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Article ; Online: Which Localizing Strategy is the Most Cost-Effective in Reoperative Primary Hyperparathyroidism?

Gazivoda, Victor / Prioli, Katherine M / Li, Albert C / Pizzi, Laura / Laird, Amanda M / Beninato, Toni

2024 Volume 296, Page(s) 547–555

Abstract: Introduction: 2%-10% of patients with primary hyperparathyroidism (PHPT) who undergo parathyroidectomy develop persistent/recurrent disease. The aim of this study was to determine which preoperative localization method is most cost-effective in ... ...

Abstract	Introduction: 2%-10% of patients with primary hyperparathyroidism (PHPT) who undergo parathyroidectomy develop persistent/recurrent disease. The aim of this study was to determine which preoperative localization method is most cost-effective in reoperative PHPT. Methods: Clinical decision analytic models comparing cost-effectiveness of localizing studies in reoperative PHPT were constructed using TreeAge Pro. Cost and probability assumptions were varied via Probabilistic Sensitivity Analysis (PSA) to test the robustness of the base case models. Results: Base case analysis of model 1 revealed ultrasound (US)-guided fine-needle aspiration with PTH assay as most cost-effective after localizing US. This was confirmed on PSA of model 1. Model 2 showed four-dimensional computed tomography (4D-CT) as most cost-effective after negative US. If not localized by US, on PSA, 4D-CT was the next most cost-effective test. Conclusions: US-guided FNA with PTH is the most cost-effective confirmatory test after US localization. 4D-CT should be considered as the next best test after negative US.
MeSH term(s)	Humans ; Hyperparathyroidism, Primary/surgery ; Cost-Benefit Analysis ; Technetium Tc 99m Sestamibi ; Parathyroidectomy ; Four-Dimensional Computed Tomography/methods ; Parathyroid Glands/surgery
Chemical Substances	Technetium Tc 99m Sestamibi (971Z4W1S09)
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2024.01.015
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Article ; Online: Post hoc depression analysis from a pharmacist-led diabetes trial.

Bateman, M Thomas / McCarthy, Caitlin / Prioli, Katherine M / Wagner, Mary L

The mental health clinician

2023 Volume 13, Issue 1, Page(s) 18–24

Abstract: Introduction: Diabetes and depression may present concurrently, and clinical pharmacists are well equipped to manage these conditions. Clinical pharmacists were grant funded to implement a diabetes-focused randomized controlled trial in a Federally ... ...

Abstract	Introduction: Diabetes and depression may present concurrently, and clinical pharmacists are well equipped to manage these conditions. Clinical pharmacists were grant funded to implement a diabetes-focused randomized controlled trial in a Federally Qualified Health Center. The objective of this analysis is to evaluate if glycemic control and depressive symptoms improve for patients with diabetes and depression with additional management from clinical pharmacists compared with those receiving the standard of care. Methods: This is a post hoc subgroup analysis of a diabetes-focused randomized controlled trial. Pharmacists enrolled patients with type 2 diabetes mellitus (T2DM) and a glycated hemoglobin (A1C) greater than 8% and randomly assigned them to 1 of 2 cohorts, one managed by the primary care provider alone and one with additional care from the pharmacist. Pharmacists completed encounters with patients who have T2DM with or without depression to comprehensively optimize pharmacotherapy while tracking glycemic and depressive outcomes throughout the study. Results: A1C improved from baseline to 6 months in patients with depressive symptoms who received additional care from pharmacists by -2.4 percentage points (SD, 2.41) compared with a -0.1 percentage point (SD, 1.78) reduction in the control arm ( Discussion: Patients with T2DM and depressive symptoms experienced better diabetes outcomes with additional pharmacist management compared with a similar cohort of patients with depressive symptoms, managed independently by primary care providers. These patients with diabetes and comorbid depression received a higher level of engagement and care from the pharmacists, which led to more therapeutic interventions.
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Journal Article
ISSN	2168-9709
ISSN (online)	2168-9709
DOI	10.9740/mhc.2023.02.018
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Article ; Online: Economic implications of FDA platelet bacterial guidance compliance options: Comparison of single-step strategies.

Prioli, Katherine M / Abersone, Ilze / Kopko, Patricia M / Herman, Jay H / Custer, Brian / Pizzi, Laura T

Transfusion

2022 Volume 62, Issue 2, Page(s) 365–373

Abstract: Background: Bloodborne pathogens pose a major safety risk in transfusion medicine. To mitigate the risk of bacterial contamination in platelet units, FDA issues updated guidance materials on various bacterial risk control strategies (BRCS). This ... ...

Abstract	Background: Bloodborne pathogens pose a major safety risk in transfusion medicine. To mitigate the risk of bacterial contamination in platelet units, FDA issues updated guidance materials on various bacterial risk control strategies (BRCS). This analysis presents results of a budget impact model updated to include 5- and 7-day pathogen reduced (PR) and large volumed delayed sampling (LVDS) BRCS. Study design and methods: Model base-case parameter inputs were based on scientific literature, a survey distributed to 27 US hospitals, and transfusion experts' opinion. The outputs include hospital budget and shelf-life impacts for 5- and 7-day LVDS, and 5- and 7-day PR units under three different scenarios: (1) 100% LVDS, (2) 100% PR, and (3) mix of 50% LVDS - and 50% PR. Results: Total annual costs from the hospital perspective were highest for 100% LVDS platelets (US$2.325M) and lowest for 100% PR-7 units (US$2.170M). Net budget impact after offsetting annual costs by outpatient reimbursements was 5.5% lower for 5-day PR platelets as compared to 5-day LVDS (US$1.663 vs. US$1.760M). A mix of 7-day LVDS and 5-day PR platelets had net annual costs that were 1.3% lower than for 100% 7-day LVDS, but 1.3% higher than for 100% 5-day PR. 7-day PR platelets had the longest shelf life (4.63 days), while 5-day LVDS had the shortest (2.00 days). Discussion: The model identifies opportunities to minimize transfusion center costs for 5- and 7-day platelets. Budget impact models such as this are important for understanding the financial implications of evolving FDA guidance and new platelet technologies.
MeSH term(s)	Blood Platelets/microbiology ; Blood Transfusion ; Costs and Cost Analysis ; Humans ; Platelet Transfusion/methods ; Specimen Handling
Language	English
Publishing date	2022-01-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16778
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Article ; Online: Cost effectiveness of non-drug interventions that reduce nursing home admissions for people living with dementia.

Jutkowitz, Eric / Pizzi, Laura T / Shewmaker, Peter / Alarid-Escudero, Fernando / Epstein-Lubow, Gary / Prioli, Katherine M / Gaugler, Joseph E / Gitlin, Laura N

Alzheimer's & dementia : the journal of the Alzheimer's Association

2023 Volume 19, Issue 9, Page(s) 3867–3893

Abstract: Introduction: Six million Americans live with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD), a major health-care cost driver. We evaluated the cost effectiveness of non-pharmacologic interventions that reduce nursing home ... ...

Abstract	Introduction: Six million Americans live with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD), a major health-care cost driver. We evaluated the cost effectiveness of non-pharmacologic interventions that reduce nursing home admissions for people living with AD/ADRD. Methods: We used a person-level microsimulation to model the hazard ratios (HR) on nursing home admission for four evidence-based interventions compared to usual care: Maximizing Independence at Home (MIND), NYU Caregiver (NYU); Alzheimer's and Dementia Care (ADC); and Adult Day Service Plus (ADS Plus). We evaluated societal costs, quality-adjusted life years and incremental cost-effectiveness ratios. Results: All four interventions cost less and are more effective (i.e., cost savings) than usual care from a societal perspective. Results did not materially change in 1-way, 2-way, structural, and probabilistic sensitivity analyses. Conclusion: Dementia-care interventions that reduce nursing home admissions save societal costs compared to usual care. Policies should incentivize providers and health systems to implement non-pharmacologic interventions.
MeSH term(s)	Adult ; Humans ; Alzheimer Disease/therapy ; Cost-Effectiveness Analysis ; Cost-Benefit Analysis ; Caregivers ; Nursing Homes
Language	English
Publishing date	2023-04-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2211627-8
ISSN	1552-5279 ; 1552-5260
ISSN (online)	1552-5279
ISSN	1552-5260
DOI	10.1002/alz.12964
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Article ; Online: Economic Analysis of the Tailored Activity Program: A Nonpharmacological Approach to Improve Quality of Life in People Living With Dementia and their Caregivers.

Pizzi, Laura T / Prioli, Katherine M / Jutkowitz, Eric / Piersol, Catherine V / Lyketsos, Constantine G / Abersone, Ilze / Marx, Katherine A / Gitlin, Laura N

Journal of applied gerontology : the official journal of the Southern Gerontological Society

2023 Volume 42, Issue 7, Page(s) 1433–1444

Abstract: We investigated costs of delivering the Tailored Activity Program (TAP) and cost savings from two perspectives (health sector and societal) for people living with dementia (PLWD) and their caregivers (dyads) compared to attention control (AC) using data ... ...

Abstract	We investigated costs of delivering the Tailored Activity Program (TAP) and cost savings from two perspectives (health sector and societal) for people living with dementia (PLWD) and their caregivers (dyads) compared to attention control (AC) using data from a randomized controlled trial. The evaluation assessed intervention delivery costs and caregiver reported health care utilization. The total intervention cost of TAP was $1707/dyad versus $864/dyad for AC, and total costs over 6 months for TAP dyads as compared to AC were $1299 (CI: -$10,496, $7898) less from the healthcare perspective, and $761 (CI: -$10,133, $8611) less from the societal perspective. TAP cost savings are driven by lower use of healthcare services among participating dyads, but further analyses with larger samples is warranted to confirm its financial impact.
MeSH term(s)	Humans ; Quality of Life ; Caregivers ; Health Care Costs ; Patient Acceptance of Health Care ; Dementia/therapy
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	155897-3
ISSN	1552-4523 ; 0733-4648
ISSN (online)	1552-4523
ISSN	0733-4648
DOI	10.1177/07334648231158091
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Article ; Online: Authors' Reply to Mintz: "Economic Implications of Pathogen Reduced and Bacterially Tested Platelet Components: A US Hospital Budget Impact Model".

Pizzi, Laura T / Prioli, Katherine M / Herman, Jay H

Applied health economics and health policy

2019 Volume 17, Issue 2, Page(s) 259–261

MeSH term(s)	Budgets ; Financial Management, Hospital ; Hospitals ; Humans
Language	English
Publishing date	2019-01-24
Publishing country	New Zealand
Document type	Letter ; Comment
ZDB-ID	2171420-4
ISSN	1179-1896 ; 1175-5652
ISSN (online)	1179-1896
ISSN	1175-5652
DOI	10.1007/s40258-018-00459-y
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Article ; Online: Reducing the Costs of an Eye Care Adherence Program for Underserved Children Referred Through Inner-City Vision Screenings.

Chung, Seung Ah / Snitzer, Melanie / Prioli, Katherine M / Pizzi, Laura T / Zhang, Qiang / Levin, Alex V

American journal of ophthalmology

2021 Volume 227, Page(s) 18–24

Abstract: Purpose: We previously reported costs and outcomes of the Children's Eye Care Adherence Program (CECAP1), a social worker intervention designed to improve adherence to eye care for underserved children in urban Philadelphia. Using cost findings from ... ...

Abstract	Purpose: We previously reported costs and outcomes of the Children's Eye Care Adherence Program (CECAP1), a social worker intervention designed to improve adherence to eye care for underserved children in urban Philadelphia. Using cost findings from CECAP1, we revised the intervention to reduce costs. The aim of this study was to evaluate costs and effectiveness of the revised intervention (CECAP2). Design: Retrospective cohort study. Methods: Records of children needing ophthalmic follow-up after 2 community-based vision screening programs were reviewed. We modified CECAP1 to prioritize children more likely to visit, decreased phone calls and scheduling attempts, better documented children already followed by other doctors, and constricted our geographic catchment area for better accessibility. Cost was calculated using time spent executing CECAP2 by our salaried social worker. Effectiveness was defined as the percentage of patients completing at least 1 follow-up visit within the recommended time frame. Results: Of 462 children referred to CECAP2 from our in-school and on-campus screening programs, 242 (52.4%) completed subsequent recommended eye examinations, a proportion identical to our prior report (52.3%). Social worker time per patient was 0.8 hours; a significant reduction from the previous 2.6 hours (P < .01). Cost per patient was $32.73; a significant reduction compared to the previous $77.20 (P < .01). Conclusions: Programmatic changes to reduce social worker intervention time and target potential patients by likelihood to attend along with constriction of the catchment area led to reduced costs by more than 50%, without impairing CECAP effectiveness.
MeSH term(s)	Adolescent ; Aftercare ; Child ; Child, Preschool ; Community Health Services/statistics & numerical data ; Continuity of Patient Care/economics ; Eye Diseases/economics ; Eye Diseases/therapy ; Female ; Health Care Costs/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Compliance/statistics & numerical data ; Philadelphia ; Referral and Consultation ; Retrospective Studies ; Social Workers/statistics & numerical data ; Urban Population/statistics & numerical data ; Vision Screening/economics ; Vulnerable Populations/statistics & numerical data
Language	English
Publishing date	2021-02-11
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2021.02.012
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Article ; Online: Pharmacists improve diabetes outcomes: a randomized controlled trial.

Wagner, Mary L / McCarthy, Caitlin / Bateman, M Thomas / Simmons, Daniel / Prioli, Katherine M

Journal of the American Pharmacists Association : JAPhA

2021 Volume 62, Issue 3, Page(s) 775–782.e3

Abstract: Background: There is a growing shortage of primary care physicians. Pharmacists can fill the gap, and interdisciplinary teams are being evaluated as part of health care reform.: Objective: This study aimed to determine whether adding a pharmacist to ... ...

Abstract	Background: There is a growing shortage of primary care physicians. Pharmacists can fill the gap, and interdisciplinary teams are being evaluated as part of health care reform. Objective: This study aimed to determine whether adding a pharmacist to an interprofessional health team will improve diabetes outcomes. Methods: In this 2-phase pilot study, Medicaid-eligible patients with diabetes were randomized to receive standard of care (control arm) or standard of care plus the care of a pharmacist (intervention arm) for 12 months (phase 1). The primary outcome was change in glycated hemoglobin (A1C) from baseline. Secondary outcomes included identifying and correcting medication therapy problems (MTPs) for comorbid conditions, adherence to preventive care visits, health care utilization, self-rated health, and satisfaction surveys. After phase 1, patients in the control arm who did not achieve an A1C of < 8% were eligible to enroll into phase 2 where they received treatment with a pharmacist for 6 months. Results: Of the 239 patients enrolled, 122 completed phase 1. At 12 months, intervention patients' mean A1C was 1.85 percentage point (pp) below baseline versus 0.94 pp for control (between-group difference 0.91 pp; P = 0.0218). Most control patients (79%) who completed phase 1 and enrolled into phase 2 improved their A1C by more than 1 pp (P < 0.01). The pharmacists completed 806 patient visits and identified 2638 MTPs. Intervention patients were more adherent to preventive care visits with nutrition (P = 0.043), ophthalmology (P = 0.002), and dentistry (P = 0.007). For intervention patients, 78% rated their experience with the pharmacist as excellent whereas, for control patients, 37% rated their experience with their provider as excellent. Conclusion: Pharmacist comanagement of patients with diabetes can significantly improve glucose control and patient satisfaction. Creative payment models were used to include pharmacists in the interprofessional patient care team.
MeSH term(s)	Diabetes Mellitus, Type 2/drug therapy ; Glycated Hemoglobin A/analysis ; Humans ; Medication Adherence ; Pharmacists ; Pilot Projects
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2021-12-25
Publishing country	United States
Document type	Clinical Trial, Phase II ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2118585-2
ISSN	1544-3450 ; 1544-3191 ; 1086-5802
ISSN (online)	1544-3450
ISSN	1544-3191 ; 1086-5802
DOI	10.1016/j.japh.2021.12.015
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Article: Analysis of Stakeholder Engagement in the Public Comments of ICER Draft Evidence Reports.

Gerlach, Jean A / Snow, Brian / Prioli, Katherine M / Vertsman, Ronald / Patterson, Julie / Pizzi, Laura T

American health & drug benefits

2020 Volume 13, Issue 4, Page(s) 136–142

Abstract: Background: Health technology assessment is becoming increasingly important to healthcare payers' decision-making. The Institute for Clinical and Economic Review (ICER) is the most established US-based research group performing value assessments. ICER ... ...

Abstract	Background: Health technology assessment is becoming increasingly important to healthcare payers' decision-making. The Institute for Clinical and Economic Review (ICER) is the most established US-based research group performing value assessments. ICER provides opportunities for stakeholder engagement, including a window of opportunity for public comments on the draft evidence report. Those public comments were reviewed in this study. Objectives: To determine which stakeholders are most often commenting on ICER technology appraisal reports and to examine what aspects of the reports are the topics of these comments. Method: We reviewed 7 ICER reports, which were used to extract stakeholder comments. All the identified comments were evaluated by 2 trained reviewers independently for stakeholder type, comment nature (positive or negative), and focus of comments (eg, methodology, data, real-world experience). Statistical analyses were used to analyze the reports for any associations between the frequency of the comments and the stakeholder type by therapeutic area. Results: A total of 463 comments were identified within the 55 letter submissions identified across the 7 ICER reviews that were included in the study. The quantity of the comments generally reflected the quantity of therapies that were included in the review. Drug manufacturers (63.1%), patients or patient advocacy groups (18.1%), and providers or provider groups (9.7%) were the stakeholders most often engaged in the public comments. The comments most often addressed the methodology of the value assessment (53.8%). Comments about missing data (14%), general criticism (8.2%), and general support (2.2%) were less common. Conclusion: ICER is committed to engaging stakeholders in their value assessment process and adapting their strategies to improve such communications. Although ICER aims to influence payer decision-making, drug manufacturers were the most involved stakeholder in the assessment process, and they were most concerned with ICER's methodology. These results show the impact that ICER may have on decision-making in healthcare, emphasize the incentives that ICER drives for certain stakeholders, and highlight areas for further investigation.
Language	English
Publishing date	2020-12-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2853721-X
ISSN	1942-2970 ; 1942-2962
ISSN (online)	1942-2970
ISSN	1942-2962
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Article ; Online: Addressing racial inequality and its effects on vaccination rate: A trial comparing a pharmacist and peer educational program (MOTIVATE) in diverse older adults.

Prioli, Katherine M / Akincigil, Ayse / Namvar, Tarlan / Mitchell-Williams, Jocelyn / Schafer, Jason J / Cunningham, Renee C / Fields-Harris, Lynn / McCoy, Megan / Vertsman, Ronald / Guesnier, Ashley / Pizzi, Laura T

Journal of managed care & specialty pharmacy

2023 Volume 29, Issue 8, Page(s) 970–980

Abstract: BACKGROUND: ...

Abstract	BACKGROUND:
MeSH term(s)	Male ; Humans ; Female ; Middle Aged ; Aged ; Pharmacists ; Influenza, Human/prevention & control ; Trust ; Vaccine-Preventable Diseases ; Vaccination ; Influenza Vaccines
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2023-07-30
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2376-1032
ISSN (online)	2376-1032
DOI	10.18553/jmcp.2023.29.8.970
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