PMSA 2016 Conference Awards

Congratulations to the recipients of the PMSA 2016 Best Podium Presentation and Best Poster Presentation awards!

Best Podium Presentation
Epilepsy Outcome Drivers: Using APLD to Uncover Drivers of Epilepsy Outcomes to Engage Advocates and Influence Policymakers
Cindie Dilley, UCB, Inc. and Bill Coyle, ZS Associates

Best Poster Presentation
Longitudinal Commercial Claims-Based Cost Analysis of Diabetic Retinopathy Screening Patterns
Thomas Weisman, Genentech


The submitted abstract for each of the winning presentations is below:

Epilepsy Outcome Drivers: Using APLD to Uncover Drivers of Epilepsy Outcomes to Engage Advocates and Influence Policymakers
Patients with Epilepsy have a number treatment options available to them, but significant unmet need remains. Even among current approaches to care, there is little clear real-world, independently generated data to help physicians and patients know what the right approach is for them.

By engaging thought leaders and using patient level data, we were able to hypothesize and then demonstrate what factors impact outcomes for Epilepsy patients. Robust analyses were conducted on both open and closed APLD datasets to understand how factors like drug choice, access to specialists, proximity to centers of excellence, deliberate effort to optimize therapy, insurance type, and formulary policy impact patient outcomes, as measured by hospitalizations (both epilepsy related and all-cause).

Results shows that the use of 2nd generation anti-epilepsy drugs resulted in improved outcomes, as did deliberate effort to optimize therapy (as seen via switches and add-ons). Second order effects showed that access to specialists, proximity to centers of excellence, and better formulary coverage led to higher use of 2nd generation therapies, and, thus, better outcomes for patients.

Outputs of the analysis were featured in a peer-reviewed publication, and used to create state “scorecards” that the Epilepsy Foundation used in its advocacy efforts with policymakers.


Longitudinal Commercial Claims-Based Cost Analysis of Diabetic Retinopathy Screening Patterns
BACKGROUND: Diabetic retinopathy is one of the most common complications of diabetes. The screening of patients with diabetes to detect retinopathy is recommended by several professional guidelines but is an underutilized service.

OBJECTIVE: To analyze the relationship between the frequency of retinopathy screening and the cost of care in adult patients with diabetes.

METHODS: Truven Health MarketScan commercial databases (2000-2013) were used to identify the diabetic population aged 18 to 64 years for the performance of a 2001-2013 annual trend analysis of patients with type 1 and type 2 diabetes and a 10-year longitudinal analysis of patients with newly diagnosed type 2 diabetes. In the trend analysis, the prevalence of diabetes, screening rate, and allowed cost per member per month (PMPM) were calculated. In the longitudinal analysis, data from 4 index years (2001-2004) of patients newly diagnosed with type 2 diabetes were combined, and the costs were adjusted to be comparable to the 2004 index year cohort, using the annual diabetes population cost trends calculated in the trend analysis. The longitudinal population was segmented into the number of years of diabetic retinopathy screening (ie, 0, 1-4, 5-7, and 8-10), and the relationship between the years of screening and the PMPM allowed costs was analyzed. The difference in mean incremental cost between years 1 and 10 in each of the 4 cohorts was compared after adjusting for explanatory variables.

RESULTS: In the trend analysis, between 2001 and 2013, the prevalence of diabetes increased from 3.93% to 5.08%, retinal screening increased from 26.27% to 29.58%, and the average total unadjusted allowed cost of care for each patient with diabetes increased from $822 to $1395 PMPM. In the longitudinal analysis, the difference between the screening cohorts’ mean incremental cost increase was $185 between the 0- and 1-4–year cohorts (P <.003) and $202 between the 0- and 5-7–year cohorts (P <.023). The cost differences between the other cohorts, including $217 between the 0- and 8-10–year cohorts (P <.066), were not statistically significant.

CONCLUSIONS: Based on our analysis, the annual retinopathy screening rate for patients with diabetes has remained low since 2001, and has been well below the guideline-recommended screening levels. For patients with type 2 diabetes, the mean increase in healthcare expenditures over a 10-year period after diagnosis is not statistically different among those with various retinopathy screening rates, although the increase in healthcare spending is lower for patients with diabetes who were not screened for retinopathy compared with patients who did get screened.