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Highlighted Studies

A real-world study of immunoglobulin (IG) reveals multiple cost-saving opportunities 

Hub Domain(s): Immunology, oncology, costs of care, IngenioRx, policy guidance
Summary: 

  • Background: Immunoglobulins (IG) are costly blood-derived products accounting for more than $500m in annual spending in the Anthem membership
  • Methods: HealthCore examined IG utilization using claims data to evaluate appropriateness of use, the extent of site-of-care optimization and non-preferred IG use.
  • Results: The findings revealed significant off-label use of IGs (30%), including 22% for indications that were neither approved by FDA nor covered by Anthem, but were accepted by other health plans; and 8% for indications that were neither approved by FDA nor covered by any health plan
    • Additionally, 25% of the IG use was observed in the most expensive site of administration of hospital outpatient (HOPD) and non-preferred IG use accounted for 71% of the total IG use
  • Key Takeaways: Examining the IG uses from various dimensions presents several opportunities to IngenioRx and Anthem:
    • Reducing off-label IG use represented an estimated $27.8m annual savings opportunity
    • Shifting IG utilization from HOPD to a less expensive site of care could drive a further estimated $6.3m in annual savings
    • The study also identified opportunities to increase the share of preferred IG products used by our patients.


Major depressive disorder (MDD) patients highly impacted by COVID-19 face daunting challenges

Hub Domain(s): COVID, member experience
Summary: 

  • Background: Disruption to daily life and lockdown measures that were imposed in an attempt to contain the spread of COVID-19 presented new hurdles for at-risk populations, such as patients with major depressive disorder (MDD)
  • Methods: Conducted a 2020 internet survey to understand reasons for antidepressant continuation, switching and discontinuation in patients with MDD; COVID-19 pandemic questions were developed and added to survey.
    • COVID-19 Pandemic Impact (CPI) score was calculated and, based on their CPI scores, patients were categorized as experiencing low (LPI), medium (MPI) or high pandemic impact (HPI).
  • Results: Compared with LPI and MPI patients, HPI patients reported:
    • Significantly more problems accessing healthcare; few reported not having health insurance benefits due to loss of/reduced health insurance coverage (Figure 1).
    • More challenges obtaining depression prescription medications in terms of:
      • Filling new/current prescription(s)
      • Receiving samples from healthcare providers
      • Paying for prescription(s) due to loss of/reduced health insurance coverage and/or pharmacy benefits
    • Since start of COVID-19 pandemic engaged in significantly more:
      • Alcohol, drug, and tobacco use
      • Unhealthy mindless eating
      • Sedentary behavior
  • Key Takeaways: Our findings are consistent with literature showing that traumatic events, e.g. pandemics, can negatively impact health behaviors.
    • More research is needed to explore the COVID-19 impact in other patient populations.
    • Education opportunities exist for health plans to increase awareness among providers and patients of possible short and long-term COVID-19 effects on health behaviors.

Figure 1: Impact of COVID-19 pandemic on accessing healthcare/mental healthcare

  • Publications: Poster presented at the Virtual American Society of Clinical Psychopharmacology (ASCP) Annual Meeting, June 1-4, 2021

Major depressive disorder (MDD) patients highly impacted by COVID-19 face daunting challenges

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Teams at Carelon Research

The clinical research team at Carelon Research coordinates and conducts a broad range of clinical trials and registries – from small studies focused on rare and orphan diseases to large studies of complex and chronic conditions. We work with projects across the research spectrum, including life sciences, biotech, medical device, diagnostics, the government (National Institutes of Health, CDC, etc.) and academic institutions. For more information, visit our clinical research page.
The business development and marketing and communications experts at Carelon Research work with external clients and internal subject matter experts to develop a variety of research projects and disseminate results via conferences and digital marketing platforms including email and social media.
The HEOR team at Carelon Research develops study designs, translates value stories, and facilitates payer collaborations. Our researchers generate evidence of the real-world value of biomedical products and translate that evidence into actionable information for stakeholders. For more information, visit our health economics and outcomes research page.
The research operations team at Carelon Research focuses on improving the efficiency, effectiveness, and profitability of business performance and operations. The team includes the project and program management team, operational leaders focused on ensuring program/project goals are met according to plan, schedule, and scope; the data management team, specializing in the application of techniques to access, collect, integrate, cleanse, govern, store, and prepare data for analytics and ensures the body of data at Carelon Research is accurate and consistent, accessible, and properly secured; and the data analytics team of biostatisticians and analysts provide advanced analytic expertise and programming capabilities to lead and support the company’s scientific portfolio of database and clinical research.
The safety & epidemiology research team at Carelon Research uncovers vital evidence on the utilization, safety, and effectiveness of biopharmaceuticals and devices in large, real-world patient populations. Our researchers provide a broad range of expertise and operational experience to the timely and accurate execution of epidemiologic studies in the pre- and post-marketing settings. For more information, visit our safety and epidemiology research page.