News

New Orleans-When faced with ensuring the appropriate use of high-risk, high-cost drugs, physician credentialing may be another option worth considering.

The Bush administration's $2 trillion budget proposal for fiscal year 2003 includes $190 billion to improve Medicare, almost half of that aimed to help seniors buy medicines.

Hartford Hospital, Hartford, CT-Although the economic advantages of IV to oral (PO) antibiotic conversion programs have been documented in numerous studies, most of these programs require physician contact to encourage the switch.

To retain resources or to justify allocation of additional resources, it's essential to demonstrate the value that outcomes projects bring to organizations. The Agency for Healthcare Research and Quality's project review process serves as a useful model for how to do so. This month's column explores the AHRQ process for following up and communicating the results of outcomes projects conducted at various practice settings.

WellPoint Health Networks plans to take reference drug pricing into new territory-commercial pharmacy benefits.

Medications currently available to treat osteoporosis slow the rate of bone loss primarily by reducing bone resorption. The purported advantage of the anabolic agent teriparatide is that it actually promotes new bone growth. Clinical trials have shown the drug to be effective for vertebral fracture prevention in postmenopausal women at high risk. Additional evidence is accumulating to support teriparatide's use in other populations (including men) with osteoporosis. This injectable is likely to receive FDA approval in the second half of this year.

Pharmacologic therapy is the second cornerstone of the medical management of reflux esophagitis. Because the merits of various drug classes for reflux esophagitis have been widely discussed, the focus of this article is on differing strategies for using these classes. The management strategies - and the rationale and evidence for promoting or rejecting them - are discussed for step-up therapy, empiric therapy, ste-down therapy, on-demand proton pump inhibitor use, combination therapies, and other considerations.

Many workers in the healthcare industry got here by chance, but personalsatisfaction keeps them here

PBMs redefine their role in the wake of class-action lawsuits and a slightly skeptical payer community

While members are the ultimate recipients of a health plan's efforts, trying to interact directly with several million individuals is not exactly practical.

Ranked by net increase in total enrollment as of January 1, 2001

VA Medical Center, Miami-ACE inhibitor therapy is recognized as the gold standard treatment for congestive heart failure (CHF) as well as diabetic nephropathy due to its effect on the morbidity and mortality associated with these conditions.

FDA actions in brief as reported February 1, 2002

New combination: Fixed niacin/statin combination for second-line lipid therapy

NME: Topical nonsteroid for second-line eczema Tx

NME: 5-alpha reductase inhibitor for treatmentof benign prostatic hyperplasia

NME: Loratadine successor for symptoms of seasonal allergic rhinitis

as reported February 1, 2002

Atypical antipsychotics withstand strong Geodon debut; Reminyl slices into formulary presence of Alzheimer rivals

With its FDA approval in November, valdecoxib becomes the hird COX-2 inhibitor to gain US market clearance. This Focus article examines valdecoxib's pharmacologic, pharmacokinetic, and therapeutic aspects and considers its role in relation to other COX-2 inhibitors and traditional NSAIDs. Special attention is devoted to its comparative COX-1:COX-2 inhibitory ratio and an array of unpublished efficacy and safety trials.

This 287-study meta-analysis aimed to address unanswered questions about antiplatelet therapy in patients at high risk for occlusive vascular events. It yielded several new findings or clarifications, including these: (1) Antiplatelets protect against vascular events in patients with unstable angina, intermittent claudication, and atrial fibrillation. (2) Antiplatelet therapy can be started promptly during acute ischemic stroke and continued long-term. (3) Daily aspirin doses of 75 to 150 mg seem to be as effective as higher doses for long-term treatment.

Fluoroquinolones and nitrofurantoin have surpassed trimethoprim-sulfamethoxazole (TMP-SMZ) as the most frequently prescribed antibiotics for uncomplicated urinary tract infections (UTIs) in women, according to a new national analysis. This is despite well-established recommendations (from the Infectious Disease Society of America and others) that TMP-SMZ is the drug of choice for UTIs due to cost and concerns about antibiotic resistance.

A three-tier pharmacy benefit can reduce prescription drug spending without increasing other medical resource use or fueling medication discontinuation rates. So concludes the fully published report of an analysis whose preliminary results were presented last year and reported by Formulary (2001;36:522). It is the first well-designed, controlled study to explore such consequences of three-tier benefits.

Clinicians must use caution in adopting newly revised national guidelines for treating elevated cholesterol, concludes a new study from the University of Maryland Pharmaceutical Health Services Research Department.

An experimental antiviral medication can shorten the duration of colds and reduce the severity of cold symptoms, reported Frederick Hayden, MD. He presented a pooled analysis of data from two phase III trials of the drug at the 41st annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held recently in Chicago.

Emerging data are continually refining our understanding of the risks and benefits of hormone replacement therapy (HRT) in postmenopausal women. This review assesses the current state of evidence on these various risks and benefits, concluding with an outline of what's established and where varying degrees of uncertainty remain. Algorithms for use of HRT for several established indications are featured.

While government agencies and private health plans struggle to deal with rising pharmacy bills, the federal government is expanding support for biomedical research and FDA

Idaho State University, Pocatello-Evidence in the literature has suggested that a pharmacist-run clinic provides quality care in chronic disease state management. In addition

VA Medical Center, Miami-ACE inhibitor therapy is recognized as the gold standard treatment for congestive heart failure (CHF) as well as diabetic nephropathy due to its effect on the morbidity and mortality associated with these conditions.

Ranked by total HMO enrollment, January 1, 2001