Cost-effectiveness analysis of Mammostrat® compared with Oncotype DX® to inform the treatment of breast cancer.

Purpose: To compare the cost-effectiveness of the tumor subtyping assays Mammostrat® and Oncotype DX® for assessing risk of recurrence in early-stage breast cancer and the potential benefit of adjuvant chemotherapy.

Methods: Cost-effectiveness analysis from a US third-party payer perspective. A 10 year Markov model was developed to estimate costs and effects of using each method of risk assessment.

Cost effectiveness analysis of a next generation risk assessment score for cardiovascular disease.

Objectives: The goal of this study is to determine the cost-effectiveness of MIRISK VP, a next generation coronary heart disease risk assessment score, in correctly reclassifying and appropriately treating asymptomatic, intermediate risk patients.

Study Design: A Markov model was employed with simulated subjects based on the Multi-Ethnic Study of Atherosclerosis (MESA). This study evaluated three treatment strategies: (i) practice at MESA enrollment, (ii) current guidelines, and (iii) MIRISK VP in MESA.

Evaluation of economic efficiencies in clinical retina practice: activity-based cost analysis and modeling to determine impacts of changes in patient management.

Background: The purpose of this study is to report the use of activity-based cost analysis to identify areas of practice efficiencies and inefficiencies within a large academic retinal center and a small single-specialty group. This analysis establishes a framework for evaluating rapidly shifting clinical practices (anti-vascular endothelial growth factor therapy, microincisional vitrectomy surgery) and incorporating changing reimbursements for care delivery (intravitreal injections, optical coherence tomography [OCT]) to determine the impact on practice profitability. Pro forma modeling targeted the impact of declining reimbursement for OCT imaging and intravitreal injection using a strategy that incorporates activity-based cost analysis into a direct evaluation schema for clinical operations management.

Cost-effectiveness of 70-gene MammaPrint signature in node-negative breast cancer.

Objective: To evaluate the cost-effectiveness of 70-gene MammaPrint signature (Agendia Inc, Huntington Beach, CA) vs Adjuvant! Online software (AS) (http://www.adjuvantonline.com) in patients 60 years or younger with early-stage breast cancer.

Development of an activity-based costing model to evaluate physician office practice profitability.

Objective: Newer treatment regimens for age-related macular degeneration have significantly affected traditional and non-traditional retinal services across all types of practice settings around the country as they seek to find a balance among delivering best patient care, keeping operating costs under control, and maintaining profitability.

Design: A systematic retrospective review of a multi-city, multi-physician retinal practice's accounting system to obtain data on revenues, expenses, and profit. Data reviewed were from practice management systems to obtain claims level data on clinical procedures across 7 primary activity centers: non-laser surgery, laser surgery, office visits, optical coherence tomography (OCT), non-OCT diagnostics, drugs and drug injections, and research.

Sleep apnea testing and outcomes in a large cohort of Medicare beneficiaries with newly diagnosed heart failure.

Rationale: Previous studies have demonstrated a high prevalence of sleep apnea (SA) in patients with chronic heart failure (HF), which is associated with higher rates of morbidity, mortality, and health care use.

Objectives: To investigate the reported incidence, treatment, outcomes, and economic cost of SA in new-onset HF in a large U.S.

Economic burden of plantar fasciitis treatment in the United States.

Although plantar fasciitis (PF) is prevalent among adults in the United States, few studies have quantified the economic burden of this condition. In the present study, which was based on PF treatment patterns identified by Riddle and Schappert in 2004, we quantified the costs of treatment and explored the magnitude of the burden on third-party payers. Costs for these established treatment options were obtained from 2007 fee schedules and relative value units released by the Centers for Medicare and Medicaid Services.

Surgical treatment patterns among Medicare beneficiaries newly diagnosed with lumbar spinal stenosis.

Background Context: Lumbar spinal stenosis (LSS) is a prevalent degenerative condition in the elderly that can be managed medically or with surgical treatments. Recent studies have shown an increase in the utilization of surgery in the United States and great regional variations. An understanding of treatment patterns and costs in a population-based setting will help identify subgroup differences to help inform strategies for optimal care in patients with LSS.

Costs and rehabilitation use of stroke survivors: a retrospective study of Medicare beneficiaries.

Objective: To examine mortality, costs, and rehabilitation use in patients with stroke and stroke-related hemiparesis during a 4-year period following stroke onset.

Method: This study was a retrospective, longitudinal claims analysis. Patients newly diagnosed with stroke and discharged from the hospital were identified from a 5% random sample of Medicare beneficiaries.