News

Ruling shows that external review remains viable option for patients

HMOs challenge Kentucky law that prevents plans from limiting providernetworks

Irene Brewster*, a 31-year-old mother of two who was in her 31st week of pregnancy, woke up one morning and noticed that her calf was abnormally swollen. After a call to her obstetrician, who was out of town, Brewster rounded up her children and drove to the hospital.

It was lightning quick, as acquisitions go. From the first announcement to the final approval, WellPoint Health Networks rolled RightCHOICE Managed Care's 2.8 million members into its portfolio in just three months.

People always experience a certain amount of anxiety when adopting a new technology. When implementing that change costs tens of millions of dollars, however, it could become downright nerve-wracking.

by degree of integration and performance level, April 2002

Consortiums, Web visits and online management help payers overcome reluctance to increase online care

HCA joins Leapfrog, MBGH says 30% health care costs unnecessary, Rush Prudential v. Moran with ERISA, BCBSM compares prices of brand name drugs with generics, Kaiser study on state-by-state prescription drug cost

Does a disabled employee have the right to put his health at risk on the job? Here&s the gist of the Supreme Court&s reasoning on that question.

Just before leaving Washington for the Memorial Day recess in May, Congress approved legislation to enhance the ability of hospitals and public health agencies to respond to bioterrorist threats.

Three case-controlled studies published in the Archives of Internal Medicineshow naproxen sodium has cardioprotective effects that other NSAIDs don't.An accompanying editorial says that no evidence indicates that the COX-2inhibitor rofecoxib increases (or decreases) MI risk. It simply fell victimto being compared with the only NSAID (ie, naproxen) shown to have a cardioprotectivebenefit. (None of these new studies directly compared non-naproxen NSAIDswith COX-2 inhibitors.)

Pipeline Preview as reported July 1, 2002

Eplerenone, a selective aldosterone inhibitor in phase III clinical trials,is an effective agent for reducing blood pressure in a variety of patientswith hypertension, including African-Americans, said presenters at the 17thannual scientific meeting of the American Society of Hypertension in NewYork City.

Administrative databases are a potentially useful source of data for conducting retrospective studies. Information in such a database can be used to evaluate the effects of organizational policy changes, new programs, or pharmaceutical therapies. This month?s column reviews the six essential steps required for conducting a simple database analysis. An example involving sepsis is used to further illustrate key points.

Alefacept (Amevive) is the first immunosuppressive agent directed specifically at inhibiting the activation of, and possibly killing, T cells, which are involved in the cascade of events leading to psoriatic plaque formation and inflammation. In May, an FDA advisory committee recommended alefacept for approval as a first-line therapy against moderate to severe plaque psoriasis. The authors of this Focus article review the clinical characteristics of alefacept as well as make comparisons with other systemic drugs currently used to treat chronic psoriasis and the likely biologic competitors etanercept and infliximab.

The evidence supporting a role for the angiotensin II receptor blockers (ARBs) in patients with nephropathy and/or heart failure continues to evolve. Currently, the FDA is in late-stage review of the first ARB for a heart failure indication and is reviewing another ARB for a diabetic nephropathy indication. The authors of this article present and interpret the clinical evidence for ARB use in these two disease states. Included in their discussion are the most recent recommendations on ARBs’ place in therapy according to the American Diabetes Association, the American College of Cardiology, and the American Heart Association.

Anoka Regional Treatment Facility, Anoka, MN-This 150-bed regional treatment facility was spending over half its annual budget on atypical antipsychotic medications. In an effort to better control rising drug class costs, a market share shift analysis of the products currently in use at the facility was conducted.

National Reports - A U.S. Supreme Court ruling was expected before theend of June that could stop individual states from regulating or preemptingEmployee Retirement Income Security Act plans.

The ruckus over designer babies, human cloning and genetic discrimination has colored much of the debate and perception of genetic services, but the discipline is gaining momentum as research propels new tests to determine the susceptibility to more common diseases, as well as a slew of rare ones.

You need to come from hardy stock to survive in Louisiana. The summer months can be sweltering, the spicy cuisine can set the taste buds afire, and in some parts, it's not uncommon to wake up and find an alligator in the backyard swimming pool.

The CDC calls for immunizing health care response teams against smallpox

Addendum questionnaire to June Focus On: Tadalafil

Addendum to June Focus On: Tadalafil

The investigational inhaled insulin product (Exubera) could prove a boon to patients with diabetes, cutting or eliminating the need for injections. So indicate findings from a phase III trial presented at the annual meeting of the American Association of Clinical Endocrinologists (AACE). For patients with type 1 diabetes, a regimen of inhaled insulin before meals and one injection at night could control blood glucose as well as or possibly better than injections alone. These results add to some phase III data presented last June that showed a small but significant number of patients with type 2 diabetes reached recommended blood glucose levels at 6 months.

as reported June 1, 2002

New Indication: COX-2 inhibitor gains rheumatoid arthritis indication

New Indication: GlaxoSmithKline Indication broadened to include HIT prevention during PCI

Albert Einstein Healthcare Network, Philadelphia-What are the real-world consequences of inadequate beta blocker therapy in patients with congestive heart failure (CHF)? That is what this group of clinicians at Prestige Health-a 50,000 member managed care organization in Philadelphia-set out to determine.

In studies reported this month at the European League Against Rheumatism meeting in Stockholm, the anti-TNF antibody adalimumab (D2E7) for rheumatoid arthritis is showing good long-term results, even in patients for whom other disease modifying antirheumatic drugs (DMARDs) have failed.

In this final installment of this series, the authors focus on the use of SSRIs in alcohol dependence, chronic pain, eating disorders, premenstrual dysphoric disorder, and sexual dysfunction. For each condition, the authors examine how well clinical trial evidence supports the application, discuss dosing and safety considerations, and provide their recommendations on preferred and alternative SSRIs, based on the weight of the evidence.