Despite the availability of numerous antiepileptic drugs, some epilepsies remain resistant to treatment. We compared utilization and costs in patients with uncontrolled epilepsy to those with stable epilepsy using commercial insurance claims data. We found patients with uncontrolled epilepsy use more services and incur higher costs compared with those with stable epilepsy. Epilepsy-related costs accounted for <50% of the total costs, suggesting that comorbid conditions and/or under identification of utilization may substantially contribute to costs. This study was published in Epilepsy & Behavior and can be read here.
Given the small magnitude of benefit with adjuvant therapy in stage II colon cancer, chemotherapy is often selected for patients based on their physicians’ subjective assessment of clinical factors. To help guide oncologists’ adjuvant treatment recommendations for standard risk patients where other existing markers are not informative, the 12-gene colon cancer Oncotype DX® Recurrence Score® Assay was developed. The investigators at PHAR in collaboration with Genomic Health studied the effects of the assays by conducting physician surveys. U.S. medical oncologists who ordered the assay for ≥3 stage II colon cancer patients were asked to complete a web-based survey regarding their most recent such patient. They found that the use of the Oncotype DX assay is associated with an overall change of nearly one in three treatment recommendations for stage II colon cancer patients, and that it may lead to more appropriate use of adjuvant treatment. The study can be read here.
There are no clinical guidelines on best practices for the use of bronchoscopy and esophagoscopy in diagnosing head and neck cancer. Dr. Gordon Sun of PHAR partnered with investigators from the University of Michigan and the University of Pennsylvania to examine variation in the use of bronchoscopy and esophagoscopy across hospitals in Michigan through a retrospective cohort study of the Michigan State Ambulatory Surgery Database. The authors found that patients with head and neck cancer who are undergoing diagnostic laryngoscopy are much more likely to undergo concurrent bronchoscopy and esophagoscopy at low- and medium-volume hospitals than at high-volume hospitals. The publication can be viewed here.
Patients with cystic fibrosis (CF), a common life-shortening inherited disorder, often don’t take all their medications. It has been proposed that better adherence could improve these patients’ health more than any specific medical treatment. Investigators at PHAR, LLC, in collaboration with Genentech, Inc. conducted a retrospective cohort analysis and confirmed that there was generally low adherence to dornase alfa, a key drug for CF. The study also found that better adherence was associated with shorter hospital stays. This publication can be viewed by visiting the Journal of Medical Economics website.
PHAR researchers collaborated with investigators at Eisai Inc. to evaluate the prevalence of hematologic conditions in patients with myelodysplastic syndrome (MDS). Researchers compared two MDS patient groups: patients receiving hypomethylating agents (HMAs) and patients receiving supportive care alone. The study concluded that hematologic conditions were more common in patients who received HMAs, with the most frequently observed conditions being anemia and neutropenia. A poster detailing the findings was presented at the 2012 MASCC/ISOO International Symposium on Supportive Care in Cancer. This study was published in the November/December issue of American Health & Drug Benefits and can be viewed here.
PHAR, LLC, in collaboration with Bristol-Myers Squibb and Otsuka Pharmaceutical Development & Commercialization, Inc, conducted a study to evaluate how antipsychotic medication half-life affects the risk of psychiatric hospital admission and emergency department (ED) visits for patients with schizophrenia. The study found that patients taking medication with a longer half-life had fewer comorbid mental health conditions, took fewer psychiatric medications, and had a lower risk of hospital admission and ED visits for mental disorders. The full study can be found in the January 2012 edition of the Journal of Medical Economics.
The literature on chronic idiopathic urticaria (CIU) lacks information on demographic characteristics and comorbidities. To fill this gap, investigators at PHAR, LLC initiated an analysis to better define the insured population. By conducting a cross-sectional analysis of insurance claims, investigators found that although antihistamines were the most common treatment for CIU, physicians also frequently prescribed oral corticosteroids. The study was conducted in partnership with Genentech, Inc. as well as investigators at the David Geffen School of Medicine at UCLA and NOVA Southeastern University College of Osteopathic Medicine. View the abstract at the Annals of Allergy, Asthma & Immunology website.
Using a retrospective cohort analysis, investigators at PHAR, LLC and Genentech, Inc. examined patterns of omalizumab use in the first 5 years after the drug’s approval. The study found that omalizumab is most often used with appropriate concomitant medications. In addition, most omalizumab prescriptions come from specialist physicians. These findings were published in the December 2011 edition of the Journal of Asthma.
Cost-effectiveness techniques can provide valuable insight into breast cancer treatment. A recent PHAR, LLC study assessed the impact on health outcomes and healthcare expenditures of adopting a 21-gene assay for women with early-stage, minimally node-positive, estrogen receptor-positive HER2-negative breast cancer. The study found that the use of this 21-gene assay was associated with improved outcomes for these breast cancer patients, with no additional cost. To see the publication in its entirety, visit The American Journal of Managed Care website.
Investigators at PHAR, LLC evaluated the economic impact of alvimopan in clinical practice. They found that, along with other initiatives to improve quality and reduce costs of surgical care, alvimopan may be a good choice for use in the perioperative management of patients who undergo segmental bowel resection. This research was published in the P & T journal.