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Pharmacy benefit management

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https://www.readbyqxmd.com/read/28287008/the-value-of-open-access-and-a-patient-centric-approach-to-oral-oncolytic-utilization-in-the-treatment-of-chronic-myelogenous-leukemia-a-u-s-perspective
#1
Lopamudra Das, Matthew Gitlin, Lisa R Siegartel, Dinara Makenbaeva
Since the introduction of tyrosine kinase inhibitors (TKIs), the treatment of patients with chronic myelogenous leukemia (CML) has resulted in significant improvement in patient survival but at a higher pharmaceutical cost to payers. The recent introduction of generic imatinib presents an opportunity to lower pharmacy costs within a population that is growing due to improved survival. Recent literature has focused on the likely benefits to payers of step therapy through generic imatinib. Areas covered: This review provides a perspective that is broader than the evaluation of financial savings or narrowly defined health economic metrics by incorporating factors such as CML patient heterogeneity, including varying levels of disease progression risk, comorbidities, and genetic mutation status, differences in TKI product profiles, clinical guideline recommendations, and the importance of individualized patient care...
March 13, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28283585/the-incidence-and-health-care-resource-burden-of-the-myelodysplastic-syndromes-in-patients-in-whom-first-line-hypomethylating-agents-fail
#2
Christopher R Cogle, Sandra E Kurtin, Tanya G K Bentley, Michael S Broder, Eunice Chang, Scott Megaffin, Steven Fruchtman, Michael E Petrone, Sudipto Mukherjee
BACKGROUND: Although hypomethylating agents (HMAs) are effective and approved therapies for patients with myelodysplastic syndromes (MDS), many patients do not benefit from treatment, and nearly all ultimately stop responding to HMAs. The incidence and cost burden of HMA failure are unknown yet needed to appreciate the magnitude and significance of such failure. METHODS: We analyzed a de-identified dataset of over 5 million individuals with private health insurance in the U...
March 10, 2017: Oncologist
https://www.readbyqxmd.com/read/28282646/point-of-care-sexually-transmitted-infection-diagnostics-proceedings-of-the-star-sexually-transmitted-infection-clinical-trial-group-programmatic-meeting
#3
Anthony D Cristillo, Claire C Bristow, Rosanna Peeling, Barbara Van Der Pol, Sasha Herbst de Cortina, Ivan K Dimov, Nitika Pant Pai, Dong Jin Shin, Ricky Y T Chiu, Catherine Klapperich, Purnima Madhivanan, Sheldon R Morris, Jeffrey D Klausner
The goal of the point-of-care (POC) sexually transmitted infection (STI) Diagnostics meeting was to review the state-of-the-art research and develop recommendations for the use of POC STI diagnostics. Experts from academia, government, nonprofit, and industry discussed POC diagnostics for STIs such as Chlamydia trachomatis, human papillomavirus, Neisseria gonorrhoeae, Trichomonas vaginalis, and Treponema pallidum. Key objectives included a review of current and emerging technologies, clinical and public health benefits, POC STI diagnostics in developing countries, regulatory considerations, and future areas of development...
April 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28274988/incorporation-of-lean-methodology-into-pharmacy-residency-programs
#4
Natalie John, Holly Snider, Lisa Edgerton, Laurie Whalin
PURPOSE: The implementation of lean methodology into pharmacy residency programs at a community teaching hospital is described. SUMMARY: New Hanover Regional Medical Center, a community teaching hospital in southeastern North Carolina, fully adopted a lean culture in 2010. Given the success of lean strategies organizationally, this methodology was used to assist with the evaluation and development of its pharmacy residency programs in 2014. Lean tools and activities have also been incorporated into residency requirements and rotation learning activities...
March 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28241271/effect-of-reminder-devices-on-medication-adherence-the-remind-randomized-clinical-trial
#5
Niteesh K Choudhry, Alexis A Krumme, Patrick M Ercole, Charmaine Girdish, Angela Y Tong, Nazleen F Khan, Troyen A Brennan, Olga S Matlin, William H Shrank, Jessica M Franklin
Importance: Forgetfulness is a major contributor to nonadherence to chronic disease medications and could be addressed with medication reminder devices. Objective: To compare the effect of 3 low-cost reminder devices on medication adherence. Design, Setting, and Participants: This 4-arm, block-randomized clinical trial involved 53 480 enrollees of CVS Caremark, a pharmacy benefit manager, across the United States. Eligible participants were aged 18 to 64 years and taking 1 to 3 oral medications for long-term use...
February 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28239296/cost-effectiveness-of-a-nurse-led-intervention-to-optimise-implementation-of-guideline-concordant-continence-care-study-protocol-of-the-cocon-study
#6
Aaltje P D Jansen, Maaike E Muntinga, Judith E Bosmans, Bary Berghmans, Janny Dekker, Jacqueline Hugtenburgh, Giel Nijpels, Paul van Houten, Miranda G H Laurant, Huub C H van der Vaart
BACKGROUND: Guidelines on urinary incontinence recommend that absorbent products are only used as a coping strategy pending definitive treatment, as an adjunct to ongoing therapy, or for long-term management after all treatment options have been explored. However, these criteria are rarely met and a significant share of long-term product users could still benefit from therapeutic interventions recommended in guidelines for urinary incontinence. Better implementation of these guidelines can potentially result in both health benefits for women and long-term cost savings for society...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28238356/economic-utility-combinatorial-pharmacogenomics-and-medication-cost-savings-for-mental-health-care-in-a-primary-care-setting
#7
Lisa C Brown, Raymond A Lorenz, James Li, Bryan M Dechairo
PURPOSE: This study was an analysis based on a previously completed prospective study investigating medication costs of patients with mental illness guided by using the GeneSight proprietary combinatorial pharmacogenomic (PGx) test. The primary objective of this study was to determine potential cost savings of combinatorial PGx testing over the course of 1 year in patients with mental illness treated by primary care providers (PCPs) and psychiatrists who had switched or added a new psychiatric medication after patients failed to respond to monotherapy...
February 18, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#8
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230451/positive-medication-changes-resulting-from-comprehensive-and-noncomprehensive-medication-reviews-in-a-medicare-part-d-population
#9
Allison Buhl, Jill Augustine, Ann M Taylor, Rose Martin, Terri L Warholak
BACKGROUND: Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#10
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28223842/development-of-a-novel-algorithm-to-determine-adherence-to-chronic-pain-treatment-guidelines-using-administrative-claims
#11
Jay M Margolis, Nicole Princic, David M Smith, Lucy Abraham, Joseph C Cappelleri, Sonali N Shah, Peter W Park
OBJECTIVE: To develop a claims-based algorithm for identifying patients who are adherent versus nonadherent to published guidelines for chronic pain management. METHODS: Using medical and pharmacy health care claims from the MarketScan® Commercial and Medicare Supplemental Databases, patients were selected during July 1, 2010, to June 30, 2012, with the following chronic pain conditions: osteoarthritis (OA), gout (GT), painful diabetic peripheral neuropathy (pDPN), post-herpetic neuralgia (PHN), and fibromyalgia (FM)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28210864/pharmacy-benefit-management-companies-do-they-create-value-in-the-us-healthcare-system
#12
Alan Lyles
Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing...
February 16, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28186715/adoption-of-the-nova-scotia-canada-community-pharmacy-medication-management-program-1-year-post-initiation
#13
Heidi J Deal, Charmaine A Cooke, Ethel M Langille Ingram, Ingrid S Sketris
BACKGROUND: Pharmacists conduct medication reviews to optimize drug therapy. Each jurisdiction implements and funds these programs differently. OBJECTIVE: To describe the uptake of the first year of a community pharmacy medication review program reimbursed by the publically insured seniors' drug benefit program in Nova Scotia, Canada. METHODS: This retrospective analysis included 294 pharmacies and 105,000 beneficiaries enrolled in the Nova Scotia Seniors' Pharmacare Program...
February 1, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28184172/practically-prepared-pre-intern-student-views-following-an-education-package
#14
Susan McKenzie, Craig Mellis
BACKGROUND: Graduating medical students enter their internship with varied levels of practical experience in procedural skills. To address this problem, many medical schools have introduced intensive skill training courses immediately prior to graduation. This study examines the impact of a pre-intern (PrInt) education package, consisting of a short intensive course, followed by a one-month clinical attachment. METHODS: In September 2014, all PrInt students (n = 53) at the Central Clinical School (Sydney, NSW, Australia) attended three days of intensive training...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28179741/innovations-in-medication-preparation-safety-and-wastage-reduction-use-of-a-workflow-management-system-in-a-pediatric-hospital
#15
Stephen Jerome Davis, Josephine Hurtado, Rosemary Nguyen, Tran Huynh, Ivan Lindon, Cedric Hudnall, Sara Bork
Background: USP <797> regulatory requirements have mandated that pharmacies improve aseptic techniques and cleanliness of the medication preparation areas. In addition, the Institute for Safe Medication Practices (ISMP) recommends that technology and automation be used as much as possible for preparing and verifying compounded sterile products. Objective: To determine the benefits associated with the implementation of the workflow management system, such as reducing medication preparation and delivery errors, reducing quantity and frequency of medication errors, avoiding costs, and enhancing the organization's decision to move toward positive patient identification (PPID)...
January 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28118918/acceptance-model-of-a-hospital-information-system
#16
P W Handayani, A N Hidayanto, A A Pinem, I C Hapsari, P I Sandhyaduhita, I Budi
PURPOSE: The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. METHOD: This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia...
March 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28108642/the-potential-role-for-smartphones-among-older-adults-with-chronic-noncancer-pain-a-qualitative-study
#17
Joshua E Richardson, Jennifer I Lee, Anita Nirenberg, M Carrington Reid
OBJECTIVE : To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. DESIGN:  Qualitative study. SETTING:  One academically affiliated primary care practice serving older adults with CNCP in New York City. SUBJECTS : Thirteen older adults (age 65-85 years) with CNCP on chronic opioid therapy, that is, continuous use of opioids for at least six months...
January 20, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28089522/the-impact-of-medication-synchronization-on-quality-care-criteria-in-an-independent-community-pharmacy
#18
Jessica L Hinson, Gretchen K Garofoli, Betsy M Elswick
OBJECTIVES: To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. SETTING: Independent community pharmacy in Morgantown, WV. PRACTICE DESCRIPTION: Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28025924/improving-comprehensive-medication-review-acceptance-by-using-a-standardized-recruitment-script-a-randomized-control-trial
#19
Alexander Miguel, Anna Hall, Wei Liu, Jeremy Garrett, Angel Ballew, Tsu-Hsaun Yang, Richard Segal
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) require prescription drug plan sponsors to offer a comprehensive medication review (CMR) annually to eligible beneficiaries through the plans' Medication Therapy Management Programs (MTMPs). In 2011, the Pharmacy Quality Alliance endorsed the CMR completion rate as a quality measure for MTMPs, and CMS has adopted the measure into the 2016 CMS star ratings. CMS star ratings are used to describe the quality of plans to assist Medicare plan enrollees in choosing a plan and to determine quality bonus payments for Medicare Advantage plans...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#20
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
February 1, 2017: JAMA Internal Medicine
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