Health Information Technology and the Road to Reform
February 26th 2014Health information technology (HIT) was the focus of a discussion led by Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for HIT, US Department of Health and Human Services. In his Managed Markets Summit 2014 keynote address, Health IT and Reform: The Road to Right Care, Dr Mostashari touched upon the obstacles and shortcomings in our nation's healthcare landscape, and asserted that more prominent usage of HIT would help to alleviate fiscal concerns and affect better outcomes in patient care.
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Raulo S. Frear, PharmD, Says How PBMs Are Aligning Benefit Designs for Delivery System Reform
February 26th 2014Raulo S. Frear, PharmD, general manager, OmedaRx, says pharmacy benefit managers are aligning benefit designs for delivery system reform in a few ways. With respect to the delivery system reform, if you look at ACOs as a specific example, our experience has been that the ACOs are not really ready to talk about different benefit designs, Dr Frear says. They're still learning what it means to accept risk and that means risk across a lot more areas than just pharmaceuticals.
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Ed Pezalla, MD, MPH, Discusses How Health Plans are Engaging Patients in Decision-Making
February 26th 2014Ed Pezalla, MD, MPH, national medical director for pharmacy policy and strategy, office of the CMO, Aetna, says payers and health plans are preparing for patient-centered care by utilizing digital tools. Everything from virtual people to cost search tools are used to assist employed and general patient populations. Dr Pezalla says many of these tools will also be used in the public and private health insurance exchanges to help people make decisions as they purchase health plans.
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How Clinical Evidence Drives Formulary Decision-Making
February 25th 2014Laurie Wesolowicz, PharmD, director, pharmacy services clinical, Blue Cross Blue Shield of Michigan (BCBSM), says that clinical evidence and other factors can drive formulary decision-making. Evidence can influence the value and coverage recommendations for drugs covered under the pharmacy (formulary) and medical benefits.
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Farzad Mostashari, MD, Discusses the National Investment in HIT
February 25th 2014Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for health information technology (HIT), US Department of Health and Human Services, says we need to have payment reform to support the success of HIT.
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Pat Gleason, PharmD, FCCP, BCPS, director of health outcomes, Prime Therapeutics, and Shelley Sanchez, senior director of specialty product development, Prime Therapeutics, presented on 1 approach to managing the specialty drug benefit, which includes optimizing the use of PhARMA manufacturer coupons and patient assistance programs (PAPs).
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Specialty Drug Management Initiatives
February 6th 2014With nearly half of specialty spending occurring on the medical benefit in 2012, and seeing that specialty spending is predicted to account for 50% of total pharmacy spending by 2019, Mike Waterbury, president, ICORE Healthcare, specialty division of Magellan Pharmacy Solutions, reports that specialty drug costs will surpass traditional spending in the next few years.
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Healthcare Industry Transformation to Meet Employer Demand for Managing Specialty Pharmacy Costs
February 6th 2014According to Howard K. Crowley, head of pharmacy strategic initiatives, Aetna Pharmacy Management, a Towers Watson/ National Business Group on Health survey found that 29% of employers rank the rising costs of specialty drugs as a top challenge to keeping health benefit coverage affordable.
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A Comprehensive Medication Therapy Management Program
February 5th 2014James Gartner of CareSource and Jessica Frank of OutcomesMTM shared the first-year results of a cooperative comprehensive medication therapy management (MTM) program that they implemented for nearly 1 million Ohio Medicaid members.
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Medication Optimization in a New Healthcare Era
February 5th 2014In medication use and improving patient outcomes, Susan Cooper, MPH, RPh, senior director, pharmacy services, HealthPartners, says her organization envisions prescription drug optimization going beyond addressing adherence. It seeks to improve the patient experience.
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The PBM Has No Clothes: A (Public Sector) Proposal Is More Transparent Than You Think
February 4th 2014In a presentation entitled The PBM Has No Clothes: A (Public Sector) Proposal Is More Transparent Than You Think, Steffanie Mathewson, Esq, principal, Mathewson Research, described how the Freedom of Information Act (FOIA) and state sunshine laws make it easier for stakeholders to view and understand the strategic direction of major PBMs.
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The National Business Coalition on Health: Independently Assessing PBM Value for Employers
February 4th 2014According to John Miller, executive director, MidAtlantic Business Group on Health, The National Business Coalition on Health (NBCH) is an organization that seeks to drive conversations about prescription drug benefit management (PBM) to value.
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NOW AVAILABLE: A Special Report on Diabetes Innovation 2013
December 17th 2013To build on the success and ideas generated at last year's inaugural event, Joslin Diabetes Center once again brought together numerous key stakeholders in the collective battle to conquer diabetes and to provoke thought, innovation, and action. Highlights from Diabetes Innovation, which took place on October 3-5, 2013, in Washington, DC, are available in a special report published by The American Journal of Managed Care.
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Controlling the Obesity Epidemic: Where Does Pharmacy Weigh In?
December 12th 2013As the prevalence of obesity continues to increase and treatment strategies evolve, pharmacists are not only in a position to advise on appropriate use of pharmacotherapy for obesity, but also to assist in improving outcomes from gastric bypass surgery.
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Pharmacists Make Progress Toward Attaining Provider Status
December 12th 2013Speakers at the ASHP Midyear Clinical Meeting ranging from ASHP President Gerald Meyer, PharmD, to Michael Lee, PharmD, of the Indian Health Service, argued that pharmacists are closer than ever before to achieving their goal of attaining provider status.
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The Clinical Impact of Next-Generation Sequencing (NGS) on Pharmacy Practice
December 11th 2013Genomic sequencing is rapidly increasing its value as a clinical tool in the diagnosis and treatment of many diseases, including cancer. In his presentation, Justin M. Balko, PharmD, PhD, from Vanderbilt University, provided a background on the current state of next-generation genomic sequencing (NGS), and the potential role that pharmacists play as this science continues to evolve.
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The Ideal Clinical Practice: Myth or Reality
December 11th 2013New and experienced pharmacists are always on the lookout for ways to improve their careers. This presentation focuses on some key strategies for identifying new opportunities that allow new and experienced pharmacists to develop and apply their clinical skills.
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Healthcare Quality Measurement and Reporting: Experiences From the NQF
December 11th 2013Quality and performance measurement has become an integral part of the healthcare system. As pharmacists continue to increase their role and exposure as healthcare providers, they are well positioned to assist in identifying ways to improve the quality of care delivered and to play an integral role in the development of quality measures, according to Curtis Collins, PharmD, MS, BCPS (AQ-ID), FASHP, who spoke at the ASHP Midyear Meeting.
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Post-Marketing Research No Longer an Afterthought With Targeted Therapies
December 10th 2013With the rise of targeted therapies, the days of letting doctors report informally on unexpected reactions to new cancer drugs are long gone. The change signals a larger role for phase IV, the post-marketing research step in the approval process.
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From Laboratory to Licensure: Preclinical Phase Critical in Creating New Targeted Therapies
December 10th 2013One billion dollars. That can be the list price for bringing a new cancer-fighting agent from preclinical design through approval by the US Food and Drug Administration, according to Michael R. Grever, MD, of the Ohio State University.
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Newest Drugs of Abuse: Spice, Bath Salts, Salvia, and Beyond
December 10th 2013llicit drug use continues to be a prevalent and growing problem in the United States, and the use of newer substances is on the rise. Because of the increasing prevalence and tweaking of compounds to avoid detection, the identification of drug abuse by practitioners often relies on signs and symptoms. In this session, presenters reviewed some of these agents, including their history and their impact on those abusing them.
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Advanced Clinical Pharmacy Services Integration in an Accountable Care Organization
December 10th 2013In this session, a sustainable business model for pharmacists practicing in an accountable care organization environment was described by Kelly Boesen, PharmD, BCPS, and Sandra Leal, PharmD, MPH, CDE, FAPhA, of the El Rio Health Center in Tucson, Arizona.
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Rituximab, Other Antibodies Offer Hope In Advancing ALL Treatment
December 9th 2013Taking aim at relapse rates and overall poor outcomes among adult patients with acute lymphoblastic leukemia (ALL) demands both new therapies and new ways of thinking, according to Anjali S. Advani, MD, of the Cleveland Clinic. Antibodies, which have produced success in treating other blood cancers, offer promise because in some cases the same antigens are involved.
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Treating newly diagnosed patients even older ones with a combination of lenalidomide, marketed by Celgene as Revlimid, and low-dose dexamethasone, a steroid, seems likely to become the new treatment standard for multiple melanoma, based on the presentation of a mass vascular endothelial growth factor inhibitor, ive, multinational Phase III study presented Sunday at the 55th American Society of Hematology Meeting and Exhibition in New Orleans.
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