The American journal of managed care
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To identify factors associated with delayed radiotherapy (RT) in older women with early-stage breast cancer. ⋯ Timely RT should be facilitated through physician and patient education, navigation, and notification programs to improve quality of care. Queues for RT appointments should be evaluated on an ongoing basis to ensure adequate access. Future research should examine modifiable barriers to RT timeliness and whether delays impact long-term outcomes.
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To examine how the influence of cost-sharing on adherence to antihypertensive drugs varies across adherence levels. ⋯ Cost-sharing had a substantial negative association with adherence among low adherers and little association at higher adherence levels. At a clinical level, physicians should closely monitor adherence to antihypertensive drugs, particularly for patients with multiple comorbidities and those taking multiple drugs. At a health system level, current benefit designs should encourage adherence while limiting the cost burden of drugs for patients with multiple chronic conditions taking multiple drugs.
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To explore the effect of a prior authorization (PA) policy restricting access to pregabalin for the management of diabetic peripheral neuropathy (DPN) or postherpetic neuralgia (PHN) on the overall utilization of pharmacologic therapy and healthcare services among fee-for-service Medicaid plan beneficiaries. ⋯ Although the PA was shown to effectively control access to pregabalin, the overall effect was an increase in the use of opioids and alternative pain management therapies associated with increased disease-related healthcare costs.
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Comparative Study
Type 2 diabetes mellitus in China: a preventable economic burden.
To estimate the direct and indirect costs of type 2 diabetes mellitus (T2DM) in China in 2007 and project these costs for the year 2030, and to examine and compare the benefits of selected interventions. ⋯ The results indicated that T2DM consumes a large portion of healthcare expenditures and will continue to place a heavy burden on health budgets in the future. Preventive intervention, screening, and treatment strategies may effectively decrease the incidence and complications of diabetes and therefore save costs.