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Formulary Limitations and the Elderly: Results from the Managed Care Outcomes Project

According to this article, the elderly are at particular risk from formulary restrictions, an important issue as more Medicaid and Medicare patients enroll in managed care. In fact, selecting less expensive drugs may lead to greater side effects in the elderly.

The article details a study that examined whether restrictive formularies are associated with differences in health care resource utilization, including number of office visits, prescriptions and hospitalizations, and whether this association varies by age. The authors conclude that common strategies for decreasing drug expenditures may be associated with higher severity-adjusted resource utilization. In specific areas, this association is more pronounced in the elderly.

Blog Post

#TBT: Value-Based Insurance Design & New Medicare Advantage Model

As part of our Throwback Thursday blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous research...
YouTube Videos

Anthem's Malin: Having Patient-Level Data Can Improve Clinical Care Pathways

The success of a clinical care pathway is related to the breadth and quality of the information that is available to organizations developing...
YouTube Videos

Anthem's Dr. Malin on Care Pathways: Their Implementation and Evaluation

Dr. Jennifer Malin, medical director, oncology and care management, Anthem, Inc., explains that her organization uses care pathways to address the...
YouTube Videos

Anthem's Dr. Malin on Clinical Care Pathways and Innovation

Could clinical care pathways help innovation? Anthem Inc.'s Dr. Jennifer Malin, medical director, oncology and care management, says it’s a strong...
Press Release

NPC Comments on CMS’ Announcement to Allow Broader Access to Publicly Funded Databases

(Washington, DC, June 2, 2015)—The National Pharmaceutical Council (NPC) today commented on the Centers for Medicare and Medicaid Services’ (CMS)...
Press Release

State Medicaid Directors Share Views on Comparative Effectiveness Research And Its Impact on Policy in National Pharmaceutical Council Survey

(Washington, DC, April 16, 2015)—A new survey conducted on behalf of the National Pharmaceutical Council (NPC) shows that state Medicaid directors...
Press Release

Specialty Medications: Shifting the Focus From “How Much” We Spend to “How Well” We Spend

Washington, DC, June 9, 2014—As health care decision-makers grapple with how to ensure access to specialty medications, the University of Michigan...
Press Release

NBCH eValue8™ Report Reveals Health Plans’ Ability to Align Employee Incentives to Improve Health

Washington, DC (November 30, 2009) – The current rate of health care cost increases are unsustainable and health care purchasers are increasingly...
Commentary and Testimony Page

NPC Comments on CMS' Proposed Changes to Protected Classes

March 7, 2014Marilyn B. TavennerAdministratorCenters for Medicare & Medicaid ServicesU.S. Department of Health and Human Services200 Independence...
Commentary and Testimony Page

Leveling the Playing Field? Could a Landmark Decision Alter the CER Communications Landscape?

A growing chorus of voices is publicly sharing data on the effectiveness of treatment options, but one viewpoint has long been shut out of key areas...
Commentary and Testimony Page

Framework Helps ACOs Leverage Pharmaceuticals to Realize Quality, Cost Goals

Medications are more than an item on the balance sheet for health care providers. Pharmaceuticals offer a route to manage costs while achieving...
Commentary and Testimony Page

Comparative Effectiveness Research and the Changing Health Care Landscape

This content appeared in the January 2, 2012 print edition of Chain Drug Review. In the span of just one year, the health care landscape has...
YouTube Videos

Anthem's Dr. Malin on Clinical Care Pathways and Innovation

Could clinical care pathways help innovation? Anthem Inc.'s Dr. Jennifer Malin, medical director, oncology and care management, says it’s a strong...
YouTube Videos

Anthem's Malin: Communication Is Key to Success of Care Pathways

To make a clinical care pathway successful, “you have to work on many levels to engage providers,” says Dr. Jennifer Malin, medical director,...
YouTube Videos

Anthem's Malin: Having Patient-Level Data Can Improve Clinical Care Pathways

The success of a clinical care pathway is related to the breadth and quality of the information that is available to organizations developing...
YouTube Videos

Anthem's Dr. Malin on Care Pathways: Their Implementation and Evaluation

Dr. Jennifer Malin, medical director, oncology and care management, Anthem, Inc., explains that her organization uses care pathways to address the...
Blog Post

#TBT: Value-Based Insurance Design & New Medicare Advantage Model

As part of our Throwback Thursday blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous research...
Blog Post

CER Tweets of the Week: Study on Six Potential EBM “Biases”; VBID "Gets Its Medicare Close-up" (August 31-September 4)

This week on Twitter, comparative effectiveness research (CER) stakeholders shared a study examining six potential biases against patients and carers...
Blog Post

#TBT: Medicaid’s 50th Anniversary & NPC’s Medicaid Compilation Series

As part of our “Throwback Thursday” blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous...
Blog Post

#TBT: 10 Prescribing Principles for Older Patients & #WHCOA

As part of our “Throwback Thursday” blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous...

Role of Pharmaceuticals in Value-Based Healthcare: A Framework for Success

This research sets out a conceptual framework for considering the role of pharmaceuticals in...

Pharmaceutical Technology Assessment: Perspectives From Payers

The processes and evidence used in making pharmaceutical coverage decisions vary substantially...

Blue Pill or Red Pill: The Limits of Comparative Effectiveness Research

By choosing "winners and losers," CER drug trials may leave patients who best respond to the "...
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