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Audience - Health Care Providers

Adverse Drug Reactions in Hospitalized Patients: A Critique of a Meta-analysis by Marion Kvasz, MD, MPH, et al., Medscape General Medicine,
April 2000
A published meta-analysis of the incidence of adverse drug reactions (ADRs) in hospitalized patients concluded that ADRs rank as the fourth to sixth leading cause of death in the U.S. This conclusion generated considerable concern among health care providers, patients, and pharmaceutical manufacturers. To better understand the evidence behind this conclusion, a critical review of the source studies and the meta-analytic methods used to combine them was conducted. Findings suggest that the conclusions of the meta-analysis are invalid.

(You must log in to Medscape in order to view this article. If you do not have a free log-in to Medscape, you can create one by clicking here.)

Agitation and Depression in Frail Nursing Home Elderly Patients with Dementia: Treatment Characteristics and Service Use, by Stephen J. Bartels, MD, MS, et al., American Journal of Geriatric Psychiatry, Vol. 11, No. 2, March-April 2003
Agitation and depression are the two most common behavioral complications of dementia. Although the behavioral symptoms have received less attention than the cognitive symptoms of dementia, they have serious consequences, including caregiver stress, premature institutionalization, and compromised quality of life for patients and their families. This study suggests that dementia complicated by mixed agitation and depression is among the most clinically challenging problems in long-term care, and that effective interventions and services are needed to address the complex treatment needs of this high-risk group.

Are the Benefits of Newer Drugs Worth Their Cost? Evidence From the 1996 MEPS, by Frank R. Lichtenberg, Health Affairs, Vol. 20, No.5,
September/October 2001
Critics of pharmaceutical spending point to the increase in the pharmaceutical “line item” in our overall health spending as cause for alarm. Lichtenberg's research examines the value of this spending in its complete context by exploring whether there are cost offsets associated with using newer and, most often, more expensive drugs. Lichtenberg finds that we are paying more, but we are getting a bigger “bang for our buck.”

Annotated PowerPoint slides related to this article are available.

Assessing the Impact of Pharmaceutical Innovation: A Comprehensive Framework, by Jack A. Meyer, PhD, 2002
The key finding in this report is that new drugs are yielding a wide range of benefits to our society that more than justify the investment needed to produce them. This report develops a comprehensive framework for assessing the value of pharmaceutical innovation that encompasses both the cost of bringing new products to market and the direct and indirect benefits. Fact sheet available.

Combination Drugs: Innovation in Pharmacotherapy, by Albert Wertheimer, PhD and Alan Morrison, PhD, Pharmacy and Therapeutics, Vol. 27, No. 1, January 2002
Combination therapy with two or more agents having complimentary mechanisms of action represents a type of incremental innovation that has extended the range of therapeutic options in the treatment of almost every human disease. Combination products—combinations of two or more active drugs produced in a single tablet—provide the advantages of combination therapy while reducing the number of prescriptions and the attendant administrative costs. This article describes the advantages of combination products and discusses their role in pharmacotherapy.
Note: The CE credit option on this piece has expired. Fact sheet available.

Complexities and Variations in Pharmaceutical Therapy for Cancer: Next steps toward achieving quality care, 2000
This white paper, authored by a collaboration of cancer organization in partnership with NPC, suggests cancer patients may not be receiving appropriate pharmaceutical care. The paper's findings also indicate that there is a slow transition of new knowledge into clinical practice.

This article was updated and published in October 2003 as a supplement to the Journal of the National Comprehensive Cancer Network, Vol. 1, Suppl 2. The updated version is available from NPC in hard copy only. Click here to request a copy.

Compliance Navigator Software, 1997 (downloadable)
Access to a Meta-Analysis of Research on Improving Medication Compliance
This software enables the user to examine key compliance literature abstracts in a number of ways, including comparing the effectiveness of the intervention and sorting the data by disease. Enables the user to focus on abstracts of interest.

Consumer Reports on the Health Effects of Direct-to-Consumer Advertising of Prescription Drugs, by Joel S. Weissman, et al., Health Affairs Web Exclusive, February 2003
This paper reports the results of a study of the health behaviors and outcomes that result when patients initiate discussions with their doctors as a result of seeing a prescription drug ad. Consumers reported that DTCA-motivated discussions with physicians frequently result in new diagnoses for clinically important conditions, and the survey found no evidence to support concerns about adverse health consequences.

Coordinated Pharmaceutical Therapy in Chronic Care: Five Innovative Programs, September 2000
Successful models of coordinated pharmaceutical care for patients at high risk for suboptimal treatment must be identified. This collection of five diverse approaches illustrates that coordinated pharmacotherapy can be implemented effectively across a variety of health care organizations. Many of the programs have resulted in improved outcomes and/or reduced overall costs of care. Fact sheet available.

Costs and Benefits of Pharmaceuticals: The Value Equation for Older Americans, by Richard Levy, PhD, Care Management Journals, Vol. 3, No. 3, Spring 2002
Benefits from new pharmaceuticals far outweigh their costs for many key diseases of the elderly. Even incremental improvements in drug therapies contribute substantially to improved care. Chronic illness, disability, and an aging population will drive future health care spending. Pharmaceutical innovation will be an integral part of effective strategies to address this challenge.

Cultural and Genetic Diversity in America: The Need for Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, et al., 2002
Pharmacogenetic research in the past few decades has uncovered significant differences among population groups in the metabolism, clinical effectiveness, and side effect profiles of many clinically important drugs. In addition, differences in how various populations view and respond to medicines underscores the need for an individualized approach to pharmaceutical therapy. Cost management policy design must take these differences into account in order to ensure that they are broad and flexible enough to enable rational choices and individualized treatment for all patients, regardless of racial or ethnic origin. Fact Sheet available.

Annotated PowerPoint slides related to this report are available.

Disease Management for Asthma, 2004
Asthma, one of the first disease management targets, is often selected for managed intervention because high-cost patients can be easily identified via their frequent medication refills, consistent clinical practice guidelines and validated outcome measures are available that can help assess the effectiveness of the interventions, and educational interventions have been developed to help improve the behavior of both patients and health care practitioners. This bibliography presents 69 studies demonstrating the impact of educational interventions on asthma treatment and management. Fact sheet available.

Disease Management for Depression, 2003
This monograph provides an introduction to disease management along with an analysis of penetration, trends and growth. Disease management strategies have great potential to improve therapeutic outcomes for patients with depression. Although there can be some challenges in managing depression through a disease management program, many programs have had success. While not every program included in the literature search represents a comprehensive disease management program, examples of specific educational interventions for depression are included and discussed.

Disease Management for Diabetes, 2004
This monograph presents 65 studies detailing the impact of educational interventions on diabetes treatment and management as well as information on diabetes disease management programs in development. It is intended to serve as a guide for those interested in developing disease management programs for the treatment of diabetes. Fact sheet available.

Disease Management for Heart Failure, 2004
This bibliography presents 68 studies concerning the impact of educational interventions on heart failure treatment and management. It is intended to serve as a guide for those interested in developing disease management programs for the treatment of congestive heart failure. Fact sheet available.

Disease Management for Schizophrenia, 2004
Disease management efforts for schizophrenia are less well established than are efforts for other chronic illnesses such as asthma and diabetes. Managing schizophrenia poses more of a challenge than many other chronic diseases because it usually causes greater disability than other mental and physical illnesses. However, disease management strategies have the potential to improve therapeutic outcomes for patients with schizophrenia. This monograph provides an introduction to disease management as well as examples of interventions for schizophrenia.

Drug Delivery Systems Improve Pharmaceutical Profile and Facilitate Medication Adherence, by Albert I. Wertheimer, MBA, PhD, et al., Advances in Therapy, Vol. 22, No. 6, November/December 2005
Innovations in dosage forms and dose delivery systems across a wide range of medications offer substantial clinical advantages, including reduced dosing frequency and improved patient adherence; minimized fluctuation of drug concentrations and maintenance of blood levels within a desired range; localized drug delivery; and the potential for reduced adverse effects and increased safety. The advent of new large-molecule drugs for previously untreatable or only partially treatable diseases is stimulating the development of suitable delivery systems for these agents. Although advanced formulations may be more expensive than conventional dosage forms, they often have a more favorable pharmacologic profile and can be cost-effective. Inclusion of these dosage forms on drug formulary lists may help patients remain on therapy and reduce the economic and social burden of care. This file is posted here with permission of Health Communications Inc., the publisher of Advances in Therapy®. It is provided for individual use only and may not be used for commercial distribution.

Drug-Related Adverse Events: A Readers' Guide to Assessing Literature Reviews and Meta-Analyses, by Susan D. Ross, MD, Archives of Internal Medicine, Vol. 161, April 23, 2001
The objective of this article is to provide readers with a practical guide to critically appraising reviews and meta-analyses of source studies of drug-related adverse events. A critique of a highly publicized meta-analysis is used as a case study to highlight several contentious issues.

Effectiveness of Interventions to Improve Patient Compliance: A Meta-analysis, by Debra Roter, et al., Medical Care, Vol. 36, No. 8, August 1998
This NPC funded research found that comprehensive compliance interventions work best. The statistical analysis of 153 studies showed that combining several approaches were more effective.

Ethnic Disparities in the Burden and Treatment of Asthma, 2005
In the United States the burden of asthma falls disproportionately on the black and Hispanic—largely Puerto Rican—populations, especially children. Much of this disparity has been attributed to unequal access to preventive care. Black and Puerto Rican children characteristically under-use routine health care services and overuse emergency care services for asthma. This report, developed in partnership with the Asthma and Allergy Foundation of America, discusses: disparities in the burden of asthma; possible hereditary, environmental, and behavioral causes of these disparities; and ways in which these asthma disparities may be lessened.

Annotated PowerPoint slides related to this report are available.

Formulary Restriction of Selective Serotonin Reuptake Inhibitors for Depression: Potential Pitfalls, by Paula L. Hensley and H. George Nurnberg, PharmacoEconomics, Vol. 19, No. 10, 2001
Psychotropic drugs and their associated costs can be a limiting factor in mental health treatment coverage. As a result, restrictive formularies are a common method of attempting to limit costs. This paper explores the intended and unintended consequences of having a single or exclusive selective serotonin reuptake inhibitor (SSRI) on a formulary and concludes that the practice of having a single SSRI on the formulary for a health care plan seems ill founded. Giving the primary care physician several antidepressant choices can provide more options to continue treatment of his or her patient in the less expensive primary care setting. In terms of cost containment, formulary restrictions are far more likely to have the opposite effect.

Fraction of Nursing Home Admissions Attributable to Urinary Incontinence, by Alan Morrison, PhD, Richard Levy, PhD, Value in Health, Vol. 9, No. 4, July/August 2006
This brief article calculates the proportion of nursing home admissions of the elderly attributable to urinary incontinence (UI) and finds that estimates of the fraction of nursing home admissions attributable to UI exceed those previously assumed and show an imbalance between the sexes. Policies that support reimbursement for treatments of UI in the community might help prevent or delay institutionalization and offset some of the costs.

Genes, Culture, and Medicines: Bridging Gaps in Treatment for Hispanic Americans, by Carolina Reyes, MD, et al., 2004
This report brings together for the first time a growing body of scientific research demonstrating substantial disparities in pharmaceutical therapy for Hispanic Americans. These disparities in pharmaceutical treatment are substantial and often persist even after adjustment for differences in income, age, insurance coverage, and coexisting medical conditions. Emerging research demonstrates that genetic variations affect Hispanic Americans and may require dosage adjustments to achieve an optimal therapeutic effect.

Fact Sheet available.
Annotated PowerPoint slides related to this report are available.

Genetic Variations in Response to Medications: Looking at the Implications for Minority Elders, by Richard Levy and Jean Polatsek, Healthcare and Aging, Vol. 9, No. 1, Spring 2002
Genetic, environmental and cultural factors influence variations in drug response among elders from different racial and ethnic backgrounds. Racial and ethnic heritage can be an indicator of special medical needs and differing drug responses; if ignored these differences in treatment response, can lead to compromised care and greater health risks. In addition, substantial dosing adjustments may be necessary to avoid overdosing or underdosing. Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American Society on Aging San Francisco, California. Also published in Diversity Currents, Vol. 4, No. 2, Spring 2002.)

Growth in Use of Lipid-Lowering Therapies: Are We Targeting the Right Patients? by Robert W. Dubois, MD, PhD, et al., American Journal of Managed Care, Vol. 8, October 2002
This article looks at the appropriateness of statin use in 1997 (pre-DTCA guidance) and in 1999 (post-DTCA guidance). The conclusion is that although the number of people being treated with statins rose considerably from 1997 to 1999, there did not appear to be any shift towards less appropriate treatment.

The Importance of Individualized Pharmaceutical Therapy in the Treatment of Diabetes Mellitus, by David B. Nash, MD, MBA, et al., Disease Management, Vol. 4, Suppl. 1, 2001
Individualized pharmaceutical care for patients with diabetes is necessary due to the variety among the patient population, the frequency and severity of concurrent medical conditions, and other factors that influence individual health and treatment options. This 22-page supplement to the journal Disease Management emphasizes how proper care tailored to individual patient needs can improve overall health and reduce more serious complications. Fact sheet available.

Improving the Quality of Pain Management Through Measurement and Action, 2003
This monograph addresses the application of continuous quality improvement techniques to pain management and the implementation of performance measurement processes. The use of a multidisciplinary systems point of view is described and the Cycle for Improving Performance, a structured approach to improvement activities, is outlined. Factors that influence an organization's ability to implement change and improve performance are also discussed. In addition, the real-world experience of four organizations in improving pain management is described. The examples provided encompass a diversity of settings and experience and suggest strategies for overcoming obstacles to pain management improvement initiatives.

Improving and Measuring Osteoporosis Management
In the United States, an estimated 10 million people are living with osteoporosis, also called brittle bone disease. Although osteoporosis is responsible for the majority of hip fractures, and accounts for more than eighteen billion dollars in health care expenditures annually, on average only 20% of patients are ever screened or treated for the disease. A new monograph developed by The Joint Commission through an unrestricted educational grant by NPC, is now available. The monograph contains 10 voluntary measures of care, designed for a variety of healthcare settings. "Improving and Measuring Osteoporosis Management" is intended for a professional audience and contains clinical information and practical tips for implementing an osteoporosis improvement initiative, whether clinical care is given in a hospital, emergency department, rehabilitation facility, home health agency, or doctor's office.

Individualized Prescribing for the Elderly, by Karen D. Novielli, MD, et al.,
Pharmacy & Therapeutics, September 2001 (Supplement)
Advances in health care and pharmaceuticals have made it possible to treat many diseases that manifest as people age. However, a "one-drug-fits-all" approach is not ideal, especially for older patients, who are exposed to unique health-related variables. When these variables interact in an older patient, individualized drug therapy is required. Note: The CE credit option on this piece has expired.

Is Technological Change in Medicine Worth It? by David M. Cutler and Mark McClellan, Health Affairs, Vol. 20, No. 5, September/October 2001
Cutler and McClellan's research explores the relationship between spending and health benefits. They examine several different disease areas and find that, indeed, there are tremendous benefits to be had from the use of pharmaceuticals. In four of five disease areas examined, benefits outweighed costs, and in the fifth disease costs and benefits were equal. Putting a price on life is a difficult task, but Cutler and McClellan calculate that the true cost of some types of care is actually falling because of medical innovation.

View "Measuring the Value of Health Innovations: The Policy Implications of New Medical Technologies," a briefing by the Alliance for Health Reform featuring Mark McClellan, September 7, 2001, Washington, DC

Annotated PowerPoint slides related to this article are available.

MedAccess Online Bibliography on Atypical Antipsychotics
This bibliography, developed by Dr. William M. Glazer, President of Glazer Medical Solutions and Associate Clinical Professor of Psychiatry at Massachusetts General Hospital and Harvard Medical School, presents studies demonstrating the value of the atypical antipsychotic medications clozapine, olanzapine, quetiapine, and resperidone.

Medicaid Disease Management Programs: Findings from Three Leading U.S. State Programs, by Jeann L. Gillespie and Louis F. Rossiter, Disease Management & Health Outcomes, Vol. 11, No. 6, June 2003
A growing number of states are beginning legislative and administrative studies, piloting disease management programs, and expanding existing programs. There is no single, correct way to implement programs across patient populations. Results will depend upon the way the program is implemented, the model used, the diseases selected, and the ability to implement purely voluntary efforts or programs with strong incentives and outcome-driven approaches.

Newness of Drugs and Use of HMO Services by Asthma Patients, by Susan D. Horn, et al., The Annals of Pharmacotherapy, Vol. 35, No. 9, September 2001
Analyses showed an association between greater use of newer asthma drugs and lower overall drug costs and physician visits. A trend was also found between greater use of newer asthma drugs and fewer hospitalizations and emergency department visits.

Noncompliance with Medications: An Economic Tragedy with Important Implications for Health Care Reform, 1994
The economic and medical consequences of noncompliance to the U.S. health care system are examined in this 32-page NPC publication. Understand how noncompliance accounts for up to $100 billion in health care and productivity costs.

An Overview of Two Monographs on Pain Management, 2003
In 2001, the Joint Commission on Accreditation of Healthcare Organizations and the National Pharmaceutical Council began a collaborative effort to facilitate improvements in pain management. To date, this effort has produced a set of monographs intended for those involved in pain management activities, including clinicians, quality management professionals, and others involved in pain management performance, assessment, improvement, education, and policy making.

Pain: Current Understanding of Assessment, Management, and Treatments, 2001
Pain is the most common reason individuals seek health care and about 9 in 10 million Americans regularly suffer from pain. Each year, an estimated 25 million Americans experience acute pain due to injuries or surgery and another 50 million suffer chronic pain. The adverse consequences of undertreated pain are considerable. Poorly managed acute pain may cause serious medical complications, impair recovery from injury or procedures, and can progress to chronic pain. Undertreated chronic pain can impair an individual's ability to carry out daily activities and diminish quality of life.

An addendum, published in May 2005, updates clinical advances in pain management since the publication of this monograph.

CE Credit for nurses and nurse practitioners is available through NP Central. (Lesson Expires: 1/31/06)
CE Credit for physician assistants is available through the AAPA. (Lesson Expires: 12/1/06)
CE Credit for pharmacists is available through the APhA. (Lesson Expires: 12/15/07)
CE Credit for physicians and psychiatrists is available through the APS. (Lesson Expires: 6/30/07)

Patient Adherence to HIV Medication Regiments: A Review of Published and Abstract Reports, by Linda Fogarty, et al., Patient Education and Counseling, Vol. 46 2002
A literature search of published articles reporting correlates of HIV medication adherence or interventions designed to increase HIV medication adherence found that more complex regimens were related to decreased adherence, but were often successfully mitigated by medication aids. Social and psychological factors reflecting emotional adjustment to HIV/AIDS and provider support were related to adherence. Access to institutional resources was also associated with better adherence.

Pharmaceutical Diversity Serves Human Diversity: Medications for Older Adults, by Richard A. Levy, PhD, Healthcare and Aging, Vol. 7, No. 4, Winter 2000
Genetic differences in response to medicines are now known to involve some of the medications most used among elders, including drugs for high blood pressure, depression and life-threatening infections. New scientific findings about genetic influences on the effects of medications call for increased focus on subgroups of patients and on individuals. (Reprinted with permission from Healthcare and Aging, Vol. 7, No. 4, Winter 2000. Copyright © 2000 American Society on Aging, San Francisco, California.)

Pharmaceuticals and Worker Productivity Loss: A Critical Review of the Literature, by Wayne N. Burton, MD, Alan Morrison, PhD, and Albert I. Wertheimer, PhD, Journal of Occupational and Environmental Medicine, Vol. 45, No. 6, June 2003
Many chronic illnesses that affect the working population can cause losses in productivity. The evidence is very good for about a dozen drug classes that pharmaceuticals reduce productivity losses caused by respiratory illnesses (i.e. asthma, allergic disorders, bronchitis, upper respiratory infections, and influenza), diabetes, depression, dysmenorrhea, and migraine. This article should be helpful to occupational physicians who are increasingly providing recommendations on employer benefit plan designs and pharmaceutical benefits.

Annotated PowerPoint slides related to this article are available.

Pharmaceuticals for Elders: Why Innovation Matters, by Albert Wertheimer, Healthcare and Aging, Vol. 9, No. 1 Spring 2002
The current policy debate over drug-benefit reform and improved access to needed medicines for elders has generated considerable confusion and many misperceptions regarding the nature and value of incremental pharmaceutical innovation. Cumulatively, these new medicines allow for precision treatment of the individual needs of diverse patients, which is especially important for optimal treatment of older patients, because age-related physiological changes and individual differences may produce markedly diverse responses to medications in older adults. (Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American Society on Aging San Francisco, California.)

CD-ROM Prescription Medicines: Returning Value to Patients, Payers and Society, 2003
Studies confirm that indeed, medicines are one of the fastest growing areas of health care spending. And while few can imagine life without the life improving medicines that patients with diabetes, heart disease, cancer, HIV/AIDS, and many others have come to depend on, some have questioned the value of that spending – to the health care system overall and to consumers. In this compilation of materials – much of it peer-reviewed research – we hope to help answer some of the critical questions in this debate.

Q's and A's for State Officials, Physicians and Patients
Find out the benefits of disease management for Medicaid officials, providers and patients. State officials are briefed on how to determine high quality services and utilization management to chronically ill Medicaid patients. Other fact sheets explain how disease management benefits physicians and their patients.

Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, Randall W. Maxey, and Richard A. Levy, Journal of the National Medical Association, Vol. 94, No. 10 (Suppl.), October 2002
It is now well documented that substantial disparities exist in the quality and quantity of medical care received by minority Americans, especially those of African, Asian, and Hispanic heritage. In addition, the special needs and responses to pharmaceutical treatment of these groups have been undervalued or ignored. This article reviews the genetic factors that underlie varying responses to medicines observed among different ethnic and racial groups.

Annotated PowerPoint slides related to this report are available.

CME credit is available through the National Medical Association.

The Silver Book: Chronic Disease and Medical Innovation in an Aging Nation
The Silver Book, a project of the Alliance for Aging Research is an almanac of hundreds of facts, statistics, graphs, and information from close to 100 agencies, organizations and experts. It is a searchable database that is constantly updated and expanded in order to highlight the latest research and data on the burden of chronic disease and the value of investing in medical research. The Silver Book database is searchable by specific terms or by sections. The database is also interactive, allowing users to submit data from additional studies and reports.

Executive Summary: Too Many Drugs? The Clinical and Economic Value of Incremental Innovations, by Albert Wertheimer, Richard Levy and Thomas O'Connor, 2001
Some believe that incremental advances within the pharmaceutical industry are too costly and do not ultimately benefit the consumer. This is a misconception. The new agents resulting from this evolutionary process can offer advantages in terms of improved efficacy, better patient satisfaction and compliance and, in some cases, greater cost effectiveness.

Annotated PowerPoint slides related to this report are available.

Too Many Drugs? The Clinical and Economic Value of Incremental Innovations, by Albert Wertheimer, Richard Levy and Thomas O'Connor, Research in Human Capital and Development: Investing in Health: The Social and Economic Benefits of Health Care Innovation,
Vol. 14, 2001
The history of clinical pharmacology is characterized by incremental improvements in the safety, efficacy, selectivity, and utility of drugs within a given class. This report makes the case for a fully developed class of drugs to allow precision prescribing in order to achieve optimum outcomes in the most cost effective manner.

Annotated PowerPoint slides related to this article are available.

Toward Individualized Pharmaceutical Care of East Asians, by Alan Morrison, PhD, and Richard A. Levy, PhD, Pharmacogenomics, Vol. 5,
No. 6, September 2004
Research into the relationship between genetics and drug response has focused on variations in genes that encode drug-metabolizing enzymes. Much of this work has targeted East Asians, a genetically distinguishable and populous group. Variations known to inactivate a drug-metabolizing enzyme are predictive of poor metabolism of drugs processed by that pathway. Genetic tests can be used to screen for individuals who are poor metabolizers, with the ultimate goal of better predicting the clinical effects of drugs. A non-technical summary of this paper is available.

Treatment of Depression in Older Primary Care Patients in Health Maintenance Organizations, by Stephen J. Bartels, PhD, et al., Psychiatry in Medicine, Vol. 27, No. 3, 1997
Older patients enrolled in managed care plans are being prescribed older anti-depressants, indicating that this issue is an important target for improving quality of care for depression in the elderly. Authors of this 1997 journal article found that the elderly who were prescribed anti-depressants received older varieties that have more side effects.

Urinary Incontinence: Economic Burden and New Choices in Pharmaceutical Treatment, by Richard Levy, PhD and Nancy Muller, Advances in Therapy, Vol. 23, No. 4, July/August 2006
In the year 2000, an estimated 17 million community-dwelling adults in the United States had daily urinary incontinence (UI) and an additional 33 million suffered from the overlapping condition, overactive bladder. Estimates of the total annual cost of these conditions range up to $32 billion. Until recently, pharmaceutical therapy for UI has been limited, especially because the adverse effects of available agents resulted in poor adherence to treatment regimens. Recent innovations in molecular design and new dosage forms of UI medications offer the promise of fewer and less severe adverse effects and, thus, better treatment outcomes for patients. New pharmacologic treatment options for UI have the potential to allow greater independence for older persons who reside at home and to delay or avoid the costs of admission to long-term care facilities. This file is posted here with permission of Health Communications Inc., the publisher of Advances in Therapy®. It is provided for individual use only and may not be used for commercial distribution.

The Value of Disease Management: Balancing Cost and Quality in the Treatment of Asthma, by Jeann Lee Gillespie, PharmD, MS, Disease Management, Vol. 5, No. 4, 2002
Asthma is often selected for disease management programs because of its high prevalence and large economic impact and the frequent failure to provide appropriate patient care and achieve optimal outcomes. The article examines the value of disease management in both improving the quality of care received and managing costs associated with the treatment of asthma. Case studies from state Medicaid initiatives and private sector HMO programs are provided.

The Value of Disease Management: Balancing Cost and Quality in the Treatment of Congestive Heart Failure, by Jeann Gillespie, PharmD, MS, Disease Management, Vol. 4, No. 2, 2001
This article reviews the literature to identify reports concerning the impact of educational interventions on heart failure treatment and management. It also discusses why heart failure is often selected for disease management, outlines the management and treatment of heart failure, and provides a review of heart failure disease management literature.

The Value of Disease Management: Balancing Cost and Quality in the Treatment of Diabetes Mellitus, by Jeann Lee Gillespie, PharmD, MS, Disease Management, Vol. 5, No. 1, 2002
The article examines the value of disease management in both improving the quality of care received and managing costs associated with the treatment of diabetes. Case studies from state Medicaid initiatives and private sector HMO programs are provided, as well as a bibliography of 56 studies citing disease management interventions and outcomes for further reference.

The Value of Incremental Pharmaceutical Innovation for Older Americans, by Albert Wertheimer, PhD, MBA, Thomas W. O'Conner, Jr., PharmD, MBA, and Richard Levy, PhD, 2001
This monograph explains that small incremental improvements within drug classes provide important health benefits, especially for elderly patients. The monograph illustrates therapeutic advantages of these newer drugs in a class including: fewer side effects, improved safety and greater effectiveness; easier use, which facilitates compliance with prescribed regimens; and better tailoring to fit individual patient needs. Fact sheet available.

CD-ROM The Value of Medical Innovation
This collection of materials on the increasingly important role of pharmaceuticals in health care delivery includes selected research from the Health Affairs September/October 2001 issue, video highlights from the September 7, 2001, Capitol Hill symposium held to discuss research featured in the issue, key points from the research, illustrative charts, and selected news articles covering the research and its implications.

The Virginia Health Outcomes Partnership: A Demonstration Project, 1997
Learn how to select diseases for Medicaid disease management from this 18-page NPC booklet written by Judith Jones, the Degge Group. See what Virginia considered before selecting asthma as its first targeted intervention. Fact sheet available.

Why the Elderly Need Individualized Pharmaceutical Care, by David Nash, MD, MBA, et al., April 2000
A “one drug fits all” approach does not work for elderly patients because they are exposed to unique health variables that are rare in younger patients. This 18-page report explains the pharmacological, physiological and epidemiological reasons why therapy for this population must be personalized.

Annotated PowerPoint slides related to this report are available.
Fact sheet available.

Your Pharmacy Benefit: Make it Work for You!
This 16-page booklet, available through the Federal Citizen Information Center offers helpful advice for those with prescription drug coverage through and employer, union, or other group plan, or who are eligible for prescription drug coverage under Medicare. The booklet guides readers through important questions to ask and things to consider when choosing a plan, and offers tips for troubleshooting problems filling prescriptions once enrolled in a plan. Includes a sample appeal letter. Also available in Spanish.