Pharmacoeconomics and Pharmaceutical Economics Commons^™

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 …

Budget Impact Analysis Of Upadacitinib For The Management Of Moderate-To-Severe Atopic Dermatitis In Patients Treated With Systemic Therapies In The United States, Haya O. Alobaid

Theses and Dissertations

Objective: This study evaluated the budget impact of introducing upadacitinib for patients with uncontrolled moderate-to-severe atopic dermatitis (AD) from a United States (U.S.) private payer perspective.

Methods: The model estimated costs before and after the adoption of upadacitinib for a hypothetical one million covered lives over 3 years. The model included immunosuppressant agents and dupilumab. Market uptake was assumed to be 2% per year. Treatments incur a cost for drug acquisition, and the costs associated with drug administration, laboratory testing, and clinic visits. The model calculated the impact on the budget in 2022 U.S. dollars. Various assumptions on market …

The Economic Value Of Pharmacist-Physician Collaborative Care Models In Hypertension Management, Jessica S. Jay

Theses and Dissertations

Background: Hypertension is highly prevalent in the United States, affecting nearly half of all adults (43%). Studies have shown that pharmacy-physician collaborative care models (PPCCM) for hypertension management significantly improve blood pressure (BP) control rates and provide consistent control of BP. Time in target range (TTR) for systolic BP is a novel measure of BP control consistency that is independently associated with decreased cardiovascular (CV) risk. There is no evidence observed improvement in TTR for systolic BP with PPCCM is cost effective.

Objective: This study aimed to compare the cost-effectiveness of PPCCM with usual care for the management of hypertension …

Trajectories Of Medication Non-Adherence With Time-Varying Predictors And Association With Health Outcomes: A Comparison Of Classical Statistical Methods With Machine Learning Algorithms, Vasco Pontinha

Theses and Dissertations

Background: Medication adherence is a major obstacle to improving health care outcomes in long-term therapies for chronic diseases. According to the World Health Organization, interventions for improving medication adherence can have a higher impact on the health of the population than any other advance in medical treatments. Approximately 125,000 individuals die every year in the U.S. because of non-adherence to medication, representing societal costs of $100-289 billion. Previous research has successfully used group-based trajectories methods to identify similar longitudinal medication adherence trajectories. However, medication adherence is not an isolated behavior and is influenced by many factors that current interventions fail …

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 …

Graduation Of Antidepressant Assortment By The Method Of Expert Evaluations On The Pharmaceutical Market Of The Republic Of Uzbekistan, Abror Rahimov

Problems and Perspectives in Pharmaceutics and Drug Discovery

In the condition of the pharmaceutical market of Uzbekistan, for the first time, we carried an expert evaluation of the nomenclature of antidepressant drugs, considering the competence of experts and the representativeness of respondents of the studied group of drugs. Marketing research was carried out to study the opinions of psychiatrists from Tashkent city for two months: September – October 2020. As a tool for measuring the opinions of experts, an expert survey questionnaire was developed in advance with specified criteria. The study of antidepressants used in domestic conditions was carried out under the international non-proprietary name (INN). Also, based …

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. …

Government As The First Investor In Biopharmaceutical Innovation: Evidence From New Drug Approvals 2010–2019, Ekaterina Galkina Cleary, Matthew J. Jackson, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

The discovery and development of new medicines classically involves a linear process of basic biomedical research to uncover potential targets for drug action, followed by applied, or translational, research to identify candidate products and establish their effectiveness and safety.

This Working Paper describes the public sector contribution to that process by tracing funding from the National Institutes of Health (NIH) related to published research on each of the 356 new drugs approved by the U.S. Food and Drug Administration from 2010-2019 as well as research on their 218 biological targets.

Monetary Incentives For Producing Counterfeit, Adulterated, And Misbranded Medicine: Case Studies And Examples, Heather R. Campbell, Robert A. Lodder

Pharmaceutical Sciences Faculty Publications

Background: Pharmaceutical fraud can be very profitable. Those working in pharmaceuticals are in a tempting position as the nature of the product and supply is complex, making detection of fraud difficult and expensive. However, a reliable pharmaceutical supply can often be a life-or-death situation for patients. Thus, when detection of fraud occurs, a Regulator's Dilemma often emerges (recall a drug for which a supplier is the sole source, or allow a substandard product to be sold)—generally resulting in pharmaceutical companies receiving minimal penalties even for the worst acts. Despite pharmaceutical companies' unique leverage over regulators and profitability, studies are rare …

Pembiayaan Pasien Covid-19 Dan Dampak Keuangan Terhadap Rumah Sakit Yang Melayani Pasien Covid-19 Di Indonesia Analisis Periode Maret 2020 – Desember 2020, Wiwi Ambarwati

Jurnal Ekonomi Kesehatan Indonesia

Hospital visit volumes decline to 50% during the COVID-19 pandemic, which has reduced hospital revenue. The burden of hospitals handling COVID-19 patients is getting higher due to the late payment of COVID-19 claims. This study aims to review COVID-19 payment regulation in hospitals, constraints of policy implementation, and hospital financial challenges in Indonesia. This is a descriptive-analytic study, data collection is carried out through literature searches from scientific journals, BPJS Kesehatan, the Ministry of Health, Hospital Associations, and scientific seminars in online mass media. BPJS Kesehatan data as of 28 January 2020 shows, number of COVID-19 claims was 433,077 and …

Pengaruh Pengadaan Barang Dan Jasa Pada Masa Pandemi Corona Virus Disease 2019 (Covid-19) Terhadap Kondisi Keuangan Rumah Sakit Di Rsup Dr. Kariadi Semarang, Himawan Sasongko

Jurnal Ekonomi Kesehatan Indonesia

The mechanism for procuring goods and services in handling emergencies is different from regular/ordinary conditions. The main difference is in the stage of the procurement implementation. Today's problems are the enormous price disparity, the increasing availability and demand, especially for personal protective equipment (PPE). The disparity has resulted in more significant expenses in hospital spending, this condition impact hospital finances. This research is an observational study. The method is qualitative with interviews and data collection. The data taken are primary data and secondary data. Informants consist of main informants and triangulation informants. The data collection instrument was an in-depth interview …

Mandatory Social Distancing For Covid-19 Outbreak And Its Economic Consequences In West Sumatera - Indonesia, Endrizal Ridwan, Besti Novianda

Jurnal Ekonomi Kesehatan Indonesia

The Governor of West Sumatra Province of Indonesia imposed a mandatory social distancing (PSBB) to slow down the Covid-19 outbreak from 22 April to 7 June 2020. The cons argued that PSBB was ineffective because of the impossibility to limit people’s movements. The pros, on the other hand, viewed PSBB as a training facility to increase people’s awareness about the pandemic. Our research aims at evaluating the effectiveness of PSBB by using the Kermack-McKendrick SIR pandemic model and the NLSUR non-linear least square estimation. Using daily data published by the Covid-19 task force, we found that PSBB had a positive …

Behavioral Changes In Accessing Outpatient Care During The Covid-19 Pandemic, Alfiah Hasanah, Donny Hardiawan, Jefani Marrosa, Adlan Ramadhan, Heriyaldi Heriyaldi, Estro Dariatno Sihaloho, Adiatma Y. M. Siregar

Jurnal Ekonomi Kesehatan Indonesia

Unwillingness to seek healthcare has been observed in citizens from many countries during the Covid-19 pandemic. Previous studies show that the changes in behavior are due to various reasons such as economic slowdown, loss of health insurance due to termination of employment, and fear of contracting the virus. This behavior may result in worsened health conditions, making a individual more susceptible to the virus. The supply side of health care is one of the things that should be considered in the discussion about access to health care in developing countries. This paper investigates access to the healthcare problem of Indonesians, …

Perhitungan Cost Of Treatment Pada Pasien Rawat Inap Penderita Stroke Peserta Bpjs Di Rsud Dr. Mohamad Saleh Kota Probolinggo, Azizah Munawwarah

Jurnal Ekonomi Kesehatan Indonesia

Stroke is one of the catastrophic diseases which is the most cause of death in Indonesia. Probolinggo is the second highest prevalence city of stroke in East Java. The prevalence and mortality of stroke have increased in RSUD dr. Mohamad Saleh Probolinggo. Stroke is a high-cost and life-threatening disease, so that the propitious financial management is needed to ensure the effectiveness and efficiency of this services. Therefore, it is necessary to do a study of cost of treatment that measures the cost of stroke treatment. The purpose of this study was to describe cost of treatment of stroke patients as …

Clinical Pharmacy Services And Medication Utilization In Hospice Care, Aishwarya Kulkarni

Electronic Theses and Dissertations

Background: As discussed within the guidelines from the American Society of Health-System Pharmacists (ASHP), pharmacists are an integral part of the hospice multidisciplinary team involved in optimizing the treatments. Methadone, a long-active opioid, is particularly useful in this population but may be clinically underutilized. Additionally, the cost share of medication utilization in hospice and palliative care is shifting towards hospice providers. The assessment of medication utilization and methadone use in this setting can help develop overall cost/clinical optimization strategies. Thus, there is a need to understand the use and expenditure of various medications and pharmacists' role in providing methadone …

Comparing Long-Term Value Creation After Biotech And Non-Biotech Ipos, 1997–2016, Ekaterina Galkina Cleary, Laura M. Mcnamee, Skyler De Boer, Jeremy Holden, Liam Fitzgerald, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

We compared the financial performance of 319 BIOTECH companies focused on developing therapeutics with IPOs from 1997–2016, to that of paired, non-biotech CONTROL companies with concurrent IPO dates. BIOTECH companies had a distinctly different financial structure with high R&D expense, little revenue, and negative profits (losses), but a similar duration of listing on public markets and frequency of acquisitions. Through 2016, BIOTECH and CONTROL companies had equivalent growth in market cap and shareholder value (> $100 billion), but BIOTECH companies had lower net value creation ($93 billion vs $411 billion). Both cohorts exhibited a high-risk/high reward pattern of return, with …

Association Of Electronic Prescription In Controlled Substances Used, Archana Suwal, Jemima Akinyi Okonjo

Theses, Dissertations and Capstones

Introduction: Controlled substances have been described as pharmaceuticals or illegal medicines that act primarily on the central nervous system and could cause physical and mental dependence, eventually leading to addiction. Prescription opioids were a significant contributor to the opioid epidemic, accounting for more than 70,000 opioid-related overdose deaths, including illicit and prescription opioids, between 2018 and 2019. The Electronic Prescriptions for Controlled Substances (EPCS) initiative recently aimed to reduce rates of prescription opioid addiction, abuse, diversion, and death. The system for controlled substances had become more widely used as providers and governments trying to combat the opioid problem. Because …

Late-Stage Product Development And Approvals By Biotechnology Companies After Initial Public Offering, 1997-2016, Laura M. M. Mcnamee, Ekaterina Galkina Cleary, Sunyi Zhang, Usama Salim, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Purpose: This work describes the late-stage product portfolios of the biotechnology companies that completed initial public offerings (IPOs) from 1997 to 2016. We asked whether these emerging companies continue to develop innovative, biologic products and produce the innovation promised by the early biotechnology industry.

Methods: We identified therapeutic products that reached Phase III development from 1997 to 2016, the characteristics of the products, the dates of the initiation of Phase III and product approval, proxy indicators of the innovativeness of each product, and the contribution of each biotechnology company. Companies were characterized by IPO window and clinical status of the …

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 …