The American journal of managed care
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This study was designed to assess the effect of tyrosine kinase inhibitor (TKI) use on nonpharmaceutical medical spending for patients with chronic myeloid leukemia (CML), and estimate the association between cost-sharing and the TKI medication possession ratio (MPR). ⋯ Use of TKIs was associated with a 30% reduction in non-pharmaceutical medical spending for CML patients. This difference is approximately equal to 40% of the incremental pharmaceutical cost associated with using TKI therapy. The net annual cost of TKI therapy is roughly $15,000. An informal calculation suggests that this is well within the range of conventional cost-effectiveness thresholds. On balance, coverage of TKIs is relatively generous, with the vast majority of patients exhibiting high levels of adherence to therapy.
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The management of type 2 diabetes mellitus (T2DM) remains challenging. Limitations associated with many current therapies include hypoglycemia and weight gain. An increased understanding of the pathophysiology of T2DM has led to the development of incretin-related antihyperglycemic therapies. ⋯ As a result, they can lower blood glucose levels with a low risk of hypoglycemia or weight gain. Incretin-based therapies, the dipeptidyl peptidase 4 inhibitors and the glucagonlike peptide-1 receptor agonists, are now integrated into T2DM treatment algorithms. Trial data and clinical experience have shown that these agents are efficacious and generally well tolerated.
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Observational Study
The option value of innovative treatments in the context of chronic myeloid leukemia.
To quantify in the context of chronic myeloid leukemia (CML) the additional value patients receive when innovative treatments enable them to survive until the advent of even more effective future treatments (ie, the "option value"). ⋯ The option value of innovative treatments has significance in the context of CML and, more broadly, in disease areas with rapid innovation. Incorporating option value into traditional valuations of medical innovations is both a feasible and a necessary practice in health technology assessment.
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Eleven classes of antidiabetic medicines are now available to help the 25.8 million Americans with type 2 diabetes control their blood sugar levels when diet and lifestyle modifications are not sufficient. Although patients benefit from the myriad of treatment options, there are little comparative data to effectively differentiate the products and predict their relative utility. ⋯ In addition to traditional CER approaches such as systematic reviews, meta-analyses, and retrospective claims analyses, Markov modeling and Bayesian analysis can be applied to predict patient outcomes in scenarios in which clinical trials are not feasible. CER may be the best way to consolidate and interpret data on the many agents involved and thereby guide rational treatment decisions.