May/June 2012, Vol 5, No 3

Identifying low-cost medication alternatives can be time-consuming and is often therefore not followed by clinicians. A group of pharmacists led by Nicole Allie, PharmD, CGP, at Atrius Health, Watertown, MA, instituted the Chart Flag Service, a program designed to alert prescribing providers, in real time, on appropriate, lowcost medication alternatives.

Enrollment in consumer-directed health plans (CDHPs) has evolved as a strategy to control healthcare costs and improve member satisfaction. According to the Mercer National Survey of Employer-Sponsored Health Plans, in 2010, 10% of employers offered their employees CDHPs; in 2011, that grew to 13%; and by June 8, 2012, 10% of employers offered CDHPs to their employees.

The use of high-deductible health plans (HDHPs) is a growing strategy by employers to control costs, who claim that they encourage member responsibility and reduce unnecessary care utilization. Opponents of HDHPs suggest that this may result in some members going without necessary care. Katrina Moore, PharmD, and colleagues at SelectHealth, Murray, UT, conducted a retrospective database analysis to compare medical and pharmacy costs, as well as clinical outcomes, between members in traditional health plans (N = 21,480) or in an HDHP (N = 971).

Knowledge of pharmacogenomics—a collection of genomic factors contributing to individual variability in response to drug therapy—enhances the ability to diagnose, prevent, and treat disease. Although understanding the correct application of pharmacogenomics may be essential to providing cost-effective care, barriers include the absence of provider knowledge and inappropriate reimbursement strategies. Angela Luong, PharmD, and colleagues at OPTUMInsight conducted a survey of pharmacists regarding their knowledge of genetic testing and utilization strategies.

The first known study to use real-world, nontrial data to evaluate the cost-effectiveness of first-line combination therapies for patients with advanced nonsquamous non–small-cell lung cancer (NSCLC) was conducted by Manan Shah, PharmD, PhD, and colleagues at Xcenda, Palm Harbor, FL. The therapies included were pemetrexed/ platinum (Pem/P) relative to carboplatin/paclitaxel plus bevacizumab (C/Pa + B).

Pompe disease is a rare condition, with a global incidence rate estimated to be between 1 in 40,000 (0.0025%) and 1 in 300,000 (0.0003%) live births.1 According to a study published in 1998, the annual incidence of Pompe disease in New York City was estimated to be approximately 1 in 40,000 births, and approximately 90 babies are assumed born with Pompe disease in the United States annually.2 A similar incidence rate was found in the Dutch population (1 in 40,000 births), a relatively lower rate was found among the Chinese (1 in 50,000 births; 0.0020%), and a higher ra

Beyond “Patient Amusement”: New Treatments and Genetic Disease

Atrial fibrillation (AF) is a significant health and cost concern for the Medicare population (age ≥65 years), because of its association with an increased risk for stroke and all-cause mortality.1 The risk for stroke in patients with AF is almost 5-fold higher than in patients without AF.2 One of every 6 strokes in the United States is associated with AF,3 and strokes in patients with AF are more severe and disabling than in patients without AF.4 The prevalence of AF in the Medicare population increased from 3.2% in 1992 to 6.0% in 2002.5

Warfarin Utilization in Medicare Patients with Nonvalvular Atrial Fibrillation: Sentinel Data from an Administrative Claims Database

For the political junkies among us, the acronym SCOTUS (otherwise known as the Supreme Court of the United States) has practically become a household word. By now, oceans of ink have been devoted to media coverage of the Affordable Care Act (ACA), the 3 days of unprecedented legal hearings and speculation about the potential outcome to be announced sometime in June. My colleagues in health policy circles have been making friendly wagers, not just about what the ultimate decision will be, but how the actual vote count will fall.

Hypertension, defined as systolic blood pressure (BP) ≥140 mm Hg, diastolic BP ≥90 mm Hg, increases with age, affecting more than 50% of patients aged ≥60 years, and approximately 66% of those aged ≥65 years.1-3 It is well known that by 2030, 1 of 5 Americans is expected to be 65 years or older.

Improving Hypertension Management in the Elderly a Core Clinical Goal

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  •  Association for Value-Based Cancer Care
  • Oncology Practice Management
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Rheumatology Practice Management
  • Urology Practice Management
  • Lynx CME