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About two hours after a colleague and I lamented over breakfast about Americans' shortcomings in wellness, I heard the news that the vaccine for human papillomavirus (HPV) had received the final nod from FDA. Now there was something Americans were actually doing pretty well: immunizing.

Childhood obesity and its inherent health risks have become a majorhealth crisis. Just a few decades ago, the idea of an obesityepidemic would have seemed inconceivable. As late as the 1960s and1970s, the rate of overweight children remained steady and nominal.By the mid-1980s, however, the numbers began rising and by the1990s, they were surging. In fact, obesity in children ages 6 to 11years has quadrupled the last 25 years and doubled for adolescents,according to the Centers for Disease Control.

All projections of rising healthcare costs assume that advances inmedical science will add to the cost. This is a reasonableassumption, since it has been uniformly true in the past.Antibiotics are a great advance, but bacteria develop resistanceand newer and more expensive antibiotics must be developed. Peoplewho would have died at home in the pre-antibiotic era now survive,but after the greater cost of antibiotics and, possibly,hospitalization. The same is true for advances in cardiac stents,cancer treatment, imaging with CT scanners and MRIs, etc. Thetechnology can be life-saving but is typically expensive.

If misery loves company, then Beverly Thomas of Carbondale, Ill.,isn't alone. She is one of thousands of dual eligibles(beneficiaries covered by both Medicaid and Medicare) who went tothe pharmacy after January 1, 2006, only to find that it would notfill their prescriptions. Unfortunately, her medication for mentalillness is so critical that if she misses even a day, she could behospitalized. With the help of Southern Illinois Regional SocialServices, Thomas got squared away, but admits she still is confusedabout how the new Medicare Part D benefit operates.

Effexor HR

This dual-acting antidepressant is believed to exert its effect through the inhibition of neuronal serotonin and norepinephrine reuptake. Venlafaxine was approved on November 18, 2005, for the treatment of panic disorder, with or without agoraphobia, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

Today's Approach to interventions that address chronic disease and conditions is both broader and deeper than ever before. But there is another group of patients who rarely, if ever, directly benefit from these programs. According to Alan Wright, MD, former chief medical officer of TheraCom, these are patients who might use more than $100,000 a year in pharmaceutical spending and/or resources, patients who have a disease that is progressive with no known cure. These are the patients who have a rare disease, such as pulmonary arterial hypertension (PAH), a rare blood vessel disorder characterized by increased pressure in the pulmonary artery.

In late October, FDA announced that pemoline will no longer be available in the United States because the risks of liver toxicity associated with the drug's use outweigh the benefits of the therapy.

Hispanic Market Momentum

If managed care organizations are doing their homework and reading the statistics, they would know that conscientiously marketing specific services to the Hispanic population would reap a rich pay-off. Hispanics are the fastest growing group in the country; the U.S. Census Bureau estimates that after 2020, Hispanics will add more people to the U.S. population every year than all other race/ethnic groups combined.

Hispanic Market Momentum

If managed care organizations are doing their homework and reading the statistics, they would know that conscientiously marketing specific services to the Hispanic population would reap a rich pay-off. Hispanics are the fastest growing group in the country; the U.S. Census Bureau estimates that after 2020, Hispanics will add more people to the U.S. population every year than all other race/ethnic groups combined.

Mild to moderate psoriasis is generally treated first with topical corticosteroids and other topical remedies. When the disease is widespread or unresponsive to topical agents, ultraviolet phototherapy may be used at home or in the physician's office.

Generics should get a large boost in the next few years as branded drugs accounting for more than $38 billion, including Prevacid, Prevachol, Zocor, Zoloft and Paxil, are expected to come off patent by the end of 2008. With the generic dispensing rate remaining under 42% over the past 10 years, there is room for improvement; savings of nearly 1% by plan sponsors for every 1% increase in the use of generics, according to Express Scripts.

The marketplace increasingly relies on multi-specialty DM companies, but one organization is pursuing a contrarian approach for disease management. Cypress, Calif.-based PacifiCare Health Systems is following what Gordon K. Norman, MD, its vice president for disease management, calls a "best of breed" strategy.

Symlin

This novel echinocandin antifungal exerts its antibiotic activity by inhibiting the synthesis of 1,3-?-D-glucan, an essential component of fungal cell walls.

Health Understood

Health literacy is the next frontier in effective delivery.