This is the title of a new paper published American Journal of Manade Care (AJMC) Jacob Faznore, Early Zhang and Donald Nichols with co-writers. The essence is below.
Objective: (1) Develop a metric that quantitically measures the risk that the use pose to patients with management (UM) policies and (2) measures the relationship between the real world UM use of this metric and payments.
study design: We performed a target literature review and an expert eligues practice to create data-based use management risk designation (Burden) score. The real -world data analysis measured the relationship between the burden and the actual payment policies.
Methods: Burden score was based on 9 UM factors affecting patient results. The factors were weighed on the basis of an expert eligues process with 6 stakeholders. The UM policy restrictions were prepared from the special drug evidence and coverage databases of the Tufts Medical Center, and the net price data came from SSR Health. The simple class regression was demonstrated to examine the relationship between the burden score and coverage policies.
Result: According to Burdon score, 30 of the 98 treatments known in 30 unique diseases, UM policies were given the highest risk for patients for mysthania gravis, multiple myeloma, and lupus nephritis. When there was a high burden score in treatment, the probability of paying any UM ban was 22.0% less (P= .041) And the possibility of implementing 36.2% step edits (P= .039).
conclusion: This study developed a quantitative remedy (burden) to estimate the relative risk of the payable UM policies. Payers appeared politely sensitive to treatment, which pose a high risk to patients, which should be applied to UM. However, the decisions of coverage were not completely patient-focused, as some high burden products experienced an increase in UM use.
You can read the entire paper here.
