Pub Date : 2024-10-01Epub Date: 2024-06-12DOI: 10.1080/14737167.2024.2365421
Svenn Alexander Kommandantvold, Annabelle Lemenuel-Diot, Chris Skedgel, Richard Pitman, Peter Rouse, Hassan Zaraket, Hao Zhou, Marie-Helene Blanchet Zumofen
Background: Baloxavir marboxil is an oral, single-dose, cap-dependent endonuclease inhibitor that reduces the duration of influenza symptoms and rapidly stops viral shedding. We developed a susceptible, exposed, infected, recovered (SEIR) model to inform a cost-effectiveness model (CEM) of baloxavir versus oseltamivir or no antiviral treatment in the UK.
Research design and methods: The SEIR model estimated the attack rates among otherwise healthy and high-risk individuals in seasonal and pandemic settings. The CEM assumed that a proportion of infected patients would receive antiviral treatment. Results were reported at the population level (per 10,000 at risk of infection).
Results: The SEIR model estimated greater reductions in infections with baloxavir. In a seasonal setting, baloxavir provided incremental cost-effectiveness ratios (ICERs) of £1884 per quality-adjusted life-year (QALY) gained versus oseltamivir and a dominant cost-effectiveness position versus no antiviral treatment in the total population; ICERs of £2574/QALY versus oseltamivir and £128/QALY versus no antiviral treatment were seen in the high-risk population. Baloxavir was also cost-effective versus oseltamivir or no antiviral treatment and reduced population-level health system occupancy concerns during a pandemic.
Conclusion: Baloxavir treatment resulted in the fewest influenza cases and was cost-effective versus oseltamivir or no antiviral treatment from a UK National Health Service perspective.
{"title":"A cost-effectiveness analysis of reduced viral transmission with baloxavir marboxil versus oseltamivir or no treatment for seasonal and pandemic influenza management in the United Kingdom.","authors":"Svenn Alexander Kommandantvold, Annabelle Lemenuel-Diot, Chris Skedgel, Richard Pitman, Peter Rouse, Hassan Zaraket, Hao Zhou, Marie-Helene Blanchet Zumofen","doi":"10.1080/14737167.2024.2365421","DOIUrl":"10.1080/14737167.2024.2365421","url":null,"abstract":"<p><strong>Background: </strong>Baloxavir marboxil is an oral, single-dose, cap-dependent endonuclease inhibitor that reduces the duration of influenza symptoms and rapidly stops viral shedding. We developed a susceptible, exposed, infected, recovered (SEIR) model to inform a cost-effectiveness model (CEM) of baloxavir versus oseltamivir or no antiviral treatment in the UK.</p><p><strong>Research design and methods: </strong>The SEIR model estimated the attack rates among otherwise healthy and high-risk individuals in seasonal and pandemic settings. The CEM assumed that a proportion of infected patients would receive antiviral treatment. Results were reported at the population level (per 10,000 at risk of infection).</p><p><strong>Results: </strong>The SEIR model estimated greater reductions in infections with baloxavir. In a seasonal setting, baloxavir provided incremental cost-effectiveness ratios (ICERs) of £1884 per quality-adjusted life-year (QALY) gained versus oseltamivir and a dominant cost-effectiveness position versus no antiviral treatment in the total population; ICERs of £2574/QALY versus oseltamivir and £128/QALY versus no antiviral treatment were seen in the high-risk population. Baloxavir was also cost-effective versus oseltamivir or no antiviral treatment and reduced population-level health system occupancy concerns during a pandemic.</p><p><strong>Conclusion: </strong>Baloxavir treatment resulted in the fewest influenza cases and was cost-effective versus oseltamivir or no antiviral treatment from a UK National Health Service perspective.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"953-966"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-06-12DOI: 10.1080/14737167.2024.2366439
Lieke Maas, Annelies Boonen, Nannan Li, Caroline E Wyers, Joop P Van den Bergh, Mickaël Hiligsmann
Background: This study aims to assess the lifetime cost-effectiveness of a multi-component adherence intervention (MCAI), including a patient decision aid and motivational interviewing, compared to usual care in patients with a recent fracture attending fracture liaison services (FLS) and eligible for anti-osteoporosis medication (AOM).
Research design and methods: Data on AOM initiation and one-year persistence were collected from a quasi-experimental study conducted between 2019 and 2023 in two Dutch FLS centers. An individual level, state-transition Markov model was used to simulate lifetime costs and quality-adjusted life years (QALYs) with a societal perspective of MCAI vs usual care. One-way and probabilistic sensitivity analyses were conducted including variation in additional FLS and MCAI costs (no MCAI cost in baseline).
Results: MCAI was associated with gain in QALYs (0.0012) and reduction in costs (-€16) and is therefore dominant. At the Dutch willingness-to-pay threshold of €50,000/QALY, MCAI remained cost-effective when increasing costs of the FLS visit or the yearly maintenance cost for MCAI up to +€60. Probabilistic sensitivity analysis demonstrated MCAI to be dominant in 54% of the simulations and cost-effective in 87% with a threshold of €50,000/QALY.
Conclusions: A MCAI implemented in FLS centers may lead to cost-effective allocation of resources in FLS care, depending on extra costs.
{"title":"Cost-effectiveness of a multicomponent-adherence intervention in fracture liaison services.","authors":"Lieke Maas, Annelies Boonen, Nannan Li, Caroline E Wyers, Joop P Van den Bergh, Mickaël Hiligsmann","doi":"10.1080/14737167.2024.2366439","DOIUrl":"10.1080/14737167.2024.2366439","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the lifetime cost-effectiveness of a multi-component adherence intervention (MCAI), including a patient decision aid and motivational interviewing, compared to usual care in patients with a recent fracture attending fracture liaison services (FLS) and eligible for anti-osteoporosis medication (AOM).</p><p><strong>Research design and methods: </strong>Data on AOM initiation and one-year persistence were collected from a quasi-experimental study conducted between 2019 and 2023 in two Dutch FLS centers. An individual level, state-transition Markov model was used to simulate lifetime costs and quality-adjusted life years (QALYs) with a societal perspective of MCAI vs usual care. One-way and probabilistic sensitivity analyses were conducted including variation in additional FLS and MCAI costs (no MCAI cost in baseline).</p><p><strong>Results: </strong>MCAI was associated with gain in QALYs (0.0012) and reduction in costs (-€16) and is therefore dominant. At the Dutch willingness-to-pay threshold of €50,000/QALY, MCAI remained cost-effective when increasing costs of the FLS visit or the yearly maintenance cost for MCAI up to +€60. Probabilistic sensitivity analysis demonstrated MCAI to be dominant in 54% of the simulations and cost-effective in 87% with a threshold of €50,000/QALY.</p><p><strong>Conclusions: </strong>A MCAI implemented in FLS centers may lead to cost-effective allocation of resources in FLS care, depending on extra costs.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"987-996"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-07-15DOI: 10.1080/14737167.2024.2378983
Wenwang Lang, Lian Deng, Meijun Lu, Ming Ouyang
Background: This study compares first-line pembrolizumab plus chemotherapy with chemotherapy alone for patients with HER2-negative advanced gastric cancer (GC) and gastroesophageal junction cancer (GEJC) in China.
Methods: A Markov state-transition model was developed based on the phase 3 randomized KEYNOTE-859 clinical trial data. The health state utility values and direct medical costs were derived from the KEYNOTE-859 clinical trial, the relevant literature, and local charges. The measured outcomes included quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER). Probabilistic and one-way sensitivity analyses (OWSA) were performed to assess the uncertainty of the model.
Results: In the base analysis, the incremental effectiveness and cost of pembrolizumab plus chemotherapy versus chemotherapy alone were 0.22 QALYs and $16,627.31, respectively, resulting in an ICER of $76,936.60/QALY, which is higher than the willingness-to-pay threshold in China ($35,864.61/QALY). Subgroup analyses revealed that the ICERs of pembrolizumab plus chemotherapy versus chemotherapy alone were $72,762.68 and $34,813.70 in the populations with PD-L1 CPS of 1 or higher (CPS ≥ 1) and PD-L1 CPS ≥ 10 (CPS ≥ 10), respectively.
Conclusions: As first-line therapy for patients with locally advanced or metastatic HER2-negative GC/GEJC in China, pembrolizumab plus chemotherapy is less cost-effective than chemotherapy alone, however, in the CPS ≥ 10 subgroup is more.
{"title":"Cost-effectiveness analysis of pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric/gastroesophageal junction cancer in the Chinese healthcare system.","authors":"Wenwang Lang, Lian Deng, Meijun Lu, Ming Ouyang","doi":"10.1080/14737167.2024.2378983","DOIUrl":"10.1080/14737167.2024.2378983","url":null,"abstract":"<p><strong>Background: </strong>This study compares first-line pembrolizumab plus chemotherapy with chemotherapy alone for patients with HER2-negative advanced gastric cancer (GC) and gastroesophageal junction cancer (GEJC) in China.</p><p><strong>Methods: </strong>A Markov state-transition model was developed based on the phase 3 randomized KEYNOTE-859 clinical trial data. The health state utility values and direct medical costs were derived from the KEYNOTE-859 clinical trial, the relevant literature, and local charges. The measured outcomes included quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER). Probabilistic and one-way sensitivity analyses (OWSA) were performed to assess the uncertainty of the model.</p><p><strong>Results: </strong>In the base analysis, the incremental effectiveness and cost of pembrolizumab plus chemotherapy versus chemotherapy alone were 0.22 QALYs and $16,627.31, respectively, resulting in an ICER of $76,936.60/QALY, which is higher than the willingness-to-pay threshold in China ($35,864.61/QALY). Subgroup analyses revealed that the ICERs of pembrolizumab plus chemotherapy versus chemotherapy alone were $72,762.68 and $34,813.70 in the populations with PD-L1 CPS of 1 or higher (CPS ≥ 1) and PD-L1 CPS ≥ 10 (CPS ≥ 10), respectively.</p><p><strong>Conclusions: </strong>As first-line therapy for patients with locally advanced or metastatic HER2-negative GC/GEJC in China, pembrolizumab plus chemotherapy is less cost-effective than chemotherapy alone, however, in the CPS ≥ 10 subgroup is more.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1027-1042"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1080/14737167.2024.2406797
Ibrahim Alabbadi,Sara Al-Ajlouny,Yazan Alsoud,Ayah Bani Hani,Bayan A Arar,Eman M Massad,Suhaib Muflih,Mays Shawawrah
BACKGROUNDMultiple Sclerosis (MS) is a chronic neurological autoimmune disease that imposes a significant financial burden on healthcare systems. This study aims to determine the cost of illness for MS in Jordan, a country where data on the economic impact of MS are scarce. The objective of this study is to assess both direct and indirect costs associated with MS care in Jordan's public healthcare system.METHODSData were collected during the year 2020-2021, annual cost of illness was estimated using a cross-sectional snowball sampling design. Eligible patients completed a self-reported questionnaire to provide sociodemographic, physician visit, and diagnostic and laboratory test data. We estimated indirect costs using an adjusted Human Capital Approach.RESULTSThis study included 383 people with MS (PwMS), 73.1% of whom were female and 61.4% between 26 and 45. Nearly 79.6% of PwMS took Disease Modifying Therapies (DMTs), and 40% had relapses in the year 2020-2021. One-third use non-DMTs and equipment for assistance like canes and walkers. The average annual cost per patient was 11,719 USD, with direct costs amounting to 11,252 USD and indirect costs at 467 USD. The total cost for all participants was 748,299 USD. The estimated cost of non-DMT, medical tools, diagnostic tests, and hospitalization per patient was 53 USD, 51 USD, 99 USD, and 235 USD respectively.CONCLUSIONThe high costs for Disease Modifying Therapies (DMTs) state the necessity of resource optimization in Jordan public healthcare facilities. Such findings yield policy-informing actionable insights, suggesting strategic investments in more cost-effective DMTs with potential improvement in accessibility and reduction in the overall economic burden faced by both patients and governments.
{"title":"The cost-of-illness of multiple sclerosis in Jordan.","authors":"Ibrahim Alabbadi,Sara Al-Ajlouny,Yazan Alsoud,Ayah Bani Hani,Bayan A Arar,Eman M Massad,Suhaib Muflih,Mays Shawawrah","doi":"10.1080/14737167.2024.2406797","DOIUrl":"https://doi.org/10.1080/14737167.2024.2406797","url":null,"abstract":"BACKGROUNDMultiple Sclerosis (MS) is a chronic neurological autoimmune disease that imposes a significant financial burden on healthcare systems. This study aims to determine the cost of illness for MS in Jordan, a country where data on the economic impact of MS are scarce. The objective of this study is to assess both direct and indirect costs associated with MS care in Jordan's public healthcare system.METHODSData were collected during the year 2020-2021, annual cost of illness was estimated using a cross-sectional snowball sampling design. Eligible patients completed a self-reported questionnaire to provide sociodemographic, physician visit, and diagnostic and laboratory test data. We estimated indirect costs using an adjusted Human Capital Approach.RESULTSThis study included 383 people with MS (PwMS), 73.1% of whom were female and 61.4% between 26 and 45. Nearly 79.6% of PwMS took Disease Modifying Therapies (DMTs), and 40% had relapses in the year 2020-2021. One-third use non-DMTs and equipment for assistance like canes and walkers. The average annual cost per patient was 11,719 USD, with direct costs amounting to 11,252 USD and indirect costs at 467 USD. The total cost for all participants was 748,299 USD. The estimated cost of non-DMT, medical tools, diagnostic tests, and hospitalization per patient was 53 USD, 51 USD, 99 USD, and 235 USD respectively.CONCLUSIONThe high costs for Disease Modifying Therapies (DMTs) state the necessity of resource optimization in Jordan public healthcare facilities. Such findings yield policy-informing actionable insights, suggesting strategic investments in more cost-effective DMTs with potential improvement in accessibility and reduction in the overall economic burden faced by both patients and governments.","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":"47 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-01-04DOI: 10.1080/14737167.2023.2296561
Katrina S Firlik, Vamshi Ruthwik Anupindi, Vincent Hayes, Mitchell DeKoven, Asif Shaikh, Jessica Franchino-Elder
Objective: To assess the impact of the HealthPrize RespiPoints™ program on treatment adherence and persistence in adults with chronic obstructive pulmonary disease (COPD).
Methods: In this retrospective cohort study, program participants and nonparticipants receiving tiotropium bromide (TIO) or TIO and olodaterol between 1 January 2015-31 March 2020 were propensity score matched (PSM), from the linked database of the HealthPrize patient list and IQVIA PharMetrics® Plus. Treatment adherence, persistence, healthcare resource utilization, and costs were compared. Multivariable logistic regression models assessed the odds of adherence (≥80% proportion of days covered [PDC]), adjusted risk of discontinuation, and adjusted total healthcare costs.
Results: Program participants (n = 262) demonstrated a 44% greater adherence during followup than nonparticipants (n = 262) (mean [standard deviation] PDC: 0.72 [0.27] vs 0.50 [0.36], p < 0.0001). Participants had higher odds of adherence vs nonparticipants (adjusted odds ratio: 2.51; 95% confidence interval: 1.72-3.66, p < 0.0001) and a lower percentage of participants discontinued their index medication (19.85% vs 33.59%, p = 0.0004). Fewer participants were hospitalized during follow-up (13.74% vs 17.56%, p = 0.23); adjusted total medical costs were 24% lower (p = 0.08). Higher pharmacy costs partially offset lower healthcare costs.
Conclusions: Program participants showed improved COPD medication adherence and persistence compared to nonparticipants.
目的评估HealthPrize RespiPoints™计划对慢性阻塞性肺病(COPD)成人患者坚持治疗的影响:在这项回顾性队列研究中,从HealthPrize患者名单和IQVIA PharMetrics® Plus的链接数据库中对2015年1月1日至2020年3月31日期间接受噻托溴铵或噻托溴铵和奥洛他特罗治疗的计划参与者和非参与者进行倾向得分匹配(PSM)。比较了治疗依从性、持续性、医疗资源利用率和成本。多变量逻辑回归模型评估了坚持治疗的几率(覆盖天数比例≥80% [PDC])、调整后的停药风险和调整后的总医疗费用:计划参与者(n = 262)在随访期间的依从性比非参与者(n = 262)高出 44%(平均 [标准差] PDC:0.72 [0.27] vs 0.50 [0.36],p p = 0.0004)。随访期间住院的参与者较少(13.74% vs 17.56%,p = 0.23);调整后的医疗总费用降低了 24%(p = 0.08)。较高的药费部分抵消了较低的医疗费用:结论:与非参与者相比,该计划的参与者在慢性阻塞性肺病药物治疗的依从性和持续性方面都有所改善。
{"title":"Improved medication adherence in COPD patients using tiotropium or tiotropium olodaterol with the HealthPrize digital behavior change program.","authors":"Katrina S Firlik, Vamshi Ruthwik Anupindi, Vincent Hayes, Mitchell DeKoven, Asif Shaikh, Jessica Franchino-Elder","doi":"10.1080/14737167.2023.2296561","DOIUrl":"10.1080/14737167.2023.2296561","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of the HealthPrize RespiPoints™ program on treatment adherence and persistence in adults with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>In this retrospective cohort study, program participants and nonparticipants receiving tiotropium bromide (TIO) or TIO and olodaterol between 1 January 2015-31 March 2020 were propensity score matched (PSM), from the linked database of the HealthPrize patient list and IQVIA PharMetrics® Plus. Treatment adherence, persistence, healthcare resource utilization, and costs were compared. Multivariable logistic regression models assessed the odds of adherence (≥80% proportion of days covered [PDC]), adjusted risk of discontinuation, and adjusted total healthcare costs.</p><p><strong>Results: </strong>Program participants (<i>n</i> = 262) demonstrated a 44% greater adherence during followup than nonparticipants (<i>n</i> = 262) (mean [standard deviation] PDC: 0.72 [0.27] vs 0.50 [0.36], <i>p</i> < 0.0001). Participants had higher odds of adherence vs nonparticipants (adjusted odds ratio: 2.51; 95% confidence interval: 1.72-3.66, <i>p</i> < 0.0001) and a lower percentage of participants discontinued their index medication (19.85% vs 33.59%, <i>p</i> = 0.0004). Fewer participants were hospitalized during follow-up (13.74% vs 17.56%, <i>p</i> = 0.23); adjusted total medical costs were 24% lower (<i>p</i> = 0.08). Higher pharmacy costs partially offset lower healthcare costs.</p><p><strong>Conclusions: </strong>Program participants showed improved COPD medication adherence and persistence compared to nonparticipants.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"829-843"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-01DOI: 10.1080/14737167.2024.2373184
Dalma Hosszú, Alexandra L Dima, Francisca Leiva Fernández, Marie Paule Schneider, Liset van Dijk, Krisztina Tóth, Mark Duman, Wendy Davis, Cristian Andriciuc, Rebecca Egan, Bernard Vrijens, Przemyslaw Kardas, Noemi Bitterman, Iva Mucalo, Cristina Mihaela Ghiciuc, Tamás Ágh
Background: This study aims to create a comprehensive framework for the development and implementation of digital medication adherence technologies (DMATech), focusing on critical stages where engagement of medication users (MU) is considered meaningful, i.e. adds significant value, as agreed upon by participating stakeholders.
Methods: Through a literature review and expert consensus, a framework was outlined covering key DMATech development and implementation phases and steps. An in-person workshop with MU representatives and adherence experts, using the Nominal Group Technique, further refined these stages for MU engagement.
Results: The DMATech framework included three phases: 'Innovation,' 'Research and Development,' and 'Launch and Implementation,' each encompassing multiple steps. The workshop, attended by five MU representatives and nine adherence experts, identified critical stages for MU input including context analysis, ideation, proof of concept, prototype creation, DMATech's iteration, critical evaluation, healthcare implementation, real-world assessment, and improvement. Nevertheless, there was a divergence of consensus regarding the importance of MUs engagement in regulatory, financial, and marketing aspects.
Conclusions: This study provides a holistic framework for DMATech development and implementation and underscores the necessity of MU engagement at various stages. Modes of MU engagement cannot be generalized; a case-by-case evaluation of engagement strategies is essential.
{"title":"Engagement of medication users in the development and implementation of digital medication adherence technologies: a multi-stakeholder study.","authors":"Dalma Hosszú, Alexandra L Dima, Francisca Leiva Fernández, Marie Paule Schneider, Liset van Dijk, Krisztina Tóth, Mark Duman, Wendy Davis, Cristian Andriciuc, Rebecca Egan, Bernard Vrijens, Przemyslaw Kardas, Noemi Bitterman, Iva Mucalo, Cristina Mihaela Ghiciuc, Tamás Ágh","doi":"10.1080/14737167.2024.2373184","DOIUrl":"10.1080/14737167.2024.2373184","url":null,"abstract":"<p><strong>Background: </strong>This study aims to create a comprehensive framework for the development and implementation of digital medication adherence technologies (DMATech), focusing on critical stages where engagement of medication users (MU) is considered meaningful, i.e. adds significant value, as agreed upon by participating stakeholders.</p><p><strong>Methods: </strong>Through a literature review and expert consensus, a framework was outlined covering key DMATech development and implementation phases and steps. An in-person workshop with MU representatives and adherence experts, using the Nominal Group Technique, further refined these stages for MU engagement.</p><p><strong>Results: </strong>The DMATech framework included three phases: 'Innovation,' 'Research and Development,' and 'Launch and Implementation,' each encompassing multiple steps. The workshop, attended by five MU representatives and nine adherence experts, identified critical stages for MU input including context analysis, ideation, proof of concept, prototype creation, DMATech's iteration, critical evaluation, healthcare implementation, real-world assessment, and improvement. Nevertheless, there was a divergence of consensus regarding the importance of MUs engagement in regulatory, financial, and marketing aspects.</p><p><strong>Conclusions: </strong>This study provides a holistic framework for DMATech development and implementation and underscores the necessity of MU engagement at various stages. Modes of MU engagement cannot be generalized; a case-by-case evaluation of engagement strategies is essential.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"853-860"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-09DOI: 10.1080/14737167.2024.2378178
Tamás Ágh, Mickaël Hiligsmann
{"title":"Bridging the gap: enhancing medication adherence through research and innovation.","authors":"Tamás Ágh, Mickaël Hiligsmann","doi":"10.1080/14737167.2024.2378178","DOIUrl":"10.1080/14737167.2024.2378178","url":null,"abstract":"","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"773-775"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-10DOI: 10.1080/14737167.2024.2377663
Siraj Al-Obaidi, Rima Hijazeen, Rasha M Arabyat, Ibrahim Alabbadi
Background: Recent practice guidelines favor direct oral anticoagulants (DOACs) over warfarin for primary stroke prevention in patients with non-valvular atrial fibrillation (NVAF). However, challenges persist in Iraq's private pharmaceutical sector. DOACs have been sold at high and inconsistent retail prices and lack insurance coverage, leading to significant out-of-pocket (OOP) costs. The objective of this study is to investigate the impact of OOP costs on oral anticoagulants (OAC) adherence among NVAF patients.
Research design and methods: This multicenter cross-sectional study interviewed 359 eligible patients attending three private cardiology clinics within Iraq's southern region from December 2022 to February 2023. The 8-item Morisky Adherence Scale evaluated patient adherence. Statistical analyses, including descriptive analysis, ANOVA, and chi-square. p < 0.05 was considered statistically significant.
Results: The most frequently prescribed OAC were DOACs (62.8%). Patient adherence level to OAC was chiefly medium (54.6%) with no significant difference in adherence based on OAC type. Patient adherence was significantly associated with monthly income (p = 0.001), number of daily pills (p = 0.006), and OACs' average monthly cost (p = 0.011).
Conclusion: Addressing the issue of cost-related non-adherence to OACs requires multiple actions. These include ensuring comprehensive health insurance coverage for OACs, increasing the use of affordable generic alternatives, and establishing effective cost-related discussions between healthcare providers and patients.
{"title":"Adherence to oral anticoagulants in patients with non-valvular atrial fibrillation: the role of patients' characteristics and out-of-pocket payments.","authors":"Siraj Al-Obaidi, Rima Hijazeen, Rasha M Arabyat, Ibrahim Alabbadi","doi":"10.1080/14737167.2024.2377663","DOIUrl":"10.1080/14737167.2024.2377663","url":null,"abstract":"<p><strong>Background: </strong>Recent practice guidelines favor direct oral anticoagulants (DOACs) over warfarin for primary stroke prevention in patients with non-valvular atrial fibrillation (NVAF). However, challenges persist in Iraq's private pharmaceutical sector. DOACs have been sold at high and inconsistent retail prices and lack insurance coverage, leading to significant out-of-pocket (OOP) costs. The objective of this study is to investigate the impact of OOP costs on oral anticoagulants (OAC) adherence among NVAF patients.</p><p><strong>Research design and methods: </strong>This multicenter cross-sectional study interviewed 359 eligible patients attending three private cardiology clinics within Iraq's southern region from December 2022 to February 2023. The 8-item Morisky Adherence Scale evaluated patient adherence. Statistical analyses, including descriptive analysis, ANOVA, and chi-square. <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The most frequently prescribed OAC were DOACs (62.8%). Patient adherence level to OAC was chiefly medium (54.6%) with no significant difference in adherence based on OAC type. Patient adherence was significantly associated with monthly income (<i>p</i> = 0.001), number of daily pills (<i>p</i> = 0.006), and OACs' average monthly cost (<i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>Addressing the issue of cost-related non-adherence to OACs requires multiple actions. These include ensuring comprehensive health insurance coverage for OACs, increasing the use of affordable generic alternatives, and establishing effective cost-related discussions between healthcare providers and patients.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"845-852"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-03-25DOI: 10.1080/14737167.2024.2334893
Ahmad Z Al Meslamani, Nannan Li
{"title":"Assessing the economic impact of digital endpoints on medication adherence.","authors":"Ahmad Z Al Meslamani, Nannan Li","doi":"10.1080/14737167.2024.2334893","DOIUrl":"10.1080/14737167.2024.2334893","url":null,"abstract":"","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"783-785"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-24DOI: 10.1080/14737167.2024.2370911
Jessica Q Duong, Ryan F Bloomquist, Steven R Feldman
Introduction: Medication non-adherence is a major contributor to suboptimal disease treatment across medical specialties and is a particular hurdle with topicals. While adherence is a patient behavior affected by many socioeconomic and health system factors, physicians can play an important role in encouraging good adherence.
Areas covered: We discuss methods for measuring adherence, including ethics of such research, provide select examples of dermatology-specific adherence studies, and conclude with physician-focused practices to improve patients' adherence. Articles were selected from a PubMed search spanning 2003 to 10 December 2023, using the following terms: 'dermatology,' 'medication,' 'treatment,' 'adherence,' 'compliance,' and 'intervention.'
Expert opinion: Poor adherence to treatment is a major cause of poor treatment outcomes. As the goal of medical care is to achieve successful treatment outcomes, encouraging good adherence may be as much a foundation of care as making the right diagnosis and prescribing the right treatment. Taking a doctor-centric perspective on reasons for non-adherence may be more productive than simply finding fault with the patient. Establishing trust and accountability is a foundation for good adherence; after establishing the provider-patient relationship, physicians can improve adherence by incorporating behavioral and counseling strategies, communicating through technology, and advocating for distribution of validated educational information.
{"title":"How can physicians improve medication adherence and outcomes in dermatological conditions?","authors":"Jessica Q Duong, Ryan F Bloomquist, Steven R Feldman","doi":"10.1080/14737167.2024.2370911","DOIUrl":"10.1080/14737167.2024.2370911","url":null,"abstract":"<p><strong>Introduction: </strong>Medication non-adherence is a major contributor to suboptimal disease treatment across medical specialties and is a particular hurdle with topicals. While adherence is a patient behavior affected by many socioeconomic and health system factors, physicians can play an important role in encouraging good adherence.</p><p><strong>Areas covered: </strong>We discuss methods for measuring adherence, including ethics of such research, provide select examples of dermatology-specific adherence studies, and conclude with physician-focused practices to improve patients' adherence. Articles were selected from a PubMed search spanning 2003 to 10 December 2023, using the following terms: 'dermatology,' 'medication,' 'treatment,' 'adherence,' 'compliance,' and 'intervention.'</p><p><strong>Expert opinion: </strong>Poor adherence to treatment is a major cause of poor treatment outcomes. As the goal of medical care is to achieve successful treatment outcomes, encouraging good adherence may be as much a foundation of care as making the right diagnosis and prescribing the right treatment. Taking a doctor-centric perspective on reasons for non-adherence may be more productive than simply finding fault with the patient. Establishing trust and accountability is a foundation for good adherence; after establishing the provider-patient relationship, physicians can improve adherence by incorporating behavioral and counseling strategies, communicating through technology, and advocating for distribution of validated educational information.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"799-806"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}