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.
Physician receptivity to use of formulary-loaded PDAs is high, study finds
April 1st 2002Providing formulary information on PDA devices improves formulary compliance and is gaining in physician acceptance as well. These were the findings of a 4-month pilot program involving 104 Connecticut-based physicians conducted by ePocrates and AdvancePCS.
Applying multiattribute utility technology to the formulary evaluation process (PDF)
April 1st 2002Seldom are the attributes of drugs under formulary consideration conveniently measured on the same scale, and if they are, they typically do not carry the same weight in a decision. Fortunately, application of Multiattribute Utility Technology (MAUT) provides a way to incorporate several valued attributes of disparate weights into a unitary measure for the purpose of evaluating options. This month's column presents the core elements of MAUT and explores its use in the drug evaluation process through a mock formulary committee example.
Rosuvastatin: A new HMG0CoA reductase inhibitor for hypercholesterolemia (PDF)
April 1st 2002Rosuvastatin is an investigational HMG-CoA reductase inhibitor expected to gain FDA approval later this year for treatment of hypercholesterolemia. It has significantly exceeded atorvastatin, pravastatin, and simvastatin in reducing LDL cholesterol in clinical trials. This Focus article reviews those trials as well as rosuvastatin's pharmacologic and safety profiles in an effort to delineate its likely role in cholesterol-reducing therapy.
Why physicians start or stop prescribing a drug: Literature review and formulary implications (PDF)
April 1st 2002These authors report on their literature search of studies assessing the impact of factors influencing the diffusion of new drug therapies and physicians' adoption and eventual relinquishment of those therapies. They specifically explore how their finds can help better align physician prescribing with formulary objectives.
Automatic IV to PO conversion process provides greatest gains for hospital, patient
March 1st 2002Hartford Hospital, Hartford, CT-Although the economic advantages of IV to oral (PO) antibiotic conversion programs have been documented in numerous studies, most of these programs require physician contact to encourage the switch.
Assessing the impact of outcomes projects: Take your lead from the AHRQ approach (PDF)
March 1st 2002To retain resources or to justify allocation of additional resources, it's essential to demonstrate the value that outcomes projects bring to organizations. The Agency for Healthcare Research and Quality's project review process serves as a useful model for how to do so. This month's column explores the AHRQ process for following up and communicating the results of outcomes projects conducted at various practice settings.
Review and assessment of pharmacologic management strategies for reflux esophagitis (PDF)
March 1st 2002Pharmacologic therapy is the second cornerstone of the medical management of reflux esophagitis. Because the merits of various drug classes for reflux esophagitis have been widely discussed, the focus of this article is on differing strategies for using these classes. The management strategies - and the rationale and evidence for promoting or rejecting them - are discussed for step-up therapy, empiric therapy, ste-down therapy, on-demand proton pump inhibitor use, combination therapies, and other considerations.
Success of a P & T policy for use of a second ACE inhibitor before switching to an ARB (PDF)
February 1st 2002VA Medical Center, Miami-ACE inhibitor therapy is recognized as the gold standard treatment for congestive heart failure (CHF) as well as diabetic nephropathy due to its effect on the morbidity and mortality associated with these conditions.
Three-tier benefit cuts Rx costs without unintended consequences
February 1st 2002A three-tier pharmacy benefit can reduce prescription drug spending without increasing other medical resource use or fueling medication discontinuation rates. So concludes the fully published report of an analysis whose preliminary results were presented last year and reported by Formulary (2001;36:522). It is the first well-designed, controlled study to explore such consequences of three-tier benefits.
Study cautions against overtreatment when adopting new NCEP III guidelines
February 1st 2002Clinicians must use caution in adopting newly revised national guidelines for treating elevated cholesterol, concludes a new study from the University of Maryland Pharmaceutical Health Services Research Department.