The American journal of managed care
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AbbVie's adalimumab (Humira) is the top-selling pharmaceutical in the world. Due to concerns about government health program spending on Humira, the US House Committee on Oversight and Accountability opened an investigation in 2019 to investigate AbbVie's pricing and marketing practices. ⋯ These strategies are not unique to AbbVie and shed light on pharmaceutical market dynamics that may be hindering a competitive market. Policy reform and legal initiatives may help reduce anticompetitive behaviors by pharmaceutical manufacturers and increase access to competitive therapeutic options such as biosimilars.
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To describe the continuity of opioid prescribing and prescriber characteristics among older adults with chronic noncancer pain (CNCP) who are on long-term opioid therapy (LTOT) and to evaluate the association of continuity of opioid prescribing and prescriber characteristics with the risk of opioid-related adverse events. ⋯ We found that higher continuity of opioid prescribing, but not provider specialty, was significantly associated with fewer opioid-related adverse outcomes among older adults with CNCP.
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To evaluate the association of dialysis transition planning factors (eg, nephrologist care, vascular access placement, place of dialysis) with inpatient (IP) stays, emergency department (ED) visits, and mortality. ⋯ A planned transition to dialysis was associated with reduced odds of IP stays and lower mortality.
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Many individuals with chronic kidney disease (CKD) are undiagnosed or unaware of the disease and at risk of not receiving services to manage their condition and of "crashing" into dialysis. Past studies report higher health care costs among patients with delayed nephrology care and suboptimal dialysis initiation, but they are limited because they focused on patients undergoing dialysis and did not evaluate costs associated with unrecognized disease for patients "upstream," or patients with late-stage CKD. We compared costs for patients with unrecognized progression to late-stage (stages G4 and G5) CKD and end-stage kidney disease (ESKD) with costs for individuals with prior CKD recognition. ⋯ Our findings indicate that costs associated with undiagnosed CKD extend to patients not yet requiring dialysis and highlight potential savings from earlier disease detection and management.
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Observational Study
Pediatric oral health services in Medicaid managed care and fee for service.
In 2008, Florida's Medicaid program began reimbursing medical providers for preventive oral health services (POHS) delivered to children aged 6 months to 42 months. We examine whether Medicaid comprehensive managed care (CMC) and fee for service (FFS) had different rates of POHS during pediatric medical visits. ⋯ POHS rates among pediatric medical visits in Florida were similar for visits paid via FFS and CMC, with low rates that increased modestly over time. Our findings are important because more children continue to be enrolled in Medicaid CMC.