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The objective of this study was to assess the inpatient care burden among individuals with autism using the 2007 Health Care Utilization Project Nationwide Inpatient Sample [HCUP-NIS]). There were ~26,000 hospitalizations among individuals with autism in 2007, with an overall rate of 65.6/100,000 admissions. Rates of hospitalizations were the highest among individuals with autism aged 10-20 years, males, having household income >$63,000, and with private insurance, respectively. In terms of hospital characteristics, rates were the highest in hospitals in large urban areas, located in the Northeast region, and with teaching status, respectively. Individuals with autism had significantly higher LOS (6.5 vs. 4.2; p < 0.0001) and total charges ($24,862 vs. $23,225; p < 0.0001) as compared to those without autism.

PURPOSE Preemptive pharmacogenetic testing aims to optimize medication use by having genetic information at the point of prescribing. Payers’ decisions influence implementation of this technology. We investigated U.S. payers’ knowledge, awareness, and perspectives on preemptive pharmacogenetic testing. METHODS A qualitative study was conducted using semi-structured interviews. Participants were screened for eligibility through an online survey. A blended inductive and deductive approach was used to analyze the transcripts. Two authors conducted an iterative reading process to code and categorize the data. RESULTS Medical or pharmacy directors from 14 payer organizations covering 122 million U.S. lives were interviewed. Three concept domains and ten dimensions were developed. Key findings include: clinical utility concerns and limited exposure to preemptive germline testing, continued preference for outcomes from randomized controlled trials, interest in guideline development, importance of demonstrating an impact on clinical decision making, concerns of downstream costs and benefit predictability, and the impact of public stakeholders such as the FDA and CMS. CONCLUSION Both barriers and potential facilitators exist to developing cohesive reimbursement policy for pharmacogenetics, and there are unique challenges for the preemptive testing model. Prospective outcome studies, more precisely defining target populations, and predictive economic models are important considerations for future research.

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BACKGROUND: Primary medication nonadherence (PMN) is any instance whereby patients fail to initiate a pharmacotherapy regimen after receiving a prescription for new therapy. The Pharmacy Quality Alliance (PQA) has proposed a standardized definition for PMN and a quality measure to assess the rates of PMN in community pharmacies.