Keith L. Davis

Prevalence and cost of nonadherence with antiepileptic drugs in an adult managed care population.

Purpose: This study assessed the extent of refill nonadherence with antiepileptic drugs (AEDs) and the potential association between AED nonadherence and health care costs in an adult‐managed care population.

Direct economic burden of chronic hepatitis C virus in a United States managed care population.

Goals and Background To estimate all-cause and disease-related resource utilization and costs among managed care enrollees with chronic hepatitis C virus (HCV). Study A large United States claims database was analyzed (1/1/2002 to 12/31/2006). Inclusion criteria were: diagnosis of chronic HCV; no hepatitis B diagnoses; ≥6 and ≥12 months of continuous plan enrollment prediagnosis and postdiagnosis, respectively. Use and costs of medical services and prescription drugs over a 12-month period postdiagnosis were evaluated. Outcomes were assessed in controls without HCV matched (1:1) on age, sex, and plan enrollment. All cost estimates were generated using multivariate generalized linear models to adjust for additional covariates and skewness common in health care cost data. Results Of the 20,662 patients who met all inclusion criteria, mean age was 49 years; 61% were male. Adjusted all-cause costs were

Adherence to antiretroviral treatment and correlation with risk of hospitalization among commercially insured HIV patients in the United States.

20,961 per HCV patient, compared with

Prevalence and cost of nonadherence to antiepileptic drugs in elderly patients with epilepsy

5451 per control (P<0.0001). Hospitalization occurred in 24% of HCV patients compared with 7% of controls (P<0.0001). Mean inpatient costs were

Association of antiepileptic drug nonadherence with risk of seizures in adults with epilepsy.

5892 and

Association between daily antiretroviral pill burden and treatment adherence, hospitalisation risk, and other healthcare utilisation and costs in a US medicaid population with HIV

1159 per patient, respectively (P<0.0001). Patients with HCV had higher prescription costs compared with controls (

The inpatient burden of abdominal and gynecological adhesiolysis in the US

6191 vs.

Prevalence and cost of medication nonadherence in Parkinson's disease: Evidence from administrative claims data

1315; P<0.0001). At

Impact of Constipation on Opioid Use Patterns, Health Care Resource Utilization, and Costs in Cancer Patients on Opioid Therapy

6864 per patient, disease-related costs were nearly one-third of all costs in patients with HCV, which exceeded all-cause costs among controls by 26% (P<0.0001). Conclusions Chronic HCV is a costly disease to managed care organizations. Disease-related costs in HCV exceed all-cause costs in demographically matched controls. Increased efforts in HCV screening and early treatment, particularly before progression to liver cirrhosis, may lead to long-term cost savings in HCV management for managed care systems.

Treatment Patterns and Adherence among Patients with Chronic Hepatitis C Virus in a US Managed Care Population

Purpose A lower daily pill burden may improve adherence to antiretroviral treatment (ART) and clinical outcomes in patients with human immunodeficiency virus (HIV). This study assessed differences in adherence using the number of pills taken per day, and evaluated how adherence correlated with hospitalization. Methodology Commercially insured patients in the LifeLink database with an HIV diagnosis (International Classification of Diseases, 9th Revision, Clinical Modification code 042.xx) between 6/1/2006 and 12/31/2008 and receipt of a complete ART regimen were selected for inclusion. Patients were grouped according to their daily pill count and remained on ART for at least 60 days. Outcomes included adherence and rates of hospitalization. Adherence was measured as the proportion of days between the start and end of the regimen in which the patient maintained supply of all initiated ART components. Logistic regressions assessed the relationship between pills per day, adherence, and hospitalization, controlling for demographics, comorbidities, and ART-naïve (vs. experienced) status. Results 7,073 patients met the study inclusion criteria, and 33.4%, 5.8%, and 60.8% received an ART regimen comprising one, two, or three or more pills per day, respectively. Regression analysis showed patients receiving a single pill per day were significantly more likely to reach a 95% adherence threshold versus patients receiving three or more pills per day (odds ratio [OR] = 1.59; P<0.001). Regardless of the number of pills received per day, patients were over 40% less likely to have a hospitalization if they were adherent to therapy (OR = 0.57; P<0.001). Patients receiving a single pill per day were 24% less likely to have a hospitalization versus patients receiving three or more pills per day (OR = 0.76; P = 0.003). Conclusions ART consisting of a single pill per day was associated with significantly better adherence and lower risk of hospitalization in patients with HIV compared to patients receiving three or more pills per day.