Treatment of hepatitis C virus, the most common chronic viral infection in United States, has historically suffered from challenges including serious side effects, low efficacy, and ongoing transmission reinfection. Recent innovations have produced breakthrough therapies that are effective more than 90 percent patients. These treatments could dramatically reduce virus's prevalence but costly. To quantify benefit these to society, value reduced transmission, we estimated effects several...

This study analyzed hospital readmission rates of patients with schizophrenia who were treated long-acting injectable antipsychotics (LAIs) or oral after being discharged from a hospitalization.Medical claims ages 18-64 and had first hospitalization for serious mental illness (index hospitalization, October 2007 through September 2012) at least one prescription first- second-generation antipsychotic the Truven Health MarketScan Multi-State Medicaid Database. Analyses conducted sole diagnosis...

IMPORTANCE Surrogate end points may be used as proxy for more robust clinical points.One prominent example is the use of progression-free survival (PFS) a surrogate overall (OS) in trials oncologic treatments.Decisions based on expedite regulatory approval but not accurately reflect drug efficacy.Payers and clinicians must balance potential benefits earlier treatment access against risks uncertainty.OBJECTIVE To present framework evaluating expected net benefit or cost providing early to new...

With some Medicaid state programs still restricting patient access to hepatitis C (HCV) treatment, it is important demonstrate how states could expand treatment a broader population and balance short-term budget concerns. We used the HCV Transmission Progression (TaP) Markov model quantify impact of removing restrictions on infected populations, expenditures, net social value for North Carolina (NC), Oregon (OR), Wisconsin (WI) programs. Four scenarios were modeled: 1) Baseline: Patients...

To characterize treatment decision-making processes and formalize consensus regarding key factors headache specialists consider in decisions for patients with migraine, considering novel therapies.

Approval of new drugs is increasingly reliant on "surrogate endpoints," which correlate with but imperfectly predict clinical benefits. Proponents argue surrogate endpoints allow for faster approval, critics charge they provide inadequate evidence. We develop an economic framework that addresses the value improvement in predictive power, or "quality," endpoints, and clarifies how quality can influence decisions by regulators, payers, manufacturers. For example, shows lower-quality surrogates...

<ns4:p>The radioisotope cobalt-60 (Co-60) is important for commercial, medical, and agricultural applications. Its widespread use has meant that Co-60 can be found in less secured facilities, leading to the fear unauthorized persons could obtain it produce a “dirty bomb”. This potential security concern led government calls phasing-out other radiation sources, despite ongoing safety regulations handling, transport of radioactive sealed sources.</ns4:p><ns4:p> </ns4:p><ns4:p> paper explores...

Objective: To examine how observed medication nonadherence to 2 second-line, oral anticancer medications (axitinib and everolimus) affects progression-free survival (PFS) among patients with renal cell carcinoma. Methods: We used an adherence–exposure–outcome model simulate the impact of adherence on PFS. Using a pharmacokinetic/pharmacodynamic (PK/PD) population model, we simulated drug exposure measured by area under plasma concentration–time curve (AUC) minimum blood or trough...

Cost-effectiveness (CE) models are being developed and employed with increasing frequency to help determine the relative value of healthcare treatments services, inform efforts improv...

Abstract: Neurodegenerative diseases are a leading cause of disability and death in the United States, burden rare neurodegenerative conditions such as atypical Parkinsonian syndromes is expected to grow coming years size older population increases at an unprecedented rate. Atypical encompass collective that often misdiagnosed Parkinson's disease due similar signs symptoms. These include progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD),...

Background. Over the last 25 years, clinical practice guidelines have emerged as a means to standardize and improve care. As pharmaceutical innovations develop, are updated incorporate new interventions. However, extent which pharmacotherapies represented treatment options in guideline recommendations has not been well elucidated. This study aimed quantify role pharmacotherapy played across range of chronic diseases over past 20 years. Methods. Clinical published from 2000 2021 were...

The BRICS countries (Brazil, Russia, India, China, and South Africa) have experienced tremendous economic health gains in recent decades. Two of the major challenges faced by other low middle income are decreasing inequity outcomes increasing affordability insurance. One fiscally sustainable option for governments is a public subsidy system private insurance plans. This essay lays out potential applicability impacts subsidies plans, as well opportunities implementation, countries. Overall,...

Aims: This study quantifies the value of survival gains attributable to novel treatments approved since 2003 for United States (US) patients with relapsed/refractory multiple myeloma (RRMM). Methods: We estimated increase in lenalidomide and bortezomib (MM) 1983–2013 Surveillance, Epidemiology, End Results (SEER) registry. To estimate benefit 2015 (carfilzomib, elotuzomab, daratumumab, used combination dexamethasone) we clinical trial data calibrate using SEER data. then conducted an...

BACKGROUND: Despite therapeutic advances for patients with schizophrenia, improving patient outcomes and reducing the cost of care continue to challenge formulary decision makers. OBJECTIVES: To (1) understand perspectives makers on challenges optimal schizophrenia population management (2) identify best practices recommendations mitigating these challenges. METHODS: This mixed-methods study, conducted in a double-blind manner, comprised in-depth telephone interviews from February through...

BACKGROUND: Despite therapeutic advances for patients with schizophrenia, improving patient outcomes and reducing the cost of care continue to challenge formulary decision makers. OBJECTIVES: To (1) understand perspectives makers on challenges optimal schizophrenia population management (2) identify best practices recommendations mitigating these challenges. METHODS: This mixed-methods study, conducted in a double-blind manner, comprised in-depth telephone interviews from February through...

Objectives: To estimate the comprehensive value of direct-acting antivirals (DAAs) for treatment hepatitis C virus (HCV) compared with peginterferon alfa and ribavirin (PEG/riba) employing a generalized cost-effectiveness analysis (GCEA). Study Design: assess societal-level DAA HCV, we extended previously published discrete-time Markov simulation model HCV transmission progression to include market dynamics broader elements value. Methods: We followed stepwise process add novel traditional...

Objective: Characterize psoriatic arthritis (PsA) heterogeneity and develop a conceptual framework to model the clinical economic value of treatments on key PsA disease domains. Methods: We performed narrative literature review identify domains outcome measures for these explore existing evidence base evaluations current propose an modelling that could estimate Results: Our identified following domains: peripheral arthritis, dactylitis, enthesitis, spondylitis, skin, nail lesions, associated...