STATinMED Research

February 2012 Newsletter

admin — Tue, 21 Feb 2012 15:45:54 +0000

Geographic variation trends in critical limb ischemia
prevalence in the United States.

Targeted prevention and treatment could gain better control

Critical limb ischemia (CLI) is a severe obstruction of the arteries that seriously decreases blood flow to the extremities. The hallmark of peripheral arterial occlusive disease is an inadequate blood flow to supply vital oxygen demanded by the limb. CLI occurs after a chronic lack of blood supply results in a cascade of pathophysiologic events that ultimately leads to severe pain in the feet or toes, even while resting.Complications of poor circulation can include sores and wounds that will not heal in the legs and feet. If left untreated, CLI will lead to amputation of the affected limb. Although CLI continues to be a significantly morbid disease process for the aging population, the epidemiology of CLI remains sparse in the U.S. population.

A recent presentation at the ISPOR Annual European Congress by STATinMED Research revealed that the spatial distribution of CLI prevalence is uneven and strongly suggests a geographic variation of CLI risk areas.

STATinMED Research‘s study sample was based on national medical claims data from 2006 through 2008. Patients with CLI were identified using the International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM) diagnosis codes (440.22, 440.23, 440.24) recorded in inpatient and outpatient claims files for Medicare beneficiaries age 65 years and older. The direct standardization method was used to assess year, age, gender, race and diabetes-adjusted prevalence of CLI.

The change in prevalence of CLI over the 3 years was assessed and the variation in the prevalence of CLI was tested by state. Sensitivity analysis was explored to test whether prevalence and incidence of CLI vary among the use of several coding methods, namely between ICD-9 codes only and ICD-9 codes together with Current Procedural Terminology (CPT) codes.Geographic variation in the prevalence of CLI was obtained for patients over the age of 65 when adjusted by age, gender, race and diabetes status. Although approximately constant prevalence of CLI was reported in Utah (less than 0.15%) and Maryland (greater than 0.30%), a progressively increasing prevalence of CLI was observed in Montana (2006: 0.149%; 2007: 0.163.%; 2008: 0.277%) and Delaware (2006: 0.245%; 2007:0.247%; 2008: 0.330%) while progressively decreasing prevalence of CLI was observed in Arkansas, Colorado, Georgia, Ohio, Virginia, West Virginia, and Washington. The total trend over 3 years followed the pattern of higher rates in eastern states and lower rates in western states.

The spatial distribution of CLI prevalence is uneven and strongly suggests a geographic variation of CLI risk areas. Targeted prevention and treatment could help gain better control of CLI in the United States.

Prevalence of CLI in the United States in 2006 and 2008

Baser O, Wang L. Geographic variation trends in critical limb ischemia prevalence in the United States. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 14th Annual European Congress. Madrid, Spain: November 5-8, 2011.

STATinMED Research has experience with the following datasets:

100% MEDICARE (Inpatient, Outpatient, Provider, Denominator Files)
MarketScan Data (Commercial, Medicare, Medicaid, Health and Productivity Management)
MarketScan Hospital Drug Data Set (Solucient data set)
Veterans Affairs (VA) Data Set
United Health Data
PharMetrics
Blue Cross Blue Shield of Michigan
The Impact Data Set (IHCIS)
Lab Rx
Premier
Electronic Medical Records
Health Core Integrated Research Database
SEER-Medicare Database
Medicare Current Beneficiary Survey
Medical Expenditure Panel Survey
The Long Term Care Minimum Data Set

STATinMED Research publishes in Am J Man Care

admin — Fri, 17 Feb 2012 20:06:06 +0000

STATinMED Research’s article on the effect of thromboembolism prophylaxis in medical inpatients on outcomes and costs was accepted for publication as a web exclusive by the American Journal of Managed Care, and will be published in print in the June 2012 issue.

CEO distance learning professor for ISPOR

admin — Mon, 06 Feb 2012 14:33:57 +0000

Dr. Onur Baser, CEO of STATinMED Research, was selected as a distance learning professor by the International Society of Pharmaceutical Outcomes Research (ISPOR). He will be teaching a course on estimation of health care costs.

CEO on IES Statistics & Modeling Panel

admin — Wed, 18 Jan 2012 15:27:42 +0000

Dr. Onur Baser, CEO of STATinMED Research, was selected for the Scientific Review Committee of the U.S. Institute of Education Sciences (IES), Statistics and Modeling Panel.

December 2011 Newsletter

admin — Tue, 20 Dec 2011 19:05:18 +0000

Patients initiating insulin glargine disposable pen:
better glycemic control at no increase in health care cost

Also better persistence and adherence rates

In the United States, diabetes affects an estimated 25.8 million people, equivalent to 8.3% of the U.S. population, with type 2 diabetes mellitus (T2DM) comprising 90% to 95% of all diagnosed cases of diabetes. Real-world data comparing outcomes of T2DM patients initiating different insulin regimens can help with treatment decisions and patient management.

Clinical and economic outcomes following initiation with insulin glargine disposable pen (GLA-P) or insulin detemir disposable pen (DET-P) in T2DM patients were compared over 1-year follow-up. A recent article in Advances in Therapy by STATinMED Research reveals that patients initiating GLA-P were more likely to persist with and adhere to treatment, with better glycemic control and similar overall hypoglycemia rate at no increase in health care cost.

A retrospective cohort analysis was conducted on data in a US national managed care claims database (July 2006 to September 2010) from patients initiating insulin treatment with GLA-P or DET-P. Treatment persistence, adherence, glycated hemoglobin (A1C), hypoglycemic events, and health care costs during follow-up were compared.

In all, 1682 patients were identified; 1016 (60.4%) started using GLA-P, 666 (39.6%) started using DET-P. After 1:1 propensity score matching, each cohort comprised 640 patients. Patients initiating GLA-P were significantly more likely to persist and adhere to treatment, and used a lower daily consumption dose.

Over the last quarter of follow-up, fewer GLA-P users switched to DET-P compared with those switching from DET-P to GLA-P. GLA-P was associated with lower A1C levels and higher reduction of A1C levels from baseline, with no significant difference in the number of patients having hypoglycemic events.Patients in both cohorts had similar total and diabetes-related health care costs, but health care costs were lower in the GLA-P cohort for each 1% reduction in A1C from baseline.

This real-world study demonstrated that patients initiating GLA-P were more likely to persist with and adhere to treatment, with better glycemic control and similar overall hypoglycemia rate at no increase in health care cost.

Adv Ther. 2011;28(11):1000-11.

This article in Advances in Therapy, entitled “A Real-World Study of Patients With Type-2 Diabetes Initiating Basal Insulins via Disposable Pens”, has been downloaded 167 times in November 2011, making it one of the most downloaded articles.

STATinMED Research has experience with the following datasets:

100% MEDICARE (Inpatient, Outpatient, Provider, Denominator Files)

MarketScan Data (Commercial, Medicare, Medicaid, Health and Productivity Management)

MarketScan Hospital Drug Data Set (Solucient data set)

Veterans Affairs (VA) Data Set

United Health Data

PharMetrics

Blue Cross Blue Shield of Michigan

The Impact Data Set (IHCIS)

Lab Rx

Premier

Electronic Medical Records

Health Core Integrated Research Database

SEER-Medicare Database

Medicare Current Beneficiary Survey

Medical Expenditure Panel Survey

The Long Term Care Minimum Data Set

STATinMED Research CEO on Adv Ther Advisory Board

admin — Wed, 30 Nov 2011 16:28:27 +0000

The President & CEO of STATinMED Research was selected for the advisory board of the Advances in Therapy journal.

STATinMED Research has new recently accepted journal articles

admin — Wed, 30 Nov 2011 16:26:40 +0000

STATinMED Research has two new recently accepted journal articles; one on September 29, 2011 to Thrombosis (therapeutic area: cardiovascular diseases) and one October 13, 2011 to Current Medical Research and Opinion (therapeutic area: oncology).

Grant request to NIH

admin — Wed, 30 Nov 2011 16:23:24 +0000

Grant request to the National Institute of Health

STATinMED Research and The University of Michigan have jointly submitted a grant request to the National Institute of Health (NIH) related to biologics therapies for rheumatoid arthritis and their effects on elective surgeries.

O. Baser and co-researchers’ findings advance asthma knowledge

admin — Wed, 09 Dec 2009 21:08:05 +0000

Findings from O. Baser and co-researchers advance knowledge in asthma

In this recent report published in the journal Value in Health, researchers in the United States conducted a study “To review the efficacy of instrumental variable (IV) models in addressing a variety of assumption violations to ensure standard ordinary least squares (OLS) estimates are consistent. IV models gained popularity in outcomes research because of their ability to consistently estimate the average causal effects even in the presence of unmeasured confounding.”

Read the whole article: Medical News Article on Asthma Findings from O. Baser and co-researchers advance knowledge in asthma.

Metabolic screening after ADA’s consensus statement

admin — Tue, 14 Apr 2009 21:12:35 +0000

Metabolic screening after ADA’s consensus statement on atypical antipsychotic drugs

According to the American Diabetes Association (ADA), metabolic monitoring guidelines for antipsychotics are largely unheeded. Researchers found that recommendations for lipid and glucose monitoring for patients on atypical antipsychotic drugs have made scarcely a dent on clinical practice. Metabolic screening and monitoring rates rose by 5% or less since 2004, when the FDA warned of increased diabetes and cardiovascular risk with antipsychotic medications, according to two separate analyses of large insurance claim databases reported here at the American Diabetes Association meeting.

Read the complete story: “Metabolic Screening after the ADA’s Consensus Statement on Antipsychotic Drugs and Diabetes” was recently accepted for publication in Diabetes Care. Dr. Baser co-authored the publication.