BACKGROUND: Multiple sclerosis (MS) is a costly and crippling neurologic disease. Approximately 250,000 to 400,000 persons in the United States are currently diagnosed with MS. Most individuals experience their first symptoms between the ages of 20 and 40 years; therefore, this disease may have substantial impact over many years of life on health, quality of life, productivity, and employment. Whereas a number of studies have utilized a cross-sectional design to evaluate the costs associated with MS, no study has used a large administrative claims database to analyze the direct costs associated with newly diagnosed MS. OBJECTIVE: To estimate the additional health care utilization and costs in otherwise healthy patients with newly diagnosed MS. METHODS: This was a retrospective cohort analysis of the Medstat MarketScan Commercial Claims and Encounters database, which is composed of medical and pharmacy claims for approximately 8 million beneficiaries from 45 U.S. commercial health plans. Cases extracted fr...

Background: The goal of this review was to assess the state of the published literature on health economics and compliance of vials/syringes versus pen devices. Methods: A literature search was performed using the Embase search engine for publications that linked drug terms (insulin and insulin lispro) to disease terms (insulin-dependent diabetes mellitus, non–insulin-dependent diabetes mellitus) and other terms (accuracy, article, clinical trial, controlled clinical trial, controlled study, cost benefit analysis, drug delivery system, drug dosage form, drug dosage form comparison, drug dose comparison, drug preference, equipment design, force, glycemic control, healthcare cost, human, insulin treatment, needle, patient attitude, patient compliance, patient safety, torque) along with author keywords (Diabetes, Dose accuracy, FlexPen ^® [Novo Nordisk, Bagsvaerd, Denmark], Insulin, Next Generation FlexPen). Results: The search yielded 39 articles, of which five articles met our study criteria. The focus of the critical outcomes was patient adherence to insulin pen devices versus insulin vials (syringes), hypoglycemic events, emergency department visits due to hypoglycemic events, and costs associated with diabetes and health care. The observation period, mean age of patients, and data sources differed across the studies. The studies indicated that there was an improved adherence with insulin pen devices as opposed to insulin vials (syringes) and that the associated healthcare resource utilization and costs associated with them were found to decrease with the use of pen devices, compared to vials. Conclusions: The use of pen devices improves the health economics benefits and adherence to insulin therapy.

Background: To estimate the potential cost savings by following the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline recommendations in patients being treated for chronic obstructive pulmonary disease (COPD) with the combination of long-acting β₂-agonist (LABA), long-acting muscarinic antagonist (LAMA) or inhaled corticosteroids (ICS). Methods: The Geisinger Health System (GHS) database was utilized to identify subjects between January 1, 2004 to March 12, 2007. The index date was based on the first prescription of a LAMA plus LABA, LAMA plus LABA/ICS, or LABA plus ICS. Patients were included in the study if they: had a COPD diagnosis; had data representative of treatment 12 months prior to and 12 months post index date; were 40 years of age or over; had no prior diagnosis for asthma; and had pulmonary function test (PFT) data. We examined the baseline characteristics of these patients along with their healthcare resource utilization. Based on PFT data within 30 days of the index date, a subgroup was classified as adhering or non-adhering to GOLD guidelines. Results: A total of 364 subjects could be classified as adhering or non-adherent to current GOLD guidelines based on their PFT results. The adherent subgroup received COPD medications consistent with current GOLD guidelines. Of the LAMA plus LABA cohort, 25 patients adhered and 39 patients were non-adherent to current GOLD guidelines. In the cohort of LABA plus ICS, 74 patients were adherent and 180 patients non-adherent to current GOLD guidelines. In the cohort of LAMA plus LABA/ICS, 21 patients were adherent and 25 patients non-adherent to current GOLD guidelines. GOLD adherence was associated with mean total cost of all services savings of $5,889 for LAMA plus LABA, $3,330 for LABA + ICS, and $10,217 for LAMA plus LABA/ICS cohorts. Conclusion: Staging of COPD with a PFT and adherence to current GOLD guidelines was associated with lower costs in subjects with moderate to severe COPD. Appropriate use of LAMA plus LABA, LABA plus ICS, and LAMA plus LABA/ICS has economic as well as clinical benefits for patients and payers.