News

State Medicaid budgets are being squeezed between soaring costs and plummeting revenues, making it difficult to cope with growing enrollment while maintaining expanded services. As budget shortfalls widen, state officials are seeking ways to curb outlays, which could mean payment cuts for providers and plans.

It might have been a fluke the first time, some healthcare insiders thought in 1996. That was the year that both Newsweek and U.S. News & World Report did their stories on the best HMOs in America, and the top-rated company was Fallon Community Health Plan, a regional mixed-model HMO with 193,000 members.

Playing it safe can reduce costs and headaches.

New formulation: Once daily administration for continuous Tx of chronic moderate-to-severe pain

New indication: Long-term, twice-daily treatment of bronchospasm associated with COPD

New indication: For delaying relapse in long-term treatment of schizophrenia

as reported May 1, 2002

Enoxaparin (Lovenox) is typically used during hospitalization after orthopedic or abdominal surgery. Recent studies of its use after orthopedic surgery have shown that extending administration of the low-molecular-weight heparin after hospital discharge significantly reduces the frequency of deep-vein thrombosis (DVT). A new study confirms this is also the case for abdominal surgery for cancer, which carries a high risk of this complication.

The investigational vasopeptidase inhibitor omapatrilat is as effective as enalapril in preventing major adverse cardiac outcomes in patients with moderate to severe heart failure, but failed to show superiority, said Milton Packer, MD.

LIPS: Statin reduces cardiac event risk by 22% in first PCI procedureAzithromax ineffective for reducing recurrent CV events

as reported May 1, 2002

Drug therapy to control heart rate is at least as effective as antiarrhythmicdrug therapy in preventing adverse clinical events in patients with atrialfibrillation (AF), according to separate studies.

Therapy starting with the angiotensin receptor blocker (ARB) losartansignificantly reduced the risk of cardiovascular outcomes and new-onsetdiabetes compared with a beta blocker in older high-risk hypertensive patients,said Björn Dahlöf, MD. The improved outcomes with losartan occurredeven after adjusting for small differences in blood pressure reduction betweenthe two study drugs.

Atlanta-The low-molecular-weight heparin enoxaparin improves outcomes compared with currently recommended therapy in patients with non-ST-segment elevation acute coronary syndromes (ACS) who are being treated with a glycoprotein (GP) IIb/IIIa inhibitor, said Shaun Goodman, MD.

Lercanidipine is currently under FDA review for the management of hypertension. In comparative clinical trials, lercanidipine has shown antihypertensive efficacy comparable to that of slow-release nifedipine, amlodipine, nitrendipine, verapamil, captopril, and atenolol. Its side effect profile is similar or superior to these agents. This Focus article reviews those trials as well as lercanidipine?s pharmacologic properties and addresses the agent?s potential role in patients with comorbid conditions.

Although selective serotonin reuptake inhibitors (SSRIs) are prescribed most often for depression disorders, they are increasingly being used to treat a variety of other conditions. In this article, the authors assess the evidence on anxiety disorders—generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, and social phobia. For each condition, they present the rationale for SSRI use, the degree of supportive clinical trial evidence, indication-specific dosing and safety considerations, and their recommendations for the preferred and alternative SSRIs.

Adding the investigational cholesterol absorption inhibitor ezetimibe to statin therapy results in additional reductions in low-density lipoprotein (LDL) cholesterol of up to 14%.

There is is a rising chorus in Washington and across the nation for action to control increased prescription drug expenditures.

The American Psychiatric Association has issued updated guidelines for the treatment of patients with bipolar disorder. The guidelines were last updated in 1994.

Last month the FDA's Nonprescription Drugs Advisory Committee unanimously supported loratadine's (Claritin, Schering-Plough) switch from prescription to over-the-counter status for treatment of chronic idiopathic urticaria, moving the drug one step closer to full OTC status (see significant event timeline in sidebar).

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Predictive modeling, personalization and guided self care can help determinethe ideal intervention

Enrollment data as of January 2001

Great-West eliminates confusion in the marketplace by consolidating itsplans under a single name

Offering broader networks, educating members and eliminating referrals are just a few ways plans are meeting member wishes

Bioterror forces new contingency plans to better coordinate resources and information to contain and minimize an outbreak

Customized health plans offer consumers the choice and control that theydesire

In today's world, it's easy to assume that the more sophisticated and complex a solution is, the better it is. After all, we live in a world where cutting-edge technologies make us safer, better connected and more efficient.

While the Bush administration persists in promoting a Medicare RxDrug Card plan, pharmaceutical companies continue to unveil their own versions.