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Minneapolis Veterans Administration Medical Center-Decreasing or eliminating the use of alprostadil-based erectile dysfunction treatments and converting to 100% sildenafil use would save this VA medical center more than $101,000 annually. Furthermore, the projected savings would allow an additional 405 men with erectile dysfunction to be treated for an entire year, say clinicians at this facility.

Patients' adherence ability is by far the top patient factor guiding selection of a first-line antiretroviral regimen for HIV, according to a new physician survey.

A few weeks ago, it looked like the national economic slowdown, which was eroding the anticipated federal budget surplus, might put the costly Medicare pharmaceutical benefit on the endangered list. Congress was having trouble agreeing on a coverage plan, and interest groups were squabbling over how to craft a fair and effective pharmacy program for the elderly.

Pipeline Preview

Pipeline Preview as reported September 1, 2001

More Strong Medicine

George Halvorson does not pull punches or skirt sensitive issues. In the first chapter of his 1993 book Strong Medicine,

Flush from victory in passing patients' rights legislation, Senate Democrats are expected to push for a Medicare prescription drug benefit this fall. The new Senate leadership seems to have found that championing health care is a winning strategy and is eager to build on its success.

The issues are much the same, but many of the key players have changed. With the clock ticking, compromise may prove as elusive as ever.

The states' solutions

Tired of waiting for Washington to act, governors and legislators are becoming reluctant reformers. A heady mix of proposals is seasoned by money problems and well stirred by neophyte legislators.

Prescription drug costs are a favorite target for employers these days, but the forces that drive spending increases range far beyond pricing.

Are health plans managing care or cash? And who should pay when things go wrong for patients? Emerging lawsuits have many employers worried.