News

Memantine (Namenda, Forest) is the newest medication to receive FDA approval for the treatment of Alzheimer?s disease and the first to be approved with a moderate-to-severe indication. All previously approved Alzheimer?s disease treatments belong to the cholinesterase inhibitor class and are approved with a mild-to-moderate indication. Memantine has been used for more than 10 years in Germany and features a novel mechanism of action: N-methyl-d-aspartate (NMDA) antagonism. It has been shown to be effective in double-blind, placebo-controlled trials as monotherapy and in combination therapy with the cholinesterase inhibitor donepezil in patients with moderate-to-severe Alzheimer?s disease.

Can occupational medicine produce a profitable outcome?

This month's analysis of employer data

Organizational support intented for moms can provide lifestyle benefits for all women in healthcare

Loss of potential competition is a loss of consumer welfare under antitrust laws

Incentives for personal gain are common, but those that motivate us to help others are rare and valuable

Source: Atlantic Information Services

Despite obstacles, post-acute and nursing-home facilities see value of IT in improving care

As healthcare delivery continues to change, the intertwined components have met a number of knots along the way. Processes to monitor, evaluate and encourage physicians to practice what is determined to be quality medicine seem to be particularly bound up in logistics.

Prior to the massive financial woes that helped "The Governator" take office in California, one of the state's most talked-about stories was a universal healthcare coverage proposal from Bruce Bodaken, chairman, CEO and president of Blue Shield of California (BSC). Other states, such as neighboring Oregon, have considered universal coverage plans in the past, but to date none have been implemented. Due to California's severe economic crisis, Bodaken's plan has been put on the back burner too. But it's still a much-discussed proposal in the state's healthcare circles, and once Gov. Schwarzenegger gets acclimated to his responsibilities and finds a way to stem the state's financial bleeding, it is expected to take center stage once again.

Efalizumab (Raptiva, Genentech/Xoma) is a humanized monoclonal antibody of CD11a that exerts its effect through the blockade of the interaction between leukocyte function-associated antigen-1 (LFA-1) and intercellular adhesion molecule-1 (ICAM-1). FDA recently granted approval for efalizumab in the treatment of chronic moderate-to-severe plaque psoriasis in adults aged 18 years and older. Efalizumab does not achieve clinical response rates equal to cyclosporine or methotrexate, but it lacks the systemic organ toxicities of these agents and is associated with a more rapid onset of action (significant improvements in Psoriasis Area and Severity Index [PASI] response after 2 doses). In addition, efalizumab will likely compete with another approved biologic, alefacept, and off-label use of 2 other biologics currently on the market, etanercept and infliximab. At this time, until further studies comparing efalizumab to other drugs indicated for the treatment of psoriasis are completed and post-marketing surveillance is conducted, the agent?s place on the formulary remains unclear.

New policies expand coverage and promote generics while emphasizing pharmacy care and cost-effectiveness

Letrozole therapy, in follow-up to 5 years of tamoxifen treatment, significantly improves disease-free survival compared to placebo, according to a study published in The New England Journal of Medicine.

A regimen of docetaxel and cisplatin offers better survival and response rates than a combination of vinorelbine and cisplatin in the treatment of advanced non-small-cell lung cancer, according to a phase 3 study published in the online version of the Journal of Clinical Oncology. In addition, the findings demonstrated that docetaxel is as effective as vinorelbine/cisplatin when combined with another platinum, carboplatin.

The clinical benefit of aspirin on first myocardial infarction diminishes with regular-but not intermittent-use of nonsteroidal anti-inflammatory drugs, according to a study published in the journal Circulation.

New Orleans-The results of the Antihypertensive and Lipid-Lowering Treatmentto Prevent Heart Attack (ALLHAT) Trial, along with the highlights of theSeventh Report of the Joint National Committee on Prevention, Detection,Evaluation, and Treatment of High Blood Pressure (JNC 7), were reviewedat an educational session of the recently concluded 38th ASHP Midyear ClinicalMeeting.

The American Heart Association (AHA) Scientific Sessions comprise the largest meeting of its kind held in the cardiovascular field, with several thousand presentations given each year. The recently concluded 2003 AHA Scientific Sessions included presentations of trials that evaluated potential therapeutic compounds, as well as widely used and accepted compounds in new dosages or combinations, for the treatment of cardiovascular disorders. The compilation of clinical news reviewed focuses on the cardiovascular pharmacotherapy trials of greatest interest to formulary decision-makers, including: VALIANT, REVERSAL, SPORTIF V, PAPABEAR, PRIMO-CABG, and CREST.

SBM combines prevention and wellness strategies for improved outcomes and cost savings

health risks are not the only drawback for overweight kids ... take my word for it!

MCOs should word arbitration clauses as carefully as the rest of the contract

DM plays a key role in the evolution of specialty pharmacy

Developing preferred relationships with members leads to increased market share for payers

Sources: Atlantic Information Systems; Managed Care Week

What do you do when you have exhausted all options for improving performance in an environment that is determined to protect the status quo? What do you do when your organization has reached the presumed limit of potential performance and has grown all too comfortable with its market lead?

An insightful man named Blake Segal once said, "It is not a parent's job to protect their kids from life, but to prepare them for it." Wise words indeed, and ones that Bob Greczyn has taken to heart. Although he has three children of his own, he wants to help prepare yours for a healthy future, and everyone else's as well.

Our recent "ER is a Hit With Insured Americans" news item stirred up some reader response.

Bethesda, Md.-The daily activities of health-system pharmacists are greatlyaffected by the Health Insurance Portability and Accountability Act of 1996(HIPAA). To help keep practitioners up-to-date with current regulationsand other important information, ASHP has developed an online resource centeron its website, www.ashp.org.

James E. Orlikoff (pictured at right), an expert in health-care governance,organizational development, and leadership quality, will be the keynotespeaker during the meeting's Opening General Session that takes place from9 a.m. to 11 p.m. on Monday, Dec. 8, in Hall D. He is president of Orlikoffand Associates, Inc., a consulting firm specializing in health-care governanceand leadership quality, organizational development, strategy, and risk management.He is the National Advisor on Governance and Leadership to the AmericanHospital Association and Health Forum.

An intravenous formulation of lansoprazole has been developed and is under review by FDA. If approved, lansoprazole will be the second IV proton pump inhibitor available in the United States, providing an alternative to the currently available pantoprazole IV. The pharmacokinetic and pharmacodynamic properties of lansoprazole IV have been found to be comparable to the oral form. Until more data are available the agent, if approved, should be reserved as an option for patients unable to take lansoprazole via the oral route.

Atazanavir is a novel azapeptide protease inhibitor (PI) that has been approved by FDA for use in combination with other antiretroviral agents in treatment-naïve and treatment-experienced HIV-infected individuals. Atazanavir has a low pill burden consisting of 2 capsules administered once daily and it has an adverse effect profile that is not associated with clinically relevant lipid effects. In clinical studies of up to 48 weeks, atazanavir demonstrated comparable antiretroviral efficacy to nelfinavir and efavirenz in treatment-naïve patients. The most common adverse effect associated with atazanavir is a reversible dose-related increase in unconjugated (indirect) bilirubin.