Preference for sublingual immunotherapy with tablets in a Spanish population with allergic rhinitis.

Background: This study investigated patients' preference for allergy immunotherapy (AIT) administered as either sublingual immunotherapy-tablets versus monthly or weekly subcutaneous immunotherapy (SCIT) from a Spanish patient perspective.

Methods: A discrete choice experiment (DCE) consisting of two blocks with eight choice sets in each was constructed to elicit the preferences for AIT. Three attributes were included in the DCE for the mode of administration, including the frequency of administration, the risk of systemic reactions and the co-payment.

Preference for Immunotherapy with Tablets by People with Allergic Rhinitis.

Background: People with allergic rhinitis (AR) who are not controlled on conventional therapy can be treated using allergy immunotherapy (AIT) administered as tablets, injections or drops. In the US, the use of sublingual immunotherapy as tablets (SLIT-tablets) is limited in comparison to subcutaneous immunotherapy (SCIT).

Objective: This study investigated patients' preference for SLIT-tablets vs monthly or weekly SCIT from a US patient perspective.

Subcutaneous immunotherapy takes more than the time in the clinic.

Objective: The aim of this study was to investigate the time use and both direct and indirect costs associated with subcutaneous immunotherapy (SCIT) for adults with allergic rhinitis (AR) and caregivers of children with AR in the US.

Methods: We conducted a survey to assess the retrospective time use and direct costs of SCIT. The populations surveyed included adults and caregivers of children (aged 5-17) with symptomatic AR of moderate or higher severity who are currently receiving or have previously started allergy immunotherapy (AIT).

Real-world evidence costs of allergic rhinitis and allergy immunotherapy in the commercially insured United States population.

Objective: To assess total and allergic rhinitis (AR)-related healthcare costs among AR patients residing in the United States with a focus on patients persisting with AIT.

Methods: AR patients were identified in the IBM MarketScan database between 1 January 2014 to 31 March 2017. Patients receiving allergy immunotherapy (AIT) were identified with relevant billing codes (earliest AIT claim = index date); non-AIT patients were identified with claims containing a diagnosis code for AR (earliest AR claim = index date).

Real-world mapping of allergy immunotherapy in the United States: The argument for improving adherence.

There is a dearth of real-world evidence studies focused on allergy immunotherapy (AIT) use among patients with allergic rhinitis (AR). This study examined claims data of AR patients residing in the United States to assess patient characteristics and health outcomes. AR patients were identified in the IBM MarketScan database between January 1, 2014, and March 31, 2017.

Evidence supporting an association between hypoglycemic events and depression.

Objectives: This retrospective study investigated the association between hypoglycemic events (HEs) and depression events (DEs) in patients with diabetes mellitus (type 1 and type 2).

Methods: Analyzed data were from health care claims for individuals with employer-sponsored primary or Medicare supplemental insurance from the Thomson Reuters Market Scan database during the years 2008 and 2009. A baseline period (January 2008 to December 2008) was used to identify eligible patients and collect baseline clinical and demographic characteristics.

Differences in rates of hypoglycemia and health care costs in patients treated with insulin aspart in pens versus vials.

Objectives: To study whether initiation of insulin aspart therapy with a pen vs. a vial/syringe has an impact on the risk of subsequent hypoglycemic episodes and health care costs.

Methods: This was a longitudinal, retrospective analysis of the MarketScan and IMS LifeLink health plan claims databases for patients with type 1 or type 2 diabetes who initiated insulin aspart with a pen or a vial/syringe.

Assessing achievement and maintenance of glycemic control by patients initiating basal insulin.

Objective: Describe characteristics of diabetic patients who initiated basal insulin and assess their glycemic control.

Research Design And Methods: Physician encounters in the General Electric EMR Database (2005-2010) were assessed for patients with type II diabetes (T2DM) who initiated basal insulin between February 2006 and August 2009, with initiation defined as no prescription record of insulin in prior 15 months. Patients were followed for an average 2.

Association between hypoglycaemic events and fall-related fractures in Medicare-covered patients with type 2 diabetes.

Aims: This retrospective observational study examined the association between International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)-coded outpatient hypoglycaemic events and fall-related fractures in Medicare-covered patients with type 2 diabetes.

Methods: Data were derived from healthcare claims for individuals with employer-sponsored Medicare supplemental insurance. The study period consisted of two consecutive 1-year periods; the baseline period (1 April 2008 to 31 March 2009) and the evaluation period (1 April 2009 to 31 March 2010).

Administration burden associated with recombinant human growth hormone treatment: perspectives of patients and caregivers.

Patients treated with recombinant human growth hormone (rhGH) for growth hormone disorders follow a challenging treatment schedule. This study assessed patient and caregiver experiences with rhGH therapy treatment regimens. Patients 13 years or older with growth hormone deficiency and caregivers completed Web-based surveys.

Cost of self-monitoring of blood glucose in the United States among patients on an insulin regimen for diabetes.

Background: People with diabetes are at an increased risk of developing numerous complications, resulting in increased health care expenditures, economic burden, and higher mortality. For patients using an insulin pump or multiple insulin injections, self-monitoring of blood glucose (SMBG) is recognized as a core component of effective diabetes self-management. However, little is known about the real-world frequency and true costs associated with SMBG as a percentage of an insulin regimen in the United States.

Cost-effectiveness of insulin detemir: a systematic review.

The prevalence of diabetes and cost of associated treatment are steadily increasing, as is the resulting burden on healthcare systems worldwide. Current treatment recommendations for Type 1 and Type 2 diabetes advise a prominent role for basal insulin. We examined the published health-economic literature pertaining to the basal insulin analog insulin detemir (IDet) to determine whether IDet is a cost-saving and/or cost-effective treatment for suboptimally controlled Type 1 or Type 2 diabetes.

Coverage of insulin delivery devices and basal insulin analogs by US managed care organizations.

Objective: The perception in the US is that insulin formulations prescribed for type 1 and type 2 diabetes and delivered via insulin pens are more costly to patients than the same or similar products provided in vials, and that basal insulin analogs offered either in pens or vials are likewise more costly to patients than human insulin formulations. This study compares levels of coverage and copays by private and Medicare Part D plans for insulin pens and vials containing basal insulin analogs and for NPH formulations in vials.

Methods: A commercially available formulary database (Access Point, Pinsonault Associates; updated quarterly) was analyzed as of January 2010 for private insurance plans and as of March 2010 for Medicare Part D plans.

Adherence and persistence to a regimen of basal insulin in a pre-filled pen compared to vial/syringe in insulin-naïve patients with type 2 diabetes.

Objective: This study was conducted to compare adherence and persistence of patients initiating basal insulin therapy with Levemir FlexPen versus those initiating basal insulin therapy with NPH via vial and syringe.

Materials And Methods: Data were gathered from a large US retrospective claims database, and included patients with type 2 diabetes that initiated basal insulin therapy with either Levemir FlexPen or NPH in vials. Patients were defined as adherent to therapy if they had a medication possession ratio (MPR) of ≥80% in the 12-month follow-up period and were defined as persistent with therapy if they had no gaps in insulin therapy in the follow-up period.

Economic benefits of improved insulin stability in insulin pumps.

Purpose: Insulin pump users discard unused medication and infusion sets according to labeling and manufacturer's instructions. The stability labeling for insulin aspart (rDNA origin] (Novolog) was increased from two days to six. The associated savings was modeled from the perspective of a hypothetical one-million member health plan and the total United States population.

Evidence linking hypoglycemic events to an increased risk of acute cardiovascular events in patients with type 2 diabetes.

Objective: This retrospective study examined the association between ICD-9-CM-coded outpatient hypoglycemic events (HEs) and acute cardiovascular events (ACVEs), i.e., acute myocardial infarction, coronary artery bypass grafting, revascularization, percutaneous coronary intervention, and incident unstable angina, in patients with type 2 diabetes.

Concurrent control of blood glucose, body mass, and blood pressure in patients with type 2 diabetes: an analysis of data from electronic medical records.

Objective: This cross-sectional study describes glycemic, body mass, and blood pressure (BP) control in patients with type 2 diabetes mellitus (T2DM) in an ambulatory care-based database of electronic medical records (EMRs).

Methods: Patients aged ≥18 years with T2DM documented in 2008 and with glycosylated hemoglobin (HbA(1c)) value, body mass index (BMI), and BP charted within 90 days before or after T2DM documentation were identified using the General Electric Centricity EMR research database. Control of glycemia (controlled, <7.

Human growth hormone treatment: synthesis of literature on product delivery systems and administration practices.

Purpose: To synthesize current literature on recombinant human growth hormone (rhGH) use and to identify areas of research that have received little to no attention in light of administration practice and patient perception/behavior.

Design And Methods: Relevant articles for a systematic review were identified through PubMed.

Results: A total of 43 articles were identified: 9 (15.

Association between glycemic control and short-term healthcare costs among commercially insured diabetes patients in the United States.

Unlabelled: Abstract Objectives: Glycemic control, measured by HbA(1c), is well known to be a risk marker for long-term costly diabetes-related complications. The relationship between HbA(1c) and short-term costs is unclear. This study investigates how HbA(1c) is correlated to short-term diabetes-related medical expenses.

Does type of bolus insulin matter in the hospital? Retrospective cohort analysis of outcomes between patients receiving analogue versus human insulin.

Background: Poor glycemic control in hospitalized patients has been associated with increased morbidity and mortality. Research suggests that analogue bolus insulin may be more effective in achieving blood glucose (BG) control compared with human bolus insulin.

Objective: This study compares mortality, length of stay (LOS), costs, and BG control in hospitalized patients receiving either analogue or human bolus insulin.

Evaluation of the long-term cost-effectiveness of insulin detemir compared with neutral protamine hagedorn insulin in patients with type 1 diabetes using a basal-bolus regimen in Sweden.

Aims: To evaluate the long-term clinical and economic outcomes associated with insulin detemir and neutral protamine hagedorn (NPH) insulin in combination with mealtime insulin aspart in patients with type 1 diabetes in Sweden, based on data from a two-year, multi-national, open-label, randomized, controlled trial.

Methods: Insulin detemir was associated with significant improvements in glycaemic control after 24 months (HbA1c 7.36% versus 7.

Cost of diabetes: comparison of disease-attributable and matched cohort cost estimation methods.

Objective: To estimate and compare the annual direct healthcare cost among Type 1 (T1DM) and Type 2 (T2DM) diabetes patients using two cost estimation methods: (1) DM-attributable cost and (2) all cause case-control cost.

Research Design And Methods: An administrative claims cohort study using the HealthCore Integrated Research Database (HIRD(R)) identified T1DM and T2DM patients age >or=18 and <65 years between 1/1/2006 - 12/31/2006. DM patients (cases) were matched 1:1 with non-DM patients (controls) by age, gender, state, and commercial plan type (HMO, PPO, POS).

Assessment of adherence and healthcare costs of insulin device (FlexPen) versus conventional vial/syringe.

Introduction: Diabetes is difficult to manage and treatment involves significant lifestyle adjustments. Unlike the traditional method of insulin administration via the vial and syringe method, insulin pens might be perceived as less cumbersome and have potential to significantly increase patient adherence.

Methods: Using "real world" data, we examined the differences in adherence and costs between diabetic patients using an insulin FlexPen (Novo Nordisk Inc, Princeton, NJ, USA) and those using traditional vial and syringe administration.

Cost-effectiveness of switching to biphasic insulin aspart from human premix insulin in a US setting.

Objectives: To evaluate the cost-effectiveness of switching to biphasic insulin aspart (BIAsp 30) from human premix insulin for type 2 diabetes patients in the United States (US) setting.

Methods: The previously published and validated IMS Core Diabetes Model was used to project life expectancy, quality-adjusted life expectancy (QALE) and costs over 30 years. Patient characteristics and treatment effects were based on Canadian patients included the IMPROVE observational study (n = 311).

Healthcare utilization changes in relation to treatment intensification with insulin aspart in patients with type 2 diabetes. Data from a large US managed-care organization.

Objective: Most patients with type 2 diabetes eventually require exogenous insulin therapy to achieve good glycemic control due to the progressive nature of the disease. Insulin aspart is a rapid-acting insulin analog developed for prandial use. This study aimed to illustrate the implications on healthcare costs of adding insulin aspart to basal therapy in a real-world setting.