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Impact of adherence to interferons in the treatment of multiple sclerosis: a non-experimental, retrospective, cohort study.

https://arctichealth.org/en/permalink/ahliterature146126
Source
Clin Drug Investig. 2010;30(2):89-100
Publication Type
Article
Date
2010
Author
Stephanie C Steinberg
Richard J Faris
Cyril F Chang
Andrew Chan
Mark A Tankersley
Author Affiliation
Accredo Health Group, Inc., The University of Memphis, Memphis, Tennessee, USA.
Source
Clin Drug Investig. 2010;30(2):89-100
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cohort Studies
Emergency Medical Services - statistics & numerical data
Female
Health Resources - utilization
Hospitalization - statistics & numerical data
Humans
Insurance Claim Review
Insurance, Pharmaceutical Services - statistics & numerical data
Interferon Type I - therapeutic use
Male
Middle Aged
Multiple Sclerosis - drug therapy
Office visits - statistics & numerical data
Patient compliance
Recombinant Proteins
Recurrence
Retrospective Studies
United States
Abstract
Relapsing-remitting multiple sclerosis (RRMS) is a chronic disease affecting about 400 000 people in the US characterized by increasing patient disability and burden on society. While there is no cure for multiple sclerosis (MS), pharmaceutical treatments exist that can limit the number of relapses a patient experiences, and slow disease progression. One such class of agents used to treat RRMS are the interferons: interferon-beta-1a (Rebif and Avonex and interferon-beta-1b (Betaseron and Extavia). Patients must take these injectable medications regularly to achieve the optimal outcomes. However, patient issues and potential adverse effects of the medication may prevent the patient from taking the medication as directed and lower adherence. To date, limited evidence exists regarding the effect of patient adherence to interferon-beta therapies on clinical and economic outcomes.
The purpose of this study was to explore the impact of patient adherence to interferon-beta therapy on MS relapse rates and healthcare resource utilization.
Using a non-experimental, retrospective cohort design, a sample population (n = 1606) was drawn from patients identified in a database that includes both pharmacy and medical claims data. The study population was separated into two groups based on a measure of medication possession ratio (MPR)-adherent and non-adherent patients, and adherence was defined as MPR > or =85% in a given year during the study period (2006-8). Key outcome variables included MS relapses and healthcare resource utilization. Data were analysed using parametric and non-parametric statistics, and regression modeling.
During the study period, the average MPR for all patients on interferon-beta therapy varied from 72% to 76%. Only 27-41% of patients in each year were considered adherent (i.e. MPR > or =85%) and only 4% of patients had an MPR of > or =85% throughout the 3-year study period (2006-8). Patients who were adherent tended to have a lower risk of relapses over 3 years than non-adherent patients. A significantly lower risk of relapses was found in 2006 (risk ratio [RR] 0.89; 95% CI 0.81, 0.97). Furthermore, an increasingly larger effect emerged between adherence and relapses when comparing adherent patients (MPR > or =85%) with subgroups of non-adherent patients (
PubMed ID
20067327 View in PubMed
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Technical efficiency in the use of health care resources: a comparison of OECD countries.

https://arctichealth.org/en/permalink/ahliterature58231
Source
Health Policy. 2004 Jul;69(1):55-72
Publication Type
Article
Date
Jul-2004
Author
Donna Retzlaff-Roberts
Cyril F Chang
Rose M Rubin
Author Affiliation
Management Science, University of South Alabama, Mobile, AL, USA.
Source
Health Policy. 2004 Jul;69(1):55-72
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Comparative Study
Cross-Cultural Comparison
Developed Countries - economics
Efficiency, Organizational - statistics & numerical data
Health Resources - supply & distribution - utilization
Health Services Research - methods
Health Status Indicators
Humans
Infant
Infant mortality
Infant, Newborn
International Agencies
Life expectancy
Models, Econometric
Quality Assurance, Health Care
Abstract
Our paper analyzes technical efficiency in the production of aggregate health outcomes of reduced infant mortality and increased life expectancy, using Organization for Economic Cooperation and Development (OECD) health data. Application of data envelopment analysis (DEA) reveals that some countries achieve relative efficiency advantages, including those with good health outcomes (Japan, Sweden, Norway, and Canada) and those with modest health outcomes (Mexico and Turkey). We conclude the USA may learn from countries more economical in their allocation of healthcare resources that more is not necessarily better. Specifically, we find that the USA can substantially reduce inputs while maintaining the current level of life expectancy.
PubMed ID
15484607 View in PubMed
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