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Факторы риска, выходящие за рамки воздействия химиотерапии на вторичные миелоидные неоплазмы после рака гематологов: исследование на основе СЭЭУ.

UNLABELLED. По мере того, как показатели выживаемости лимфоидных магнатов продолжают улучшаться, для выживших людей все большее значение приобретает понимание поздних последствий после лечения, таких, как вторичные миелоидные новообразования (SMN). В этом крупномасштабном исследовании населения (SEER-Medicare) были изучены факторы риска и кумулятивная распространенность SMN у пациентов с диагнозом диффузной большой лимфомы B-клеток (DLBCL), фолликулярной лимфомы (FL) и множественной миеломы между 2000 и 2011, с последующими мерами 2015. Пациенты с ПЛ постоянно увеличивают совокупное число НРМ

Use of real-world evidence in the Medicare Drug Price Negotiation Program: A checklist for the Centers for Medicare and Medicaid Services and manufacturers.

Under the Inflation Reduction Act's (IRA's) - Medicare Drug Price Negotiation Program, the Centers for Medicare & Medicaid Services' (CMS's) "maximum fair price" must be informed by evidence on factors such as therapeutic advance of the selected drug compared with its alternative, comparative effectiveness across clinical and patient-reported outcomes, the impact on specific populations, and the ability to address unmet medical needs. This paper describes how real-world evidence could improve CMS decision-making and creates a best practices checklist to help CMS evaluate the quality of any man

Ассоциация по борьбе с раком и острыми почечными травмами среди населения, получающего медицинскую плату за услуги.

RATALE & ObJECTive: Острая травма почек (AKI) является частым осложнением рака в силу множественных факторов. Наша цель состояла в том, чтобы оценить современные связи между различными раковыми заболеваниями и инцидентами, связанными с АКИ, среди бенефициаров программы " Медикэр " . ИССЛЕДОВАНИЕ: Ретроспективное исследование наблюдений. УЧАСТНИКИ: Бенефициары медицинской помощи в возрасте ≥66 Годы. Новый диагноз рака. Случай АКИ. АНАЛИТИЧЕСКИЙ ПОДХОД: Последующая деятельность началась с диагностики рака или с декабря 31, 2014, для контроля и до конца на дату AKI, смерть, рак в контро

Utilization of novel systemic therapies for multiple myeloma: A retrospective study of front-line regimens using the SEER-Medicare data.

The landscape of treatment for multiple myeloma (MM) has significantly changed over the last decade due to novel agents that have shown superiority in efficacy such as proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs) over traditional therapies. However, the real-world utilization of these new agents has not been studied well. This study evaluated year-to-year changes in treatment choices in a cohort of patients aged 66 or older in the Surveillance, Epidemiology, and End Results (SEER) registry linked with Medicare claims (SEER-Medicare) data who were diagnosed with MM between 200

Racial and ethnic differences in the utilization of autologous transplantation for lymphoma in the United States.

BackgroundRacial/ethnic disparities in the utilization of hematopoietic cell transplantation (HCT) have been reported for patients with hematologic malignancies, but population-based data are lacking for lymphoma patients. The objective of this study was to determine whether racial and ethnic disparities exist in the utilization of autologous HCT for lymphoma in the United States.MethodWe used Surveillance, Epidemiology, and End Results data linked to Medicare fee-for-service claims. We included Medicare beneficiaries aged 66+ years with Hodgkin or Non-Hodgkin lymphomas diagnosed between 2008

The epidemiology of herpes zoster and its complications in Medicare cancer patients.

BACKGROUND: Literature on the epidemiology of herpes zoster (HZ) in cancer patients is sparse and does not include the elderly. The objectives of this study were to determine the incidence of HZ and related complications in elderly cancer patients and assess risk factors associated with HZ. METHODS: Patients ≥65 years diagnosed with cancer in 1991-2007 were identified from the Surveillance, Epidemiology, and End Results (SEER) cancer registry-Medicare linked database in this retrospective, longitudinal, open cohort study. The observation period spanned from first cancer diagnosis until the en

Socioeconomic Deprivation and Health Care Use in Patients Enrolled in SWOG Cancer Clinical Trials.

ImportanceReducing acute care use is an important strategy for improving value. Patients with cancer are at risk for unplanned emergency department (ED) visits and hospital stays (HS). Clinical trial patients have homogeneous treatment; despite this, structural barriers to care may independently impact acute care use.ObjectiveTo examine whether ED visits and HS within 12 months of trial enrollment are more common among Medicare enrollees who live in areas of socioeconomic deprivation or have Medicaid insurance.Design, setting, and participantsThis cohort study included patients with cancer who

Impact of Remote Symptom Monitoring With Electronic Patient-Reported Outcomes on Hospitalization, Survival, and Cost in Community Oncology Practice: The Texas Two-Step Study.

PurposeThere is raising interest to implement electronic patient-reported outcomes (ePROs) for symptom monitoring to enhance the quality of cancer care. Step 1 of the Texas Two-Step Study demonstrated successful implementation of an ePRO system in >200 sites of service of a large community oncology practice. We now report step 2 of this study which evaluates the impact of ePROs on outcomes among patients enrolled in the Centers for Medicare & Medicaid Services' Oncology Care Model (OCM) program.MethodsThis observational study focused on patients with metastatic cancer enrolled in OCM at large

Use of bone-modifying agents and clinical outcomes in older adults with multiple myeloma.

BACKGROUND: Guidelines recommend bone-modifying agents (BMAs) for all patients initiating treatment for myeloma. We examined adherence to this recommendation, and BMA effectiveness in the era of bortezomib/lenalidomide-based therapy among Medicare beneficiaries. METHODS: From the linked Surveillance, Epidemiology, and End Results-Medicare registry, we selected beneficiaries receiving anti-myeloma chemotherapy in 2007-2013. We matched BMA recipients (within 90 days of first chemotherapy) to nonrecipients using a propensity score, balancing patient-, disease-, and therapy-related confounders. C

The social vulnerability index as a risk stratification tool for health disparity research in cancer patients: a scoping review.

PurposeThe social vulnerability index (SVI), developed by the Centers for Disease Control and Prevention, is a novel composite measure encompassing multiple variables that correspond to key social determinants of health. The objective of this review was to investigate innovative applications of the SVI to oncology research and to employ the framework of the cancer care continuum to elucidate further research opportunities.MethodsA systematic search for relevant articles was performed in five databases from inception to 13 May 2022. Included studies applied the SVI to analyze outcomes in cancer

A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care.

BackgroundConcerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prioritizing insured services offers a valuable strategy for informing Medicare coverage policy. We designed and evaluated a decision exercise that allowed cancer patients and family members to choose Medicare benefits for advanced cancer patients.MethodsThe decision tool, Choosing Health plans All Together (CHAT) was modified to select services fo

Financial challenges of being on long-term, high-cost medications.

The isocitrate dehydrogenase (IDH) inhibitor, vorasidenib, may offer a promising new treatment option for patients with IDH-mutant gliomas. However, the indefinite nature of this targeted therapy raises significant financial concerns. High costs of targeted cancer therapies, often exceeding $150 000 annually, contribute to financial toxicity, characterized by medical debt, income loss, and psychological stress, and place stress on health systems. This review analyzes the drug approval and pricing mechanisms in various countries and their impact on healthcare costs and patient access, focusing

Oral cancer therapy: policy implications for the uninsured and underinsured populations.

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Prevalence and risk of skeletal complications and use of radiation therapy in elderly women diagnosed with metastatic breast cancer.

OBJECTIVE: Real-world data regarding patient factors associated with the occurrence of spinal cord compression (SCC) or pathological fracture (PF), or need for bone surgery (BS), or use of radiation therapy (RAD) (i.e. skeletal complications and radiation therapy; SCRT) are limited for women with metastatic breast cancer (BCa). Given the substantial clinical and economic burden of these events in advanced BCa, we conducted the present study to understand the prevalence and identify the risk factors associated with these events among elderly women presenting with de novo metastatic BCa. METHOD

Diagnostic imaging for spinal disorders in the elderly: a narrative review.

The high prevalence of neck and low back pain in the rapidly aging population is associated with significant increases in health care expenditure. While spinal imaging can be useful to identify less common causes of neck and back pain, overuse and misuse of imaging services has been widely reported. This narrative review aims to provide primary care providers with an overview of available imaging studies with associated potential benefits, adverse effects, and costs for the evaluation of neck and back pain disorders in the elderly population. While the prevalence of arthritis and degenerative

Клиническое и экономическое бремя лиц, получающих пособия по уходу за больными, с множественными миеломами и почечными расстройствами: исследование наблюдений.

Данные о реальных клинических и экономических результатах лечения пациентов с множественными миеломой (ММ) и почечными расстройствами (РИ) в Соединенных Штатах ограничены. Цель этого ретроспективного исследования состояла в том, чтобы подготовить обновленную всеобъемлющую оценку клинических и экономических результатов лечения пациентов с РИ с использованием поддающихся идентификации данных исследования " Медикэр " с увязкой с частью D, что могло бы помочь в оценке общего клинического и социально-экономического бремени этих пациентов с высокой степенью риска и труднодоступным лечением

Enhancing medication adherence with blister-packed oral oncolytics: A case example in chronic lymphocytic leukemia.

IntroductionMedication nonadherence is a prevalent issue in the oncology population and can be costly on the healthcare system while leading to worsened outcomes, including increased mortality. One intervention that has been shown to help promote medication adherence to oral therapies for chronic conditions is blister-packaging. However, no literature is available assessing the potential impact of blister-packaging in oncology. Therefore, we aimed to quantify the impact of blister-packaging oral oncolytics on medication adherence and healthcare costs.MethodsAn economic model was designed to as

Реальные модели лечения и результаты лечения пациентов с множественной миеломой, инициирующих эгранатамаб: результаты ALTITUDE-1 и ALTITUDE-2 Ретроспективные когортные исследования.

AIM: Elranatamab в настоящее время является антителом с биенной спецификой, утвержденным в Соединенных Штатах (США) для лечения повторной/охлажденной множественной миеломы (ММ). С учетом его недавнего одобрения реальные данные являются ограниченными. МЕТОДЫ: РЕЗУЛЬТАТЫ РАБОТЫ two исследования реального мира (РВ) с использованием административных требований (см.ALTITUDE-1) и данные о плате за услуги (ALTITUDE-2) сообща сообщаются здесь. Американские пациенты с MM, которые запустили Elranatamab после августа 2023 в сентябре/октябре 2025. Сообщалось о характеристиках пациентов, клинической истори

Patient perspectives on BCMA-targeted therapies for multiple myeloma: a survey conducted in a patient advocacy group.

BackgroundAdvances in multiple myeloma (MM) treatment have shifted the therapeutic landscape. Understanding patients' perspectives can assist physicians in helping patients make informed decisions. This study aimed to understand the patient decision-making process and gain insights into patient perspectives on B-cell maturation antigen (BCMA)-targeted therapies for MM.MethodsAn 18-question survey was completed by patients with MM enrolled in HealthTree® Cure Hub, an online portal helping patients with plasma cell dyscrasias navigate their disease.ResultsFrom October 28, 2022, to January 12, 20

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… Among 246 respondents who answered the question about insurance, about half patients (129/246, 52%) reported having commercial insurance (44% through work and 8% through personal plan); most of the other half of patients had Medicare coverage (36% Medicare Part B, 35% Medicare Part A, 23% Medicare Part … Part B | 88 (36%) Medicare Part A | 87 (35%) Medicare Part D | 57 (23%) Medigap or Medicare supplemental | 47 (19%) Medicare Advantage | 34 (14%) Medicaid | 5 (2%) Other | 20 (8%) Highest level of education (254 respondents, 78% of total surveyed) College and above | 192 (76%) Some college or associate …

Cost-Effectiveness Analysis of Adding Daratumumab to Bortezomib, Melphalan, and Prednisone for Untreated Multiple Myeloma.

Background: To evaluate the cost-effectiveness of adding daratumumab to bortezomib, melphalan, and prednisone for transplant-ineligible newly diagnosed multiple myeloma patients. Methods: A three-state Markov model was developed from the perspective of US payers to simulate the disease development of patient's life time for daratumumab plus bortezomib, melphalan, and prednisone (D-VMP) and bortezomib, melphalan, and prednisone (VMP) regimens. The primary outputs were total costs, expected life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). R

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… Medicare Part B Drug Average Sales Price [Online] . Available at: https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/2020-asp-drug-pricing-files ( Accessed August, 2020). CMS ( 2020c ). Center for Medicare and Medicaid Services. Physician Fee Schedule [Online] . …