Desi Peneva

The Rising Burden of Preeclampsia in the United States Impacts Both Maternal and Child Health

OBJECTIVE Preeclampsia is one of the top six causes of maternal mortality in the United States (US) and is associated with considerable perinatal morbidity and mortality. Evidence suggests the US incidence of preeclampsia has increased dramatically over the past two decades. This study aims to compile, summarize, and critique the literature on the health and economic burden of preeclampsia and early-onset preeclampsia. STUDY DESIGN We reviewed the literature for estimates of burden of preeclampsia and early-onset preeclampsia to both mother and child, summarized the evidence on economic and social burden, and highlighted current gaps in the literature. RESULTS No recent studies comprehensively assess the costs and health consequences of preeclampsia or early-onset preeclampsia for both mother and child. Where it exists, the literature suggests preeclampsia and early-onset preeclampsia cause numerous adverse health consequences, but these conditions currently lack effective treatment. The need for preterm delivery from early-onset preeclampsia suggests its costs are substantial: very (28-31 weeks) and extremely (<28 weeks) preterm birth cost approximately 40 and 100 times a term pregnancy, respectively. CONCLUSION Given the severity of outcomes from preeclampsia, further research on its health and economic consequences is essential to inform policy and resource allocation decisions in health care.

HIV Care Providers Emphasize the Importance of the Ryan White Program for Access to and Quality of Care

With the implementation of the Affordable Care Act (ACA) under way, some policy makers have questioned the continued relevance of the Ryan White HIV/AIDS Program as a safety net for people living with HIV/AIDS. We surveyed HIV care providers to understand the role of the Ryan White Program and to identify concerns regarding the ACA implementation. We also addressed whether the program is still relevant after ACA implementation and, if so, what elements should be retained. We found that providers consider the Ryan White Program to be critical in facilitating high-quality care for people living with HIV/AIDS. Most of the providers highlighted the programs support for providing medical and nonmedical case management as especially valuable and important to the entire continuum of care and for all patient subpopulations. Whether care is supplied by the Ryan White Program, Medicaid, or other means, our findings suggest that case management services will remain critical in treating HIV/AIDS as the health care landscape continues to evolve.

Short-term costs of preeclampsia to the United States health care system

Background Preeclampsia is a leading cause of maternal morbidity and mortality and adverse neonatal outcomes. Little is known about the extent of the health and cost burden of preeclampsia in the United States. Objective This study sought to quantify the annual epidemiological and health care cost burden of preeclampsia to both mothers and infants in the United States in 2012. Study Design We used epidemiological and econometric methods to assess the annual cost of preeclampsia in the United States using a combination of population‐based and administrative data sets: the National Center for Health Statistics Vital Statistics on Births, the California Perinatal Quality Care Collaborative Databases, the US Health Care Cost and Utilization Project database, and a commercial claims data set. Results Preeclampsia increased the probability of an adverse event from 4.6% to 10.1% for mothers and from 7.8% to 15.4% for infants while lowering gestational age by 1.7 weeks (P < .001). Overall, the total cost burden of preeclampsia during the first 12 months after birth was

Estimating the future burden of cardiovascular disease and the value of lipid and blood pressure control therapies in China

1.03 billion for mothers and

Cost-effectiveness of sequenced treatment of rheumatoid arthritis with targeted immune modulators

1.15 billion for infants. The cost burden per infant is dependent on gestational age, ranging from

Predicting Real-World Effectiveness of Cancer Therapies Using Overall Survival and Progression-Free Survival from Clinical Trials: Empirical Evidence for the ASCO Value Framework

150,000 at 26 weeks gestational age to

The value of surrogate endpoints for predicting real-world survival across five cancer types

1311 at 36 weeks gestational age. Conclusion In 2012, the cost of preeclampsia within the first 12 months of delivery was

The Impact of State AIDS Drug Assistance Policies on Clinical and Economic Outcomes of People With HIV

2.18 billion in the United States (

The Importance of Economic Trade-offs in Cancer Drug Pricing

1.03 billion for mothers and

Economic burden of multiple myeloma among patients in successive lines of therapy in the United States

1.15 billion for infants), and was disproportionately borne by births of low gestational age.