Download real-world research and value

+
catalysts driving
successful decisions
in life sciences
real-world
research
and value
insights from ispor
international
JUNE 2016
real-world research and value
introduction
As the healthcare market evolves it’s more crucial than ever to be able to provide evidence
of your product’s value. Kantar Health has a long-standing track record of generating
evidence for our clients to maximize the value of products in all stages of the lifecycle.
it’s more crucial
than ever to
provide evidence
of your product’s
value.
We understand the importance of value story creation. With a unique combination of
broad, global, scientific expertise, backed by operational infrastructure, we fully execute
all fieldwork and analyze, publish and communicate all of the data we generate. In total,
our team has produced more than 1,500 publications in well-known scientific journals and
conferences, adding more than 100 publications in 2015 alone. We invite you to explore our
most recent research and look forward to your thoughts.
Our real-world evidence and market access team recently presented more than 20
presentations at the ISPOR 21st Annual International Meeting, including research utilizing
mHealth. We invite you to explore our most recent research and look forward to your
thoughts.
VALUE
IDENTIFICATION
© 2016 Kantar Health
www.kantarhealth.com
VALUE
QUANTIFICATION
VALUE
COMMUNICATION
2
real-world research and value
contents
CONTENTS
featured research
Predictors of Intentional and Unintentional Non-Adherence and
Associated Health Utilities Among Women Receiving Oral Treatments
for Breast Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The Real-World Pain Experience of Adults with Rheumatoid
Arthritis Using a Mobile Survey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
The Incremental Effect of Over-the-Counter Medications on Work
Productivity and Healthcare Resource Utilization Among Adults
with Pain in the United States. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
recent publications
Therapeutic focus
Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Dermatologic Conditions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Healthcare Use and Policy Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Infectious Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Metabolic Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Muscular-Skeletal Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Neurological Conditions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Sensory System Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
© 2016 Kantar Health
www.kantarhealth.com
3
real-world research and value
Predictors of Intentional and Unintentional Non-Adherence
and Associated Health Utilities Among Women Receiving Oral
Treatments for Breast Cancer
amir goren, phd
Director, Health
Outcomes Research
shaloo gupta, MS
Manager, Health
Outcomes Research
lulu lee, phd
Manager, Health
Outcomes Research
non-adherence
was found to be
associated with
age, with younger
patients being
more likely to be
non-adherent
than older
patients.
© 2016 Kantar Health
The breast cancer (BC) market is seeing an increase in survivorship. To maintain longterm survival and prevent recurrence, adjuvant endocrine therapy (ET) is essential.
Despite the importance of this therapy, many patients are non-adherent. In order to
address this we explored predictors of unintentional non-adherence (UNA), such as
forgetting to take medication, and intentional non-adherence (INA), such as not filling
medications or deliberately skipping doses, in women receiving oral BC treatments.
Data from the 2010-2015 U.S. National Health and Wellness Survey (NHWS) were used
to evaluate the demographics and lifestyle behaviors of BC patients receiving adjuvant or
metastatic oral therapies, as well as their health outcomes and quality of life (QoL, using
Short-Form-6D health utilities (SF-6D)). Using the Morisky Medication Adherence Scale
(MMAS) equivalent items from MMAS-4 and MMAS-8, we calculated scores to evaluate
INA and UNA.
Of BC patients surveyed, 6.0% reported INA, 22.4% reported UNA, and 3.2% reported
both INA and UNA. Our research shows that those reporting INA were more likely to
be younger, have normal BMI and have an income of $25,000 or less per year. Those
reporting UNA were more likely to report lower rates of exercise and higher rates of
smoking, and be obese and of non-white ethnicity. Non-adherence was found to be
associated with age, with younger patients being more likely to be non-adherent than
older patients, both intentionally and unintentionally. We also found that patients who are
non-adherent (both INA and UNA), have significantly lower health utility scores than those
who are adherent.
Understanding the factors that contribute to non-adherence in breast cancer, including
obesity, smoking and living a sedentary lifestyle, helps identify opportunities for targeted
interventions, potentially improving outcomes and survivorship for at-risk populations.
To read more about the study, see our research presentation, which was presented at the
ISPOR 21st Annual International Meeting.
REFERENCES:
1.
Morisky et al. Med Care. 1986;24:67-74.
2.
Morisky et al. J Clin Hypertens. 2008;10(5):348-354.
www.kantarhealth.com
4
real-world research and value
The Real-World Pain Experience of Adults with Rheumatoid
Arthritis Using a Mobile Survey
dave pomerantz
Senior Vice President
brian mondry
Global Head of Digital
Innovation
Our mobile survey
app allowed us
to evaluate the
ebbs and flows of
patients’ symptom
experience.
Rheumatoid arthritis (RA) is associated with disability, decreased quality of life (QoL) and
high societal burden. The condition is highly symptomatic, with pain being one of the
most commonly experienced symptoms. Despite the significant impact that RA poses
to patients and society, few studies have been published on how the condition affects
patients’ day-to-day lives. To explore this, we used a mobile survey application to evaluate
patients’ experience living with chronic pain in a real-world setting.
To understand how disease affects patients’ lives not only at the clinical but emotional,
quality-of-life level, we utilized our mobile survey app to deploy daily surveys to patients
with RA who participated in a seven-day pain diary study. The survey allowed us to collect
quantitative data, such as comorbidities and treatment, as well as questions related to the
McGill Pain Questionnaire to rate their daily experience relating to 15 pain dimensions and
pain intensity levels. Patients were also able to upload pictures with descriptive captions
to further convey how they lived with chronic pain.
Our study found that the most commonly experienced comorbidities were insomnia,
anxiety and depression. To evaluate how these comorbidities related to patients’ pain
experience, each dimension of pain was correlated by comorbidity and the level of
pain intensity. We found that patients who described pain as “stabbing” were likely to
experience anxiety and depression. We also found that those who described pain as
“punishing” were likely to experience pain of greater intensity.
This longitudinal, mobile-centric study allowed us to evaluate changes in patients’
experience over time versus at only one point, and how the ebbs and flows of their
symptom experience affected their day-to-day lives and functioning. Understanding
which dimensions of pain are most strongly associated with pain experience and health
outcomes provides the insight needed to help inform disease management.
To read more about the study, see our research poster, which was presented at the ISPOR
21st Annual International Meeting.
© 2016 Kantar Health
www.kantarhealth.com
5
real-world research and value
The incremental effect of over-the-counter medications on
work productivity and healthcare resource utilization among
adults with pain in the united states
ian kudel, phd
Manager, Health
Outcomes Research
82% of patients
using otc
medications
to treat their
pain symptoms
do so without
consulting a
healthcare
provider.
Analgesics are the most commonly used over-the-counter (OTC) medications. Eighty-two
percent of patients using OTC medications to treat their pain symptoms do so without
consulting a healthcare provider. Pain is a highly prevalent and symptomatic condition and
is associated with significant work productivity loss. With increased OTC options available
to treat consumers’ pain symptoms, we sought to evaluate how the widespread use of
these medications affected work productivity and healthcare resource use (HCRU).
Participants in the 2013 U.S. National Health and Wellness Survey (NHWS) who reported
experiencing pain in the previous 12 months were categorized into four groups: those
who took no medication (untreated), those who used just an OTC (OTC only), those who
used just a prescription medication (Rx), and those who used a combination of OTC and
prescription medication (OTC+Rx). Their responses were compared across two sets of
measures: work productivity (Work Productivity and Activity Impairment questionnaire)
and self-reported HCRU.
The OTC-only group had significantly lower rates of presenteeism, overall work
impairment and activity impairment compared with the untreated group. Additionally,
the OTC+Rx group had lower activity impairment than those taking a a prescription only.
Comparisons of HCRU found that the OTC-only group reported fewer hospitalizations
than the untreated group and that the OTC-only group reported fewer provider visits,
hospitalizations and ER visits than the OTC+Rx group.
These results may be attributed to OTC analgesics helping reduce pain symptoms, thus
improving work productivity and reducing HCRU among U.S. adults experiencing pain.
This study was sponsored by Pfizer, Inc.
To read more about the study, see our research poster, which was presented at the ISPOR
21st Annual International Meeting.
REFERENCES:
1.
US Food and Drug Administration. Prescription to over-the-counter (OTC) switch list. Available
at: http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/
ucm106378.htm. Accessed: April 12, 2016.
2.
Consumer Healthcare Products Association. The value of OTC medicine to the United States.
Available at: http://www.chpa.org/OTCValue.aspx. Accessed: April 12, 2016
3.Consumer Healthcare Products Association. Your health at hand: perceptions of over-thecounter medicine in the U.S. Available at: http://www.yourhealthathand.org/images/uploads/
CHPA_YHH_Survey_062011.pdf. Accessed: April 12, 2016.
4.Lerner D, Rogers WH, Chang H, et al. The health care and productivity costs of back and
neck pain in a multi-employer sample of utility industry employees. J Occup Environ Med.
2015;57(1):32-43.
5. Consumer Healthcare Products Association. Understanding trust in OTC medicines: consumer
and healthcare provider perspectives. Available at: http://www.yourhealthathand.org/images/
uploads/CHPA_OTC_Trust_Survey_White_Paper.pdf. Accessed: April 12, 2016.
6. Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and
activity impairment instrument. Pharmacoeconomics. 1993;4(5):353-365.
© 2016 Kantar Health
www.kantarhealth.com
6
real-world research and value
recent
publications
Cancer
++ Government Reimbursement Values Versus Real Chemotherapy Costs in the Brazilian
Public Healthcare System: Another Barrier to Treatment Access?
Lemmer T, Goes L, Piedade AD
++ Predictors of Intentional and Unintentional Non-Adherence and Associated Health
Utilities Among Women Receiving Oral Treatments for Breast Cancer
Goren A, Gupta S, Lee L, Kuang-Yi W, Geynisman D
++ Intra-Operative Anastomotic Leak Rates and Testing Methodology in Colon Resection
Surgery
Schiff A, Roy S, Ghosh SK, Fegelman E, Pignot M
++ Retrospective Chart Review Study to Evaluate the Cost of Care of Patients with
Symptomatic Multiple Myeloma in France
Gonzalez-McQuire S, Yong K, Leleu H, Flinois A, Gazzola C, Schoen P, Campioni M,
DeCosta L, Fink L
++ Retrospective Chart Review Study to Evaluate Healthcare Resource Utilization in
Patients with Symptomatic Multiple Myeloma in Italy
Gonzalez-McQuire S, Yong K, Flinois A, Gazzola C, Schoen P, Mennini FS, Campioni M,
DeCosta L, Fink L
++ Chart Review Study to Evaluate Healthcare Resource Utilization of Patients with
Symptomatic Multiple Myeloma in the United Kingdom
Gonzalez-McQuire S, Yong K, Flinois A, Gazzola C, Schoen P, Campioni M, DeCosta L,
Fink L
DERMATOLOGIC CONDITIONS
++ The Burden of Atopic Dermatitis in Adults: Results from the 2013 United States
National Health and Wellness Survey (NHWS)
Whiteley J, Emir B, Seitzman R, Makinson G
Healthcare use and policy studies
++ The Incremental Effect of Over-the-Counter Medications on Work Productivity and
Healthcare Resource Utilization Among Adults with Pain in the United States
Lee LJ, Kudel I, Schepart AL, Kellstein D
++ Patient Safety: An Overview of the Hospital Accreditation Process in Brazil
Bueno CC, Alves AF, Retamero A, Castro AP, Clark LH, Clark OA
++ Improving Patient Safety Through Communication: A Brazilian Perspective
Bueno CC, Almeida PR, Clark LG, Clark OA
++ Caregiver Burden in the United States Workforce: Healthcare Resource Utilization and
Quality of Life
Reimers Iadeluca L, Hopps M, Raghunath R, McDonald M, Makinson G
© 2016 Kantar Health
www.kantarhealth.com
7
real-world research and value
Infectious Disease
++ Economic Impact of Dengue on Tourism in Brazil
Nishikawa AM, Clark OA, Genovez V, Pinho A, Durand L
++ Public Health and Economic Impact of a Quadrivalent Influenza Vaccine in Comparison
to the Trivalent Influenza Vaccine in Brazil over the Period of 2010-2013
Bricks L, Lopez JG, Macabeo B, Piedade AD, Clark OA, Nishikawa AM, Bottoni A,
Gonclaves T
Metabolic Conditions
++ Cost Analysis of Insulin Degludec in Comparison with Insulin Glargine U100 in the
Treatment of Type 1 Diabetes Mellitus in the Brazilian Private Healthcare System
Piedade AD, Paladini L, Alves JS, Gonclaves Td, Griciunas F
++ Cost Analysis of Insulin Degludec in Comparison with Insulin Glargine U100 in the
Treatment of Type 1 Diabetes Mellitus in the Brazilian Public Healthcare System
Piedade AD, Paladini L, Alves JS, Gonclaves Td, Griciunas F
++ Prevalence and Health Outcomes Associated with Types of Diabetes Complications
Goren A, Strader C
Methods
++ Application of Item Response Theory in Validating the Patient Health Questionnaire
(PHQ-9) in the American General Population
Gupta S, Witt E
++ Determining Whether Three Methods of Scoring a Patient-Reported Outcome
Instrument Differentially Impacts Associations with Various Predictors
Kudel I
Muscular-Skeletal Disorders
++ The Real-World Experience of Adults with Rheumatoid Arthritis Using a Mobile Survey
Pomerantz D, Mondry B
neurological Disorders
++ Examining the Association Between Epilepsy Seizure Frequency and Health Economics
Outcomes among Caregivers
Helmers SL, Gupta S, Knoth R
++ The Burden of Multiple Sclerosis in Japan
Yamabe K, Witt EA
Sensory System Disorders
++ Incremental Burden of Cardiovascular Comorbidity or Psoriatic Arthritis Among
Individuals with Moderate to Severe Psoriasis
Augustin M, Tian H, Gilloteau I, Mollon P, Vietri J
© 2016 Kantar Health
www.kantarhealth.com
8
real-world research and value
real-world
research
and value
Advancing Healthcare and Driving Better Patient Outcomes
Kantar Health is a world-class evidence specialist with the most comprehensive
databases across the globe. Whether your need originates from market access, medical
affairs or health economics and outcomes research, we can help you with:
++ Value Strategies
++ Strategic Market Access
++ Pricing and Reimbursement
++ Health Economics and Outcomes Research (HEOR)
++ Patient-Reported Outcomes
++ Observational Studies and Registries
++ Phase IV Studies
++ Post-Authorization Safety and Efficacy Studies (PASS/PAES)
++ Risk Management and Pharmacoepidemiology
++ Systematic Literature Reviews
++ Real-World Evidence Proprietary Databases
© 2016 Kantar Health
www.kantarhealth.com
9
real-world research and value
why
kantar
health
Kantar Health is a leading global healthcare consulting firm and trusted advisor to
many of the world’s leading pharmaceutical, biotech and medical device and diagnostic
companies. It combines evidence-based research capabilities with deep scientific,
therapeutic and clinical knowledge, commercial development know-how, and brand and
marketing expertise to help clients evaluate opportunities, launch products and maintain
brand and market leadership.
Kantar Health deeply understands the influence of patients, payers and physicians,
especially as they relate to the performance and payment of medicines and the delivery of
healthcare services. Our advisory services, built on a solid foundation of market research
and data, span three areas critical to bringing new medicines and pharmaceutical
products to market – commercial development, clinical strategies and marketing
effectiveness.
Kantar Health operates in more than 40 countries and employs more than 600 healthcare
industry specialists and practitioners, including a high number of medical doctors,
epidemiologists, PhDs, PharmDs and pharmacists, and biologists, biochemists and
biophysicists. We work across the product lifecycle, from preclinical development to
launch, and are experts at bringing multiple stakeholders together to advance the
commercialization of pharmaceutical products. Our team acts as catalysts to successful
decision making in the life sciences industry, helping our clients prioritize their product
development and portfolio activities, differentiate their brands and drive product success
post-launch. Kantar Health is part of Kantar, the data investment management division of
WPP.
If you would like us to act as catalysts for you, contact us at www.kantarhealth.com/
contactus.
© 2016 Kantar Health
www.kantarhealth.com
10