News on Biologics
June 7, 2010
Biologic Switching and Discontinuation in Patients With Rheumatoid Arthritis
More than half of patients with rheumatoid arthritis who were treated with a biologic discontinued treatment, and another 12% switched to at least 1 other biologic within a 2-year treatment period, according to a study led by Chureen Carter, PharmD, of Centocor Ortho Biotech Services. More »
April 16, 2010
Comparative Effectiveness Research—Part 2: The Impact on Decision Making
As publicly funded health care payment programs have grown over decades because of demographic shifts and expansion of coverage, comparative effectiveness research (CER) has emerged to address value in health care. The American Recovery and Reinvestment Act of 2008 (ARRA) included $1.1 billion for CER initiatives, and the new health care legislation created the Patient-Centered Outcomes Research Institute, which will be funded with $500 million or more annually. In these efforts exist the... More »
April 16, 2010
The Benefits and Challenges of Health Care Reform
The pharmaceutical industry aggressively supported efforts to pass health care reform, even pledging to trim drug costs by $80 billion.1 In addition, it pumped millions of dollars into lobbying and ad campaigns to push the legislation to a successful conclusion, even joining with groups such as Families USA, which ironically spent years attacking drug makers in the early part of the decade.2 More »
February 17, 2010
A Comparison of the Clinical Effectiveness and Cost-Effectiveness of Treatments for Moderate to Severe Psoriasis
This study investigated the clinical effectiveness and cost-effectiveness of treatments for moderate to severe psoriasis from a managed health care systems perspective. An analysis was conducted of randomized clinical trials evaluating biologic and oral systemic medications and phototherapy for patients with moderate to severe psoriasis. More »
August 1, 2009
Rheumatologists Embrace Biologics Despite Coverage Limits
As the number of biologic agents for rheumatoid arthritis (RA)—and rheumatologists’ use of these agents for RA and other rheumatological diseases—grows, getting coverage for RA treatment is taking an increasing investment of physicians’ staff time. However, the majority of respondents to a recent survey say it is an investment in patient care that is worth making. More »
April 1, 2008
Biologics Are Changing the Face of Psoriasis Treatment
As dermatologists' use of biologic drugs for psoriasis grows, MCOs must take an increasingly active role in managing the near-term utilization of these high-cost agents while also taking into account that some of the "payback" for these drugs comes in the form of long-term costs avoided. Meanwhile, physicians, insurers, and employers continue to wrestle with issues such as step-down dosing; step therapy; patient-administration versus physician-administration; and whether biologic drugs should be... More »
March 1, 2008
New Push for Generic Biologics
More »
March 1, 2008
Personalized Medicine: A New Medical Paradigm
Recent advances in diagnostic testing have increased the likelihood that our current model of medical treatment will soon be supplanted, at least in part, by personalized medicine. With this change in the medical paradigm will come numerous benefits and opportunities for patients, caregivers, drug developers, diagnostics firms, and MCOs. More »
February 1, 2008
Medicare Prescription Drug Coverage
More »
February 1, 2008
The Future of Inhaled Insulin Therapy
Diabetes is a destructive disease that kills thousands each year in the United States and disables thousands more, and its incidence has been rising dramatically. Glycemic control is imperative to forestall complications; however, it can be difficult for patients to achieve glycemic goals. More »
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What pay for performance means for musculoskeletal medicine

Pay for performance (P4P) is causing physicians to examine how they provide care individually and collectively within local health systems. It is the most recent attempt by Medicare and commercial payers to reduce the cost and improve the outcomes of health care. Understanding P4P and deciding how to manage the multiple programs being implemented by payers will challenge physicians' ethics and practice resources. Improving health care for musculoskeletal diseases will require cooperation among the specialties that share responsibility for this care and improved methods for coordinating and documenting it.

 

Antidepressants: Brand Name or Generic?

For many antidepressants, the issue of brand-name versus generic has no practical significance. Elavil was first marketed almost a half century ago, and its patent has long expired. It lives on, however, but as generic amitriptyline. Today, only a few antidepressants are still fully protected by patents, namely, Cymbalta (2010), Lexapro (2012), and Pristiq (2022) for major depressive disorder (MDD); and Seroquel (2011) and Symbyax (2017) for bipolar depression. The issue of brand-name versus generic, however, is far more complex than merely listing patent expiration dates. Patents can be extended, challenged, and infringed on; financial considerations are enormous; and patient care issues are often of central importance. To place antidepressants in proper perspective, it is first necessary to provide some general background about patents and drug regulation.

 

RA therapies in 2009: The latest on drug effectiveness

Clinical study findings of recent years support the notion that patients with rheumatoid arthritis (RA) should be treated earlier and more aggressively. Monotherapy with disease-modifying antirheumatic drugs (DMARDs) is effective in some cases, but triple DMARD therapy is superior to double therapy or monotherapy in early or late RA. Leflunomide is at least as effective as methotrexate (MTX) and sulfasalazine and more effective than placebo. Tumor necrosis factor α antagonists are effective in patients with early or late RA, especially in combination with MTX. Anakinra is more effective than placebo as monotherapy or when combined with MTX. Rituximab and abatacept are useful as monotherapy but are more effective when used in combination with other DMARDs.

 

Payer’s budget to get right targeted drug to right patient

When laboratory tests are inaccurate or misinterpreted, patients may receive costly targeted drugs that provide no benefit. If the medical community doesn’t resolve the problem, payers will take action on their own.

 
Journal Scan
Risk stratification schemes, anticoagulation use and outcomes: the risk–treatment paradox in patients with newly diagnosed non
heart.bmj.com - 12/15/11
research plan analysed data and drafted and revised the manuscript. ... Briefly we obtained data by linking five administrative databases in a single-payer healthcare system with universal access and 100% capture of all interactions ...
2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: Executive Summary: A Report of the American College of Cardiol
content.onlinejacc.org - 12/6/11
4.4 Hormonal Manipulation......2594 4.5 Perioperative Beta Blockers......2594 4.6 Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers......2594 4.7 Smoking Cessation......2594 4.8 Emotional Dysfunction and Psychosocial Considerations......2595 ... guidelines for cardiovascular diseases and procedures directs and oversees this effort. ... the basis for regulatory or payer decisions the goal should be ...
Cost-benefit analysis in occupational health: a comparison of intervention scenarios for occupational asthma and rhinitis among
oem.bmj.com - 9/30/11
stakeholders (employers employees and society (tax-payers)). ... high risk workers defined as workers sensitised to occupational allergens and/or reporting upper respiratory symptoms are identified through health surveillance. ... available for general asthma and rhinitis and not for specific occupational symptoms. ...
Payment source, quality of care, and outcomes in patients hospitalized with heart failure.
pubmed.com - 9/26/11
Patients were grouped on the basis of payer status (private/health maintenance ... (OR: 0.86; 95% CI: 0.78 to 0.96). Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and beta-blockers were prescribed less frequently in the Medicare group (OR: 0.89; ...
Payment Source, Quality of Care, and Outcomes in Patients Hospitalized With Heart Failure -- Kapoor et al. 58 (14): 1465 -- Jour
content.onlinejacc.org - 9/26/11
Patients were grouped on the basis of payer status (private/health maintenance ... (OR: 0.86; 95% CI: 0.78 to 0.96). Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and beta-blockers were prescribed less frequently in the Medicare group (OR: 0.89; ...

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