{"id":17098,"date":"2011-12-09T18:20:07","date_gmt":"2011-12-09T23:20:07","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=17098"},"modified":"2011-12-10T03:43:41","modified_gmt":"2011-12-10T08:43:41","slug":"message-in-a-bottle-2","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/12\/09\/message-in-a-bottle-2\/","title":{"rendered":"message in a bottle&#8230;"},"content":{"rendered":"<div align=\"justify\">This washed up into my email inbox, I know not how or why. But it felt like something that just had to be shared with friends:<\/div>\n<div align=\"center\"><a target=\"_blank\" href=\"http:\/\/www.shbc.us\/\"><img decoding=\"async\" width=\"277\" vspace=\"5\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/shbc.gif\" \/><\/a><\/div>\n<div align=\"center\"><a target=\"_blank\" href=\"http:\/\/www.ajpblive.com\/\"><img loading=\"lazy\" decoding=\"async\" height=\"116\" width=\"277\" vspace=\"5\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/ajpb.gif\" \/><\/a><br \/>         <sup>click logos for the respective websites<\/sup><\/div>\n<blockquote>\n<div align=\"center\"><a href=\"http:\/\/www.ajpblive.com\/login\/14371\" target=\"_blank\"><u><strong><font color=\"#200020\">Economic Outcomes of Switching Treatment in Major Depressive Disorder Patients<\/font><\/strong><\/u><\/a><br \/>                  <sup>by Maryna Marynchenko,  Andrew P. Yu, Veronique Lauzon, Karthik Ramakrishnan,  Eric Q. Wu, Rym Ben-Hamadi, Steven I. Blum, Moshe Haim  Erder, and Anjana Bose<\/sup><br \/>                  <strong><font color=\"#200020\">American Journal of Pharmacy Benefits<\/font><\/strong>. 2011 3[6]:e111-e120.<\/div>\n<p>               <\/p>\n<div align=\"justify\"><sup><u><strong><font color=\"#200020\">Objectives<\/font><\/strong><\/u>: To  evaluate the economic consequences associated with switching major  depressive disorder [MDD] patients from a generic selective serotonin  reuptake inhibitor [SSRI] treatment to escitalopram,  venlafaxine\/duloxetine, or another generic SSRI.<br \/>                    <u><strong><font color=\"#200020\">Study Design<\/font><\/strong><\/u>: Adult MDD patients treated with a generic  SSRI, identified in the Ingenix Impact database, were included if they  were switched to escitalopram, venlafaxine\/duloxetine, or another  generic SSRI.<br \/>                    <u><strong><font color=\"#200020\">Methods<\/font><\/strong><\/u>: Urgent care utilization during the 3-month  follow-up period and costs incurred during the 3 months before and after  the switching date were compared both descriptively and using  multivariate regression analyses.<br \/>                    <u><strong><font color=\"#200020\">Results<\/font><\/strong><\/u>: The study identified 7774 patients switched  to escitalopram, 10,505 to venlafaxine\/duloxetine, and 6723 to another  generic SSRI. Compared with escitalopram switchers, venlafaxine\/duloxetine switchers had an increased adjusted risk of any-cause, mental  health&ndash;related, and MDD-related urgent care utilization [odds ratio  [OR] = 1.10, 1.30, and 1.36, respectively; all <em>P<\/em> &lt;.05].  Patients who were switched to a generic SSRI experienced increased  adjusted risk of mental health&ndash;related urgent care utilization [OR  =1.17, <em>P<\/em> = .0319]. Compared with switchers to another generic  SSRI, medical costs were significantly reduced for switchers to  escitalopram [&ndash;$402] or venlafaxine\/duloxetine [&ndash;$254; both <em>P<\/em> &lt;.05]. Escitalopram switchers had relative savings of $383 [<em>P<\/em> = .016] and $172 [<em>P<\/em> = .276] compared with venlafaxine\/duloxetine switchers and generic SSRI switchers, respectively.<br \/>                    <u><strong><font color=\"#200020\">Conclusions<\/font><\/strong><\/u>: Switching from generic SSRI therapy to  escitalopram appears to be a more effective strategy in MDD than  switching to venlafaxine\/duloxetine and at least as cost-effective as  switching to another generic SSRI therapy.<\/sup><\/div>\n<\/blockquote>\n<blockquote>\n<div align=\"center\"><a href=\"http:\/\/www.ajpblive.com\/login\/13059\" target=\"_blank\"><u><strong><font color=\"#200020\">Healthcare Costs Associated With Escitalopram and Alternative SSRIs<\/font><\/strong><\/u><\/a><br \/>            <sup>by Dominick Esposito,  Peter Wahl, Gregory W. Daniel, Michael A.  Stoto, and Thomas W. Croghan<\/sup><br \/>             <strong><font color=\"#200020\">American Journal of Pharmacy Benefits<\/font><\/strong>. 2011 3[5]:e93-e101.<\/div>\n<p>              <\/p>\n<div align=\"justify\"><sup> <u><strong><font color=\"#200020\">Objective<\/font><\/strong><\/u>:  To compare healthcare costs associated with initiating treatment on  escitalopram or an alternative selective serotonin reuptake inhibitor.<strong><br \/>              <u><font color=\"#200020\">Study Design<\/font><\/u><\/strong>: Retrospective cohort study using administrative claims data.<br \/>              <u><strong><font color=\"#200020\">Methods<\/font><\/strong><\/u>: Patients were included if they had a  depression-related diagnosis and 6 months or longer of health plan  eligibility before and after the date of their first claim for a study  antidepressant. Dependent variables included total healthcare costs and  component pharmacy, medical, inpatient, and mental health treatment  costs in the 6 months after initiation of antidepressant therapy.  Propensity score analysis was used to account for selection bias in  antidepressant choice [escitalopram vs other antidepressants].  Incorporating this adjustment, regression analysis was used to examine  the association between antidepressant choice and subsequent healthcare  costs.<br \/>              <u><strong><font color=\"#200020\">Results<\/font><\/strong><\/u>: Escitalopram initiators had lower total healthcare costs [$2327 vs $2383,<em> P<\/em> &lt;.05], lower medical costs [$1666 vs $1807, <em>P<\/em> &lt;.01], higher inpatient costs [$555 vs $541, <em>P<\/em> &lt;.01], and higher total pharmacy costs [$587 vs $503, <em>P<\/em>  &lt;.01] in the 6 months after initiation compared with patients  initiating with other antidepressants. There was a statistically significant difference in lower total healthcare costs for escitalopram  initiators. Escitalopram was also associated with higher mental  healthcare costs [$377 vs $304, <em>P<\/em> &lt;.01].<br \/>              <u><strong><font color=\"#200020\">Conclusions<\/font><\/strong><\/u>: Total healthcare costs were only slightly  lower for patients initiating treatment with escitalopram. These  reductions are unlikely to reflect improved clinical outcomes associated  with escitalopram. Their impact on health plan budgets is unknown.<\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\">Don&#8217;t you just love, &quot;<strong><font color=\"#200020\">Translating Evidence-Based Research into Value-Based Decisions<\/font><\/strong>.&quot; It sounds like it ought to be set to music &#8211; maybe rap. But that&#8217;s not all. The email is a treasure trove of resources:<\/div>\n<div align=\"center\"><a href=\"http:\/\/www.cbinet.com\/conference\/pc11183\" target=\"_blank\"><img decoding=\"async\" width=\"450\" vspace=\"5\" border=\"1\" src=\"http:\/\/1boringoldman.com\/images\/tacs.gif\" \/><\/a><\/div>\n<div align=\"center\"><a href=\"http:\/\/www.cbinet.com\/conference\/pc11121\" target=\"_blank\"><img decoding=\"async\" width=\"450\" vspace=\"5\" border=\"1\" src=\"http:\/\/1boringoldman.com\/images\/cmac.gif\" \/><\/a><br \/>        <sup>click logos for the respective websites<\/sup><\/div>\n<p>       <\/p>\n<div align=\"justify\">I found <a href=\"http:\/\/www.cbinet.com\/conference\/pc11121\" target=\"_blank\"><u><strong><font color=\"#200020\">CMAC 2011<\/font><\/strong><\/u><\/a> particularly interesting:<\/div>\n<blockquote>\n<div><strong><font color=\"#200020\">Industry&#8217;s Senior Commercial Executives Convene this December in Philadelphia!<\/font><\/strong>        <\/p>\n<div align=\"justify\"><sup>Join executives responsible for ensuring the commercial success of  new drugs, devices and diagnostics at CBI&rsquo;s 2nd Annual Commercialization  and Market Access Congress. &nbsp;With increased generic competition,  growing pressure to align product price with value and a trend toward  reductions in marketing and sales forces, companies must consider  factors that make a product commercially viable at every step of  development and launch. &nbsp;How is the U.S.  marketplace impacted by healthcare reform and how can companies  position themselves for success in a shifting market? &nbsp;What information  do payers need to make a positive reimbursement decision? &nbsp;How should  internal product teams interact with clinical development and external  thought leaders to pave the way for an effective launch? &nbsp;These and many  other questions are addressed in this interactive forum. &nbsp;Building off  our successful premier event, CMAC  2011 will be co-located with the 7th Annual Biopharmaceutical Trade  &amp; Channel Strategies, increasing your networking and benchmarking  opportunities!<\/sup><\/div>\n<\/div>\n<\/blockquote>\n<div align=\"justify\">So in this one unsolicited email, I got detailed evidence-based information from the Managed Care industry about how to shave costs and pick generic medications based on overall cost analyses <u>AND<\/u> just missed an opportunity to fly to Philadelphia to find out how to optimize profits launching new drugs, and how to get Managed Care companies to accept them. I particularly liked, &quot;<strong><font color=\"#200020\">How should  internal product teams interact with clinical development  and external  thought leaders to pave the way for an effective launch?<\/font><\/strong>&quot; In case you&#8217;ve been in a coma in Sleepy Hollow for 25 years, an <strong><font color=\"#200020\">external  thought leader <\/font><\/strong>is a physician\/psychiatrist disguised as an expert who is on a drug company&#8217;s speaker&#8217;s bureau, or does industry-funded Continuing Medical Education, or signs on to an industry-written journal article.<\/p>\n<table cellspacing=\"0\" cellpadding=\"2\" border=\"0\" align=\"center\">\n<tr>\n<td valign=\"top\"><a target=\"_blank\" href=\"http:\/\/www.youtube.com\/watch?v=Q-MZJwnaocs\">And I just can&#8217;t keep from crying sometimes <br \/>   Well, I just can&#8217;t keep from crying sometimes<br \/>     When my heart&#8217;s full of sorrow and my eyes are filled with tears<br \/>     Lord, I just can&#8217;t keep from crying sometime<\/a><\/td>\n<td rowspan=\"2\"><a target=\"_blank\" href=\"http:\/\/www.youtube.com\/watch?v=Q-MZJwnaocs\"><img decoding=\"async\" width=\"100\" border=\"1\" src=\"http:\/\/www.lonestarmusic.com\/uploaded\/artistphotos\/blindwillie.gif\" \/><\/a> <\/td>\n<\/tr>\n<tr>\n<td align=\"right\"><a target=\"_blank\" href=\"http:\/\/www.youtube.com\/watch?v=Q-MZJwnaocs\">Blind Willie Johnson [1897-1945] <\/a><\/td>\n<\/tr>\n<\/table><\/div>\n","protected":false},"excerpt":{"rendered":"<p>This washed up into my email inbox, I know not how or why. But it felt like something that just had to be shared with friends: click logos for the respective websites Economic Outcomes of Switching Treatment in Major Depressive Disorder Patients by Maryna Marynchenko, Andrew P. Yu, Veronique Lauzon, Karthik Ramakrishnan, Eric Q. Wu, [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-17098","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/17098","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=17098"}],"version-history":[{"count":22,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/17098\/revisions"}],"predecessor-version":[{"id":17128,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/17098\/revisions\/17128"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=17098"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=17098"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=17098"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}