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At least 1,063 records · Page 59Linked to original sources
PubMed2003

A comparison of Canadian general pediatric dosing publications.

A comparison of the general pediatric dosing guidelines published in Canada was conducted. Institutions that publish pediatric dosing guidelines as a separate publication or as part of the hospital formulary were mailed a survey of questions to describe their publication. Publications that met the inclusion criteria were evaluated using 12 assessment criteria: approval or submissions by medical specialty groups, drug inclusion, dosing guidelines, dosing in organ failure, pharmacokinetic/pharmacodynamic parameters, therapeutic guidelines, intravenous and oral administration guidelines, adverse drug reactions/drug interactions, referencing, drug acquisition costs, organization and readability. Four Canadian pediatric centres satisfied the criteria for publishing general pediatric dosing guidelines. These were reviewed by the process of formulary selection (in alphabetical order by city): Formulary of Drugs and Dosing Manual (Halifax), Formulary of Drugs (Toronto), Drug Dosage Guidelines and Formulary (Vancouver), and Pediatric Drug Dosage Handbook (Winnipeg). Dosing guidelines from published pediatric drug trials have been collated with institutional experience and historical practice to produce a practical source of pediatric dosing information.

Canada↗
PubMed2003

[An analysis of appearance frequency of formulations and crude drugs in Jin-Kui-Yao-Lue].

A systematic database was constructed to examine the frequency of appearance of individual formulations and crude drugs in Jin-Kui-Yao-Lue, a traditional Chinese formulary used for miscellaneous chronic internal diseases. This formulary contains 263 kinds of genuine formulations, but because of overlapping or repetition, the total number of formulations mentioned is as high as 309. It was proved that among the 212 kinds of crude drugs described in Jin-Kui-Yao-Lue, the five crude drugs most frequently mentioned are Glycyrrhizae Radix, Cinnamomi Ramulus, Zhingiberis Rhizoma, Zizyphi Fructus and Paeoniae Radix, which are used in Guizhi-tang, Keishi-to in Japanese. Mel used for preparing pills appears more frequently in Jin-Kui-Yao-Lue than in Shang-Han-Lun, which is the most commonly Chinese medical formulary referred to for treatment of acute externally contracted diseases. The ways of using Astragali Radix, Sinomeni Caulis et Rhizoma, Moutan Cortex and Cnidii Rhizoma described in Jin-Kui-Yao-Lue differ from that described in Shang-Han-Lyn. Furthermore, the directions for using Pinelliae Tuber for cold-phlegm syndrome and Poria for dampness-retention syndrome are developed in Jin-Kui-Yao-Lue.

China↗
PubMed2003

Impact of Maine's Medicaid drug formulary change on non-Medicaid markets: spillover effects of a restrictive drug formulary.

BACKGROUND: Market penetration of HMOs affect physician practice styles for non-HMO patients. OBJECTIVE: To study the impact of a restrictive Medicaid drug formulary on prescribing patterns for other patients, ie, so-called spillover effects. DESIGN: A before-and-after, 3-state comparison study. EVENT: On January 1, 2001, Maine's Medicaid program implemented a restrictive drug formulary for the proton pump inhibitor class, with pantoprazole as the only preferred drug. MAIN OUTCOME MEASURE: The Medicaid and non-Medicaid market shares of pantoprazole in Maine (vs New Hampshire and Vermont and among Maine physicians with different Medicaid share of practice. RESULTS: After 3 months, the market share of pantoprazole in Maine (vs 2 control states) increased 79% among Medicaid prescriptions (vs 1%-2%), 10% among cash prescriptions (vs 3%), and 7% among other third-party payer prescriptions (vs 1%). The market shares increased more among Maine physicians with a higher Medicaid share of practice (high vs middle vs low [market]: 16% vs 8% vs 5% [cash]; 11% vs 5% vs 4% [other third-party payers]). Linear regression results indicate that practicing medicine in Maine leads to a 72% increase in pantoprazole share among Medicaid prescriptions (P < .001). In addition, for each 10% Medicaid share of practice in Maine, the share of pantoprazole increases 1.8% among cash prescriptions (P = .01) and 1.4% among other third-party payer prescriptions (P < .001). CONCLUSIONS: Maine's Medicaid drug formulary generated spillover effects in cash and other third-party payer markets, with somewhat stronger effects in the cash market.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2003

Antithrombotic therapy for the treatment of venous thromboembolism.

VTE is a major but often-overlooked healthcare problem resulting in significant morbidity, mortality, and resource expenditures. The efficacy of anticoagulation therapy has been well documented in patients with The availability of LMWHs has advanced treatment of VTE by allowing for effective anticoagulation without the need for dose adjustments and routine monitoring. In addition, patients with uncomplicated DVT can be safely treated in the outpatient setting, allowing for shorter hospital stays and cost savings. LMWHs have been replacing traditional anticoagulants and are now considered the antithrombotic agents of choice in the initial treatment of VTE. Research on additional novel anticoagulants such as DTIs and factor Xa inhibitors is promising. These agents may offer potential benefits over current therapies, but their exact role in clinical practice remains to be determined pending additional ongoing clinical studies. Benefit-to-risk analyses will be necessary for determining how effective novel therapies will compare with established regimens.

Ambulatory Care↗
PubMed2003

Medicare program; Medicare prescription drug discount card. Interim final rule with comment period.

Section 101, subpart 4 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, codified in section 1860D-31 of the Social Security Act, provides for a voluntary prescription drug discount card program for Medicare beneficiaries entitled to benefits, or enrolled, under Part A or enrolled under Part B, excluding beneficiaries entitled to medical assistance for outpatient prescription drugs under Medicaid, including section 1115 waiver demonstrations. Eligible beneficiaries may access negotiated prices on prescription drugs by enrolling in drug discount card programs offered by Medicare-endorsed sponsors. Eligible beneficiaries may enroll in the Medicare drug discount card program beginning no later than 6 months after the date of enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and ending December 31, 2005. After December 31, 2005, beneficiaries enrolled in the program may continue to use their drug discount card during a short transition period beginning January 1, 2006 and ending upon the effective date of a beneficiary's outpatient drug coverage under Medicare Part D, but no later than the last day of the initial open enrollment period under Part D. Beneficiaries with incomes no more than 135 percent of the poverty line applicable to their family size who do not have outpatient prescription drug coverage under certain programs--Medicaid, certain health insurance coverage or group health insurance (such as retiree coverage), TRICARE, and Federal employees Health Benefits Program (FEHBP)--also are eligible for transitional assistance, or payment of $600 in 2004 and up to $600 in 2005 of the cost of covered discount card drugs obtained under the program. In most cases, any transitional assistance remaining available to a beneficiary on December 31, 2004 may be rolled over to 2005 and applied toward the cost of covered discount card drugs obtained under the program during 2005. Similarly, in most cases, any transitional assistance remaining available to a beneficiary on December 31, 2005 may be applied toward the cost of covered discount card drugs obtained under the program during the transition period. The Centers for Medicare & Medicaid Services will solicit applications from entities seeking to offer beneficiaries negotiated prices on covered discount card drugs. Those meeting the requirements described in the authorizing statute and this rule, including administration of transitional assistance, will be permitted to offer a Medicare-endorsed drug discount card program to eligible beneficiaries. Endorsed sponsors may charge beneficiaries enrolling in their endorsed programs an annual enrollment fee for 2004 and 2005 of no more than $30; CMS will pay this fee on behalf of enrollees entitled to transitional assistance. To ensure that eligible Medicare beneficiaries take full advantage of the Medicare drug discount card program and make informed choices, CMS will educate beneficiaries about the existence and features of the program and the availability of transitional assistance for certain low-income beneficiaries; and publicize information that will allow Medicare beneficiaries to compare the various Medicare-endorsed drug discount card programs.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2003

Impact of formularies on clinical innovation.

It is important to consider, in light of how innovation has so often occurred, whether today's managed care environment is conducive to continued psychopharmacologic innovation. The initial step in the development of a new area in psychopharmacology has historically relied in large part on individual clinicians who pursued unconventional methods of treatment. When a set of guidelines such as a formulary (a list of drugs eligible for reimbursement compiled by a managed care organization) becomes restrictive, it decreases clinician innovation. In addition to this long-term threat to innovation, studies have found greater restrictiveness in formularies to be associated with higher health care utilization. Thus, restricted formularies that are based on a naive interpretation of "therapeutic equivalence" may slow the advance of medical science without even achieving the only goal that could possibly justify such restrictions-cost control. If innovation is to flourish, formularies must be flexible and advisory, not restrictive. Preserving the climate for innovation in health care requires the management culture to focus on the long-term impact of policies on quality and innovation as well as on the overall health cost in the system.

Antipsychotic Agents↗
PubMed2003

The economic and human impact of new drugs.

The benefits of new drugs to society exceed their cost by a substantial margin. These benefits include net decrease in overall medical expenditures, reduced limitations on work and other activities contributing to quality of life, and increased longevity. Further, new drugs contribute to health and economic growth in the United States. Formularies, to the extent that they restrict drug choices, restrict access to new drugs.

Drug Industry↗