12 results on '"Timothy J. Inocencio"'
Search Results
2. Re: Response letter to Sanofi’s communication related to 'the budget impact of enzyme replacement therapy in type 1 Gaucher disease in the United States'
- Author
-
Sepehr Farahbakhshian, Timothy J. Inocencio, Gregory Poorman, Ekaterina Wright, Ravi Ramesh Pathak, and Michael Bullano
- Subjects
Health Policy - Published
- 2023
- Full Text
- View/download PDF
3. The budget impact of enzyme replacement therapy in type 1 Gaucher disease in the United States
- Author
-
Sepehr Farahbakhshian, Timothy J. Inocencio, Gregory Poorman, Ekaterina Wright, Ravi Ramesh Pathak, and Michael Bullano
- Subjects
Budgets ,Gaucher Disease ,Cost Savings ,Health Policy ,Humans ,Enzyme Replacement Therapy ,Drug Costs ,United States - Abstract
Gaucher disease (GD) is a rare autosomal recessive condition. Type 1 GD (GD1) is the most prevalent form of GD in Western countries; enzyme replacement therapy (ERT) is a treatment option for patients with GD1. To understand the economic value of the GD1 ERT velaglucerase alfa, a budget impact model (BIM) was developed from a United States (US) payer perspective.We estimated the budget impact of velaglucerase alfa for a 10-million-member US health plan by comparing the annual total costs of therapy between a scenario using current velaglucerase alfa uptake to a projected scenario with increased velaglucerase alfa uptake. Total drug costs for both scenarios were estimated as the sum of the product of the number of eligible patients on each treatment and the annual per-patient cost of each medication. Average per-patient costs for ERTs were calculated by adding the yearly drug acquisition, drug administration, and site-of-care markup costs. The budget impact was measured over years 1-3.An estimated 65 patients would receive velaglucerase alfa treatment in year 1, increasing to 90 patients by year 3. Across analyses, cost savings were realized with velaglucerase alfa compared with imiglucerase ($115,909) and taliglucerase alfa ($80,401). An annual total budget savings of $8.67 million could be realized for a hypothetical 10-million-member US health plan with increased velaglucerase alfa uptake. The per-member per-month costs decreased by $0.0241 across years 1-3.BIM results show that increased velaglucerase alfa uptake for GD1 treatment is cost-saving for US health plans.Type 1 Gaucher disease (GD1) is a rare inherited condition. Long-term enzyme replacement therapy (ERT) can reverse and prevent complications. Imiglucerase, taliglucerase alfa, and velaglucerase alfa are 3 ERTs used to treat GD1. In this study, we estimated how increasing uptake of velaglucerase alfa
- Published
- 2022
- Full Text
- View/download PDF
4. The association between insurance coverage for insulin pen needles and healthcare resource utilization among insulin-dependent patients with diabetes in China
- Author
-
A. Chandran, Zheng Wei, Timothy J Inocencio, Richard H. Chapman, Qifu Li, Zilin Sun, Guijun Qin, Stefan DiMario, and Linong Ji
- Subjects
Male ,China ,medicine.medical_specialty ,Injections, Subcutaneous ,Population ,030209 endocrinology & metabolism ,Pen needles ,Type 2 diabetes ,Insurance Coverage ,Health administration ,03 medical and health sciences ,Diabetes mellitus ,Drug Delivery Systems ,0302 clinical medicine ,Insulin ,Humans ,Hypoglycemic Agents ,Medicine ,030212 general & internal medicine ,education ,Reimbursement ,Family Characteristics ,education.field_of_study ,Insurance, Health ,business.industry ,lcsh:Public aspects of medicine ,Syringes ,Health Policy ,Lipohypertrophy ,Insulin pen ,lcsh:RA1-1270 ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Costs ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Needles ,Emergency medicine ,Female ,Health Expenditures ,business ,Research Article - Abstract
Background Pen needles are an important component of insulin delivery among patients with diabetes, but are not universally covered in China. We compared clinical and economic characteristics of insulin-dependent patients in China who have some level of pen needle (PN) reimbursement to those with no PN reimbursement. Methods A cross-sectional study was conducted among 400 insulin users with Type 1 or Type 2 diabetes treated in outpatient endocrinology units of four large tertiary care hospitals in Nanjing, Chongqing, Beijing and Zhengzhou. Demographics, medical history, healthcare resource utilization (RU), out-of-pocket costs, insurance and PN reimbursement status were surveyed. Unit costs were assigned to healthcare RU and compared using descriptive statistics and multivariate regression models. Results A total of 400 patients were analyzed; 142 (35.5%) with some level of PN coverage/reimbursement and 258 (64.5%) without. Patients without PN reimbursement had a higher prevalence of lipohypertrophy (59.3% vs. 40.7%, p = 0.0007), greater median PN reuse (12 vs. 7 times per needle, p
- Published
- 2018
- Full Text
- View/download PDF
5. Mortality, Hospital Costs, Payments, and Readmissions Associated With Clostridium difficile Infection Among Medicare Beneficiaries
- Author
-
Joseph L. Kuti, Nicole Ciewhon Quon, Shamonda F. Braithwaite, Hemal Shah, Kelly C. Broderick, Edward M. Drozd, Dayo Jagun, and Timothy J. Inocencio
- Subjects
Microbiology (medical) ,Hospital readmission ,medicine.medical_specialty ,Healthcare use ,genetic structures ,Hospitalized patients ,Payment reform ,business.industry ,media_common.quotation_subject ,Medicare beneficiary ,Original Articles ,clostridium difficile ,Clostridium difficile ,Payment ,mortality ,Infectious Diseases ,hospital readmission ,cost ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,medicine ,Intensive care medicine ,business ,health care economics and organizations ,media_common - Abstract
Supplemental digital content is available in the text., Background The management of Clostridium difficile infection (CDI) among hospitalized patients is costly, and ongoing payment reform is compelling hospitals to reduce its burden. To assess the impact of CDI on mortality, hospital costs, healthcare use, and Medicare payments for beneficiaries who were discharged with CDI listed as a secondary International Classification of Diseases, Ninth Revision, Clinical Modification claim diagnosis. Methods Data were analyzed from the 2009 to 2010 5% random sample Medicare Standard Analytic Files of beneficiary claims. Patients with index hospitalizations with CDI as a secondary diagnosis and no previous hospitalization within 30 days were identified. Outcomes included inpatient and 30-day mortality, inpatient costs, index hospital payments, all-provider payments, net hospital losses, payment to cost ratio, length of stay (LOS), and 30-day readmission; outcomes were each risk adjusted using propensity score matching and regression modeling techniques. Results A total of 3262 patients with CDI were identified after matching to patients without a CDI diagnosis. After risk adjustment, secondary CDI was associated with statistically significantly (all P < 0.05) greater inpatient mortality (3.1% vs. 1.7%), 30-day mortality (4.1% vs. 2.2%), longer LOS (7.0 days vs. 3.8 days), higher rates of 30-day hospital readmissions (14.8% vs. 10.4%), and greater hospital costs ($16,184 vs. $13,954) compared with the non-CDI cohort. The risk-adjusted payment-to-cost ratio was shown to be lower for patients with CDI than those without (0.76 vs. 0.85). Conclusions Secondary CDI is associated with greater adjusted mortality, costs, LOS, and hospital readmissions, while receiving similar hospital reimbursement compared with patients without CDI in a Medicare population.
- Published
- 2015
- Full Text
- View/download PDF
6. Characterization of Continued Antibacterial Therapy After Diagnosis of Hospital-Onset Clostridium difficile Infection: Implications for Antimicrobial Stewardship
- Author
-
Amy L. Pakyz, Spencer E. Harpe, Timothy J. Inocencio, Ron E. Polk, and Michael Oinonen
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,genetic structures ,Administration, Oral ,Patient Readmission ,Severity of Illness Index ,Cohort Studies ,Vancomycin ,Severity of illness ,medicine ,Humans ,Antimicrobial stewardship ,Pharmacology (medical) ,Aged ,Retrospective Studies ,Antibacterial agent ,Academic Medical Centers ,Cross Infection ,Clostridioides difficile ,business.industry ,Retrospective cohort study ,Length of Stay ,Middle Aged ,Pharmacoepidemiology ,Clostridium difficile ,Hospitals ,United States ,Anti-Bacterial Agents ,Metronidazole ,Treatment Outcome ,Concomitant ,Clostridium Infections ,Female ,business ,medicine.drug - Abstract
Study Objectives To determine the proportion of hospitalized adults with hospital-onset Clostridium difficile infection (CDI) who continued to receive concomitant non-CDI antibacterial agents, to characterize the antibacterial therapy that these patients received before and after the diagnosis of CDI, and to compare hospital outcomes between those patients who did and those who did not have their previous antibacterial therapy discontinued after CDI diagnosis. Design Retrospective cohort study. Data Source Drug use and administrative discharge data from 42 United States academic medical centers. Patients A total of 5968 adult inpatients with hospital-onset CDI between January 1, 2002, and June 30, 2006. Measurements and Main Results We characterized patient-level antibacterial agent use before and after CDI diagnosis. Overall, 3479 patients (58.3%) continued antibacterial therapy for 2 or more days after CDI diagnosis (interhospital range 6.7–72.2%). Although the number of different antibacterial agents received in the week preceding CDI diagnosis was positively associated with continued antibacterial therapy, the relationship between continuation and severity of illness was statistically significant but nonlinear. Patients who were receiving oral vancomycin alone were less likely to have antibacterial therapy continued (28/61 patients [45.9%]) than patients receiving metronidazole alone (1154/2333 patients [49.5%]) or receiving both metronidazole and oral vancomycin (2297/3576 [64.2%]). After adjusting for confounders, patients who continued to receive antibacterial therapy had a 62.7% (95% confidence interval [CI] 48.6–78.0%, p
- Published
- 2012
- Full Text
- View/download PDF
7. Adherence and persistence associated with an appointment-based medication synchronization program
- Author
-
Timothy J. Inocencio and David A. Holdford
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,MEDLINE ,Medication adherence ,Pharmacology (nursing) ,Pharmacy ,Community Pharmacy Services ,Persistence (computer science) ,Medication Adherence ,Internal medicine ,medicine ,Humans ,Thiazide ,Aged ,Pharmacology ,Aged, 80 and over ,Community pharmacies ,business.industry ,Middle Aged ,Metformin ,Drug class ,Pharmaceutical Preparations ,Chronic Disease ,Physical therapy ,Female ,Rural Health Services ,business ,medicine.drug - Abstract
Objective To assess the impact of an appointment-based medication synchronization (ABMS) program on medication adherence and persistence with chronic medications. Design Quasiexperimental study in which study patients were matched with control patients. Setting Rural pharmacies in the Midwestern United States between June 30, 2011, and October 31, 2012. Patients Individuals receiving at least two refills for one of six categories of medications to treat chronic diseases (i.e., angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, dihydropyridine calcium channel blockers, thiazide diuretics, metformin, statins). Intervention Patients in the ABMS program were compared with control patients receiving usual care. Main outcome measures 1-year adherence rates using proportion of days covered (PDC) and 1-year nonpersistence rates. Results Depending on the drug class, patients enrolled in the medication synchronization program (n = 47–81) had adherences rates of 66.1% to 75.5% during 1 year versus 37.0% to 40.8% among control patients. Program patients had 3.4 to 6.1 times greater odds of adherence compared with control patients. Control patients were 52% to 73% more likely to stop taking their chronic medications over 1 year. Conclusion An ABMS program in community pharmacies was associated with improved patient adherence and reduced likelihood of nonpersistence.
- Published
- 2013
8. The economic burden of opioid-related poisoning in the United States
- Author
-
Timothy J. Inocencio, David A. Holdford, Norman V. Carroll, and Edward J. Read
- Subjects
Total cost ,business.industry ,Poison control ,General Medicine ,Emergency department ,Health Care Costs ,medicine.disease ,Opioid-Related Disorders ,Occupational safety and health ,United States ,Analgesics, Opioid ,Indirect costs ,Anesthesiology and Pain Medicine ,Environmental health ,Injury prevention ,Absenteeism ,medicine ,Prevalence ,Humans ,Neurology (clinical) ,Medical emergency ,business ,Productivity ,health care economics and organizations - Abstract
OBJECTIVE: To estimate the yearly economic burden of opioid-related poisoning in the United States. BACKGROUND: Rates of opioid poisoning and related mortality have increased substantially over the past decade. Although previous studies have measured the costs of misuse and abuse, costs related specifically to opioid poisoning have not been quantified. This study quantifies the economic burden of opioid poisoning in the United States to help evaluate the economic case for efforts to reverse or prevent opioid poisoning and its associated morbidity and mortality. METHODS: Mean costs and prevalence estimates were estimated using publically available datasets. A societal perspective was assumed and accordingly estimated direct medical and productivity costs. Direct medical costs included treatment for opioid poisoning in the emergency department (ED) and inpatient settings, along with emergency transport and drug costs. Productivity costs were estimated using the human capital method and included lost wages due to mortality and absenteeism costs from ED visits and hospitalizations. All costs were inflated to 2011 U.S. dollars. RESULTS: In 2009, total costs were estimated at approximately $20.4 billion with indirect costs constituting 89% of the total. Direct medical costs were approximately $2.2 billion. ED costs and inpatient costs were estimated to be $800 million and $1.3 billion, respectively. Absenteeism costs were $335 million and lost future earnings due to mortality were $18.2 billion. CONCLUSION: Opioid-related poisoning causes a substantial burden to the United States each year. Costs related to mortality account for the majority of costs. Interventions designed to prevent or reverse opioid-related poisoning can have significant impacts on cost, especially where death is prevented. Language: en
- Published
- 2013
9. PCN86 Cost-Utility Analysis of Nilotinib Compared to Imatinib for Newly Diagnosed Chronic Myeloid Leukemia (CML) in Chronic Phase
- Author
-
David A. Holdford, A. Seetasith, Timothy J. Inocencio, P. Bose, and A. Newland
- Subjects
Oncology ,medicine.medical_specialty ,Cost–utility analysis ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Myeloid leukemia ,Imatinib ,Newly diagnosed ,Nilotinib ,Internal medicine ,medicine ,business ,medicine.drug - Published
- 2012
- Full Text
- View/download PDF
10. The economic burden of opioid poisoning in the United States
- Author
-
Edward J. Read, Timothy J. Inocencio, David A. Holdford, and Norman V. Carroll
- Subjects
Injury control ,Accident prevention ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Poison control ,Human factors and ergonomics ,medicine.disease ,Suicide prevention ,Occupational safety and health ,Opioid ,Injury prevention ,medicine ,Medical emergency ,business ,medicine.drug - Published
- 2013
- Full Text
- View/download PDF
11. Understanding the impact of settings of care and the development of chemotherapy-induced nausea and vomiting within a population of commercially insured patients
- Author
-
A. Powers, Claudio Faria, Richard H. Chapman, R.L. Knoth, Timothy J Inocencio, Michael Johnsrud, and Barnabie C Agatep
- Subjects
Cancer Research ,medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,humanities ,Clinical Practice ,Oncology ,Physical therapy ,medicine ,Intensive care medicine ,business ,education ,Chemotherapy-induced nausea and vomiting - Abstract
298 Background: Research evaluating the impact of different clinical practice patterns according to settings of care and oncology patient outcomes is limited. This study describes chemotherapy-induced nausea and vomiting (CINV) rates in chemotherapy (CT) naïve cancer patients starting CT in a hospital outpatient (HOP) or community outpatient (COP) setting. Methods: Using the Optum Normative Health Information Database, patients with a new claim of CT and ≥1 outpatient cancer diagnosis claim between 1/1/06 – 6/30/12 were identified. Patients with previous inpatient cancer diagnoses, multi-day CT regimens or Medicare/Medicaid patients were excluded. CINV was defined using relevant claims-based ICD-9-CM diagnosis and procedure codes or a prescription claim for antiemetics within days 2-7 of 1st 8 CT cycles or 1st 6 months following the index CT claim. CINV events were evaluated descriptively and using regression models Results: Patients receiving CT in HOP vs. COP were similar in age. Patients receiving CT in COP vs. HOP setting were more likely to be female (78.7% vs. 62.8%), breast cancer patients (66.8% vs. 46.7%), live in the South region (49.7% vs. 44.1%) and have higher baseline healthcare costs (mean $24,950 vs. $24,629) (all p
- Published
- 2014
- Full Text
- View/download PDF
12. Investigating rates of CINV across settings of care in Medicare: A retrospective claims-based analysis
- Author
-
Richard H. Chapman, Barnabie C Agatep, Claudio Faria, R.L. Knoth, Michael Johnsrud, Timothy J Inocencio, and A. Powers
- Subjects
Cancer Research ,medicine.medical_specialty ,business.industry ,Nausea ,Cancer ,medicine.disease ,humanities ,Clinical Practice ,Oncology ,Emergency medicine ,Physical therapy ,Vomiting ,Medicine ,medicine.symptom ,Quality of care ,business - Abstract
297 Background: Clinical practice may differ according to settings of care and may impact both the quality of care delivered and, ultimately, patient outcomes. This study describes the differences in chemotherapy-induced nausea and vomiting (CINV) rates between chemotherapy (CT) naïve Medicare cancer patients starting CT in a hospital outpatient (HOP) or community outpatient (COP) setting. Methods: Using the 5% Medicare Fee-for-Service standard analytic files, patients with a new claim of CT and ≥1 outpatient cancer diagnosis claim between 1/1/10 – 6/30/11 were identified. Patients with a previous inpatient cancer diagnosis, multi-day CT cycles or who switched CT relevant to emetogenic potential were excluded. CINV was defined using relevant claims-based ICD-9-CM diagnosis and procedure codes within days 2-7 of the first 8 single-day CT cycles or the first 6 months following the index CT claim. CINV events were evaluated descriptively and using regression models. Results: Medicare patients receiving CT in HOP (n=1,007) vs. COP (n=1,080) were similar in demographics such as age, race, and baseline healthcare costs. However, Medicare patients receiving CT in COP compared to those in HOP settings were more likely to be female (57.0% vs. 44.7%), breast cancer patients (27.6% vs. 16.0%), live in the South region (37.7% vs. 32.3%), have higher Charlson Comorbidity Index scores (mean 5.2 vs. 4.8) and receive moderately to highly emetogenic CT (44.1% vs. 36.0%) (all p
- Published
- 2014
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.