Treatment Patterns, Healthcare Resource Utilization, and Costs Among Patients Diagnosed With Locally Advanced/Metastatic Urothelial Carcinoma Prior to Receiving Enfortumab Vedotin: A Real-World Evidence Study.

Objective: To describe real-world patient characteristics, prior treatment patterns, and associated healthcare resource utilization (HRU) and costs among patients with locally advanced/metastatic urothelial carcinoma (la/mUC) treated with enfortumab vedotin (EV).

Methods: This retrospective study used the United States (US) Centers for Medicare and Medicaid Services 100% Medicare claims data from 2015 to 2020. Included patients had a diagnosis of la/mUC and received treatment with EV.

Real-world survival and economic burden among patients with locally advanced or metastatic urothelial carcinoma in the United States.

Background: Given the changing treatment landscape for locally advanced or metastatic urothelial carcinoma (la/mUC), this study aimed to describe real-world treatments, overall survival (OS), health care resource utilization (HCRU), and costs among US patients with la/mUC receiving first-line therapy.

Methods: This retrospective study was conducted using 100% Medicare claims data (2015-2020). Patients with la/mUC were selected; initiation of first-line therapy was the index date.

Real-World Treatment Patterns and Clinical Outcomes in Patients With Locally Advanced or Metastatic Urothelial Carcinoma by Eligibility for Maintenance Avelumab.

Introduction: 1L PBC has historically been recommended for patients with la/mUC. Maintenance avelumab is recommended for patients without disease progression following 1L PBC. Real-world data on the proportion of patients eligible for maintenance avelumab are limited, and outcomes among patients ineligible for maintenance avelumab are uncertain.

Patient Preferences for First-Line Treatment of Locally Advanced or Metastatic Urothelial Carcinoma: An Application of Multidimensional Thresholding.

Objectives: Patient preferences have the potential to influence the development of new treatments for locally advanced/metastatic urothelial carcinoma (la/mUC), and therefore we explored how patients with la/mUC value different attributes of first-line treatments.

Methods: An online preference survey and multidimensional thresholding (MDT) exercise were developed following a targeted literature review and qualitative interviews with physicians, patients with la/mUC, and their caregivers. Treatment attributes included two benefits (overall response rate [ORR], pain related to bladder cancer [scored 0-100; 100 being the worst pain possible]) and four treatment-related risks (peripheral neuropathy, severe side effects, mild to moderate nausea, mild to moderate skin reactions).

The real world experience of pediatric primary hyperoxaluria patients in the PEDSnet clinical research network.

The rarity of primary hyperoxaluria (PH) challenges our understanding of the disease. The purpose of our study was to describe the course of clinical care in a United States cohort of PH pediatric patients, highlighting health service utilization. We performed a retrospective cohort study of PH patients < 18 years old in the PEDSnet clinical research network from 2009 to 2021.

Clinical and economic impact of primary hyperoxaluria: a retrospective claims analysis.

Primary hyperoxaluria (PH) is a family of rare, life-threatening genetic liver disorders characterized by elevated production and excretion of oxalate. To date, the clinical and economic burden associated with PH has not been well characterized due to the rarity of the disease and previous challenges with diagnostic coding that prevented proper identification of patients with PH in claims data. To characterize the clinical and economic costs, as well as health care resource utilization (HCRU), associated with PH relative to a matched cohort of patients without PH.

Cost-effectiveness of vortioxetine compared with levomilnacipran and vilazodone in patients with major depressive disorder switching from an initial antidepressant.

Many patients with major depressive disorder (MDD) do not achieve remission with their first antidepressant (AD), resulting in a high burden due to treatment failure. Vortioxetine is a valid treatment option for patients with MDD only partially responding to their first AD. Characterization of vortioxetine's potential benefits versus other approved treatments is important.

Modeling the impact of patient treatment preference on health outcomes in relapsing-remitting multiple sclerosis.

Model how moving from current disease-modifying drug (DMD) prescribing patterns for relapsing-remitting multiple sclerosis (RRMS) observed in the United Kingdom (UK) to prescribing patterns based on patient preferences would impact health outcomes over time. A cohort-based Markov model was used to measure the effect of DMDs on long-term health outcomes for individuals with RRMS. Data from a discrete choice experiment were used to estimate the market shares of DMDs based on patient preferences (i.

Adapting the Goal Attainment Approach for Major Depressive Disorder.

The need for patient-centered care has become a focal point of healthcare improvement initiatives. Shared decision making-in which patients and clinicians communicate about various treatment options and goals and patient input is considered when making treatment decisions-has been associated with improved health and quality of life. A method of treatment evaluation allowing incorporation of patient-specific goals and perspectives is of increasing interest to healthcare providers, payers, and patients.

Patient attitudes toward and goals for MDD treatment: a survey study.

Major depressive disorder (MDD) is a highly prevalent disorder, frequently diagnosed and treated in a primary care setting; however, little information is available about the treatment decision-making process between MDD patients and their providers. A shared decision-making and goal attainment approach to establishing and tracking progress toward treatment goals that are meaningful to individual patients is explored in this survey study. In addition, information about patient perspectives on setting treatment goals, medication selection/switching, and engaging patients with their health care professionals was also collected and evaluated.

Economic burden of relapse/recurrence in patients with major depressive disorder.

: This study was conducted to determine the incremental healthcare resource utilization (HRU) and costs associated with relapse or recurrence (R/R) in patients with major depressive disorder (MDD) treated with antidepressants (AD) in US clinical practice. : In this retrospective cohort study, adult patients with MDD treated with a branded AD were selected from the Truven Health Analytics MarketScan Databases (January 1, 2004-March 31, 2015). Time to first indicator of R/R was described.

Cost sharing and branded antidepressant initiation among patients treated with generics.

Objectives: To determine the relationship between consumer cost sharing for branded antidepressants and the initiation of branded therapy among patients with major depressive disorder (MDD) filling a prescription for generic MDD medication.

Study Design: Retrospective cross-sectional analyses.

Methods: Patients aged 18 to 64 years with MDD who filled a generic antidepressant were identified in commercial claims data for 2012 to 2014.

Impact of adherence to antidepressants on healthcare outcomes and costs among patients with type 2 diabetes and comorbid major depressive disorder.

Objective: To evaluate the association between adherence to antidepressants and an effect on clinical outcomes and healthcare costs in patients with major depressive disorder (MDD) and comorbid type 2 diabetes (T2D).

Methods: This retrospective study used MarketScan claims data from January 2012 to March 2014. Study entry was the first claim for an antidepressant and a diagnosis code for MDD and T2D in the prior 6 months.

Staging dementia from symptom profiles on a care partner website.

Background: The World Wide Web allows access to patient/care partner perspectives on the lived experience of dementia. We were interested in how symptoms that care partners target for tracking relate to dementia stage, and whether dementia could be staged using only these online profiles of targeted symptoms.

Objectives: To use clinical data where the dementia stage is known to develop a model that classifies an individual's stage of dementia based on their symptom profile and to apply this model to classify dementia stages for subjects from a Web-based dataset.

Road to the nursing home: costs and disease progression among medicare beneficiaries with ADRD.

Objectives: To estimate long-term care costs and disease progression among Medicare beneficiaries aged 65+ with ADRD.

Methods: Retrospective analysis of Medicare Part A claims and nursing home (NH) Minimum Data Set (MDS) records among beneficiaries 1999-2007. Expenditures were grouped into 3 periods; PRE, events occurring between date of ADRD diagnosis, before first NH admission; PERI, from first NH admission to at least 100 days; and, PERM, after 120 days.

Validation of an informant-reported web-based data collection to assess dementia symptoms.

Background: The Web offers unprecedented access to the experience of people with dementia and their care partners, but data gathered online need to be validated to be useful.

Objective: To test the construct validity of an informant Web-based data collection to assess dementia symptoms in relation to the 15-point Dependence Scale (DS).

Methods: In an online survey posted on the DementiaGuide website, care partners of people with dementia built individualized profiles from the 60-item SymptomGuide and completed a questionnaire, which included the DS and a staging tool.

Dependence as a unifying construct in defining Alzheimer's disease severity.

This article reviews measures of Alzheimer's disease (AD) progression in relation to patient dependence and offers a unifying conceptual framework for dependence in AD. Clinicians typically characterize AD by symptomatic impairments in three domains: cognition, function, and behavior. From a patient's perspective, changes in these domains, individually and in concert, ultimately lead to increased dependence and loss of autonomy.

A qualitative assessment of the concept of dependence in Alzheimer's disease.

Background: The Dependence Scale (DS) was designed to assess levels of patient need for care due to deficits typical of Alzheimer's disease (AD). This study examined content validity of the DS based on input from patients, caregivers, and clinicians.

Methods: Qualitative interviews with experts, patients, and caregivers were used to collect information on the concept of dependence and to assess content validity.

Burden of Alzheimer's disease and association with negative health outcomes.

Objective: To examine the association of Alzheimer's disease (AD) with common chronic conditions, acute care events, and risk of hospitalization.

Study Design: Retrospective matched cohort analysis.

Methods: Community-dwelling subjects with a diagnosis of and/or medication for AD were matched to subjects without AD based on age, sex, and geographic region.

Racial differences in switching, augmentation, and titration of lipid-lowering agents by Medicare/Medicaid dual-eligible patients.

Research Objective: The goal of this study was to examine prescription fill patterns of lipid-lowering agents among Medicare/ Medicaid dual-eligible patients by ethnicity.

Data And Methods: Study data were obtained from the Thomson Medstat MarketScan Medicaid claims database. Medicare/Medicaid beneficiaries who filled prescriptions for lipid-lowering agents during 2003 were included in the study.

Meta-analysis of disease risk associated with smoking, by gender and intensity of smoking.

Background: The risks associated with cigarette smoking can be substantial, particularly for females. In 2000, the mortality rate for lung cancer among women was higher than that for breast cancer.

Objective: To obtain overall risk for intensity of smoking for both males and females, a meta-analysis was performed on recent studies that assessed the morbidity and mortality associated with smoking.