Resources

The Lewin Group Center for Comparative Effectiveness Research combines consulting, research, and data assets to advance the health care industry's understanding—and application—of the most effective clinical protocols available.

We invite you to review the downloadable resources in our archives to examine our work in greater detail:

CER UPDATES

September 18, 2009 - Final report on the"Economic Analysis of Availability of Follow-on Protein Products" published online.
June 30, 2009 - Federal Coordinating Council on CER releases Annual Report to Congress
June 30, 2009 - Institute of Medicine releases Initial National Priorities for Comparative Effectiveness Research

LEARN MORE ABOUT OUR CER RELATED WORK

October 28, 2009 - Presented report titled "Comparative Effectiveness Research and Personalized Medicine: From Contradiction to Synergy" at the conference on Comparative Effectiveness Research and Personalized Medicine: Science, Policy and Business hosted by the National Pharmaceutical Council and the Personalized Medicine Coalition.
Lewin publications in health technology assessment and evidence-based medicine
Lewin presentation to ISPOR 2009 on CER - The CER Train Has Left ... for Where? Are You on Board?
i3 presentation on the Merits of Observational Research
i3 webinar on CER - Comparative Effectiveness Requirements and the Payer - Recorded September 16, 2008

The comparative effectiveness of rosuvastatin vs. other statins in patients with an increased risk of failure to reach NCEP ATP III goal.

June 2010

Test

Submitted by: Harley CR, Gandhi S, Heien H, Nelson SP.

Abstract

BACKGROUND: Previous studies have demonstrated that failure to reach National Cholesterol Education Program (NCEP) target low-density lipoprotein cholesterol (LDL-C) goal increases the risk of cardiovascular events. Ability to meet goal may be impacted by the choice of statin therapy. PURPOSE: This study compares rosuvastatin to other statin therapies among patients presenting with risk factors associated with failure to reach NCEP goal. METHODS: Retrospective analysis using medical and pharmacy claims linked to laboratory results from a national health plan encompassing private and MedicareAdvantage enrollees age > or = 18 years and newly treated with statins from 1 August 2003 to 28 February 2005. Predictors of failure to reach goal were statin treatment group, age, gender, NCEP risk level, per cent reduction required to attain goal and days from index to LDL-C measurement. Results: Of 11,814 eligible patients, 9.6% were initiated on rosuvastatin, 54.2% atorvastatin, 17.9% simvastatin, 7.1% pravastatin, 2.0% fluvastatin and 9.3% lovastatin. Independent predictors of failure to reach goal included > or = 15% LDL-C reduction required to reach goal, and high and moderate NCEP risk status. In the subset of patients at higher risk of failure to reach goal, rosuvastatin demonstrated a significantly lower rate of failure to achieve goal than atorvastatin, simvastatin, pravastatin, fluvastatin or lovastatin. CONCLUSIONS: Real-world factors associated with high risk of failure to reach goal may be used in identifying patients more likely to succeed on rosuvastatin compared with other statins. Low-risk patients needing < 15% LDL-C reduction would be suitable candidates for initiation of most other statins, specifically simvastatin, which has recently become available in the generic form.

PubMed Reference: PM 18479282

An observational study of fixed dose combination fluticasone propionate/salmeterol or fluticasone propionate alone on asthma-related outcomes.

June 2010

Submitted by: Stanford RH, Fuhlbrigge A, Riedel A, Rey GG, Stempel DA.

Abstract

OBJECTIVE: To identify the relationship between resource utilization and treatment of asthma in subjects who were first time users of controller therapies, either fluticasone propionate (FP) and salmeterol delivered in a single Diskus device (FSC) or FP monotherapy.METHODS: A retrospective, observational cohort analysis evaluated pharmacy and medical claims from subjects from a commercial managed-care database, which is similar in makeup to the US privately insured population, with a diagnosis of asthma and >/=1 prescription for FSC or FP dispensed from 1/1/2001 to 4/30/2005. Outcomes of interest were asthma-related emergency department (ED) visits, inpatient (IP) visits,

PubMed Reference: PM 18838055

Lipid levels and low-density lipoprotein cholesterol goal attainment in diabetic patients: rosuvastatin compared with other statins in usual care.

June 2010

Submitted by: Harley CR, Gandhi SK, Heien H, McDonough K, Nelson SP.

Abstract

OBJECTIVE: To compare change in low-density lipoprotein cholesterol (LDL-C) levels and National Cholesterol Education Program (NCEP) Adult Treatment Panel III LDL-C goal attainment in diabetic patients treated with rosuvastatin versus other statins in a large, managed care health plan. RESEARCH DESIGN AND METHODS: This retrospective cohort analysis used medical and pharmacy claims linked to laboratory results from a commercial/MedicareAdvantage health plan. Study participants were >or= 18 years of age, had a diagnosis of diabetes, were newly treated with statins from 8/1/03 to 2/28/05, and were considered at high risk for cardiovascular events as defined by NCEP guidelines. Subjects were continuously enrolled for 12 months pre-index and >or= 30 days post-index, with variable follow-up until therapy discontinuation or end of health plan eligibility. MAIN OUTCOME MEASURES: Change in LDL-C from baseline, and attainment of NCEP LDL-C goal among patients not at goal before starting therapy. RESULTS: A total of 3337 adult patients with diabetes were identified with new use of statin therapy during the identification period. A total of 9% (n = 301) started on rosuvastatin, 49.4% (n = 1,649) on atorvastatin, 20.7% (n = 690) on simvastatin, 7.0% (n = 234) on pravastatin, 11.7% (n = 391) on lovastatin and 2.2% (n = 72) on fluvastatin. After controlling for covariates, rosuvastatin patients experienced a significantly greater decrease in LDL-C from baseline (38.7%) than patients taking atorvastatin (34.2%) (p = 0.05), simvastatin (31.5%), pravastatin (24.2%), fluvastatin (26.3%) or lovastatin (24.9%) (p < 0.0001). Rosuvastatin users were significantly more likely to attain LDL-C goal than those taking the other statins (odds ratio: 0.44, 0.28, 0.14, 0.14, 0.19, respectively; p < 0.001). Predicted percent attaining goal was significantly greater for those taking rosuvastatin (87.3%) than for those taking atorvastatin (76.9%), simvastatin (68.7%), pravastatin (55.0%), lovastatin (55.3%) or fluvastatin (61.3%) (p < 0.001). CONCLUSION: For diabetic patients, rosuvastatin is more effective at reducing LDL-C levels and attaining NCEP ATP III LDL-C goal than other statins in real-world clinical practice.

PubMed Reference: PM 18345946

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