The American journal of managed care
-
Amyotrophic lateral sclerosis (ALS) is a fatally progressive degenerative disease, with many patients succumbing to the condition within 3 to 5 years after diagnosis. It is a rare, orphan disease with an estimated US prevalence of 25,000 patients. Patients with ALS and their caregivers are faced with a substantial financial burden as a result of the condition, as ALS has an estimated national financial burden of $1.03 billion. ⋯ Other recently approved therapies include oral edaravone, a combination therapy of sodium phenylbutyrate and taurursodiol (PB/TURSO), and tofersen, which is administered intrathecally and approved under an accelerated approval. Long-term studies have shown PB/TURSO to have a dual benefit on survival and function. The Institute for Clinical and Economic Review (ICER) 2022 Evidence Report for ALS does not value the high price points of edaravone and PB/TURSO as cost-effective based on the current evidence, despite valuing the need for new treatment options for this patient population.
-
To compare the frequency of self-reported gaps in care coordination and self-reported preventable adverse events among adults with vs without diabetes. ⋯ Interventions to improve quality of care for patients with diabetes could incorporate patient-reported gaps in care coordination to aid in preventing adverse events.
-
The Medicare Diabetes Prevention Program (MDPP) provides unprecedented coverage of a behavior change program for older adult Medicare beneficiaries, but uptake has been extremely limited; only 1.5 sites deliver the program per 100,000 beneficiaries nationwide. Inadequate reach and utilization of the MDPP threaten its long-term success; thus, the purpose of this project was to determine facilitators and barriers to MDPP implementation and use in western Pennsylvania. ⋯ Findings from this project can be used to improve implementation of the MDPP in western Pennsylvania, support Medicare policy refinement, and inform implementation research to promote broader adoption of the MDPP across the United States.
-
To estimate the economic benefit of evidence-based patient-initiated virtual physical therapy (PIVPT) service among a nationally representative sample of commercially insured patients with musculoskeletal (MSK) conditions. ⋯ PIVPT service provides added value to MSK care by facilitating earlier access and better adherence to PT and lowering the cost of PT.
-
To estimate neighborhood income differences between the locations of 340B-covered entities and their contract pharmacies (CPs) and examine whether these differences vary between hospitals and grantees. ⋯ CPs serve at least 2 purposes: They can increase low-income patients' access to medicines directly when a CP is closer to where a covered entity's patients live, and they can increase profits for covered entities (some of which are potentially passed on to patients) and CPs. We find that in 2019, both hospitals and grantees used CPs to generate income but generally they do not appear to contract with pharmacies located in neighborhoods where low-income patients are likeliest to live. Prior research findings have suggested that hospitals and grantees behave differently from each other with respect to CP use, but results of our analysis suggest the opposite.