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Pharmacy benefit management

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https://www.readbyqxmd.com/read/29450233/pharmacogenomics-guided-policy-in-opioid-use-disorder-oud-management-an-ethnically-diverse-case-based-approach
#1
Earl B Ettienne, Edwin Chapman, Mary Maneno, Adaku Ofoegbu, Bradford Wilson, Beverlyn Settles-Reaves, Melissa Clarke, Georgia Dunston, Kevin Rosenblatt
Introduction: Opioid use disorder (OUD) is characterized by a problematic pattern of opioid use leading to clinically-significant impairment or distress. Opioid agonist treatment is an integral component of OUD management, and buprenorphine is often utilized in OUD management due to strong clinical evidence for efficacy. However, interindividual genetic differences in buprenorphine metabolism may result in variable treatment response, leaving some patients undertreated and at increased risk for relapse...
December 2017: Addictive Behaviors Reports
https://www.readbyqxmd.com/read/29395904/design-of-an-automated-staff-scheduling-system-for-an-independent-pharmacy
#2
Ilgin Acar
BACKGROUND: In service industries, employee salaries and wages often constitute the largest portion of the costs to the company. This is very true in the case of an independent pharmacy, which employs pharmacists and pharmacy technicians. Thus, for pharmacies to cost effectively meet the increasing demand for pharmaceuticals, it is crucial that pharmacy managers efficiently allocate the pharmacy staff's time. METHOD: Through a case study, this paper demonstrates the use of an Excel VBA based on a mathematical model to schedule the staff of an independent pharmacy...
January 25, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29386865/talk-of-a-default-drug-formulary-rattles-industry-cms-could-move-in-that-direction-for-marketplace-plans-after-2019-but-the-discussion-has-already-started
#3
Stephen Barlas
A proposed CMS rule promising to consider a federal default prescription drug benefit after 2019 has startled manufacturers, pharmacy benefit managers, P&T committees, and pharmacies alike. We consider the rationale and potential effects of such a rule.
February 2018: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29384030/the-effect-of-florida-medicaid-s-state-mandated-formulary-provision-on-prescription-drug-use-and-health-plan-costs-in-a-medicaid-managed-care-plan
#4
Kiraat D Munshi, Douglas Mager, Krista M Ward, Brian Mischel, Rochelle R Henderson
BACKGROUND: Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. OBJECTIVE: To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders...
February 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29384028/budget-impact-analysis-of-a-pharmacist-provided-transition-of-care-program
#5
Weiyi Ni, Danielle Colayco, Jonathan Hashimoto, Kevin Komoto, Chandrakala Gowda, Bruce Wearda, Jeffrey McCombs
BACKGROUND: Postdischarge medication management services have been shown to reduce the incidence of medication-related problems during the transition from inpatient to outpatient care. A pharmacist-run transition of care (TOC) program has been developed to reduce the unplanned readmissions of a high-risk managed Medicaid population after hospitalization. OBJECTIVE: To estimate the budget impact of adding an outpatient pharmacy-based TOC program to a medical benefit from the payer perspective...
February 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29384023/prevalence-and-management-of-drug-related-problems-in-chronic-kidney-disease-patients-by-severity-level-a-subanalysis-of-a-cluster-randomized-controlled-trial-in-community-pharmacies
#6
Patricia Quintana-Bárcena, Anne Lord, Annie Lizotte, Djamal Berbiche, Lyne Lalonde
BACKGROUND: Drug-related problems (DRPs) are prevalent among chronic kidney disease (CKD) patients. However, little is known about their severity and management by community pharmacists. OBJECTIVES: To (a) describe the prevalence of DRPs by severity level in CKD patients and (b) assess the effect of a training-and-communication network program in nephrology (ProFiL) on these DRPs. METHODS: This is a secondary analysis of a cluster randomized controlled trial evaluating the effect of the ProFiL-program...
February 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29384022/clinical-and-economic-benefits-of-pharmacist-involvement-in-a-community-hospital-affiliated-patient-centered-medical-home
#7
Meredith L Tate, Sydney Hopper, Sean Paul Bergeron
BACKGROUND: The primary goals of an accountable care organization (ACO) are to reduce health care spending and increase quality of care. Within an ACO, pharmacists have a unique opportunity to help carry out these goals within patient-centered medical homes (PCMHs). Pharmacy presence is increasing in these integrated care models, but the pharmacist's role and benefit is still being defined. OBJECTIVE: To exhibit the clinical and economic benefit of pharmacist involvement in ACOs and PCMHs as documented by clinical interventions (CIs) and drug cost reductions...
February 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29362007/building-capacity-in-primary-care-the-implementation-of-a-novel-pharmacy-first-scheme-for-the-management-of-uti-impetigo-and-copd-exacerbation
#8
Fiona Stewart, Gail Caldwell, Kirstin Cassells, Jonathan Burton, Anne Watson
Aim This service aimed to improve patient access to treatment for urinary tract infections (UTI), impetigo and exacerbation of chronic obstructive pulmonary disease (COPD) and relieve pressure on general practice and out of hours services. BACKGROUND: In 2016, a service (Pharmacy First) was introduced in Forth Valley for the management of UTI, impetigo and exacerbation of COPD using patient group directions in community pharmacies. Trained pharmacists supplied a limited range of prescription medicines...
January 24, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29344376/effectiveness-of-pharmacist-s-intervention-in-the-management-of-cardiovascular-diseases
#9
REVIEW
Stefano Omboni, Marina Caserini
The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist's intervention...
2018: Open Heart
https://www.readbyqxmd.com/read/29340562/medicare-spending-and-potential-savings-on-brand-name-drugs-with-available-generic-substitutes-excluded-by-2-large-pharmacy-benefit-managers-2012-through-2015
#10
Alexander C Egilman, Joshua D Wallach, Joseph S Ross, Sanket S Dhruva
No abstract text is available yet for this article.
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29290171/health-care-costs-and-thromboembolic-events-in-hydroxyurea-treated-patients-with-polycythemia-vera
#11
Shreekant V Parasuraman, Nianwen Shi, Dilan C Paranagama, Machaon Bonafede
BACKGROUND: Patients with polycythemia vera (PV) are at increased risk of thromboembolic events (TEs), which are key contributors to reduced overall survival compared with the age- and sex-matched general population. In addition to aspirin and phlebotomy to maintain hematocrit level < 45%, many patients receive cytoreduction with hydroxyurea (HU), which is associated with improved survival and may reduce the risk of cardiovascular events and TEs. However, 1 in 4 patients become resistant to or intolerant of HU...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29290169/evaluating-oncology-value-based-frameworks-in-the-u-s-marketplace-and-challenges-in-real-world-application-a-multiple-myeloma-test-case
#12
Laurence M Djatche, Joseph A Goble, Grace Chun, Stefan Varga
BACKGROUND: With the continuous rise in costs for oncology drugs, the American Society of Clinical Oncology (ASCO), the Institute for Clinical and Economic Review (ICER), the Memorial Sloan Kettering Cancer Center's Drug Abacus (DrugAbacus), and the National Comprehensive Cancer Network (NCCN) have developed value-based frameworks (VBFs) to assist stakeholders in formulary and treatment decision-making processes. Since emerging VBFs have the potential to affect available treatment options for patients, it is important to understand the differences associated with these VBFs within various therapeutic areas...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29278980/clinic-level-population-health-intervention-by-pgy2-ambulatory-care-pharmacy-residents-to-optimize-medication-management-in-a-self-insured-employer-health-plan-population
#13
Joseph Vande Griend, Danielle R Fixen, Cy W Fixen, Jason Zupec, Joseph J Saseen
BACKGROUND: Postgraduate year 2 ambulatory care pharmacy residents (PGY2 residents) may be able to improve healthcare quality by providing clinical pharmacy services provided to self-insured employer health plan patients. The objectives of this study are to describe this care delivery in a family medicine clinic, and to identify patients most likely to benefit from the service. METHODS: From October 1, 2014 till June 30, 2015, comprehensive medication review was completed by PGY2 residents for patients insured by CU Anthem at the University of Colorado Westminster Family Medicine...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29276253/direct-and-indirect-remuneration-fees-the-controversy-continues
#14
Michael Gabay
The Centers for Medicare and Medicaid Services (CMS) initially created direct and indirect remuneration (DIR) fees with the enactment of Medicare Part D in order to track rebates and other price adjustments made to pharmacy benefit managers (PBMs). PBMs have expanded the use of these fees to "claw back" money from pharmacies on already dispensed medications. Community and specialty pharmacies claim these fees are not transparent, hurt patients and taxpayers, and negatively impact their fiscal bottom line, while PBMs assert that these fees actually reduce premiums for patients...
December 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29273028/implementation-of-a-novel-population-panel-management-curriculum-among-interprofessional-health-care-trainees
#15
Catherine P Kaminetzky, Lauren A Beste, Anne P Poppe, Daniel B Doan, Howard K Mun, Nancy Fugate Woods, Joyce E Wipf
BACKGROUND: Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees...
December 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29249652/know-your-numbers-creation-and-implementation-of-a-novel-community-health-mobile-application-app-by-student-pharmacists
#16
Michelle Vu, Vi Nguyen, Soumya Vishwanath, Courtney Wolfe, Sweta Patel
OBJECTIVES: A free mobile application (app), Know Your Numbers (KYN), was developed by student pharmacists to assist underserved community members to track their health numbers. The study objectives included creating a health app, implementing a pilot program, and analyzing the frequency of app use and perceptions of community members toward their health numbers, pharmacists, and health apps. SETTING: Student pharmacists recruited participants at the community clinics and health fairs organized in underserved communities of the Atlanta metropolitan area...
December 14, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29233324/development-and-evaluation-of-a-continuing-pharmacy-education-cpe-program-in-thrombosis-management
#17
Artemis Diamantouros, Romina Marchesano, William H Geerts, Peter Pennefather, Merrick Zwarenstein, Zubin Austin
BACKGROUND AND PURPOSE: A continuing education (CE) course in thrombosis management for pharmacists was developed through the Office of Continuing Professional Development (CPD) at the University of Toronto to address pharmacists' needs for the knowledge and skills to provide care to patients receiving anticoagulants. This article describes the development of the course as well as the evaluation designed to assess its impact on pharmacists' knowledge, attitudes, and changes in practice...
September 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233312/implementation-of-an-online-ethics-course-into-a-pharmacy-curriculum
#18
Christopher DeMella, Krista Donohoe, Laura Morgan, Lisa Phipps, Aulbrey Drisaldi, Michael Forder
BACKGROUND AND PURPOSE: To evaluate students' ethical reasoning skills after implementation of a series of online modules containing ethical content. EDUCATIONAL ACTIVITY AND SETTING: A four-module online ethics series was created and embedded in the learning management system of a second-year pharmacy skills lab course. The Defining Issues Test Version 2 (DIT-2) was administered before and after completion of the ethics module series. Results of the DIT-2 were used to evaluate the impact of the modules on students' ethical thinking ability...
September 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233149/advances-in-clinical-pharmacy-education-in-germany-a-quasi-experimental-single-blinded-study-to-evaluate-a-patient-centred-clinical-pharmacy-course-in-psychiatry
#19
Monika Dircks, Andreas Mayr, Annette Freidank, Johannes Kornhuber, Frank Dörje, Kristina Friedland
BACKGROUND: The pharmacy profession has shifted towards patient-centred care. To meet the new challenges it is necessary to provide students with clinical competencies. A quasi-experimental single-blinded teaching and learning study was carried out using a parallel-group design to evaluate systematically the benefits of clinical teaching in pharmacy education in Germany. METHODS: A clinical pharmacy course on a psychiatric ward was developed and implemented for small student groups...
December 12, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29203682/reasons-why-people-do-not-attend-nhs-health-checks-a-systematic-review-and-qualitative-synthesis
#20
Emma Harte, Calum MacLure, Adam Martin, Catherine L Saunders, Catherine Meads, Fiona M Walter, Simon J Griffin, Jonathan Mant, Juliet A Usher-Smith
BACKGROUND: The NHS Health Check programme is a prevention initiative offering cardiovascular risk assessment and management advice to adults aged 40-74 years across England. Its effectiveness depends on uptake. When it was introduced in 2009, it was anticipated that all those eligible would be invited over a 5-year cycle and 75% of those invited would attend. So far in the current cycle from 2013 to 2018, 33.8% of those eligible have attended, which is equal to 48.5% of those invited to attend...
December 4, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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