Latest Healthcare Brief: 

Delivering on the Potential of Biosimilar Medicines

The purpose of this report is to describe the potential role for biosimilars and their contribution to healthcare systems; the risks for stakeholders to realize that full potential value; and the requirements for competitive functioning markets in order to capture the full value. It draws on analysis of trends across EU nations over the past decade and observations of the differing practices undertaken by stakeholder groups. 


IMS Institute Healthcare Briefs

  • Price Declines after Branded Medicines Lose Exclusivity in the U.S.

    27 Jan 2016

    The purpose of this healthcare brief is to document the changing price of medicines as generics enter the market. While the public discourse and debate are focused on the issue of rising drug costs, we take this opportunity to highlight the reduction in prices associated with the use of generic medicines.

  • Branded Medicine Price Increases and the Impact of Off-Invoice Discounts and Rebates

    11 Nov 2015

    The purpose of this healthcare brief is to draw specific attention to previously published research from the IMS Institute which highlights not only the visible aspects of price increases, but also the less visible off-invoice discounts, rebates, coupons, and other price concessions to payers that often substantially offset these changes in list price.

  • Emergence and Impact of Pharmacy Deductibles: Implications for Patients in Commercial Health Plans

    24 Sep 2015

    The objective of this report is to bring forward insights on the extent to which pharmacy deductibles are becoming a more common aspect of health plan design, and the impact they have on patient behavior related to pharmaceutical use.

  • The Role of Generic Medicines in Sustaining Healthcare Systems: A European Perspective

    10 Jun 2015

    The purpose of this report is to understand current European market trends and to quantify the full scope of generic medicines’ contributions.

  • Understanding the Role and Use of Essential Medicines Lists

    17 Apr 2015

    The purpose of this report is to summarize how the Essential Medicines List has changed, describe how the list is used, and to provide considerations for future revision

  • Impact of Cost-per-QALY Reimbursement Criteria on Access to Cancer Drugs

    10 Mar 2015

    The purpose of this report is to further the understanding of the impacts that alternative approaches to reimbursement decisions have on patient care.

  • Understanding the Pharmaceutical Value Chain

    04 Nov 2014

    The purpose of this report is to advance the understanding of the pharmaceutical value chain - describing the elements of the medicine value chain, the quantifying price build up for specific areas and countries, and the diversity of approaches and costs associated with the value chain.

  • Assessing Biosimilar Uptake and Competition in European Markets

    10 Oct 2014

    This report summarizes the findings of a study undertaken by IMS Health to assess drivers of biosimilar uptake and to measure the impact of biosimilar competition in Europe.

  • Bringing Healthy Living to Ageing Citizens: The Role of Technology

    04 Jun 2014

    This report raises awareness of the urgent need to find and apply new approaches to supporting the health of ageing populations.

  • Patient Savings Program Use Analysis

    01 Feb 2014

    A large number and variety of patient savings programs have been established over the past twenty years by pharmaceutical manufacturers in an effort to reduce financial barriers to patients and enable them to receive the medicines prescribed to them by healthcare professionals. The purpose of this report is to summarize the findings of a study undertaken by IMS Health (funded by Pfizer, Inc.).

  • Defeating India's Silent Killer: The Fight to Diagnose and Treat Cervical Cancer

    26 Nov 2013

    This study puts into perspective the key aspects pertaining to disease burden, screening, prevention, diagnosis and treatment of cervical cancer; and, to share learning's from other countries and provide our recommendations for effective control. 

  • Impact of Patent Settlements on Drug Costs Estimation of Saving

    28 Jun 2013

    Generic drugs are now used to fill about 85 percent of all prescriptions dispensed in the U.S., saving consumers and the healthcare system nearly $4 billion every week. This study quantifies the impact of patent settlements and early generic market entry on drug costs, measured at the trade price level.

  • Electronic Prescribing: Prevalence Within the Cholesterol Lowering Market

    07 May 2013

    This paper examines the current extent and intensity of retail e-prescribing.

  • Key Findings from GPhA Study

    20 Aug 2012

    The Generic Pharmaceutical Association – GPhA – released its annual study showing cost savings generated by generic medicines in the United States. Murray Aitken, Executive Director, discusses key findings from the GPhA study and analysis conducted by the IMS Institute for Healthcare Informatics.

  • Transformations in Disease Treatment

    13 Aug 2012

    We continue the discussion of anticipated transformations in disease treatments through 2016 and offer additional perspective on new medicines that are expected to be launched over the next five years. We also highlight the gaps that are expected to remain in the treatment of several priority diseases, as identified in a 2004 report by the World Health Organization.

  • A Changing Landscape for Generics and Biosimilars

    23 Jul 2012

    An accelerated shift in spending for generics will occur in the next five years, increasing from $242 billion in 2011 to $224-244 billion by 2016, and impacting global spending on medicines. We discuss the changing landscape for generics and biosimilars from the IMS Institute’s new forecast.

  • Patient Sharing among Physicians and Costs of Care: A Network Analytic Approach to Care Coordination Using Claims Data

    26 Jun 2012

    Improving care coordination is a national priority and a key focus of healthcare reforms. However, its measurement and ultimate achievement is challenging. Using the IMS LifeLink Health Plan Claims Database, this study, published in the Journal of General Internal Medicine, was designed to test whether patients whose providers frequently share patients with one another, "care density", tend to have lower costs of care and likelihood of hospitalization. Researchers found that patients treated by sets of physicians who share high numbers of patients tend to have lower costs.

  • Cost-Effectiveness of Real-Time Continuous Glucose Monitoring (RT-CGM) in Type 2 Diabetes (T2DM)

    26 Jun 2012

    Intermittent “doses” of RT-CGM (unblinded use) were associated with a sustained reduction in A1C over 52 weeks as compared with daily self-monitoring of blood glucose (SMBG) (RT-CGM: -1.1% vs. SMBG: -0.5%) in patients with T2DM not on prandial insulin. This current analysis modeled the cost-effectiveness of RT-CGM for this type of intervention. Using the IMS CORE Diabetes Model, researchers projected the lifetime clinical and economic outcomes for RT-CGM vs. SMBG. The results show that RT-CGM is a cost-effective disease management option in the U.S. for people with T2DM not on prandial insulin. Repeated use of RT-CGM may result in additional cost-effective health benefits, due to longer-term impact on physiological parameters.

  • FDA Study Analyzes Medicine Use Within Pediatric Population

    18 Jun 2012

    Outpatient drug utilization among the U.S. pediatric population is not fully understood or widely characterized. We discuss a recent FDA study on the topic, and offer an IMS Institute analysis on prescription volume trends for antibiotic and ADHD medications in the U.S. pediatric population.

  • Lipitor’s Market Performance: Six Weeks Post Expiry

    16 Jun 2012

    News media has continued to report, almost weekly, about Lipitor following the drug’s loss of patent protection on November 30, 2011. We put in context Lipitor’s performance six weeks post-expiry, comparing it to the six-week post-expiry performance of other primary care medications with significant prescription volume that also faced generic competition in 2010 and 2011.

  • IMS Information Featured in Several Research Presentations at ASHECon

    11 Jun 2012

    At the 4th Biennial Conference of the American Society of Health Economists, several papers featuring IMS prescription data were presented. The conference, which featured 170 concurrent sessions with over 500 papers and 150 poster presentations on topics ranging from health policy to pharmaceutical innovation to economic disparity, is one of the preeminent events attended by health economists. We discuss the research presented.

  • Continuing Growth in Cancer Therapies

    04 Jun 2012

    ASCO, considered one of the largest medical professional events, has continued to serve as the showcase event for new therapies, research advances and innovation for combating cancer. We highlight global and U.S. spending for cancer treatments, noting that cancer therapies will remain the leading therapy class, both globally and in the United States.

  • Trends in Antihypertensives Use among Moroccan Patients

    31 May 2012

    Researchers analyzed consumption trends of antihypertensives in Morocco during the 1991–2010 period and the impacts after the institution of Mandatory Health Insurance and the marketing of generic drugs. Published in Pharmacoepidemiology and Drug Safety, researchers used IMS sales data in their analysis. They concluded that antihypertensive consumption increased between 1991 and 2010. However, despite the increase of generic drugs consumption, the levels of antihypertensive consumption remained lower than the needs of hypertensive patients.

  • Persistence and Compliance of Medications used in the Treatment of Osteoporosis â Analysis using a Large Scale, Representative, Longitudinal German Database

    31 May 2012

    Osteoporosis can be effectively treated with a number of medications. However, high persistence and compliance are required to assure efficacy. This retrospective analysis, published in the International Journal of Clinical Pharmacology and Therapeutics, examined persistence and compliance for a variety of medical interventions in Germany. The researchers utilized IMS LRx data; they concluded that persistence and compliance during the treatment of osteoporosis was found to be insufficient where treatment via an intravenous route and PTH showed the highest persistence and compliance rates, while daily oral bisphosphonates demonstrated lower persistence and compliance.

  • Infused Chemotherapy Use in the Elderly After Patent Expiration

    31 May 2012

    The use of anticancer drugs is an important determinant of national spending trends, and recent policies have aimed to accelerate generic entry among chemotherapies to generate cost savings. In this analysis, published in the Journal of Oncology Practice, researchers examined the effects of generic entry on the choice of chemotherapy for the treatment of metastatic colorectal cancer (MCRC) between 2006 and 2009, noting that the generic entry of irinotecan resulted in a 17% to 19% decrease in use among elderly patients with MCRC compared with oxaliplatin. Their results suggested that the potential savings derived from the generic entry of irinotecan for public payers were overestimated, likely confounded by oncologists' response to financial incentives, changes in scientific evidence, and promotional activities.

  • Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality

    31 May 2012

    This research, published in The Commonwealth Fund, used data from the Organization for Economic Cooperation and Development, IMS Health and other sources to compare healthcare spending, supply, utilization, prices, and quality in 13 industrialized countries. The researchers concluded that the U.S. spends far more on healthcare than any other country, and that higher spending is more likely due to higher prices and perhaps more readily accessible technology and greater obesity. Japan exhibited the lowest health spending, achieved primarily through aggressive price regulation.

  • Patient Out-of-Pocket Payments for Oral Oncolytics: Results From a 2009 U.S. Claims Data Analysis

    31 May 2012

    Oral oncolytics are an increasingly important treatment option for cancer, and often fall within the pharmacy benefit, with the potential for increased out-of-pocket cost burden for patients. Researchers used the IMS LifeLink Health Plan Claims Database to evaluate patient out-of-pocket payments for oral oncolytic therapies in U.S. managed care plans. They concluded that among 21 oral oncolytics, average out-of-pocket costs ranged from $15 to >$500, and confirmed previous findings that showed wide differences among oral oncolytic options.  The study was published in the American Journal of Managed Care.

  • Update of the Evolution of Breast Cancer Incidence in Relation to Hormone Replacement Therapy use in Belgium and Review of Other Countries

    31 May 2012

    Belgium has one of the highest incidences of breast cancer in Europe and one of the highest rates of hormone replacement therapy (HRT) use. In this updated study, published in Maturitas, the researchers examined whether increased use of HRT led to reduced incidents of breast cancer. They used European standardized incidence rates for invasive breast cancer for patients age 50–69 years and IMS Health HRT sales data in the analysis. The researchers noted that, although this study is hampered by a number of limitations, these data support the idea that the drop in breast cancer incidence can be partly attributed to the decrease in HRT use.

  • Changes in Antipsychotic Use among Patients with Severe Mental Illness after a Food and Drug Administration Advisory

    30 May 2012

    A 2003 U.S. FDA advisory warned of increased hyperlipidemia and diabetes risk for patients taking second-generation antipsychotics (SGAs). Researchers examined subsequent changes in incident and prevalent SGA use among individuals with severe mental illness. They used IMS Health claims data, concluding that the metabolic risk advisory and the published consensus statement were associated with a selective reduction in olanzapine use without evidence of treatment disruptions among this population. The study was reported in the publication Pharmacoepidemiology and Drug Safety.

  • Valuing Real-World Evidence Post Launch

    28 May 2012

    IMS believes that we’ve reached a tipping point where taking an active role in RWE can help create a platform for building stronger stakeholder relationships and better inform healthcare decision making. We discuss the need to include real-world evidence in post-launch drug assessments and how regulatory bodies across the world are addressing RWE in their evaluations of new medicines.

  • A Retrospective Observational Single-Centre Study on the Burden of Immune Thrombocytopenia (ITP)

    25 May 2012

    German data on economic consequences of immune thrombocytopenia (ITP) are limited. Researchers from IMS Health and the University Hospital of Munich conducted a retrospective, observational study based on chart review of adult patients with a confirmed diagnosis of ITP at a German university hospital. They found that data concerning current healthcare provision for ITP patients in Germany indicate considerable resource consumption and the need for more effective treatment options in individual patients. The study was published in Onkologie.

  • Despite 2007 Law Requiring FDA Hotline to be Included in Print Drug Ads, Reporting of Adverse Events by Consumers Still Low

    26 Apr 2012

    In 2007, the federal government began requiring drug makers to include in their print direct-to-consumer advertisements information for consumers on how to contact the FDA directly to report any adverse events experienced after taking a prescription drug. In this Health Affairs article, researchers studied adverse event reports for 123 drugs before and after the enactment of the print advertising requirement and estimated that requirement’s impact with model simulations. They concluded that additional measures, such as more publicity about the Adverse Event Reporting System or more consumer education, should be considered to promote patient reporting of adverse events. The authors used IMS Health promotional spending data in their analysis.

  • Economic Outcomes of Exenatide versus Liraglutide in Type 2 Diabetes Patients in the United States: Results from a Retrospective Claims Database Analysis

    26 Apr 2012

    The safety and efficacy of the GLP-1 receptor agonists exenatide BID (exenatide) and liraglutide for treating type 2 diabetes mellitus (T2DM) have been established in clinical trials. This study, published in the Journal of Medical Economics, examined cost offsets and medication adherence for exenatide versus liraglutide in a large, managed care population in the United States. Using claims data from IMS Health, the researchers concluded patients initiating exenatide versus liraglutide for T2DM had similar medication adherence and total healthcare costs; however, exenatide patients had significantly lower total pharmacy costs.

  • Prevalence, Utilization, and Costs of Antiepileptic Drugs for Epilepsy in Germany—a Nationwide Population-Based Study in Children and Adults

    26 Apr 2012

    Nationwide analyses of drug use can provide a prevalence estimate of the underlying disease and can help in understanding the characteristics of treatment. This study, published in the Journal of Neurology, examined the utilization of antiepileptic drugs (AED) for epilepsy in Germany. Utilizing the IMS LRx database and IMS Disease Analyzer, researchers concluded that prevalence and prescribing patterns changed with age. Additionally, they noted that costs of AED against epilepsy added up to 1% of total medication costs in Germany.

  • Off-Label Use of Drugs and Medical Devices: A Review of Policy Implications

    26 Apr 2012

    "Off-label use" occurs when the use of a medication or device deviates from what is mentioned in its U.S. Food and Drug Administration (FDA) product label.  While common, legal and an important source of innovation, using the IMS Health National Disease and Therapeutic Index, researchers noted that “off-label use” can be costly, and strong evidence of the efficacy and safety of such use may be lacking.  They concluded that given the contradictory and unresolved expectations of major stakeholders, off-label use remains problematic requiring a new policy paradigm that can successfully balance the need for innovation against the imperatives of evidence-based practice and finite health-care resources.  The research was published in Clinical Pharmacology & Therapeutics.

  • Assessing Adherence-Based Quality Measures in Epilepsy

    26 Apr 2012

    The study, published in the International Journal for Quality in Health Care, aimed to examine the relationship of three alternative measures of adherence with seven negative outcomes associated with epilepsy for development of a quality measure in epilepsy. The design was a retrospective cohort analysis using the IMS LifeLink Health Plan Claims database.  For each definition of adherence, the odds ratios (ORs) comparing non-adherent with adherent groups were assessed for consistency and direction for the number of hospital admissions, emergency room (ER) visits, head injuries, including traumatic brain injuries, falls, motor vehicle accidents (MVAs), fractures and a "seizure" outcome defined as hospital admissions or ER visits with a primary diagnosis of epilepsy or convulsions.  The researchers concluded that the adherence measures defined non-adherent groups who were associated with negative outcomes in epilepsy.

  • Cost Comparison of Outpatient Treatment with Granulocyte Colony-Stimulating Factors in Germany

    26 Apr 2012

    Granulocyte colony-stimulating factors (G-CSF) are available for prevention of neutropenia and reduction of its complications in cytostatic chemotherapy.  This analysis, published in the International Journal of Clinical Pharmacology and Therapeutics, sought to determine the consumption rates for various G-CSF and to compare outpatient medication costs per patient and treatment cycle.  Using the IMS LRx database, prescription data of statutory health insurance members in Germany with G-CSF prescriptions between January 2008 and July 2010 were evaluated.  Treatment with the original preparation lenograstim was shown to be significantly cheaper compared to the other two original drugs and biosimilar, while the costs of G-CSF treatment with the original preparation lenograstim and the filgrastim biosimilars were in a similar range, but with a significantly lower cost for lenograstim.  Compared to their reference product, the biosimilars showed a cost advantage.

  • Treatment Cost of Invasive Fungal Disease in Patients with Acute Myelogenous Leukaemia or Myelodysplastic Syndrome in German Hospitals

    26 Apr 2012

    Invasive fungal disease (IFD) causes increasing morbidity and mortality in haematological cancer patients, and reliable cost data for treating IFD in German hospitals is not available.  The objective of the study, published in Mycoses, was to determine the institutional cost of treating the IFD.  Data were obtained by retrospective chart review in German hospitals. From the perspective of hospitals in Germany, the economic burden of IFD in patients with Acute Myelogenous Leukaemia or Myelodysplastic Syndrome is substantial, and prevention of IFD is necessary with respect to both clinical and economic reasons.

  • A Retrospective Database Analysis on Persistence with Inhaled Corticosteroid Therapy: Comparison of Two Dry Powder Inhalers During Asthma Treatment in Germany

    26 Apr 2012

    Asthma is one of the most common chronic diseases worldwide. Patient persistence with treatment is essential to achieve sufficient outcomes, in particular to avoid exacerbations.  The objective of the study, published in the International Journal of Clinical Pharmacology and Therapeutics, was to investigate inhaled corticosteroid (ICS) therapy with two different inhalers (Novolizer® and Turbuhaler®) by comparing persistence, concomitant use of additional asthma medication and occurrence of exacerbations in real life. Using the IMS Disease Analyzer, researches conducted a retrospective analysis of prescription data from outpatient treatment comparing treatment persistence of asthma patients using 200 μg budesonide either via Novopulmon®/Budecort® (Novolizer group = NOV) or Pulmicort® (Turbuhaler group = TUR). They found better therapy persistence with NOV compared to TUR during asthma treatment in Germany.

  • Cost-Effectiveness of Posaconazole versus Fluconazole or Itraconazole in the Prevention of Invasive Fungal Infections among High-Risk Neutropenic Patients in Spain

    26 Apr 2012

    IMS researchers evaluated the cost-effectiveness of posaconazole compared with standard azole therapy (SAT; fluconazole or itraconazole) for the prevention of invasive fungal infections (IFI) and the reduction of overall mortality in high-risk neutropenic patients with acute myelogenous leukaemia (AML) or myelodysplastic syndromes (MDS).  Posaconazole was associated with fewer IFI, increased life-years saved , and significantly lower costs, excluding costs of the underlying condition per patient relative to SAT.  Posaconazole was determined to be a cost-saving prophylactic strategy (lower costs and greater efficacy) compared with fluconazole or itraconazole in high-risk neutropenic patients.  The study was published in BMC Infectious Diseases.

  • Amputation Rate and Risk Factors in Type 2 Patients with Diabetic Foot Syndrome Under Real-life Conditions in Germany

    05 Apr 2012

    Complications related to diabetes can cause significant medical and economic burden on the health system and early therapeutic intervention is essential for patients with diabetic foot syndrome. In this study, published in Primary Care Diabetes, researchers analyzed the risk of amputation and the influencing factors for amputation for patients with type 2 diabetes that were suffering from diabetic foot syndrome. Using IMS Disease Analyzer, they concluded lower-limb amputations were independently associated with higher age, male gender, higher HbA1c value and longer diabetes duration but also some other diabetes complications.

  • The Burden of Illness of Osteoporosis in Canadian Men

    26 Mar 2012

    There is dearth of information about the burden of osteoporosis in Canadian men. To fill this gap, researchers conducted a burden of illness study aimed at estimating the economic burden attributable to osteoporosis in Canadian men aged 50 years and older.  They used the IMS Health Canadian Disease and Therapeutic Index survey and five national data sources to estimate healthcare resource utilization and costs associated with osteoporosis in men.  The study, published in the Journal of Bone and Mineral Research, revealed that male osteoporosis has a substantial economic burden on the Canadian society.

  • Clinical and Economic Outcomes in an Observational Study of COPD Maintenance Therapies: Multivariable Regression Versus Propensity Score Matching

    21 Mar 2012

    Randomized clinical trials (RCTs) have important limitations and, as a result, outcomes observed in RCTs cannot necessarily be generalized to the real world of clinical practice, where patients present with varying degrees of disease severity and a range of comorbidity profiles. In this study, researchers investigated equivalency of results from multivariable regression (MR) and propensity score matching (PSM) models using, as an example, a large study of chronic obstructive pulmonary disease (COPD) initial maintenance therapy. Utilizing the IMS LifeLink Health Claims database, the researchers concluded results from both methods were similar in direction and statistical significance, suggesting that MR and PSM were equivalent methods for mitigating bias. The research was published in the International Journal of Chronic Obstructive Pulmonary Disease.

  • The Impact of the Affordable Care Act on Health Spending

    21 Mar 2012

    Regardless of how the Supreme Court rules on the constitutionality of the Affordable Care Act, a number of reform provisions have already been implemented, or are underway, impacting spending and utilization of medicines in the U.S. Murray Aitken highlights how health reforms will positively impact the use of medicines as more Americans gain access to health insurance and prescription medications.

  • Impacts of Patent Expiry and Regulatory Policies on Daily Cost of Pharmaceutical Treatments: OECD Countries, 2004-2010

    21 Mar 2012

    Cross-country variability in regulatory frameworks, industrial policy, physician/pharmacy autonomy, brand/generic distinctions, and in the practice of medicine contributes to ambiguous interpretations of pharmaceutical cost comparisons.  In this working report, with research support and analysis provided by the IMS Institute for Healthcare Informatics and IMS Health's MIDAS database, researchers sought to provide insights into cross-country pharmaceutical cost comparisons by focusing on eleven therapeutic classes that between 2004 and 2010 experienced patent expiration and loss of market exclusivity in eight industrialized countries.  They determined that five of the eleven classes experienced double-digit declines in daily costs, averaged over all countries: ace inhibitors (-19%), antinauseants (-14%), anti-ulcerants (-13%), calcium channel blockers (-12%) and lipid regulators (-11%), each of which experienced major patent expirations and generic entry.  The researchers noted that their research presents clear evidence on the downward evolution of prices and thus countries’ drug expenditures for therapeutic classes experiencing patent expiration over the 2004-2010, but future research needs to be done to assess how this evolution of costs has affected utilization.

  • Potential Cost-Effectiveness and Benefit-Cost Ratios of Adult Pneumococcal Vaccination in Germany

    21 Mar 2012

    Invasive and non-invasive Streptococcus pneumoniae infections in adults are associated with substantial morbidity, mortality and costs.  In Germany, Pneumococcal polysaccharide vaccination (PPV23) is recommended for all persons >60 years and for defined risk groups (age 5-59).  The aim of this study was to estimate the potential cost-effectiveness and benefit-cost ratios of the adult vaccination program (18 years and older), considering the launch of the pneumococcal conjugate vaccine for adults (PCV13).  Results showed that the health economic benefit of immunizing adults with PCV13 can be expected to outperform the sole use of PPV23, if the effectiveness of PCV13 is comparable to the effectiveness of PCV7.  The research was published in Health Economics Review.

  • Do Patient-Reported Outcomes Have a Role in the Management of Patients with Cystic Fibrosis?

    21 Mar 2012

    Health-related quality of life (HRQoL) is a rapidly growing area of expertise and the most commonly used patient-reported outcome. This study, published in Frontiers in Pharmacology, sought to assess the affect of cystic fibrosis on HRQoL, to ascertain the reliability and validity of the United Kingdom Sickness Impact Profile and the Cystic Fibrosis Quality of Life Questionnaire in the adult CF population, and to examine their role in the management of patients. The areas of HRQoL most impaired by CF were employment and concerns regarding the future. The results underpinned the value of HRQoL as a patient-reported outcome measure in the management of adult CF.

  • Cost-Effectiveness of Tapentadol in Severe Chronic Pain in Spain: A Cost Analysis of Data From RCTs

    21 Mar 2012

    Chronic pain is known to be a significant and common health problem. Tapentadol, a recently developed centrally active, oral analgesic agent is used to treat adults with severe chronic pain that can be adequately managed only with opioid analgesics. This study, published in Clinical Therapeutics, compared the cost-effectiveness of tapentadol to that of opioids commonly used as first-line treatment of severe, chronic, nonmalignant pain from the perspective of the health care payer in Spain. Based on the findings from the present model, tapentadol was likely to be a cost-effective first-line treatment in patients with severe, chronic, nonmalignant pain in Spain according to the commonly accepted willingness-to-pay thresholds.

  • Budgetary Impact Analysis of Buprenorphine-Naloxone Combination (Suboxone®) in Spain

    21 Mar 2012

    Opioid addiction is a worldwide problem, and Methadone has been the most widely used agonist opioid treatment AOT.  However, buprenorphine, a partial mu-opiod agonist and a kappa-opiod antagonist, is fast gaining acceptance.  This study, published in Health Economics Review, sought to assess the budgetary impact in Spain of the introduction of buprenorphine-naloxone (B/N) combination. Using IMS MIDAS data, the researcher developed a budgetary impact model to estimate healthcare costs of the addition of B/N combination to the therapeutic arsenal for treating opioid dependent patients.  They determined that the addition of B/N combination would imply a maximum incremental yearly cost of Euros10.58 per patient compared to scenario only with methadone and would provide additional benefits.

  • Relative Risk of Acute Pancreatitis in Initiators of Exenatide Twice Daily Compared with other Anti-Diabetic Medication: a Follow-Up Study

    21 Mar 2012

    Previously, a retrospective cohort study found no increased risk of acute pancreatitis with current or recent use of exenatide twice daily compared with use of other anti-diabetic drugs. This follow-up study, investigated incident acute pancreatitis, with the use of a different data source and analytic method, in patients exposed to exenatide twice daily compared with patients exposed to other anti-diabetic medications. Published in Diabetic Medicine, the analysis used the IMS Health LifeLink Health Claims database which showed that exposure to exenatide twice daily was not associated with an increased risk of acute pancreatitis compared with exposure to other anti-diabetic medications.

  • Healthcare Spending: Inpatient Services

    19 Mar 2012

    For the privately insured population, facility-based services represent 84% of spending on inpatient services where members with chronic conditions driving the majority of expenditures. We continue our discussion on healthcare spending, focusing on patterns of spending and use for inpatient services among health plan members.

  • Antihypertensive Treatment and Risk of Dementia: a Retrospective Database Study

    05 Mar 2012

    Vascular risk factors play an important role in the pathogenesis of vascular dementia, as well as in Alzheimer’s disease, however the effect of antihypertensive medication on risk of dementia is unclear. Researchers aimed to investigate the association between antihypertensive prescriptions and incident dementia, using an IMS Health primary care database. The study, published in the International Journal of Clinical Pharmacology and Therapeutics, indicated a possible protective effect of some antihypertensive agents (betablockers, ACE-inhibitors) on the development of dementia and concluded that randomized controlled trials are required to confirm this finding.

  • Changes in Prescription Patterns before and after Reporting of the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression Trial

    05 Mar 2012

    Recent trends suggest a decreased use of ezetimibe/simvastatin combination and coadministered ezetimibe plus statin therapies. This analysis, published in the Journal of Clinical Lipidology, evaluated changes in prescription patterns for ezetimibe/simvastatin, ezetimibe plus statins, and statin therapies and expected effects on low-density lipoprotein cholesterol (LDL-C) lowering during 2007 to 2008. The researchers patient-level data from the IMS Health Longitudinal Rx database six months before and after reporting of the results of The Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression trial (ENHANCE) trial on Jan.14, 2008.  Their analysis showed that more patients switched from ezetimibe/simvastatin and ezetimibe plus statin to statin monotherapy six months after the reporting of the ENHANCE trial.

  • Anticancer Drug Development from Traditional Cytotoxic to Targeted Therapies: Evidence of Shorter Drug Research and Development Time, and Shorter Drug Lag in Japan

    05 Mar 2012

    Concern about the drug lag, the delay in marketing approval between one country and another, for anticancer drugs has increased in Japan. Researchers sought to investigate the current trend in oncology drug lag between the U.S. and Japan and identify oncology drugs approved in only one of the two countries, concluding that the emergence of new molecularly targeted agents has contributed to reducing the approval lag, most likely due to improvements in R&D strategy. In their analysis, published in the Journal of Clinical Pharmacy and Therapeutic, researchers used IMS MIDAS data.

  • Pharmaceutical Patents and Prices of Generics in Morocco and Neighboring Economies

    05 Mar 2012

    The importance of generics in relation to the need to enlarge access to pharmaceuticals in Morocco and its neighbor countries was profiled in this paper that appeared in the Journal of World Intellectual Property.  The attained results demonstrated the effective price decrease of generics relative to the originator drug, as well as a reduction the prices of the originals, as a means to enlarge access to medicines.

  • Healthcare Spending: A Look at the Top 1% Privately Insured

    27 Feb 2012

    We highlight the newest report from the IMS Institute, Healthcare Spending Among Privately Insured Individuals Under Age 65, which uses comprehensive, proprietary de-identified data to examine the cost drivers, member characteristics and healthcare utilization trends of private health plan members.

  • The U.S. Generic Landscape and Growth of Biosimilars

    21 Feb 2012

    We offer additional perspective on the future of generic medicines and the commercial landscape for biosimilars, which were two critical areas of discussion during the Generic Pharmaceutical Association annual meeting in February.

  • Trends in Attention Deficit Hyperactivity Disorder Ambulatory Diagnosis and Medical Treatment in the United States, 2000–2010

    15 Feb 2012

    Health researchers sought to quantify the changes in the diagnosis of ADHD and its pharmacologic treatment, from 2000 through 2010, as a result of several recent clinical and regulatory changes for these medications in the United States. Using the IMS National Disease and Therapeutic Index, they examined aggregate trends among children and adolescents under 18 years of age to measure how diagnosis and treatment patterns have evolved. The research, published in Academic Pediatrics, demonstrated that the number of physician outpatient visits where ADHD was diagnosed increased 66 percent, from 6.2 million to 10.4 million, over the 10 year period, but concluded that the effects of these changing treatment patterns on children’s health outcomes and their families were unknown.

  • Opioid Shopping Behavior: How Often, How Soon, Which Drugs, and What Payment Method

    15 Feb 2012

    Sales of opioids quadrupled between 1999 and 2010, raising concern about abuse, misuse and diversion for these medicines. It had been shown in studies that doctor shopping was one method that patients have used to gain access to the medicines. Researchers from IMS Health and Janssen examined shopping behavior related to opioids and patient method of payment in this cohort study. Utilizing the IMS LRx database, the researchers determined that subjects with shopping behavior filled schedule II opioids more often than subjects without shopping behavior and more often paid in cash. The research was published in the Journal of Clinical Pharmacology.

  • Differences in the Reporting Rates of Serious Allergic Adverse Events From Intravenous Iron by Country and Population

    14 Feb 2012

    The use of intravenous (IV) iron has been growing over the last decade, and recent reports have indicated that, of the IV iron products, the highest risk for anaphylaxis and other serious allergic reactions occurs with iron dextran products. Using IMS sales data, health researchers compared the adverse event rates of IV iron products for different countries. They noted considerable international variation in both iron use and choice of product, and in rates of all adverse events and serious allergic adverse events reported for each product. The study was published in Clinical Advances in Hematology & Oncology.

  • Adjusting For Risk Selection In State Health Insurance Exchanges Will Be Critically Important And Feasible, But Not Easy

    14 Feb 2012

    The viability and success of state-level health exchanges will require effective risk-adjustment strategies to compensate for differences in enrollees’ health status across health plans. For this Health Affairs article, the authors performed a simulation to show that under the premium rating restrictions in the law, large incentives for insurers to attract healthier enrollees will be likely to persist—resulting in substantial overpayment to plans with very healthy enrollees and underpayment to plans with very sick members. Using the IMS LifeLink Health Plans Claims Database, they concluded that risk adjustment based on patients’ diagnoses will yield paymooents to insurers that will be more accurate than what will come solely from the age-adjusted and other ratings allowed by the Affordable Care Act.

  • Canadian Guidelines for Rhinosinusitis: Practical Tools for the Busy Clinician

    13 Feb 2012

    Acute bacterial rhinosinusitis (ABRS) and chronic rhinosinusitis (CRS) frequently present in clinical practice; however, because ABRS and CRS have different pathologies and management strategies it is critical that clinicians understand the differences so appropriate treatment can be started. Published in BMC Ear, Nose and Throat Disorders, the authors discuss current Canadian guidelines for treating Rhinosinusitis, using the IMS Canadian Disease and Therapeutic Index to show that prescribing habits were nearly identical for patients with ABRS and for those with CRS. They noted that as the knowledge base of ABRS and CRS pathology and management continues to grow and evolve, physicians who desire to understand the current state of the pathologies and treatment approaches for ABRS and CRS, as well as their patients, will benefit from these guidelines.

  • IMS Ranks the Top 100 Integrated Health Networks

    06 Feb 2012

    Changes in the U.S. healthcare delivery system are upon us, and integrated health systems – whether they are termed ACOs, Integrated Delivery Networks, or Integrated Health Networks –all seek to improve health outcomes at lower cost by operating effectively as an integrated unit. Understanding the performance level and degree of integration is important to the evolving structure of our healthcare system. We highlight the IMS rankings and discuss our key findings.

  • Shaping the Biosimilars Opportunity

    30 Jan 2012

    Important changes are driving new momentum for biosimilars, paving the way for their accelerated growth over the next decade. We highlight the IMS white paper — Shaping the Biosimilars Opportunity — and discuss the landscape for these medicines, including key therapies expected to be at the forefront of the market and growth for biosimilars through 2020.

  • State Medicaid Programs Did Not Make Use of Prior Authorization to Promote Safer Prescribing After Rosiglitizone Warning

    27 Jan 2012

    Preferred drug lists are used by state Medicaid programs help to limit prescribing of high-cost medicines and free providers from having to obtain prior authorization for a given prescription. For this Health Affairs article, researchers conducted a retrospective cohort study related to the FDA’s May 2007 safety warning regarding rosiglitizone (Avandia) to determine the impact of this warning on the drug’s availability on state Medicaid preferred drug lists and on the prescribing of diabetes medications to Medicaid beneficiaries. They found that state Medicaid programs missed important opportunities to promote safer, more effective prescribing following the safety warning. The researchers used IMS Health Xponent data to conduct their study.

  • Cost-Effectiveness Analysis on Pioglitazone Add-On Therapy to Patients Failing Insulin

    27 Jan 2012

    This study modeled long-term effects of adding pioglitazone to insulin in type 2 diabetes mellitus patients in Germany. Using the IMS Core Diabetes Model, the researchers examined how pioglitazone plus insulin treatment affected quality-adjusted life expectancy for patients and if higher drug acquisition costs of the combination treatment could partly be offset by decreases in complications. They found the addition of pioglitazone to insulin treatment was projected to be highly cost-effective in the German setting when compared to insulin from a healthcare payer perspective. The study was published in Gesundheitsökonomie.

  • The Association Between Leukotriene-Modifying Agents and Spontaneously Reported Suicide

    14 Jan 2012

    Suicide is a significant public health issue. This study, published in the Drug Information Journal, examined the association between leukotriene-modifying agents (LTMAs) and completed suicide. The researchers used IMS Xponent and FDA Adverse Event Reporting System data from 1999 to 2009. They found that rates of reported completed suicides associated with montelukast increased substantially following warnings issued by the FDA.

  • Trends in Neutropenia-Related Inpatient Events

    14 Jan 2012

    Neutropenic complications after myelosuppressive chemotherapy are associated with significant morbidity and mortality. Researchers conducted a cross-sectional analysis to study trends in neutropenia-related events. They used  hospital discharge data for patients with various cancers from 1989 to 2007 and IMS drug distribution data to estimate growth factors and myelosuppressive chemotherapy from 1994 to 2008. Published in the Journal of Oncology Practice, the researchers concluded that while the  number of hospitalizations with cancer diagnoses had remained steady since 1989, hospitalizations for neutropenic complications increased approximately two-fold from 1989 to 1997 before stabilizing.

  • Variation of Health-care Resource Utilization According to GERD-associated Complications

    14 Jan 2012

    The impact of gastroesophageal reflux disease (GERD) associated complications on healthcare utilization can include many symptoms and deserves further evaluation. In this study, published in Diseases of the Esophagus, researchers used the IMS LifeLink Health Plan Claims Database to identify commercial insurance enrollees, age 18 to 75 years, with claims for GERD, and subsequent usage of proton pump inhibitors from Jan. 1, 2005 to Jun. 30, 2009. They compared patient characteristics, healthcare utilization, and costs between stage A and each stage with complicated GERD (B–D). They found that compared with stage A, all other cohorts had significantly higher all-cause and GERD-related costs, and determined that, while patients with more severe GERD represented a relatively small portion of the GERD cohort, these patients demonstrated significantly greater healthcare costs and overall utilization than patients with uncomplicated GERD.

  • Trends in Use of Second-Generation Antipsychotics for Treatment of Bipolar Disorder in the United States, 1998–2009

    14 Jan 2012

    The authors examined trends in the use of second-generation antipsychotics for treatment of bipolar disorder before and after the US FDA’s approval in 2000 of olanzapine for use in treating acute manic episodes of bipolar disorder. Using IMS Health National Disease and Therapeutic Index, the researchers derived monthly patient treatment visits between January 1998 and December 2009 by individuals 18 and older with a diagnosis of bipolar disorder who were treated with one or more pharmacotherapies. They concluded that second-generation antipsychotics are increasingly used for bipolar disorder, and their effectiveness compared with therapeutic alternatives merits further research. The study was published in Psychiatric Services.

  • Cost Analysis: Treatment of Chemotherapy-Induced Anemia with Erythropoiesis-Stimulating Agents in Five European Countries

    14 Jan 2012

    Researchers evaluated the cost-effectiveness of darbepoetin-alfa (DARB), epoetin-alfa (EPO-A) and epoetin-beta (EPO-B) for treatment of chemotherapy-induced anemia in Belgium, extending the analysis to Austria, France, Italy, Portugal and Spain. They found that, in all countries, total and anemia-related costs were lowest in patients receiving DARB versus EPO-A or EPO-B, noting their findings could be valuable in healthcare decision-making in oncology patients treated in each of the countries studied. The researchers used IMS Health sales data in their analysis, which was published in the Journal of Medical Economics.

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