Biomedical subjects

A H Heaton

Publications and source records attributed to A H Heaton.

5 recordsLinked to original sources

PubMed2001

The managed care pharmacy perspective.

Despite the important reproductive and noncontraceptive benefits of hormonal therapy, both oral contraceptives (OCs) and hormone replacement therapy (HRT) are underutilized, with only a small portion of eligible women receiving therapy. Increased use of hormonal therapy will result in greater pharmacy costs, a concern in the present era of cost containment that is reflected in the wide variability in coverage of hormonal therapy provided by managed care organizations. However, pharmacoeconomic research demonstrates that relatively small expenditures in pharmacy costs for hormonal therapy result in significantly lower healthcare costs per patient, through the prevention of unintended pregnancy with OCs and the noncontraceptive health benefits of both OCs and HRT.

Climacteric↗

PubMed1996

Cost effectiveness of risk reduction: the managed care perspective.

Coronary artery disease (CAD) is responsible for nearly $140 billion in healthcare expenditures each year. A major opportunity for cost savings lies in reducing the overutilization of hospitalization for CAD patients. This goal may be accomplished through several strategies: more precise diagnosis of CAD, primary and secondary prevention, and early intervention. Underutilization of health services and treatment also contributes to higher overall medical costs. Even though drug therapy incurs costs, effective medications can produce substantial savings by reducing the need for additional medical care. For example, lipid-lowering agents are particularly cost effective when used as secondary prevention in patients with CAD; however, only 25% of patients receive such therapy. Likewise, not all patients who suffer acute myocardial infarction are treated with any of the agents proven to reduce the risk of subsequent adverse cardiovascular events. The elimination of variability in prescribing practices should help optimize the cost effectiveness of therapies aimed at reducing CAD risk.

Cost-Benefit Analysis↗

PubMed1996

Pharmacoeconomic comparison of loop diuretics in the treatment of congestive heart failure.

As MCOs explore opportunities for delivering more cost-effective medical care, prioritization based on drug utilization reviews alone may not adequately highlight those disease states that consume a disproportionate share of overall resource cost; the daily cost of pharmacotherapy may not reflect the overall economic effect. As the elderly proportion of the population grows, the treatment of congestive heart failure may represent for MCOs an increasingly important opportunity to achieve acceptable or even improved outcomes while controlling the costs of hospitalization and other resources. The introduction of new pharmaceuticals presents an ongoing challenge for managed care to determine whether they offer a pharmacoeconomic advantage over current treatment regimens. This paper reports on an economic assessment made between a new and an existing loop diuretic in the treatment of congestive heart failure.

Aged↗

PubMed1993

Gastric ulcer perforation associated with the use of injectable ketorolac.

OBJECTIVE: To report a case of a perforated gastric ulcer associated with the use of injectable ketorolac tromethamine. DATA SYNTHESIS: A 77-year-old woman with no previous history of peptic ulcer disease developed a perforated gastric ulcer after four days of treatment with ketorolac. To date, six other cases of gastrointestinal (GI) perforation associated with the use of ketorolac have been reported to the manufacturer. CONCLUSIONS: Although ketorolac is an effective analgesic, it is a nonsteroidal antiinflammatory agent and thus has the propensity for causing GI ulceration. Caution should be used when administering this drug and patients should be monitored for GI adverse effects.

Aged↗

PubMed1992

Cefotetan disodium-induced hemolytic anemia.

OBJECTIVE: To report a case of cefotetan disodium-induced hemolytic anemia. DATA SOURCES: Original research articles and case reports. DATA SYNTHESIS: A 46-year-old woman developed fulminant hemolytic anemia following a second exposure to intravenous cefotetan disodium for postoperative prophylaxis. She developed respiratory failure requiring intubation and acute renal failure requiring hemodialysis. The hemolysis was successfully treated with plasmapheresis, but the patient died on the 25th postoperative day. Positive Coomb's tests have been reported in less than three percent of patients receiving cefotetan. To our knowledge, this is the first case of fulminant hemolytic anemia associated with intravenous cefotetan disodium therapy. CONCLUSIONS: Cefotetan should be added to the list of drugs known to cause hemolytic anemia. Monitoring for hemolysis should be considered for patients who receive multiple courses of therapy.

Anemia, Hemolytic↗