Publications & Webinars

Responsible Use Of Medicines: Applying levers for change

IMS Institute’s Murray Aitken discusses the research approach used and implications gleaned from a study on the responsible use of medicines prepared for a Health Ministers summit in October 2012 organized by the Dutch Ministry of Health. Learn more: www.responsibleuseofmedicines.org

Off-label Antidepressant Use in Children and Adolescents Compared with Young Adults: Extent and Level of Evidence

July 2012

Researchers sought to estimate the degree of, and level of evidence supporting, off-label antidepressant (AD) prescribing for children and adolescents compared with young adults.  Utilizing IMS medical and pharmacy claims data, from U.S.-managed care plans, from 1997-2009, they found that pediatric off-label AD prescribing occurs frequently without a strong evidence base, highlighting a need to generate additional evidence to ensure safe and effective use.  The study was published in Pharmacoepidemiology and Drug Safety.

Pharmaceutical Innovation and Longevity Growth in 30 Developing and High-income Countries, 2000-2009

July 2012

Researchers examined the impact of pharmaceutical innovation, as measured by the vintage of prescription drugs used, on longevity.  Utilizing IMS longitudinal, country-level data for 30 developing and high-income countries during the period 2000-2009, they noted that life expectancy at all ages and survival rates above age 25 increased faster in countries with larger increases in drug vintage.  The study authors concluded that pharmaceutical innovation was estimated to have accounted for almost three-fourths of the 1.74-year increase in life expectancy at birth in the 30 countries during the time period analyzed, and for about one third of the 9.1-year difference in life expectancy at birth in 2009 between the top 5 countries (ranked by drug vintage in 2009) and the bottom 5 countries (ranked by the same criterion).  The research was published as a NBER Working Paper.

Seasonality and Temporal Correlation between Community Antibiotic Use and Resistance in the United States

July 2012

Therapeutic antibiotic use in humans is a significant driver of antibiotic resistance, and the seasonal effect of antibiotic use on antibiotic resistance has been poorly quantified because of lack of large-scale, spatially disaggregated time-series data on antibiotic use and resistance.  In this study, published in Clinical Infectious Diseases, researchers used IMS prescription data to examine antibiotic use and resistance in the United States.  They sought to estimate the effect of aminopenicillin, fluoroquinolone, trimethoprim/sulfamethoxazole, and tetracycline usage on resistance of Escherichia coli to drugs within these classes.  The researchers found that large-scale usage of antibiotics can generate seasonal patterns of resistance that fluctuate on a short time scale, suggesting that the use of antibiotics in the winter could have a significant effect on resistance. In addition, they noted that the strong correlation between community use of antibiotics and resistance isolated in the hospital was an indication that restrictions imposed at the hospital level were unlikely to be effective unless coordinated with campaigns to reduce unnecessary antibiotic use at the community level.

The Impact of Pharmaceutical Innovation on Longevity and Medical Expenditure in Sweden, 1997-2010: Evidence from Longitudinal, Disease-Level Data

July 2012

Longevity increase is increasingly recognized by economists to be an important part of economic growth and development.  Researchers used IMS longitudinal, disease-level data to analyze the impact of pharmaceutical innovation on longevity and medical expenditure in Sweden, where mean age at death increased by 1.88 years during the period 1997-2010.  The study authors found that pharmaceutical innovation contributed to an estimated mean age at death of 0.60 years during the period; it also reduced hospital utilization in Sweden, contributing to a low cost per life-year gained from the introduction of new drugs. The research was published as a CESifo Working Paper.

Results of a 2-Year Retrospective Cohort Study of Newly Prescribed Triptan Users in European Nationwide Practice Databases

July 2012

Persistency related to prescriptions of triptan monotherapy for newly prescribed migraine headache sufferers in European primary-care practices has not been well described.  In this study, published in Cephalalgia, researchers sought to characterize prescription refill patterns for triptans among European patients with new prescriptions of triptans.  Using IMS prescription data, they found that migraine patients who received new prescriptions of triptan monotherapy from their primary-care physicians exhibited poor refill rates.  They noted that their findings should be interpreted with caution given certain inherent limitations associated with the database study design.

Predictors for the Initiation of a Basal Supported Oral Therapy (BOT) in Type 2 Diabetic Patients Under Real-life Conditions in Germany

June 2012

IMS Health researchers assessed the predictors for the initiation of a basal supported oral therapy (BOT) in type 2 diabetic patients under real-life conditions in Germany.  A historical cohort study utilizing representative German real-life data from the IMS Disease Analyzer database was performed.  The researchers determined that the highest probability of initiating a BOT under real-life conditions was found for patients with poor metabolic control, midlife age and pre-treatment with specific OADs such as SU, GLI or AGI before initiation of insulin therapy.  The study was published in Primary Care Diabetes.

Psychometric Performance of the CushingQoL Questionnaire in Conditions of Real Clinical Practice

June 2012

This study evaluated HRQoL in Cushing's syndrome (CS) with the disease-generated CushingQoL questionnaire. It sought to confirm its psychometric properties of test-retest reliability and sensitivity to change.  Researchers found that the CushingQoL questionnaire shows good test-retest reliability and sensitivity to change in clinical practice conditions.  The study was published in the European Journal of Endocrinology.

Effect of a Continuous Measure of Adherence with Infliximab Maintenance Treatment on Inpatient Outcomes in Crohn's Disease

June 2012

Researchers assessed the impact of a continuous measure of adherence with infliximab maintenance treatment in Crohn's disease (CD) during the first year of treatment on CD-related health care utilization, CD-related hospitalizations, inpatient costs, and length of hospital stay. A retrospective claims analysis using the IMS LifeLink Health Plan Claims Database (September 1, 2004, to June 30, 2009) was conducted.  Researchers found that adherence with maintenance infliximab over 12 months was associated with lower rates of CD-related hospitalizations and inpatient costs and a shorter length of hospital stay. The study was published in Patient Preference and Adherence.

Second-Line Treatment Outcomes after First-Line Sunitinib Therapy in Metastatic Renal Cell Carcinoma

June 2012

This study, undertaken by  IMS Health researchers and published in Clinical Genitourinary Cancer, evaluated the treatment outcomes associated with common second-line targeted therapies given after first-line sunitinib for metastatic renal cell carcinoma (mRCC). The sample comprised patients with mRCC who were receiving second-line everolimus, sorafenib, or temsirolimus between April 1, 2008, and February 29, 2011, after first-line sunitinib treatment. The patients were followed-up from the start of second-line treatment until treatment failure (defined as advancement to a third-line therapy or to mortality) or the last observation in the medical and pharmacy databases. The results of this real-world data analysis suggest that the risk of second-line treatment failure after first-line sunitinib was significantly higher with temsirolimus and sorafenib compared with everolimus.

Profile of the Free Distribution of Emergency Contraception for Adolescents in São Paulo's Counties

June 2012

The position adopted by São Paulo's counties, which received amounts of emergency contraception from the Federal Health Department in 2005 and 2006, is described in relation to the distribution of contraceptives to adolescents. Using IMS sales data, and quantitative surveys carried out with semi-structured questionnaires, services and health care professionals and the criteria of dispensation were examined. Researchers concluded that there exists selectivity in the method's dispensation, very scarcely offered in Basic Adolescent Health Care Services, which makes it difficult for adolescents to have access to emergency birth control in situations where pregnancy is a risk. The study was published in the Journal of Human Growth and Development.

Risk of Suicide Attempt in Asthmatic Children and Young Adults Prescribed Leukotriene-Modifying Agents: A Nested Case-Control Study

June 2012

The US FDA has issued safety alerts about leukotriene–modifying agents (LTMAs) and suicidality/suicide, but because these were based on case reports, there is controversy about the association. In this study, researchers used the IMS LifeLink Health Plan Claims Database to conduct a nested case-control study to determine the association between LTMAs and attempted suicide among asthmatic children and young adults. They found that use of LTMAs was not associated with an increased risk of suicide attempts in children, adolescents, and young adults with asthma. The study was published in the Journal of Allergy and Clinical Immunology.

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

June 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)

June 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.

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

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.

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

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.

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

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.

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

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.

Trends in Antihypertensives Use among Moroccan Patients

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

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.

Trends in Antihypertensives Use among Moroccan Patients

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.

Infused Chemotherapy Use in the Elderly After Patent Expiration

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.

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

April 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.

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

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.

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

April 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.

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

April 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.

Cost-Effectiveness of Biphasic Insulin Aspart 30 vs. Human Premix Insulin in Type 2 Diabetes from the Payer's Perspective in Bulgaria

April 2012

This study sought to assess the long-term cost-effectiveness of biphasic insulin aspart 30 versus human premix insulin in patients with type 2 diabetes from a third-party payer perspective in a Bulgarian setting.  Researchers used the IMS CORE Diabetes Model in their analysis which was published in BIO. They concluded biphasic insulin aspart 30 was shown to be more effective and less costly from a third-party payer perspective than human premix insulin for type 2 diabetes in Bulgaria, and may be considered dominant.

Assessing Adherence-Based Quality Measures in Epilepsy

April 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

April 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.

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

April 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.

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

April 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

April 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.

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

April 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.

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

March 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.

The Burden of Illness of Osteoporosis in Canadian Men

March 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.

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

March 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

March 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.

Gap between Recommended and Actual Practice in Pediatric Obsessive-Compulsive Disorder

March 2012

Pediatric obsessive–compulsive disorder is a debilitating disorder that has a clear evidence base for what treatments ‘work’ (i.e., cognitive-behavioral therapy and serotonin-reuptake inhibitor medications). Yet, the provision of such therapies does not follow practice parameters resulting in suboptimal treatment response and the potential for adverse health outcomes. This article, published in Clinical Practice, presents widely used clinical practices for pediatric obsessive–compulsive disorder that are at odds with evidence-based practice guidelines.  The IMS Health National Disease and Therapeutic Index, years 1998–2004, was cited.  Potential areas for remediation in training and dissemination efforts were highlighted.

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

March 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.

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

March 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. T he results underpinned the value of HRQoL as a patient-reported outcome measure in the management of adult CF.

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

March 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.

Pharmaceutical Patents and Prices of Generics in Morocco and Neighboring Economies

March 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.

Antihypertensive Treatment and Risk of Dementia: a Retrospective Database Study

March 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.

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

March 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.

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

March 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.

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

March 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.

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

March 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.

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

February 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

February 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.

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

February 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 payments 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.

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

February 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.

Canadian Guidelines for Rhinosinusitis: Practical Tools for the Busy Clinician

February 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.

Trends in Neutropenia-Related Inpatient Events

January 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

January 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.

Changes in Trend of Antipsychotics Prescription in Patients Treated with Cholinesterase Inhibitors After Warnings from Italian Medicines Agency. Results From the EPIFARM-Elderly Project

January 2012

This study sought to assess the trend of antipsychotic prescriptions in elderly patients taking cholinesterase inhibitors (ChEIs) from 2002 to 2008 and the changes subsequent to two main official warnings issued by the Italian Medicines Agency to restrict their use. Researchers used the IMS National Disease and Therapeutic Index to conduct an interrupted time-series analysis of patients aged 65–94 years who received at least one prescription of ChEIs between Jan. 1, 2002 and  Dec. 31, 2008. They found  after the first safety warning the prevalence of prescriptions for risperidone and olanzapine dropped significantly, while the use of quetiapine increased substantially. They also noted that haloperidol prescriptions increased, especially after the second warning. The study was published in European Neuropsychopharmacology.

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

January 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.

The Association Between Leukotriene-Modifying Agents and Spontaneously Reported Suicide

January 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.

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

January 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.

Optimizing Treatment for Patients with Metastatic Renal Cell Carcinoma in the Central and Eastern European Region

December 2011

Metastatic renal cell carcinoma (mRCC) is one malignancy with historically poor prognosis and high incidence and mortality rates in Central and Eastern Europe. In this paper, published in Expert Opinion on Pharmacotherapy, researchers sought to idenify the unique challenges faced in the treatment of metastatic renal cell cancer in this region. They used IMS oncology market information, concluding that a wealth of clinical trial data supporting the use of targeted therapies for first-line treatment of mRCC, cytokine-based immunotherapy is still used in some of these European countries. They also noted that with implementation and adherence to existing guidelines, treatment can be clinically and economically optimized in patients with mRCC.

The Association Between Drospirenone and Hyperkalemia: A Comparative-Safety Study

December 2011

Drospirenone/ethinyl-estradiol is an oral contraceptive (OC) that possesses unique antimineralocorticoid activity, which has been conjectured that drospirenone, when taken alone or concomitantly with spironolactone, may be associated with an increased risk of hyperkalemia. Published in BMC Clinical Pharmacology, researchers conducted a retrospective cohort study of women between 18-46 years of age to evaluate the association between drospirenone and hyperkalemia. They used the IMS LifeLink Health Plan Claims Database in their analysis, concluding that in a large cohort of young women, drospirenone did not cause a clinically significant increase in risk for hyperkalemia when compared with other progestin-containing OCs. They also noted that physicians were not following the monitoring requirements for serum potassium assays in the package insert for patients taking these two medications.

Cost Effectiveness of Rivaroxaban versus Enoxaparin for Prevention of Post-Surgical Venous Thromboembolism from a US Payer's Perspective

December 2011

Major orthopaedic surgery, such as total hip replacement (THR) and total knee replacement (TKR), is associated with an increased risk of venous thromboembolism (VTE). IMS researchers sought to compare the costs and outcomes associated with rivaroxaban, a once-daily, orally administered Factor Xa inhibitor, and enoxaparin for the prevention of VTE in patients undergoing THR or TKR. Their analysis, published in PharmacoEconomics, compared rivaroxaban to enoxaparin from a US payer's perspective. They concluded that rivaroxaban may be cost saving in both the THR and the TKR populations, when compared with enoxaparin in the US.

A Comparison of the Therapeutic Efficacy of Diclofenac in Osteoarthritis: A Systematic Review of Randomized Controlled Trials

December 2011

This study compared the relative efficacy of diclofenac, a nonsteroidal anti-inflammatory drug (NSAID) commonly prescribed for pain relief in osteoarthritis (OA) to other pain relief medications used in OA, including alternative NSAIDs and cyclooxygenase type 2 (COX-2) inhibitors. The researchers concluded that the efficacy of diclofenac is largely unchallenged in that it remains as effective as newer pain relief medications employed in OA, and a review of the available data demonstrates that diclofenac continues to provide physicians with a benchmark pharmacological treatment for OA. IMS Health National Prescription Audit data was used for this analysis which was published in Current Medical Research and Opinion.

Patient/Caregiver Perceived Benefits and Barriers to Elective Orthopedic Surgery (EOS) in Patients with Congenital Hemophilia with Inhibitors

December 2011

Congenital hemophilia patients with inhibitors are at greater risk for developing arthropathy and orthopedic complications compared to those without inhibitors, suggesting that elective orthopedic surgeries (EOS) may be an option for these patients and may provide long-term cost savings due to reduced bleed frequency. IMS Health researchers conducted a US-based patient/caregiver survey describe inhibitor patient experiences and outcomes following EOS and to develop a comprehensive understanding of patient preferences for EOS. The research, published in the Journal of Medical Economics, concluded that quality of life improved for most inhibitor patients who reported having EOS.

Impact of the 2008-2009 Economic Recession on Screening Colonoscopy Utilization Among the Insured

December 2011

This study, published in Clinical Gastroenterology and Hepatology, sought to determine whether the recent, severe economic recession was associated with diminished screening colonoscopy rates among an insured population and to assess the relationship between out-of-pocket (OOP) costs and screening colonoscopy use. Using the IMS Health LifeLink Health Plan Claims Database, researchers analyzed monthly rates of screening colonoscopies performed on 50–64 year old beneficiaries between January 2005 and November 2007 (pre-recession) and December 2007 through June 2009 (recession). They concluded that insured individuals reduced their use of screening colonoscopy during the recession when compared with the two years before the recession began, and OOP costs were also inversely related to screening use, especially during the recession. The study authors suggested that policies to reduce cost sharing could increase adherence to recommended preventive services such as colonoscopy examinations.

Changes in Prescription Patterns Before and After Reporting of ENHANCE Results and Expected Effects on LDL-C Reduction

December 2011

This analysis evaluated changes in prescription patterns for ezetimibe/simvastatin, ezetimibe+statins and statin therapies and expected effects on LDL-C lowering during 2007-2008. Using patient-level data from the IMS Health Longitudinal Rx database, researchers concluded that more patients switched from ezetimibe/simvastatin and ezetimibe+statin to statin monotherapy, 6 months after the reporting of the ENHANCE trial, the majority of which were prescribed less potent, LDL-C lowering therapies. This study was published in the Journal of Clinical Lipidology.

Perspective: Generic Atorvastatin and Health Care Costs

December 2011

The New England Journal of Medicine published this perspective exploring the possible economic impact of the availability of generic atorvastatin. Using IMS National Prescription Audit data, researchers examined past trends in statin use to project potential future cost savings. They studied the market entry of generic simvastatin when the patent for Zocor (Merck) expired in 2006, which provided a historical example to guide their projections, and also considered the effect that the aging of the population would have on the demand for statins.

Longitudinal Change in HbA1c After Insulin Initiation in Primary Care Patients with Type 2 Diabetes: A Database Analysis in UK and Germany

November 2011

Researchers evaluated the 3-year change in HbA1c values after start of insulin therapy among patients with type 2 diabetes in primary care practices in the UK and Germany. They concluded that the initiation of insulin therapy in primary care patients in Germany and the UK was associated with a similar moderate improvement in glycemic control over the first 12 months, but after this period, insulin therapy only maintained HbA1c values without additional improvement in glycemic control. The study was published in Primary Care Diabetes and utilized longitudinal data from IMS Disease Analyzer.

Benzodiazepine Discontinuation with Prolonged-release Melatonin: Hints from a German Longitudinal Prescription Database

November 2011

Researchers conducted a retrospective study examining prolonged-release melatonin in Europe in patients aged 55 years and above. The objective was to describe prescription patterns and the medication’s impact on hypnotics use in routine clinical practice. The authors utilized IMS Disease Analyzer in the study, concluding that prolonged-release melatonin may help to facilitate benzodiazepine discontinuation in older insomniacs. The research was published in Expert Opinion on Pharmacotherapy.

One-Year Treatment Persistence and Potential Adverse Events Among Patients With Atrial Fibrillation Treated With Amiodarone or Sotalol: A Retrospective Claims Database Analysis

November 2011

IMS researchers conducted a retrospective cohort study examining the risk-benefit profile of anti-arrhythmic drugs (AADs) and their affect on choice of pharmacotherapy for maintenance of sinus rhythm. Utilizing claims data, they studied adverse events associated with AAD medications and their influence on patient compliance, as well as if these medications compromise the management of atrial fibrillation (AF). The researchers concluded that patients with AF receiving amiodarone versus sotalol therapy had differing clinical characteristics. Patients experienced frequent adverse events (particularly cardiovascular events) with amiodarone and sotalol, and many discontinued treatment during the first year. The study was published in Clinical Therapeutics.

Low Molecular Weight Heparins (LMWHs) in Croatia: Influence of New Clinical Guidelines and Introduction of Oral LMWHs

November 2011

Oral LMWHs medications were introduced into the Croatian drug list in 2009. This study, published in the Croatian Scientific Bibliography, investigated influences of new clinical guidelines for LMWHs therapy and new trends in usage. Drawing on drug utilization data from IMS from 2001-2010, the researchers concluded that usage and financial expenditure of LMWHs in Croatia increased during the investigated period, especially with the introduction of new clinical guidelines for the prevention of thromboembolic incidents. They also noted that the introduction of oral LMWHs could lead to better patient compliance and decrease of thromboembolic incidents and medical costs in the treatment of medical complications.

Reasons for Patient Visit to a Rural General Practitioner (GP) Practice in Kwa-Zulu Natal, South Africa Compared with those in First World Countries

November 2011

Common reasons that patients visit a rural general practitioner (GP) in South Africa may be different to those of GP practices in urban areas and different from patient visits in first world countries. In this study, researchers used IMS Health NDTI data for South Africa to examine the common reasons why patients visited a GP in Kwa-Dukuza, South Africa. They conducted a cross-sectional descriptive survey, from February 1, 2006 to May 30, 2006, recording the reason for each patient encounter, age, sex, payment method (cash or medical aid), presenting symptoms and signs, and clinical assessments. They found that the majority of patients presented with fever, cough and diarrhea, with a substantial number of people visiting the GP practice for administrative reasons, concluding that the common presenting symptoms in Kwa-Zulu Natal were similar to those of patients from a Canadian and British practice.

Do Rheumatoid Arthritis Patients Have Equal Access to Treatment with New Medicines? Tumour Necrosis Factor-alpha Inhibitors Use in Four European countries

November 2011

The prospects of patients receiving biological tumour necrosis factor alpha (TNFalpha) inhibitor treatment depends on the country in which they live. Health researchers used sales data from the Norwegian Institute of Public Health and IMS Health to explore TNFalpha inhibitor usage in the treatment of rheumatoid arthritis. Data from four European countries – Ireland, the Netherlands, Norway and Portugal – were included in the study published in Health Policy. The researchers found that utilization varied widely, concluding that, in order to have uniformity of management and treatment, the extent and the causes of variation should feature prominently on future public health agendas.

Suicide and Prescription Rates of Intranasal Corticosteroids and Nonsedating Antihistamines for Allergic Rhinitis: An Ecological Study

November 2011

The relationship between allergy, allergens and suicidal behavior, and suggestions of a possible immune mediation, led the researchers to hypothesize that intranasal corticosteroids, known to reduce local airway production of T-helper cell type 2 cytokines, may be associated with reduced risk of suicide. Published in the Journal of Clinical Psychiatry, the researchers used country-level allergy and antidepressant data from IMS Health to estimate the relationship between anti-allergy drug prescription rates and suicide across the United States and over time. Their analysis found a possible association between completed suicide and medications for allergic rhinitis and also first reported an association of intranasal corticosteroid use with a lower suicide rate. They concluded that this association should be considered preliminary and deserving of further investigation.

Quantifying Factors for the Success of Stratified Medicine

November 2011

Co-developing a drug with a diagnostic to create a stratified medicine presents challenges for product developers, regulators, payers and clinicians. Researchers sought to develop a shared framework and tools to understand the impact of these challenges; they used several sources, including personalized medicine data from IMS, and modelling from case studies related to oncology and Alzheimer's disease. The study, published in Nature Reviews Drug Discovery, concluded that a stratified medicine development strategy often generates a higher positive net economic value than an all-comers approach and found that three key factors from a stratified medicine approach serve as the most crucial determinants of the potential economic value for a developer: the therapeutic effect, predictive biomarker prevalence and the clinical performance of the companion diagnostic.

HEOR AccessPoint

November 2011

The latest HEOR newsletter features insights into U.S. senior drug costs, the growing need for real-world evidence for medicines, and game-changing drug reform in France.

Real-life Treatment Patterns, Compliance, Persistence, and Medication Costs in Patients with Hypertension in Germany

November 2011

This retrospective patient analysis was initiated to describe current treatment patterns of patients in Germany with arterial hypertension, with a special focus on compliance, persistence, and medication costs of fixed-dose and unfixed combinations of angiotensin receptor blockers (ARBs), amlodipine (AML) and hydrochlorothiazide (HCT). Published in the Journal of Medical Economics, researchers found considerable variations in ARB treatment patterns among patients, with the majority of patients treated with fixed-dose or semi-fixed combination therapy. Fixed-dose combinations of ARBs with HCT and/or AML also appeared to result in better compliance and persistence compared to unfixed regimes of these drug classes, leading to reduction in all-cause hospitalizations and emphasizing the benefit and potential cost-savings of using fixed-dose regimes in Germany. IMS Disease Analyzer was used in the researchers’ analysis.

The Evolving Use of Estrogen and Hormone Therapy: Practical Advice for the Practicing Clinician

November 2011

The use of estrogen and hormone therapy in clinical practice continues to evolve. Published as a roundtable article in OBG Management, a group of leading women’s healthcare experts discussed how clinical practice recommendations are evolving and are applicable to everyday clinical practice. They cited survey data from the IMS National Disease and Therapeutic Index from 2001 to 2009 that found systemic hormone therapy declined each year from 2002 to 2009, while the use of lower-dose and vaginal products showed moderate increases, and standard-dose oral hormone therapy remained the dominant formulation. From their discussion, the women’s health experts concluded that a gap exists between practice recommendations and clinical practice, and special attention should be given to practice habits including dose, route of administration, and analysis of patient risk through the use of care-based prescribing examples.

Patient-reported Outcomes and Different Approaches to Urinary Parameters in Overactive Bladder: What Should We Measure?

October 2011

Overactive bladder represents a serious public health issue. It is a common condition in both men and women, and tends to be under-diagnosed and under-treated, affecting patient health-related quality of life (HRQoL). This article, published in the International Urogynecology Journal, highlights the importance of HRQoL assessments and outlines tools available for use in clinical trials and real-world clinical practice.

Impact of the French Campaign to Reduce Inappropriate Ambulatory Antibiotic Use on the Prescription and Consultation Rates for Respiratory Tract Infections

October 2011

Prescribing rates of certain respiratory tract infections (RTIs) in France is persistently high. Researchers sought to assess the long term trends in the volume of ambulatory antibiotic prescriptions, and prescription and consultation rates, for RTIs in relation to yearly public antibiotic campaigns in France since 2002. They collected representative cohorts of office-based physicians and pharmacies in France from IMS Health panels between 1980 and 2009. Their findings, published in the Journal of Antimicrobial Chemotherapy, concluded that during its first three years, the French public campaign accelerated a pre-existing decrease in ambulatory antibiotic prescriptions. They also found that not all types of RTIs were equally affected with the largest decrease in prescriptions observed for nasopharyngitis and influenza, while rates for bronchitis, sinusitis, otitis media and tonsillitis remained persistently high.

Rationalizing Antibiotic Use to Limit Antibiotic Resistance in India

October 2011

Antibiotic resistance is particularly pressing in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. This report, published in the Indian Journal of Medical Research used IMS prescription data to examine the use of and growing resistance to antibiotics in India. Based on their research, the authors recommend: reducing the need for antibiotics; lowering resistance-enhancing drug pressure through improved antibiotic targeting; and eliminating antibiotic use for growth promotion in agriculture. Additionally, they noted that the highest priority needs to be given to a national surveillance of antibiotic resistance and antibiotic use followed by increasing the use of diagnostic tests and setting up and/or strengthening infection control committees in hospitals, restricting the use of antibiotics for non-therapeutic uses in agriculture.

Pharmacodynamic Evaluation of Commonly Prescribed Oral Antibiotics Against Respiratory Bacterial Pathogens

October 2011

Upper and lower respiratory tract infections (RTIs) account for a significant portion of outpatient antibiotic utilization. Using the IMS National Index of Therapeutics and Diseases data from Brazil, researchers analyzed the most commonly prescribed oral antibiotic regimes, including azithromycin 500mg QD, amoxicillin 500mg TID, and levofloxain 500mg QD, to assess the probability of achieving the requisite pharmacodynamic exposure for antibacterial regimens commonly prescribed for respiratory infections in adults. The findings, published in BMC Infectious Diseases, suggest the need to reconsider empiric antibiotic regimen selection among adults with RTIs. The researchers also noted that this type of study could be used optimize prescribing patterns in certain regions.

The Effect of FDA Advisories on Branded Pharmaceutical Firms' Valuations and Promotion Efforts

October 2011

The US Food and Drug Administration (FDA) expends considerable effort to regulate medications approved for use. Several studies have estimated the magnitude and timing of changes in physician prescribing of drugs following FDA-requested labeling changes and public health advisories (PHAs). In this National Bureau of Economic Research working paper, the authors propose a behavioral framework for examining the effects of PHAs on the stock market valuations of pharmaceutical firms and whether and how firms may respond to PHAs. They conclude that pharmaceutical firms’ market valuations are negatively affected by FDA Medwatch advisory releases targeting patent-protected drugs. They also note that in response to FDA-required labeling changes, firms appear to decrease drug-specific promotion to physicians.

Pharmaceutical Price Convergence in the EU: Preliminary Results from the Panel Data Unit Root Test

October 2011

The European Union (EU) has instituted several structural reforms to increase competition, monitor cross-country price differences and increase transparency within its product markets. Recognizing the importance of price competition and price convergence in the EU pharmaceutical market, the authors used cardiovascular disease-centered pricing data from IMS to examine how market integration affects cross-country drug pricing. The results, published in the Journal of Business and Economics Research, contribute to existing literature on European integration and pharmaceutical price convergence, with long term price differences arising from country fixed effects such as demographics, culture and medicine consumption attitudes.

Generic-to-Branded Drug Switch-back Patterns: Exploratory Analysis and Insights from the Statin Class

October 2011

Generic utilization continues to increase as a total percentage of all dispensed prescriptions. Understanding switch-back patterns from brands to generics by patients and the role of physicians and payers, as well as potential policy implications is of paramount importance. Researchers employed de-identified patient-level data from IMS to analyze generic-to-brand switch-back patterns of statin medications for 17.3 million unique patients over a two-year period. The study, published in the Journal of Pharmaceutical Health Services Research, found that managed care controls play a significant role in encouraging initial brand-to-generic substitution for some classes of patients, and a universal policy approach mandating generic utilization for all patients, particularly when driven on purely cost grounds, is not appropriate.

Oncology Market Research Provides a Feasible Index for Standardization of Colorectal Cancer Chemotherapy

September 2011

There has been an increasing level of interest in the standardization of cancer treatments in Japan, including chemotherapy, as promoted by the Japanese Cancer Control Act in 2007. This research, published in the Japanese Journal of Clinical Oncology, evaluated the standardization of CRC chemotherapy globally, comparing treatment practices before and after the major revisions to colorectal cancer chemotherapy published by the Japanese Society for Cancer of the Colon and Rectum in 2009. The researchers were able to show that the chemotherapy regimens used at cancer centers, university hospitals and general hospitals resembled each other, but that there were large differences among these institutions before the revision of the guidelines. In addition to confirming the change in treatment guidelines had an impact on patient care and drug usage, the research also concluded that oncology market research is a useful tool and has the potential to contribute to the advent of more effective therapy from an oncological and economic perspective.

Patent Replacement and Welfare Gains

September 2011

Published in the Journal of Economic Dynamics and Control, the authors used National Sales Perspectives and National Prescription Audit data to perform simulations of patent replacement and to assess the impacts on welfare and innovation. They concluded that replacing patents with an intertemporal-bounty arrangement has the potential to increase welfare in the United States through reform of pharmaceutical patents by $43.9–$194 billion in present value terms (0.3–1.3% of annual GDP).

Association of Doxycycline Prescriptions and Tick-Related Emergency Department Visits in North Carolina

September 2011

Southern Medical Journal carried this study that utilized Xponent data to compare the seasonal frequency of doxycycline prescriptions with tick-related emergency department (ED) visits in North Carolina. The researchers found that doxycycline prescription use did not always correlate well with suspected tick activity in North Carolina and cannot necessarily be used as a surrogate measure of tick activity for infectious disease surveillance.

Relationship Between Leukotriene-Modifying Agent Prescriptions Dispensed and Rate of Suicide Deaths by County in the U.S.

September 2011

Published in Drug, Healthcare, and Patient Safety, the authors examined the association between leukotriene receptor-modifying agents (LTMA) prescriptions dispensed and suicide deaths, finding a negative within-county association between the rate of total LTMA prescriptions dispensed and the suicide rate by at the county level. The authors used Xponent data to support their research.

Recent Respiratory Infection and Risk of Venous Thromboembolism: Case–control Study through a General Practice Database

September 2011

This article, published in the International Journal of Epidemiology, explored the association between respiratory infection and venous thromboembolism (VTE). The research, which utilized anonymized patient-level information, found more similarities in the epidemiology of VTE and arterial disease, suggesting that planning related to any prophylactic measures should consider thrombotic events as a whole rather than for arterial and venous events separately.

Cost–utility Analysis of Liraglutide Compared with Sulphonylurea or Sitagliptin, All as Add-on to Metformin Monotherapy in Type 2 Diabetes Mellitus

September 2011

Researchers used the CORE Diabetes Model to investigate the cost-effectiveness of liraglutide as add-on to metformin vs. glimepiride or sitagliptin in patients with Type 2 diabetes in the United Kingdom. The research, published in Diabetic Medicine, concluded that Liraglutide, added to metformin monotherapy, is a cost-effective option for the treatment of Type 2 diabetes in a UK setting.

Outpatient Antibiotic Prescribing and Nonsusceptible Streptococcus pneumoniae in the United States, 1996–2003

September 2011

Published in Clinical Infectious Diseases, researchers evaluated the relationship between antibiotic prescribing and nonsusceptibility among invasive pneumococcal disease (IPD) isolates. They concluded that where antibiotic prescribing is high, the proportion of nonsusceptible IPD is also high, suggesting that local prescribing practices contribute to local resistance patterns. Additionally, the researchers noted that antibiotic use is a major factor contributing to the spread of antibiotic resistance and strategies to reduce antibiotic resistance should continue to include judicious use of antibiotics.

Antifungal Management and Resource Use in Patients with Acute Myeloid Leukaemia (AML) after Chemotherapy – Retrospective Analysis of Changes over Three Years in a German Hospital

September 2011

Published in the European Journal of Haematology, researchers performed a retrospective, single center analysis to study changes in costs of managing AML patients hospitalized for chemotherapy, neutropenia and infections after myelosuppressive chemotherapy, with a special focus on prophylaxis and treatment patterns as well as resource use related to invasive fungal infections (IFI), from January 2004 to December 2006 in Germany. Their analysis demonstrated a change in antifungal management of AML patients between 2004/5 and 2006, accompanied by a decline in total costs.

Estimating Effect of Antiviral Drug Use during Pandemic (H1N1) 2009 Outbreak, United States

September 2011

Published in the CDC journal, Emerging Infectious Diseases, the researchers used prescription data to explore health outcomes in the use of antiviral medicines during the 2009 H1N1 influenza pandemic. They found that nearly 10,000 influenza-related hospitalizations were prevented by these drugs, largely due to CDC’s coordination in getting treatment to those who were clinically ill, and which likely prevented clinical cases from deteriorating into severe cases requiring hospitalizations.

A Systematic Review of Patient-Reported and Economic Outcomes: Value to Stakeholders in the Decision-Making Process in Patients With Type 2 Diabetes Mellitus

August 2011

This study, published in Clinical Therapeutics, assessed healthcare outcomes, patient-reported outcomes, and economic outcomes in terms of validity and appropriateness to healthcare decision-making in type 2 diabetes mellitus (T2DM). It concluded that the need to incorporate patient and payer perspectives in measuring health results has generated a large and heterogeneous group of healthcare outcomes. However, a critical percentage in T2DM have not been adequately validated and not enough evidence has been found to support their systematic use.

Work and Productivity Loss Related to Herpes Zoster

August 2011

The authors’ estimated absenteeism and presenteeism –related work loss due to herpes zoster (HZ) among workers from 50 to 64 years of age in this study published in the Journal of Medical Economics. They documented a substantial social burden of HZ-related work and productivity loss.

The Burden of Moderate/Severe Premenstrual Syndrome and Premenstrual Dysphoric Disorder in a Cohort of Latin American Women

August 2011

Published in Value in Health, researchers investigated the relationship between symptom severity, cost, and impairment in women with moderate/severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) in Latin America. While the analysis showed the relationship between cost, quality of life, and severity to be unclear, it did show a consistent relationship between disease severity and measures of disease burden, suggesting a significant burden and an increasing impairment associated with moderate/severe PMS and PMDD.

The Level of Income Appears to Have No Consistent Bearing on Pharmaceutical Prices Across Countries

August 2011

Published in Health Affairs, this study sought to determine whether pharmaceutical prices varied systematically with income comparing average prices in fourteen middle-income countries to three high-income countries (France, the United Kingdom, and the United States) and a low-income region in western Africa, from 1999 through 2008. The researchers found that pricing does not appear to have been systematically related to income, suggesting that these variations my illustrate the need for new policies on pharmaceutical pricing to improve access to medicines globally.

Prices of Pharmaceuticals in Poor Countries are Much Lower than in Wealthy Countries

August 2011

The authors addressed the issue of affordability of medicines in developing countries and reported their empirical findings from a study of drug prices in twenty-nine countries between 2007 and 2007 in this Health Affairs article. Using data from IMS Health, the researchers’ analyses show that drug prices tend to track per capita national income levels within the drug categories studied and the average price differences between industrialized and middle-income countries are largely due to higher drug prices in the United States.

Economic Perspectives on the Advance Market Commitment for Pneumococcal Vaccines

August 2011

Providing a preliminary economic analysis of a pilot advance market commitment program for pneumococcal vaccines announced in 2007, this Health Affairs article included an empirical analysis for delivering a preliminary assessment of the pilot program. The authors compared the rollout of the vaccines supported by the program in countries eligible for GAVI’s (Global Alliance for Vaccines and Immunizations) assistance to the rollout of earlier-generation pneumococcal vaccines and found that making the program’s terms more generous, thereby increasing the supply of vaccines in developing countries, generated large social gains. The authors used IMS MIDAS data in their research.

National Trends in Ambulatory Asthma Treatment,
1997-2009

July 2011

Despite reductions in morbidity and mortality, little is known regarding changes in asthma treatment patterns. Published in the Journal of General Internal Medicine, this study examined national trends in office-based treatment of asthma in patients less than 50 years of age between 1997 and 2009. The researchers concluded that changes in office-based treatment, including increased inhaled steroid use and increased combined steroid/long-acting β2-agonist use coincide with reductions in asthma morbidity and mortality.

Medicare Part D at Age Five: What Has Happened to Seniors’ Prescription Drug Prices?

July 2011

We examined the magnitude and causes of change in the average cost of therapy over the first five years of the Medicare Part D program, illustrating how cost containment mechanisms in the program have led to significantly lower costs than originally projected.

Healthcare Costs Associated with Treatment Modification in Type 2 Diabetes Mellitus Patients Taking Oral Anti-diabetic Drugs

June 2011

Managed Care published this retrospective study comparing healthcare costs among patients with type 2 diabetes mellitus who added a new oral anti-diabetes drug (OAD) to their initial regimen. The research concludes that while the addition of another OAD may result in higher medication costs, the lower inpatient costs and overall offset in subsequent total costs may have clinical benefits with the add-on treatment.

Community Antibiotic Consumption in Chile, 2000-2008

June 2011

The authors performed a retrospective analysis to study the impact of established regulatory measures related to the consumption of antibiotics in Chile. Their research determined that, from 2000 to 2002, the regulatory measures had an impact; however, since 2002 antibiotic consumption had increased, especially for amoxicillin, returning to similar levels observed in 1998. IMS Health pharmacy data was used to perform this analysis.

Pharmaceutical Pricing in Emerging Markets: Effects of Income, Competition and Procurement

June 2011

Large variations in ex-manufacturer prices for originator and generic drugs across countries is of broad interest, but somewhat misunderstood. This study analyzed determinants of ex-manufacturer prices for originator and generic drugs across a large sample of countries. They authors examined the effects of per capita income, income dispersion, number and type of therapeutic and generic competitors, and distribution to retail pharmacies vs. tendered procurement by NGOs. They concluded that drugs are least affordable relative to income in the lowest income countries; the number of therapeutic and generic competitors only weakly affects prices to retail pharmacies; and tendered procurement attracts multi-national generic suppliers, significantly reducing prices for originators and generics, compared to prices to retail pharmacies.

Are We Giving Patients Enough Information on How to Use Topical Treatments? Analysis of 767 Prescriptions in Psoriasis

June 2011

The British Journal of Dermatology published a recently released study that analyzed the quality of topical therapy prescriptions in psoriasis to determine factors associated with high-quality prescription writing. The authors concluded that almost two thirds of topical prescriptions are not adequately written, and do not include the required information to help patients to correctly manage their topical treatment in psoriasis.

Drug Utilization Patterns and Reported Health Status in Ethnic German Migrants (Aussiedler) in Germany: A Cross-sectional Study

June 2011

In this study published in BMC Public Health, the authors investigated aspects of the current health status, main health risk factors, and drug consumption patterns of ethnic German migrants living in Germany in comparison to the native German population. They concluded that Ethnic German migrants seem to differ only slightly from Germans in health status, drug utilization, and disease risk factors.

New Signals for Liraglutide, Quetiapine and Varenicline

May 2011

The authors used National Prescription Audit™ data to describe the number of outpatient dispensed prescriptions for medications commonly used to treat Type 2 Diabetes in 2010. Also, by using QuarterWatch™, an independent publication that monitors all domestic, serious adverse drug events reported to the FDA, they evaluated the rates of adverse events associated with the number of dispensed prescriptions. The researchers found an increase in adverse reports from manufacturers (+33%) but a decrease from healthcare professionals (-17%) in addition to a 1.3% increase in outpatient dispensed prescriptions.

The Global Use of Medicines: Outlook Through 2015

May 2011

The future level of global spending on medicines has implications for healthcare systems and policy makers across developed and emerging economies. In this newest report, we examine the spending and usage of medicines in 2015.

HEOR AccessPoint Report

May 2011

In the latest issue of ACCESSPOINT, IMS HEOR experts provide insights to the latest U.S. healthcare reforms, market access changes in Germany, HTA convergence, and other pivotal dynamics driving change, challenge and potential for health and economics outcomes research.

Cost-effectiveness of Liraglutide versus Rosiglitazone, Both in Combination with Glimepiride in Treatment of Type 2 Diabetes in the U.S.

May 2011

IMS and Novo Nordisk researchers published this study in Current Medical Research and Opinion to estimate the cost-effectiveness of a once-daily GLP-1 analog Victoza [Novo Nordisk] versus a thiazolidinedione (TZD), rosiglitazone in patients with Type 2 Diabetes.

Size and Usage Patterns of Private TB Drug Markets in the High Burden Markets

May 2011

The TB Alliance and the Bill and Melinda Gates Foundation partnered with IMS on this published study, which concludes that the expansion of diagnosis and treatment in the public sector could have a greater impact in strengthening TB treatment outcomes.

The Use of Medicines in the United States: Review of 2010

April 2011

Last year reinforced the slowing growth trends of the previous decade in spending and the use of medicines in the United States. In this newest report, we detail these trends and put 2010 into context for healthcare decision makers.

Does Pay for Performance Improve Cardiovascular Care in a “Real-World” Setting?

April 2011

This research, published in the American Journal of Medical Quality, examines the impact of a pay-for-performance program (P4P) on quality care and outcomes among cardiovascular disease (CVD) patients.

Use of Fibrates in the United States and Canada

March 2011

Published in the Journal of the American Medical Association (JAMA), this population-level, observational cohort study uses data from IMS to examine trends in the current use of fibrates, and the relationship and use of brand-name versus generic formulations of fenofibrate, and the economic implications in the United States and Canada.

Basal Supported Oral Therapy with Insulin Glargine Results in Longer Persistence and Lower Costs Compared with Insulin Detemir in Type 2 Diabetics in Germany

February 2011

Health Outcomes Research in Medicine published this study investigating the persistence of basal supported oral therapy (BOT) with either insulin glargine (GLA) or insulin detemir (DET) in Type 2 diabetics.

Evaluation of the Long-term Cost-effectiveness of Insulin Detemir Compared with Neutral Protamine Hagedorn Insulin in Patients with Type 1 Diabetes using a Basal-bolus Regimen in Sweden

February 2011

Published in the Scandinavian Journal of Public Health, this study evaluates the long-term clinical and economic outcomes associated with insulin detemir and neutral protamine hagedorn (NPH) insulin in combination with mealtime insulin aspart in patients with Type 1 diabetes in Sweden.

Risk of Cardiovascular Disease Events in Patients With Type 2 Diabetes Prescribed the Glucagon-Like Peptide 1 (GLP-1) Receptor Agonist Exenatide Twice Daily or Other Glucose-Lowering Therapies: A Retrospective Analysis of the LifeLink Database

January 2011

Published research in DiabetesCare tests the hypothesis that exenatide twice-daily reduces the relative incidence of cardiovascular disease (CVD) events among patients with type 2 diabetes compared with other glucose-lowering agent(s), concluding twice-daily treatment was associated with a lower risk of CVD events and hospitalizations than treatment with other glucose-lowering therapies.

Trends in Antibiotic Utilization in Eight Latin American Countries, 1997–2007

December 2010

Resistance to antibiotics is an important public health problem that can lead to treatment failures and the increased empirical use of more costly broad-spectrum antibiotics. Published Rev Panam Salud Publica, this research analyzed retail sales data for oral and injectable antibiotics between 1997 and 2007 for Argentina, Brazil, Chile, Colombia, Mexico, Peru, Uruguay and Venezuela to measure antibiotic utilization rates and trends. The researchers concluded that there was substantial variation and increase in antibiotic consumption between 1997 and 2007 of escalating antibiotic resistance among these Latin American countries fueled by a combination of forces.

GRAND: The German Retrospective Cohort Analysis on Compliance and Persistence and The Associated Risk of Fractures in Osteoporotic Women Treated with Oral Bisphosphonates

January 2011

Osteoporosis International published this analysis of over 4,000 German women prescribed oral bisphosphonates between December 2004 and November 2007 to demonstrate that compliance and persistence with oral bisphosphonates in German women with osteoporosis were inadequate.

HEOR AccessPoint Report

November 2010

ACCESSPOINT, IMS Health Economics and Outcomes Research (HEOR) twice-yearly publication features news, views and insights from IMS experts.

Management and Outcomes in the Acute Heart Failure Global Survey

November 2010

Published in the Journal of Intensive Care, this study examines AHF (Acute Heart Failure), and specifically the outcome differences between de novo AHF (first occurrence) vs. patients with pre-existing AHF.

Drug Therapies for Parkinson's Disease: Patient Compliance & Persistence

August 2010

Based on a retrospective longitudinal patient-level data analysis, this study evaluates Parkinson's disease patient compliance and persistence by drug therapy.

Characterizing Markets for Biopharmaceutical Innovations

August 2010

IMS’s Murray Aitken joins with Massachusetts Institute of Technology researchers Ernst Berndt and Mark Trusheim to explore the distinction between biologics and small molecules.

Risk of Serious Cardiac Events in Older Adults Using Antipsychotic Agents

April 2010

Published in the American Journal of Geriatric Pharmacotherapy, the authors compared the risk of cardiac events in those taking atypical versus typical antipsychotics on adults older than 50 years of age and receiving antipsychotic medication from July 2011 through December 2007. They found comparable rates of serious cardiac events for each group; 11.9% in those using atypical antipsychotics and 12.4% in those using typical antipsychotics. However, using survival analyses, there was an increased risk of serious cardiovascular events for those taking typical agents. The LifeLink™ Health Plan Claims Database was used in this analysis.

Cost Effectiveness of Pregabalin in Treatment of Fibromyalgia (UK)

April 2010

Published in Current Medical Research and Opinion, this study evaluated the cost effectiveness of pregabalin in the treatment of fibromyalgia, concluding that pregabalin 300 mg and 450 mg to be cost effective compared with placebo and, within the limits of available evidence, against duloxetine using standard UK criteria in patients with fibromyalgia experiencing severe pain.

The Pharmerging Shake-up: New Imperatives in a Redefined World

March 2010

IMS's white paper offers new perspective on the pharmerging markets.

Cost-Effectiveness of Switching to Biphasic Insulin Aspart from Human Premix Insulin in a U.S. Setting

March 2010

The Journal of Medical Economics examines the cost-effectiveness of switching to Biphasic insulin as part from human premix insulin in the United States.

Validation of the Atrial Fibrillation Quality of Life Questionnaire

January 2010

Europace Advance Access examines the validation of the AF-QoL, a disease-specific quality of life questionnaire for patients with atrial fibrillation.

The Cost and Effectiveness of Adherence - Improving Interventions for Antihypertensive and Lipid-Lowering Drugs

January 2010

The International Journal of Clinical Practice publishes an IMS original paper about the cost and effectiveness of adherence-improving interventions for antihypertensive and lipid-lowering drugs.

Changing the Channel

December 2009

This IMS published white paper delivers keen insights into how specialty pharmaceutical products are dominating pipelines and the changes needed to support their rapid growth.

Sowing the Seeds of a Blockbuster Launch in China

July 2009

Drivers for a successful product launch in China is covered in this IMS white paper, which also includes a case study on Baraclude's gold standard launch in hepatitis C.

Dementia Care Initiative in Primary Practice – Study Protocol of a Cluster Randomized Trial on Dementia Management in a General Practice Setting

June 2009

Published in BioMed Central, this study compared complex intervention for dementia patients against usual care in terms of time to nursing home placement.

Prevalence of COPD in Spain: Impact of Undiagnosed COPD on Quality of Life and Daily Life Activites

June 2009

One of the world’s leading respiratory journals – Thorax – published this study aimed at determining the prevalence of COPD in Spain and, if undiagnosed, its impact on the patient’s quality of life.

Cost-Effectiveness of Stroke Unit Care Followed by Early Supported Discharge

November 2008

This study, published in Stroke, examined the significant burden that stroke places on the economy in England and Wales, concluding that both stroke units and early supported discharge is both an effective and cost-effective strategy with gains in years of life saved.

Using Triple Antiplatelet Therapy in Patients with Non-ST Elevation Acute Coronary Syndrome Managed Invasively: A Cost-Effectiveness Analysis

September 2008

The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) published this study assessing the incremental cost-effectiveness ratio of glycoprotein IIb/IIIa inhibitors in patients in Value in Health.

The Economic Impact of Overactive Bladder Syndrome in Six Western Countries

June 2008

The costs of illness for OAB is a substantial economic and human burden.  This study, published in the British Journal of Urology International, examined cost-effective treatments and management strategies that can reduce the burden of OAB.