Pharmacoeconomics and Pharmaceutical Economics Commons^™

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Charity Pharmacies: An Integrative Overview Of Operations: A Continuing Education Program For Pharmacists, Stella Bertram

Honors Theses

PROGRAM DESCRIPTION

The goal of this activity is to educate pharmacists about Charity Pharmacies by creating an integrative overview of their purpose, laws and regulations, processes and procedures, eligibility, and opportunities for involvement. This course will ensure pharmacists are competent in the operations involved in volunteering or working within a charitable pharmacy.

Additionally, the information provided supports pharmacists in understanding their roles as well as roles of volunteers. They will understand the importance of their role in the community and the depth of their service within Charity Pharmacies.

The Revised Cdc Chronic Pain Guidelines And Payer Opioid Analgesic Policies In Michigan, Victoria Tutag Lehr, Cynthia L. Arfken

Michigan Journal of Public Health

Abstract

The 2016 publication of A Guideline for Prescribing Opioids for Chronic Pain by the Centers for Disease Control and Prevention motivated commercial and Medicaid payers to restrict their opioid prescribing policies including the imposition of hard limits on opioid daily dosages and duration. One result of these policies was an increase in abrupt opioid discontinuation and rapid tapering events for patients receiving long-term opioid therapy. Responding to this misapplication of the 2016 guideline, the 2022 revised guidelines emphasized individualized opioid therapy and exclusion of certain chronic diseases. However, it is not known if the payers changed their policies to …

Estimasi Biaya Produktivitas Yang Hilang Akibat Kematian Dini Pasien Covid-19 Di Rs Pku Muhammadiyah Gamping, Yuni Andriani, Sugiyono Sugiyono

Jurnal Ekonomi Kesehatan Indonesia

COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 virus infection has had an impact on the global health and economic system, including in developing countries. This research is an observational study by estimating the indirect costs of lost productivity due to premature deaths in COVID-19 patients at PKU Muhammadiyah Gamping Hospital in 2021 and knowing the characteristics of the patients. This hospital was chosen as the research site because the percentage of Bed Occupancy Rate (BOR) was the highest in Sleman Regency in 2021, reaching 68.94%. The results of the research show …

Menakar Kesiapan Puskesmas Dalam Penuntasan Penanganan Penyakit: Analisa Data Riset Fasilitas Kesehatan 2019, Harimat Hendarwan, Suparmi Suparmi

Jurnal Ekonomi Kesehatan Indonesia

The completion of disease treatment at the health center was important for payment of Capitation Based on Fulfillment of Service Commitment (PCFSC/KBPKP) and the Non-Specialist Case Outpatient Referral (NSOR/RRNS) was one of the key indicators. This study aimed to assess public health center readiness in the completion of disease treatment for those stipulated in Ministerial Decree number 514 of the year 2015. This study used Health Facility Research (Rifaskes) data conducted in 2019 with a total of 9831 health centers as observations. Analysis was conducted by comparing the availability of equipment, laboratories, and medicines with existing regulations. Health center readiness …

Who Marries Whom Matters: Kesamaan Pendidikan Orangtua Dan Berat Badan Saat Lahir Di Indonesia, Mudya Johanna, Omas Bulan Samosir

Jurnal Ekonomi Kesehatan Indonesia

Despite ongoing efforts and commitment to reducing Low Birth Weight (LBW) babies, globally, the incidence of LBW has stagnated. This study uses a combined factor of maternal and husband/partner education variables to analyze the complexity of LBW incidents. This research uses secondary data from the 2017 SDKI with a multilevel logistic regression analysis method to look at the relationship between the similarity of parental education and the baby's birth weight at the individual and community levels. The results of the research show that mothers who have husbands/partners with equivalent education and higher education (≥high school or equivalent) have a lower …

Pelayanan Kesehatan Primer Sebagai Gatekeeper Dan Kebijakan Diskusi Peer Review: Antara Kualitas Dan Realitas Untuk Menurunkan Kasus Rujukan Non Spesialistik, Zahrina Zahrina, Royasia Viki Ramadani, Khairun Nisa Il Hulwah, Siti Nurlatifah, Aldi Andalan, Ascobat Gani, Golda Kurniawaty, Ery Setiawan

Jurnal Ekonomi Kesehatan Indonesia

Almost 80% of the source of funds is spent on hospital. This situation indicates the failure of the gatekeeper function in primary health care. Performance-based capitation is implemented to ensure the cost and quality of primary care, with non-specialist referral rate as one of the particular parameters. The peer review policy is a discussion between BPJS Health, District/City Health Services, IDI, provincial and branch Team of KMKB and other relevant stakeholders to determine which diagnoses must be handled at FKTP also to accommodate and improve the capacity of FKTP to handle patients and minimize referral cases. This study aims to …

Pharmacoeconomics Of Metastatic Colorectal Cancer Treatment With Targeted Therapies Guided By Companion Molecular Diagnostics, Luis E. Fernández-Garza, Hector Sánchez-Ibarra, Daniela Treviño-Sáenz, Hugo A. Barrera-Saldaña

Research Symposium

Background: To guide the treatment with monoclonal antibodies (MAbs) against the epidermal growth factor receptor (EGFR) of metastatic colorectal cancer (mCRC), the FDA recommends prior companion molecular diagnosis (CMDx). It initially recommended screening for mutations in exon 2 of the KRAS gene, and most recently to extend to screening to exons 2, 3, and 4 of KRAS and 2, 3, and 4 of NRAS genes; furthermore, to evaluate the BRAF exon 15 mutation status (including V600E). To date, no studies have been done to compare the cost-benefit of these different CMDXs.

Methods: We have compared the cost of treatment without …

Hubungan Karakteristik Pasien, Prosedur, Dan Penyakit Penyerta Dengan Biaya Langsung Medis Pada Pasien Rawat Inap Jantung Koroner, Rita Tri Wahyuni, Eri Witcahyo, Yennike Tri Herawati

Jurnal Ekonomi Kesehatan Indonesia

Coronary heart disease is a catastrophic disease that causes a high burden of medical costs. At Dr.Iskak Tulungagung hospital, coronary heart disease is the disease with the highest cost. The number of coronary heart patients who are hospitalized is also increasing every year. Several Previous studies have shown that the amount of direct medical costs of coronary heart patients reach more than 50% of the total costs of treatment. Therefore, it is necessary to do research on the factors associated with the increasing direct medical costs of coronary heart patients. The purpose of this study was to analyze the factors …

The Association Of Long Working Hours And The Use Of Prescription Sedatives Among U.S. Workers., Emmanuel Ezekekwu

Electronic Theses and Dissertations

BACKGROUND: Meeting the needs of a round-the-clock and globalized society has led to an increase in long working hours. This trend has been accompanied by a corresponding rise in sleep disorders and subsequent use of sedating medications. Overtime hours have been associated with adverse health outcomes such as cardiovascular diseases, symptoms of psychological distress, and health behaviors, including risky intake of alcohol and smoking. Hence, the main objectives of this three-paper dissertation were to examine the multi-faceted relationship between working hours, the use of prescription sleep aids, the onset of psychological distress, and the use of health care services. METHODS: …

Prescription Drug Retail Sales In The Mountain West, Caren Royce Yap, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet synthesizes data on prescription drug retail sales in the Mountain West (Arizona, Colorado, Nevada, New Mexico, and Utah). "Retail Sales for Prescription Drugs Filled at Pharmacies by Payer," a 2019 report by the Kaiser Family Foundation, includes data on the amount of retail sales for prescription drugs made in each state by dollar amount, along with the method of coverage, including commercial, Medicare, Medicaid and cash payment.

Redlining And Opioid Overdose Outcomes: Do Historical Housing Policies Still Impact Health Today?, Sahana Paravantavida

Honors Theses

This study examines the relationship between historical housing policies and current health outcomes, specifically the impact of redlining on opioid overdose rates. Using data collected from the state of New Jersey, neighborhoods with a history of redlining have higher rates of opioid overdose deaths. My findings suggest that historical housing policies, which systematically excluded certain populations from accessing affordable housing and resources, continue to impact health outcomes today.

Clinical And Economic Burden Of Inflammatory Chronic Conditions Among Adults In The United States: Evidence From Three Nationally Representative Surveys, Mohammad Ikram

Graduate Theses, Dissertations, and Problem Reports (ETD)

A significant proportion of adults in the United States (US) suffer from various inflammatory chronic conditions (ICCs). They include a wide range of diseases such as diabetes, rheumatoid arthritis, asthma, and chronic obstructive pulmonary diseases. ICCs are not curable, and their management typically involves medications such as NSAIDs and corticosteroids. Recently, a whole health approach that places patients’ well-being at the center is increasingly being used for better management of ICCs. The whole health approach uses an integrated approach that includes multimodal management with complementary and alternative medicines (CAM) and prescription drugs. However, the use of CAM and prescription drugs …

Financial Hardship From Purchasing Prescription Drugs Among Older Adults In The United States Before, During, And After The Medicare Part D “Donut Hole”: Findings From 1998, 2001, 2015, And 2021, Anthony W. Olson, Jon C. Schommer, David A. Mott, Olajide Adekunle, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: Cost-related nonadherence compromises successful and effective management of chronic disease. The Medicare Modernization Act of 2003 (MMA) and Patient Protection and Affordable Care Act of 2010 (ACA) aimed to increase the affordability of outpatient prescription drugs for older adults (older than age 64 years). The Medicare Part D prescription drug insurance coverage gap (“donut hole”) created by the MMA was fully closed in 2020 by the ACA.

OBJECTIVES: To (1) describe prescription drug coverage and financial hardship from purchasing prescription drugs among older American adults for 2021, (2) compare these results with findings from data collected before the MMA …

Incidence Of Cancer, Depression, And Economic Burden Of Prescription Nsaids Among Older Adults With Osteoarthritis: Statistical And Machine Learning Approaches, Nazneen Fatima Mohammed Umer Shaikh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding the role of chronic inflammation among older adults is critical because of its implications on chronic inflammatory conditions as well as its interaction with anti-inflammatory medications. Osteoarthritis (OA) is a heterogeneous multi-faceted joint disease with multi-tissue involvement of varying severity, and increasing evidence demonstrates a key role of chronic inflammation in its pathogenesis. Approximately 30 million adults in the United States have OA, and it is reported that a large proportion (43%) of them are older than 65 years. OA is typically treated using non-steroidal anti-inflammatory drugs (NSAIDs) for minimizing pain and reducing inflammation. NSAIDs have consistently shown clinically …

Pharmacists' Role In Opioid Use Disorder And Overdose Prevention And Treatment And Their Attitudes And Perceptions Towards Distributing Naloxone Under A Standing Order, Stephen C. Ijioma

Theses and Dissertations

Background: Opioids are a class of drugs that bind to opioid receptors (mu, delta, and kappa), located in the central and peripheral nervous systems, to exert responses such as analgesia, respiratory depression, euphoria, and miosis. The opioid epidemic is characterized in large part by an increase in opioid overdose deaths. Community pharmacists are one of the most accessible healthcare professionals who frequently interact with patients and can implement OUD and opioid overdose prevention strategies. Treatment for opioid overdose and OUD include naloxone for overdose deaths as well as medication-assisted treatment for OUD.

Objective: The specific aims of this thesis include …

Cost-Effectiveness Analysis Of Tisagenlecleucel, Blinatumomab, And Clofarabine For Treatment Of B-Cell Precursor Acute Lymphoblastic Leukemia, Kamron Lotfi

Pharmaceutical Sciences (MS) Theses

Acute lymphoblastic leukemia (ALL) is a common type of adolescent and young adult leukemia in the United States (U.S.). Patients who are refractory or relapsed after receiving two or more lines of systemic therapy have the option of taking tisagenlecleucel. Due to the high cost of this treatment, a cost-effectiveness analysis was performed to assess the treatments for tisagenlecleucel, clofarabine combination, and blinatumomab. Objectives

The objective of this study is to evaluate the cost-effectiveness of tisagenlecleucel; clofarabine, etoposide, cyclophosphamide; and blinatumomab for the treatment of relapse- refractory ALL for adolescents and young adults from the U.S. health care payer perspective. …

Association Of Incident Cancer To Low-Value Care And Healthcare Cost Burden Among Elderly Medicare Beneficiaries, Chibuzo Iloabuchi

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the United States (US), 25% of healthcare spending is considered wasteful because it is spent reimbursing low-value care. Low-value care is the utilization of healthcare services, medical tests, and procedures that have unclear or no clinical benefit to patients but still exposes them to risk. World-wide, low-value care imposes a significant economic burden on patients, payers, governments, and society. Cancer care among older adults > 65 years is one of the biggest drivers of healthcare expenditure in the US and accounts for nearly 40% of all spending, and low-value care among cancer patients is prevalent and contributes to the financial …

Multimorbidity, Immune Checkpoint Inhibitor Use, And Healthcare Expenditures Among Older Patients With Late-Stage Melanoma, Pragya Rai

Graduate Theses, Dissertations, and Problem Reports (ETD)

With decades of unchanged cancer care with no added survival benefit, immune checkpoint inhibitors (ICI) changed the treatment landscape of late-stage melanoma in 2011. A key factor in determining the use of ICIs is the presence of pre-existing chronic conditions, which can influence the outcome. However, the prevalence of multimorbidity (defined as presence of two or more chronic conditions) among older patients with late-stage melanoma remains unknown. It also remains unknown if the presence of multimorbidity factors into the use of ICIs. Hospital-related factors associated with ICI use have been studied. Yet, patient-level factors, such as age, sex, marital status, …

Preserving Ancient Cultures Through Medicinal Narratives, Mckenzie Jewel Moss

Honors Projects

“Preserving Ancient Cultures through Medicinal Narratives” is a comprehensive project that takes an interdisciplinary approach to understanding the effects that culture has on health. The project as a whole includes the initial work and readings I performed to better understand differences in healing between the cultures found throughout South America, where Inca culture is still prevalent, and that of the Unites States, as well as an independent documentary. The documentary contains my own personal commentary complemented by video clips of interviews I performed with individuals living in South America.

Improving Healthcare Costs And Patient Outcomes Across Healthcare Professions, Hannah Lamb, Jourdan Ujlaki, Paige Torbet, Isabel Cwikla, Rebecca Worden, Michael Rush

Pharmacy and Wellness Review

Healthcare professionals must be aware of the importance of preventive medicine and the responsibility they have in contributing to it. There are three levels of preventive medicine that a healthcare professional can provide based on the patient population that is receiving care and the goals of the particular service. Preventive medicine has the ability to improve both overall healthcare costs and have a positive impact on a patient's quality of life. All healthcare professionals have the potential to fulfill a role in each level of preventive medicine, and should understand the role of each member of the healthcare team, to …

Makena®: A Drug For Reducing The Risk Of Preterm Labor, Amanda Lovell, Kasie Bellman, Kelsey Fink, Jessica Beck, Michelle Musser

Pharmacy and Wellness Review

Makena®, hydroxyprogesterone caproate, is an intramuscular injection that is U.S. Food and Drug Administration (FDA) approved to reduce the risk of preterm delivery before 37 weeks of pregnancy in pregnant women with a history of spontaneous preterm birth, who are not currently carrying multiple children. One in nine babies born in the United States each year is born prematurely, or before 37 weeks gestation, and mothers who have previously delivered a premature baby are 2.5 times more likely to deliver another baby prematurely. Makena® is administered by a health care professional as a single intramuscular injection to the hip and …

Marketing Channel Effectiveness Of New Medications/Medical Technology, Hadley Mccormick

Celebration of Learning

This research project will study what marketing platforms/channels are most effective in the dissemination of new medical product news. Many people like myself have an illness/disease that requires daily medication, or require the daily use of a medical device. Due to the increasing influence of Direct to Consumer advertising of pharmaceuticals and the constant development of new medications and devices, patients may now more often go to the doctor with perceptions of what they should do to manage their illness/disease. This study aims to look at how the developers of these medications/medical devices promote their products currently and how certain …

Ethnic And Demographic Differences In Colectomy Rates And Timing For Ulcerative Colitis: 2007-2014, Daniel Bodek, Alana Persaud, Brian Blair, Ahlawat Sushil

Rowan-Virtua Research Day

Ulcerative Colitis (UC) is a chronic inflammatory disease of the bowel, with one third of patients requiring a colectomy for fulminant disease and tissue dysplasia. In 2007, infliximab was approved for induction and maintenance of remission in UC, with some evidence to suggest a potential reduction in colectomies. The aim of this study is to examine relative colectomy rates for UC among different ethnicities from 2007 to 2014 in order to evaluate for development of new trends or disparities.

Discrepancies in colectomy rates and timing are seen in our models which mirror closely findings in a prior study from 1999-2003 …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …

Multiple Sclerosis Drugs Have Been Getting A Lot More Expensive, Ben Jay

Capstones

Multiple Sclerosis is a very expensive disease. According to a 2016 study in the American Journal of Managed Care, treating it can cost patients anywhere from $30,000 to $100,000 per year, which can meet or even exceed the average US household median income, depending on how severe your case is. For a disease that has no known cure, and requires frequent medical attention to manage symptoms that can completely debilitate a person if left untreated, that can mean spending $4.1 million over the course of a lifetime, according to the same study. However, in the last 20 years, that …

Burden Of Lipohypertrophy Among Insulin Dependent Diabetes Mellitus Patients In China: An Analysis Of Outcomes And Impact Of Pen Needle Reimbursement Policy, Arthi Chandran

Dissertations and Theses

Background

Diabetes is a global epidemic and with an aging population accompanied by rapid urbanization China ranks highest in disease prevalence and associated burden. Independent of diabetes type, insulin is an eventual and costly requirement for disease management. The consequences of insulin administration however are poorly understood. Lipohypertrophy (LH) is one such consequence. It is hypothesized that method of insulin delivery and poor delivery technique are significant risk factors for this condition which is believed to alter insulin pharmacodynamics. Subsequently, insulin pen needles are a critical component of care however access to pen needles varies across China.

Objective

The objective …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …

Analyzing The Differentiation Among State Medical Marijuana Policies By Examining State Policies & Trends, Richard Furlong

Political Science Theses and Capstones

Support for marijuana has been growing nationwide. This increased support has gained a lot of momentum since the late 1990s when California became the first state to legalize marijuana for medical use by enacting Proposition 215, or the Compassionate Use Act. Since the enactment of Proposition 215, 28 more states and the District of Columbia have legalized marijuana for medicinal use. I look into why states have begun to adopt these laws, and what makes these states differ throughout the country in the timeliness of their actions. I assembled data to examine a variety of state policies to attempt to …

Prescription Drug Monitoring Programs And Opioid Poisoning: Evaluating The Impact Of Prescriber Use Mandates On Prescription Opioid Poisoning Emergency Department Visits, Sarah Almanie

Theses and Dissertations

Introduction: Prescription drug monitoring programs (PDMPs) are one strategy established to curb the prescription opioid abuse epidemic. Prescriber use mandates has emerged as a promising practice to increase PDMPs impact on prescription opioid abuse; however, evidence of its effectiveness has not yet been established. Kentucky was the first state to implement comprehensive prescriber use mandates in July 2012.

Objective: To assess the relationship between prescriber use mandates policy and emergency department (ED) visits related to prescription opioid poisoning among adults in Kentucky and

North Carolina. Secondary aim: to evaluate the economic impact of prescriber use mandates in Kentucky.

Methods: A …