Posted by James
The clinical studies used for the pooled analysis were of similar design. All were rigorous, multicenter, randomized, double-blind, parallel-design, placebo-controlled trials, and all of them used the same measurements to demonstrate the efficacy of gabapentin in the treatment of PHN. Patients were randomly assigned to receive either medication gabapentin or placebo. They then entered a period of titration to the maximum dose and were monitored for seven to eight weeks.
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Posted by James
INTRODUCTION
Pain is one of the most common reasons why patients seek health care. Estimates indicate that 20% of the elderly in the general population and 50% of community-dwelling older adults have some form of persistent pain. Approximately 20% of older people take analgesics several times a week for pain relief.
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Posted by James
USE OF PHARMACOECONOMIC DATA
The growing prominence of drug therapies in health care and their rapidly rising costs have led to a dramatic rise in the use of health outcomes data for therapeutics and formulary decisions. The expanded use of cost-effectiveness data, analyses of health outcomes, and various pharmacoeconomic (PE) models have become commonplace in today’s world of rising costs and increased utilization. For a medication to be considered effective—and at the same time to be less expensive to use than other drugs available in the therapeutic class—numerous cost comparisons are required along with health outcomes studies.
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Posted by James
CHANGES IN THE MAKEUP OF P&T COMMITTEES
Every day, decisions about which drugs to accept into a health plan or onto a hospital formulary, issues surrounding their coverage, and the level of co-pays, deductibles, and coinsurance affect physicians, pharmacists, and patients. The composition of P&T committees is changing to meet their increasing demands and responsibilities. These committees were originally composed primarily of physicians and pharmacists. Today’s committees utilize the assistance of numerous physician-specialists and experts and include input from various advisory subcommittees. Some organizations are also adding health care ethicists, economists, and geneticists to their P&T committees (Table 1).
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Posted by James
FORMULARIES AND COMMITTEE EVOLUTION THROUGH EMERGING MANAGED SYSTEMS OF CARE
Pharmaceutical care and the number of individuals who play a large role in its delivery have made rapid strides over the years. Part 1 of this series, published in the November 2004 issue of P&T, described how and when pharmacy and therapeutics (P&T) committees came into being and their specific roles over the years.
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Posted by James
Rareful readers of P&T know that I have tackled the issue of the relationship between academic medicine and the pharmaceutical industry before. Although my editorial, “Seeking Middle Ground” (P&T, February 2004), laid the framework for this relationship, it did not offer specific guidance. I hope to accomplish aspects of that mission in this editorial.
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Posted by James
It seems paradoxical that the federal agency that administers Medicare would refuse to fund advanced pharmacist clinical education less than a year before the new Medicare drug benefit goes into effect, but that is the position of the Centers for Medicare & Medicaid Services (CMS). Once again, the agency is saying—by virtue of its silence—that it will not kick in money for second-year hospital pharmacy residency programs in areas such as oncology, primary care, geriatrics, and infectious diseases, to name a few possibilities.
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