In evaluating and approving proposals from Medicare prescription drug plans (PDPs), CMS says it will examine a plan's formulary list, pharmacy and therapeutics (P&T) committee operations, and benefit management tools, such as prior authorization and appeals and exceptions policies.
FDA new indications and the latest generics
Coromary heart disease (CHD) is the leading cause of death for men and women in the United States. There's a direct relationship between cholesterol levels and the risk of death due to CHD. Statin medications inhibit cholesterol synthesis and reduce cholesterol levels substantially.
The Sept. 30 Voluntary Recall of Vioxx (rofecoxib) by Merck is just another in a long list of headline-making news for the industry. The action was based on the results of a three-year, randomized double-blind trial that indicated that after taking Vioxx for 18 months, patients had twice the risk of heart attack compared with a placebo.
Recent scares about suicidality linked to antidepressants and painkillers intensifying interest in policies to ensure the safe use.
The managed care backlash is easing up, probably because consumers are feeling the pinch of rising costs.
By withholding information about some antidepressant medications that cause an increase in suicidal tendencies among teenagers, the Food and Drug Administration (FDA) created heightened public concern about the value of antidepressants.
Vioxx liability claims could run well over $10 billion.
New indications
Several drug regimens are available for asthmatics, but the key to asthma control is to reduce airway inflammation, and therefore limit the need for short-term rescue medications.
The study indicates HRA products can induce positive health behavior changes.
Lincolnshire, Ill.- Healthcare cost increases, while high, are moderating because of decelerating cost trends, according to Hewitt Associates.
The National Institutes of Health's new research strategy aims to address obesity on several fronts.
Specialty drugs falling under pharmacy benefit
Specialty pharmaceutical coverage by managed care plans
FDA actions and new molecular entities
Everyone's familiar with nonsteroidal anti-inflammatory medications (NSAIDs). These are household names, sold in every drugstore, and consumers use them for headaches, athletic injuries, and other minor aches and pains.
WellPoint supports putting gold-standard generics in most drug classes on the first tier.
One hundred fifty billion dollars is a staggering figure. Combine it with the phrase, "in losses," and the number becomes a nightmare. That nightmare-$150 billion in losses-is one estimate of the cost of health insurance fraud and abuse in America.
Through its research correlating copayments with utilization, Express Scripts, a pharmacy benefits manager (PBM) in St. Louis, found that a three-tier structure can control prescription drug costs without causing any unintended consequences, such as visits to the emergency room or hospitalizations.
While plan managers have been doing it for nearly two decades with oral medications that are paid on the pharmacy benefit, the product-preferencing process is relatively novel for injectable medications. The next natural discussion is the role of benefit designs in the management of the cost of injectable products, since this is closely tied to product preferencing.
MORPHINE, the first and best-known of the opioid analgesics, is a natural substance produced from the opium poppy, papaver somniferum. It's been used to relieve pain since ancient times; Hippocrates prescribed poppy juice as a narcotic. Today many different semisynthetic opioid analgesics are used to relieve moderate to severe pain, but morphine remains the standard of comparison used to describe their effectiveness.
New combinations
Workers’ comp pays 74% more than group health for the same drugs, due to lack of control over AWP and limited purchasing power.
