Pub Date : 2015-09-15DOI: 10.18553/JMCP.1999.5.6.516
A. Barber
OBJECTIVE: To determine the cost effectiveness of a pharmacist directed disease management program for patients with heart failure. DESIGN: A disease management approach for heart failure based on ...
目的:确定药师指导的心力衰竭患者疾病管理项目的成本效益。设计:基于…的心力衰竭疾病管理方法
{"title":"Congestive Heart Failure: A Disease Management Approach in Long-Term Care Patients","authors":"A. Barber","doi":"10.18553/JMCP.1999.5.6.516","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.6.516","url":null,"abstract":"OBJECTIVE: To determine the cost effectiveness of a pharmacist directed disease management program for patients with heart failure. DESIGN: A disease management approach for heart failure based on ...","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":"67488227","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.1999.5.4.331
S. Bull
OBJECTIVE: To gain insight into the accuracy of dosing guidelines and the overall success of a therapeutic' interchange program by analyzing pharmacy claims data. DESIGN: Evaluation of prescribing patterns via retrospective analysis of pharmacy claims data for therapeutic interchange between angiotensin II converting enzyme inhibitors (ACEls). SETTING: A California IPA-model HMO. MAIN OUTCOME MEASURES: Percentage of conversion doses that corresponded with pharmacy and therapeutics (P&T) guidelines variation among actual conversion doses utilized, and number of dosage titrations associated with implementing conversions. RESULTS: The analysis revealed that dosing ratios utilized to convert patients from lisinopril, quinapril, enalapril, and ramipril to benazepril HCI corresponded with P&T guidelines 83%, 78%, 54%, and 26% of the time, respectively. The variance in conversion doses from enalapril and ramipril was significantly greater than from lisinopril and quinapril (p less than O.01). The overall percent...
{"title":"Utilization of Pharmacy Claims Data to Evaluate Therapeutic Interchange Programs","authors":"S. Bull","doi":"10.18553/JMCP.1999.5.4.331","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.4.331","url":null,"abstract":"OBJECTIVE: To gain insight into the accuracy of dosing guidelines and the overall success of a therapeutic' interchange program by analyzing pharmacy claims data. DESIGN: Evaluation of prescribing patterns via retrospective analysis of pharmacy claims data for therapeutic interchange between angiotensin II converting enzyme inhibitors (ACEls). SETTING: A California IPA-model HMO. MAIN OUTCOME MEASURES: Percentage of conversion doses that corresponded with pharmacy and therapeutics (P&T) guidelines variation among actual conversion doses utilized, and number of dosage titrations associated with implementing conversions. RESULTS: The analysis revealed that dosing ratios utilized to convert patients from lisinopril, quinapril, enalapril, and ramipril to benazepril HCI corresponded with P&T guidelines 83%, 78%, 54%, and 26% of the time, respectively. The variance in conversion doses from enalapril and ramipril was significantly greater than from lisinopril and quinapril (p less than O.01). The overall percent...","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":"67488464","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.1999.5.1.19
E. Bergen
care organization (MCO) headquartered in Edina, Minnesota, recently instituted pharmacy benefits consolidation and streamlining that reduced its double-digit pharmacy cost trend to less than 6% in 1997, while improving customer and physician satisfaction through a three-tier pharmacy plan. The methods employed are expected to afford continued savings and benefits through 1998 and beyond. After United HealthCare acquired MetraHealth in late 1996, the organization served more than 13 million individuals across the United States through preferred provider, health maintenance, and exclusive provider organizations as well as through managed indemnity, point of service, group and individual Medicare, worker's compensation, and specialized provider network products. Approximately 7.5 million pharmacy lives were covered under thousands of different benefit designs, dozens of pharmacy networks, and more than a dozen different formularies nationwide. Each health plan independently managed its pharmacy program. Although United HealthCare had a pharmacy benefit manager (PEM), Diversified Pharmaceutical Services Inc., it became clear that consolidation and streamlining of pharmacy benefits was needed to reduce a trend in which other medical ex-
{"title":"Pharmacy Cost Reduction Imperative at United HealthCare","authors":"E. Bergen","doi":"10.18553/JMCP.1999.5.1.19","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.1.19","url":null,"abstract":"care organization (MCO) headquartered in Edina, Minnesota, recently instituted pharmacy benefits consolidation and streamlining that reduced its double-digit pharmacy cost trend to less than 6% in 1997, while improving customer and physician satisfaction through a three-tier pharmacy plan. The methods employed are expected to afford continued savings and benefits through 1998 and beyond. After United HealthCare acquired MetraHealth in late 1996, the organization served more than 13 million individuals across the United States through preferred provider, health maintenance, and exclusive provider organizations as well as through managed indemnity, point of service, group and individual Medicare, worker's compensation, and specialized provider network products. Approximately 7.5 million pharmacy lives were covered under thousands of different benefit designs, dozens of pharmacy networks, and more than a dozen different formularies nationwide. Each health plan independently managed its pharmacy program. Although United HealthCare had a pharmacy benefit manager (PEM), Diversified Pharmaceutical Services Inc., it became clear that consolidation and streamlining of pharmacy benefits was needed to reduce a trend in which other medical ex-","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":"67487588","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.1999.5.6.525
C. Stern
OBJECTIVE: To provide an in-depth discussion of the philosophies, design, and structure of the prescription pharmacy benefit. DATA SOURCES: Benefit consultants, texts. CONCLUSION: Pharmacy benefits are structured using the same principles as other health care benefits. However, the design of benefits as wage alternatives complicates their implementation as employers insist upon performance and employees insist on receiving their benefits as entitlements. The resultant benefit designs are a balance between cost and risk management and provision of the services that beneficiaries expect.
{"title":"The History, Philosophy, and Principles of Pharmacy Benefits","authors":"C. Stern","doi":"10.18553/JMCP.1999.5.6.525","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.6.525","url":null,"abstract":"OBJECTIVE: To provide an in-depth discussion of the philosophies, design, and structure of the prescription pharmacy benefit. DATA SOURCES: Benefit consultants, texts. CONCLUSION: Pharmacy benefits are structured using the same principles as other health care benefits. However, the design of benefits as wage alternatives complicates their implementation as employers insist upon performance and employees insist on receiving their benefits as entitlements. The resultant benefit designs are a balance between cost and risk management and provision of the services that beneficiaries expect.","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":"https://sci-hub-pdf.com/10.18553/JMCP.1999.5.6.525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488288","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.1999.5.6.543
L. Coleman
OBJECTIVE: To review the importance of short- and long-term glucose monitoring in people with diabetes, emphasizing the relationship between elevated fasting and postprandial glucose levels and their association with hemoglobin A1c (HbA1c). DESIGN: Literature review. RESULTS: Numerous epidemiologic and interventional studies have demonstrated that lowering blood glucose to normal or near-normal levels for several years prevents the onset and delays the progression of microvascular complications including retinopathy, nephropathy, and neuropathy. Based on a substantial amount of data, the American Diabetes Association recommends that treatment of all individuals with diabetes be aimed at lowering blood glucose to normal or near-normal levels. CONCLUSIONS: Frequent self-monitoring of blood glucose (SMBG), if used properly, can be effective at improving glycemic control on a day-to-day basis. 5MBG should be done daily and should include measurement of both fasting and postprandial blood glucose levels. Routi...
{"title":"Importance of Blood Glucose Monitoring to Achieve Short- and Long-Term Glycemic Control","authors":"L. Coleman","doi":"10.18553/JMCP.1999.5.6.543","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.6.543","url":null,"abstract":"OBJECTIVE: To review the importance of short- and long-term glucose monitoring in people with diabetes, emphasizing the relationship between elevated fasting and postprandial glucose levels and their association with hemoglobin A1c (HbA1c). DESIGN: Literature review. RESULTS: Numerous epidemiologic and interventional studies have demonstrated that lowering blood glucose to normal or near-normal levels for several years prevents the onset and delays the progression of microvascular complications including retinopathy, nephropathy, and neuropathy. Based on a substantial amount of data, the American Diabetes Association recommends that treatment of all individuals with diabetes be aimed at lowering blood glucose to normal or near-normal levels. CONCLUSIONS: Frequent self-monitoring of blood glucose (SMBG), if used properly, can be effective at improving glycemic control on a day-to-day basis. 5MBG should be done daily and should include measurement of both fasting and postprandial blood glucose levels. Routi...","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":"67488974","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.2001.7.2.105
J. Eichenholz
{"title":"Trends in Managed Care Pharmacy: Preparing for the Future","authors":"J. Eichenholz","doi":"10.18553/JMCP.2001.7.2.105","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.2.105","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":"67489129","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.2001.7.2.95
D. Tipton
{"title":"Managed Care Concepts Prominently Featured in Innovative Management Programs at Duquesne University","authors":"D. Tipton","doi":"10.18553/JMCP.2001.7.2.95","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.2.95","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":"67489482","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.2001.7.1.17
M. Cloutier
{"title":"RxHealthValue Offers Three Recommendations and Cost Research","authors":"M. Cloutier","doi":"10.18553/JMCP.2001.7.1.17","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.1.17","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":"67489514","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.2001.7.5.342
D. Ginsburg
{"title":"Privacy Just Took on a Whole New Meaning: What HIPAA Means to Pharmacists","authors":"D. Ginsburg","doi":"10.18553/JMCP.2001.7.5.342","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.5.342","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":"67489824","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.2001.7.4.257
C. Tsourounis
o you know that right now most consumers can purchase any prescription medication online without a prescription? That’s right, any consumer with a valid credit card can purchase lifestyle-enhancing medications sildenafil (Viagra) and finasteride (Propecia). They can also purchase controlled substances such as hydrocodone/a cetaminophen (Vicodin), acetaminophen/codeine (Tylenol #3), or even diazepam (Valium). Gaining access to injectible testosterone and other steroids is easy. Unscrupulous entrepreneurs have even written manuals (available for purchase) that describe how to exploit the Internet for prescription medications. How did this virtual deregulation of pre
{"title":"Getting a Quick Fix Online","authors":"C. Tsourounis","doi":"10.18553/jmcp.2001.7.4.257","DOIUrl":"https://doi.org/10.18553/jmcp.2001.7.4.257","url":null,"abstract":"o you know that right now most consumers can purchase any prescription medication online without a prescription? That’s right, any consumer with a valid credit card can purchase lifestyle-enhancing medications sildenafil (Viagra) and finasteride (Propecia). They can also purchase controlled substances such as hydrocodone/a cetaminophen (Vicodin), acetaminophen/codeine (Tylenol #3), or even diazepam (Valium). Gaining access to injectible testosterone and other steroids is easy. Unscrupulous entrepreneurs have even written manuals (available for purchase) that describe how to exploit the Internet for prescription medications. How did this virtual deregulation of pre","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":"67490002","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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