The American journal of managed care
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This study evaluates the impact of concomitant medical conditions on patients with and without migraine, assessing healthcare utilization, and total cost of care. Medical and pharmacy claims from multiple health plans, both nationally and internationally, were examined to evaluate overall real-world trends in commercially insured patients diagnosed with migraine. A total of 53,608 patients with diagnosis codes for migraine met the study criteria and were matched 1:1 with controls (81.8% female; mean age, 42 years; mean Charlson Comorbidity Index score, 0.34). ⋯ These patients also utilize healthcare resources at a significantly higher rate compared with similar patients without a migraine diagnosis. An unmet need exists for new treatment modalities in this patient population. More effective interventions and proper management may lead to improved patient outcomes and healthcare costs for patients with migraine.
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To examine factors associated with discontinuation of new hepatitis C drugs-second-generation direct-acting antivirals (DAAs)-among Medicare beneficiaries with chronic hepatitis C. ⋯ Real-world discontinuation of DAA therapy was low, but it was 3 times more likely than in clinical trials and varied by patient characteristics. Efforts to increase DAA adherence would help lower patients' risk of developing resistance to future treatments and reduce potential waste of resources.
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Proton beam therapy (PBT) is a type of radiation therapy (RT) used for certain cancer types because it minimizes collateral tissue damage. The high cost and limited availability of PBT have constrained its utilization. This study examined patterns and determinants of PBT use in California. ⋯ Significant differences exist in PBT use by demographics and health insurance type. The identified racial and socioeconomic disparities merit further investigation. More granular studies on both use patterns and effectiveness of PBT for specific cancers are needed to draw stronger conclusions about its cost-benefit ratio.
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To evaluate the cost-effectiveness of brentuximab vedotin (Adcetris) in combination with cyclophosphamide, doxorubicin, and prednisone (A+CHP) in the first-line setting for CD30-expressing peripheral T-cell lymphoma (PTCL). ⋯ Based on the ECHELON-2 trial data, this analysis found A+CHP to be cost-effective for patients with previously untreated CD30-expressing PTCL.
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To project the social value of transcatheter aortic valve replacement (TAVR) for inoperable patients with severe, symptomatic aortic stenosis (SSAS). ⋯ Policy makers and payers should take this social value into account when considering decisions related to the care of inoperable patients with SSAS.