Electronic prescribing resulted in greater generic and formulary drug use, according to Crystal Chang, PharmD, and colleagues at Blue Shield of California, San Francisco. It also led to an average cost savings of 17.3% for both the member and the payer.
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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 »

Owing to the recent senatorial election results in Massachusetts, anticipated health care reform agendas for the United States are undergoing change again as the electorate and Congress struggle with a burgeoning health care system. More »

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 »

Specialty formulary management strategies, ePrescribing, and unique formulary benefit designs top the list of critical initiatives at MCOs, according to Cynthia J. Pigg, RPh, MHA, executive director of the Foundation for Managed Care Pharmacy. She discusses results from the Foundation’s 2009 Emerging Trends Survey. More »

In early November, the FDA announced the launch of the Safe Use Initiative, a program to protect patients from injury and death caused by improper use of over-the-counter and prescription medications. More »

Under new FDA rules going into effect this month, more patients will be able to access experimental drugs without taking part in clinical trials. The new rules are meant to clarify a formal process in place since 1987 More »

Dr Schommer is professor, University of Minnesota College of Pharmacy, Minneapolis. Cindy Chen, Jagannath Muzumdar and Siting Zhou are doctoral candidates at the University of Minnesota College of Pharmacy. More »

I hear from my physician friends that the “hassle factor” to obtain health plan coverage of prescribed therapy is increasing exponentially and that many of them are thinking of retiring or cutting back their practices. That is my experience and reaction as well. More »

A proposal for a pilot project to save money for a health plan was developed collaboratively with a clinic manager and the medical director of a local clinic. The goal was to encourage and support physicians in changing the proton pump inhibitor (PPI) medication prescribed for patients from a brand-name PPI to omeprazole, a more cost-effective generic option. The health plan identified members who had filled a prescription for a brand-name PPI and asked their physicians to consider switching... More »

A total of 50 health care professionals, including 25 health plan medical directors, 20 health plan pharmacy directors, and 5 pharmacy directors for pharmacy benefit management companies were surveyed regarding their perceptions of the value of 3 novel cancer therapies. The physicians and pharmacists were asked to estimate the monthly average wholesale price of each therapy, overall survival benefit of bevacizumab for treatment of persons with advanced colorectal cancer and erlotinib for... More »

Employers and their employees are facing tough times in today’s economy. To stay competitive, employers must scrutinize all areas of business for cost-cutting opportunities, including health care benefits. Consumers, too, face challenges. In October, a Kaiser Family Foundation poll reported that the percentage of consumers who skipped dosages or split pills in the past year to save on medication costs had increased to 22%, up from 19% in April. The percentage of consumers who reported not... More »

New guidelines from the Centers for Medicare & Medicaid Services (CMS) that increase the number of compendia health insurers rely on to determine whether a drug use is appropriate will greatly expand the number of off-label uses of chemotherapy agents for which the agency will reimburse. More »

In response to recommendations from the Government Accountability Office (GAO), the Centers for Medicare & Medicaid Services (CMS) says it is cracking down on insurers that offer private fee-for-service (PFFS) plans under the Medicare Advantage (MA) program. More »

Asthma affects approximately 22 million adults and children in the United States and poses a significant economic burden on the health care system and on employers. According to the National Heart, Lung, and Blood Institute, direct and indirect costs for all forms of asthma totaled $19.7 billion in 2007. Prescription drugs represented the largest single direct cost at $6.2 billion. More »