A study conducted by researchers at PHAR found that hospitals collect substantial profits from administering injectable and infused drugs. The share of profits retained by hospitals is far greater than than the amount retained by physicians who administer the same drugs in an office setting. Hospital profits also exceed the amount that goes to the manufacturer of these products. While pharmaceutical manufacturers are often the focus of criticism regarding drug pricing, the role of others in the supply chain, including hospitals, should be considered. A summary of the findings can be found here, and the full report here.

Jesse Ortendahl, Director of Health Economics at PHAR, recently spoke at the 2019 annual meeting of the American Society of Preventive Cardiology in San Antonio, TX. At the meeting, Jesse joined Dr. Seth J. Baum, MD, FACC, FACPM, FAHA, FNLA, FASPC, in presenting the symposium “Economics 101- What Every Clinician Needs to Know”. This symposium was designed to provide clinicians with essential information to allow them to better understand, critique, and utilize economic evaluations.

Chronic Hepatitis C Virus (HCV) is a common infectious disease that affects 2.4 million people in the United States. The clinical and economic impact of HCV on the US healthcare system is significant. Direct-acting antiviral (DAA) treatments have been shown to provide a cure for HCV in most individuals, however there has been debate over the price. Building upon a recently published analysis, PHAR investigated the costs of using DAAs to treat individuals with HCV, and found there were substantial savings associated with decreased consequences of the disease, far exceeding the costs of the treatments themselves. A report summarizing these findings can be found here.

Los Angeles, CA and Boston, MA – July 18, 2019 – PHAR LLC (Los Angeles, CA and Boston, MA), a boutique health care consultancy dedicated to the practice of health economics and outcomes research, announces the appointment of Mallik Greene, BPharm, PhD, DBA to the position of Vice President for Health Economics and Outcomes Research (mgreene@pharllc.com).

Dr. Greene has worked in the pharmaceutical industry for nearly two decades, conducting hundreds of health economic and outcomes research studies using a wide variety of innovative research methods and study designs.  Working at such globally recognized pharmaceutical companies as Eli Lilly, Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, Otsuka, and Vertex Pharmaceuticals, Dr. Greene developed and implemented successful strategies to improve brand differentiation and demonstrate value to payers, physicians and patients. His work has resulted in more than 200 peer-reviewed publications in dozens of journals and conferences, spanning a wide variety of therapeutic areas. Dr. Greene’s experience and training—including a degree in pharmacy, a PhD in health economics and outcomes research, post-doctoral fellowship in health economics and outcomes research and a doctorate in business administration—make him uniquely suited to help PHAR’s clients to achieve their goals.

PHAR’s highly trained staff has been providing health economics and outcomes research services to the life science industry for more than 15 years. PHAR’s unique business model brings clinical and methodologic expertise to every engagement by including a pharmacist, a physician, a doctoral level researcher, and a statistician on every project team. By bringing this unparalleled level of strategic insight and methodologic rigor to every project, PHAR has published hundreds of peer-reviewed papers and garnered numerous awards for its work in the pharmaceutical, medical device, and diagnostics industries.

Rising costs, expensive new products, and heightened scrutiny of pharmaceutical industry practices combine to increase the challenge HEOR professionals face in developing a clear value proposition. This challenge makes PHAR LLC’s hiring of Mallik Greene as VP, HEOR particularly timely. “Dr. Greene’s training and experience will make him a unique asset to researchers and leaders in the pharmaceutical industry as they work to differentiate and demonstrate the value proposition of their brand,” commented Michael Broder, MD, MSHS, President of PHAR LLC.

Two studies conducted by PHAR were presented at the 24th Congress of the European Hematological Association in Amsterdam. This research, done in partnership with Celgene Corporation, shed light on the treatment patterns and economic burden associated with relapse in patients with follicular lymphoma. The first study showed that over a quarter of second-line treatment regimens for relapsed follicular lymphoma fail, suggesting a need for alternative treatment options. The second revealed a substantial burden of medical costs in the period following relapse. The two posters on treatment patterns and costs can be accessed on the PHAR publications page.

Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease of unknown cause, with median survival of 3 to 5 years. Establishing a diagnosis of IPF can be challenging, with misdiagnoses and delays commonly reported, which cause delays in treatment that can slow the disease progression. The researchers at PHAR recently published a study in which they used Medicare data to examine patterns of diagnostic respiratory testing and pulmonologist visits that precede IPF diagnosis to investigate potential diagnostic delays. This paper was then highlighted in an editorial in the Annals of the American Thoracic Society, where the author “commended [them] for taking on this challenge of examining the real-world temporal relationship between test performance and IPF diagnosis” and commented, “Their findings raise important questions with practical implications for the clinical care of subjects with IPF.” The study and related publications can be found on the PHAR publications page.

Three studies conducted by teams at PHAR were presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting in San Diego. One study done in partnership with AstraZeneca illustrated how value framework tools designed by ASCO, ICER, and NCCN can be used in a real-world setting by physicians, pharmacists, and health services researchers to systematically assess therapy value in oncology. The two studies done in partnership with Otsuka Pharmaceuticals Development & Commercialization, Inc. and H. Lundbeck A/S focused on the impact of different antipsychotics on medical costs in patients with schizophrenia. The posters can be accessed on the PHAR website.

A real-world study of lymphoma costs conducted by PHAR in conjunction with Kite, a Gilead Company, was recently published in The Oncologist. This study identified multiple important drivers of cost in the understudied population of patients with diffuse large B-cell lymphoma (DLBCL) receiving second-line treatment, such as hematopoietic stem cell transplant (HSCT) and chemotherapy. Even though HSCT is currently the only curative therapy for DLBCL, less than one third of patients receiving second-line and subsequent treatment underwent transplant, which indicates potential underuse. The variation in chemotherapy regimens suggested a lack of consensus for best practices. The full text of the article, as well as a related poster, can be accessed on the PHAR website.

Two real-world studies completed by PHAR in partnership with Otsuka Pharmaceuticals Development & Commercialization, Inc. and H. Lundbeck A/S were recently published in Advances in Therapy and the Journal of Medical Economics. Together the studies highlight potential treatment options that may reduce healthcare costs in patients with chronic mental illness. The Advances in Therapy article focused on the association between timing of augmentation of antidepressants (ADs) with antipsychotics (APs) and healthcare costs in patients with major depressive disorder. Adding an AP earlier in patients who had inadequately responded to first-line ADs reduces overall healthcare costs. The Journal of Medical Economics article examined medication adherence to oral atypical APs and the impact on psychiatric-related hospitalizations and associated costs in patients with bipolar I disorder (BD-I). Better medication adherence to oral atypical APs was associated with fewer psychiatric-related hospitalizations and lower costs in patients with BD-I. The full text of both articles, as well as related posters, can be accessed on the PHAR website.

Research focusing on schizophrenia, major depressive disorder, and bipolar I disorder conducted by PHAR and supported by Otsuka Pharmaceuticals Development & Commercialization, Inc. and H. Lundbeck A/S was well-represented at ISPOR Asia Pacific 2018. One study focusing on the effect of timing of long-acting injectable initiation in patients with schizophrenia was selected as an oral presentation, and four others were presented as posters. A study on the impact of comorbid substance abuse on costs in bipolar I disorder won the Best Poster General Research Presentation. The posters and related manuscripts can be accessed on the PHAR website.