In collaboration with Genentech, PHAR published their analysis of Medicare FFS claims data examining healthcare utilization and costs in a US Medicare population diagnosed with Huntington’s disease (HD). Their investigation quantified healthcare needs and associated costs that were substantially higher among Medicare beneficiaries diagnosed with HD compared to those without, primarily driven by higher outpatient pharmacy utilization. In a stratified analysis, total healthcare costs were highest among beneficiaries with late-stage HD, reflecting the need for effective treatments that delay or prevent disease progression. Their findings can be read in the Journal of Medical Economics, and was previously presented in posters at the 2020 Academy of Managed Care Pharmacy (AMCP) conference.
PHAR’s Sheila Reiss Reddy, PhD, RPh, Eunice Chang, PhD, and Marian Tarbox, MPP worked with collaborators at Bristol Myers Squibb to conduct an administrative claims study examining treatment patterns, including duration of dasatinib use after pleural effusion, and healthcare resource utilization and costs among patients with chronic myeloid leukemia treated with dasatinib who experienced a subsequent pleural effusion. The poster was presented at the 63rd Annual Meeting and Exposition of the American Society of Hematology and can be viewed on the PHAR Publications page, and the accompanying abstract published in the November supplement issue of Blood.
PHAR’s Sheila Reiss Reddy, PhD, RPh, Eunice Chang, PhD, and Michael S. Broder, MD, MSHS, in collaboration with F. Hoffmann-La Roche/Genentech, Inc., compared mortality and hospitalization between Medicare beneficiaries with idiopathic pulmonary fibrosis (IPF) who initiated antifibrotic therapy and those who did not receive treatment. This retrospective observational study of Medicare beneficiaries using the 100% Medicare Research Identifiable Files showed that antifibrotic treatments reduce hospitalization and death among older patients with advanced age (>80 years), which is a population that has been excluded from key clinical trials despite being disproportionately affected by IPF. The study can be read in the December issue of the Journal of Managed Care + Specialty Pharmacy.
PHAR, with support from Takeda Pharmaceuticals, produced a Monte Carlo simulation model of projected mean costs for treating patients with moderate to severe ulcerative colitis with either vedolizumab or adalimumab. The investigation found that mean estimated total costs per patient treated with either therapy over 1 year were $14,322 lower for vedolizumab than for adalimumab, which may help to inform formulary decision-making. Jesse Ortendahl, Director of Health Economics at PHAR, presented the findings at the American College of Gastroenterology’s Annual Scientific Meeting & Postgraduate Course. See the poster here, and the abstract published in the October supplement issue of the American Journal of Gastroenterology.
Research conducted by PHAR and supported by Amgen was presented in the poster sessions at AMCP Nexus in Denver, CO. PHAR’s claims analysis on psoriatic arthritis (PsA) patients compared biologic initiation risk in systematic-naïve PsA adult patients using apremilast versus methotrexate, building on research previously presented at AMCP 2021 and AAD VMX. The investigators’ findings suggest that patients who initiate apremilast are more adherent and have a lower likelihood of biologic initiation when compared with patients initiating methotrexate. In patients who do need biologics, time to biologic initiation is longer in apremilast users than in methotrexate users. The poster can be viewed on PHAR’s publications page and the abstract was published in the October supplement issue of AMCP’s Journal of Managed Care & Specialty Pharmacy (JMCP).
Two studies conducted by PHAR were presented at the 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). The first study, done in partnership with Sanofi US, examined the effectiveness of teriflunomide in patients with relapsing multiple sclerosis (RMS) who switched from other DMTs following disease progression. The authors of this retrospective chart review study observed that RMS patients who switched to teriflunomide after progression may have experienced reductions in EDSS scores and stable or reduced relapse rates. In the second study, PHAR collaborated with Genentech to develop a claims-based algorithm to identify patients with neuromyelitis optica spectrum disorder (NMOSD) and distinguish them from patients with multiple sclerosis and other central nervous system inflammatory disorders, allowing researchers and clinicians to better estimate NMOSD burden. The posters can be viewed on the PHAR website publications page and the abstracts were published in the October supplement issue of Multiple Sclerosis Journal.
PHAR, with support from Dompé US, Inc., published their synthesis of clinical recommendations for the management of neurotrophic keratopathy (NK), an uncommon, underdiagnosed degenerative corneal disease, in BMC Ophthalmology. The investigators gathered an 11-member expert panel who reviewed published evidence and independently rated 735 patient scenarios using a validated methodology (a RAND/UCLA modified Delphi panel) to develop consensus on when to screen for and how best to diagnose and treat NK. Diagnosis may be delayed in NK because patients experience few symptoms, however, the best opportunity to reverse ocular surface damage and prevent progression is early in the disease course.
Michael S. Broder, MD, MSHS, President at PHAR, and Jesse Ortendahl, Director of Health Economics at PHAR, discuss the inherent racial equity problem in cost-effectiveness analysis and how the history of racial injustice in health outcomes can be unintentionally perpetuated by researchers. Read their post at HealthEconomics.com here.
PHAR’s David Beenhouwer, Michael S. Broder, Sarah Newman Gibbs, and Irina Yermilov, in collaboration with Novartis Pharmaceuticals, organized a multidisciplinary panel of practicing emergency department (ED) clinicians and used the modified Delphi panel process to develop an order set for managing acute pain in sickle cell disease (SCD) patients in the ED. Painful, incapacitating vaso-occlusive episodes (VOEs) are a hallmark of SCD. Recommended treatment within 30 minutes of triage is rarely achieved in clinical practice; ED order sets may facilitate better VOE management. The description of the process and resulting order set was published in the Journal of the American College of Emergency Physicians Open and can be read here. The resulting order set is presently undergoing review, adoption, and implementation in several NYC EDs.
PHAR’s Sheila Reiss Reddy, PhD, RPh, Eunice Chang, PhD, and Marian Tarbox, MPP, in collaboration with investigators at Akcea Therapeutics, Inc., presented at the American Association of Heart Failure Nurses 17th Annual Meeting. The study found that patients diagnosed with hereditary transthyretin amyloidosis (ATTRv [variant]) have considerable cardiovascular disease burden in the 5 years preceding diagnosis. Heart failure nurses’ recognition of ATTRv cardiovascular manifestations may increase clinical suspicion, leading to earlier diagnosis. The poster can be found here, and the abstract published in Heart & Lung‘s July/August 2021 issue.