News

An array of both existing and investigational biologic agents are showing efficacy in clearing psoriasis and may prove useful for long-term psoriasis management. So suggests a collection of studies presented at the 60th annual meeting of the American Academy of Dermatology, held recently in New Orleans.

Seldom are the attributes of drugs under formulary consideration conveniently measured on the same scale, and if they are, they typically do not carry the same weight in a decision. Fortunately, application of Multiattribute Utility Technology (MAUT) provides a way to incorporate several valued attributes of disparate weights into a unitary measure for the purpose of evaluating options. This month's column presents the core elements of MAUT and explores its use in the drug evaluation process through a mock formulary committee example.

Rosuvastatin is an investigational HMG-CoA reductase inhibitor expected to gain FDA approval later this year for treatment of hypercholesterolemia. It has significantly exceeded atorvastatin, pravastatin, and simvastatin in reducing LDL cholesterol in clinical trials. This Focus article reviews those trials as well as rosuvastatin's pharmacologic and safety profiles in an effort to delineate its likely role in cholesterol-reducing therapy.

Seeking help for depression is finally losing some of its stigma. The National Association of Psychiatric Health Systems (NAPHS) 2001 Annual Survey Report, "Trends in Behavioral Healthcare Systems," says both hospital occupancy and outpatient visits for behavioral health problems increased 11% and nearly 12%, respectively, between 1999 and 2000.

Employers feel your pain. Truly. They are not nae to the challenges facing the healthcare industry, and they recognize that there are some areas they need to shore up themselves.

To retain resources or to justify allocation of additional resources, it's essential to demonstrate the value that outcomes projects bring to organizations. The Agency for Healthcare Research and Quality's project review process serves as a useful model for how to do so. This month's column explores the AHRQ process for following up and communicating the results of outcomes projects conducted at various practice settings.

Medications currently available to treat osteoporosis slow the rate of bone loss primarily by reducing bone resorption. The purported advantage of the anabolic agent teriparatide is that it actually promotes new bone growth. Clinical trials have shown the drug to be effective for vertebral fracture prevention in postmenopausal women at high risk. Additional evidence is accumulating to support teriparatide's use in other populations (including men) with osteoporosis. This injectable is likely to receive FDA approval in the second half of this year.

Pharmacologic therapy is the second cornerstone of the medical management of reflux esophagitis. Because the merits of various drug classes for reflux esophagitis have been widely discussed, the focus of this article is on differing strategies for using these classes. The management strategies - and the rationale and evidence for promoting or rejecting them - are discussed for step-up therapy, empiric therapy, ste-down therapy, on-demand proton pump inhibitor use, combination therapies, and other considerations.