Cost-effectiveness of Simple Insulin Infusion Devices Compared to Multiple Daily Injections in Uncontrolled Type 2 Diabetics in the United States Based on a Simulation Model.

Background: As type 2 diabetes (T2D) progresses, administering basal and bolus insulin through multiple daily injections (MDI) is often required to achieve target control, although many people fail to achieve target levels. Continuous subcutaneous insulin infusion (CSII) treatment with traditional pumps has proven effective in this population, but use remains limited in T2D due to CSII cost and complexity. A new class of simple insulin infusion devices have been developed which are simpler to use and less expensive.

Impact of extended-release quetiapine fumarate on hospitalization length and cost in schizophrenia and bipolar disorder patients: a retrospective, hospital-based, US-cohort analysis.

Aim: The aim was to evaluate the impact of quetiapine extended release (XR) on hospitalization length and cost in schizophrenia or bipolar disorder, versus quetiapine immediate release (IR), using Premier Perspective™ inpatient hospital database data.

Methods: Inpatient discharges classified within diagnosis-related group 430 (psychoses), prescribed quetiapine XR or IR, were identified. Patients had International Classification of Disease-9 diagnosis of schizophrenia or bipolar disorder.

Impact of once-daily extended-release quetiapine fumarate on hospitalization length in patients with acute bipolar mania.

Aims: Evaluate the impact of quetiapine extended release (XR) versus quetiapine immediate release (IR) on hospitalization length in acute bipolar mania using Truven Health Analytics MarketScan Hospital Drug Database.

Patients & Methods: Generalized linear model analyses were used, adjusting for patient and hospital characteristics.

Results: Using data from 3088 discharges, quetiapine XR reduced hospitalization length by 6.

Cost and burden of gastroesophageal reflux disease among patients with persistent symptoms despite proton pump inhibitor therapy: an observational study in France.

Background: Gastrointestinal reflux disease (GERD) is a common disorder that negatively impacts health-related quality of life (HRQL) and work productivity. Many patients have only a partial response to proton pump inhibitor (PPI) therapy and continue to experience GERD symptoms despite optimized treatment. This observational study aimed to provide information on symptoms, HRQL, resource usage, costs and treatment pathways associated with partial response to PPI therapy in French patients with GERD.

Partial response to proton pump inhibitor therapy for GERD: observational study of patient characteristics, burden of disease, and costs in the USA.

Background: Disease burden and associated costs are not well understood among patients with gastroesophageal reflux disease (GERD) who have persistent symptoms despite optimized proton pump inhibitor (PPI) therapy. The aim of this study was to investigate disease burden and costs of GERD in partial responders to PPI therapy.

Methods: The Partial Response to PPI treatment: the Cost to Society and the Burden to the Patient in the US (REMAIN US) study was a 12-month, multicenter, noninterventional, observational study of 552 partial PPI responders in the USA.

The burden of disrupting gastro-oesophageal reflux disease: a database study in US and European cohorts.

Background: Recent data indicate that among patients with gastro-oesophageal reflux disease (GORD) there is a subgroup with a higher disrupting burden of illness in terms of symptom frequency and overall impact.

Objective: The aim of this study was to evaluate the burden of disrupting versus non-disrupting GORD on individuals, healthcare providers and society.

Methods: Data were obtained from European (France, Germany, Italy, Spain and the UK) and US respondents in the 2007 National Health and Wellness Survey (NHWS).

Objective measurement of work absence and on-the-job productivity: a case-control study of US employees with and without gastroesophageal reflux disease.

Objective: To establish an association between gastroesophageal reflux disease (GERD) and increased work absence, as well as reduced productivity while at work, by using objective productivity measurements.

Methods: Retrospective case-control analysis of a database containing US employees' administrative health care and payroll data for employees (N = 11,653 with GERD; N = 255,616 without GERD) who were enrolled for at least one year in an employer-sponsored health insurance plan.

Results: Employees with GERD had 41% more sick leave days (P < 0.

The Work Productivity and Activity Impairment Questionnaire for Patients with Gastroesophageal Reflux Disease (WPAI-GERD): responsiveness to change and English language validation.

Background: A validated productivity questionnaire, the Work Productivity and Activity Impairment questionnaire for Gastroesophageal Reflux Disease (WPAI-GERD), exists for Swedish patients with GERD.

Objective: To assess responsiveness to change of the WPAI-GERD and construct validity of the English language version.

Methods: We used the WPAI-GERD in a before-after treatment clinical study of Canadian GERD patients with moderate or severe symptoms treated with esomeprazole 40 mg once daily for 4 weeks.

Employers need to have a wider horizon than drug costs alone when considering the implementation of health care intervention programs.

The study of Mabasa and Ma in a previous issue of JMCP reports on the successful utilization and drug cost savings for proton pump inhibitors (PPIs) in a Canadian employer-sponsored drug plan that implemented a therapeutic maximum allowable cost (MAC) program.1 Any successful health care intervention program aiming to maximize value for money is praiseworthy, especially for diseases that are associated with a high prevalence and/or have high treatment costs. From an employer perspective, however, the current study is associated with a number of fundamental flaws that are essential to point out if similar intervention programs are to be planned and implemented.

The impact of illness in patients with moderate to severe gastro-esophageal reflux disease.

Background: Gastro-esophageal reflux disease (GERD) is a common disease. It impairs health related quality of life (HRQL). However, the impact on utility scores and work productivity in patients with moderate to severe GERD is not well known.

A review of self-report instruments measuring health-related work productivity: a patient-reported outcomes perspective.

Health impairment often leads to work impairment in the form of both absenteeism and presenteeism (i.e. reduced productivity while at work).

Cost effectiveness of esomeprazole compared with omeprazole in the acute treatment of patients with reflux oesophagitis in the UK.

Background: Clinical studies have demonstrated that esomeprazole is superior to omeprazole for the acute treatment of reflux oesophagitis.

Objective: To compare the cost effectiveness of esomeprazole 40mg once daily with omeprazole 20mg once daily in patients with reflux oesophagitis.

Methods: Pooled data were used from three 8-week clinical trials comparing the efficacy and safety of esomeprazole 40mg once daily and omeprazole 20mg once daily for the acute treatment of reflux oesophagitis.

Cost effectiveness of proton pump inhibitors in gastro-oesophageal reflux disease without oesophagitis: comparison of on-demand esomeprazole with conventional omeprazole strategies.

Objectives: To evaluate the cost effectiveness of on-demand treatment with esomeprazole 20mg compared with two alternative omeprazole treatment strategies for the long-term management of patients with gastro-oesophageal reflux disease (GORD) without oesophagitis.

Design: A simple Markov model was designed to compare the cost effectiveness of on-demand esomeprazole 20mg therapy for 6 months with a strategy consisting of intermittent 4-week acute treatment courses of omeprazole 20mg once daily or a strategy consisting of continuous omeprazole treatment (20mg once daily) following acute treatment of first relapse while on no drug treatment (a commonly used conventional care strategy). Relapse probabilities were based on pooled results from two 6-month placebo-controlled clinical studies of on-demand esomeprazole 20mg treatment in patients with GORD without oesophagitis and on results from a GORD study with a 6-month untreated follow-up.

Validity of a Work Productivity and Activity Impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD)--results from a cross-sectional study.

Objectives: To validate a Work Productivity and Activity Impairment questionnaire (WPAI-GERD) developed to measure lost productivity due to symptoms of gastro-esophageal reflux disease (GERD).

Methods And Data: The WPAI-GERD was administered along with two quality-of-life questionnaires, Quality of Life in Reflux and Dyspepsia (QOLRAD) and Short Form 36 (SF-36), to a Swedish working population (N = 136) visiting a general practitioner for symptoms attributed to GERD. Correlation coefficients were calculated between each productivity variable derived from the WPAI-GERD and symptom severity, symptom frequency, quality of life dimensions, age, and gender.