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Pharmacists in Canada were recently given broader responsibilities including, in certain provinces, prescribing privileges, vaccination abilities, and the ability to order and interpret laboratory tests. This newly expanded role for Canadian pharmacists can benefit both patients and physicians, according to an article in the Canadian Medical Association Journal.

Drug evaluation and selection models are changing. Safety and efficacy have become the starting point for consideration by many payers. What they really want to see is evidence of superior performance in real world patient populations.

The majority of antibiotics prescribed for adults in ambulatory care settings are broad-spectrum agents, most commonly fluoroquinolones and macrolides. These are frequently prescribed for conditions where no antibiotic therapy is needed at all, such as for bronchitis and colds, which are caused by viruses, according to a study published online July 25, 2013, in the Journal of Antimicrobial Chemotherapy.

Accountable care organizations (ACOs) are groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to the patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds in both delivering high-quality care and spending healthcare dollars more wisely, it will share in the savings it achieves for the Medicare program.1 The overall goal of the ACO is to reduce costs by focusing on preventative care and disease management.

It is estimated that 30 million people will gain access to medical care beginning in 2014, with implementation of the Patient Protection and Affordable Care Act (ACA). Administratively, the federal government and most states have not worked out the details of how patients will gain access to the healthcare system, let alone receive care. Primary care providers (PCPs) are ill-prepared to accept this enormous influx of new patients, which will place an even greater strain on the already strapped primary care workforce. Estimates are that an additional 17,000 PCPs are currently needed, and another 40,000 PCPs may be needed by 2025 to care for the nation’s aging population. How best to handle this large influx of patients into the healthcare system is at issue.

The American Migraine Prevalence and Prevention (AMPP) Study recommends new options for those with cardiovascular event histories who also need migraine treatment

In July of 2012, a provision in the newly ratified Food and Drug Administration (FDA) Safety and Innovation Act (FDASIA), paved the way for the FDA to further assist drug manufacturers in expediting the development and introduction of new drugs demonstrating early signs of advancement in the treatment of key conditions. Known as the “breakthrough therapy” designation, this new tool is seen by many as yet another positive sign that the FDA is committed to ensuring that innovative drug products are brought to market even more quickly for the millions of patients with serious medical conditions, desperately in need of new therapeutic options.

Many patients suffer from both hypertension and high cholesterol, putting them at greater risk of coronary heart disease (CHD). Controlling the hypertension and high cholesterol would reduce CHD risk by 50% or more, but less than a third of patients have achieved adequate control of both, according to an online study in Circulation.

When metformin cannot maintain glycemic control, sulfonylureas are often used as add-on therapy in type 2 diabetes; however, risks include weight gain and hypoglycemia. Dapagliflozin is an SGLT2 inhibitor and increases urinary glucose excretion and reduces hyperglycemia independently of insulin secretion or action.

In patients with type 2 diabetes, treatment with exenatide has shown beneficial effects on cardiovascular risk factors. A recent study used the GE Healthcare database to evaluate the risk of heart failure, myocardial infarction, and stroke in 2,795 patients taking exenatide twice daily and in 51,547 patients taking insulin in routine clinical practice.

The US healthcare system could avoid hundreds of millions of dollars in medical costs if medication adherence rates improved, according to a CVS Caremark report.

The new update to the 2009 American Society of Clinical Oncology (ASCO) guideline on the pharmacologic interventions for breast cancer risk reduction now lists aromatase inhibitor exemestane (Aromasin, Pfizer) as an option for postmenopausal women for primary risk reduction that are at an increased risk of developing invasive breast cancer.

Estimates of the cost of fraud in the Medicare system range broadly from $17 billion to $90 billion. However, there are no estimates of-or methods to detect-how much of the wasted money is attributable to old-fashioned human error rather than blatant crime.

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