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This study compares the cost-effectiveness of the 4 most common empiric antimicrobial regimens used for the treatment of adults with community-acquired pneumonia (CAP) at a community health system during a 6-month period. Associations between initial antimicrobials and total hospital costs were determined. Cost-effectiveness ratios were determined by dividing the total hospital costs by the percent survival. A total of 415 patients met criteria for the Pneumonia Severity Index (PSI) risk class IV or V. Costs (adjusted for inflation) were as follows (median, 25th and 75th percentile): total hospital costs ($5,078 [$3,218–$8,144]), pharmacy costs ($753 [$455–$1,357]), and antibiotic costs ($139 [$82–$229]). The most favorable cost-effectiveness ratio was observed for patients who received levofloxacin monotherapy ($4,635 per life saved), followed by ceftriaxone plus a macrolide ($5,278), ceftriaxone monotherapy ($5,368), and ceftriaxone plus levofloxacin ($6,317).

Desmopressin tablets 0.1 and 0.2 mg (equiv to DDAVP tablets).

Pioglitazone acts primarily by decreasing insulin resistance, while metformin improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose.

Valsartan (Diovan, Novartis) received an expanded indication for reducing cardiovascular mortality in patients who are at high risk due to left ventricular failure or dysfunction after myocardial infarction.

This NSAID is believed to exert its therapeutic effect through inhibition of prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2). Celecoxib was approved on July 29, 2005, for the relief of the signs and symptoms of ankylosing spondylitis (AS).

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.

Services being provided by PPOs and percentage of plans offering

Services being provided by PPOs and percentage of plans offering

New pharmacy systems are emerging that allow for deeper analysis

Plans and enrollees reach compromise

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.

Change the culture. Turn things around. Start fresh. There are dozens of catch phrases for describing what the four healthcare CEOs featured in this month's Executive Profile did to redefine their respective companies.

In Some Parts of the United States, health plans have observed a growing trend of hospital-based provider groups, such as radiologists, pathologists, anesthesiologists, and emergency room physicians refusing to contract with health benefit plans. When a health plan enrollee seeks services from an in-network hospital in order to obtain lower out-of-pocket costs (for a PPO product) or full benefits (for an HMO product), the enrollee can be hit with a large, unexpected bill from the provider.

Women's trust in public ratings.

Phase 3 clinical trial results have demonstrated that the dual alpha/gamma peroxisome proliferator-activated receptor (PPAR) agonist muraglitazar achieves significant beneficial lipid effects compared with pioglitazone, and the agent also provides long-term glycemic control in type 2 diabetics. The results were reported during the American Diabetes Association (ADA) 65th Annual Meeting in San Diego, Calif.

A review of antipsychotic agents in late-stage development (August 2005).

A study was conducted to evaluate the clinical and economic burden of overactive bladder (OAB) among patients <60 years of age in a managed care population, especially with regard to the prevalence of related comorbidities and associated annual medical costs.

Phase 3 clinical trial results have demonstrated that the dual alpha/gamma peroxisome proliferator-activated receptor (PPAR) agonist muraglitazar achieves significant beneficial lipid effects compared with pioglitazone, and the agent also provides long-term glycemic control in type 2 diabetics. The results were reported during the American Diabetes Association (ADA) 65th Annual Meeting in San Diego, Calif.

Levothyroxine, a critical medication for millions of Americans, has had a long and turbulent history. In the face of tougher FDA regulations and especially its reclassification as a "new drug" in 1997, manufacturers have struggled to carve out their niche in an expansive market. The principal concern of physicians, patients, endocrinologists, manufacturers, and FDA is levothyroxine's relative bioequivalence. Even after FDA classified several products as bioequivalent, a single brand name product still holds most of the market share, despite the fact that it is more costly. Current issues surrounding levothyroxine include: controversy about research, the number and types of recalls, the lack of a single reference-listed drug for comparison, and conflicting claims about the bioequivalence of various formulations. (Formulary. 2005;40:258–271.)

After months of delay, the Senate confirmed Lester M. Crawford, DVM, PhD, in July as the official head of FDA. Despite efforts by some Senators to hold up the vote pending resolution of some FDA policies, most legislators agreed with Republican and Democratic leaders that the agency would be better off with a permanent chief than without.

Highly resistant strains of both gram-positive and gram-negative bacteria are becoming commonplace in both the inpatient and outpatient setting. Recently developed antimicrobials have targeted resistant gram-positive pathogens, but the problem of resistant gram-negative pathogens remains. Tigecycline (Tygacil, Wyeth) is an injectable antimicrobial and the first in a new class of agents (the glycylcyclines) that possesses activity against key gram-positive and gram-negative bacterial pathogens. Tigecycline overcomes common tetracycline resistance mechanisms and has shown in vitro and in vivo activity against multidrug-resistant organisms. Tigecycline treatment produced clinical and microbiologic outcomes similar to standard comparator agents in patients with complicated skin and skin structure infections and complicated intra-abdominal infections and was approved for these indications in June 2005. The most common adverse events associated with tigecycline's administration during clinical trials were..

FDA approved moxifloxacin (Avelox, Schering-Plough) tablets and injection for the once-daily treatment of adults with complicated skin and skin structure infections (cSSSIs) caused by methicillin-susceptible Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Enterobacter cloacae.

Efficacy. The efficacy of ramelteon in the treatment of chronic insomnia was evaluated in 2 randomized, double-blind trials employing polysomnography (PSG).

Alvimopan (Entereg, Adolor/GlaxoSmithKline) for the treatment of postoperative ileus.

Discount prescription drug cards can help employees afford costly medication.

Entrepreneurial criminals actually are abandoning drug trafficking or more dangerous activities in favor of healthcare fraud.

August DTR Analysis.