No description available.

No description available.

Aim: Biosimilar medicines offer significant cost-savings potential over their reference products, which can be re-allocated to provide access to other cancer treatments on a budget-neutral basis. Methods: Simulation study using cost data for the USA under consideration of several prophylaxis patterns. Results: Potential savings from conversion from reference filgrastim to biosimilar filgrastim-sndz are significant. These savings expand budget-neutral access to novel immunotherapies (obinutuzumab; pembrolizumab) or supportive care (filgrastim-sndz). Conclusion: The combination of biosimilar savings and expanded access increases the value of cancer care as the same supportive care is provided at lower cost, additional cancer care is enabled at no additional cost, and more patients will have access to cancer care.

Introduction: Awareness and usage of Electronic cigarettes (e-cigs) among smokers have increased rapidly over the past few years, majorly in quitting smoking. The main objectives for this study were: 1) To estimate the prevalence and study sociodemographic predictors for e-cigs use among individuals with Chronic Obstructive Pulmonary Disease (COPD) 2) To examine the predictors and estimate the total healthcare costs among current smokers with COPD 3) To estimate the economic impact of adopting e-cigs as a smoking cessation tool among current smokers with COPD. Methods: The National Health Interview Survey data from the year 2014 was utilized to estimate the prevalence and identify sociodemographic predictors associated with e-cigs use among COPD adult population. Total healthcare costs and sociodemographic and clinical predictors among current smokers with COPD were estimated using the Medical Expenditure Panel Survey data from the year 2012-2013. Economic impact for adoption of e-cigs was obtained by developing an epidemiological cohort-Markov model from a societal perspective over the period of 5-year. The targeted population was current smokers with COPD and willing to quit smoking. Smoking abstinence for e-cigs was compared with Varenicline, Bupropion, and Nicotine Replacement therapy. Outcomes evaluated were the 1-year and accumulated 5-year total healthcare costs savings associated with e-cigs over other options. Results: Among individuals with COPD, 8.65% and 24.37% were current and ever e-cig users respectively. Current e-cigs use was found to be associated with individuals who have tried quitting smoking in the past (OR: 2.0; 95%CI: 1.05, 3.97). Adjusted total healthcare costs per patient per year among current smokers with COPD were found to be higher by $1,811 in comparison to non-smokers with COPD. The adoption of e-cigs among COPD current smokers can have a positive impact on the healthcare budget and can lead to healthcare cost savings of $37.71 million over the period of 5-year. Furthermore, a positive impact on budget were found among women and individuals with age 65 & above. Conclusion: E-cigs may be beneficial to the current US healthcare system if adopted as a smoking cessation tool among COPD individuals. However, uncertainty associated with product safety, efficacy and adherence for cessation warrants further studies and evaluation.

<p><strong>Background </strong></p> <p>The EQ-5D is one of the most widely used instruments to measure health status. It consists of a descriptive profile with a corresponding scoring algorithm. Multiple scoring algorithms have since been developed from EQ-5D preference elicitation studies.</p> <p><strong>Objectives </strong></p> <p>To identify key methodological issues in the construction of EQ-5D preference elicitation studies and to assess the validity of using a standard methodology in the construction of EQ-5D scoring algorithms.</p> <p><strong>Search methods </strong></p> <p>We searched the MEDLINE, EMBASE, Cochrane Library, NHS Economic Evaluation Database, and Health Economic Evaluation Database, (1990 to 2012). The EuroQol Group website was also searched.</p> <p><strong>Selection criteria </strong></p> <p>EQ-5D preference elicitation studies that reported the directly estimated health state scores and estimated scoring algorithm.</p> <p><strong>Data collection and analysis </strong></p> <p>Two reviewers independently assessed articles for inclusion. The observed and estimated EQ-5D preference scores were compared across studies. A standard scoring algorithm with fixed variables was estimated. The model performance of the standard algorithm and the study reported algorithm were assessed and compared.</p> <p><strong>Results </strong></p> <p>A total of 38 preference elicitation studies were included in this review. Key differences identified include: method of valuation, selection of health states, transformation of health state values, and method of estimation of the scoring algorithm. The observed health state values were found to be significantly different. The predicted health state values showed high levels of rank correlation. In general, a standard scoring algorithm was found to be no different in model performance than study specific scoring algorithms, with only three studies reporting a significant better model performance using the study specified scoring algorithm.</p> <p><strong>Conclusion</strong></p> <p>Methodological differences were identified across EQ-5D valuation studies. A standard scoring algorithm may yield similar model performance to study specific scoring algorithms, however further research is needed to identify when the use of a standard algorithm is appropriate.</p> / Master of Science (MSc)

Class of 2007 Abstract / Objectives: To evaluate the impact of a training program in health outcomes and pharmacoeconomics (PE) to determine how it has impacted PE application in the workplace and what topics and teaching methods are most useful to participants. Methods: This study is a descriptive study of data obtained through a questionnaire that surveyed course participants from the 2005 and 2006 University of Arizona Health Outcomes and PharmacoEconomic Center training programs. Results: There were a total of 20 respondents from the two programs, 70% had a pharmacy background and 55% practice in a pharmaceutical industry setting. The respondents felt that lecture based workshops were the most helpful and 90% responded that the program enhanced their communication with colleagues regarding PE and outcomes research. Conclusions: The program participants benefited from participation in the training program and have integrated material from the training program into the workplace. Lecture and case-based workshops were the most useful teaching methods used in the training program.

Class of 2006 Abstract / Objectives: To investigate the types of information and resources either used or required for the management of products in the pipeline as perceived by decision-makers in the biotechnology and pharmaceutical (B&P) industries. More specifically, the objectives are to ascertain the strategic use of pharmacoeconomic (PE), financial, and decision- making tools and financing requirements amongst pipeline candidates. Methods: A study-specific survey instrument was used for the project. In detail, this survey is based upon the use of financial, PE, and decision-making tools for drug product development. Approximately 396 B&P firms were surveyed via postal mail, wherein the primary contact was the Chief Financial Officer (CFO). If the CFO was not listed on the firm’s website, the survey will be addressed to the Business and Development Officer (BDO) or Chief Executive Officer (CEO). The companies’ information will be identified by use of publicly-available databases. A modified form of a total survey design will be used for the postal mailings, including one initial mailing with a cover letter and survey, a follow-up reminder postcard, a second cover letter and survey for non-responders, and a final follow-up reminder postcard then after. Results: Survey instruments were completed by 20 firms, with 5 of them from public firms and 15 from the private sector. Capital and regulatory requirements and investor expectations are the most important factors considered during early and late phase clinical trials. Net present value (NPV) and internal rate of return (IRR) are the most commonly used financial analytic tools used for making research and development (R&D) decisions. PE are reported to be first used during all clinical phases prior to Food and Drug Administration (FDA) approval, and most drug candidates undergo formal PE evaluations. PE is also used in various areas of R&D and marketing components, such as licensing and go/no-go decisions. Capital/securities markets and venture capital (VC) are the primary sources of capital used in the development of a new drug. VC is important during all phases of R&D and numerous VC firms get involved. B&P firms disagree that VC companies should be involved with the managerial roles of the firm. Conclusions: It has been determined that the strategic use of PE, financial and decision-making tools, and capital requirements amongst pipeline candidates are important during all phases of R&D.

Background: Pharmacy-related performance measures have gained significant attention in the transition to value-based healthcare. Pharmacy-level quality measures, including those developed by the Pharmacy Quality Alliance, are not yet publicly accessible. However, the publication of report cards for individual pharmacies has been discussed as a way to help direct patients towards high-quality pharmacies. This study aimed to measure the relative strength of patient preferences for community pharmacy attributes, including pharmacy quality. Additionally, this study aimed to identify and describe community pharmacy market segments based on patient preferences for pharmacy attributes. Methods: This study elicited patient preferences for community pharmacy attributes using a discrete choice experiment (DCE) among a sample of 773 adults aged 18 years and older. Six attributes were selected based on published literature, expert opinion, and pilot testing feedback. The attributes included hours of operation, staff friendliness/courtesy, pharmacist communication, pharmacist willingness to establish a personal relationship, overall quality, and a drug-drug interaction specific quality metric. Participants responded to a block of ten random choice tasks assigned by Sawtooth v9.2 and two fixed tasks, including a dominant and a hold-out scenario. The data were analyzed using conditional logit and latent class regression models, and Hierarchical Bayes estimates of individual-level utilities were used to compare preferences across demographic subgroups. Results: Among the 773 respondents who began the survey, 741 (95.9%) completed the DCE and demographic questionnaire. Overall, study participants expressed the strongest preferences for quality-related pharmacy attributes. The attribute importance values (AIVs) were highest for the specific, drug-drug interaction (DDI) quality measure, presented as, “The pharmacy ensured there were no patients who were dispensed two medications that can cause harm when taken together,” (40.3%) and the overall pharmacy quality measure (31.3%). The utility values for 5-star DDI and overall quality ratings were higher among women (83.0 and 103.8, respectively) than men (76.2 and 94.5, respectively), and patients with inadequate health literacy ascribed higher utility to pharmacist efforts to get to know their patients (26.0) than their higher literacy counterparts (16.3). The best model from the latent class analysis contained three classes, coined the Quality Class (67.6% of participants), the Relationship Class (28.3%), and the Convenience Class (4.2%). Conclusions: The participants in this discrete choice experiment exhibited strong preferences for pharmacies with higher quality ratings. This finding may reflect patient expectations of community pharmacists, namely that pharmacists ensure that patients are not harmed by the medications filled at their pharmacies. Latent class analysis revealed underlying heterogeneity in patient preferences for community pharmacy attributes.

Introduction The main objectives of this study were: 1) to examine the prevalence and characteristics of opioid exposures, 2) to estimate the economic costs associated with opioid poisonings, and 3) to examine the characteristics associated with opioid poisoning-related health care resource use (HCRU) and costs in children. Methods Data from the National Poison Data System from January 1, 2010 to December 31, 2014 were utilized to examine the prevalence and characteristics of opioid exposures and poisonings in children <18 years. Economic costs were estimated using the 2012 Nationwide Emergency Department Sample, Kids’ Inpatient Database, Multiple Cause-of-Death file and other published sources, applying a societal perspective. Direct costs included costs associated with ED visits, hospitalizations and ambulance transports. Indirect cost included productivity costs due to caregivers’ absenteeism and premature mortality among children. Results There were a total of 83,418 pediatric opioid exposures and nearly half of them resulted in poisoning. The epidemiology of opioid exposures differed considerably by age. Opioid exposures were more prevalent and mainly accidental in young children. Exposures in adolescents were more likely to be intentional and severe. The total economic costs of pediatric opioid poisonings in the United States were calculated at $230.8 million in 2012. Total direct costs were estimated to be over $21.1 million. Total productivity costs were calculated at $209.7 million, and 98.6% of these costs were attributed to opioid poisoning-related mortality. Conclusions Opioid exposures and poisonings in children continue to occur and impose an economic burden on the society.

No description available.