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The number of patients presenting with typical gastroesophageal reflux disease (GERD) symptoms and the prevalence of GERD symptoms in the general population make the prescription of proton-pump inhibitors (PPIs) by primary-care physicians commonplace. An active medication use evaluation (MUE) program that places symptom control as a primary concern can help rationalize PPI drug therapy and improve patient care. A treatment guideline that follows the current practice of empiric therapy, recommends periodic monitoring, and encourages further gastroesophageal evaluation (ie, endoscopy and pH monitoring) for assessing adequacy of treatment and treatment failures is a key component of a successful program.

The demand for consumer-directed healthcare (CDH) is growing. Once justan idea tossed around in health plan boardrooms and industry think tanks,CDH is now taking root, with an increasing number of national and regionalhealth plans offering a variety of consumer-directed products and services.

The Medicare health plan marketplace has stabilized and is poised foranother period of growth, although some experts don't know whether thatgrowth curve will be modest or steep.

Is it legal to ask health plan members their race and ethnicity? Accordingto the Civil Rights Act of 1964, it is; however, California, New Jersey,New Hampshire and Maryland restrict the use and collection of racial data.With the go-ahead from the federal government, health insurers are usingthe data to design strategies to improve care for specific populations.

In the past 15 years, with the introduction of largemolecule, biologically engineered therapies, the treatment of multiple sclerosis (MS) has been revolutionized. While still not curable, today MS is eminently treatable.

Some conditions better lend themselves to remote monitoring, but others produce false positives

August Desktop Resource Chart

FDA actions and new molecular entities

The human immunodeficiency virus (HIV) attacks the immune system, particularly white blood cells known as CD4 T-cells. As a result, the immune system becomes less able to fight off infection and disease. The final stage of HIV infection is acquired immunodeficiency syndrome (AIDS), but some people live with HIV for years or even decades before the disease progresses to AIDS.

Health insurers learned long ago that one size doesn't fit all. As a result, they tailor care delivery to members based on specific disease states, gender, age and risk status. But today, that simply is not sufficient-not with the U.S. Bureau of Census' prediction that by 2035, Americans of color will comprise more than 40% of the population.

HealthPartners CEO Mary K. Brainerd pushes the limit on healthcare process, structure and environment

On June 21, a unanimous U.S. Supreme Court held that state law is completely pre-empted by the Employee Retirement Income Security Act (ERISA)of 1974 with respect to disputes over denial of benefits under ERISA-regulated health benefit plans. The Court's ruling appears to insulate managed care organizations from punitive and extra-contractual damages related to denial of benefits. In its decision, the Court overruled two lower court rulings.

The proposal would offset the cost of tax incentives by setting a cap on employers' tax exclusions.

HHS could decide in the future to pay for gastric bypass surgery.

I have learned over the years that I am, for better or worse, a fairly risk-averse person. Given the choice between steady production and a high-risk/high-reward opportunity, I'll almost always choose the former.

Consumer-driven healthcare will greatly influence benefit and co-pay structures over the next decade, HealthTrans leaders predict.

Proposals to allow Medicare to negotiate prices similar to those available to the VA are unjustified, according to PhRMA.

According to a study published in the New England Journal of Medicine, short-term use of estrogen plus progestin significantly decreased the risk of colorectal cancer among postmenopausal women; however, for unknown reasons, the colorectal cancers that did develop in the hormone-treated group were diagnosed at a more advanced stage.

Pioglitazone was also significantly superior to the other 2 treatment groups in decreasing triglycerides.

A recent study found that atorvastatin at its starting dosage reduces the risk of a first major cardiovascular event in patients with type 2 diabetes, said Helen Colhoun, MD, at the 64th scientific sessions of the American Diabetes Association (ADA) in Orlando.

Release of GLP-1 in responseto an ingested meal and glucose load plays a major role in the development of impaired insulin secretion.

At Digestive Disease Week in New Orleans, Steve Flamm, MD, associate professor of medicine and medical director of liver transplantation, Northwestern University, Chicago, Ill, presented study findings indicating that patients with chronic hepatitis C virus (HCV) infection and persistently normal liver enzymes derive as much benefit from pegylated interferon-alfa 2b plus ribavirin therapy as do patients with elevations in serum alanine aminotransferase (ALT). According to Dr Flamm, lead investigator for the study, "... a fraction of patients with normal liver enzymes do have aggressive liver disease on liver biopsy despite their liver tests being normal."

Amidst a national focus and heated debate over rising drug costs and price hikes, Abbott Laboratories quadrupled the price in December of its widely used protease inhibitor ritonavir (Norvir) from $1.71 to $8.57 for a 100 mg capsule.

Three months after the stroke, recovery was significantly higher among the patients who had been taking statins.

Rifaximin (Xifaxan, Salix), the first nonsystemic, gastrointestinal-selective oral antibiotic to receive approval for the treatment of travelers' diarrhea, is also an effective prophylaxis for travelers' diarrhea, according to data released at Digestive Disease Week in New Orleans.

Peginterferon alfa-2a monotherapy demonstrated superior end-of-follow-up response rates to peginterferon alfa-2 in combination with lamivudine.

A study was conducted to assess hospital admission rates for congestive heart failure in patients dispensed cyclooxygenase-2 (COX-2) inhibitors or nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). Researchers at the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada, studied patients taking rofecoxib (Vioxx, Merck), celecoxib (Celebrex, Pfizer), and nonselective NSAIDs, with a control group consisting of non-NSAID users who were not given any study drugs. Study findings indicate that, relative to non-NSAID users, patients receiving rofecoxib and nonselective NSAIDs had an increased risk of admission for congestive heart failure than patients taking celecoxib.

Tumor necrosis factor (TNF) antagonists increase the risk of granulomatous infectious disease, including tuberculosis, according to a study-the largest of its kind to date-published in the journal Clinical Infectious Diseases. The risk of infection was 3.25-fold greater among patients who received infliximab (Remicade, Centocor) than among those who received etanercept (Enbrel, Wyeth/Amgen), the study found.

The parasympatholytic action of trospium reduces the tonus of smooth muscle in the bladder by antagonizing the effect of acetylcholine on muscarinic receptors. Trospium was approved on May 28, 2004, for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency.

Medicare officials predict that beneficiaries will realize more substantial savings as sponsors drop their prices even more.