1
|
Soen S, Wang A, Hamaya E, Chien HC, Lin TC. Drug utilization pattern of romosozumab and other osteoporosis treatments in Japan, 2019-2021. J Bone Miner Metab 2024:10.1007/s00774-024-01530-6. [PMID: 38987505 DOI: 10.1007/s00774-024-01530-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/18/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Describe real-world treatment of osteoporosis and romosozumab treatment patterns in Japan. MATERIALS AND METHODS Data for patients initiating romosozumab or other antiosteoporotic medications between March 01, 2018, and May 31, 2022, were extracted from the Medical Data Vision (MDV) and Japan Medical Data Center (JMDC) databases. Patients were categorized into four cohorts: those who newly initiated romosozumab within the first (MDV: n = 4782; JMDC: n = 2578) or second (MDV: n = 3888; JMDC: n = 2446) year after launch and those who initiated teriparatide (TPTD; MDV: n = 14,576; JMDC: n = 8259) or non-TPTD antiosteoporotic medications within the first year of romosozumab launch (MDV: n = 352,142; JMDC: n = 185,785). RESULTS Mean age, sex, baseline cardiovascular history, comorbidities, and concomitant medications were similar across cohorts. In the MDV database, fracture history was higher in the romosozumab year-1 (59.3%), year-2 (64.1%), and TPTD (65.5%) cohorts versus the non-TPTD cohort (24.4%). Similar rates were identified in the JMDC database: romosozumab year-1 (64.7%), year-2 (66.6%), TPTD (67.5%), and non-TPTD (27.8%). Vertebral fractures were most common in all cohorts. 12-month romosozumab discontinuation varied between the year-1 and year-2 cohorts in MDV (62.4% and 58.8%) and JMDC (57.1% and 52.7%), whereas mean number of injections remained consistent (MDV: 9.7 and 9.8; JMDC: 7.3 and 7.8). Romosozumab persistence was lower in year-1 versus year-2 (MDV: 37.6% and 42.9%; JMDC: 41.2% and 47.3%). CONCLUSION Patients initiating romosozumab and TPTD had a high fracture history. Given the dual effects of promoting bone formation and suppressing resorption, improving romosozumab adherence and persistence over time may be important for antiosteoporotic therapy.
Collapse
Affiliation(s)
- Satoshi Soen
- Soen Orthopedics, Osteoporosis, and Rheumatology Clinic, 2-14-10 Okamoto, Higashinada-Ku, Kobe, Hyogo, 658-0072, Japan.
| | - Alex Wang
- Medical Development, Amgen Inc, Sydney, Australia
| | | | - Hsu-Chih Chien
- Center for Observational Research, Amgen Inc, Thousand Oaks, CA, USA
| | - Tzu-Chieh Lin
- Center for Observational Research, Amgen Inc, Thousand Oaks, CA, USA
| |
Collapse
|
2
|
Ikeda N, Yamashita H, Hattori J, Kato H, Nishi N. Economic effects of dietary salt reduction policies for cardiovascular disease prevention in Japan: a simulation study of hypothetical scenarios. Front Nutr 2023; 10:1227303. [PMID: 38024379 PMCID: PMC10665469 DOI: 10.3389/fnut.2023.1227303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Reducing dietary salt intake is an essential population strategy for cardiovascular disease (CVD) prevention, but evidence on healthcare costs and outcomes is limited in Japan. We aimed to conduct a pilot economic evaluation under hypothetical scenarios of applying the salt reduction policies of England to Japan. Methods We examined salt reduction policies in England: media health promotion campaigns, front-of-pack labeling, and voluntary and mandatory reformulation with best-case and worst-case policy cost scenarios. We assumed that these policies were conducted in Japan for 10 years from 2019. We used published data on epidemiology and healthcare expenditures in Japan and the costs and effects of salt reduction policies in England, and defined the benefits as a decrease in national medical expenditures on CVD. We developed a Markov cohort simulation model of the Japanese population. To estimate the annual net benefits of each policy over 10 years, we subtracted monitoring and policy costs from the benefits. We adopted a health sector perspective and a 2% discount rate. Results The cumulative net benefit over 10 years was largest for mandatory reformulation (best case) at 2,015.1 million USD (with costs of USD 48.3 million and benefits of USD 2063.5 million), followed by voluntary reformulation (net benefit: USD 1,895.1 million, cost: USD 48.1 million, benefit: USD 1,943.2 million), mandatory reformulation (worst case, net benefit: USD 1,447.9 million, cost: USD 1,174.5 million, benefit: USD 2,622.3 million), labeling (net benefit: USD 159.5 million, cost: USD 91.6 million, benefit: USD 251.0 million), and a media campaign (net benefit: USD 140.5 million, cost: USD 110.5 million, benefit: USD 251.0 million). There was no change in the superiority or inferiority of policies when the uncertainty of model parameters was considered. Conclusion Mandatory reformulation with the best-case cost scenario might be economically preferable to the other alternatives in Japan. In future research, domestic data on costs and effects of salt reduction policies should be incorporated for model refinement.
Collapse
Affiliation(s)
- Nayu Ikeda
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Osaka, Japan
| | - Hitomi Yamashita
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Osaka, Japan
| | - Jun Hattori
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Osaka, Japan
| | - Hiroki Kato
- Department of Healthcare Information Management, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Osaka, Japan
- Graduate School of Public Health, St. Luke’s International University, Chuo-ku, Tokyo, Japan
| |
Collapse
|
3
|
Noda T, Ueda N, Tanaka Y, Ishiguro Y, Matsumoto T, Uenishi T, Yamaguchi H, Shoji A, Myung JE, Kusano K. Cost-effectiveness analysis of cardiac implantable electronic devices with reactive atrial-based antitachycardia pacing. Europace 2023; 25:1087-1099. [PMID: 36691793 PMCID: PMC10062312 DOI: 10.1093/europace/euad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/30/2022] [Indexed: 01/25/2023] Open
Abstract
AIMS Reactive atrial-based anti-tachycardia pacing (rATP) in pacemakers (PMs) and cardiac resynchronization therapy defibrillators (CRT-Ds) has been reported to prevent progression of atrial fibrillation, and this reduced progression is expected to decrease the risk of complications such as stroke and heart failure (HF). This study aimed to assess the cost-effectiveness of rATP in PMs and CRT-Ds in the Japanese public health insurance system. METHODS AND RESULTS We developed a Markov model comprising five states: bradycardia, post-stroke, mild HF, severe HF, and death. For devices with rATP and control devices without rATP, we compared the incremental cost-effectiveness ratio (ICER) from the payer's perspective. Costs were estimated from healthcare resource utilisation data in a Japanese claims database. We evaluated model uncertainty by analysing two scenarios for each device. The ICER was 763 729 JPY/QALY (5616 EUR/QALY) for PMs and 1,393 280 JPY/QALY (10 245 EUR/QALY) for CRT-Ds. In all scenarios, ICERs were below 5 million JPY/QALY (36 765 EUR/QALY), supporting robustness of the results. CONCLUSION According to a willingness to pay threshold of 5 million JPY/QALY, the devices with rATP were cost-effective compared with control devices without rATP, showing that the higher reimbursement price of the functional categories with rATP is justified from a healthcare economic perspective.
Collapse
Affiliation(s)
- Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan.,Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine and Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Yuji Tanaka
- Healthcare Economics and Government Affairs, Medtronic Japan Co., Ltd., 1-2-70 Konan, Minato-ku, Tokyo 108-0075, Japan
| | - Yoko Ishiguro
- Healthcare Economics and Government Affairs, Medtronic Japan Co., Ltd., 1-2-70 Konan, Minato-ku, Tokyo 108-0075, Japan
| | - Tomoko Matsumoto
- Healthcare Economics and Government Affairs, Medtronic Japan Co., Ltd., 1-2-70 Konan, Minato-ku, Tokyo 108-0075, Japan
| | - Tatsuhiro Uenishi
- Data Science Department, Medilead, Inc., 3-20-2 Nishi-Shinjuku, Shinjuku-ku, Tokyo 163-1424, Japan
| | - Hiroko Yamaguchi
- Data Science Department, Medilead, Inc., 3-20-2 Nishi-Shinjuku, Shinjuku-ku, Tokyo 163-1424, Japan
| | - Ayako Shoji
- Data Science Department, Medilead, Inc., 3-20-2 Nishi-Shinjuku, Shinjuku-ku, Tokyo 163-1424, Japan.,Healthcare Consulting Inc., 1-8-19 Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
| | - Jae-Eun Myung
- Government Affairs and Market Access, Medtronic Korea Ltd., #534, Teheran-ro, Gangnam-gu, Seoul 06181, Korea.,Department of Pharmaceutical Medicine and Regulatory Science, College of Medicine and Pharmacy, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| |
Collapse
|
4
|
Takashima N. Importance of Continuous Monitoring of Stroke Recurrence in the General Population. J Atheroscler Thromb 2022; 29:1699-1700. [PMID: 35598984 PMCID: PMC9881472 DOI: 10.5551/jat.ed202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Naoyuki Takashima
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
| |
Collapse
|
5
|
Boutros CF, Khazaal W, Taliani M, Said Sadier N, Salameh P, Hosseini H. One-year recurrence of stroke and death in Lebanese survivors of first-ever stroke: Time-to-Event analysis. Front Neurol 2022; 13:973200. [PMID: 36452174 PMCID: PMC9702576 DOI: 10.3389/fneur.2022.973200] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/14/2022] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND To date, despite the application of secondary prevention worldwide, first-ever stroke survivors remain at imminent risk of stroke recurrence and death in the short and long term. The present study aimed to assess the cumulative risk rates and identify baseline differences and stroke characteristics of Lebanese survivors. METHODS A prospective longitudinal study was conducted among survivors ≥18 years old who were followed-up for 15 months through a face-to-face interview. Kaplan-Meier method was used to calculate the cumulative rates of stroke mortality and recurrence. Cox-regression univariate and multivariable analyses were performed to identify the predictors of both outcomes. RESULTS Among 150 subjects (mean age 74 ± 12 years; 58.7% men vs. 44.3% women; 95.3% with ischemic stroke vs. 4.3% with intracerebral hemorrhage), high cumulative risk rates of stroke recurrence (25%) and death (21%) were highlighted, especially in the acute phase. Survival rates were lesser in patients with stroke recurrence compared to those without recurrence (Log rank test p < 0.001). Older age was the main predictor for both outcomes (p < 0.02). Large artery atherosclerosis was predominant in patients with stroke recurrence and death compared to small vessel occlusion (p < 0.02). Higher mental component summary scores of quality of life were inversely associated with stroke recurrence (p < 0.01). Lebanese survivors exhibited the highest percentages of depression and anxiety; elevated Hospital Anxiety and Depression Scale (HADS) scores were seen in those with stroke recurrence and those who died (≥80% with mean HADS scores ≥8). Lower Mini-Mental State Examination scores at the acute phase increased the risk of both outcomes by 10% (p < 0.03). Three out of 13 mortalities (23.1%) were presented with early epileptic seizures (p = 0.012). High educational level was the protective factor against stroke recurrence (p = 0.019). Administration of intravenous thrombolysis decreased the risk of both outcomes by 10% (p > 0.05). CONCLUSION Higher rates of stroke recurrence and death were observed in the first year following a stroke in Lebanon. Various factors were identified as significant determinants. Thus, health care providers and officials in Lebanon can use these findings to implement effective preventive strategies to best address the management of these factors to reduce the stroke burden and improve the short and long-term prognosis of stroke survivors.
Collapse
Affiliation(s)
- Celina F. Boutros
- Institut Mondor de Recherche Biomédicale (IMRB)-INSERM U955, Ecole Doctorale Science de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
| | - Walaa Khazaal
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Maram Taliani
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Najwane Said Sadier
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Pascale Salameh
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Hassan Hosseini
- Institut Mondor de Recherche Biomédicale (IMRB)-INSERM U955, Ecole Doctorale Science de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
- Hôpital Henri Mondor, AP-HP, Créteil, France
| |
Collapse
|
6
|
Koumo M, Goda A, Maki Y, Yokoyama K, Yamamoto T, Hosokawa T, Katsura J, Yanagibashi K. Indicators Predicting Inpatient Mortality in Post-Stroke Patients Admitted to a Chronic Care Hospital: A Retrospective Pilot Study. Healthcare (Basel) 2022; 10:healthcare10061038. [PMID: 35742088 PMCID: PMC9222313 DOI: 10.3390/healthcare10061038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/28/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023] Open
Abstract
Evidence concerning the mortality of post-stroke patients admitted to a chronic-phase hospital seems to be lacking. This pilot study aimed to identify mortality-related clinical variables in the admission of post-stroke patients from a retrospective perspective. A group of 38 non-survival stroke patients and another group of 46 survival stroke patients in a chronic-phase ward of the single center were recruited. Clinical variables including age, sex, stroke type, and Barthel index (BI) score were collected. The difference in the age and BI scores on admission were statistically significant between the two groups (p < 0.01). Polytomous logistic regression analysis revealed that age (odds ratio = 1.09, p = 0.03, and 95% confidence interval: 1.01−1.07), male sex (odds ratio = 5.04, p = 0.01, and 95% confidence interval: 1.39−18.27), and BI scores on admission (odds ratio = 0.90, p = 0.01, and 95% confidence interval: 0.83−0.97) could be prognostic variables. The percentage of correct classification was 83.3%. Age, male sex, and BI scores on admission may be prognostic indicators. The result of this study could lay the groundwork for palliative care for such a clinical population.
Collapse
Affiliation(s)
- Masatoshi Koumo
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
| | - Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Correspondence: ; Tel.: +81-(0)75-574-4313
| | - Yoshinori Maki
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
- Department of Neurosurgery, Hikone Chuo Hospital, Shiga 522-0054, Japan
| | - Kouta Yokoyama
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
| | - Tetsuya Yamamoto
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
| | - Tsumugi Hosokawa
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
| | - Junichi Katsura
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
| | - Ken Yanagibashi
- Department of Rehabilitation, Hikari Hospital, Shiga 520-0002, Japan; (M.K.); (Y.M.); (K.Y.); (T.Y.); (T.H.); (J.K.); (K.Y.)
| |
Collapse
|
7
|
Kanai M, Toda T, Yamamoto K, Akimoto M, Hagiwara Y. A Mobile Health-Based Disease Management Program Improves Blood Pressure in People With Multiple Lifestyle-Related Diseases at Risk of Developing Vascular Disease ― A Retrospective Observational Study ―. Circ Rep 2022; 4:322-329. [PMID: 35860354 PMCID: PMC9257458 DOI: 10.1253/circrep.cr-22-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 11/25/2022] Open
Abstract
Background: The overlap of multiple lifestyle-related diseases increases the risk of vascular diseases. This study investigated the effects of a mobile health (mHealth)-based disease management program on blood pressure and the safety of this program in people with multiple lifestyle-related diseases at risk of developing vascular disease. Methods and Results: This retrospective observational study was conducted using secondary data collected by PREVENT Inc. People with a full history of hypertension, diabetes, and dyslipidemia and who participated in a 6-month mHealth-based disease management program were included in the study. The primary outcome was blood pressure. Adverse events during the program were investigated to evaluate safety. In total, 125 participants (mean [±SD] age 55.3±6.2 years) were examined. Systolic and diastolic blood pressure were significantly lower after the intervention than at baseline (systolic blood pressure, 128.0±12.3 vs. 131.9±12.7 mmHg [P<0.001]; diastolic blood pressure, 81.2±9.3 vs. 83.6±8.9 mmHg; P=0.003). No serious adverse events occurred during the program. Conclusions: The present results indicate that the mHealth-based disease management program may reduce blood pressure in people with multiple lifestyle-related diseases at risk of developing vascular disease and that the program is safe. These findings will help shape future health instructions using mHealth-based interventions.
Collapse
Affiliation(s)
- Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University
| | | | | | | | | |
Collapse
|
8
|
Impacts of treatments on recurrence and 28-year survival of ischemic stroke patients. Sci Rep 2021; 11:15258. [PMID: 34315990 PMCID: PMC8316573 DOI: 10.1038/s41598-021-94757-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/13/2021] [Indexed: 12/21/2022] Open
Abstract
Aspirin and nicametate are well-established therapies for preventing recurrence and mortality from stroke in patients diagnosed as ischemic stroke. However, their respective effects on the recurrence, making allowance for the duration of recurrence and death without the occurrence of recurrence, and long-term survival have not been well elucidated. We aimed to evaluate long-term effect of two kinds of treatment on cerebrovascular death among ischemic stroke patients with or without the recurrence of stroke. Data used in this study were derived from the cohort based on a multicenter randomized double-blind controlled trial during 1992 to 1995 with the enrollment of a total of 466 patients with first-time non-cardioembolic ischemic stroke who were randomly allocated to receive aspirin (n = 222) or nicametate (n = 244). The trial cohort was followed up over time to ascertain the date of recurrence within trial period and death until Sep of 2019. The time-dependent Cox regression model was used to estimate the long-term effects of two treatments on death from cerebrovascular disease with and without recurrence. A total of 49 patients experienced stroke recurrence and 89 cerebrovascular deaths was confirmed. Patients treated with nicametate were more likely, but non statistically significantly, to have recurrence (aHR: 1.73, 95% CI 0.96–3.13) as compared with those treated by aspirin. Nicametate reduced the risk of cerebrovascular death about 37% (aHR: 0.63, 95% CI 0.41–0.97) compared with aspirin. The aspirin group had a lower recurrence rate than the nicametate group even with recurrence after 1–2 years of follow-up of first stroke but the latter had significantly reduced death from cerebrovascular disease for nicametate group, which requires more research to verify.
Collapse
|