Rohit Borker

Economic burden of cardiovascular events and fractures among patients with end-stage renal disease

ABSTRACT Objective: To quantify direct medical costs of fractures and cardiovascular diseases among end-stage renal disease (ESRD) patients. Methods: Medicare claims data from year 2001 of the United States Renal Data System were used to quantify direct medical costs of acute episodic events (acute myocardial infarction (MI), stroke, heart valve repair, heart valve replacement, fractures) and chronic conditions (arrhythmia, peripheral vascular disease (PVD), heart valve disease (HVD), congestive heart failure (CHF), coronary heart disease, and non-acute stroke). Costs of hospitalized episodes of arrhythmia, PVD, CHF, and angina were also quantified. For acute events, costs were quantified using an episode-of-care approach. For chronic conditions, annualized costs were reported. Only costs specific to the events or conditions of interest were included and reported, in 2006 US dollars. Drug and dialysis-related costs were excluded. Diagnosis and procedure codes were used to identify these events and conditions. Results: Among acute events analyzed as clinical episodes, PVD (

A Cost-Effectiveness Analysis of First-Line Controller Therapies for Persistent Asthma

358 million) was associated with the greatest economic burden, followed by CHF, arrhythmia, angina, acute MI, heart valve replacement, hip fracture, acute stroke, heart valve repair, vertebral fracture, and pelvic fracture (

Cost-effectiveness of early versus late cinacalcet treatment in addition to standard care for secondary renal hyperparathyroidism in the USA.

8.6 million). The cost per episode ranged from approximately

Healthcare costs in postmenopausal women with hormone-positive metastatic breast cancer.

12 000 to 104 000. Among chronic conditions, CHF (

PAA10 BUDGET IMPACT ANALYSIS: COMBINATION FLUTICASONE AND SALMETEROL FOR ASTHMA

681 million) contributed the greatest economic burden; HVD (

Healthcare costs in women with metastatic breast cancer receiving chemotherapy as their principal treatment modality.

100 million) contributed the least. The costs per patient-year ranged from

Healthcare costs in patients with metastatic lung cancer receiving chemotherapy

23 000 to 45 000 among chronic conditions. The costing methodology utilized could contribute to an underestimate of the economic impact of each condition; therefore these results are considered conservative. Conclusion: The economic burden of these selected conditions was substantial to health services payers who finance ESRD patient care. Episodic costs were high for most acute events.

Adherence to K/DOQI practice guidelines for bone metabolism and disease.

BackgroundAsthma is one of the most common chronic diseases in the US, and its prevalence continues to increase. Despite the availability of effective asthma controller medications, many patients with asthma are still not meeting therapeutic goals because of poor disease management. The high disease prevalence combined with the high costs associated with the poor management of asthma, make patients with asthma a costly group to treat for managed care organisations (MCOs) and this motivates decision makers in MCOs to consider both the clinical and economic value of asthma therapies.ObjectiveTo compare the cost effectiveness of first-line controller asthma therapies in patients with mild-to-moderate persistent asthma from an MCO payer perspective.MethodsA decision-analysis model was developed to evaluate the cost effectiveness of fluticasone propionate and salmeterol administered in a single inhaler (salmeterol/fluticasone propionate 50/100µg), compared with fluticasone propionate inhaled corticosteroids (FPIC), non-fluticasone propionate inhaled corticosteroids (nFPIC) and leukotriene modifiers. The model estimated costs (

Economic burden of adverse events in patients with metastatic renal cell carcinoma (mRCC).

US, year 2005 values) and health outcomes over a 1-year period. Costs and outcomes data were obtained from published clinical trials and observational studies, and model assumptions on the relationship between adherence and effectiveness were evaluated by a panel of experts. Effectiveness measures included symptom-free days and rescue medication-free days. The cost effectiveness of first-line asthma therapies was compared using a step-wise approach, with FPIC as the reference case. Both one-way and probabilistic sensitivity analyses were performed to assess the robustness of results over a range of assumptions.ResultsThe step-wise comparison found that the additional costs for achieving an incremental effectiveness unit (incremental cost-effectiveness ratio) using single-inhaler salmeterol/fluticasone propionate compared with FPIC was

PCN58 HEALTH CARE COSTS IN WOMEN WITH INCIDENT METASTATIC BREAST CANCER RECEIVING CHEMOTHERAPY AS THEIR PRINCIPAL TREATMENT MODALITY

US9.55 per symptom-free day and