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Disparities in clinical trial participation among older adult Medicare beneficiaries with hematologic malignancies from 2006 to 2019: A SEER-Medicare analysis.

BACKGROUND: Clinical trials (CTs) are essential for expanding treatment options across hematologic malignancies (HM) and providing access to novel treatments. However, older adults with HM are often underrepresented in CTs, and a national-level evaluation of factors influencing their participation is lacking. METHODS: The authors conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, identifying patients ≥66 years old diagnosed with HM between 2006 and 2018 (follow-up to December 2019). CT participation was defined by Medicare cl

Effect of a community-based nursing intervention on mortality in chronically ill older adults: a randomized controlled trial.

BackgroundImproving the health of chronically ill older adults is a major challenge facing modern health care systems. A community-based nursing intervention developed by Health Quality Partners (HQP) was one of 15 different models of care coordination tested in randomized controlled trials within the Medicare Coordinated Care Demonstration (MCCD), a national US study. Evaluation of the HQP program began in 2002. The study reported here was designed to evaluate the survival impact of the HQP program versus usual care up to five years post-enrollment.Methods and findingsHQP enrolled 1,736 adult

Наблюдение за финансовыми трудностями пациентов с множественной миеломой и хронической лимфоцитической лейкемией, проходящих лечение в онкологических клиниках США (Alliance A231602CD).

ЦЕЛИ: Оценка доли и корреляции финансовых трудностей, о которых сообщают сами пациенты с множественной миеломой (ММ) или хронической лимфоцитической лейкемией (КЛ). Вечеринка: Sixty-six Общинная практика США и практики меньшинств в области онкологии связана с Программой общинных онкологических исследований Национального института раковых заболеваний (НКОРП). Участники: в целом 521 (больные)≥18 С согласия MM или CLL и 416 :: ответы на опрос (процент завершения)79.8%). Респонденты имели диагноз MM (MM-диагностика)74.0%), степень бакалавра или выше (53.4%), белые (или белые).89.2%), застрахованны

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… Comparison of Out-of-Pocket Spending on Ultra-Expensive Drugs in Medicare Part D vs Commercial Insurance. JAMA Health Forum . 2023;4:e231090. doi: 10.1001/jamahealthforum.2023.1090. 64. Cubanski J, Neuman T, Damico A. … Your Money or Your Life - The High Cost of Cancer Drugs under Medicare Part D. N Engl J Med. 2022;386:2164–7. doi: 10.1056/NEJMp2202726. 66. Conti RM, Frank RG, Nichols LM. How Do Commercial Insurance Plans Fare Under Proposed Prescription Drug Price Regulation? …

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

Более широкие соображения в отношении интеграции медицинских и стоматологических данных

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… In 2003, Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (Medicare Part D). …

Socioeconomic Factors and Survival of Multiple Myeloma Patients.

BackgroundOutcome of Multiple Myeloma (MM) patients has improved as the result of the introduction of novel medications and use of autologous hematopoietic cell transplantation. However, this improvement comes at the expense of increased financial burden. It is largely unknown if socioeconomic factors influence MM survival.MethodsWe used the National Cancer Database, a database that houses data on 70% of cancer patients in the US, to evaluate the effect of socioeconomic factors on the survival of 117,926 MM patients diagnosed between 2005 and 2014.ResultsPatients aged ≥65 years who were privat

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… In 2011 the mean out-of-pocket per patient per month cost for cancer patients (not myeloma-specific) enrolled in Medicare Part D who took oral anticancer medications was significantly higher (USD 832) than that of privately insured patients (USD 198) [ 18 ]. …

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

Phase-Specific and Lifetime Costs of Multiple Myeloma Among Older Adults in the US.

ImportanceHealth care costs associated with diagnosis and care among older adults with multiple myeloma (MM) are substantial, with cost of care and the factors involved differing across various phases of the disease care continuum, yet little is known about cost of care attributable to MM from a Medicare perspective.ObjectiveTo estimate incremental phase-specific and lifetime costs and cost drivers among older adults with MM enrolled in fee-for-service Medicare.Design, setting, and participantsA retrospective cohort study was conducted using population-based registry data from the 2007-2015 Su

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

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

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… The claims data include Medicare Part D pharmacy claims during 2007–2009. In addition, a cohort of non-cancer patients comprised of a random 5% sample of Medicare beneficiaries residing in the SEER registry areas is contained in the SEER-Medicare data and was included in our study for comparison. … With the availability of Medicare Part D data beginning in 2007, a new prescription for a medication used to treat HZ-related pain was also required within 60 days of the HZ visits in the first criterion. …

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

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

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

Launch and Post-Launch Prices of Injectable Cancer Drugs in the US: Clinical Benefit, Innovation, Epidemiology, and Competition.

BackgroundRising cancer drug prices adversely affect patients' adherence and survival.ObjectiveWe aimed to identify and quantify factors associated with launch prices and post-launch price changes of injectable cancer drugs in the US from 2005 to 2023.Data and methodsAll anticancer drugs with US FDA approval between 2000 and 2022 were identified in the Drugs@FDA database. The sample was then restricted to cancer drugs covered under Medicare Part B (injectable drugs). Data characterizing each drug's clinical benefits, disease epidemiology, approved indications, competition, and price were obtai

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… In general, Medicare Part B covers injectable cancer drugs (typically drugs that are administered at a hospital or doctor’s office), while Medicare Part D covers oral cancer drugs (typically self-administered drugs). … Among these, we identified 170 anticancer agents with FDA approval for a total of 455 indications; 104 of these drugs were covered under Medicare Part D and were therefore excluded from our analysis. …

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

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… A relatively newer Medicare Part D was created in 2006 to help with oral medication costs, such as newer targeted agents that are not covered by Part B, but these plans still have high out-of-pocket costs, 37 which often exceed $10 000 USD annually. … Of note, Medicare Part D is a voluntary supplementary plan for outpatient prescription benefits and not included in some traditional Medicare plans. …

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

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

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

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… We were unable to determine the number of prior lines of therapy prior to transplant since complete treatment information (including Medicare Part D data) was not available for most patients in the cohort. …

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

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

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… The Medicare Part D program is different from the tiered payment structure. Individuals qualify for Medicare Part D if they are over the age of 65 or under the age of 65 with certain disabilities, such as end-stage renal disease or amyotrophic lateral sclerosis. … The standard drug benefit through Medicare Part D begins with a $275 deductible and a 25% copayment for drugs that cost between $275 and $2510 (Gu, Zeng, Patel, & Tripoli, 2010). …