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Journal of Managed Care & Specialty Pharmacy

Melanie K Kuester, E Anne Jackson, Brenda M Runyan, Edmund J Pezalla, Samuel R Nussbaum
BACKGROUND: The advent of personalized medicine creates opportunities for regenerative therapies to deliver extended clinical benefit from a single administration. Policymakers and health insurers in the United States are evaluating coverage and payment arrangements for these therapies. One challenge involved in these evaluations is the perception that subscribers change insurers relatively often. However, the effect of pediatric rare diseases on retention rates for commercial health insurers has not been well studied...
September 26, 2018: Journal of Managed Care & Specialty Pharmacy
Kelsey L Hawkins, Jordan King, Thomas Delate, Kerri Martinez, Kathleen McCool, Nathan P Clark
BACKGROUND: There is increasing demand on pharmacist time within clinical pharmacy services, and pharmacy technicians are a crucial resource for expanding pharmacy practice. OBJECTIVE: To assess the safety and effectiveness of pharmacy technician management of stable, in-range international normalized ratio (INR) results compared with usual care. METHODS: This retrospective, longitudinal, noninferiority cohort study was conducted at an integrated health care delivery system with a centralized anticoagulation service...
November 2018: Journal of Managed Care & Specialty Pharmacy
Daniel C Lane, Stephen Stemkowski, Richard H Stanford, Zhuliang Tao
BACKGROUND: Evidence suggests that real-world treatment patterns of chronic obstructive pulmonary disease (COPD) do not always follow evidence-based treatment recommendations such as those of the Global Initiative for Chronic Obstructive Lung Disease, which recommends treatment escalation based on disease progression. This U.S. database study evaluated treatment patterns in patients with COPD, focusing on time to initiation of triple therapy using multiple inhalers. OBJECTIVES: To (a) estimate time from diagnosis to initiation of long-acting muscarinic antagonist (LAMA) monotherapy, inhaled corticosteroid (ICS)/long-acting beta2-agonist (LABA) dual therapy, or LAMA/LABA dual therapy; (b) estimate time to initiation of triple therapy from LAMA monotherapy and ICS/LABA or LAMA/LABA dual therapies; and (c) estimate the likelihood of patient progression to triple therapy...
November 2018: Journal of Managed Care & Specialty Pharmacy
Xue Han, D Steven Fox, Michelle Chu, J Samantha Dougherty, Jeffrey McCombs
BACKGROUND: The American College of Cardiology and American Heart Association (ACC/AHA) issued new cholesterol treatment guidelines in 2013. Two of the groups designated for primary prevention were analyzed: patients with a low-density lipoprotein cholesterol (LDL-C) level ≥ 190 mg per dL and diabetic patients aged 40-75 years. OBJECTIVE: To estimate the effects of primary prevention as specified in the 2013 guidelines on cardiovascular event risk and cost. METHODS: Primary prevention patients were identified using laboratory and diagnostic data for Humana members from 2007 to 2013...
November 2018: Journal of Managed Care & Specialty Pharmacy
Suthasinee Dokbua, Piyameth Dilokthornsakul, Nathorn Chaiyakunapruk, Bandana Saini, Ines Krass, Teerapon Dhippayom
BACKGROUND: Current evidence of the effects of pharmacy services on asthma outcomes are not conclusive, since most pharmacy services comprise a variety of interventions. OBJECTIVE: To assess the effect of a service containing self-management support delivered by community pharmacists to patients with asthma. METHODS: A systematic search was performed in the following databases from inception to January 2017: PubMed, Embase, Cochrane Library's Central Register of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus, International Pharmaceutical Abstracts, and PsycInfo...
November 2018: Journal of Managed Care & Specialty Pharmacy
Dylan J Mezzio, Victor B Nguyen, Andrew Kiselica, Ken O'Day
BACKGROUND: Behavioral economics is a field of economics that draws on insights from psychology to understand and identify patterns of decision making. Cognitive biases are psychological tendencies to process information in predictable patterns that result in deviations from rational decision making. Previous research has not evaluated the influence of cognitive biases on decision making in a managed care setting. OBJECTIVE: To assess the presence of cognitive biases in formulary decision making...
November 2018: Journal of Managed Care & Specialty Pharmacy
Jennifer S Albrecht, Maya Hanna, Dure Kim, Eleanor M Perfetto
BACKGROUND: Predictive models for earlier diagnosis of Alzheimer's disease and related dementias (ADRD) that rely on variables requiring assessment during an office visit, such as cognitive function, body mass index, or lifestyle factors, may not be broadly applicable, since that level of data may be inaccessible or inefficient. OBJECTIVE: To build a predictive model for earlier diagnosis of ADRD using only administrative claims data to enhance applicability at the health care-system level...
November 2018: Journal of Managed Care & Specialty Pharmacy
Chi-Fang Wu, Li Xu, Shuangshuang Fu, Ho-Lan Peng, Craig A Messick, David R Lairson
BACKGROUND: The incidence and death rate of anal cancer in the United States has been increasing on average 2%-3% per year over the past 10 years. Human papillomavirus (HPV) vaccination is a potentially viable prevention strategy, since about 80% of anal cancers are attributable to HPV. To understand the effect of HPV vaccination, it is important to estimate the treatment costs for the HPV-related disease. OBJECTIVE: To estimate the 2-year per patient mean direct health care costs associated with anal cancer in a commercially insured population in the United States...
November 2018: Journal of Managed Care & Specialty Pharmacy
Rashad Carlton, Rosa Coppolecchia, Kristin Khalaf-Gillard, Barb Lennert, Ashton Moradi, Todd Williamson, Jennifer Cameron
BACKGROUND: Cardiovascular disease remains the leading cause of death in adults in the United States and constitutes a substantial portion of overall national health expenditures. Aspirin is generally recommended for primary cardiovascular event prevention based on a given patient's underlying cardiovascular event risk profile, particularly for those aged 50-69 years with a 10-year risk of coronary heart disease of ≥ 10%. Evidence-based clinical guidelines are in agreement for secondary prevention consisting of lifelong, low-dose aspirin therapy following a cardiovascular event...
November 2018: Journal of Managed Care & Specialty Pharmacy
Hiraku Kumamaru, Moa P Lee, Niteesh K Choudhry, Yaa-Hui Dong, Alexis A Krumme, Nazleen Khan, Gregory Brill, Shun Kohsaka, Hiroaki Miyata, Sebastian Schneeweiss, Joshua J Gagne
BACKGROUND: Medication nonadherence is a major public health problem. Identification of patients who are likely to be and not be adherent can guide targeted interventions and improve the design of comparative-effectiveness studies. OBJECTIVE: To evaluate multiple measures of patient previous medication adherence in light of predicting future statin adherence in a large U.S. administrative claims database. METHODS: We identified a cohort of patients newly initiating statins and measured their previous adherence to other chronic preventive medications during a 365-day baseline period, using metrics such as proportion of days covered (PDC), lack of second fills, and number of dispensations...
November 2018: Journal of Managed Care & Specialty Pharmacy
Thomas Vanderholm, Hannah M Renner, Samuel F Stolpe, Alex J Adams
The Statin Use in Persons with Diabetes (SUPD) measure has been adopted by the Centers for Medicare and Medicaid Services as a display measure for Medicare Part C and Part D plan sponsors and is slated for inclusion within the primary star rating measure set. As such, the measure has become a focal point for quality improvement efforts by many health plans. Current pharmacy-based interventions reported in the literature involve pharmacists recommending that a patient's provider issue a prescription for a statin; studies to date have not shown that this intervention has been effective for the majority of patients with diabetes...
November 2018: Journal of Managed Care & Specialty Pharmacy
Kiran Gupta, Jeffrey Trocio, Allison Keshishian, Qisu Zhang, Oluwaseyi Dina, Jack Mardekian, Lisa Rosenblatt, Xianchen Liu, Shalini Hede, Anagha Nadkarni, Tom Shank
BACKGROUND: The ARISTOTLE trial demonstrated that apixaban had significantly lower rates of stroke/systemic embolism (SE) and major bleeding than warfarin; however, no direct clinical trials between apixaban and other direct oral anticoagulants (DOACs) are available. Few real-world studies comparing the effectiveness and safety between DOACs have been conducted. OBJECTIVE: To compare effectiveness, safety, and health care costs among oral anticoagulants (OACs) for nonvalvular atrial fibrillation (NVAF) patients in the U...
November 2018: Journal of Managed Care & Specialty Pharmacy
Deborah S Ling Grant, Ronald D Scott, Teresa N Harrison, T Craig Cheetham, Shen-Chih Chang, Jin-Wen Y Hsu, Rong Wei, Susan H Boklage, Victoria Romo-LeTourneau, Kristi Reynolds
BACKGROUND: Lipid screening determines eligibility for statins and other cardiovascular risk reduction interventions. OBJECTIVE: To examine trends in lipid screening among adults aged ≥20 years in a large, multiethnic, integrated health care delivery system in southern California. METHODS: Temporal trends in lipid screening were examined from 2009 to 2015 with an index date of September 30 of each year. Lipid screening was defined as the proportion of eligible members each year who (a) had ever been screened among those aged 20-39 years and (b) had been screened in the previous 6 years for those aged ≥ 40 years...
November 2018: Journal of Managed Care & Specialty Pharmacy
(no author information available yet)
AMCP Nexus 2018: Preparing for the Next Generation of Care in Orlando, Florida, is expected to attract more than 2,400 managed care pharmacists and other health care professionals who manage and evaluate drug therapies, develop and manage networks, and work with medical managers and information specialists to improve the care of all individuals enrolled in managed care programs. The AMCP Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice...
October 2018: Journal of Managed Care & Specialty Pharmacy
Luba Nalysnyk, Rebecca Sugarman, Clifford Cele, Jennifer Uyei, Alexandra Ward
BACKGROUND: Gaucher disease type 1 (GD1) is a rare, genetic, lysosomal storage disease with no cure. Current treatment options include intravenous (IV) enzyme replacement therapy ([ERT]; imiglucerase, velaglucerase alfa, or taliglucerase alfa) or oral substrate reduction therapy ([SRT]; eliglustat or miglustat). The cost to U.S. payers of an IV-administered drug can vary depending on the site of care (i.e., home, outpatient clinic, or hospital setting). Treatment with oral eliglustat may present an opportunity for cost savings...
October 2018: Journal of Managed Care & Specialty Pharmacy
Blake Shay, Julie Kennerly-Shah, Marjorie Neidecker, Stuart Beatty, Leslie Witkoff, Nicole Brown, Eric Kraut
BACKGROUND: Pharmacists have the ability to enhance comprehensive care for bleeding disorders patients by bridging the gap between hemophilia treatment centers (HTC) and specialty pharmacies, specifically by monitoring bleeding logs. In September 2015, a pharmacist-driven monitoring program was implemented through the specialty pharmacy associated with a medical center to improve bleeding log completeness and electronic documentation for HTC patients. OBJECTIVE: To measure the effect of a pharmacist-driven bleeding disorder monitoring program on bleeding log completeness, successful bleeding log documentation in the electronic health record (EHR), and pharmacist-driven clinical interventions using an EHR tool...
October 2018: Journal of Managed Care & Specialty Pharmacy
Jiyeon Joy Park, Lauren Boutillier, Joseph E Cruz, GaEun Joung, Jeffrey Nemeth
BACKGROUND: Infliximab dose rounding is a commonly accepted practice at many institutions to contain costs. Currently, there is limited data on the clinical and financial implications of infliximab dose rounding standardization. OBJECTIVE: To determine whether standardized infliximab dose rounding is comparable with nonstandardized dosing in patients with Crohn's disease or ulcerative colitis in terms of cost and efficiency, using a cost comparison between the 2 dosing methods at an outpatient infusion center attached to a community teaching hospital...
October 2018: Journal of Managed Care & Specialty Pharmacy
Pratyusha Vadagam, Khalid M Kamal, Jordan R Covvey, Vincent Giannetti, Kumar Mukherjee
BACKGROUND: Cystic fibrosis (CF) is a chronic, progressive, genetic disease affecting more than 30,000 people in the United States and 70,000 people globally. The goals of treatment are to slow disease progression, reduce pulmonary exacerbations, relieve chronic symptoms, and improve the patient's quality of life. Lumacaftor/ivacaftor is a new therapy for CF that has demonstrated good clinical outcomes, including improved absolute percentage predicted forced expiratory volume in 1 second (FEV1 %)...
October 2018: Journal of Managed Care & Specialty Pharmacy
David Merola, Candice Yong, Stephen J Noga, Kenneth M Shermock
BACKGROUND: The use of novel drug agents in the treatment of multiple myeloma (MM) has been associated with improved therapeutic outcomes and survival; however, MM continues to pose a significant economic burden on patients and health care systems. Evaluating economic implications of therapies can provide key points of distinctions between available treatment options. Patients with MM may experience productivity loss, including lost days from work or inability to work due to MM symptoms or to undergoing treatment...
October 2018: Journal of Managed Care & Specialty Pharmacy
Johlee S Odinet, Chelsea E Day, Jennifer L Cruz, Gregory A Heindel
BACKGROUND: Several authors have hypothesized that adverse drug events (ADEs) upon switching from reference biologics to biosimilar products are related to the nocebo effect. However, a thorough and current review of the existing literature has not been conducted. OBJECTIVE: To evaluate if patient and/or physician knowledge of a switch from a reference biologic product to a biosimilar product was associated with an increase in ADEs likely to be susceptible to the nocebo effect...
October 2018: Journal of Managed Care & Specialty Pharmacy
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