A19 (F= 3.16 and F= 3.15). The results from the regression model showed that as age increases, the expenditure rises especially at old ages. Patients from lower income groups spent more on ambulatory services than those in higher income groups, as well as individuals living in regions with very high level of social exclusion. Among other main determinants, individuals that looked for private health care attention along with those that perceived their health problems as severe increased their health expenditure. ConClusions: Out of pocket expenditure has been regressive among health care users at IMSS. Therefore especial attention to lower income patients should be paid.
with a disease combination for a subpopulation was computed by taking the difference between LHC for members of that subpopulation without disease and LHC for members of that subpopulation who had that disease combination. Racial differences were measured in the absolute differences in LHC and LCD between black women/men and white women/men. Results: Our sample comprised of 53,035 individuals ages 40-79 years with a weighted population of 104 million. Higher percentage of blacks in comparison to whites were obese (44.3% vs. 33.4%) and reported OCC (21.7% vs. 14.1%). Overall, black women, ages 70-79 years, paid $9,003 higher than white women with cost difference highest for the population with at least CHD. Racial difference in LCD was higher for women for all OCC's for all age cohorts, but not for age cohort 70-79 years. The LCD was highest for black women ages 60-69 years for stroke, with black women incurring $42,286 higher costs than white women. Conclusions: Racial differences in LCD associated with all OCC's are wide in women ages 40-69. Policies addressing obesity prevention may help reduce the economic burden of OCC's among this subpopulation.
Objectives: To assess trends in branded antidiabetic drug prices and to evaluate factors associated with antidiabetic drug prices at market entry in the US in the period 1980-2014. MethOds: Regulatory data were derived from the FDA. Average wholesale prices (AWP) and national average drug acquisition costs (NADAC) were derived from the RedBook (Truven Health Analytics) and the Centers for Medicare and Medicaid Services, respectively. Prices were adjusted to 2014 dollars using the consumer price index (CPI) and converted to prices per 30-day supply using defined daily dose (DDD). The AWP compounded annual growth rate (CAGR) was estimated for each drug. A multivariate regression model was conducted to examine factors associated with antidiabetic drug prices at market entry. Results: In the period 1980-2014, there were 88 antidiabetic drugs (86 NDAs, 2 BLAs) marketed in the US, including 37 insulins and analogues and 51 non-insulin antidiabetic drugs. Animal-sourced insulins were excluded from analysis. The CPI-adjusted AWP CAGR from approval to December 2014, or to drug discontinuation date, was positive for antidiabetic drugs except for two inhaled insulins (one discontinued from the market), troglitazone (discontinued) and metformin/rosiglitazone. The average of NADAC per unit, as percentage of the AWP per unit on December 31, 2014, was 80.95% (n= 42; range:79.50%-82.09%). The year of market entry of insulins and analogues was associated with the CPI-adjusted AWP 30-days at market entry (p< 0.001). The FDA approval date (p< 0.001) and priority review process (p= 0.005) of oral non-insulin antidiabetic drugs were associated with an increase in the AWP-30 days; whereas a FDA-labeled boxed warning was associated with a decrease in the AWP-30 days (p< 0.001). cOnclusiOns: In the study period, antidiabetic drug prices increased above the inflation rate. The year of approval is significantly associated with antidiabetic drugs prices. The FDA priority review and FDA-labeled boxed warning are associated with prices of oral antidiabetic drugs.
In complex DFUs with exposed tendon, muscle or bone, the use of Neox was the less costly option to attain higher wound closure rates over the same time period. This was due to the fact that fewer Neox product applications were required. Prospective randomized controlled trials or manufacturer sponsored registries might be considered in order to verify these early results for this serious condition and unmet medical need.
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