Clinical guidance from a PHAR research study on how to taper thrombopoietin receptor agonists (TPO-RAs) in immune thrombocytopenia (ITP) was presented at the 2020 American Society of Hematology Annual Meeting & Exposition. PHAR developed this important guidance with clinical experts using the RAND/UCLA modified Delphi panel process. The consensus statements presented could serve as a guide for clinical care by identifying patients who could safely taper and discontinue TPO-RAs and help to inform the design and development of future clinical trials. The study was also published in the December 2020 issue of Research and Practice in Thrombosis and Haemostasis. The presentation and manuscript can be found on our publications page.
Michael S. Broder, MD, MSHS, president at PHAR, wrote a post on healtheconomics.com about how health economics and outcomes researchers can help defeat COVID-19. He pointed out the important role that HEOR professionals have in not being silent about facts related to COVID-19 and in helping lay people find reliable data sources instead of wading through misinformation. He stressed that health economics and outcomes researchers can help stop the pandemic and save lives by simply stopping misinformation from spreading and sharing facts instead. The post can be found here.
Since its establishment in 2004, PHAR has collaborated with many partners in academia and industry on a numerous number of studies. These studies have resulted in over 750 publications, covering nearly 100 different products, 90 health conditions, and more than 30 data sources, and appearing in more than 200 different journals and conferences. PHAR has compiled the publications into an interactive bibliography book titled, Health Services Research Insights. The bibliography book is organized thematically, with each of four main sections devoted to a different broad area of HEOR, then further broken down by type and clinical specialty. The book is available for download now here.
Many studies conducted by PHAR were presented at Virtual ISPOR 2020 HEOR: Advancing Evidence to Action and in the journal Value in Health. The topics covered a variety of range, including breast cancer, arthritis, COPD, and many more. One of the studies presented at ISPOR was a secondary data analysis done in partnership with Genentech, Inc., which investigated the healthcare utilization and costs by disease stage in Medicare beneficiaries with Huntington’s disease. This study showed that beneficiaries with late-stage disease had significantly higher healthcare utilization and cost burden compared to those with early- or middle-stage disease. The poster on healthcare utilization and costs as well as the abstracts published in Value in Health can be found 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.
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.
A study done by PHAR in partnership with Prothena Biosciences Inc., was recently published in the Journal of Comparative Effectiveness Research. The study estimated the healthcare utilization and costs in amyloid light-chain (AL) amyloidosis. The authors identified AL amyloidosis patients in claims data from 2007 to 2015 and reported inpatient hospitalizations, emergency department visits, non-ED outpatient service visits, and pharmacy utilization. The study found that the general prescribing practices changed over time, with the use of bortezomib increasing and the use of melphalan decreasing. Healthcare utilization and costs decreased between the first and second year after diagnosis. The full text of the study can be read here.
On August 16, the Journal of Oncology Practice (JOP) published a joint guidance statement from ASCO and the American Academy of Hospice and Palliative Medicine (AAHPM) regarding high-quality palliative care as delivered as part of routine cancer care. PHAR supported the development of this important guidance by moderating a meeting of experts using the RAND/UCLA modified Delphi panel process. With this method, over 900 potential palliative care services were rated by more than 20 participants on multiple dimensions. Those services which were both highly ranked and which had a high level of agreement were included in the final guidance. Read the full study here.
Carcinoid syndrome describes the hormonal effects of carcinoid tumors, including the secretion of serotonin into the systemic circulation causing episodic diarrhea. Despite the frequent occurrence of this symptom, the healthcare costs and utilization associated with non-infectious diarrhea has not been elucidated. The researchers at PHAR and Novartis Pharmaceuticals Corporation presented their study on the economic impact of Non-Infectious Diarrhea in Patients with Carcinoid Syndrome at the 2015 North American Neuroendocrine Tumor Society’s Annual Symposium. They found that non-infectious diarrhea in newly-diagnosed carcinoid syndrome patients is associated with a significantly increased annual healthcare utilization and an additional $30,000 in total annual healthcare costs. The poster can be viewed here.