Arielle G. Bensimon

Evaluation of compliance and health care utilization in patients treated with single pill vs. free combination antihypertensives.

Abstract Objectives: To compare compliance/persistence, health care resource utilization, and costs associated with single-pill combination (SPC) vs. free-combination (FC) therapies among adult hypertension patients at the national and state level. Combination therapies with angiotensin receptor blocker (ARB) + calcium channel blocker, ARB + hydrochlorothiazide, and angiotensin-converting enzyme inhibitor + hydrochlorothiazide were evaluated. Methods: Patients initiated on SPC or FC were identified in the MarketScan Database (2006–2008). Multivariate regression models were used to compare the health care outcomes of SPC vs. FC use during the 6-month study period. National- and state-level outcomes were analyzed and reported. Compliance was measured by medication possession ratio (MPR), and persistence was assessed based on treatment discontinuation (i.e., a lapse in therapy exceeding 30 days). Utilization and cost outcomes included frequencies of inpatient and emergency room (ER) visits and changes in health care costs from baseline. Results: Adjusting for baseline characteristics, SPC patients (N = 382,476) demonstrated significantly higher MPR than FC patients (N = 197,375) (difference = 11.6%; 95% confidence interval [CI]: 11.4%, 11.7%). SPC patients had fewer all-cause hospitalizations (adjusted incidence rate ratio [IRR] = 0.77; 95% CI: 0.75, 0.79) and ER visits (adjusted IRR = 0.87; 95% CI: 0.86, 0.89) than FC patients. Results for cardiovascular-related utilization were similar to all-cause results. Compared to FC, SPC patients showed significantly greater reductions post-therapy initiation in all-cause medical costs by −

Cost Per Responder Associated with Biologic Therapies for Crohn’s Disease, Psoriasis, and Rheumatoid Arthritis

208 (95% CI: −

Efficacy and Safety of Adalimumab among Patients with Moderate to Severe Psoriasis with Co-Morbidities

302, −

Effect of adalimumab on work productivity and indirect costs in moderate to severe Crohn's disease: a meta-analysis.

114), but larger increases in hypertension-related prescription costs by

Effect of adalimumab on clinical laboratory parameters in patients with Crohn's disease: Results from the CHARM trial

53 (95% CI:

Copayment level, treatment persistence, and healthcare utilization in hypertension patients treated with single-pill combination therapy

51,

Compliance, Persistence, Healthcare Resource Use, and Treatment Costs Associated with Aliskiren plus ARB versus ACE Inhibitor plus ARB Combination Therapy

55). State-level results were generally consistent in magnitude and direction for comparisons of compliance and utilization, with greater regional variation in costs. Limitations include the possibility of residual confounding from factors not observable in claims. Conclusion: SPC use was associated with significantly better compliance/persistence and fewer hospitalizations and ER visits than FC in hypertensive patients at the national level and in almost all states. Larger reductions in medical costs with SPC use more than offset higher drug costs within most states.

Economic consequence of switching to citalopram after its generic entry for adult patients with major depressive disorder (MDD) treated with escitalopram: a 6-month retrospective study.

IntroductionBiologic therapies have demonstrated efficacy and safety in several chronic systemic disorders. The authors indirectly compared response rates and costs per responder associated with biologic treatments for moderate-to-severe Crohn’s disease (CD), psoriasis (Ps), and/or rheumatoid arthritis (RA).MethodsA systematic literature search was performed to identify phase 3 randomized controlled trials of biologics for CD (adalimumab, infliximab), Ps (adalimumab, etanercept, infliximab, ustekinumab 45 mg, ustekinumab 90 mg), or methotrexate-refractory RA (abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab). Food and Drug Administration-approved dosing schedules were evaluated. Published response rates were extracted, with response defined in CD, Ps, and RA as: ≥70-point reduction in CD Activity Index at 12 months; ≥75% improvement in Psoriasis Area and Severity Index at 3 months; and ≥50% improvement in American College of Rheumatology component scores at 6 months. Within each indication, mixed-treatment comparison meta-analyses were conducted to derive pooled estimates and 95% CIs of response rate difference versus placebo for each biologic, adjusting for cross-trial variation in control-arm response rates. Cost per responder was estimated for each biologic as projected per patient drug costs (2011 US

Comparison of Skeletal Complications and Treatment Patterns Associated With Early vs. Delayed Zoledronic Acid Therapy in Multiple Myeloma

) divided by response rate difference.ResultsAltogether, 23 publications were selected. In CD, 12-month cost per responder was estimated at

Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase-positive metastatic non-small cell lung cancer in the United States

116,291 (95% CI