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Recompression Chamber Utilization at Naval Base Guam: An Update.

INTRODUCTION: Since 1971, the U.S. Naval Base Guam recompression chamber (NBGRC) has provided hyperbaric oxygen therapy (HBO2) to primarily treat diving decompression sickness (DCS) but also to treat other indicated medical conditions. In 2017, Rendina et al. last reviewed the NBGRC's utilization. The current paper is an update of the chamber's activity from January 2017 through October 2024 including pre- and post-COVID-19 data. The goal of the current study is to report the diagnoses, treatments, demographic data, and estimated costs when providing HBO2 at NBGRC. This information will potent

Quality of Life After Axillary Lymph Node Dissection Among Racial and Ethnic Minority Women.

IMPORTANCE: Higher lymphedema rates after axillary lymph node dissection (ALND) have been found in Black and Hispanic women; however, there is poor correlation between subjective symptoms, quality of life (QOL), and measured lymphedema. Additionally, racial and ethnic differences in QOL have been understudied. OBJECTIVE: To evaluate the association of race and ethnicity with long-term QOL in patients with breast cancer treated with ALND. DESIGN, SETTING, AND PARTICIPANTS: This cohort study enrolled women aged 18 years and older with breast cancer who underwent unilateral ALND at a tertiary c

Treatment Patterns and Medication Use in Patients with Postherpetic Neuralgia.

BACKGROUND: Postherpetic neuralgia (PHN) is a chronic, painful condition characterized by persistent pain following resolution of a herpes zoster (HZ) infection. Epidemiologic data demonstrate that the risks for HZ infections and the development of PHN increase with age. OBJECTIVE: To characterize prescribing patterns, health care utilization, and treatment costs for adults with PHN based on real-world data. METHODS: This study analyzed medical and pharmacy claims from 2010 to 2014 in the MarketScan Commercial and Medicare Supplemental databases. PHN patients were identified based on criteri

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

Analgesic opioid use in a health-insured epilepsy population during 2012.

RATIONALE: Analgesic opioid use has increased dramatically in the general population. Although opioid analgesics are not indicated for the treatment of epilepsy, frequent opioid use has been reported in the epilepsy population. It is not clear whether comorbid disorders and/or epilepsy-associated injuries due to seizures foster opioid use. Our primary objective was to compare the prevalence of analgesic opioid use in an insured patient population with epilepsy to a matched control population without epilepsy. After observing increased frequency of opioid use in people with epilepsy compared wi

Cost-effectiveness of obinutuzumab versus rituximab biosimilars for previously untreated follicular lymphoma.

BACKGROUND: In the randomized phase 3 GALLIUM trial, first-line treatment with obinutuzumab (GA101; G) plus chemotherapy (G + chemo) resulted in superior progression-free survival (PFS) compared with rituximab plus chemotherapy (R + chemo) for patients with follicular lymphoma (FL). G + chemo was found to be cost-effective when compared with R + chemo (incremental cost-effectiveness ratio [ICER] of approximately $2,300 per quality-adjusted life-year [QALY] gained). Two rituximab biosimilars, rituximab-abbs (Ra) and rituximab-pvvr (Rp), have been approved by the FDA for use in this setting. How

Patterns of Statin Use in a Real-World Population of Patients at High Cardiovascular Risk.

BACKGROUND: Widespread use of statins has improved hypercholesterolemia management, yet a significant proportion of patients remain at risk for cardiovascular (CV) events. Analyses of treatment patterns reveal inadequate intensity and duration of statin therapy among patients with hypercholesterolemia, and little is known about real-world statin use, specifically in subgroups of patients at high risk for CV events. OBJECTIVE: To examine patterns of statin use and outcomes among patients with high-risk features who newly initiated statin monotherapy. METHODS: Adult patients (aged > 18 years)

Real-world persistence and costs among patients with chronic migraine treated with onabotulinumtoxinA or calcitonin gene-related peptide monoclonal antibodies.

BACKGROUND: Chronic migraine (CM) is a common neurologic disorder that imposes substantial burden on payers, patients, and society. Low rates of persistence to oral migraine preventive medications have been previously documented; however, less is known about persistence and costs associated with innovative nonoral migraine preventive medications. OBJECTIVE: To evaluate real-world persistence and costs among adults with CM treated with onabotulinumtoxinA (onabotA) or calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs). METHODS: This was a retrospective, longitudinal, observational

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

Dissonance in the Sole Quality Measure for Outpatient Chemotherapy, OP-35.

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… All three programs require patients to have continuous Medicare Part A and Part B enrollment 30 days after outpatient chemotherapy treatment. 3 , 7 , 8 However, only the Hospital OQR and PCHQR programs require patients to have 1 year of continuous Part A and Part B enrollment before treatment, which …

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

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

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

A review of the first year of Medicare coverage of erythropoietin.

Recombinant human erythropoietin (rHuEPO) is a new drug for treating anemia associated with end stage renal disease (ESRD). In a study of rHuEPO diffusion, costs, and effectiveness, we analyze ESRD program data and all claims submitted to Medicare for reimbursement of rHuEPO administered to ESRD dialysis patients. Access to rHuEPO was rapid and extensive during the first year of Medicare coverage. Dosing of rHuEPO and achieved hematocrit were lower than expected based on the results of clinical trials. rHuEPO cost Medicare $144 million in its first year. The analysis of insurance claims data a

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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… The Patient Entitlement and Diagnosis Summary (Medicare enrollment information), the Medicare Provider Analysis and Review (MEDPAR) (inpatient Medicare Part A claims), the National Claims History (NCH) file (provider Medicare Part B claims), and the Outpatient (institutional Medicare Part B claims) files … We included only those cases enrolled in Medicare Part A and B FFS plans and limited attention to individuals over age 65 at diagnosis in order to calculate the comorbidity index. …

Estimated number of prevalent cases of metastatic bone disease in the US adult population.

BackgroundThe prevalence of metastatic bone disease in the US population is not well understood. We sought to estimate the current number of US adults with metastatic bone disease using two large administrative data sets.MethodsPrevalence was estimated from a commercially insured cohort (ages 18-64 years, MarketScan database) and from a fee-for-service Medicare cohort (ages ≥65 years, Medicare 5% database) with coverage on December 31, 2008, representing approximately two-thirds of the US population in each age group. We searched for claims-based evidence of metastatic bone disease from Januar

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

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