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1.
J Med Econ ; 25(1): 741-749, 2022.
Article in English | MEDLINE | ID: covidwho-1864882

ABSTRACT

AIMS: To compare long-term healthcare resource utilization (HCRU) and costs among patients who initiated ixekizumab (IXE) or adalimumab (ADA) for treatment of psoriasis in the United States. METHODS: Adult patients with psoriasis who had ≥1 claim for IXE or ADA were identified from IBM MarketScan claims databases prior to the COVID-19 pandemic (1 March 2016-31 October 2019). The index date was the date of first claim for the index drug of interest. Inverse probability of treatment weighting was employed to balance treatment cohorts. All-cause and psoriasis-related HCRU and costs were examined for 24 months of follow-up. Costs were reported as per patient per month. Costs of psoriasis-related biologics were adjusted using published Institute for Clinical and Economic Review (ICER) discount factors. Index drug costs were adjusted for adherence and ICER discount rates. RESULTS: The analyses included 407 IXE and 2,702 ADA users. IXE users had significantly higher inpatient admission rate (all-cause HCRU: 14.9% vs. 11.0%; p =0.012) and greater mean length of stay per admission (days, 6.6 vs. 4.1; p =0.004) than ADA users. ICER-adjusted costs were significantly higher in IXE than ADA users (all-cause costs: $4,132 vs. $3,610; p <0.001; psoriasis-related costs $3,077 vs. $2,700; p <0.001). After adjusting for ICER and adherence, IXE and ADA drug costs were comparable ($3,636 vs. $3,677; p =0.714). LIMITATIONS: Study relied on administrative claims data, subjected to data coding limitations and data entry errors. Rebates, patient assistance programs, and commission to wholesalers are not always captured in claims. Adjustment made by ICER discount factors may lead to double-discounting if the discounts have been applied in claim payments. CONCLUSIONS: All-cause HCRU was higher in IXE than ADA users. Healthcare costs were also higher in IXE than ADA users after ICER adjustment, over 24 months. Cost differences were largely driven by higher treatment adherence associated with IXE. Index drug costs were comparable after ICER and adherence adjustments.


Subject(s)
Antirheumatic Agents , COVID-19 , Psoriasis , Adalimumab/therapeutic use , Adult , Antibodies, Monoclonal, Humanized , Antirheumatic Agents/therapeutic use , Drug Costs , Follow-Up Studies , Health Care Costs , Humans , Pandemics , Psoriasis/drug therapy , Retrospective Studies , United States
2.
J Manag Care Spec Pharm ; 28(5): 573-576, 2022 May.
Article in English | MEDLINE | ID: covidwho-1863467

ABSTRACT

DISCLOSURES: Dr Mattingly reports consulting fees from Arnold Ventures, Pharmaceutical Research and Manufacturers of America, and research support from the US Food and Drug Administration unrelated to this article.


Subject(s)
Commerce , Drug Costs , Humans
3.
Curr Oncol ; 29(4): 2504-2508, 2022 04 02.
Article in English | MEDLINE | ID: covidwho-1822416

ABSTRACT

The government of Canada now plans to bring into force new federal drug pricing regulations on 1 July 2022. We do not take issue with the goal of medication affordability, which is vital in healthcare the world over. Our concern is that the new guidelines are being implemented without due consideration for three major unintended consequences: regulatory changes will lower the number of clinical trials for new medications in Canada, fewer clinical trials will mean lower research and development investments, and changes will reduce patients' access to new medications. Access to effective medications is a cornerstone of healthcare for Canadian patients. As physicians, our duty to patient care demands that we tell the government to protect the right of Canadians to timely access to life-changing medicines.


Subject(s)
Drug Costs , Canada , Costs and Cost Analysis , Humans
6.
Salud Colect ; 16: e2897, 2020 10 17.
Article in Spanish | MEDLINE | ID: covidwho-1608979

ABSTRACT

Taking into account the latent threat of future pandemics, the objective of this study is to analyze - particularly with respect to medications - the sustainability of the health system, healthcare coverage, budgetary efficiency, and connections with the pharmaceutical patent system. In this context, the pharmaceutical patent system acts as a determining factor, given that promoting its existence stimulates the production of research, but in turn its existence stands in the way of rapid advancements, primarily due to the development of protective legislation concerning patents, which has largely accommodated the industry. Given that the pharmaceutical industry has managed to extend the duration of patents and avoid the incorporation of generics, our analysis focuses on the influence of pharmaceutical patents; this influence has led to reflection on the possibility of combining efforts by forging alliances between numerous companies and the public sector in order to face the challenges posed by new diseases caused by viruses that give rise to epidemics and pandemics.


Ante la amenaza latente de futuras pandemias, este estudio tiene como objetivo analizar ­desde el eje de los medicamentos­ la sostenibilidad del sistema sanitario, la cobertura, la eficiencia del gasto y su vinculación al sistema de patentes farmacéuticas. En este marco, el sistema de patentes farmacéuticas adquiere un papel determinante, dado que fomentar su existencia estimula la producción de investigación pero, a su vez, su existencia no suscita un rápido avance, debido al desarrollo legislativo protector que han tenido las patentes y que ha dado lugar a un acomodamiento de la industria. Como la industria farmacéutica ha conseguido extender la duración de patentes y evitar la incorporación de genéricos, se analiza la influencia de las patentes farmacéuticas que ha dado lugar a reflexionar acerca de la posibilidad de consorciar esfuerzos realizando alianzas entre varias empresas y el sector público para afrontar los retos que plantean nuevas enfermedades producidas por virus que dan lugar a epidemias y pandemias.


Subject(s)
Antiviral Agents , Drug Costs , Drug Industry/organization & administration , Health Policy , Health Services Accessibility/organization & administration , Patents as Topic , Virus Diseases/drug therapy , Antiviral Agents/economics , Antiviral Agents/therapeutic use , Drugs, Generic , Global Health , Humans , Pandemics , Program Evaluation , Virus Diseases/economics , Virus Diseases/epidemiology , Virus Diseases/prevention & control
7.
Am J Health Syst Pharm ; 79(8): 676-682, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1597954

ABSTRACT

PURPOSE: To decrease drug waste and cost by implementing automated chemotherapy dose rounding rules in the electronic health record (EHR). Dose rounding of chemotherapy is a recognized method for reducing drug waste, and professional organizations have published guidelines recommending dose rounding when possible. SUMMARY: On the basis of current literature and guideline recommendations, Mayo Clinic developed system-wide consensus to allow dose rounding for biologic and chemotherapy agents to the nearest vial size if rounding resulted in the dose being within 10% of the originally calculated dose or to a convenient measurable volume, based on concentration of the drug, if rounding to the nearest vial size resulted in the dose being outside the 10% range. Oncology pharmacists reviewed and analyzed all drugs listed in the EHR used in injectable form for the treatment of cancer and developed dose rounding rules. The rules were implemented and applied at the dose calculation stage before provider signature. From January to June 2019, approximately 40,000 cancer treatment doses were administered. The rounding rules saved a total of 9,814 vials of drug, of which 5,329 were for biologic agents and 4,485 were for oncolytic drugs. This resulted in a total 6-month cost savings of $7,284,796 (in 2019 dollars; biologics, $5,727,402; oncolytics, $1,557,394). CONCLUSION: Systematic implementation of dose rounding rules utilizing the EHR can result in significant reduction of drug waste and realization of savings.


Subject(s)
Antineoplastic Agents , Drug Costs , Cost Savings , Electronic Health Records , Humans , Workflow
9.
Health Aff (Millwood) ; 40(11): 1815, 2021 11.
Article in English | MEDLINE | ID: covidwho-1502081
10.
Arch Dis Child ; 107(3): e1, 2022 03.
Article in English | MEDLINE | ID: covidwho-1501687

ABSTRACT

Whether all children under 12 years of age should be vaccinated against COVID-19 remains an ongoing debate. The relatively low risk posed by acute COVID-19 in children, and uncertainty about the relative harms from vaccination and disease mean that the balance of risk and benefit of vaccination in this age group is more complex. One of the key arguments for vaccinating healthy children is to protect them from long-term consequences. Other considerations include population-level factors, such as reducing community transmission, vaccine supply, cost, and the avoidance of quarantine, school closures and other lockdown measures. The emergence of new variants of concern necessitates continual re-evaluation of the risks and benefits. In this review, we do not argue for or against vaccinating children against COVID-19 but rather outline the points to consider and highlight the complexity of policy decisions on COVID-19 vaccination in this age group.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Mass Vaccination , Age Factors , COVID-19/complications , COVID-19/transmission , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/economics , COVID-19 Vaccines/supply & distribution , Child , Drug Costs , Humans , Pandemics/prevention & control , Risk Assessment , SARS-CoV-2
12.
Med Hypotheses ; 144: 109976, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1386300

ABSTRACT

Several attempts to control the dreadfulness of SARS-CoV-2 are still underway. Based on the literature evidences we have speculated a prospective contemporary remedy, which was categorized into Specificity, Remedy, and a Conveyor. In which, pros and cons were discussed and inferred the possible alternatives. (a) Specificity: Implicit to express the ACE2 receptors in conveyor cells to deceive SARS-CoV-2 frompreponetargets. (b) Remedy: As depletion of pulmonary surfactants causes strong acute respiratory distress syndrome, we propose an entity of a cost-effective artificialsurfactantsystem as a remedy to pulmonary complications. (c) Conveyor: We propose red blood cells (RBCs) as a conveyor with embedded artificial surfactant and protruding ACE2 receptors for the target-specific delivery. Overall we postulate focused insights by employing a combinational contemporary strategy to steer towards a prospective direction on combating SARS-CoV-2.


Subject(s)
Angiotensin-Converting Enzyme 2/therapeutic use , COVID-19/virology , Erythrocytes , Pulmonary Surfactants/therapeutic use , Receptors, Virus/therapeutic use , SARS-CoV-2/physiology , Viral Tropism , Angiotensin-Converting Enzyme 2/administration & dosage , COVID-19/complications , COVID-19/prevention & control , Drug Costs , Drug Delivery Systems , Humans , Pulmonary Alveoli/drug effects , Pulmonary Alveoli/virology , Pulmonary Surfactants/administration & dosage , Pulmonary Surfactants/chemical synthesis , Pulmonary Surfactants/economics , Receptors, Virus/administration & dosage , Respiratory Distress Syndrome/prevention & control
13.
Br J Cancer ; 125(11): 1477-1485, 2021 11.
Article in English | MEDLINE | ID: covidwho-1360190

ABSTRACT

Important breakthroughs in medical treatments have improved outcomes for patients suffering from several types of cancer. However, many oncological treatments approved by regulatory agencies are of low value and do not contribute significantly to cancer mortality reduction, but lead to unrealistic patient expectations and push even affluent societies to unsustainable health care costs. Several factors that contribute to approvals of low-value oncology treatments are addressed, including issues with clinical trials, bias in reporting, regulatory agency shortcomings and drug pricing. With the COVID-19 pandemic enforcing the elimination of low-value interventions in all fields of medicine, efforts should urgently be made by all involved in cancer care to select only high-value and sustainable interventions. Transformation of medical education, improvement in clinical trial design, quality, conduct and reporting, strict adherence to scientific norms by regulatory agencies and use of value-based scales can all contribute to raising the bar for oncology drug approvals and influence drug pricing and availability.


Subject(s)
Drug Approval , Drug Costs , Medical Oncology/ethics , Antineoplastic Agents/economics , Antineoplastic Agents/therapeutic use , Bias , COVID-19/epidemiology , Cost Control/ethics , Cost Control/organization & administration , Cost Control/standards , Cultural Evolution , Drug Approval/economics , Drug Approval/legislation & jurisprudence , Drug Approval/organization & administration , Drug Costs/ethics , Drug Costs/legislation & jurisprudence , Humans , Medical Oncology/economics , Medical Oncology/organization & administration , Medical Oncology/standards , Neoplasms/drug therapy , Neoplasms/economics , Neoplasms/mortality , Organizational Innovation , Pandemics
16.
Am J Health Syst Pharm ; 78(14): 1294-1308, 2021 07 09.
Article in English | MEDLINE | ID: covidwho-1195708

ABSTRACT

PURPOSE: To report historical patterns of pharmaceutical expenditures, to identify factors that may influence future spending, and to predict growth in drug spending in 2021 in the United States, with a focus on the nonfederal hospital and clinic sectors. METHODS: Historical patterns were assessed by examining data on drug purchases from manufacturers using the IQVIA National Sales Perspectives database. Factors that may influence drug spending in hospitals and clinics in 2021 were reviewed-including new drug approvals, patent expirations, and potential new policies or legislation. Focused analyses were conducted for biosimilars, cancer drugs, generics, coronavirus disease 2019 (COVID-19) pandemic influence, and specialty drugs. For nonfederal hospitals, clinics, and overall (all sectors), estimates of growth of pharmaceutical expenditures in 2021 were based on a combination of quantitative analyses and expert opinion. RESULTS: In 2020, overall pharmaceutical expenditures in the United States grew 4.9% compared to 2019, for a total of $535.3 billion. Utilization (a 2.9% increase) and new drugs (a 1.8% increase) drove this increase, with price changes having minimal influence (a 0.3% increase). Adalimumab was the top drug in 2020, followed by apixaban and insulin glargine. Drug expenditures were $35.3 billion (a 4.6% decrease) and $98.4 billion (an 8.1% increase) in nonfederal hospitals and clinics, respectively. In clinics, growth was driven by new products and increased utilization, whereas in hospitals the decrease in expenditures was driven by reduced utilization. Several new drugs that will influence spending are expected to be approved in 2021. Specialty and cancer drugs will continue to drive expenditures along with the evolution of the COVID-19 pandemic. CONCLUSION: For 2021, we expect overall prescription drug spending to rise by 4% to 6%, whereas in clinics and hospitals we anticipate increases of 7% to 9% and 3% to 5%, respectively, compared to 2020. These national estimates of future pharmaceutical expenditure growth may not be representative of any particular health system because of the myriad of local factors that influence actual spending.


Subject(s)
COVID-19/economics , Drug Costs/trends , Economics, Pharmaceutical/trends , Health Expenditures/trends , Prescription Drugs/economics , Biosimilar Pharmaceuticals/economics , Biosimilar Pharmaceuticals/therapeutic use , COVID-19/drug therapy , COVID-19/epidemiology , Databases, Factual/trends , Drugs, Generic/economics , Drugs, Generic/therapeutic use , Health Policy/economics , Health Policy/trends , Humans , Pharmacy/trends , Prescription Drugs/therapeutic use , United States/epidemiology
20.
Daru ; 29(1): 217-221, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1130965

ABSTRACT

The social restrictions amid coronavirus disease 2019 (COVID-19) pandemic have posed a serious threat to mental health and have implications in the use of medications for mental health including antidepressants (ADs). This study investigated the trends in prescriptions and costs of various ADs in England during COVID-19 pandemic. National prescribing rates and net ingredient costs (NIC) of all ADs prescriptions during 2016 to 2020 were analyed. The total number of ADs prescriptions dispensed during COVID-19 pandemic (January to December 2020) were 78 million, 4 million more than in 2019 that costed NHS England £ 139 million more than in 2019. Sertraline, an SSRI antidepressant drug, alone accounted for an extra £113 million during 2020 than in 2019. The peak dispensing for ADs was observed in March 2020 while the total costs for AD drugs peaked in April 2020. The rising prescription costs for ADs during COVID-19 pandemic is a potential cause of concern, in particular the increasing use in adolescents and younger adults needs attention, who are at a higher risk of life-threatening adverse drug reactions.


Subject(s)
Antidepressive Agents/economics , COVID-19/economics , COVID-19/epidemiology , Drug Costs/trends , Drug Prescriptions/economics , Antidepressive Agents/therapeutic use , Depression/drug therapy , Depression/economics , Depression/epidemiology , England/epidemiology , Humans
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