Sanjeev Balu

Direct treatment cost of atrial fibrillation in the elderly American population: a Medicare perspective

Abstract Objective: Although atrial fibrillation (AF) is the most commonly sustained arrhythmia in adults, few studies have examined the direct treatment cost of AF. Methods: A Medicare database of a 5% random national sample of all beneficiaries was used to identify patients diagnosed with AF in 2003 and to follow them for 1 year after diagnosis. These patients were matched on a 1:1 basis by age, gender and race. The incremental cost of treating AF was calculated with multivariate regression models adjusting for covariates. Results: In total, 55,260 subjects developed new AF, of which 69% were ≥75 years old, 54% were female and 91% were White. The adjusted mean incremental treatment cost of AF was

Cost-efficiency analyses for the US of biosimilar filgrastim-sndz, reference filgrastim, pegfilgrastim, and pegfilgrastim with on-body injector in the prophylaxis of chemotherapy-induced (febrile) neutropenia

14,199 (95% confidence interval

The burden of diurnal and nocturnal gastroesophageal reflux disease symptoms

13,201–15,001; p<0.01). Some of this cost was attributable to the incidence of stroke and heart failure at the 1-year post-AF diagnosis. A significantly higher proportion of AF patients experienced stroke (23.1 vs. 13.3%; p<0.01) and heart failure (36.7 vs. 10.4%; p<0.01) compared with Medicare beneficiaries without AF. Conclusions: Mean incremental direct treatment costs for Medicare beneficiaries with AF were higher than previously reported. Interventions that can reduce the incidence of AF and its complications may also reduce the national economic impact of AF.

Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim

Abstract Aims: Guidelines recommend prophylaxis with granulocyte colony-stimulating factor for chemotherapy-induced (febrile) neutropenia (CIN/FN) based on regimen myelotoxicity and patient-related risk factors. The aim was to conduct a cost-efficiency analysis for the US of the direct acquisition and administration costs of the recently approved biosimilar filgrastim-sndz (Zarxio EP2006) with reference to filgrastim (Neupogen), pegfilgrastim (Neulasta), and a pegfilgrastim injection device (Neulasta Onpro; hereafter pegfilgrastim-injector) for CIN/FN prophylaxis. Methods: A cost-efficiency analysis of the prophylaxis of one patient during one chemotherapy cycle under 1–14 days’ time horizon was conducted using the unit dose average selling price (ASP) and Current Procedural Terminology (CPT) codes for subcutaneous prophylactic injection under four scenarios: cost of medication only (COSTMED), patient self-administration (SELFADMIN), healthcare provider (HCP) initiating administration followed by self-administration (HCPSTART), and HCP providing full administration (HCPALL). Two case studies were created to illustrate real-world clinical implications. The analyses were replicated using wholesale acquisition cost (WAC). Results: Using ASPu2009+u2009CPT, cost savings achieved with filgrastim-sndz relative to reference filgrastim ranged from

Expanded access to cancer treatments from conversion to neutropenia prophylaxis with biosimilar filgrastim-sndz

65 (1u2009day) to

Clinical Outcomes of Treatment with Filgrastim Versus a Filgrastim Biosimilar and Febrile Neutropenia-Associated Costs Among Patients with Nonmyeloid Cancer Undergoing Chemotherapy

916 (14 days) across all scenarios. Relative to pegfilgrastim, savings with filgrastim-sndz ranged from

Impact of 5-HT3 receptor antagonist (5HT3-RA) selection within triple antiemetic regimens on the risk of uncontrolled chemotherapy-induced nausea and vomiting with highly emetogenic chemotherapy (HEC) in breast cancer patients.

834 (14 days) up to

Economic Burden of Patients With GERD Showing Both Day-Time and Night-Time Heartburn Symptoms

3,666 (1u2009day) under the COSTMED, SELFADMIN, and HPOSTART scenarios; and from

Incidence of febrile neutropenia during chemotherapy among patients with nonmyeloid cancer receiving filgrastim vs a filgrastim biosimilar

284 (14 days) up to

Expanded Access To Pembrolizumab from Cost-Savings Generated by Biosimilar Filgrastim (BIOSIM-FIL) in The Prophylaxis of Chemotherapy-Induced (FEBRILE) Neutropenia (CIN/FN): Simulation Study

3,666 (1u2009day) under the HPOALL scenario. Similar to the cost-savings compared to pegfilgrastim, filgrastim-sndz achieved savings relative to pegfilgrastim-injector: from