study. Dalbavancin eligibility criteria were given to providers. Eligible patients were given a single dose of dalbavancin and then discharged. The primary outcome was the difference between percentage of avoidable admissions from the ED with dalbavancin use in the retrospective cohort and prospective cohort. The secondary outcomes were estimated length of stay avoidance, percentage of treatment success without ED re-visit within 30 days, estimated hospital cost avoidance and drug cost reimbursement. The primary outcome was assessed using the Chi-square test. Descriptive statistics were used for the secondary outcomes. Results Fourteen patients received dalbavancin and avoided hospital admissions. The percentages of admissions avoided in the retrospective and prospective cohorts were 16.02% and 6.67%, respectively (Figure 1). A difference of 9.35% was found to be statistically significant (p=0.01). The total estimated length of stay avoidance was 50 days. No patients re-visited the ED within 30 days with treatment failure. The total estimated hospital cost avoidance was &148,852 (Table 1). The net reimbursement for dalbavancin over drug cost was &5,100 (Table 2). Conclusion Dalbavancin use decreased avoidable admissions. At our institution, annual hospital cost savings can reach &1,015,794 if dalbavancin was utlilized to all eligible patients. Disclosures All Authors: No reported disclosures


Cancer ◽  
2021 ◽  
Author(s):  
Heidi V. Russell ◽  
Yueh‐Yun Chi ◽  
M. Fatih Okcu ◽  
M. Brooke Bernhardt ◽  
Carlos Rodriguez‐Galindo ◽  
...  

CMAJ Open ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. E1048-E1054
Author(s):  
Mina Tadrous ◽  
Benjamin Daniels ◽  
Sallie-Anne Pearson ◽  
Tara Gomes

2021 ◽  
pp. e20210011
Author(s):  
Chanh-Phong Tran ◽  
John J Kim ◽  
Jordan J Feld ◽  
William WL Wong

Background: Currently, there are no pharmacological options available for the treatment of non-alcoholic steatohepatitis (NASH). In the 18-month interim analysis of an ongoing randomized, placebo-controlled phase 3 trial (REGENERATE), early results demonstrated that obeticholic acid (OCA) 25 mg significantly improved fibrosis with no worsening of NASH among patients with NASH and fibrosis compared to placebo (PBO). This study aimed to assess the potential cost-effectiveness of OCA compared to PBO in NASH patients. Methods: A state-transition model was developed to perform a cost-utility analysis comparing two treatment strategies, PBO and OCA 25 mg, from a Canadian public payer perspective. The model time horizon was lifetime with annual cycle lengths. Cost and utility parameters were discounted at 1.5% annually. The efficacy data were obtained from the REGENERATE trial, and costs and utilities were derived from other published literature. Probabilistic and deterministic sensitivity analyses were performed to test the robustness of the model. Results: Treatment with OCA led to reductions of 3.58% in decompensated cirrhosis cases, 3.95% in hepatocellular carcinoma, 7.88% in liver transplant, and 6.01% in liver-related death. However, at an annual price of CDN$36,000, OCA failed to be cost-effective compared to PBO at an incremental cost-effectiveness ratio of $815,514 per quality-adjusted life year (QALY). An 88% reduction in drug price to an annual cost of $4,300 would make OCA cost-effective at a willingness-to-pay threshold of $50,000/QALY. Conclusions: OCA failed to be cost-effective compared to PBO, despite demonstrating clinical benefits due to a high drug cost. A significant price reduction would be needed to make the drug cost-effective.


2021 ◽  
pp. OP.21.00207
Author(s):  
Erlene K. Seymour ◽  
Lucius Daniel ◽  
Eva Pointer ◽  
Jordan Julian ◽  
Stephen T. Smith ◽  
...  

PURPOSE: High-cost drugs impose a financial burden on patients with cancer. Karmanos Specialty Pharmacy (KSP) developed a process to automate financial assistance (FA) applications to decrease patient drug cost. We evaluate the outcomes of this program on cost to patients and payers. METHODS: This is an observational, retrospective study of the KSP claims data set from January to December 2019, accessed by 13 statewide cancer centers within Michigan. Drug cost of patients, payers, FA (funds to lower patient drug cost), and types of FA were obtained. A subset analysis was performed to determine drug delivery times. RESULTS: In 2019, 869 prescriptions and 1,722 prescription fills were provided to 463 patients through KSP. The total cost of drug claims was approximately $10 million US dollars (USD) among Medicare patients (58%), approximately $3.4 million USD for privately insured patients (20%), and approximately $3.7 million USD for Medicaid patients (22%). Twenty-seven percent of patients (22% of all prescription fills) required additional FA with initial total co-payment claims of $335,216 USD. $280,988 USD of FA was obtained, which substantially lowered total patient costs by 81%. $250,818 USD of FA obtained was from foundation grants (327 fills), and $21,441 USD from manufacturer co-pay cards (47 fills). An additional $12,260 USD (12 fills) from a Karmanos Patient Assistance Fund was used. There was high dependence on foundation grant assistance among Medicare patients (33% of claims). In a subset analysis, the median time from prescription written to delivery to the patient was < 7 days (0-56 days). CONCLUSION: Twenty-seven percent of patients (22% of prescriptions fills) in 2019 required additional FA for high-cost drugs. KSP substantially reduced patient cost by implementing an efficient process using additional pharmacy assistants to obtain FA.


2021 ◽  
Vol 20 (4) ◽  
pp. 762-767
Author(s):  
Indriyati Hadi Sulistyaningrum ◽  
Susi Ari Kristina ◽  
Ali Ghufron Mukti ◽  
Satibi

Objectives: This study aims to analyze the of drug costs for patients with chronic diseases in the capitation system in public primary health cares (Public PHCs). Materials and Methods: This research is a quantitative study with an observational cross-sectional approach at 16 Public PHCs. Data collection used the retrospective method. The total sample was 293 outpatients in 2016. Results: The results showed that 63% of patients are female. The most patients are aged between 56-65 years (37%). The average drug cost for patients receiving more than 3 types of drugs is IDR 7,726. The biggest drug cost is patients with DM type 2 with which the average cost is IDR 7.400. And the metformin treatment is 17 (6%) patients with the cost IDR 4,500,-. Chi-square analysis shows that the quantity of drug items, type of disease and prescriptions there are have significant effect on drug cost (p-value <0.05). However, gender and age group there are no significant effect on drug cost (p-value >0.05). Drug prescriptions are an important component in managing chronic diseases patients. Prescribing costs provide important information in the sustainability of the management of chronic disease programs. Conclusion: This study recommends that the prolanis policy in public PHCs is focused on the elderly age group patients and female group. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.762-767


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 544-544
Author(s):  
Federico Manevy ◽  
Gabriele Filkauskas ◽  
Pierre Levy ◽  
Judy Fredriksson ◽  
Jesse Sussell

544 Background: In patients with HER2-positive early breast cancer (BC), pertuzumab (P) added to trastuzumab (T) and chemotherapy has been recognized as a standard-of-care, improving the risk of recurrence. P and T treatments can be given intravenously (PT IV) or, more recently, subcutaneously − via PH FDC SC. Both methods are comparable in terms of efficacy and safety profiles. However, PH FDC SC allows for a faster infusion than that of PT IV, and this can be associated with lower costs. The aim of this study is to estimate the incremental difference in non-drug costs between PH FDC SC and PT IV for a typical patient receiving treatment for HER2-positive early BC in Western Europe and the United States. Methods: A model-based cost-minimization analysis was performed to quantify mean non-drug cost differences per patient over a full course of therapy (18 cycles). Western Europe: costs in the analysis are based on an archetypal country, and explicitly include estimates for costs for patient chair time, active healthcare professional (HCP) time, usage of non-drug consumables, port-a-cath placement surgeries and patients’ productivity losses. Costs are calculated by multiplying the resource use by its corresponding unit price. Costing data were obtained from literature sources on T SC time and cost savings for Western European countries, and assumptions on PH FDC SC and PT IV times and costs. United States: non-drug costs for the two strategies were estimated using average net reimbursement amounts for relevant procedure codes for intravenous and SC therapy administration among commercial payers in the MarketScan databases. Results: PH FDC SC is estimated to reduce non-drug costs by 73% − 80% in Western Europe, and 75% in the United States. Total monetary non-drug savings per patient over 18 cycles of treatment are estimated in the range of €2,474 − €8,975 in Western Europe, and at $10,138 in the United States. In Western Europe, where the analysis allows for a disaggregation by cost category, cost savings related to savings in patient chair time (excluding patients’ productivity losses) are estimated to account for up to 62% of overall non-drug cost savings. Patients’ productivity losses are estimated to explain up to 11% of non-drug cost differences. Conclusions: The use of PH FDC SC for the treatment of HER2-positive BC can potentially result in substantial non-drug cost savings. These savings could easily derive in overall net cost savings to the healthcare system, contributing to the long-term sustainability of the healthcare spending, while still providing a safe and effective therapy.[Table: see text]


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jielin Du ◽  
Jiajia Xie ◽  
Yan Qian ◽  
Mingyue Wu ◽  
Wenjing Huang ◽  
...  

Abstract Background China proposed the Zero Markup Drug Policy (ZMDP), which popularized in tertiary hospitals across the country in 2017, to control drug expenditures’ rapid growth further and reduce the public’s medical burden. This study aims to evaluate the impact of ZMDP on the drug cost of chronic disease outpatients in the tertiary hospital in Chongqing. Methods We collected and described the drug-cost data for outpatients with chronic diseases in a Chongqing’s tertiary hospital from 2015 to 2019. The instantaneous and long-term changes of the outpatient volume and average drug cost after the ZMDP were evaluated using interrupted time series (ITS). We also analyzed the policy’s impact under the stratification of gender, age, and basic medical insurance types. Results A total of 350,848 outpatients were collected from January 2015 to February 2019. After the ZMDP, the outpatient volume for diabetes, hypertension, and coronary heart disease (CHD) all showed a downward trend, with a decrease of 53.04 (P = 0.012), 142.19 (P < 0.01) and 12.16 (P < 0.001) per month. Simultaneously, the average drug cost decreased by 4.44 yuan (P = 0.029), 5.87 yuan (P < 0.001) and 10.23 yuan (P = 0.036) per month, respectively. By gender, the average drug cost of diabetes in males had the most considerable instantaneous change, reducing by 51.21 yuan (P = 0.017); the decline of CHD in women is the most obvious, with an average monthly decrease of 12.51 yuan (P < 0.001). By age, the instantaneous change of CHD was the greatest for those older than 65 years old, with a decrease of 102.61 yuan (P = 0.030). CHD in 46–65 years old showed the most significant reduction, with an average monthly decline of 11.70 yuan (P < 0.01). BMIUE’s hypertension had the most considerable instantaneous change, which decreased 59.63 yuan (P = 0.010). BMIUE’s CHD showed the most apparent downward trend, with an average monthly decrease of 10.02 yuan (P = 0.010). Conclusion The ITS analysis is an effective method of health policy evaluation. The implementation of the ZMDP can reduce the drug cost for chronic disease outpatients in the tertiary hospital and their economic burden. Follow-up policies still require targeted price adjustments in the health service system to adjust the drug cost-effectively.


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