The introduction of imatinib, a tyrosine kinase inhibitor (TKI), has greatly increased survival for patients with chronic myeloid leukemia (CML). Conversely, nonadherence to imatinib and other TKIs undoubtedly results in disease progression treatment resistance. We examined trends expenditures from 2002 2011 assessed the association between copayment requirements TKI adherence.We used MarketScan health plan claims identify adults (age 18 64 years) CML who initiated therapy January 1, 2002,...

OBJECTIVE To evaluate the cost-effectiveness of a genetic testing policy for HNF1A-, HNF4A-, and GCK-MODY in hypothetical cohort type 2 diabetic patients 25-40 years old with MODY prevalence 2%. RESEARCH DESIGN AND METHODS We used simulation model diabetes complications based on UK Prospective Diabetes Study data, modified to account natural history disease by subtype compare at diagnosis versus no testing. Under screening policy, successful sulfonylurea treatment HNF1A-MODY HNF4A-MODY was...

Purpose There is substantial concern surrounding affordability of orally administered anticancer therapies, particularly for Medicare beneficiaries. We examined rates initiation and adherence to tyrosine kinase inhibitors (TKIs) among beneficiaries with chronic myeloid leukemia (CML) without cost-sharing subsidies. selected TKIs given their effectiveness strong indication use patients diagnosed CML. Patients Methods Using SEER-Medicare data, we identified individuals CML from 2007 2011. used...

This study evaluated the societal cost-effectiveness of continuous glucose monitoring (CGM) in patients with type 1 diabetes (T1D) using multiple insulin injections.

Background: Guidelines recommend sodium–glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP1) receptor agonists as second-line therapy for patients with type 2 diabetes. Expanding their use first-line has been proposed but the clinical benefits may not outweigh costs. Objective: To evaluate lifetime cost-effectiveness of a strategy SGLT2 or GLP1 agonists. Design: Individual-level Monte Carlo–based Markov model. Data Sources: Randomized trials, Centers Disease Control...

Abstract Objective To estimate the association between oncologists’ receipt of payments from pharmaceutical industry and delivery non-recommended or low value interventions among their patients. Design Cohort study. Setting Fee-for-service Medicare claims. Participants beneficiaries with a diagnosis incident cancer (new occurrence code in proximity to claims for treatment, no such codes during ≥1 year washout period) 2014-19, who met additional requirements identifying them as at risk one...

OBJECTIVE Continuous glucose monitoring (CGM) has been found to improve control in type 1 diabetic patients. We estimated the cost-effectiveness of CGM versus standard diabetes. RESEARCH DESIGN AND METHODS This societal analysis (CEA) was conducted trial populations which produced a significant glycemic benefit (A1C ≥7.0% cohort adults aged ≥25 years and A1C <7.0% all ages). Trial data were integrated into simulation model diabetes complications. The main outcome cost per...

Neonatal diabetes mellitus is a rare form of diagnosed in infancy. Nearly half patients with permanent neonatal have mutations the genes for ATP-sensitive potassium channel (KCNJ11 and ABCC8) that allow switching from insulin to sulfonylurea therapy. Although treatment conversion has dramatic benefits, cost-effectiveness routine genetic testing unknown.We conducted societal cost-utility analysis comparing policy no among children diabetes. We used simulation model type 1 diabetic...

This cross-sectional study examines the association of patient use a free online symptom checker tool with plans for seeking medical care.

Sickle cell disease (SCD) and its complications contribute to high rates of morbidity early mortality cost in the United States African heritage community.

ters with patients who were nonwhite (eg, African American [OR, 0.88; 95% CI, 0.83-0.93],or Medicaid or Medicare insured 0.80; 0.68-0.95and 0.75; 0.69-0.81,respectively]), had medical history of diabetes (OR, 0.73; 0.67-0.79)and/or osteoporosis 0.79-0.98),had been seen by a PA 0.78; 0.71-0.86),and visit diagnosis pneumonia 0.55; 0.46-0.64)(Table 2).We observed substantial clinician variation 17% never using steroid injections and 13% clinicians an injection more than 40% the time (data not...

Purpose Studies examining adherence to endocrine therapy (ET) and breast cancer-related outcomes have traditionally used the proportion of days covered (PDC) by medication define which may mask true treatment–outcome associations for patients with different use behaviors. We group-based trajectory models examine association between ET patterns mortality compared a standard PDC measure. Methods Using Surveillance, Epidemiology End Results-Medicare data we included 9492 women cancer who...

Does the timing and frequency of program benefits influence student school outcomes? The poor may be especially vulnerable to income scarcity at end welfare benefit cycles. Such strain other aspects family life exacerbate children's behavior problems. We use data from Supplemental Nutrition Assistance Program (SNAP) disciplinary records compare incidence infractions beginning months among Chicago Public School students in grades 5–8 whose families did not receive SNAP. Controlling for...

Abstract Background Financial relationships between physicians and the pharmaceutical industry are common, but factors that may determine whether such result in physician practice changes unknown. Materials Methods We evaluated use of orally administered cancer drugs for four cancers: prostate (abiraterone, enzalutamide), renal cell (axitinib, everolimus, pazopanib, sorafenib, sunitinib), lung (afatinib, erlotinib), chronic myeloid leukemia (CML; dasatinib, imatinib, nilotinib). Separate...

<h2>Abstract</h2><h3>Background</h3> Coronavirus disease 2019 (COVID-19) has disrupted pharmacy practice. Little research been done to assess how COVID-19 affected pharmacists' employment, workload, and feelings of burnout. <h3>Objectives</h3> The objectives this study were characterize the impact on employment status, burnout, as well examine emotional health concerns related COVID-19. <h3>Methods</h3> Wisconsin pharmacists surveyed using an online instrument between August 25, 2020,...

Telemedicine provides patients access to episodic and longitudinal care. Policy discussions surrounding future support for telemedicine require an understanding of factors associated with successful video visits.To assess patient clinician failed visits.This was a quality improvement study 137 846 scheduled visits at single academic health system in southeastern Wisconsin between March 1 December 31, 2020, supplemented experience survey data. Patient information gathered using demographic...

Background— Previous research shows that low socioeconomic position (SEP; especially income) is associated with statin nonadherence. We investigated the relationship between SEP and adherence in a country universal coverage using group-based trajectory modeling addition to proportion of days covered. Methods Results— Using data from Finnish healthcare registers, we identified 116 846 individuals, aged 45 75 years, who initiated therapy for primary prevention cardiovascular disease. measured...

Abstract OBJECTIVES Chronic use of biologic agents is the mainstay for treating moderate to severe Crohn’s disease (CD), but many patients seek stop biologics after achieving a sustained period remission. European studies suggest that cycling may be feasible, as selected regain remission with retreatment relapse following withdrawal. This study aimed characterize and identify factors associated de-escalation in U.S. CD stable disease. METHODS We performed retrospective observational using...