March 1st 2022
Despite the promise of savings billions of dollars in the United States, adoption of biosimilars has been slow. A roundtable discussion among employers highlighted some of the barriers, including formulary design and drug pricing and rebates.
ASHP, AMA ask for federal assistance to resolve drug shortage problem
February 1st 2003Washington, DC-Representatives from the American Society of Health-SystemPharmacists and the American Medical Association met with the Health andHuman Services assistant secretary for health Eve Slater, MD, and FDA'sdeputy commissioner Lester Crawford, DVM, PhD, in late January to discussdrug shortages and ask for federal assistance in resolving the problem.
Incorporating an ethical template into pharmacy benefit decision-making (PDF)
January 1st 2003J Russell Teagarden, MA, RPh, vice president of clinical practices and therapeutics at Medco Health Solutions in Franklin Lakes, NJ, explains how using an ?ethical template? for pharmacy benefit decisions can make those decisions consistent and fair, reducing patient displeasure, conflict, and litigation.
A comparison of the newer treatment options for ADHD (PDF)
January 1st 2003Psychostimulant drugs have consistently demonstrated efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD). Innovative technology has fueled the development of novel release mechanisms and isolation of active enantiomer components with the hopes of enhancing the duration of action and improving the safety and effectiveness. As a result, several new stimulant agents have recently been added to the arsenal of ADHD treatment options. Formulary selection is complicated by the high costs and small but distinct differences among these agents. The five newest FDA-approved stimulant agents for the treatment of ADHD are detailed, and a brief summary of future treatment options, including a recently approved nonstimulant agent, is provided.
Incorporating an ethical template into pharmacy benefit decision-making
January 1st 2003If asked, could you present the underlying rationale for your pharmacy benefit coverage decisions? When considered from the consumer or employee perspective, why should they consider the payors or providers of their drug benefit legitimate decision-makers in limiting their healthcare policies?
Duloxetine: An antidepressant that inhibits both norepinephrine and serotonin uptake
January 1st 2003Duloxetine is a reuptake inhibitor at serotonergic and noradrenergic neurons and appears to have low affinity for other neurotransmitter systems. In three published clinical trials in patients with MDD, duloxetine was well tolerated and more effective than placebo. Further study is needed to compare its efficacy with that of other antidepressants, to prospectively assess time to onset of antidepressant effect, and to clarify effects on somatic symptoms and potential adverse cardiovascular and sexual effects. Duloxetine is also under investigation for the treatment of stress urinary incontinence in women (trade name to be determined, comarketed by Lilly and Boehringer Ingelheim). Preliminary information suggests that duloxetine therapy reduces the number of incontinence episodes. Duloxetine has been deemed ?approvable? for the treatment of MDD and will be comarketed under the trade name Cymbalta by Eli Lilly and Company and Quintiles.
Healthcare at the forefront on federal, state levels
December 1st 2002GOP control of both the Senate and House has pushed efforts to establish a Medicare drug benefit to the top of the legislative agenda. It also has moved proposals to reimport pharmaceuticals from Canada or Mexico and reform generic drug policy down the priority list.
Humana's four-tier benefit design: What does it look like, and how has it been working?
December 1st 2002It's been a year and a half since Humana, Inc, made the move to a four-tier benefit design. Humana's rationale for evolving to the four-tier model, the technology and programs developed to support this benefit structure, and the initial success were discussed by James Stines, director of pharmacy sales for Humana.
Migraine therapy: balancing efficacy and safety with quality of life and cost (PDF)
December 1st 2002Successful management of migraine attacks and their symptoms leads to economic benefits such as decreased reliance on healthcare resources, decreased employee absenteeism, and increased productivity. Appropriate treatment includes prophylaxis with lifestyle changes and drug therapy, and acute therapy with drugs. Over-the-counter analgesics can be effective acute therapy for mild migraine; for moderate to severe attacks, the 5HT1B/1D agonists, or triptans, offer significant efficacy and cost-effectiveness.
Ezetimibe: a novel cholesterol absorption inhibitor (PDF)
December 1st 2002Ezetimibe (Zetia), approved in late October, represents the first new class of cholesterol-lowering drugs in 15 years. Ezetimibe, an intestinal cholesterol absorption inhibitor, has a unique mechanism of action, distinct from those of statins and bile acid sequestrants. When used as monotherapy, ezetimibe lowers low-density lipoprotein cholesterol (LDL-C) levels up to 18.5%. Coadministration of ezetimibe with statin therapy reduces LDL-C levels up to an additional 22%. The article reviews ezetimibe?s chemistry, pharmacology, pharmacokinetics, and clinical trial results.
From the MTIRS: Anticonvulsant reduces migraine headache frequency
November 1st 2002A phase III study presented at the 14th annual meeting of the Migraine Trust International Research Symposium (MTIRS) in September in London showed that topiramate (Topamax) significantly reduced migraine frequency at doses as low as 100 mg/d. The onset of efficacy was observed as early as the first month of treatment. Topiramate is already approved in the United States and worldwide as an
Aripiprazole: First of a new class of antipsychotics (PDF)
November 1st 2002Aripiprazole is an investigational atypical antipsychotic that received an approvable status from FDA in September 2002 for the treatment of schizophrenia. The decision on approval could be made as early as the end of this year. Aripiprazole offers a unique mechanism of action as a dopamine system stabilizer. Aripiprazole has been found to be effective in both short-term (4?6 wk) and long-term (26?52 wk) treatment trials. It appears to produce less hyperprolactinemia, weight gain, and extrapyramidal symptoms than other antipsychotics.
HMG CoA reductase inhibitor-induced muscle toxicity: risks, monitoring, and management (PDF)
November 1st 2002Although the commonly used HMG CoA reductase inhibitors (statins) are well tolerated and relatively safe, muscle toxicity and rhabdomyolysis can occur with administration and can be severe. This risk is higher with more bioavailable and lipophilic statins. This article summarizes what is known about the etiology of statin-associated muscle toxicity, the risks for each statin, and the current recommendations for monitoring and management.
Charging drug representatives for physician visits: Three leadersexplain why and how
November 1st 2002Formulary has identified three organizations that recently begancharging pharmaceutical representatives a fee to meet withphysicians. Two of the organizations-Queen City Physicians and thePolyclinic-are physician group practices based in Cincinnati, OH,and Seattle, WA, respectively.
Rethinking approaches to reducing medication errors: An examination of 10 core processes (PDF)
September 1st 2002Although many organizations have implemented well-intentioned medication error reduction strategies, the authors of this article argue that most approaches don?t address the underlying foundation upon which many errors occur. In this article, they present 10 core process improvements?from ?genericizing? all drug names throughout the hospital/health system to purchasing all single-dose packaging?that they believe could have a significant impact on patient safety if implemented.