Breaking News
September 22, 2018 - Vici syndrome – Genetics Home Reference
September 22, 2018 - Single-dose drug can shorten flu symptoms by about a day, studies suggest
September 22, 2018 - AMSBIO launches circulating tumor DNA Reference Standards
September 22, 2018 - Sandalwood mimicking odorant could stimulate hair growth in humans
September 22, 2018 - Overlooked immune cells could play a key role in cancer immunotherapy, claims new study
September 22, 2018 - Study reveals prevalence of diagnosed type 1 and type 2 diabetes among American adults
September 22, 2018 - Researchers develop fast detection strategy to know type of virus acquired by patients
September 22, 2018 - Global Prevalence of Insufficient Activity 27.5 Percent
September 22, 2018 - Strategies to protect bone health in hematologic stem cell transplant recipients
September 22, 2018 - Brigham Genomic Medicine program unravels 30 medical mysteries
September 22, 2018 - New system harnesses power of bubbles to destroy dangerous biofilms
September 22, 2018 - Inflammation plays crucial role in preventing heart attacks and strokes, study reveals
September 22, 2018 - Calorie dense, nutrient deficient meals common across the world
September 22, 2018 - Researchers develop technology to study behavior of implants without animal testing
September 22, 2018 - First gut bacteria in newborns may have lasting effect on ability to ward off chronic diseases
September 22, 2018 - Detection of BFD virus in parrots in 8 new countries raises concerns for threatened species
September 22, 2018 - Insulin treatment shows great potential against chronic bowel inflammation
September 22, 2018 - ‘Liking Gap’ Might Stand in Way of New Friendships
September 22, 2018 - Simple factors that can avoid harmful side effects in type 2 diabetes
September 22, 2018 - ALSAM Foundation invests additional $2 million for drug discovery and development projects
September 22, 2018 - Study findings may advance discussion of how to effectively curb human-wildlife conflict
September 22, 2018 - Dopamine neurons may involve in conditions ranging from Parkinson’s disease to schizophrenia
September 22, 2018 - Protein C and Protein S Tests: MedlinePlus Lab Test Information
September 22, 2018 - Obesity and diabetes—two reasons why we should be worried about the plastics that surround us
September 22, 2018 - Concern over fussy eating prompts parents to use non-responsive feeding practices
September 22, 2018 - Novel mathematical approach uncovers existence of unsuspected biological cycles
September 22, 2018 - Cancer Research UK invests £14 million to transform London into cancer biotherapeutics hub
September 22, 2018 - Scientists predict how well the body will fight lung cancer by analyzing immune cell shapes
September 22, 2018 - New outbreak of rare eye disease identified in contact lens wearers
September 22, 2018 - Iterum Initiates SURE 2 and SURE 3 Phase 3 Clinical Trials of IV and Oral Sulopenem in Complicated Urinary Tract and Complicated Intra-abdominal Infections
September 22, 2018 - Research finds divide in dental health accessibility between city and regional areas
September 22, 2018 - Premature babies show better brain development when fed breast milk, finds study
September 22, 2018 - Novel system uses AI to detect abnormalities in fetal hearts
September 22, 2018 - UNC scientists reveal new approach to prevent obesity and diabetes
September 22, 2018 - CWRU receives NIH grant to learn how non-coding genes contribute to spread of colorectal cancer
September 22, 2018 - Scientists better understand influenza virus and how it spreads
September 22, 2018 - Scientists to focus on length of time when a person is alive and healthy
September 22, 2018 - Study shows positive financial impacts of Medicaid expansion for low-income Michigan residents
September 22, 2018 - Innovative approach for developing vaccine against most prevalent human malaria parasite
September 22, 2018 - Innovation Fund Denmark supports research project that aims to fight Clostridium difficile diarrhea
September 22, 2018 - Survey estimates caregiving costs for family members
September 22, 2018 - Inhibiting NF-kB improves heart function in a mouse model of Duchenne muscular dystrophy
September 22, 2018 - Introducing new EMR system may affect several aspects of clinic workflow
September 22, 2018 - Study finds why some human genes are more popular with biomedical researchers
September 22, 2018 - Finding epigenetic signature appears to predict inflammation risk in serious type of IBD
September 22, 2018 - Researchers develop light-based technique to measure very weak magnetic fields
September 22, 2018 - UAB researchers study dysfunction of the immune system associated with NSAID carprofen
September 22, 2018 - QIAGEN and DiaSorin launch automated, CE-marked workflow for high-throughput TB screening
September 22, 2018 - EFS checklist provides user-friendly tool for evaluating feeding skills in preterm infants
September 22, 2018 - Family history in blacks, Latinos associated with higher risk of AFib
September 22, 2018 - Researchers identify new genetic disorder in a human patient
September 22, 2018 - Cardiac MR With Contrast Feasible in Developing World
September 22, 2018 - Daily low-dose aspirin doesn’t reduce heart-attack risk in healthy people
September 21, 2018 - Children with asthma found to be disadvantaged in education and future occupation
September 21, 2018 - Interaction of chemical slurry and ancient shale in fracking wastewater causes radioactivity
September 21, 2018 - Scientists use mice to study transmission of Lyme disease bacteria by infected ticks
September 21, 2018 - Researchers find that sample size is key factor determining accuracy of study results
September 21, 2018 - Study shows how the drive to eat overpowers the brain’s signal to stop
September 21, 2018 - 30 Million Americans Now Have Diabetes
September 21, 2018 - Thousands of breast cancer gene variants engineered and analyzed
September 21, 2018 - The current fellowship interview process is cumbersome — Stanford researchers have a better idea
September 21, 2018 - Progenitor cells for human bone and cartilage have been identified
September 21, 2018 - Study reveals new therapeutic target for pediatric tumor-associated intractable epilepsy
September 21, 2018 - SLU’s College professor receives NIH grant to develop I-TEST project
September 21, 2018 - DermTech completes enrollment in clinical study to assess DNA damage and reversal
September 21, 2018 - Grieving patients treated with talk therapy have lower risk of suicide and psychiatric illness
September 21, 2018 - NIH and FDA call for eliminating involvement of RAC in human gene therapy experiments
September 21, 2018 - New system uses algorithm to convert 2D videos into 3D printed ‘motion sculptures’
September 21, 2018 - Sea squirt model reveals key molecules in dopaminergic neuron differentiation
September 21, 2018 - Effective management of neonatal abstinence syndrome requires coordinated ‘cascade of care’
September 21, 2018 - Refugees seek care for wounds of war
September 21, 2018 - Under the sea, in an octopus’ garden on ecstacy
September 21, 2018 - Eating foods with low nutritional quality ratings linked to cancer risk in large European cohort
September 21, 2018 - Giving kids honest information about water consumption may help them make healthy choices
September 21, 2018 - Horwitz Prize Awarded for Work on Hormones
September 21, 2018 - CHMP issues positive opinion supporting use of Trelegy Ellipta in broader group of COPD patients
September 21, 2018 - Scientists discover new molecules that work together to remove unwanted DNA
September 21, 2018 - Dr. Fenella France to deliver 2019 Plenary Lecture
September 21, 2018 - New research finds that MHC-II molecules have more influence on tumors than MHC-I
September 21, 2018 - Researchers study effects of cardiac cycle in simple learning task
Study shows cost-effectiveness of financial incentive program to control cholesterol

Study shows cost-effectiveness of financial incentive program to control cholesterol

image_pdfDownload PDFimage_print

A program that offered financial incentives to both patients and their physicians to control low-density lipoproteins (LDL) cholesterol could be a cost-effective intervention for patients at high risk of cardiovascular disease (CVD), according to new research led by Harvard T.H. Chan School of Public Health.

The study showed that the shared incentive program provided reasonable value even when accounting for additional costs, such as electronic pill bottles to monitor drug adherence, more frequent cholesterol measurements, administrative expenses, and the actual cash incentive, which maxed out at $1,024 per year, split between the doctor and patient.

“Financial incentive interventions are only effective sometimes. When these programs show health benefits, the next question should be whether the health gains are worth the added costs, which is what we modeled in this study,” said lead author Ankur Pandya, assistant professor of health decision science.

The study will be published on September 14, 2018 in JAMA Network Open.

CVD is the leading cause of death and health care costs in the U.S. The use of cholesterol-lowering drugs known as statins, which are cheap in their generic form, are proven to help prevent CVD. Yet long-term adherence to these medications is below 50%. One proposed strategy to improve adherence rates and lower LDL cholesterol–often referred to as “bad” cholesterol– is offering financial incentives, but it’s unclear if such programs are worth the costs.

To determine the cost-effectiveness of financial incentives, the Harvard Chan researchers, along with colleagues from Brigham and Women’s Hospital and the Perelman School of Medicine at the University of Pennsylvania, developed a model-based analysis that simulated CVD progression.

They applied this analysis to data from a 2015 clinical trial involving statins in which patients were randomized to one of four groups: no financial incentives; financial incentives for only the patient; financial incentives for only the doctor; or a financial incentive shared between the patient and doctor. That study showed the shared incentive group was superior at reducing LDL cholesterol, but it did not examine whether the health gains represented good value given the added costs. The 2015 study was also limited in that it only followed up with patients three months after the study ended.

The CVD model, developed by corresponding and senior author Thomas Gaziano, was used by Chan School researchers to simulate lifetime CVD progression among a cohort of 1 million patients that mirrored the 2015 study population. Results showed that the shared incentives program had an incremental cost-effectiveness ratio (ICER) of $60,000 per quality-adjusted life year (QALY), a metric that reflects how much money is required to produce one year of high-quality life with a particular intervention. Under current standards, ICERs between $50,000 and $150,000 per QALY represent “intermediate value.” The researchers said the findings demonstrated that the shared financial incentives program provided reasonable value for the health gains it produced compared with programs that offered financial incentives to only the patient or only the doctor or offered no financial incentive at all.

Importantly, the researchers found that the cost-effectiveness of the shared incentives intervention hinged on how long the LDL benefits persisted. They concluded that a large-scale study of the shared incentives strategy with at least five years of follow-up is warranted by the Centers for Medicare and Medicaid Services or private health care payers to test this strategy in a real-world setting.

“Combining financial incentives for providers and patients with advanced technologies to monitor compliance, including electronic pill bottles, has the potential to improve patient care while remaining cost-effective, and this strategy should be further evaluated,” said Gaziano, assistant professor in the department of health policy and management at Harvard Chan School and director of the global cardiovascular health policy and prevention unit at Brigham and Women’s Hospital.

Source:

Increasing cholesterol medication adherence with financial incentives may be cost-effective

About author

Related Articles