National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Asthma (1)
- Behavioral Health (3)
- Cancer (4)
- Cancer: Lung Cancer (1)
- Cancer: Ovarian Cancer (1)
- Children/Adolescents (1)
- Comparative Effectiveness (1)
- Depression (1)
- Diabetes (3)
- Disparities (2)
- Elderly (1)
- Eye Disease and Health (1)
- (-) Healthcare Costs (24)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Health Insurance (3)
- Hepatitis (1)
- Human Immunodeficiency Virus (HIV) (1)
- Low-Income (1)
- Medicaid (1)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medicare (6)
- (-) Medication (24)
- Obesity (1)
- Opioids (1)
- Osteoporosis (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (3)
- Patient Safety (1)
- Practice Patterns (1)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- Screening (1)
- Substance Abuse (1)
- Treatments (2)
- Uninsured (1)
- Vaccination (1)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedEaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Poonawalla IB, Parikh RC, Du XL
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
The authors evaluated the cost-effectiveness of various chemotherapeutic and targeted therapy alternatives for ovarian cancer. They found that standard platinum-taxane combination chemotherapy for first-line treatment was most cost-effective.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Parikh RC, Du XL .
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
Pharmacoeconomics 2015 Nov;33(11):1155-85. doi: 10.1007/s40273-015-0304-9.
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Keywords: Treatments, Healthcare Costs, Medication, Cancer: Ovarian Cancer
Miller GE, Sarpong EM, Hill SC
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Hill SC .
Does increased adherence to medications change health care financial burdens for adults with diabetes?
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Diabetes, Patient Adherence/Compliance, Medication
Hernandez I, Zhang Y
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
This study compared clinical and economic outcomes between teriparatide (monthly costs $1120) and bisphosphonates (monthly costs $14) among postmenopausal women with osteoporosis. It found that teriparatide users had higher risk of fracture and higher costs, compared with similar bisphosphonates users. The hazard ratios of fracture for teriparatide relative to bisphosphonates ranged from 1.37 to 2.12, depending on methods.
AHRQ-funded; HS018657.
Citation: Hernandez I, Zhang Y .
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
J Eval Clin Pract 2015 Oct;21(5):840-7. doi: 10.1111/jep.12389.
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Keywords: Medication, Women, Osteoporosis, Healthcare Costs
Shih YC, Smieliauskas F, Geynisman DM
Trends in the cost and use of targeted cancer therapies for the privately insured nonelderly: 2001 to 2011.
This study sought to define and identify drivers of trends in cost and use of targeted therapeutics among privately insured nonelderly patients with cancer receiving chemotherapy between 2001 and 2011. It found a large increase in the use of targeted intravenous anticancer medications and a gradual increase in targeted oral anticancer medications; targeted therapies accounted for 63 percent of all chemotherapy expenditures in 2011.
AHRQ-funded; HS018535; HS020263.
Citation: Shih YC, Smieliauskas F, Geynisman DM .
Trends in the cost and use of targeted cancer therapies for the privately insured nonelderly: 2001 to 2011.
J Clin Oncol 2015 Jul 1;33(19):2190-6. doi: 10.1200/jco.2014.58.2320..
Keywords: Healthcare Costs, Cancer, Health Insurance, Medication
Yazdany J, Dudley RA, Chen R
Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D.
The aim of this study was to conduct the first systematic, national investigation of how Part D plans cover biologic disease-modifying anti-rheumatic drugs (DMARDs) and to determine patients’ financial burden under current cost-sharing structures. It found that all Medicare Part D drug plans cover at least 1 biologic DMARD, access is highly controlled through prior authorization requirements, and beneficiaries face significant cost sharing.
AHRQ-funded; HS017723; HS016772.
Citation: Yazdany J, Dudley RA, Chen R .
Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D.
Arthritis Rheumatol 2015 Jun;67(6):1474-80. doi: 10.1002/art.39079..
Keywords: Medicare, Medication, Healthcare Costs, Arthritis
Conti RM, Padula WV, Larson RA
Changing the cost of care for chronic myeloid leukemia: the availability of generic imatinib in the USA and the EU.
This article discusses various issues associated with potential impact on health system spending levels for chronic myeloid leukemia after generic imatinib becomes available. Included is a review of their implications for the development of country-specific cost-effectiveness models to predict the implications for cost and quality of care from generic imatinib.
AHRQ-funded; HS023710.
Citation: Conti RM, Padula WV, Larson RA .
Changing the cost of care for chronic myeloid leukemia: the availability of generic imatinib in the USA and the EU.
Ann Hematol 2015 Apr;94 Suppl 2:S249-57. doi: 10.1007/s00277-015-2319-x..
Keywords: Cancer, Medication, Healthcare Costs
Predmore ZS, Mattke S, Horvitz-Lennon M
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
The authors presented findings of an analysis conducted to quantify the potential net savings to state budgets from interventions to improve adherence to antipsychotic drugs among patients with schizophrenia. Their financial model estimated an annual cost of $21.4 billion (in 2013 dollars) to Medicaid programs and other state agencies for people with schizophrenia. They concluded that better adherence could yield annual net savings of $3.28 billion to states and recommended that states consider interventions shown to increase medication adherence in this patient group.
AHRQ-funded; HS000029.
Citation: Predmore ZS, Mattke S, Horvitz-Lennon M .
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
Psychiatr Serv 2015 Apr;66(4):343-5. doi: 10.1176/appi.ps.201400506.
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Keywords: Healthcare Costs, Medication, Behavioral Health, Patient Adherence/Compliance
Adams AS, Soumerai SB, Zhang F
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
This study aimed to evaluate the impact of removing a significant financial barrier to prescription medications (drug caps) on existing black-white disparities in antidepressant treatment rates among patients with diabetes and comorbid depression. It found that policies that remove financial barriers to medications may increase depression treatment rates among patients with diabetes overall while exacerbating treatment disparities.
AHRQ-funded; HS018577; HS018072.
Citation: Adams AS, Soumerai SB, Zhang F .
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
Clin Ther 2015 Mar;37(3):597-609. doi: 10.1016/j.clinthera.2014.12.011..
Keywords: Medication, Disparities, Depression, Diabetes, Healthcare Costs
Prentice JC, Conlin PR, Gellad WF
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
The researchers compared the effects of neutral protamine Hagedorn (NPH) and long-acting insulin analogues on long-term outcomes. They found no consistent difference in long-term health outcomes when comparing use of long-acting insulin analogues and NPH insulin. The higher cost of analogue insulin without demonstrable clinical benefit raises questions of its cost effectiveness in the treatment of patients with diabetes.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
Am J Manag Care 2015 Mar;21(3):e235-43..
Keywords: Comparative Effectiveness, Diabetes, Healthcare Costs, Medication, Outcomes
Davidoff AJ, Hendrick FB, Zeidan AM
AHRQ Author: Davidoff AJ
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
This study examined use of erythropoiesis-stimulating agents (ESAs) to manage anemia in patients with myelodysplastic syndromes (MDS). It found that few patients with MDS received ESAs through Part D. OOP payments required under Part D were substantially higher than under Part B. Cost sharing, as reflected by low-income subsidy receipt, likely affected decisions to prescribe ESAs outside of the physician office.
AHRQ-authored.
Citation: Davidoff AJ, Hendrick FB, Zeidan AM .
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
J Oncol Pract 2015 Mar;11(2):e190-8. doi: 10.1200/jop.2014.001527..
Keywords: Elderly, Healthcare Costs, Medicare, Medication
Zhang Y, Baik SH, Newhouse JP
Use of intelligent assignment to Medicare Part D plans for people with schizophrenia could produce substantial savings.
The investigators simulated Medicare Part D savings from replacing random assignment with an "intelligent assignment" algorithm that would assign beneficiaries to the least expensive plan in 2010 based on their drug usage in the previous year. They found that intelligent assignment could have saved about $150 million for Medicare and beneficiaries with schizophrenia combined in 2010.
AHRQ-funded; HS018657.
Citation: Zhang Y, Baik SH, Newhouse JP .
Use of intelligent assignment to Medicare Part D plans for people with schizophrenia could produce substantial savings.
Health Aff 2015 Mar;34(3):455-60. doi: 10.1377/hlthaff.2014.1227.
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Keywords: Healthcare Costs, Medicare, Medication, Behavioral Health
Pershing S, Pal Chee C, Asch SM
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
The researchers examined the diffusion of new biologics ranibizumab and bevacizumab, both for the treatment of macular degeneration but differing in price, in fee-for-service Medicare and Veterans Affairs (VA) systems during 2005-11, in part to assess the impact that differing financial incentives had on prescribing. Their analysis indicated that there are opportunities in both the VA and Medicare to adopt more value-conscious treatment patterns and that multiple mechanisms exist to influence utilization.
AHRQ-funded; HS018434.
Citation: Pershing S, Pal Chee C, Asch SM .
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
Health Aff 2015 Feb;34(2):229-38. doi: 10.1377/hlthaff.2014.1032.
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Keywords: Healthcare Costs, Eye Disease and Health, Medicare, Medication
Kim DD, Hutton DW, Raouf AA
Cost-effectiveness model for hepatitis C screening and treatment: Implications for Egypt and other countries with high prevalence.
The researchers examined the cost-effectiveness of screening and treatment for HCV infection for asymptomatic, average-risk adults using a Markov decision analytic model. They found that, in Egypt, implementing a screening program using triple-therapy treatment (sofosbuvir with pegylated interferon and ribavirin) was dominant compared with no screening because it would have lower total costs and improve health outcomes.
AHRQ-funded; HS013853.
Citation: Kim DD, Hutton DW, Raouf AA .
Cost-effectiveness model for hepatitis C screening and treatment: Implications for Egypt and other countries with high prevalence.
Glob Public Health 2015;10(3):296-317. doi: 10.1080/17441692.2014.984742..
Keywords: Hepatitis, Screening, Healthcare Costs, Medication
Jackson H, Mandell K, Johnson K
Cost-effectiveness of injectable extended-release naltrexone compared with methadone maintenance and buprenorphine maintenance treatment for opioid dependence.
The authors estimated the cost-effectiveness of injectable extended-release naltrexone (XR-NTX) compared with methadone maintenance and buprenorphine maintenance treatment for adult males enrolled in treatment for opioid dependence in the United States from the perspective of state-level addiction treatment payers. They found that XR-NTX is a cost-effective medication for treating opioid dependence if state addiction treatment payers are willing to pay at least $72 per opioid-free day.
AHRQ-funded; HS000083.
Citation: Jackson H, Mandell K, Johnson K .
Cost-effectiveness of injectable extended-release naltrexone compared with methadone maintenance and buprenorphine maintenance treatment for opioid dependence.
Subst Abus 2015;36(2):226-31. doi: 10.1080/08897077.2015.1010031.
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Keywords: Healthcare Costs, Medication, Opioids, Substance Abuse, Treatments
Raghavan R, Brown DS, Allaire BT
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
The authors aimed to quantify the magnitude of Medicaid expenditures incurred in the purchase of psychotropic drugs for children with histories of abuse or neglect. They concluded that Medicaid agencies should focus their cost containment strategies on antidepressants and antimanic drugs, consider expanding primary care case management arrangements, and expand use of instruments such as the Child Behavior Checklist to identify and treat high-need children.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
Psychiatr Serv 2014 Dec;65(12):1445-51. doi: 10.1176/appi.ps.201400028.
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Keywords: Children/Adolescents, Healthcare Costs, Medicaid, Medication, Behavioral Health
Trish E, Joyce G, Goldman DP
Specialty drug spending trends among Medicare and Medicare Advantage enrollees, 2007-11.
The authors analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007-11 pharmacy claims data. They found that annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, but specialty drugs accounted for less than ten percent of total drug spending per beneficiary. Additionally, in 2011, cost-sharing reductions under the Affordable Care Act significantly reduced specialty drug users' out-of-pocket burden, which decreased 26 percent from 2010.
AHRQ-funded; HS000046.
Citation: Trish E, Joyce G, Goldman DP .
Specialty drug spending trends among Medicare and Medicare Advantage enrollees, 2007-11.
Health Aff 2014 Nov;33(11):2018-24. doi: 10.1377/hlthaff.2014.0538.
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Keywords: Healthcare Costs, Health Insurance, Medicare, Medication
Starner CI, Alexander GC, Bowen K
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
The investigators examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. They found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic anti-inflammatory drugs or with drugs for multiple sclerosis. They highlighted that, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
AHRQ-funded; HS018960.
Citation: Starner CI, Alexander GC, Bowen K .
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
Health Aff 2014 Oct;33(10):1761-9. doi: 10.1377/hlthaff.2014.0497.
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Keywords: Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Crisp GD, Roberts AW, Esserman DA
The University of North Carolina's Health Care Pharmacy Assistance Program.
This study examined a program providing financial assistance to uninsured residents of North Carolina who need prescription medications. It found that from 2009 to 2011, the program served 7,180 patients in 81 counties. These patients received a mean of 23 prescriptions at an average cost of $754 per recipient per year.
AHRQ-funded; HS000032
Citation: Crisp GD, Roberts AW, Esserman DA .
The University of North Carolina's Health Care Pharmacy Assistance Program.
N C Med J. 2014 Sep-Oct;75(5):303-9..
Keywords: Healthcare Costs, Uninsured, Medication, Healthcare Utilization
Sarpong EM
AHRQ Author: Sarpong EM
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
The author examined the impact of obesity on medication use and expenditures among nonelderly adults with asthma using the Medical Expenditure Panel Survey. He found that obese classes II/III individuals were more likely to have current asthma, seek treatment for asthma, use more medications, and have higher medication and health care expenditures compared with normal weight individuals. His results suggested that reduction in body weight may help reduce health resource use and expenditures for nonelderly adults with asthma.
AHRQ-authored.
Citation: Sarpong EM .
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
J Health Care Poor Underserved 2014 Aug;25(3):1245-61. doi: 10.1353/hpu.2014.0142.
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Keywords: Asthma, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medication, Obesity
Smieliauskas F, Chien CR, Shen C
Cost-effectiveness analyses of targeted oral anti-cancer drugs: a systematic review.
The researchers’ objective was to perform the first comprehensive review of cost-effectiveness analyses of targeted oral anti-cancer medications (OAMs). They concluded that in over half of the treatment settings in which a targeted OAM was compared with treatment that was not a targeted OAM, targeted OAMs were considered cost-effective.
AHRQ-funded; HS018535.
Citation: Smieliauskas F, Chien CR, Shen C .
Cost-effectiveness analyses of targeted oral anti-cancer drugs: a systematic review.
Pharmacoeconomics 2014 Jul;32(7):651-80. doi: 10.1007/s40273-014-0160-z..
Keywords: Cancer, Healthcare Costs, Medication
Zhang Y, Zhou C, Baik SH
A simple change to the Medicare Part D low-income subsidy program could save $5 billion.
The authors used an intelligent reassignment algorithm and 2008-09 Medicare Part D drug use and spending data to match enrollees to available Part D plans according to their medication needs. They found that such a reassignment approach, compared to the current approach, could have saved the federal government over $5 billion in 2009.
AHRQ-funded; HS018657.
Citation: Zhang Y, Zhou C, Baik SH .
A simple change to the Medicare Part D low-income subsidy program could save $5 billion.
Health Aff 2014 Jun;33(6):940-5. doi: 10.1377/hlthaff.2013.1083.
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Keywords: Healthcare Costs, Low-Income, Medicare, Medication
Forrester SH, Hepp Z, Roth JA
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
The study objective was to estimate the cost-effectiveness of computerized provider order entry versus traditional paper-based prescribing in reducing medications errors and adverse drug events in the ambulatory setting of mid-sized medical group. Using a decision-analytic model, the researchers found that the adoption of CPOE in the ambulatory setting provides excellent value for the investment.
AHRQ-funded; HS014739
Citation: Forrester SH, Hepp Z, Roth JA .
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
Value Health. 2014 Jun;17(4):340-9. doi: 10.1016/j.jval.2014.01.009..
Keywords: Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Patient Safety, Healthcare Costs, Ambulatory Care and Surgery, Prevention