1
|
Sehanobish E, Ye K, Imam K, Sariahmed K, Kurian J, Patel J, Belletti D, Chung Y, Jariwala S, White A, Jerschow E. Elaborate biologic approval process delays care of patients with moderate-to-severe asthma. J Allergy Clin Immunol Glob 2023; 2:100076. [PMID: 37780792 PMCID: PMC10509902 DOI: 10.1016/j.jacig.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/08/2022] [Accepted: 10/19/2022] [Indexed: 10/03/2023]
Abstract
Background mAbs (biologics) are indicated in patients with poorly controlled moderate-to-severe asthma. The process of prior authorization and administration of a biologic requires exceptional commitment from clinical teams. Objective Our aim was to evaluate the process of approval and administration of biologics for asthma and determine the most common reasons associated with denials of biologics and delays in administration. Methods We examined the records of patients with asthma who were prescribed biologics from January 2018 to January 2020 at 2 centers, Montefiore Medical Center (Bronx, NY) and Scripps Clinics (San Diego, Calif). Demographics, insurance information, and details on the approval process were collected. Results After querying of electronic health records, the records of 352 and 70 patients with moderate-to-severe asthma were included from Montefiore and Scripps, respectively. Most patients at Montefiore (58.2%) were insured under Managed Care Medicaid (MC Medicaid), whereas most patients at Scripps (61.4%) had commercial insurance. The median times from prescription to administration of a biologic were similar: 34 days (interquartile range [IQR] = 18-63 days) and 34 days (IQR = 22.5-56.0 days) (P = .97) for Montefiore and Scripps, respectively. However, the median approval time for Montefiore was 6 days (IQR = 1-20 days) and that for Scripps was 22 days (IQR = 10-36 days) (P < .001). Approval times for prescriptions requiring appeals were significantly longer than for prescriptions approved after the initial submission: 23 days versus 2.5 days and 40.5 days versus 15.5 days (for Montefiore and Scripps, respectively [P < .001 for both]). Conclusions Lengthy appeals contribute to delays between prescribing and administering a biologic. Site-specific practices and insurance coverage influence approval timing of the biologics for asthma.
Collapse
Affiliation(s)
- Esha Sehanobish
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Kenny Ye
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | | | - Karim Sariahmed
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Joshua Kurian
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | | | | | - Yen Chung
- AstraZeneca Pharmaceuticals, Wilmington, De
| | - Sunit Jariwala
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | | | - Elina Jerschow
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minn
| |
Collapse
|
2
|
Sariahmed K, Kurian J, Singh AK, Leyton C, Minuti A, Jerschow E, Arora S, Jariwala SP. Social, political, and economic determinants of access to biologics: A scoping review of structural determinants in the clinical disparities literature. Res Social Adm Pharm 2022; 18:4038-4047. [DOI: 10.1016/j.sapharm.2022.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/05/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
|
3
|
Kaplinsky NJ, Gilbert SF, Cebra-Thomas J, Lilleväli K, Saare M, Chang EY, Edelman HE, Frick MA, Guan Y, Hammond RM, Hampilos NH, Opoku DSB, Sariahmed K, Sherman EA, Watson R. The Embryonic Transcriptome of the Red-Eared Slider Turtle (Trachemys scripta). PLoS One 2013; 8:e66357. [PMID: 23840449 PMCID: PMC3686863 DOI: 10.1371/journal.pone.0066357] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/03/2013] [Indexed: 11/28/2022] Open
Abstract
The bony shell of the turtle is an evolutionary novelty not found in any other group of animals, however, research into its formation has suggested that it has evolved through modification of conserved developmental mechanisms. Although these mechanisms have been extensively characterized in model organisms, the tools for characterizing them in non-model organisms such as turtles have been limited by a lack of genomic resources. We have used a next generation sequencing approach to generate and assemble a transcriptome from stage 14 and 17 Trachemys scripta embryos, stages during which important events in shell development are known to take place. The transcriptome consists of 231,876 sequences with an N50 of 1,166 bp. GO terms and EC codes were assigned to the 61,643 unique predicted proteins identified in the transcriptome sequences. All major GO categories and metabolic pathways are represented in the transcriptome. Transcriptome sequences were used to amplify several cDNA fragments designed for use as RNA in situ probes. One of these, BMP5, was hybridized to a T. scripta embryo and exhibits both conserved and novel expression patterns. The transcriptome sequences should be of broad use for understanding the evolution and development of the turtle shell and for annotating any future T. scripta genome sequences.
Collapse
Affiliation(s)
- Nicholas J. Kaplinsky
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Scott F. Gilbert
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Judith Cebra-Thomas
- Department of Biology, Millersville University, Millersville, Pennsylvania, United States of America
| | - Kersti Lilleväli
- Department of Developmental biology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
- Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Merly Saare
- Department of Developmental biology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Eric Y. Chang
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Hannah E. Edelman
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Melissa A. Frick
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Yin Guan
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Rebecca M. Hammond
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Nicholas H. Hampilos
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - David S. B. Opoku
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Karim Sariahmed
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Eric A. Sherman
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Ray Watson
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| |
Collapse
|