Patients treated with nab-P + G (vs FOLFIRINOX) had similar treatment duration but lower costs of outpatient prescriptions, treatment administration and supportive care. Lower supportive care costs in the nab-P + G cohort were mainly driven by lower utilization of pegfilgrastim and anti-emetics.

Objectives: Dementia is a costly diagnosis and increases an individual's cost of healthcare 2.2-2.4 fold. No studies have been published in the U.S. which assess the financial access barriers to care for patients with dementia. This study aims 1) to determine if patients with dementia have more financial access challenges to healthcare use than patients without dementia; and 2) to investigate if financial access barriers among patients with dementia varies by race/ethnicity. Methods: This is a pooled cross-sectional study using 2011-2017 National Health Interview Survey (NHIS) data. Financial access measurement was based on individuals "yes" response to any of the following survey prompts: "couldn't afford dental care past 12 months", "couldn't afford eyeglasses past 12 months", "couldn't afford to see a specialist past 12 months", or "couldn't afford follow-up care past 12 months". We performed univariate and bivariate analyses to describe respondent characteristics and to estimate an unadjusted association between dementia status and financial access. In addition, propensity score adjusted multivariate logistic regression was utilized. Results: 89,451 respondents were identified in this study. Approximately 26% (n=24,218) of respondents had at least one financial access challenge. About 81.57% (n=70,360) of respondents were white, while 12.11% (n=12,941) were black. After adjusting for covariates, multivariate results showed that patients with dementia are 50% more likely to have financial access challenges compared to those without dementia (AOR=0.50: 95% CI=(0.44, 0.56)). Multivariate analyses of race/ethnicity sub-groups showed that white patients with dementia are 60% more likely to have financial access challenges compared to their counterparts (AOR=0.40: 95% CI=(0.34, 0.46)). Conclusions: Individuals with dementia are more likely to have financial access challenges compared to individuals without dementia. Individuals of white race/ ethnicity with dementia are more likely to have financial access challenges. Healthcare providers should be sensitive to the potential financial access challenges for patients with dementia in daily clinical practice.

BackgroundVenous thromboembolism, including deep vein thrombosis and pulmonary embolism, results in a substantial healthcare system burden. This retrospective observational study compared hospital length of stay (LOS) and hospitalization costs for patients with venous thromboembolism treated with rivaroxaban versus those treated with warfarin.Methods and ResultsHospitalizations for adult patients with a primary diagnosis of deep vein thrombosis or pulmonary embolism who were initiated on rivaroxaban or warfarin were selected from MarketScan's Hospital Drug Database between November 1, 2012, and December 31, 2013. Patients treated with warfarin were matched 1:1 to patients treated with rivaroxaban using exact and propensity score matching. Hospital LOS, time from first dose to discharge, and hospitalization costs were reported descriptively and with generalized linear models (GLMs). The final study cohorts each included 1223 patients (751 with pulmonary embolism and 472 with deep vein thrombosis). Cohorts were well matched for demographic and clinical characteristics. Mean (±SD) LOS was 3.7±3.1 days for patients taking rivaroxaban and 5.2±3.7 days for patients taking warfarin, confirmed by GLM‐adjusted results (rivaroxaban 3.7 days, warfarin 5.3 days, P<0.001). Patients with provoked venous thromboembolism admissions showed longer LOSs (rivaroxaban 5.1±4.5 days, warfarin 6.5±5.6 days, P<0.001) than those with unprovoked venous thromboembolism (rivaroxaban 3.3±2.4 days, warfarin 4.8±2.8 days, P<0.001). Days from first dose to discharge were 2.4±1.7 for patients treated with rivaroxaban and 3.9±3.7 for patients treated with warfarin when initiated with parenteral anticoagulants (P<0.001), and 2.7±1.7 and 3.7±2.1, respectively, when initiated without parenteral anticoagulants (P<0.001). Patients initiated on rivaroxaban incurred significantly lower mean total hospitalization costs ($8688±$9927 versus $9823±$9319, P=0.004), confirmed by modeling (rivaroxaban $8387 [95% confidence interval, $8035–$8739]; warfarin $10 275 [95% confidence interval, $9842–$10 708]).ConclusionsRivaroxaban was associated with significantly shorter hospital LOS and lower hospitalization costs compared with warfarin.

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Introduction: Oral glucocorticoids (GC) have been the mainstay of treatment for giant cell arteritis (GCA). We estimated the risk and dose-effect relationship of potential GC-related adverse events (AEs) in patients with GCA. Methods: This retrospective, observational cohort study utilized data from the IBM Explorys Electronic Health Records database from 2008 through 2016. Inclusion criteria included the presence of at least two GCA diagnostic codes in subjects aged 50 or older along with supporting laboratory [C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)], prescription data on oral GCs, and at least 12 months of follow-up before and after the first oral GC prescription for GCA (index date). Potential AEs captured on the basis of new diagnoses, prescriptions, and laboratory tests were assessed during the 12 months post-index date. Results were descriptively summarized across cohorts according to quartiles (Q) of mean daily GC dose measured over the first 6 months of follow-up (Q1, C 1.00 to B 13.75 mg; Q2, [ 13.75 to B 25.00 mg; Q3, [ 25.00 to B 40.00 mg; Q4, [ 40.00 mg). Results: We identified 785 eligible patients with GCA. The mean (SD) age of the cohort was 76 (9) years and 70% were female. The mean oral GC dose during the first 6 months post-index was 28.9 mg/day. A dose-effect response was observed from Q1 to Q4 in the following potential GC-related AEs: newly diagnosed type 2 diabetes/HbA1c [ 7.5% (range 7.5-24.5%), blood glucose C 200 mg/dL (range 7.5-15%), serious infection (range 16.8-24.8%), cataracts (range 12.0-21.7%), gastrointestinal bleed/ulcer (range 6.0-11.8%), and increase in BMI C 5 units (range 4.1-6.4). Conclusions: In patients with GCA, potential GC-related AEs increased with higher daily oral GC doses. This highlights the need for effective therapies that reduce GC exposure and toxicity. Funding: Genentech, Inc.