In 2021, Medicare spending on biologics was $926 million in Part B (FFS) and $1.3 billion in Part D (FFS/MA). Between 2017 and 2021, annual Medicare spending on biologics increased by approximately 200%. Between 2023 and 2025, Medicare Part D OOP costs for biologics will decrease by an estimated 50%-60%.
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http://dx.doi.org/10.1002/alr.23344 | DOI Listing |
Am J Med
December 2024
Department of Dermatology, Stanford University School of Medicine, Redwood City, California. Electronic address:
J Am Heart Assoc
December 2024
Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Department of Medicine Beth Israel Deaconess Medical Center Boston MA USA.
Background: Transcatheter edge-to-edge repair of the mitral valve (mTEER) reduced a hierarchical end point that included death and heart failure hospitalization in COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation Trial). However, the magnitude to which mTEER increases the number of days a patient spends at home (DAH) in the first few years after treatment, a patient-centered end point not captured routinely in clinical trials, has not been evaluated. We compared 1- and 2-year DAH among patients with functional mitral regurgitation and heart failure randomized to mTEER plus medical therapy versus medical therapy alone (control) by linking the COAPT trial to comprehensive health care claims data.
View Article and Find Full Text PDFJ Health Econ Outcomes Res
December 2024
Milliman (United States).
Rising oncology healthcare costs have led to value-based care reimbursement models that coordinate care and improve quality while reducing overall spending. These models are increasingly important for traditional Medicare and other payers. To compare the incidence of adverse events (AEs), AE-associated excess costs, and total cost of care (TCOC) of 3 cohorts receiving first-line treatment for metastatic pancreatic ductal adenocarcinoma (mPDAC).
View Article and Find Full Text PDFCureus
November 2024
Department of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, USA.
Background The United States continues to rank as one of the most expensive healthcare systems in the world, and cataract surgery, the most commonly performed surgery, is one of the primary drivers of healthcare expenditure. Increasing efforts have been made to try to minimize U.S.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
Center for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St Louis, Missouri.
Importance: Hospital participation in the Bundled Payments for Care Improvement-Advanced (BPCI-A) initiative has been associated with modest savings and stable clinical outcomes overall, but it is unknown whether the program performs differently for medical and surgical or procedural (henceforth, surgical) episodes.
Objective: To assess the association of BPCI-A participation with Medicare spending and clinical outcomes for medical and surgical episodes.
Design, Setting, And Participants: This retrospective difference-in-differences cohort study utilized 100% Medicare fee-for-service inpatient claims for episodes initiated between January 1, 2017, and September 30, 2019, and included 90 days of follow-up.
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