News

BCBSIL Chief Medical Officer Dr. Stanley Borg wants a financial model that supports PCPs

MCOs will likely see significant budgetary savings after full-market adoption and full payment for DES.

Verispan's Managed Care Profiling Solutions

As the industry has evolved, the complexity of copay structures has increased,say industry watchers.

To his co-workers, Mark is an outgoing, healthy, 34-year-old young manwith a friendly personality (although they've noticed he does miss workoften). What they don't know is that Mark suffers from Type A hemophilia,chronic pain, addiction to painkillers and recently was diagnosed with HIV,most likely contracted from factor 8 transfusion he received as a teenager.

Organizations come together to make the healthcare system more responsive and more effective.

Court's decision shows that increasing transparency might decrease PBMs' ability to compete

Expert analysis of this month's DTR

In phase 3 trials, the first agent in a novel class known as the selective cannabinoid type 1 receptor blockers doubled the odds of quitting smoking while reducing post-cessation weight gain compared with placebo. The agent, rimonabant, also improved several features of the metabolic syndrome in patients with abdominal obesity, reported researchers at the 53rd Annual Scientific Session of the American College of Cardiology (ACC).

Mark McClellan, MD, PhD, now administrator of the Centers for Medicare and Medicaid Services (CMS), is seeking more evidence-based information about how medical treatments affect patients in the real world. Dr McClellan says his first priority is to use the new Medicare pharmacy program, starting with the drug discount card, to lower drug costs. One prime strategy for doing so is to evaluate which therapies are most efficacious as well as cost-effective for specific patient subgroups in order to curb unnecessary spending on prescription drugs.

Erectile dysfunction (ED) is now recognized as a common problem in men. Several medical problems, including diabetes mellitus, coronary artery disease, hypertension, and hyperlipidemia are known to increase the likelihood of developing ED. Diagnosis depends on an adequate history and physical examination. Several therapies are now available for the treatment of ED. With the advent of the phosphodiesterase type 5 (PDE5) inhibitors, therapy for ED has become more acceptable for many men. Oral therapy is usually the first-line treatment due to the ease of use and the effectiveness of this therapy. For men who do not respond to or have a contraindication to PDE5 therapy, intrapenile injection therapy, intraurethral therapy, and vacuum devices are effective alternatives.

Rasagiline (Teva/Eisai), a second-generation irreversible MAO inhibitor highly selective for type B of the enzyme, is expected to gain FDA approval in late 2004/early 2005 for the treatment of Parkinson’s disease in monotherapy or as adjunct therapy to levodopa. Rasagiline is more potent than selegiline, the only FDA-approved drug within the same class, and may be devoid of the undesirable effects (blood pressure increases, euphoria, and sleep disturbances) often reported with selegiline. Rasagiline has been studied and proven effective versus placebo in patients with moderate and advanced Parkinson’s disease in both phase 2 and 3 clinical trials. The drug is administered orally once daily and does not require titration. Furthermore, rasagiline has demonstrated neuroprotective activity in various in vitro models and may show promise in the treatment of other neurologic diseases; however, these properties have yet to be studied in humans.

Savvy executives must seek market growth

Putting the rate enhancement back into benefit programs can only improve quality

Vendors vary in their DM measurement methodology, so be aware of standarized metrics

U.S. joins the suit against Highmark in false Medicare claims case

This month's analysis of the PPO market

Should you implement a healthcare reimbursement debit card? A few tips will help clear the path.

From AIS's Directory of Health Plans, 2004

New medical devices, FDA actions and first-time generics

The jury is still out on tiered provider networks. While effectiveness is frequently a criterion for including a specific drug on a preferred drug list, thus far, quality is only playing a small part in designing provider tiers.

A veteran of nearly 25 years in the managed care industry, as well as a decorated veteran of the Vietnam war, Paul Caliendo is the founder and president/CEO of Preferred Medical Claim Solutions (PMCS).

He's an anomaly in our nation's capital: a leading health policy maker who enjoys almost unanimous support and admiration.

Aggressive lipid-lowering with high-dose atorvastatin initiated immediatelyafter hospitalization for an acute coronary syndrome (ACS) significantlyreduces the risk of long-term adverse cardiovascular outcomes compared withlipid-lowering with standard-dose pravastatin. As such, target levels oflow-density lipoprotein cholesterol (LDL-C) may need to be lower than theones currently recommended in patients at risk of cardiovascular events,said Christopher Cannon, MD, at the 53rd annual scientific session of theAmerican College of Cardiology in New Orleans.

Chronic obstructive pulmonary disease (COPD) is a major public health problem, with inhaled anticholinergic agents being the treatment of choice. The disadvantage of currently approved therapies for the treatment of COPD is that agents such as ipratropium (Atrovent, Boehringer Ingelheim) must be administered numerous times daily. Tiotropium (Spiriva, Pfizer/Boehringer Ingelheim) is a new, recently FDA-approved, long-acting anticholinergic drug that requires only once-daily dosing. Tiotropium displays selective receptor kinetics by dissociating more slowly from M1 and M3 receptors than M2 receptors. In patients with COPD, tiotropium 18 mcg inhaled once daily results in significant improvement in lung function. Furthermore, improvements appear sustained for up to 3 weeks after discontinuing tiotropium. Tiotropium is well tolerated with minimal systemic absorption resulting in a favorable adverse effect profile. The most common adverse effect associated with tiotropium is dry mouth. Given the longer duration of action, once-daily dosing, minimal adverse effects, and documented improvements in lung function, tiotropium is poised to replace ipratropium as the inhaled anticholinergic of choice.

One of the most common ophthalmic conditions that directs a patient to a primary-care physician or eye-care practitioner is the red, itchy eye. The highest percentage of conjunctivitis is noninfectious or inflammatory, and frequently these cases are allergic in nature. The ophthalmic armamentarium is now filled with a number of pharmaceutical compounds that act specifically at different points along the inflammatory cascade. Formulary decision-making should be based on sound knowledge of the ocular inflammatory cascade and the pathways through which the various ophthalmic antiallergic preparations exert their anti-inflammatory effects.

FDA rolls out new policies on DTC advertising,counterfeit drugs, and bar codes before McClellan departs

McClellan takes over at CMS amidst escalating battle over drug imports

Seniors mount campaign to ensure lower drug prices

AAHP and HIAA become AHIP