News

HSAs are popular, but will they really change the economics of healthcare for the better?

SHORTLY AFTER the Allied victory in 1945, Albert Einstein produced one of his most-famous quotes: "I do not know what will be used in the next world war?assuming there will be another one?but the fourth world war will be fought with stones."An ominous statement from a truly brilliant man, to be sure. Hopefully, we'll never have to find out, but even if the next war is fought with clubs and rocks, there will still be a need for medical specialists to take care of the wounded.

We are approaching the time of year when health insurers are beginning to calculate loss ratios and compile other financial data in order to evaluate the performance of their book of business. They will evaluate each market segment and product line, and make underwriting and rating decisions as to each.

What would you think if I told you that a country could provide healthcare coverage for its population of 6.8 million without collecting a single dollar in taxes from two-thirds of those people? Would you be intrigued?

Three studies comprising more than 3,000 primary-care patients sought to demonstrate that flexible or semi-flexible dosing of zolpidem 10 mg was effective and safe in a general practice context.

There is a growing interest in the study of insomnia; this is reflected in emerging trends in clinical management and increased research. One key question is being asked: Is insomnia a symptom or a disease?

Long-term insomnia is a substantial problem. Of the 50% of the population that report sleep difficulties, up to 36% report symptoms of insomnia lasting more than 1 year.

Approximately 11%-12% of elementary school children experience daytime sleepiness, and up to 21% have fatigue during the school day.

Sleep plays an important role in energy homoeostasis. A study was conducted to test the hypothesis that circulating levels of leptin are influenced by sleep duration.

In each issue, the Focus On article reviews a newly approved or investigational drug of interest to pharmacy and therapeutics committee members. Because so many readers have told the editors of Formulary that they reference this column frequently when making formulary decisions for their hospitals, health-systems, or managed-care organizations, the editors have compiled this review of all the Focus On articles published in 2004, along with updates on the status of each agent.

As initiatives to legalize the importation of prescription drugs draw more attention, the concern over counterfeit drugs is growing. The possibility of receiving counterfeit drugs has created an emerging dilemma for health-care professionals. FDA is relying on pharmacists to help ensure the integrity of drug products before they reach health-care consumers. Pharmacy and therapeutics committees can play a key role in achieving this goal by reviewing policies for medication acquisition and ensuring that necessary controls are in place to help prevent the acquisition of counterfeit drugs. FDA is also taking steps to help alleviate counterfeiting by mandating bar codes on all hospital drug packaging and implementing electronic pedigree papers to track distribution. FDA leaders project that by 2007, all prescription drugs will be tracked electronically to help ensure their authenticity. Formulary decision-makers, pharmacy directors, and clinicians must continue to be educated about the problem to help prevent counterfeit drugs from polluting the drug supply.

Government, industry provide pharmaceutical policy outlook for 2005; $139 million to advance information technology, records; Rofecoxib hearings point to failures in clinical testing design, decision-making transparency; New guidance for generic drugs clarifies protocol, increases speed to market

New molecular entities: erlotinib, solifenacin, natalizumab

Worldwide study finds that fluoroquinolones are still effective against CAP; Weekly nesiritide may have greatest benefit in highest-risk heart failure patients

Valdecoxib meta-analysis finds increased cardiovascular risk

Agencies encourage development of more affordable treatments and take steps to ensure safer product use

December DTR Analysis: National HMO Enrollment by State

Cultural competency improves outcomes

Consumer driven implications for inpatient medical management

DTR Chart: National HMO Enrollment by State

With one in five residents of the United States unable to speak English or speak it well, according to the U.S. Census Bureau, healthcare organizations have started to launch language services programs.

Coromary heart disease (CHD) is the leading cause of death for men and women in the United States. There's a direct relationship between cholesterol levels and the risk of death due to CHD. Statin medications inhibit cholesterol synthesis and reduce cholesterol levels substantially.

Health literacy is the next frontier in effective delivery.

George Halvorson helps to bring Kaiser Permanente to the leading edge of healthcare's own industrial revolution with a massive new EMR system.

New York Attorney General Eliot Spitzer recently pursued investigations focused on a common industry practice utilized by insurers and the brokers that represent corporate buyers of commercial insurance. At issue is whether bids are being rigged, prices fixed, and whether brokers are steering business to insurers that pay them the highest fees without getting the best deal for their corporate clients.

The National Inventors Hall of Fame is located in Akron, Ohio, about 45 minutes from the MANAGED HEALTHCARE EXECUTIVE offices. It's interesting how many of the modern day Hall of Fame inductees are researchers who were honored for their discoveries in medicine, while historical creators offered more electronic or industrial solutions.

Next-generation solutions for reducing healthcare costs resulting from obesity

Chronic obstructive pulmonary disease (COPD) is a disease state characterized by the progressive development of airflow limitation that is not fully reversible. The airflow limitation is associated with an abnormal inflammatory response of the lungs to noxious particles or gases. It affects approximately 15 million Americans and is associated with high morbidity and mortality. Previously, pharmacologic therapeutic options were limited by relatively short durations of action in the first-line medications and limited efficacy data and/or a high rate of adverse effects in the second-line medications. Today, there are several new and emerging medications to treat this disease state, and new guidelines have been published for disease management. This review examines current therapeutic options, compares efficacy data, and highlights the recommendations from international guidelines.