December 2012

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The Cancer Pill Not Taken Costs Insurers in Long Run

As oral chemotherapy becomes more common, so does nonadherence. Cost is only one of the reasons.

Frank Diamond

The push to integrate health care services and financing may portend a move away from behavioral health carve-outs

Michael D. Dalzell

Research says PA can help make treatments safer and more cost-effective, but data sharing must improve

Thomas Reinke

Even today, studies show, only half of treatments are truly based on evidence. Here’s an organization looking to better that share, and it may behoove health plans to help.

Joseph Burns

When a respected provider organization took a stand against the costly new cancer drug, it was both surprising and encouraging

Michael D. Dalzell

Departments

EDITOR’S MEMO
John Marcille
LEGISLATION & REGULATION

While local governments ponder just what course to take, health plans prepare to grab as much market share as possible

John Carroll
MEDICATION MANAGEMENT

Case management, prior authorization, and drug utilization control are required

Tom Reinke
THE FORMULARY FILES
EVIDENCE REVIEW

A summary of ECRI Institute’s Emerging Technology Evidence Report

TOMORROW’S MEDICINE

Devices that selectively destroy the renal nerves that affect hypertension have gained international approval, and availability in the United States is not far off

Thomas Morrow, MD
PLAN WATCH

The insurer’s tracking effort helps physicians keep tabs on patients who may not be taking their drugs correctly

Frank Diamond
MANAGED CARE OUTLOOK

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