The American Journal of Managed Care
This supplement to contains information regarding anticoagulationtherapy, its costs, and the impact underutilization and underdosing has on patients and thehealthcare community. This supplement is based in part on a roundtable meeting held on April 2, 2004,in San Francisco. This supplement has been peer reviewed by an expert in the field.
Chair
Ann K. Wittkowsky, PharmD, CACP, FASHP
Clinical Professor
University of Washington School of Pharmacy
Director, Anticoagulation Services
University of Washington Medical Center
Seattle, Washington
Faculty
Donald Balfour III, MD
President and Medical Director
Sharp Rees-Stealy Medical Group, Inc
San Diego, California
J. Jamie Caro, MDCM
President
Caro Research
Concord, Massachusetts
Kevin Colgan, RPh, MA
Vice President
Epi-Q, Inc
Oakbrook Terrace, Illinois
Alan S. Go, MD
Physician Scientist
Kaiser Permanente of
Northern California
Oakland, California
Daniel Kus, RPh
Vice President
Ambulatory Pharmacy Services
Clinical Program Manager
Henry Ford Health Systems
Bingham Farms, Michigan
Joseph Menzin, PhD
President
Boston Health Economics
Waltham, Massachusetts
Thomas Morrow, MD
Vice President and Medical Director
Matria Healthcare
NCQA Surveyor
Alphratta, Georgia
Michael Nelson
Director
Economic & Outcomes Research
Ingenix
Eden Prairie, Minnesota
Gary Rice, RPh, MS
Director of Pharmacy & Retail Services
Kelsey-Seybold Clinic
Houston, Texas
Kenneth L. Schaecher, MD
Medical Director
Utilization Management
Intermountain Healthcare
West Valley City, Utah
Debbie Simonson, PharmD
Manager, Clinical Pharmacy
Ochsner Health Plan
Residency Director
Ochsner Clinic Foundation
New Orleans, Louisiana
Marcus D. Wilson, PharmD
President, Chief Executive Officer
Healthcore
Newark, Delaware
Disclosure Statement
In accordance with the ACCME and the ACPE, participants for this activity have completed a conflict-of-interest disclosure statement.
In compliance with the Health Insurance Portability and Accountability Act standards, no presentationsin this CME/CE activity shall disclose the names or other unique identifiers of patients referencedwithout a signed waiver from the identified patient.
The American Journal of Managed Care
It is the policy of to have all faculty who participate in programssponsored by corporate organizations disclose any real or apparent conflicts of interest.
These participants have declared the following relationships with corporate organizations:
The following participants have declared no financial affiliations with any corporate organizations:
The American Journal of Managed Care
Signed disclosures are on file at the offices of , Jamesburg,New Jersey.
NOTE: The Food and Drug Administration (FDA) Cardiovascular & Renal Drugs Advisory Committee votedagainst recommending approval for ximelagatran (Exanta) for all 3 indications under review at the FDA. Theseindications include: prevention of stroke and other thromboembolic complications associated with atrial fibrillation;secondary prevention of venous thromboembolism (VTE) after standard treatment for an acute episode;and short-term prevention of VTE in patients undergoing knee replacement surgery. The committee agreedthat the risk management plan offered by the drug's manufacturer, AstraZeneca, did not seem adequate to preventsevere liver damage. Another concern was the number of adverse cardiac events, such as myocardialinfarction, associated with using ximelagatran for knee replacement surgery. However, these concerns could beaddressed with further safety studies. AstraZeneca is continuing discussions with the FDA and awaits a finaldecision. The FDA committee agreed that ximelagatran demonstrated efficacy in the studies and would be animportant alternative to other older therapies. New drug therapies, including ximelagatran, are discussed inthis supplement.