Pub Date : 2015-09-15DOI: 10.18553/JMCP.1999.5.2.93
Terri Bernacchi
Pharmaceutical expenditures in the United States, estimated to be in the billions, increased by 14.2% in 1997. I This growth, largely attributed to increased pharmaceutical utilization and newly patented pharmaceuticals that lack generic competition, will more than likely continue. This trend, coupled with the fact that 70% of all prescriptions are covered partially or fully by a third-party payor, I has resulted in increased scrutiny of pharmaceutical dispensing and reimbursement processes. The audit process is one means of reviewing pharmacy programs; it ensures that procedures and reimbursement mechanisms are consistent with contractual and regulatory requirements. This article presents an overview of the audit
{"title":"The Pharmacy Audit: What Is It and Are You Prepared?","authors":"Terri Bernacchi","doi":"10.18553/JMCP.1999.5.2.93","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.2.93","url":null,"abstract":"Pharmaceutical expenditures in the United States, estimated to be in the billions, increased by 14.2% in 1997. I This growth, largely attributed to increased pharmaceutical utilization and newly patented pharmaceuticals that lack generic competition, will more than likely continue. This trend, coupled with the fact that 70% of all prescriptions are covered partially or fully by a third-party payor, I has resulted in increased scrutiny of pharmaceutical dispensing and reimbursement processes. The audit process is one means of reviewing pharmacy programs; it ensures that procedures and reimbursement mechanisms are consistent with contractual and regulatory requirements. This article presents an overview of the audit","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67487817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.2001.7.2.115
Bob Elson
{"title":"Electronic Prescribing in Ambulatory Care: A Market Primer and Implications for Managed Care Pharmacy","authors":"Bob Elson","doi":"10.18553/JMCP.2001.7.2.115","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.2.115","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.2001.7.S2.10
W. Berger, D. Giaquinta, E. Cannon, G. Ledgerwood, O. Shoheiber
{"title":"The Health Care Plan Perspective","authors":"W. Berger, D. Giaquinta, E. Cannon, G. Ledgerwood, O. Shoheiber","doi":"10.18553/JMCP.2001.7.S2.10","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.S2.10","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67490158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.1999.5.2.113
John R. White
OBJECTIVE: To evaluate the pharmacologic management of Type II diabetes in terms of the effect of various regimens on the metabolic abnormalities present in patients, while considering the importance of medication cost when designing a therapeutic regimen. DESIGN: Literature review. RESULTS: The primary lesion in Type II disease which causes hyperglycemia is probably insulin resistance. Hyperglycemia often is accompanied by other metabolic abnormalities, such as hyperinsulinemia, hyperlipidemia, hypertension, and weight gain. Recently, new oral medications have been introduced, including metformin and troglitazone, which address multiple metabolic abnormalities of Type II disease. Data has proven a conclusive link between poor glycemic control and the appearance and progression of complications. CONCLUSION: While cost of medication should be considered, the most effective method of cost savings in the management of Type II disease is via strict glycemic control with medications which do not adversely affe...
{"title":"The Cost of Managing Diabetes Mellitus: Focus on the Oral Pharmacologic Management of Type II Diabetes","authors":"John R. White","doi":"10.18553/JMCP.1999.5.2.113","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.2.113","url":null,"abstract":"OBJECTIVE: To evaluate the pharmacologic management of Type II diabetes in terms of the effect of various regimens on the metabolic abnormalities present in patients, while considering the importance of medication cost when designing a therapeutic regimen. DESIGN: Literature review. RESULTS: The primary lesion in Type II disease which causes hyperglycemia is probably insulin resistance. Hyperglycemia often is accompanied by other metabolic abnormalities, such as hyperinsulinemia, hyperlipidemia, hypertension, and weight gain. Recently, new oral medications have been introduced, including metformin and troglitazone, which address multiple metabolic abnormalities of Type II disease. Data has proven a conclusive link between poor glycemic control and the appearance and progression of complications. CONCLUSION: While cost of medication should be considered, the most effective method of cost savings in the management of Type II disease is via strict glycemic control with medications which do not adversely affe...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67487706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.1999.5.6.492
J. Generali
OBJECTIVE: To develop a practical medication-use evaluation (MUE) tool flexible enough to be used in a variety of practice settings. SETTING: Institutional health care systems or managed care organizations, although the format may be adapted for use by consultant pharmacists. DESIGN: This MUE has been designed for use as part of a comprehensive outcome monitoring program. It focuses on a particular agent (tramadol hydrochloride) that has significant cost and usage implications. MAIN OUTCOME MEASURES: Appropriate patient populations and desired therapeutic outcomes can be identified with the use of this MUE. Customized interventions that are appropriate to each organization may. RESULTS: This MUE can provide a framework for institutional health care systems and' MCOs to use in developing a comprehensive monitoring program for tramadol hydrochloride and an oral analgesic. CONCLUSION: Effective high-quality pharmaceutical care incorporates the use of assessment methods that monitor patient outcomes and medic...
{"title":"Criteria for the Use of Tramadol in Adult Patients: Medication-Use Evaluation Guidelines","authors":"J. Generali","doi":"10.18553/JMCP.1999.5.6.492","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.6.492","url":null,"abstract":"OBJECTIVE: To develop a practical medication-use evaluation (MUE) tool flexible enough to be used in a variety of practice settings. SETTING: Institutional health care systems or managed care organizations, although the format may be adapted for use by consultant pharmacists. DESIGN: This MUE has been designed for use as part of a comprehensive outcome monitoring program. It focuses on a particular agent (tramadol hydrochloride) that has significant cost and usage implications. MAIN OUTCOME MEASURES: Appropriate patient populations and desired therapeutic outcomes can be identified with the use of this MUE. Customized interventions that are appropriate to each organization may. RESULTS: This MUE can provide a framework for institutional health care systems and' MCOs to use in developing a comprehensive monitoring program for tramadol hydrochloride and an oral analgesic. CONCLUSION: Effective high-quality pharmaceutical care incorporates the use of assessment methods that monitor patient outcomes and medic...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.2001.7.5.335
M. Shepherd
{"title":"Concern about Foreign-Source Pharmacy Internet Providers","authors":"M. Shepherd","doi":"10.18553/JMCP.2001.7.5.335","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.5.335","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.2001.7.6.476
Mary P. Weber, S. Reno, R. Hornbake, A. Shillington
OBJECTIVES: To evaluate and describe outcomes associated with a novel in- home administration program of respi- ratory syncytial virus (RSV) prophylaxis with palivizumab; to analyze health resource utilization and cost outcomes; and to assess parental satisfaction with in-home administration of prophy- laxis for high-risk children. DESIGN: Descriptive program evalua- tion. RESULTS: Compared with published reports of office, outpatient, or clinic- based RSV prophylaxis with palivizumab, in-home prophylaxis demonstrated low incidence of total hospitalizations (11.4% versus 14.4%) and RSV-related hospitalizations (2.3% versus 4.8%). Less than 10% of patients required an ED visit and only 1% of those were related to RSV ill- ness. Only one of the hospitalized infants required ICU admission. One- fourth of the patients experienced fever or ear infection; 43.2% devel- oped cold symptoms. In-home palivizumab prophylaxis has the potential for saving $214 per patient over drug administration and hospital- ization costs. Parental satisfaction with the in-home program was 98.6%, leading to high compliance; less than 2% of patients discontinued the program due to noncompliance. CONCLUSIONS: In-home administra- tion of palivizumab RSV prophylaxis can provide favorable outcomes, high parent satisfaction, and potential cost savings. Incidence of RSV-related hospitalizations among patients given prophylaxis at home was substantially lower than has been reported with outpatient or clinic-based prophylaxis. Compliance was excellent due to ease of administration of intramuscular palivizumab, convenience for families with multiple or premature infants or infants requiring cumbersome med- ical devices, and parents' desire to minimize the risk of exposure to RSV and other communicable diseases in clinics. Improved clinical outcomes observed with in-home prophylaxis may translate into substantial cost savings for health care purchasers.
{"title":"An In-Home Synagis Program for RSV Prevention in High-Risk Infants","authors":"Mary P. Weber, S. Reno, R. Hornbake, A. Shillington","doi":"10.18553/JMCP.2001.7.6.476","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.6.476","url":null,"abstract":"OBJECTIVES: To evaluate and describe outcomes associated with a novel in- home administration program of respi- ratory syncytial virus (RSV) prophylaxis with palivizumab; to analyze health resource utilization and cost outcomes; and to assess parental satisfaction with in-home administration of prophy- laxis for high-risk children. DESIGN: Descriptive program evalua- tion. RESULTS: Compared with published reports of office, outpatient, or clinic- based RSV prophylaxis with palivizumab, in-home prophylaxis demonstrated low incidence of total hospitalizations (11.4% versus 14.4%) and RSV-related hospitalizations (2.3% versus 4.8%). Less than 10% of patients required an ED visit and only 1% of those were related to RSV ill- ness. Only one of the hospitalized infants required ICU admission. One- fourth of the patients experienced fever or ear infection; 43.2% devel- oped cold symptoms. In-home palivizumab prophylaxis has the potential for saving $214 per patient over drug administration and hospital- ization costs. Parental satisfaction with the in-home program was 98.6%, leading to high compliance; less than 2% of patients discontinued the program due to noncompliance. CONCLUSIONS: In-home administra- tion of palivizumab RSV prophylaxis can provide favorable outcomes, high parent satisfaction, and potential cost savings. Incidence of RSV-related hospitalizations among patients given prophylaxis at home was substantially lower than has been reported with outpatient or clinic-based prophylaxis. Compliance was excellent due to ease of administration of intramuscular palivizumab, convenience for families with multiple or premature infants or infants requiring cumbersome med- ical devices, and parents' desire to minimize the risk of exposure to RSV and other communicable diseases in clinics. Improved clinical outcomes observed with in-home prophylaxis may translate into substantial cost savings for health care purchasers.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67490447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.1997.3.1.11
C. Sardinha
{"title":"AMCP Speakers Reinhardt and Satcher Paint Bright Future","authors":"C. Sardinha","doi":"10.18553/JMCP.1997.3.1.11","DOIUrl":"https://doi.org/10.18553/JMCP.1997.3.1.11","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68349651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.1997.3.1.66
D. Mednick
OBJECTIVE: To review advantages and disadvantages of commonly used study design strategies and examine issues in interpretation of study results including bias and confounding. DATA SOURCES: Clinical literature, established epidemiologic texts. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: The increasing flow of research reports on various therapeutic agents and procedures places managed care pharmacists in the position of evaluating the clinical relevance of new information and its applicability to clinical decision-making in their organizations. A solid understanding of study design strategies such as cohort, case-control, and clinical trials, and the flaws inherent in each, is invaluable for accurate interpretation of any study results. Some design strategies are more appropriate than others to answer certain clinical questions. The randomized, controlled, blinded clinical trial is the most reliable design for assessing therapeutic effects of pharmacologic agents. CO...
{"title":"Method Is Everything: Evaluating Results by Study Design","authors":"D. Mednick","doi":"10.18553/JMCP.1997.3.1.66","DOIUrl":"https://doi.org/10.18553/JMCP.1997.3.1.66","url":null,"abstract":"OBJECTIVE: To review advantages and disadvantages of commonly used study design strategies and examine issues in interpretation of study results including bias and confounding. DATA SOURCES: Clinical literature, established epidemiologic texts. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: The increasing flow of research reports on various therapeutic agents and procedures places managed care pharmacists in the position of evaluating the clinical relevance of new information and its applicability to clinical decision-making in their organizations. A solid understanding of study design strategies such as cohort, case-control, and clinical trials, and the flaws inherent in each, is invaluable for accurate interpretation of any study results. Some design strategies are more appropriate than others to answer certain clinical questions. The randomized, controlled, blinded clinical trial is the most reliable design for assessing therapeutic effects of pharmacologic agents. CO...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68350536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-15DOI: 10.18553/JMCP.1997.3.3.254
F. Curtiss
{"title":"Drug Formularies: Real Opportunities to Improve MCO Efficiency","authors":"F. Curtiss","doi":"10.18553/JMCP.1997.3.3.254","DOIUrl":"https://doi.org/10.18553/JMCP.1997.3.3.254","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68350876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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