Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Medicare / 11.01.2024

MedicalResearch.com Interview with: Kalli Koukounas, MPH Ph.D. Student, Health Services Research Brown University School of Public Health Providence, RI MedicalResearch.com: What is the background for this study? Response:  On Jan. 1st, 2021, the Centers for Medicare and Medicaid Services (CMS) implemented the End-Stage Renal Disease Treatment Choices (ETC) Model, one of the largest randomized tests of pay-for-performance incentives ever conducted in the US. The goal of the model was to enhance the use of home dialysis and kidney transplant or waitlisting among kidney failure patients in traditional Medicare. The model randomly assigned approximately 30% of US dialysis facilities and nephrologists to receive financial incentives, ranging from bonuses of 4% to penalties of 5%, based on their patients’ use of home dialysis and kidney transplant/waitlisiting. The payment adjustments apply to all Medicare-based reimbursement for dialysis services. Prior research has demonstrated that dialysis facilities that disproportionately serve populations with high social risk have lower use of home dialysis and kidney transplant, raising concerns that these sites may fare poorly in the payment model. Using data released by CMS, we examined the first year of ETC model performance and financial penalties across dialysis facilities, stratified by the measured social risk of the facilities’ incident patients. (more…)
Author Interviews, Cost of Health Care, Pharmacology / 09.12.2023

MedicalResearch.com Interview with: Joseph T. DiPiro, Pharm.D Associate Vice President, Faculty Affairs Virginia Commonwealth University Dr. DiPiro is an editor for Pharmacotherapy: A Pathophysiologic Approach MedicalResearch.com: What is the background for this study? Response: The ASHP/ASHP Foundation Pharmacy Forecast Report is constructed from a survey of health-system pharmacy leaders who were asked to rate the likelihood of events, scenarios, and trends occurring in the next five years. The purpose is for health-system pharmacists and pharmacy leaders to inform their strategic planning efforts. The Pharmacy Forecast is not intended to predict future events. Rather, the report is intended to be a provocative stimulant for the thinking, discussion, and planning that must take place in every health system. Leaders must be informed of potential developments to help position their organizations to care for patients, enhance population health, and improve medication outcomes. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmacology / 17.11.2023

MedicalResearch.com Interview with: Lisa-Marie Smale, PharmD
PhD Candidate Clinical Pharmacy
Radboud University Medical Center
Department of Pharmacy
Nijmegen, the Netherlands Lisa-Marie Smale, PharmDPhD Candidate Clinical PharmacyRadboud University Medical CenterDepartment of PharmacyNijmegen, the Netherlands   MedicalResearch.com: What is the background for this study? Response: Cancer drugs are not always fully used by patients, while these drugs are mostly expensive and environmentally damaging, both in production and (waste) disposal. Therefore we investigated whether unused drugs of patients can be collected, verified of quality by a pharmacy, to be redispensed to other patients instead of being disposed of. We were interested whether such an approach ultimately leads to lower environmental impacts and costs. (more…)
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA, UCLA / 20.05.2023

MedicalResearch.com Interview with: Julia Cave Arbanas Project Manager and     John N. Mafi, MD, MPH Associate Professor of Medicine General Internal Medicine & Health Services Research David Geffen School of Medicine at UCLAJohn N. Mafi, MD, MPH Associate Professor of Medicine General Internal Medicine & Health Services Research David Geffen School of Medicine at UCLA   MedicalResearch.com: What is the background for this study? What is lecanemab used for and how well does it work? Response: Lecanemab is a treatment for mild cognitive impairment and mild dementia that was approved in January 2023 as part of the Food and Drug Administration’s (FDA) accelerated approval program. The results from a recent phase 3 clinical trial show a modest clinical benefit: the rate of cognitive decline by 27% in an 18-month study involving participants experiencing the early stage of Alzheimer’s, with an 0.45-point absolute difference in cognitive testing scores. However, due to the risk of brain swelling and bleeding (also known as amyloid-related imaging abnormalities), treatment with lecanemab involves frequent MRIs and neurology or geriatrics appointments to monitor for these abnormalities, which can be life threatening. So far, three patient deaths have potentially been tied to lecanemab. It is likely that the FDA will grant is lecanemab traditional approval later this year, prompting Medicare to reconsider its current coverage restrictions and potentially enabling widespread use. (more…)
Author Interviews, Cost of Health Care, Heart Disease, JACC / 26.02.2023

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Section Head, Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research Associate Program Director Cardiovascular Medicine Fellowship at Beth Israel Deaconess Medical Center Assistant Professor of Medicine, Harvard Medical School @rkwadhera MedicalResearch.com: What is the background for this study? Response: High and rising prescription drug costs in the United States contribute to medication non-adherence and financial strain among adults with cardiovascular risk factors or disease. As a result, addressing prescription drug costs in patients with chronic conditions has become a national priority. In response to these growing concerns, federal policymakers passed the Inflation Reduction Act on August 16, 2022, which aims to address high out-of-pocket drug costs for adults enrolled in Medicare Part D, by placing a $2000 annual cap on out-of-pocket prescription drug costs and expanding eligibility for full low-income subsidies to individuals that reduce deductible costs and prescription copayments (among several other provisions). It is unclear how these provisions will affect Medicare beneficiaries with cardiovascular risk factors and/or conditions. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies, Yale / 22.01.2023

MedicalResearch.com Interview with: Neeraj Patel Medical Student (MS-2), Yale School of Medicine New Haven, CT MedicalResearch.com: What is the background for this study? Response: Direct-to-consumer pharmaceutical advertising has been increasing in popularity for the past two decades or so, particularly via television. But it’s highly controversial. Only two high-income countries (the U.S. and New Zealand) widely permit this type of advertising for prescription drugs. Critics have pointed to a growing body of literature that suggests that direct-to-consumer advertising for prescription drugs can be misleading, lead to inappropriate prescribing, and inflate healthcare costs. Proponents have argued that it improves public health by promoting clinically beneficial prescribing. (more…)
Author Interviews, Cost of Health Care, JAMA / 19.12.2022

MedicalResearch.com Interview with: Anna L. Goldman, M.D., M.P.A., M.P.H Assistant Professor of Medicine General Internal Medicine Boston University Chobanian & Avedisian School of Medicine   MedicalResearch.com: What is the background for this study? Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians.  In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic. (more…)
Author Interviews, Cost of Health Care, Rheumatology, University of Pittsburgh / 01.12.2022

MedicalResearch.com Interview with: Raisa Silva, M.D. Resident physician in Internal medicine University of Pittsburgh Medical Center MedicalResearch.com: What is the background for this study? Response: Systemic lupus erythematosus (lupus for short) is a complex disease that significantly affects patients’ lives. Adherence to medications for lupus is known to be suboptimal (it can be as low as 15% in some studies). Multiple social factors may affect treatment adherence. For example, costs of medications (including copayments, deductibles, co-sharing), polypharmacy (patients with lupus often have comorbid diseases that also need medications), and potential side effects are some of the reasons why patients may have difficulty in taking medications for lupus every day. The costs of insurance copayment may represent a major obstacle to adherence. The lack of adherence to lupus medications is associated with poor control of disease, more symptoms, and worse disease outcomes, such as more hospitalizations and more severe disease. In our study, we examined the association between lupus medications copayment and adherence to these medications (some of the most commonly used medications for lupus). (more…)
Author Interviews, CDC, Cost of Health Care, Hepatitis - Liver Disease / 05.10.2022

MedicalResearch.com Interview with: William W. Thompson, Ph.D. Epidemiologist Division of Viral Hepatitis CDC MedicalResearch.com: What is the background for this study? Response: Prior to this analysis, we knew only an estimated 1.2 million persons initiated hepatitis C treatment with DAA agents in the United States during 2014–2020, far below the number needed to achieve national hepatitis C elimination goals. Further, the number of persons treated was highest in 2015 and declined to its lowest level in 2020. This analysis used a large national health care claims database to assess the level and timing of hepatitis C treatment among persons with diagnosed HCV infection with breakdowns by sex, age, race, insurance type (i.e., private, Medicaid, and Medicare), and by state. (more…)
Author Interviews, Cost of Health Care, COVID -19 Coronavirus, JAMA / 26.09.2022

MedicalResearch.com Interview with:

Allison Witman PhD Assistant Professor of Economics Economics & Finance Cameron School of Business University of North Carolina, Wilmington

Yu Wang PhD Assistant Professor Congdon School of Supply Chain, Business Analytics, & Information Systems Cameron School of Business University of North Carolina Wilmington David Cho PhD Assistant Professor of Management California State University, Fullerton

MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic placed tremendous financial pressure on hospitals. Beginning in March of 2020, hospitals cancelled outpatient and elective procedures to accommodate surges in demand from COVID-19 patients. As these procedures account for more than 60% of an average hospital’s revenue, cancellation posed serious challenges to the financial health of hospitals. Revenue from COVID-19 patients may have partially offset these effects, but the American Hospital Association estimated a total loss of $202.6 billion by American hospitals between March and June 2020. In response, the U.S. government created large federal assistance programs aimed to stabilize hospitals’ financial situation as their ability to maintain operations was critical to the health of the nation. Due to differences in hospital characteristics, certain hospitals such as rural hospitals and those serving a higher share of Medicaid and uninsured patients (e.g., safety net hospitals) may have been more financially susceptible to the effects of the pandemic. These hospitals that serve vulnerable patient populations historically have had lower profit margins and were candidates for targeted COVID relief funding (e.g., Safety Net Hospitals Payments, a $10 billion component of the Provider Relief Fund). (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA / 08.09.2022

MedicalResearch.com Interview with: Jane M. Zhu, M.D., M.P.P., M.S.H.P. Assistant Professor of Medicine Division of General Internal Medicine and Geriatrics School of Medicine Oregon Health & Science University Portland, Oregon MedicalResearch.com: What is the background for this study? Response: Private equity (PE) acquisitions of physician practices are accelerating across many specialties, but there is still little robust evidence on the effects of these acquisitions. Concerns about PE involvement is predicated on the fact that these firms expect high annual returns, which require either reducing costs or increasing revenue, or both. Using PE acquisition data from 2016-2020, linked to commercial claims data, we sought to understand what common mechanisms of revenue generation were being adopted after private equity acquisition of physician practices. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 31.08.2022

MedicalResearch.com Interview with: Prof. Katharina Blankart, PhD Faculty of Economics and Business Administration University of Duisburg-Essen Essen, Germany MedicalResearch.com: What is the background for this study? Response: Given the high drug prices and policy discussions, we were interested whether the US may miss opportunities from medical innovation in availability of medicines compared to Germany. Since 2011, Germany has a unique way to determine value of new medicines after regulatory approval and to negotiate prices. We aimed to find out differences in availability of medicines in these two countries and timing of availability. We evaluated the differences in timing of availability and to characterize medicines not available to one of the two countries. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 09.06.2022

MedicalResearch.com Interview with: Benjamin N. Rome MD Instructor, Harvard Medical School Internal Medicine Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital MedicalResearch.com:  What is the background for this study? What are the main findings?  Response: Manufacturers of brand-name drugs are granted periods, free from direct competition, during which they can set and raise prices as they choose. We found that the prices for newly marketed brand-name drugs increased by 20% per year from 2008 to 2021. In 2020 and 2021, nearly half of new drugs were launched at a price greater than $150,000 per year, compared with 9% of drugs in 2008-2013. These dramatic trends are only partly explained by changes in the types of drugs coming to market. (more…)
Author Interviews, Cost of Health Care, COVID -19 Coronavirus, JAMA / 15.02.2022

MedicalResearch.com Interview with: Kao-Ping Chua, MD, PhD Assistant Professor, Department of Pediatrics Assistant Professor, Health Management and Policy School of Public Health University of Michigan MedicalResearch.com:  What is the background for this study? Response: In 2020, most insurers waived the cost of COVID-19 hospitalization for patients. In early 2021, many major insurers started to abandon those waivers. By August 2021, the vast majority of insurers had started billing patients for COVID-19 hospitalizations again. (more…)
ADHD, Author Interviews, Cost of Health Care, Eating Disorders, Pharmacology / 09.01.2022

MedicalResearch.com Interview with: Sneha Vaddadi, BS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine, classified as Schedule II substances, are sympathomimetic drugs with therapeutic use widely used in the US for Attention Deficit Hyperactivity Disorder. Changes in criteria for diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns. The goal of this study1 was to extend upon past research2 to compare the pharmacoepidemiology of these stimulants in the United States from 2010–2017, including consideration to variation within geographic regions, the Hispanic population, and the Medicaid population. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 12.12.2021

MedicalResearch.com Interview with: Jeanne Madden, PhD Associate Professor Department of Pharmacy and Health Systems Sciences School of Pharmacy and Pharmaceutical Sciences Bouvé College of Health Science Northeastern University MedicalResearch.com: What is the background for this study? Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs. There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans. (more…)
Author Interviews, Cost of Health Care, JAMA, Lung Cancer, Stanford, USPSTF / 24.10.2021

MedicalResearch.com Interview with: Summer S Han, PhD Assistant Professor Quantitative Sciences Unit Stanford Center for Biomedical Informatics Research (BMIR) Neurosurgery and Medicine Stanford University School of Medicine Stanford, CA 94304  MedicalResearch.com: What is the background for this study? Response: The US Preventive Services Task Force (USPSTF) issued their 2021 recommendation on lung cancer screening lowering the start age from 55 to 50 years and the minimum pack-year criterion from 30 to 20, relative to the 2013 recommendations. Although costs are expected to increase with the expanded screening eligibility, it is unknown if the new guidelines for lung cancer screening are cost-effective. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Cost of Health Care, JAMA / 20.10.2021

MedicalResearch.com Interview with: Anita Katharina Wagner, PharmD, MPH, DrPH Associate Professor of Population Medicine Director, Ethics Program, Point32Health (parent company of Harvard Pilgrim Health Care and Tufts Health Plan) Co-Director, HMS Fellowship in Health Policy and Insurance Research Co-Director, Center for Cancer Policy and Program Evaluation (CarPE) Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The expectation for new cancer drugs is that they help patients live better longer. Increasingly more cancer drugs are approved without documented quality of life or overall survival benefits.   At the same time, cancer drug prices are rising.  We studied use of and spending on selected new cancer drugs among patients with employer-sponsored health insurance. We found that among 37348 patients who received one or more of 44 oral targeted cancer drugs, the proportion of patients who received a drug without documented overall survival benefit increased from 13% in 2011 to 59% in 2018.  By 2018, spending on drugs without documented overall survival benefit accounted for 52% of the $3.5 million spend on the 44 drugs since 2011. (more…)
Author Interviews, Cost of Health Care, JAMA, Surgical Research / 07.09.2021

MedicalResearch.com Interview with: Andrew P. Loehrer, MD, MPH Assistant Professor Department of Surgery, Division of Surgical Oncology Dartmouth-Hitchcock MedicalResearch.com: What is the background for this study? Response: Patient cost sharing represents the portion of costs covered by insurance that individuals pay out of pocket, including deductibles, co-payment, and co-insurance. Cost sharing is increasingly common and also increasingly expensive for patients with commercial health insurance across the United States. While designed to increase patient responsibility for health care spending, prior work has shown that higher cost sharing is also associated with decreased use of health care overall, both needed and discretionary. However, little work has been done as to how high cost sharing may affect common and costly conditions like acute appendicitis and acute diverticulitis.  (more…)
Anesthesiology, Author Interviews, Cost of Health Care, JAMA / 18.08.2021

MedicalResearch.com Interview with: Ambar La Forgia, PhD Assistant Professor of Health Policy & Management Columbia University Mailman School of Public Health MedicalResearch.com: What is the background for this study? Response: Over the past few years, there has been mounting pressure to protect consumers from surprise medical bills, which occur when a patient unknowingly receives care from an out-of-network practitioner at an in-network facility. In 2018, only six states had passed comprehensive surprise billing legislation, and by 2020, 17 states had passed legislation. In addition to protecting patients from financial liability for surprise medical bills, states adopted different methods for determining payments made by a patient’s insurer to the out-of-network practitioner. For example, some states, such as California and Florida, developed a payment standard that tied provider payments to median in-network rates, Medicare rates, or the usual and customary provider charges. Other states, such as New York, developed an independent dispute resolution process, which uses a third-party arbiter to resolve payment disputes between insurers and practitioners. However, little is known about how state laws influence the prices paid to out-of-network practitioners and whether spillovers existed to in-network prices. In this study, my co-authors and I study the association between the passage of surprise billing legislation in California, Florida, and New York, and prices paid to anesthesiologists in hospital outpatient departments and ambulatory surgery centers using commercial claims data from 2012-2017. We focused on anesthesiology because it is one of the specialties with the highest proportion of potential surprise bills since patients do not usually choose their anesthesiologist. (more…)
Author Interviews, Cost of Health Care, Genetic Research, Hematology, JAMA / 22.03.2021

MedicalResearch.com Interview with: Patrick DeMartino MD Pediatric Hematology and Oncology Fellow Doernbecher Children's Hospital Oregon Health & Science University MedicalResearch.com: What is the background for this study? Response: Dozens of gene therapies are expected to be on the market within a decade or so. Much has been written about the high prices of the therapies currently on the market (exceeding $1 million). However, only a small number of patients are eligible for these existing therapies each year. Gene therapy for sickle cell disease (SCD) appears promising and would potentially apply to a relatively large number of individuals in the U.S. We sought to explore potential affordability challenges associated with a gene therapy for SCD. (more…)
Author Interviews, Cost of Health Care, JAMA / 19.03.2021

MedicalResearch.com Interview with: Sungchul Park, MPH PhD Assistant Professor, Health Management and Policy Dornsife School of Public Health Drexel University Philadelphia, PA 19104Sungchul Park, MPH PhD Assistant Professor, Health Management and Policy Dornsife School of Public Health Drexel University Philadelphia, PA 19104   MedicalResearch.com: What is the background for this study? Response: Evidence suggests that a significant share of health care costs in the US is of low value. In some cases, low-value care can be associated with harmful patient outcomes. Thus, decreasing use of low-value care is a major goal for Medicare given the potential to decrease costs and harms. Compared with traditional fee-for-service Medicare (TM), Medicare Advantage (MA) is more strongly financially incentivized to decrease use of low-value care. (more…)
Author Interviews, Cost of Health Care, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, JAMA / 05.03.2021

MedicalResearch.com Interview with: Ninh T. Nguyen, MD Chief of Gastrointestinal Division, Surgery UCI  MedicalResearch.com: What is the background for this study? What are the main findings  Response: There are limited national data on hospitalized patients in the US. To our knowledge, the current publication provides data on the largest cohort of COVID-19 patients hospitalized at US academic centers. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, COVID -19 Coronavirus, Electronic Records, JAMA, Technology / 04.03.2021

MedicalResearch.com Interview with: Carlo Giovanni Traverso, MB, BChir, PhD Associate Physician, Brigham and Women's Hospital Assistant Professor, Peter RChaiMDMMS Emergency Medicine Physician and Medical Toxicologist Harvard Medical School Brigham and Women's Hospital Department of Medicine   Dr-Spot-HealthCare-Assistant.jpgMedicalResearch.com: What is the background for this study? What are some of the functions that Dr. Spot can facilitate? Response: During the COVID-19 pandemic, we wanted to consider innovative methods to provide additional social distance for physicians evaluating low acuity individuals who may have COVID-19 disease in the emergency department. While other health systems had instituted processes like evaluating patients from outside of emergency department rooms or calling patients to obtain a history, we considered the use of a mobile robotic system in collaboration with Boston Dynamics to provide telemedicine triage on an agile platform that could be navigated around a busy emergency department. Dr. Spot was built with a camera system to help an operator navigate it through an emergency department into a patient room where an on-board tablet would permit face-to-face triage and assessment of individuals. (more…)
Author Interviews, Cost of Health Care, Dermatology, Gender Differences, JAMA, Medicare, Race/Ethnic Diversity / 18.02.2021

MedicalResearch.com Interview with: Lauren A. V. Orenstein, MD | She/her/hers Assistant Professor of Dermatology Robert A. Swerlick, MD Professor and Alicia Leizman Stonecipher Chair of Dermatology Emory University School of Medicine Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? Response: Financial incentives have the potential to drive provider behavior, even unintentionally. The aim of this study was to evaluate differences in clinic “productivity” measures that occur in outpatient dermatology encounters. Specifically, we used data from 2016-2020 at one academic dermatology practice to evaluate differences in work relative value units (wRVUs, a measure of clinical productivity) and financial reimbursement by patient race, sex, and age. 66,463 encounters were included in this study, among which 70.1% of encounters were for white patients, 59.6% were for females, and the mean age was 55.9 years old. (more…)
Author Interviews, Cost of Health Care, CT Scanning, Heart Disease, JACC, Statins / 14.01.2021

MedicalResearch.com Interview with: Prasanna Venkataraman MBBS Thomas H. Marwick MBBS, PhD Baker Heart and Diabetes Research Institute Monash University, Melbourne Melbourne, Australia   MedicalResearch.com: What is the background for this study?
  • Coronary artery calcium score (CAC) quantifies coronary calcium as determined by computed tomography and is a good surrogate marker for overall coronary plaque burden. It can help to reclassify patients at intermediate risk – many of whom are actually at low risk and can be reassured. Conversely, the finding of coronary calcium can also motivate patients (and their clinicians) to more aggressively control their cardiovascular risk factors. This is particularly problematic in those with a family history of premature coronary artery disease, where standard risk prediction tools are less accurate. However, CT CAC does not routinely attract third party payer support limiting its access and utilisation.
  • We screened 1084 participants who have a family history of premature coronary disease and a 10-year Pooled cohort Equation (PCE) cardiovascular risk >2% with CAC. We then assessed the cost-effectiveness of commencing statins in those with any coronary calcium compared to a strategy of no CAC testing and commencing statins if their PCE risk was ≥7.5% consistent with current guidelines. 
(more…)
Author Interviews, Cost of Health Care, Emory, Heart Disease, JAMA, Surgical Research / 21.09.2020

MedicalResearch.com Interview with: David H. Howard, PhD Professor, Health Policy and Management Rollins School of Public Health Emory University, Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Application of the False Claims Act (FCA) to medically unnecessary care is controversial, both in the courts and in the Department of Justice. Although there haven’t been many FCA suits against hospitals and physicians for performing unnecessary percutaneous coronary interventions (PCIs), the suits that have occurred have been against some of the highest-volume hospitals and physicians. Some cardiologists have been sentenced to prison. (more…)
Author Interviews, Cost of Health Care, Genetic Research, Immunotherapy, Melanoma, Surgical Research / 03.09.2020

MedicalResearch.com Interview with: Edmund K Bartlett, M.D. Department of Surgery/Division of Surgical Oncology Memorial Sloan Kettering Cancer Center New York, New York   MedicalResearch.com: What is the background for this study? Response: Indications for adjuvant therapy for resected, high-risk melanoma is a controversial and rapidly-evolving topic in melanoma treatment. Immunotherapy treatments targeting PD-1 have significantly improved survival in advanced-stage disease, but the magnitude of survival benefit in stage III disease--particularly stage IIIA--remains unclear. Recently, 31-GEP (a gene expression profiling assay) has been studied as a risk-stratifying tool to identify patients who are at higher risk for systemic recurrence. Ideally such a tool could identify patients most likely to benefit from immunotherapy treatment in the adjuvant setting (when all visible disease has been removed). (more…)