scholarly journals Incremental Healthcare Utilization and Cost Burden of Comorbid Insomnia in Alzheimer’s Disease Patients

2021 ◽  
pp. 1-12
Author(s):  
Zaina P. Qureshi ◽  
Ellen Thiel ◽  
James Nelson ◽  
Rezaul Khandker
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Healthcare Utilization ◽  
Real World ◽  
Healthcare Costs ◽  
Real World Data ◽  
Skilled Nursing ◽  
Comorbid Insomnia ◽  
Comorbidity Burden

Background: Insomnia is associated with worsened clinical outcomes among Alzheimer’s disease dementia (AD) patients, increased caregiver burden, and healthcare utilization. Objective: This study aimed to characterize the incremental healthcare burden of insomnia in AD using real-world data. Methods: A retrospective observational study was conducted on AD patients selected from the IBM® MarketScan Commercial and Medicare Supplemental Databases. AD patients with claims-based evidence of insomnia were direct matched to a non-insomnia cohort based on demographic factors. Healthcare utilization and associated costs were assessed for a 12-month follow-up period. Results: A total of 3,500 insomnia AD patients and 9,884 non-insomnia AD patients were analyzed. The insomnia cohort had a higher comorbidity burden at baseline (mean score on Charlson Comorbidity Index 2.5 versus 2.2, p <  0.001) and higher proportions of patients with baseline diagnoses for other conditions including depression: 40%, insomnia cohort versus 25%, non-insomnia (p <  0.001). AD patients with insomnia were more likely to have a claim for inpatient hospitalizations (39.8%versus 32.3%), emergency room services (56.4%versus 48.0%), and skilled-nursing services (42.6%versus 31.9%) (all p <  0.05). Mean total annual healthcare costs during the 12-month follow-up period were significantly higher among AD patients with insomnia as compared to those without. (Mean costs: $37,356 versus $27,990, p <  0.001). Conclusion: AD patients with comorbid insomnia are more likely to use higher-cost healthcare services such as inpatient hospitalization, and skilled nursing, and have higher total healthcare costs. This real-world analysis provides evidence that AD disease management should consider proper treatment of comorbid insomnia due to the incremental burden and cost implications.

Healthcare utilization and costs associated with first-line treatment with obinutuzumab- and rituximab-based regimens for follicular lymphoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19536-e19536
Author(s):  
Jamie T. Ta ◽  
Tu My To ◽  
Cheryl Sud ◽  
Sheila Shapouri ◽  
Arpamas Seetasith
Keyword(s):  
Follicular Lymphoma ◽  
Healthcare Utilization ◽  
Real World ◽  
Healthcare Costs ◽  
Trial Participation ◽  
Administrative Claims ◽  
Cell Transplant ◽  
First Line ◽  
Real World Data ◽  
Eligibility Criteria

e19536 Background: Current real-world data on healthcare utilization (HCU) and costs of common first-line (1L) follicular lymphoma (FL) regimens, including obinutuzumab (G), remain limited. The aim of this study was to examine real-world HCU and costs for the most common National Comprehensive Cancer Network (NCCN)-recommended 1L FL treatments. Methods: This was a retrospective cohort study using administrative claims data from the IQVIA PharMetrics Plus and IBM MarketScan Commercial and Medicare Supplemental databases. We identified patients (pts) ≥18 years, who had ≥1 inpatient claim or ≥2 outpatient claims, with a diagnosis of FL from February 1, 2015 to March 31, 2020, and had received 1L FL treatment (per NCCN guidelines) between February 1, 2016 and September 30, 2019. The first claim for FL treatment was the index date. All pts had ≥12 months of pre- and ≥6 months of post-index continuous enrollment in medical and pharmacy benefits. Pts with other primary cancers, FL treatment, or stem cell transplant during the pre-index period, and clinical trial participation or end-stage renal disease during the study period were excluded. All-cause HCU and costs (2020 USD) per pt during the 6-month post-index period were reported for the five most common 1L FL regimens (only complete NCCN regimens were considered). Results: Overall, 1991 pts met the eligibility criteria, and 53% were male. The mean (standard deviation [SD]) age and Charlson Comorbidity Index at index were 58 (10.4) years, and 1.7 (1.0), respectively. The most common 1L regimens were rituximab-bendamustine (R-benda; n=818 [41.1%]), R-monotherapy (R-mono; n=592 [29.7%]), R-CHOP (n=461 [23.2%]), G-benda (n=86 [4.3%]), and R-CVP (n=34 [1.7%]). The proportion of pts who had ≥1 hospitalization or an emergency room visit was highest with R-CHOP (26.7% and 33.6%, respectively) and lowest with R-mono (11.3% and 18.1%, respectively). Mean (SD) all-cause total healthcare costs were highest with R-benda and G-benda, followed by R-CHOP, R-CVP, and R-mono (Table). Mean (SD) all-cause medical and FL treatment costs (drug and administration) were highest for R-benda ($174,407 [$110,520]; $135,520 [$96,492]) and lowest for R-mono ($87,368 [$83,910]; $54,271 [$40,433]). Conclusions: This real-world study provides an update on HCU and costs among pts initiating current NCCN-recommended 1L treatment for FL. Unadjusted 6-month total healthcare costs were highest with R-benda, followed by G-benda, while the lowest costs were seen with R-CVP and R-mono. Future studies with adjustment for pt characteristics are needed to compare HCU and costs between FL regimens.[Table: see text]

scholarly journals Is it time to use real-world data from primary care in Alzheimer’s disease?

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Anna Ponjoan ◽  
Josep Garre-Olmo ◽  
Jordi Blanch ◽  
Ester Fages ◽  
Lia Alves-Cabratosa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Real World ◽  
Real World Data ◽  
World Data

scholarly journals Exploring the Feasibility of Using Real-World Data from a Large Clinical Data Research Network to Simulate Clinical Trials of Alzheimer’s Disease

2020 ◽  
Author(s):  
Zhaoyi Chen ◽  
Hansi Zhang ◽  
Yi Guo ◽  
Thomas J George ◽  
Mattia Prosperi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Trials ◽  
Clinical Data ◽  
Real World ◽  
Large Scale ◽  
Research Network ◽  
Real World Data ◽  
World Data ◽  
Trial Simulation

AbstractClinical trials are essential but often have high financial costs and long execution time. Trial simulation using real world data (RWD) could potentially provide insights on a treatment’s efficacy and safety before running a large-scale trial. In this work, we explored the feasibility of using RWD from a large clinical data research network to simulate a randomized controlled trial of Alzheimer’s disease considering two different scenarios: an one-arm simulation of the standard-of-care control arm; and a two-arm simulation comparing treatment safety between the intervention and control arms with proper patient matching algorithms. We followed original trial’s design and addressed some key questions, including how to translate trial criteria to database queries and establish measures of safety (i.e., serious adverse events) from RWD. Our simulation generated results comparable to the original trial, but also exposed gaps in both trial simulation methodology and the generalizability issue of clinical trials.

scholarly journals 1358. A Real-World Study of the Burden of Illness and Treatment Patterns Among Patients with Uncomplicated Urogenital Gonorrhea in the United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S765-S766
Author(s):  
Madison T Preib ◽  
Fanny S Mitrani-Gold ◽  
Ziyu Lan ◽  
Xiaoxi Sun ◽  
Ashish V Joshi
Keyword(s):  
Real World ◽  
Healthcare Costs ◽  
Linear Models ◽  
Burden Of Illness ◽  
Unmet Need ◽  
The United States ◽  
Prescribing Practices ◽  
Real World Data ◽  
The Us

Abstract Background Gonorrhea (GC) is a major public health threat in the US. The Centers for Disease Control and Prevention (CDC) estimated direct healthcare costs of &271 million in 2018. CDC 2015 guidelines (applicable up to December 18, 2020) recommended cephalosporin plus azithromycin for GC. We used real-world data to assess patterns of inappropriate or suboptimal (IA/SO) or appropriate and optimal (AP&OP) antibiotic (AB) prescription (by CDC 2015 guidelines), and related healthcare costs, in US patients with uncomplicated urogenital GC (uUGG) diagnosed from July 1, 2013–June 30, 2018. Methods A retrospective cohort study of IBM MarketScan data (commercial/Medicare claims) in patients ≥ 12 years old with uUGG. Eligible patients had an AB prescription ±5 days of uUGG diagnosis (index date) and continuous health-plan enrollment with ≥ 6 months’ baseline/≥ 12 months’ follow-up data. Patients with complicated urogenital GC were excluded. Patients were stratified by AB prescription (IA/SO or AP&OP; defined in Table 1) during the first uUGG episode (ie, within 30 days of index). Generalized linear models were used for multivariate analysis. Table 1. Definitions of appropriateness of AB prescriptions Results Of 2847 patients with uUGG (58.5% male), 77.1% had an IA/SO prescription (mostly due to IA AB class [~82.0%] and duration [24.0%]), while only 22.9% had an AP&OP prescription; uUGG episodes were more frequent with IA/SO (n=2386) than AP&OP (n=714) prescriptions during follow-up. Patients with IA/SO prescriptions had higher GC-related total adjusted costs per patient (PP) per index episode (&196) vs those with AP&OP prescriptions (&124, p &lt; 0.0001; Figure). Patients with IA/SO prescriptions also had higher GCrelated total adjusted costs PP during follow-up (&220) vs those with AP&OP prescriptions (&148, p &lt; 0.0001), mostly driven by higher outpatient ambulatory and emergency room (ER) adjusted costs with IA/SO (&148 and &71, respectively) vs AP&OP prescriptions (&129 and &12, respectively, p ≤ 0.0152; Figure). ER visits PP at index and during follow-up were higher with IA/SO vs AP&OP prescriptions (p &lt; 0.0001; Table 2). Figure. GC-related costs per patient with uUGG, stratified by appropriateness of AB prescription* Table 2. GC-related HRU per patient with uUGG, stratified by AB prescription Conclusion Most patients with uUGG were not prescribed treatments in accordance with CDC 2015 guidelines. High IA/SO AB prescriptions and associated healthcare costs suggest an unmet need for improved prescribing practices for uUGG in the US. Disclosures Madison T. Preib, MPH, STATinMED Research (Employee, Former employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder) Ziyu Lan, MSc, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Xiaoxi Sun, MA, STATinMED Research (Employee, Employee of STATinMED Research, which received funding from GlaxoSmithKline plc. to conduct this study) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder)

Causal AI with Real World Data: Do Statins Protect from Alzheimer's Disease Onset?

2021 ◽  
Author(s):  
Mattia Prosperi ◽  
Shantanu Ghosh ◽  
Zhaoyi Chen ◽  
Marco Salemi ◽  
Tianchen Lyu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Real World ◽  
Disease Onset ◽  
Real World Data ◽  
World Data

Efficacy of acetyl-cholinesterase-inhibitor (ACHEI) treatment in Alzheimer's disease: A 21-month follow-up “real world” study

2009 ◽  
Vol 49 (1) ◽  
pp. e6-e11 ◽  
Author(s):  
Marco Calabria ◽  
Cristina Geroldi ◽  
Giulia Lussignoli ◽  
Federica Sabbatini ◽  
Orazio Zanetti
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Real World ◽  
Cholinesterase Inhibitor ◽  
Acetyl Cholinesterase
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