Formulary Watch |

Alabama targets doctor shopping and Rx diversion

Alabama has targeted so-called “doctor shopping” and Rx diversion with three bills designed to stop such lawbreakers.

Last season’s flu outbreak no incentive for more to get shots

Despite last season’s flu outbreak, less than half the people surveyed (46%) by CVS/pharmacy said they were more likely to get a flu shot this year.

With emergence of ACOs, P&T committees will need to re-evaluate their medication analysis to support contractual arrangements

Accountable care organizations (ACOs) are groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to the patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds in both delivering high-quality care and spending healthcare dollars more wisely, it will share in the savings it achieves for the Medicare program.1 The overall goal of the ACO is to reduce costs by focusing on preventative care and disease management.

INFOGRAPHIC: Oral oncolytics

The pros and cons of oral oncolytics and intravenous drugs.

Recognizing pharmacists as healthcare providers-a solution for the Patient Protection and Affordable Care Act roll-out

It is estimated that 30 million people will gain access to medical care beginning in 2014, with implementation of the Patient Protection and Affordable Care Act (ACA). Administratively, the federal government and most states have not worked out the details of how patients will gain access to the healthcare system, let alone receive care. Primary care providers (PCPs) are ill-prepared to accept this enormous influx of new patients, which will place an even greater strain on the already strapped primary care workforce. Estimates are that an additional 17,000 PCPs are currently needed, and another 40,000 PCPs may be needed by 2025 to care for the nation’s aging population. How best to handle this large influx of patients into the healthcare system is at issue.

New HIV drug approved

FDA this week approved integrase strand transfer inhibitor dolutegravir (Tivicay, ViiV Healthcare , GlaxoSmithKline) to treat HIV-1 infection.

Health economic analysis shows canagliflozin monotherapy may reduce costs of type 2 diabetes

Results from a health economic and outcomes research (HECOR) simulation analysis show that canagliflozin (Invokana, Janssen), along with lifestyle management, may reduce long-term complications and associated costs for adult patients with type 2 diabetes compared to a treatment sequence without canagliflozin.

Breakthrough therapy designation: FDA’s newest mechanism for accelerating approval for promising pipeline therapies

In July of 2012, a provision in the newly ratified Food and Drug Administration (FDA) Safety and Innovation Act (FDASIA), paved the way for the FDA to further assist drug manufacturers in expediting the development and introduction of new drugs demonstrating early signs of advancement in the treatment of key conditions. Known as the “breakthrough therapy” designation, this new tool is seen by many as yet another positive sign that the FDA is committed to ensuring that innovative drug products are brought to market even more quickly for the millions of patients with serious medical conditions, desperately in need of new therapeutic options.

Responsible use of drugs could save $200B annually

Delays in treatment and medication non-adherence are the major reasons behind avoidable costs in the healthcare system, according to a new study released this week.

Patients with type 2 diabetes and a history of cardiovascular events have high rates of additional cardiovascular events

It is well known that type 2 diabetes mellitus is associated with increased risk of cardiovascular disease. A recent epidemiologic study conducted in the United Kingdom assessed the time to first major cardiovascular event in patients with type 2 diabetes mellitus in a large real-world population.

Once weekly exenatide is an alternative treatment to daily basal insulin

Typically, basal insulin is chosen as the add-on treatment in patients with severe hyperglycemia. However, it has been questioned whether it is the best option, according to research presented in June at American Diabetes Association 73rd Scientific Sessions, in Chicago.

Concomitant control of BP, cholesterol is difficult

Many patients suffer from both hypertension and high cholesterol, putting them at greater risk of coronary heart disease (CHD). Controlling the hypertension and high cholesterol would reduce CHD risk by 50% or more, but less than a third of patients have achieved adequate control of both, according to an online study in Circulation.

Study finds that dapagliflozin produces similar glycemic efficacy to glipizide

When metformin cannot maintain glycemic control, sulfonylureas are often used as add-on therapy in type 2 diabetes; however, risks include weight gain and hypoglycemia. Dapagliflozin is an SGLT2 inhibitor and increases urinary glucose excretion and reduces hyperglycemia independently of insulin secretion or action.

International study finds that dapagliflozin has metabolic benefits

An international study has found that dapagliflozin has sustained metabolic benefits compared with glipizide. Benefits included stable weight loss and low rates of hypoglycemia. Additionally, therapy was well-tolerated by patients.

Lower risk of heart failure and stroke with exenatide than with insulin

In patients with type 2 diabetes, treatment with exenatide has shown beneficial effects on cardiovascular risk factors. A recent study used the GE Healthcare database to evaluate the risk of heart failure, myocardial infarction, and stroke in 2,795 patients taking exenatide twice daily and in 51,547 patients taking insulin in routine clinical practice.

Adherence varies across market segments

The US healthcare system could avoid hundreds of millions of dollars in medical costs if medication adherence rates improved, according to a CVS Caremark report.

Triptans widely prescribed for migraine but contraindicated in patients with CV conditions

Almost 5 million Americans with episodic migraine (EM) should not be prescribed a triptan, the only class of acute medications FDA approved and developed for migraine, because of the presence of cardiovascular contraindications, according to results from the American Migraine Prevalence and Prevention (AMPP) Study.

Patients treated with weekly exenatide have better glycemic control and weight loss than patients treated with insulin glargine

A recent international, open-label, randomized, controlled study of patients with type 2 diabetes mellitus compared once-weekly exenatide to titrated insulin glargine.

Study finds that dapagliflozin demonstrates glycemic responses similar to other oral agents

Dapagliflozin produces larger reductions in HbA1c in individuals who have higher baseline levels.

Guideline adds aromatase inhibitor for breast cancer prevention

The new update to the 2009 American Society of Clinical Oncology (ASCO) guideline on the pharmacologic interventions for breast cancer risk reduction now lists aromatase inhibitor exemestane (Aromasin, Pfizer) as an option for postmenopausal women for primary risk reduction that are at an increased risk of developing invasive breast cancer.

Unauthorized prescribers bill Part D $5 million

Estimates of the cost of fraud in the Medicare system range broadly from $17 billion to $90 billion. However, there are no estimates of-or methods to detect-how much of the wasted money is attributable to old-fashioned human error rather than blatant crime.

FDA Pipeline

Complete response, priority review, fast track

FDA actions in brief

FDA approved drugs

Blood pressure response to dietary sodium is reproducible over long term

Blood pressure (BP) response to changes in dietary sodium and potassium is reproducible over the long term and may help identify potential candidates at risk for hypertension and cardiovascular disease, according to a study published in the journal Hypertension.

Long-term use of CCBs may increase risk of breast cancer

Long-term use of calcium-channel blockers (CCBs) may increase the risk of breast cancer in postmenopausal women, but additional research is needed to confirm, according to a study in JAMA Internal Medicine, published online August 5.

FDA approves first rapid diagnostic test to detect HIV-1 antigen, HIV-1/2 antibodies

FDA has approved the first rapid Human Immunodeficiency Virus (HIV) test for the simultaneous detection of HIV-1 p24 antigen as well as antibodies to both HIV-1 and HIV-2 in human serum, plasma, and venous or fingerstick whole blood specimens (The Alere Determine HIV-1/2 Ag/Ab Combo, Orgenics, Ltd. (an Alere, Inc. company) was approved.

Examining medication reconciliation from a perspective of safety

Oral oncolytics: assessing value of newer agents versus current standards of care as part of P&T processes

Oral oncolytics are relatively new to the field of cancer therapy. However, they now make up about 25% of the oncology market and their use is continually expanding. The current insurance system is not efficiently equipped to handle their rapid entry into the market.

Ample vaccine supply key to combatting unpredictability of flu season

The only predictable aspect of the influenza season is its unpredictability, according to experts.

Study finds Rx abuse among teens is a big problem

More than a third of young people believe prescription stimulant abuse is a big problem among their peers, according to a new survey.