Prevalence of opioid-related side effects among patients with CNCP who initiated opioids was substantially higher based on patient survey than from charts or claims. Opioid-related side effects were associated with significantly higher healthcare costs.
A161was defined as achieving HbA1c below 7% without weight gain and with no hypoglycaemic events in 26 weeks. With the assumption that a payer would be interested in paying only for successfully treated patients, cost of control was subsequently defined as the price per patient achieving the composite endpoint. The relevant comparator drugs, glimepiride, rosiglitazone and insulin glargine, were defined as those found both in the 'Liraglutide Effect and Action in Diabetes' clinical trial programme and on the China national drug reimbursement list. The number needed to treat (NNT) for patients achieving the composite endpoint at week 26 was also investigated. Costs of drug, needle and self-monitoring blood glucose were accounted based on the marketed retail price published by National Development and Reform Commission in 2012 Chinese value. RESULTS: The NNT for patients on liraglutide 1.2mg was 3.1 for achieving the composite endpoint, compared to between 6.7 and 16.7 for the three comparator drugs. This lead to the cost per successfully treated patient to be between 17% and 68% higher with glimepiride, insulin glargine and rosiglitazone compared to liraglutide 1.2mg in China. CONCLUSIONS: By assessing the NNT to achieve HbA1c below 7% with no weight gain and no hypoglycaemic events and the cost per patient achieving this composite endpoint, liraglutide 1.2mg was a cost-saving approach for T2DM patients in comparison with glimepiride, insulin glargine and rosiglitazone in a Chinese setting.
Background Axial spondyloarthritis (axSpA) is a new umbrella term including patients with ankylosing spondylitis (AS), as well as those with non-radiographic axSpA (nr-axSpA). The new classification provides accepted evidence-based criteria to diagnose these patients. However, in practice, patients may be diagnosed using an earlier disease concept—undifferentiated SpA (uSpA)—for which an ICD-9 code exists. While clinical studies have found that a proportion of nr-axSpA patients experience radiographic progression (ie, to AS), little is known about progression to AS in a real-world setting. Objectives Explore the rate at which patients diagnosed with uSpA were subsequently diagnosed with AS using a large claims database. Methods Patients were selected from a de-identified US private insurer claims database (2000–2010). Potential nr-axSpA patients were defined as patients with ≥1 diagnosis for uSpA (ICD-9: 720.9) and a history of back disorders (724.0-724.9) prior to uSpA diagnosis. The date of first uSpA diagnosis was used as the study index date. Patients were required to have ≥6 months of continuous enrollment in a health plan prior to index (baseline period); be ≥18 years old on index; have no diagnoses for rheumatoid arthritis (714.0) or any type of SpA (AS: 720.0; Psoriatic Arthritis: 696.0; Reactive Arthritis: 099.3, 711.1; Inflammatory Bowel Disease: 713.1) on or before index; and have no diagnoses for any type of SpA other than AS post-index. Patients were followed until the earliest of: (a) diagnosis of AS (progression); (b) end of continuous eligibility; or (c) end of data availability. Baseline characteristics were measured separately for patients who were subsequently diagnosed with AS, and compared with those with no diagnosed progression. Results 6045 patients met the sample selection criteria. Median (IQR) available follow up was 14.2 (5.8-29) months. Two years post index, 8.9% of patients were diagnosed with AS, increasing to 13.7% by the 7 year mark. 5590 patients had no subsequent AS diagnosis. These patients averaged 47.6 years of age, and 61.4% were female. In comparison, patients progressing to AS were younger (43.8 years, P<.001), and 54.1% were female (P=.002). AS progressors also had higher baseline rates of uveitis (8.4% vs. 1.5%, P<.001) and were more likely to use NSAIDs (46.4% vs. 36%, P<.001) and DMARDs (14.3% vs. 6.2%, P<.001) at baseline. Conclusions In a database study of real-world diagnostic patterns, approximately 14% of patients diagnosed with uSpA and with a history of back disorders progressed to AS over a 7 year period. Patients progressing to AS were younger and more likely to have a history of uveitis. To the extent that the combination of these ICD-9 codes serves as a proxy for nr-axSpA, the observed progression rates are on the lower end of previously reported findings in clinical studies. Disclosure of Interest A. Boonen: None Declared, N. Kirson Consultant for: Under contract with Abbott, Employee of: Analysis Group, S. Rao Shareholder of: Abbott, Employee of: Abbot...
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