A5073480231- Health Systems, Economic Evaluations, Quality of Life
- Economic and Financial Impacts of Cancer
- Pharmaceutical Economics and Policy
- Medication Adherence and Compliance
- Healthcare Policy and Management
- HIV/AIDS Research and Interventions
- Global Cancer Incidence and Screening
- HIV, Drug Use, Sexual Risk
- Blood Pressure and Hypertension Studies
- Palliative Care and End-of-Life Issues
- Pharmaceutical Practices and Patient Outcomes
- Pharmaceutical industry and healthcare
- Cardiac Health and Mental Health
- Biomedical Ethics and Regulation
- Chronic Myeloid Leukemia Treatments
- Chronic Disease Management Strategies
- Telemedicine and Telehealth Implementation
- Nursing Roles and Practices
- Diabetes Treatment and Management
- Chemotherapy-induced cardiotoxicity and mitigation
- Cancer-related cognitive impairment studies
- Schizophrenia research and treatment
- Healthcare Systems and Reforms
- Health Promotion and Cardiovascular Prevention
- Statistical Methods in Clinical Trials
Vanderbilt University
2022-2025
Wake Forest University
2024-2025
Vanderbilt University Medical Center
2024
Vanderbilt Health
2022-2023
Duke University
2019-2022
University of North Carolina at Chapel Hill
2017-2022
University of Michigan
2011
Abstract Understanding the downstream consequences of initial Medicare plan selection is necessary to ensure access and affordability health care services, especially for older adults with serious illness. We used 2008-2020 data from Health Retirement Study estimate financial burden by (traditional without supplemental coverage, traditional plus or Advantage) self-reported history cancer. Initially choosing benefits greater protections (either coverage relative was associated lower levels...
Abstract Individuals aging into Medicare must choose among plans that vary in their scope of benefits, access to health care providers, and exposure out-of-pocket expenses. When faced with complex coverage decisions, it is unclear whether older adults consider experiences prior serious illness or current medical conditions. We estimated the association between a self-reported history cancer initial plan selection 3811 Health Retirement Study participants 2008 2020. The proportion individuals...
The current Medicare Part D benefit may require greater out-of-pocket spending for beneficiaries filling prescriptions higher-price generic drugs, compared to those brand-name counterparts. This can occur among patients who reach the catastrophic coverage phase under benefit, when differences between prices and drugs are not large. scenario be common with specialty (typically high-price products used treat rare or complex conditions), number of manufacturers clinical alternatives limited. In...
Abstract Background Transportation barriers limit access to cancer care services and contribute suboptimal clinical outcomes. Our objectives were describe the frequency of Veterans reporting factors associated with transportation or from colorectal (CRC) visits. Methods Between November 2015 September 2016, incident stage I, II, III CRC completed a mailed survey assess perceived recommended care. Participants who reported difficulty appointments categorized as experiencing barriers. We...
To compare predictive analytic approaches to characterize medication nonadherence and determine under which circumstances each method may be best applied.Medicare Parts A, B, D claims from 2007 2013.We evaluated three statistical techniques predict statin adherence (proportion of days covered [PDC ≥ 80 percent]) in the year following discharge: standard logistic regression with backward selection covariates, least absolute shrinkage operator (LASSO), random forest. We used C-index assess...
Abstract Background In this study, we sought to estimate the association between oral oncology parity law adoption and anticancer medication use for patients with chronic myeloid leukemia or multiple myeloma. Methods This was an observational study of administrative claims from 2008 2017. Among individuals initiating tyrosine kinase inhibitors (TKIs) immunomodulatory drugs myeloma, compared out-of-pocket spending, adherence, discontinuation before after among in fully insured plans (subject...
Abstract Purpose To compare adherence to tyrosine kinase inhibitors (TKIs) between patients with chronic myeloid leukemia (CML) who initiated branded or generic imatinib. Methods We used MarketScan commercial claims data (January 2011‐June 2018) identify CML newly imatinib before 1 August 2015 on after 2 February 2016, and were continuously enrolled in health plans for 6 months through following their initial fill. After inverse probability of treatment weighting, we compared (proportion...
This cross-sectional study examines and compares the time taken from accelerated approval of cancer noncancer drugs to initiation confirmatory studies in US.
Many state Medicaid officials are concerned about rising prescription drug spending, particularly drugs approved through the Food and Drug Administration's (FDA) accelerated approval pathway. The authors examined how much of programs' spending is attributable to products that have demonstrated clinical benefits versus those not. Their findings provide support for states' concerns pharmaceutical companies often fail complete their required postapproval confirmatory studies within FDA's...
Despite improvements in treatment (eg, reduction pill intake), antiretroviral therapy (ART) is dispensed socially inefficient and uneconomical packaging. To make pills less conspicuous decrease the risk of being stigmatized, people living with HIV (PLWH) often engage self-repackaging - practice transferring ART from original packaging to alternative containers. This behavior has been associated nonadherence failure achieve viral load suppression. While much literature on centered around...
This cross-sectional study examines spending by health care plans and enrollees on products with accelerated approval.
The Medicare Part D low-income subsidy program drastically reduces patient cost sharing and may improve access to equitable use of high-cost antimyeloma therapy. We compared initiation adherence orally administered therapy between full-subsidy nonsubsidy enrollees assessed the association full subsidies racial/ethnic inequities in treatment use.Retrospective cohort study.We used Surveillance, Epidemiology, End Results-Medicare data identify beneficiaries diagnosed with multiple myeloma 2007...
<h3>Importance</h3> High-deductible health plans (HDHPs) require high upfront cost-sharing, which has been associated with suboptimal anticancer medication uptake and adherence. Whether HDHP enrollment limited the affordability use of lenalidomide therapy among commercially insured patients multiple myeloma is unknown. <h3>Objective</h3> To assess association out-of-pocket spending on adherence to therapy. <h3>Design, Setting, Participants</h3> In this cohort study, data were obtained from...
Uncontrolled blood pressure (BP) is common among Veterans. Rural Veterans are at risk for suboptimal care coordination as successful programs may be implemented lower rates due to individual- and system-level factors. There strong evidence support the use of remotely delivered patient-generated data from home BP monitors virtual visits manage BP.The purpose this project augment current approach addressing uncontrolled so that existing clinical staff can reach a larger patient population.Our...
Abstract Objectives To estimate the proportion and correlates of self-reported financial difficulty among patients with multiple myeloma (MM) or chronic lymphocytic leukemia (CLL). Setting 23 U.S. community minority oncology practice sites affiliated National Cancer Institute Community Oncology Research Program (NCORP). Participants 521 (≥18 years) MM CLL were consented 416 responded to a survey (completion rate=79.8%). Respondents had diagnosis (74.0%), an associate degree higher (53.4%),...
91 Background: Breast cancer is the most common in US. Up to 25% of breast cancers are classified as human epidermal growth factor receptor 2 (HER2)-positive and associated with an aggressive tumor burden. HER2-targeting monoclonal antibodies improves survival patients HER2-positive cancer. Prior work has demonstrated disparities access oncologic therapies among older women. Our study seeks examine racial/ethnic receiving HER2-targeted for trends use over time. Methods: In Surveillance,...
51 Background: Inequities in cancer care delivery can profoundly affect access to high-quality treatments and patient outcomes. Supportive medication use is important for preserving quality of life older adults with metastatic pancreatic ductal adenocarcinoma (PDAC). Whether there are differences supportive by race sex unknown. Our objectives were assess the racial/ethnic biological inequities pain, depression, insufficiency-related (PERT) among PDAC. Methods: We used Surveillance,...