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At least 811 records · Page 45Linked to original sources
PubMed1998

Determining whether managed care formularies meet the needs of pediatric patients.

UNLABELLED: This activity is designed for healthcare providers making formulary decisions for managed care organizations. GOAL: To help clinicians determine whether managed care formularies meet the needs of pediatric patients. OBJECTIVES: 1. List general considerations for establishing a pediatric drug formulary. 2. Understand the importance of growth and development when selecting drug therapy for pediatric patients. 3. Discuss potential difficulties with administering medications during school hours. 4. Identify specific medications within the drug classes of antibiotics, asthma medications, endocrine, and gastrointestinal agents that should be available on a pediatric drug formulary.

Child↗
PubMed1998

Anticonvulsants: choices and costs. Based on a presentation by Nina Graves, PharmD, FCCP.

Epilepsy is not a single disease but a constellation of different syndromes and different seizure types. Consequently, establishing a diagnosis on which to base therapy can be complicated. The most commonly used antiepileptic drugs (AEDs) fall into two broad categories: the older AEDs introduced between 1912 and 1973 and the newer AEDs introduced since 1993. The older AEDs have many off-label uses, whereas the newer AEDs, with the exception of gabapentin and lamotrigine, are used exclusively for the treatment of epilepsy. All AEDs are associated to varying degrees with adverse effects on the central nervous system, gastrointestinal tract, blood, liver, and skin. The older AEDs are less expensive than the newer AEDs, but because the newer agents are available in both titration and maintenance-dose strengths, cost savings are possible. Use of the high-strength dose of a newer AED represents a huge cost saving per day compared with using the low-strength dose. Further savings can be realized in the managed care arena if pharmacists are involved in getting patients onto high-strength tablets as quickly as possible.

Anticonvulsants↗
PubMed1999

Therapeutic interchange of conjugated and esterified estrogens in a managed care organization.

A program designed to curb increases in drug costs in an HMO by substituting esterified for conjugated estrogens was developed and studied. Patients were voluntarily switched from conjugated to esterified estrogens at an HMO in Washington State. Women were informed about the conversion through newsletters and during clinic and pharmacy visits and received physician and pharmacist counseling. Cost savings were estimated, and patient acceptance was evaluated by interviewing women in four groups, including women who were switched from conjugated to esterified estrogens and then switched back (C-E-C group), women who were not switched (C-C group), and women who were switched to esterified estrogens and not switched back (C-E group). During the first six months, 14,601 (89.2%) of 16,364 women taking conjugated estrogens were switched to esterified estrogens; of these, 13,654 (93.5%) continued taking esterified estrogens for at least six months. The HMO avoided $653,119 of an expected $750,000 cost increase for oral estrogen therapy during the first year of the program. A total of 754 women were interviewed; 65.8% in the C-E-C group and 78.4% in the C-E group reported being satisfied with the information they received. The conversion experience was rated as positive by 28.3% of women in the C-E-C group and 41.5% of women in the C-E group, negative by 25.1%, and 8.9%, and neutral by 46.6% and 49.6%. An HMO avoided a large increase in drug costs by substituting esterified for conjugated estrogens; only 6.5% of patients were switched back to conjugated estrogens at their physicians' or their own request; most patients thought the conversion was a neutral or positive experience.

Adult↗
PubMedDate not supplied

Essential drugs.

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Developing Countries↗
PubMed1980

Potential and actual drug product selection rates in Florida.

A systematic review of new prescriptions conducted 1 year after the enactment of Florida's drug product selection law showed that 36.3% were potentially subject to product interchange. Product interchange actually occurred in only 6.2% of these potentially eligible prescriptions. Positive formularies established by the pharmacies reduced the eligible population to 8.1% of all new prescriptions and the product selection rate relative to these formularies was 14.7%. Twenty drugs accounted for nearly three-fourths of all drug product selection activity.

Drug Prescriptions↗