Systematic review on infusion reactions associated with chemotherapies and monoclonal antibodies for metastatic colorectal cancer.

Objective: The objective of this systematic review is to summarize the literature to date on the rates of infusion reactions (IR) associated with chemotherapies and monoclonal antibody (mAb) drug therapies used for the treatment of metastatic colorectal cancer (mCRC) and the associated clinical and economic impact.

Methods: This study searched Medline, Medline (R) In-Process, Embase and Cochrane Library databases for studies on IRs associated with chemotherapy and mAbs in mCRC patients from 2000-2011.

Results: For chemotherapy, the incidence of IRs ranged from 0-71% for all grades and 0-15% for grade 3-4.

Treatment patterns and metastasectomy among mCRC patients receiving chemotherapy and biologics.

Background: Several long-standing chemotherapy regimens are available to treat metastatic colorectal cancer (mCRC) including: oxaliplatin plus 5-fluorouracil (5-FU) and leucovorin (FOLFOX); and irinotecan plus 5-FU and leucovorin (FOLFIRI). More recently, new biologic therapies were approved for use in mCRC.

Objectives: This study examined treatment patterns and trends in metastasectomy among newly diagnosed mCRC patients after the introduction of capecitabine (CAP) in 2001 and the biologic therapies in 2004.

The impact of methodological approach on cost findings in comparison of epoetin alfa with darbepoetin alfa.

Background: Two erythropoiesis-stimulating agents (ESAs), epoetin alfa and darbepoetin alfa, are approved for the treatment of chemotherapy-induced anemia in patients with cancer. Randomized controlled trials indicate that the drugs are similarly efficacious, but that the duration of clinical benefit (DCB) ranges from 2 to 7 days for epoetin alfa and from 7 to 21 days for darbepoetin alfa, depending on dose. Given equivalent efficacy, payers are increasingly interested in understanding the cost differences for these 2 drugs.

Treatment of nonmuscle invading bladder cancer: do physicians in the United States practice evidence based medicine? The use and economic implications of intravesical chemotherapy after transurethral resection of bladder tumors.

Background: Phase 3 clinical trials performed primarily outside the US demonstrate that intravesical instillation of chemotherapy immediately after transurethral resection of the bladder (TURB) decreases cancer recurrence rates. The authors sought to determine whether US urologists have adopted this practice, and its potential effect on costs of bladder cancer (BC) care.

Methods: By using 1997-2004 MEDSTAT claims data, the authors identified patients with newly diagnosed BC who underwent cystoscopic biopsy or TURB, and those who received intravesical chemotherapy within 1 day after TURB.

Characteristics of patients initiating raloxifene compared to those initiating bisphosphonates.

Background: Both raloxifene and bisphosphonates are indicated for the prevention and treatment of postmenopausal osteoporosis, however these medications have different efficacy and safety profiles. It is plausible that physicians would prescribe these agents to optimize the benefit/risk profile for individual patients. The objective of this study was to compare demographic and clinical characteristics of patients initiating raloxifene with those of patients initiating bisphosphonates for the prevention and treatment of osteoporosis.

Identifying patients with benign prostatic hyperplasia through a diagnosis of, or treatment for, erectile dysfunction.

Objective: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH) are highly correlated. This study examined rates of screening, diagnosis, and treatment of BPH/LUTS among men seeking care for ED.

Research Design And Methods: This was a retrospective US claims data analysis (1999-2004) evaluating men > or = 40 years old with a new diagnosis of or prescription medication for ED.

Assessment of the clinical management of fragility fractures and implications for the new HEDIS osteoporosis measure.

Background: Rates of screening for and treatment of osteoporosis have been low, even among those with fractures who are at greatest risk for new fractures.

Objective: The objective of this study was to examine trends in the clinical management of patients with fragility fractures to provide baseline data for future assessments of the impact of the new Health Plan Employer Data and Information Set (HEDIS) measure.

Research Design: The MarketScan Medicare Supplemental and Coordination of Benefits (COB) database was used to examine adherence to the 2004 HEDIS guidelines by measuring the percent of women age 67 and older who were screened and/or treated after a fracture from 2000 through 2005.

Economic burden of osteoporosis-related fractures in Medicaid.

Objective: There are limited studies concerning the economic burden of osteoporosis in the Medicaid population. This study estimated the direct cost of osteoporosis-related fractures (OPFx) to state Medicaid budgets.

Methods: This retrospective analysis utilized Medicaid claims databases from three states, which included approximately 8 million Medicaid recipients.

Medical costs associated with non-Hodgkin's lymphoma in the United States during the first two years of treatment.

Objectives: To determine the direct costs of medical care associated with aggressive and indolent non-Hodgkin's lymphoma (NHL) in the United States; to show how costs for aggressive NHL change over time by examining costs related to initial, secondary and palliative treatment phases; and to evaluate the economic consequences of treatment failure in aggressive NHL.

Patients And Methods: A retrospective cohort analysis of 1999 - 2000 direct costs in newly diagnosed NHL patients and controls (subjects without any cancer) was conducted using the MarketScan medical and drug claims database of large employers across the United States. Treatment failure analysis was conducted for aggressive NHL patients, and was defined by the need for secondary treatment or palliative care after initial therapy.

Utilization and cost of health care services associated with primary malignant brain tumors in the United States.

Objectives: To evaluate the economic burden of primary malignant brain tumors in a commercially insured population in the United States, and to identify the primary drivers of health care resource use and cost.

Patients And Methods: A retrospective cohort analysis was performed using a 1998-2000 database containing inpatient, outpatient, and pharmacy claims for employees, their dependents, and early retirees of over 50 large US employers with wide geographic distribution. Patients were followed from first brain tumor diagnosis until death, termination of health benefits coverage, or study end.

Burden of pancreatic cancer and disease progression: economic analysis in the US.

Objectives: The few studies that have estimated the costs of pancreatic cancer were limited by small sample sizes, geography or patient age range. Using a large nationwide claims database, this study examines the cost of pancreatic cancer beginning with initial diagnosis and the additional costs when disease progresses.

Methods: A retrospective cohort study was conducted using a claims database of 3 million individuals covered by large US employers.

The economic burden of lung cancer and the associated costs of treatment failure in the United States.

The economic burden of lung cancer was examined with a retrospective case-control cohort study on a database containing inpatient, outpatient and drug claims for employees, dependents and retirees of multiple large US employers with wide geographic distribution. Patients were followed for maximum of 2 years from first cancer diagnosis until death, health benefits dis-enrollment or study end (31 December 2000). Compared with controls (subjects without any cancer), patients with lung cancer (n = 2040) had greater health care service utilization and costs for hospitalization, emergency room visits, outpatient office visits, radiology procedures, laboratory procedures and pharmacy-dispensed drugs (all P < 0.

The economic burden of anemia in cancer patients receiving chemotherapy.

Background: Anemia is one of the most common hematologic complications of cancer and cytotoxic treatment. The economic burden associated with anemia in patients with malignancy has not yet been extensively studied.

Methods: Patients receiving chemotherapy within 6 months of initial cancer diagnosis were identified in a database of commercial health-care service claims and encounters.

Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures.

Background: More than 1.5 million fractures occur due to osteoporosis each year. This study examines the annual health care utilization and associated expenditures of osteoporotic patients who sustain a new fragility fracture and of those without a new fracture.

Estimating the cost of cancer: results on the basis of claims data analyses for cancer patients diagnosed with seven types of cancer during 1999 to 2000.

Purpose: Cancer accounts for 60.9 billion dollars in direct medical costs and 15.5 billion dollars for indirect morbidity costs.

Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers.

Evidence about the total cost of health, absence, short-term disability, and productivity losses was synthesized for 10 health conditions. Cost estimates from a large medical/absence database were combined with findings from several published productivity surveys. Ranges of condition prevalence and associated absenteeism and presenteeism (on-the-job-productivity) losses were used to estimate condition-related costs.

A validity analysis of the Work Productivity Short Inventory (WPSI) instrument measuring employee health and productivity.

The Work Productivity Short Inventory (WPSI) was developed to quickly estimate decrements in productivity associated with 15 common disease conditions. Three versions of the WPSI were developed that differed according to the length of the recall period (12 months, 3 months, or 2 weeks). The content, predictive, and construct validity of metrics generated from the WPSI were assessed based on response patterns found in the 3 versions and via comparison to information in national data sources or in the subject company's medical care claims and short-term disability program files.

Development and reliability analysis of the Work Productivity Short Inventory (WPSI) instrument measuring employee health and productivity.

The Work Productivity Short Inventory (WPSI), also known as the Wellness Inventory, was developed to quickly assess the prevalence of medical problems that may influence work productivity and the financial implications of those problems. The WPSI asks respondents to note the amount of time missed from work resulting from 15 medical conditions and the amount of unproductive time spent at work when affected by the condition. Three versions of the WPSI were compared that differed according to the length of the recall period (12 months, 3 months, or 2 weeks).

Developing Performance Measures for Prescription Drug Management.

Prescription drug management plans are outpatient drug benefit programs that strive to manage the cost effective and clinically appropriate delivery of prescription drugs to beneficiaries. The demand for accountability and a means to evaluate performance of drug benefit management programs is growing; nevertheless, a set of valid, standardized indicators for evaluating performance does not exist. We review drug management program activities and identify available measures for assessing performance.