Prescription medications enhance the well-being of most chronically ill patients. Many individuals, however, struggle with how to pay for their treatments and as a result experience problems with self-care and health maintenance. Although studies have documented that high out-of-pocket costs are associated with medication non-adherence, little research on prescription cost ...

CONTEXT: Somatoform disorders are an important determinant of medical care utilization, but their independent effect on utilization is difficult to determine because somatizing patients frequently have psychiatric and medical comorbidity. OBJECTIVES: To assess the extent of the overlap of somatization with other psychiatric disorders; to compare the medical utilization of ...

OBJECTIVE: To report rates of cost-related skipping of medications and other treatments, assess correlates of skipping, examine changes in skipping between 1998 and 2000, and identify factors associated with changes in skipping. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional and longitudinal analyses of surveys of a probability sample of Medicare beneficiaries in ...

Some ambulant people with HIV are cared for primarily by their general practitioner and some in an outpatient clinic. Costs and patterns of care in these settings were studied in 65 such patients based in Zürich, from a limited societal perspective (excluding patient costs) based on medical resource use. Antiretroviral ...

The past 15 years have been a time of remarkable achievement in the treatment of psoriasis. New topical medications with efficacy and safety have been introduced. At the same time, there has been resurgence in the use of traditional agents such as methotrexate and cyclosporine. An enlightened understanding of psoriasis ...

A cohort of 197 Medicaid-insured patients presenting for treatment in Kaiser Permanente's outpatient chemical dependency treatment program were observed the year prior to their program intake visit and followed for 3 years afterwards, to compare their medical costs and utilization to demographically matched commercially insured patients entering the same programs. ...

STUDY OBJECTIVE: To evaluate the effects of a cyclooxygenase (COX)-2 inhibitor prior authorization (PA) program on direct medical and pharmacy costs. DESIGN: Prospective, pre- and postimplementation cohort study with reference group. SETTING: Large corporation in the Midwest. PATIENTS: Of 26,375 continuously enrolled members, 737 used a COX-2 inhibitor in the ...

OBJECTIVES: Newer oral allergic rhinitis (AR) medications, the second-generation antihistamines (SGAs) have gained widespread acceptance because of their efficacy and reduced side effects relative to first-generation antihistamines (FGAs). There are no empirical studies comparing the costs of treatment of SGAs relative to FGAs. METHODS: We analyzed data from a 20% ...

OBJECTIVES: To compare posttreatment medical costs for patients with overactive bladder (OAB) initiating treatment with oxybutynin chloride immediate release (oxybutynin IR), oxybutynin chloride extended release (oxybutynin ER), or tolterodine extended-release tartrate capsules (tolterodine ER). METHODS: Data were drawn from administrative claims of enrollees aged 18 years and older of a ...

Heparin-induced thrombocytopenia (HIT) is a costly but potentially preventable complication associated with the use of heparin. Based on a 1% to 3% incidence of HIT, the total cost and potential financial loss due to HIT complicating open-heart surgery is estimated to range from over 100 to 300 million dollars and ...

OBJECTIVE: To examine levels of persistence and compliance as well as the economic impact of extended-release tolterodine (tolterodine ER) versus immediate- and extended-release oxybutynin (oxybutynin IR or oxybutynin ER) among commercially-insured patients with overactive bladder (OAB). METHODS: Patients with OAB who initiated tolterodine ER, oxybutynin IR, or oxybutynin ER between ...

BACKGROUND: Post-transplant prescription medications are expensive, often costing over 12,000 dollars annually. Many solid-organ transplant patients have Medicare coverage and patients enrolled in Medicare-approved drug discount card (MADDC) programs may be able to receive prescription medications at a reduced price. However, many transplant healthcare practitioners are unaware of the utility ...

OBJECTIVE: To evaluate the effects of splinting on outcomes for injured workers with epicondylitis. DESIGN: Retrospective cohort study using propensity score methodology to statistically control for all observed pretreatment differences between patients with and without splints. SETTING: Nationwide network of 253 occupational medicine clinics. PARTICIPANTS: All injured workers (N=4614) receiving ...

OBJECTIVE: To estimate the smoking attributable medical expenditures and productivity loss of people aged 35 and over in Taiwan in 2001 from a societal viewpoint. METHODS: A prevalence based approach was used to estimate smoking attributable costs. Epidemiological parameters were obtained from two follow up studies and government statistics. Data ...

OBJECTIVE: To compare the costs of the new fixed combinations for glaucoma medical therapy. METHODS: The studied drugs were: Cosopt (5-mL bottle), Combigan (5-mL bottle) and Xalacom (2.5-mL bottle). Five bottles of each drug were obtained from pharmacies, and the medications lot numbers were recorded. To calculate the drop volume, ...

This study assesses the difference in direct medical costs between on-demand treatment with esomeprazole 20 mg, continuous treatment with esomeprazole 20 mg once-daily and continuous treatment with ranitidine 150 mg twice-daily to prevent symptomatic relapse in patients with gastroesophageal reflux disease over 26 weeks. Two hundred eighty-one GP clinics in ...

PURPOSE: We performed an analysis comparing the cost of medical management with TUNA therapy for a 5-year period. MATERIALS AND METHODS: Published costs for tamsulosin, finasteride, transurethral needle ablation (TUNA, Medtronic, Inc., Minneapolis, Minnesota) and transurethral resection of the prostate were used to construct a cost analysis model comparing medication ...

The utilization and prescribing quality of non-steroidal anti-inflammatory drugs (NSAIDs) in Zagreb were assessed by calculating the number of defined daily doses (DDDs) from the number and size of packages of each prescription NSAID dispensed at 31 and 32 pharmacies during the years 2001 and 2002. NSAIDs accounting for 95% ...

OBJECTIVE: The objective of this study was to evaluate the impact of medication adherence on healthcare utilization and cost for 4 chronic conditions that are major drivers of drug spending: diabetes, hypertension, hypercholesterolemia, and congestive heart failure. RESEARCH DESIGN: The authors conducted a retrospective cohort observation of patients who were ...

BACKGROUND: Based on randomized clinical trials, consensus has been emerging that the first line of treatment for individuals with psychotic disorders should be the newer atypical or second generation antipsychotic medications rather than the older neuroleptics. Given that acquisition costs of atypical antipsychotics are generally higher than typical antipsychotics, uncertainty ...

Although medical therapy is known to reduce the risk of kidney stone recurrence, the cost effectiveness of medical prophylaxis is controversial. We evaluated medical treatment strategies including dietary measures (conservative), empiric medical therapy (empiric) or directed medical therapy (directed) based on comprehensive metabolic evaluation (CME) for patients with recurrent kidney ...

OBJECTIVE: Diabetes is the third-most expensive physical health condition among US employees. We sought to evaluate the contribution of hypoglycemia to these costs. METHODS: We studied 2664 employees using insulin for whom medical encounters and short-term disability (STD) records were available. RESULTS: Among these employees, 442 (16.6%) had a diagnosis ...

Male erectile dysfunction is a common medical condition. Recent advances in our understanding of corpora cavernosa physiology have resulted in three effective oral medications (sildenafil, vardenafil and tadalafil--all phosphodiesterase type 5 inhibitors), which can effectively treat many men with erectile dysfunction. However, a large number of men are not adequately ...

Reimbursement to providers for delivering medications in the dialysis field is a subject of current concern, with some payors limiting payment to an amount equaling the provider's acquisition cost. At the same time, some providers arbitrarily mark up medications by a large factor. For dialysis, as well as for the ...

OBJECTIVE: To estimate the direct medical costs of falls in the population of community-dwelling elderly. METHODS: Data from a sample of 4,025 consumers from the 1997 Medical Expenditure Panel Survey were used to make estimates that were representative of the population of civilian, noninstitutionalized elderly in the United States. RESULTS: ...

PURPOSE: Several studies document the impact of benign prostatic hyperplasia (BPH) in working, aged men. Direct medical costs related to BPH treatment are largely borne by employees through higher premiums. However, indirect costs related to lost work are primarily borne by the employer. In this study we used claims data ...

Irritable bowel syndrome (IBS) is a common gastrointestinal motility disorder that typically affects persons of working age and is costly to employers. The financial burden attributable to the direct (use of healthcare resources) and indirect (missed days from work [absenteeism] and loss of productivity while at work [presenteeism]) costs of ...

OBJECTIVES: To determine the extent to which homebound older people adopt strategies to reduce out-of-pocket prescription medication cost and the factors associated with level of cost-related medication management. DESIGN: Cross-sectional study. SETTING: Home-delivered meals programs in four North Carolina counties. PARTICIPANTS: Random sample of 222 home-delivered meal recipients aged 60 ...

OBJECTIVES: To identify the core best practice standards in ill-health retirement (IHR) procedures. To investigate whether changing medical criteria and introducing medical severance payments affect the rate and cost of IHR. METHODS: The core standards for best practice in IHR procedures were distilled from the published literature. On 1st April ...

Treatment standards or guidelines have been developed for most features of Parkinson's disease (PD). However, data on the actual treatment that is put into practice are scarce. In 2000, a nationwide survey on the topic of sudden onset of sleep (SOS) in PD was initiated among the members of the ...

OBJECTIVE: Patient self-report and audits of medical records are the most common approaches for obtaining information on utilization of medical services. Because of the time and cost savings associated with self-report, it is important to demonstrate the reliability of this approach, particularly in older persons who use more medical resources ...

Seven oral triptans are now generally available for the acute treatment of migraine, and physicians may sometimes feel under pressure to switch patients from one triptan to another for nonclinical reasons. This commentary article provides advice on what information should be taken into account by the physician before they consider ...

The objective of this study is to evaluate the cost-effectiveness of letrozole compared with tamoxifen as first-line therapy in post-menopausal women with advanced breast cancer in Japan. A Markov analytical model was developed to estimate life-year (LY) expectancies, using key transition probabilities obtained from the results of a multinational phase ...

While Congress continues to debate issues related to Medicaredrug benefits, senior citizens grow increasingly frustrated withtheir monthly medication bills. Many seniors are unable to affordall of their medications, and therefore find that they must choosebetween those that are the most helpful and those that have thegreatest potential for severe medical ...

BACKGROUND: Enfuvirtide (ENF) plus an optimized background (OB) antiretroviral regimen delays virological failure (VF), reduces HIV-1 viral load, and increases CD4 count compared with OB only in pretreated patients. PURPOSE: To forecast long-term outcomes, costs, and cost-effectiveness of ENF+OB vs. OB in the Italian health care system. METHOD: A Markov ...

Many chronically ill adults in the United States face high prescription medication costs, yet little is known about the strategies patients adopt to cope with these costs. Through a national survey of 4,055 adults taking prescription medications for one of five chronic diseases, we compared whether respondents cut back on ...

We conducted a systematic review of remote interpretation. Any published or unpublished research article that had telephone or videoconferenced interpretation as an intervention was included in the review. Nine articles were identified: seven on telephone and two on videoconferenced interpretation. Only one study was a randomized controlled trial. Remote interpretation ...

Hemodialysis patients take an average 12 medications (10 at home, 2 in clinic). Cost associated with clinic medications is estimated at 8,429 dollars per patient year at risk, but the medication cost associated with home medications is unknown. Our objective was to determine an estimate of the cost of home ...

This study aimed to evaluate the cost-effectiveness of formoterol (Oxis) Turbuhaler 4.5 microg and salbutamol 200 microg as reliever medications in Sweden and Spain. The study used data on effectiveness (exacerbations and symptom-free days) and resource utilisation from an open, 6-month, parallel-group, multicentre randomised trial with 18,124 asthma patients in ...

The purpose of this retrospective, multivariate analysis is to examine how medical conditions and demographic characteristics affect the costs of treating individuals diagnosed with anxiety. Data from MarketScan Databases [The MEDSTAT Group, 2000] were used to identify individuals with new episodes of anxiety. Multivariate analysis was used, with the dependent ...

INTRODUCTION: Studies have demonstrated that co-payments on medication reduce the consumption of both non-essential and essential drugs, and that the latter can lead to worse health outcomes. Far less is known about how patients cope with the cost of medication, particularly if affordability is an issue, and how this compares ...

Telemedicine is the practice of healthcare using interactive audio, visual and data communication. This includes healthcare delivery, diagnoses, consultation and treatment as well as education and transfer of medical data. The transmission of multimedia streams has remained a major challenge. Although the Internet remains basically insecure, technology allows today to ...

OBJECTIVE: To prospectively evaluate the health economic burden of patients with Parkinson's disease (PD) in Germany over a 6-month observation period and to identify the predictors of these costs. STUDY DESIGN AND METHODS: Direct and indirect costs were evaluated in 145 patients with PD (mean age 67.3 +/- 9.6 years). ...

INTRODUCTION: The purpose of this retrospective study was to examine the prevalence of comorbidities, resource use, direct medical costs, and the costs associated with missed work for adults diagnosed with attention-deficit hyperactivity disorder (ADHD). STUDY DESIGN: From a large claims database that captures inpatient, outpatient and prescription drug services, individuals ...

OBJECTIVE: To examine the clinical and financial outcomes associated with a proton pump inhibitor (PPI) prior-authorization policy. STUDY DESIGN: Interrupted time-series analyses of antisecretory prescription drug claims. Separate 6-month retrospective cohort analyses were conducted to estimate the clinical and financial effects of the policy. PATIENTS AND METHODS: More than 1.2 ...

Constipation is a prevalent condition that disproportionately affects women and older adults and leads to self-medication and/or medical consultation. It occurs as a result of functional idiopathic causes or secondarily as a result of a variety of factors including dietary and exercise patterns, adverse effects of medication and disease processes. ...

The anogenital human papillomavirus (HPV) is estimated to be the most commonly occurring sexually transmitted infection in the US. Comprehensive estimates of the annual economic burden associated with the prevention and treatment of anogenital HPV-related disease in the US population are currently unavailable. The purpose of this paper is to ...

OBJECTIVES: A pharmacoeconomic study to compare, in terms of: medical effectiveness, quality of life and costs two treatment strategies ('homeopathic strategy' vs 'antibiotic strategy') used in routine medical practice by allopathic and homeopathic GPs in the treatment of recurrent acute rhinopharyngitis in 18-month to 4-year-old children. METHODS: Statistical analysis of ...

Our objective was to evaluate relative differences in direct and total (direct and indirect) costs for medical abortion regimens using mifepristone and misoprostol or misoprostol alone. We created formulas to evaluate relative differences in costs in the United States, Chennai (Madras), India, and a hypothetical developing country based on published ...

This study aimed to identify, measure and evaluate expected costs of innovative palonosetron-based antiemetic therapy versus ondansetron-based treatment, the ultimate aim being to measure the drug price ratio (DPR) of the two pharmacological treatments in five different European countries. A decision model compared two antiemetic treatments - palonosetron and ondansetron ...