Nichole Young-Lin

An economic analysis of robotic versus laparoscopic surgery for endometrial cancer: Costs, charges and reimbursements to hospitals and professionals

OBJECTIVE To determine the actual costs, charges, and reimbursements associated with robotic vs. laparoscopic surgery for endometrial cancer. METHODS Data were collected from hospital billing records, MD professional group billing records, tumor registry, and medical records on operations performed by a single surgeon from one institution between 2008 and 2010. For comparison, surgical groups were matched based on age, histology, and stage of disease over the same time period. RESULTS Of 54 patients, 27 underwent robotic surgery (RS) and 27 had laparoscopic surgery (LS). The median age was 57 years. There were no statistically significant differences between the groups based on age, stage, and histology. The hospital charges for RS were higher at

Applications for Oncologic Drugs: A Descriptive Analysis of the Oncologic Drugs Advisory Committee Reviews

64,266 vs.

Fistula after attended delivery and the challenge of obstetric care capacity in the eastern Democratic Republic of Congo

55,130 for LS (p=0.036). However, the reimbursement to the hospital was not statistically different at

Healthcare providers' perspectives on the social reintegration of patients after surgical fistula repair in the eastern Democratic Republic of Congo☆

13,003 for RS and

Teaching NeuroImages: Infant with glutaric aciduria type 1 presenting with infantile spasms and hypsarrhythmia

10,245 for LS (p=0.29). Operating suite, room and board, anesthesia, post anesthesia care unit, and pathology accounted for over 90% of hospital charges. The surgeon charges for RS and LS were

Peroxisome proliferator-activated receptor gamma agonist as a novel treatment for interstitial cystitis: A rat model

6824 and

W258 FISTULA AFTER ATTENDED DELIVERY: THE CHALLENGE OF OBSTETRICAL CARE CAPACITY IN EASTERN DEMOCRATIC REPUBLIC OF CONGO

6327, respectively (p=0.033) and the anesthesiologist charges were

The economic impact of surgical care for morbidly obese endometrial cancer patients: a nationwide study

4049 and

475: Fetal intolerance to labor in pregnancies complicated by marginal and eccentric cord insertion

2985, respectively (p=0.001). However, there were no differences in reimbursement to the surgeon (p=0.74) and anesthesiologist (p=0.84) between the two operative approaches. CONCLUSIONS Our data showed that the direct costs and charges associated with robotic surgery were higher compared to laparoscopic surgery. However, actual reimbursements to the hospital, surgeon, and anesthesiologist were not significantly different between the two surgical approaches.

The Economic Impact of Surgical Care for Morbidly Obese Endometrial Cancer Patients: A Nationwide Study

BACKGROUND Despite advances in cancer research, the majority of drug applications submitted to the U.S. Food and Drug Administration (FDA) are not approved. It is important to identify the concerns of the Oncologic Drugs Advisory Committee (ODAC) from rejected applications. METHODS All applications referred to the ODAC from 2001 to 2012 were reviewed. RESULTS Of 46 applications, 31 (67%) were for full and 15 (33%) were for supplemental approval, 34 (74%) were for solid and 12 (26%) were for hematologic tumors. In all, 22 (48%) were not approved. ODAC comments addressed missing or inadequate data (65%), excessive toxicity (55%), inappropriate study endpoints (45%), poor study design (40%), and insufficient sample size (30%). To define efficacy, 19 applications used response rates (RR) (median = 38%), and 19 applications used hazard ratios (HR) (median = 0.67). For all organ systems combined, the median cumulative grade 3 or 4 toxicity was 64%. Drugs with higher RR, lower HR, and lower toxicity were more likely to be approved versus other drugs (89% vs. 45%; p = .02). Over time (2001-2004, 2005-2008, 2009-2012), there was an increase in the following: number of applications submitted for review (from 11 to 12 to 23, respectively), number of approvals (from 6 to 6 to 12, respectively), and proportion of trials using progression-free survival as a primary endpoint (from 0% to 50% to 70%, respectively; p = .01). CONCLUSION Of all applications, common ODAC concerns included inadequate data, excessive toxicity, and inappropriate study endpoints. Over time, there was an approximate doubling of FDA application submissions and approved oncology drugs.