Acute Coronary Syndromes (ACS) often occurs in working-age individuals. Limited data exist on the burden of ACS on employees. We attempted to determine the total burden of illness, including the direct and indirect costs associated with ACS for employees and their dependents. Medical and pharmacy claims (IMS LifeLink data) along with short term disability (STD) and long term disability (LTD) claims (Integrated Benefits Institute’s Health and Productivity Benchmarking Database) from 2007-2010 were analyzed. Indirect cost analyses consisted of work days lost and wage replacement costs for the employers. Direct costs consisted of total all-cause and ACS related health costs for those newly diagnosed with ACS in the 12 month period following diagnosis. To make direct and indirect costs comparable between the two databases, all health care cost estimates were weighted by analytic weights derived from age and gender distributions of both datasets. A total of 37,340 employees had STD or LTD claims for ACS. The majority (77.4%) was male; 94% were less than 65 years of age. Employees with ACS had on average 60.2±SE:0.29 STD and 397.9± SE:8.09 LTD days per disability incident. For employers, the estimated per claim productivity loss for STD and LTD were $7,943± SE:39.7 and $52,473± SE:1,114, respectively. Total annual ACS health care costs were $8,170± SE:106. Hospitalizations accounted for 75% of total annual ACS health costs. Out of the total number of employees (n=29,100), 36% had one or more hospitalizations for ACS. When examining this specific cohort of patients hospitalized for ACS, the mean total annual ACS health care costs per patient more than doubled ($18,899± SE: 253) These data demonstrate that ACS imposes a substantial economic burden on employees. Long term productivity losses and disability costs are significant for employers. ACS related hospitalizations represent a large portion of total medical costs.

To evaluate patient satisfaction with golimumab (GLM) and its auto-injector in rheumatoid arthritis (RA) patients switched from adalimumab (ADA) or etanercept (ETA) due to inadequate disease control. Data were from an interim analysis of 200 patients enrolled in GO-SAVE, a GLM multicenter, assessor-blinded, switch study of patients with active RA. Patients receiving methotrexate and having an inadequate response to current treatment with ADA or ETA entered the screening period at week -6 and continued current treatment. After re-screening at week 0, all eligible patients were actively switched to open-label GLM 50mg subcutaneous injections. Satisfaction prior to switching was assessed at week -2 for ADA or week -1 for ETA. Satisfaction with and preference for GLM were assessed at week 8. Mean (SD) age was 55.9 (11.3) years; 81.5% were female. Mean (SD) disease duration was 9.8 (9.7) years. Prior to switch, patients were treated with ADA pen (25.5%), ADA prefilled syringe (21.5%), ETA pen (27%), ETA prefilled syringe (24%), and ETA vial and syringe (2.0%). All 200 patients completed assessment at week -2 (ADA) or -1 (ETA); 170 completed the assessment at week 8 (GLM). At week 8, 82.9% were satisfied with the overall GLM experience, 80.0% were satisfied with injection frequency, and 75.3% were satisfied with injection device. Most patients experienced lower levels of injection related burning (80.0%), stinging (75.3%), discomfort (62.4%), redness (58.8%), and pain (57.6%) with the GLM auto-injector than with the previous injection device. Patients expressed greater preference for GLM over their previous medication (74.0%) and greater preference for the auto-injector (70.6%) over their previous injection device. A majority of RA patients switched to GLM from ADA or ETA were satisfied with their overall GLM experience, including preference for GLM and the auto-injector over previous medication and injection device.

The employer burden of CKD in terms of lost productivity, short and long term disability use, and high total health care costs has been well-documented and warrants an employer-sponsored population health management program to improve the health and lives of the workforce. Georgia Power Company (GPC) has implemented a chronic care management program aimed at early identification, disease awareness, and counseling of employees through on-site screenings. Individuals are offered voluntary participation in the CKD management program with their PCPs and nephrologists depending upon their risk and CKD stage. Health outcomes including, clinical, resource utilization, and self-reported health status and productivity are compared pre- and post- program implementation. Preliminary results at the 6-month mark show that: a) 2,589 employees were screened, 638 (25%) met program criteria for participation and 110 (17.2%) agreed to participate in the study; b) among the current enrollees, 17% have diabetes and 51% have hypertension; c) mean eGFR rates are 61.27, and HbA1C levels of 7.7, and a mean BMI of 30.5 indicating a population at high risk for developing CKD; d) participants reported missing on average 10.5 hours/week due to their CKD; and e) baseline total health care expenditures were $19,776 per member per year indicating a high cost population as well. CKD is a high-cost disease for GPC. Resources invested in creating novel CKD management programs to identify, raise awareness, and manage CKD are a worthwhile investment for employers.