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Health care resource utilization patterns among patients with Parkinson's disease psychosis: analysis of Medicare beneficiaries treated with pimavanserin or other-atypical antipsychotics.

BACKGROUND: Pimavanserin (PIM) is the only FDA-approved atypical antipsychotic (AAP) for hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Comparative real-world analyses demonstrating its benefits are needed. OBJECTIVES: To evaluate health care resource utilization (HCRU) outcomes among PDP patients treated with PIM vs. other-AAPs. METHODS: Retrospective cohort analysis of Parts A, B, and D claims from 100% Medicare sample from 01 January 2013-31 December 2019 was conducted. PDP Patients initiating (i.e. index date) continuous monotherapy (PIM vs. other-AAPs)

Patients treated with pimavanserin or quetiapine for Parkinson's disease psychosis: analysis of health resource utilization patterns among Medicare beneficiaries.

BACKGROUND: Pimavanserin (PIM) is the only FDA approved atypical antipsychotic (AAP) for the treatment of Parkinson's Disease Psychosis (PDP) while other off-label AAPs like quetiapine (QUE) are also used. Real-world comparative effects of PIM and QUE on health resource utilization (HCRU) may provide insights about their relative benefits. OBJECTIVES: To examine annual HCRU among newly initiated PIM or QUE monotherapy among patients with PDP. METHODS: Retrospective analysis of 100% Medicare (Parts A, B, and D) claims of patients with PDP during 1 January 2013 to 31 December 2019 was conducte

Preventing and controlling oral and pharyngeal cancer. Recommendations from a National Strategic Planning Conference.

In August 1996, CDC convened a national conference to develop strategies for preventing and controlling oral and pharyngeal cancer in the United States. The conference, which was cosponsored by the National Institute of Dental Research of the National Institutes of Health and the American Dental Association, included 125 experts in oral and pharyngeal cancer prevention, treatment, and research; both the private and public sectors were represented. Participants at the conference developed recommendations concerning advocacy, collaboration, and coalition building; public health policy; public ed

Cardiovascular Outcomes among New Users of GLP-1 Receptor Agonists Compared with DPP-4 Inhibitors and Sulfonylureas in Kidney Failure.

KEY POINTS: Glucagon-like peptide-1 receptor agonists are increasingly used in patients with kidney failure despite trial exclusion. Initiation was associated with a 13% lower risk of cardiovascular events and 17% lower mortality versus dipeptidyl peptidase-4 inhibitors. Initiation was associated with a 10% lower risk of heart failure hospitalization versus dipeptidyl peptidase-4 inhibitors. BACKGROUND: Few therapies improve cardiovascular outcomes for people with kidney failure. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduce cardiovascular risk in patients with non-dialysis-depe

Federal Housing Assistance and Stage at Cancer Diagnosis Among Older Adults in the US.

IMPORTANCE: A growing number of older adults live in unaffordable and unstable housing; however, whether programs designed to counter housing insecurity contribute to earlier-stage cancer diagnosis remains largely unknown. OBJECTIVE: To examine the association between the receipt of federal housing assistance, which limits household spending on rent and utilities, and cancer stage at diagnosis among older adults in the US. DESIGN, SETTING, AND PARTICIPANTS: This comparative cohort study used the Surveillance, Epidemiology, and End Results cancer registry program and Medicare database linked

Clinical Knowledge and Trends in Physicians' Prescribing of Opioids for New Onset Back Pain, 2009-2017.

IMPORTANCE: Opioid musculoskeletal pain overprescribing was widespread in the mid-2000s. The degree to which prescribing changed as awareness of the danger grew among physicians with different levels of clinical knowledge remains unstudied. OBJECTIVE: To compare the association of clinical knowledge with opioid prescribing from 2009 to 2011 when prescribing peaked nationally with 2015 to 2017 when guidelines shifted away from opioid prescribing. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 10 246 midcareer general internal medicine physicians in the United States wh

Cumulative Anticholinergic Burden and its Predictors among Older Adults with Alzheimer's Disease Initiating Cholinesterase Inhibitors.

BACKGROUND: Cumulative anticholinergic burden refers to the cumulative effect of multiple medications with anticholinergic properties. However, concomitant use of cholinesterase inhibitors (ChEIs) and anticholinergic burden can nullify the benefit of the treatment and worsen Alzheimer's disease (AD). A literature gap exists regarding the extent of the cumulative anticholinergic burden and associated risk factors in AD. Therefore, this study evaluated the prevalence and predictors of cumulative anticholinergic burden among patients with AD initiating ChEIs. METHODS: A retrospective longitudina

A Method to Quantify Mean Hypertension Treatment Daily Dose Intensity Using Health Care System Data.

IMPORTANCE: Simple measures of hypertension treatment, such as achievement of blood pressure (BP) targets, ignore the intensity of treatment once the BP target is met. High-intensity treatment involves increased treatment burden and can be associated with potential adverse effects in older adults. A method was previously developed to identify older patients receiving intense hypertension treatment by low BP and number of BP medications using national Veterans Health Administration and Medicare Part D administrative pharmacy data to evaluate which BP medications a patient is likely taking on an…

Harnessing Facebook to Investigate Real-World Mentions of Adverse Events of Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) Medications: Observational Study of Facebook Posts From 2022 to 2024.

BACKGROUND: In recent years, there has been a dramatic increase in the popularity and use of glucagon-like peptide-1 receptor agonists (GLP- … December 2022, increased media coverage in August 2023, celebrity endorsement in December 2023, and Medicare Part D coverage expansion for weight loss medications in March 2024. Gastrointestinal (GI)-related adverse events (general term) were most prevalent for posts mentioning the GLP-1 RA class (210/4885, 4.30%) and Mounjaro (241/4031, 5.98%). In contrast, the …

National and surgical health care expenditures, 2005-2025.

OBJECTIVE AND BACKGROUND: Health care expenditures for 2005 in the United States were $1.9733 trillion and 15.9% of the gross domestic product (GDP). Twenty-nine percent of those expenditures were secondary to surgical revenues. Health care expenditures are increasing 2(1/2) times the rate of the general US economy and are being fed by new technologies, new medications, the aging population, more services provided per patient, defensive medicine and little tort reform, the insurance system, and the free rider problem, ie, patients are cared for as emergencies regardless of insurance coverage a

Impact of Pain Severity and Opioid Use on Health Care Resource Utilization and Costs Among Patients with Knee and Hip Osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is the most common form of arthritis. The primary symptom of OA-pain-increases the disease burden by negatively affecting daily activities and quality of life. Opioids are often prescribed for treating pain in patients with OA but have questionable benefit-risk profiles. There is limited evidence on the economic impact of pain severity and opioid use among patients with OA. OBJECTIVES: To (a) evaluate the association of pain severity with health care resource utilization (HRU) and costs among patients with knee/hip OA and (b) characterize the association of opi

Discharge status and post-discharge healthcare costs after skeletal-related event hospitalizations among medicare patients with bone metastatic solid tumors or multiple myeloma.

BACKGROUND: Previous studies have quantified direct inpatient costs of skeletal-related events (SREs); however, costs associated with subsequent post-SRE care have not been examined. METHODS: We identified two study cohorts using 2011-2015 Medicare 20% sample data: patients diagnosed with 1) bone metastases from solid tumors or 2) multiple myeloma (MM), both with SRE-related hospitalization discharge dates January 1, 2011-September 30, 2015. We assessed discharge status and costs from discharge to the earliest of death, end of Medicare enrollment, or December 31, 2015. Discharge status was de

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… Using SNFs as an example: When a patient was admitted to a SNF, Medicare costs included those for the SNF itself, outpatient services, physician visits/DME, and pharmacy costs defined from Medicare Part D claims. …

Costs and benefits of early access to new cancer drugs through the US Food and Drug Administration's accelerated approval pathway: retrospective observational study and economic evaluation.

OBJECTIVE: To evaluate the survival gains and additional Medicare spending associated with early access to new cancer drugs granted accelerated approval by the US Food and Drug Administration (FDA), compared with access to cancer drugs following completion of confirmatory trials. DESIGN: Retrospective observational study and economic evaluation. SETTING: US Medicare programme, which provides health insurance for adults aged 65 years and older. PARTICIPANTS: Medicare beneficiaries who received new cancer drug indications from the time of FDA accelerated approval to conversion to regular appr

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… Medicare part D drug spending dashboard. https://data.cms.gov/tools/medicare-part-d-drug-spending-dashboard Available. Accessed. 36. CMS Data; [21-Jul-2025]. Medicare part B drug spending dashboard. https://data.cms.gov/tools/medicare-part-b-drug-spending-dashboard Available. Accessed. 37. …

The Impact of Biosimilar Use on Total Cost of Care and Provider Financial Performance in the Medicare Oncology Care Model: A Population-Based Simulation Study.

IntroductionPayment for oncology care is increasingly moving from fee-for-service to value-based payment (VBP). VBPs are agreements in which providers are held accountable for total cost of care (TCOC) through risk-sharing arrangements with payers that tie reimbursement levels to TCOC benchmarks. Oncology biosimilars may play an important role in managing financial risk in the VBPs like Medicare's Oncology Care Model (OCM), but there has been limited research in this area. The objective of this study is to estimate the impact of biosimilar adoption on TCOC and oncology provider financial perfo

Provider billing margin and cancer treatment selection: population based cohort study.

ObjectiveTo estimate the association between the billing (profit) margin and clinical benefit of cancer treatments and use by oncologists.DesignRetrospective population based cohort study SETTING: Population based sample using fee-for-service Medicare claims data.ParticipantsMedicare beneficiaries with an incident cancer diagnosis from 2015 to 2020; included all patients with cancer treatment indications for which the available treatment options varied in clinical benefit and billing margin.Main outcomes and measuresThe primary outcome was the cancer treatment each patient received among treat

Расовые различия в лечении и выживании пожилых пациентов с множественной миеломой.

С течением времени эволюционировали фоновые характеристики миеломы (ММ) и улучшили выживание MM. Несмотря на то, что расовые различия в лечении MM и прогнозах между неиспаноязычными афроамериканцами (NHAA) и неиспанскими белыми пациентами (NHW) хорошо зарекомендовали себя, неясно, сохранялись ли они после внедрения новых агентов. 1 год после диагностирования и оценки результатов выживаемости среди бенефициаров программы " Медикэр "≥66 ) с диагнозом MM от 2007 в адрес 2017. Мы применили многовариантные модели пропорциональных рисков кокса для оценки связи между расой и выживанием и пр

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… Part D program. … The Out‐of‐Pocket Cost Burden for Specialty Drugs in Medicare Part D in 2019. 2019. https://www.kff.org/medicare/issue‐brief/the‐out‐of‐pocket‐cost‐burden‐for‐specialty‐drugs‐in‐medicare‐part‐d‐in‐2019/ 25. Blommestein HM, Franken MG, van Beurden‐Tan CHY, et al. …

Estimating Out-of-Pocket Savings From Medicare Site-Neutral Payments on Colon, Lung, Ovarian, and Prostate Cancer Patients.

Site-neutral payment reforms seek to align Medicare reimbursement rates for common outpatient services across care sites. Recent reports have assessed the composite impact of site-neutral payment policies on beneficiaries, federal savings, and the commercial market. This analysis builds on such work, focusing on the potential patient-level savings of site-neutral reform for high-utilizing Medicare beneficiaries facing common chronic cancers. We compiled the outpatient services of standard treatment regimens for a typical lung, ovarian, prostate, and colon cancer patient over their first year o

Cost Implications of Comorbidity for Autologous Stem Cell Transplantation in Elderly Patients with Multiple Myeloma Using SEER-Medicare.

Comorbidity is more common in older patients and can increase the cost of care by increasing toxicity. Using the SEER-Medicare database from 2000 to 2007, we examined the costs and life-year benefit of Auto-HSCT for MM patients over the age of 65 by evaluating the difference over time relative to comorbidity burden. One hundred ten patients had an Auto-HSCT in the early time period (2000-2003) and 160 in the late time period (2004-2007). Patients were divided by a Charlson Comorbidity Index (CCI) of 0 or greater than 1 (CCI1+). Median overall survival was 53.5 months for the late time period p

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… First, because Medicare Part D prescription coverage for oral prescriptions did not begin until 2009, costs for oral medication (primarily lenalidomide and thalidomide, FDA-approved in 2006) were not included in our analysis. …

Validation of the Medicare-Enhanced Laboratory and Demographics (MELD™) Dataset: A Comprehensive Psychometric, Epidemiologic, and Predictive-Utility Assessment of a 60-Million-Patient Real-World Evidence Resource.

BackgroundReal-world evidence studies increasingly rely on integrated data resources that combine Medicare fee-for-service claims with electronic medical records (EMRs), laboratory results, and patient-reported outcomes. The Medicare-Enhanced Laboratory and Demographics (MELD™) dataset, developed by Columbia Data Analytics, spans 2020 through 2024 and contains 60 million unique patients, roughly 1 billion visits, and more than 241 000 clinicians. Its data-quality properties must be characterized before regulatory-grade use.ObjectiveTo provide a preregistered, multidomain validation of MELD, qu

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… The Medicare Part D denominator excludes patients with Medicare Advantage (Part C) prescription coverage. Residual pandemic-era artifacts in Q2 2020 for in-person vitals capture may warrant quarter-specific sensitivity analyses. …

Перспективы пациентов в отношении стоимостных и качественных показателей лечения рака на основе ценностей.

Перспективные перспективы и предпочтения имеют важное значение при установлении качественных и стоимостных показателей для моделей выплат на основе стоимости (ВБП), с тем чтобы обеспечить увязку услуг по лечению раковых заболеваний с учетом интересов пациентов и стимулов в отношении ПВП. Были собраны сведения о моделях оказания помощи на основе стоимости (ВБК) от пациентов с системой " Медикэр " и one В процентах 4 Обычные раковые заболевания (многообразная миелома, мочевой пузырь, лёгкие и простаты), включенные в усовершенствованную онкологическую модель Medicare. Это исследование в