Issue Area - Aging
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.
Formulary Limitations and the Elderly: Results from the Managed Care Outcomes Project, by Susan Horn, PhD, et al., The American Journal of Managed Care, Vol. 4, No. 8, 1998
Evidence is presented that the elderly are at particular risk from formulary restrictions, an important issue as more Medicaid and Medicare patients enroll in managed care. This 1998 article by Horn shows that selecting less expensive drugs may lead to greater side effects in the elderly.
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.
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.)
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.
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 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.)
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.
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 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.
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.
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