Vera Mastey

Donepezil Is Associated with Delayed Nursing Home Placement in Patients with Alzheimer's Disease

OBJECTIVES: To assess the relationship between donepezil treatment and time to nursing home placement (NHP) for patients with Alzheimers disease (AD).

efficacy of Donepezil on maintenance of activities of daily living in patients with moderate to severe Alzheimer's disease and the effect on Caregiver burden

OBJECTIVES: This study investigated the efficacy of donepezil treatment on activities of daily living (ADLs) and social functioning in patients with moderate to severe Alzheimers disease (AD) and the possible benefits of this treatment on caregiving time and stress levels.

An economic evaluation of donepezil in mild to moderate Alzheimer's disease: results of a 1-year, double-blind, randomized trial.

The costs and consequences of donepezil versus placebo treatment in patients with mild to moderate Alzheimer’s disease (AD) were evaluated as part of a 1-year prospective, double-blind, randomized, multinational clinical trial. Patients received either donepezil (n = 142; 5 mg/day for 28 days followed by 10 mg/day according to the clinician’s judgement) or placebo (n = 144). Unit costs were assessed in 1999 Swedish kronas (SEK) and converted to US dollars (USD). Donepezil-treated patients gained functional benefits relative to placebo on the Progressive Deterioration Scale (p = 0.042) and Instrumental Activities of Daily Living scale (p = 0.025) at week 52. Caregivers of donepezil-treated patients spent an average of 400 h less annually providing care than caregivers of placebo-treated patients. Mean annual healthcare costs were SEK 137,752 (USD 16,438) per patient for the donepezil group and SEK 135,314 (USD 16,147) in the placebo group. With the average annual cost of donepezil at SEK 10,723 (USD 1,280) per patient, the SEK 2,438 (USD 291) cost difference represented a 77% cost offset. When caregiver time and healthcare costs were included, mean annual costs were SEK 209,244 (USD 24,969) per patient in the donepezil group and SEK 218,434 (USD 26,066) in the placebo group, a total saving associated with donepezil treatment of SEK 9,190 (USD 1,097) per patient [95% CI of SEK –43,959 (USD –5,246), SEK 25,581 (USD 3,053); p = 0.6]. The positive effects on the efficacy outcome measures combined with no additional costs from a societal perspective indicate that donepezil is a cost-effective treatment, representing an improved strategy for the management of patients with AD.

Recent trends in exposure to secondhand smoke in the United States population

BackgroundPrevious research using the National Health and Nutrition Examination Surveys (NHANES) data documented a significant downward trend in secondhand smoke (SHS) exposure between 1988 and 2002. The objective of this study was to assess whether the downward trend in exposure continued from 2001 through 2006.MethodsWe analyzed data from the 2001-2006 NHANES to estimate exposure of nonsmokers to SHS. Geometric means of serum cotinine levels for all nonsmokers were computed.ResultsOverall serum cotinine levels (95% Confidence Intervals) in 2001-2002, 2003-2004, and 2005-2006 were 0.06 ng/mL (0.05-0.07), 0.07 ng/mL (0.06-0.09), and 0.05 ng/mL (0.05-0.06), respectively. Subgroup analysis by age, gender, and race/ethnicity groups showed similar trends in cotinine levels. Children, males, and non-Hispanic Blacks had higher cotinine levels than adults, females, and non-Hispanic Whites and Mexican Americans, respectively. Insignificant P values from the Wald test indicate that serum cotinine levels did not differ over time.ConclusionsThe long-term trend of declining exposure to SHS among nonsmokers appears to have leveled off. However, disparities noted in previous research persist today, with the young, non-Hispanic Blacks, and males experiencing higher levels of exposure.

Effects of Copayment on Initiation of Smoking Cessation Pharmacotherapy: An Analysis of Varenicline Reversed Claims

BACKGROUND Smoking cessation pharmacotherapy is a critical component of smoking cessation treatment, but most smokers use neither pharmacotherapy nor behavior counseling in attempts to quit smoking. The low rate of smoking cessation medication use is of great concern because it can negatively influence the odds of success in smoking cessation. OBJECTIVE This study was conducted to analyze how copayment may influence the likelihood of initiating smoking cessation pharmacotherapy following a reversed varenicline claim. METHODS A retrospective cohort analysis was performed using pharmacy claims data from a large national pharmacy benefits management company. Reversed claims were claims first approved by the health plan and then reversed by the pharmacy. The study population included patients with over-the-counter nicotine replacement therapy coverage and a reversed varenicline claim between January 2007 and April 2008 and who were naive to varenicline before the reversed claim. A multivariate logistic regression analysis was conducted to evaluate the probability of initiating any smoking cessation pharmacotherapy (varenicline, bupropion, and prescribed or over-the-counter nicotine replacement therapy) within 183 days of the reversed claim. RESULTS A total of 20,451 patients met the inclusion criteria. The mean (SD) age of patients was 47.8 (12.4) years, with 57.41% being female. The majority (87.72%) were covered in commercial managed care plans. A total of 17,028 patients (83.26%) had at least 1 smoking cessation medication filled 6 months after their reversed claim. The odds ratios for patients who had any smoking cessation medication filled and copayments of

An economic evaluation of donepezil in mild to moderate Alzheimer's disease: Results of a one-year, double-blind, randomized trial

31 to

Adherence to Varenicline and Associated Smoking Cessation in a Community-Based Patient Setting

40,

PPN13: DELAYS IN NURSING HOME PLACEMENT FOR PATIENTS WITH ALZHEIMER'S DISEASE ASSOCIATED WITH TREATMENT WITH DONEPEZIL MAY HAVE HEALTH CARE COST-SAVING IMPLICATIONS

41 to

PUK5 TREATMENT PATTERNS IN OVERACTIVE BLADDER: REAL-WORLD PATIENT POPULATION

60, or >

PNP13: CAREGIVER HEALTH BENEFITS AND ASSOCIATED REDUCTIONS IN HEALTHCARE COSTS AS A CONSEQUENCE OF TREATING PATIENTS WITH DONEPEZIL

60 were 0.68, 0.48, and 0.35, respectively (all, P < 0.001), compared with patients with copayments of