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While your pharmacy benefit program has no doubt been managing utilization for years with core strategies, it's important to review effectiveness often. Below are the proven strategies that payers should analyze frequently in the current market of increasing utilization.

Grace seems an unlikely acronym for a study of acute coronary events, but given the findings of the Global Registry of Acute Coronary Events published in the Journal of the American Medical Association, the name may be apropos.

More than half of all state Medicaid programs incorporate a financial incentive encouraging providers to deliver better quality care, according to a study by the Commonwealth Fund. In addition, the study finds that 70% of existing Medicaid P4P programs operate in managed care or primary care management environments. Nine Medicaid programs are joining with other payers, employers and providers in statewide or regional P4P efforts, which is an indicator that the Medicaid plans are keeping pace with HMOs-half of which are offering P4P programs of their own.

As far as Michael Howe is concerned, the healthcare community should no longer question whether retail clinics are here for the long haul. The way he sees it, the criticisms about quality and continuity remain theoretical and spoken by a vocal minority. But even more so, the millions of consumers who are driving demand for retail-clinic services seem to have answered the question already.

The practices of some California insurers have recently come under attack in lawsuits brought by private litigants and in administrative actions brought by state regulators. The practice involves the rescission of health insurance policies due to misrepresentations made in the policy application form.

Experts say that 5% of all claims are fraudulent or abusive. If the total spent on U.S. healthcare annually is approaching $2 trillion, that 5% would add up to nearly $100 billion a year in fraudulent or abusive claims. And the percentage may be higher, perhaps as high as 10% of claims.

The investigational vasopressin receptor antagonist tolvaptan had no long-term impact on clinical events in patients hospitalized with acute decompensated heart failure (ADHF), but the agent did improve symptoms and volume status over the short term, according to results presented at the 56th annual ACC scientific session.

The Prescription Drug User Fee Act (PDUFA) expires in September, therefore FDA may need to warn drug reviewers that their jobs may be eliminated if Congress does not honor the reauthorization deadline.

Nausea and vomiting (emesis) are among the most distressing side effects of chemotherapy and are associated with significant clinical consequences. Four distinct types of chemotherapy-induced nausea and vomiting (CINV) have been described: acute, delayed, anticipatory, and breakthrough. Clinical practice guidelines provide specific recommendations for controlling the different types of CINV depending on the emetogenic potential of the chemotherapy regimen being used. Three classes of antiemetics are considered potent and well-tolerated options: 5-HT3 serotonin-receptor antagonists, corticosteroids, and neurokinin-1-receptor antagonists. Phenothiazines, butyrophenones, cannabinoids, metoclopramide, and benzodiazepines are also sometimes used to prevent CINV caused by minimally emetogenic chemotherapy or to treat breakthrough CINV. This article reviews the currently available antiemetic agents and clinical practice guidelines for the management of CINV.

Schizophrenia is a chronic psychiatric disorder that affects an estimated 1% of the population. This disorder may be treated with typical (first-generation) or atypical (second-generation) agents; a recognized concern regarding these agents is that long-term use has been associated with increased risks of serious side effects, either neurologic or metabolic in nature. Bifeprunox is a partial dopamine-receptor agonist under investigation for the treatment of patients with schizophrenia.If approved, bifeprunox may serve as an additional option for the acute and maintenance treatment of schizophrenia.