Considerations for the Clinical Assessment of the Patient With Plaque Psoriasis
A review of recently published data with a commentary for managed care decision makers by Jeffrey J. Crowley, MD, FAAD
Respiratory syncytial virus (RSV) bronchiolitis and RSV pneumonia are the leading causes of hospitalization of infants younger than 1 year of age in the United States. Preterm infants, born at 32 to 35 weeks gestational age or less, are particularly at high risk for severe RSV disease. Early recognition of the risk factors known to predispose to serious RSV lower respiratory tract infection is key to planning an effective RSV disease prevention strategy in high-risk infants.
This Clinical Brief reviews the numerous unmet needs among with patients with psoriasis, a chronic and debilitating disease. In the absence of a cure, these patients seek a treatment that improves the signs and symptoms of their disease.
Respiratory syncytial virus (RSV) is the leading cause of infant hospitalization, and premature infants are particularly at high risk. This Clinical Brief explains why premature infants face a higher risk of hospitalization, illustrates the costs associated with RSV hospitalization, and offers managed care strategies to help reduce hospital admissions. Norman White, MD, Medical Director with the Presbyterian Health Plan in Albuquerque discusses steps to creating an effective RSV program for high-risk infants.
From a managed care perspective, gonadotropin self-injections may be an effective approach to follicle-stimulating hormone (FSH) therapy. Optimal outcomes with self-administered therapy depend on maximizing adherence, minimizing errors, and controlling pain and stress associated with drug administration, all of which have been shown to benefit from patient education and involvement in choice of therapy. In this single-center study, comprehensive nurse-led training classes on conventional syringe- or pen-injection FSH delivery techniques enabled participants to identify a preferred method, with the majority of patients opting for a device in the form of a disposable follitropin alfa prefilled pen.
Rheumatoid arthritis (RA) imposes a considerable disease burden. Patients experience increased medical costs, comorbid conditions, and a widened mortality gap. Existing treatments are insufficient for the current clinical demand, which is expected to increase as the population ages.
The effects of growth hormone deficiency (GHD) on the stature and maturation of children are well established. Recombinant DNA technology now allows the production and use of recombinant growth hormone to correct those effects without the limitations and safety concerns associated with growth hormone (GH) derived from pituitary tissue. GH therapy is also gaining acceptance for treating idiopathic short stature (ISS) in children whose growth rate is subnormal but who have no GH deficiency or other endocrine abnormality. The normal aging process in adults is accompanied by a substantial decline in GH, and recent research supports the damaging effects of GHD associated with atherosclerosis and osteoporosis. Other research is investigating GHD as a factor in chronic fibromyalgia and AIDS. This continuing education program provides information on the current status of GH therapy for children and adults so that managed care professionals can better understand the diagnostic and treatment algorithms and the scientific rationale for expanded use of GH therapy.
This Clinical Brief reviews the clinical information for SIMPONI™ (golimumab), which was approved by the U.S. Food and Drug Administration on April 24, 2009, for the treatment of adults with moderately to severe active rheumatoid arthritis (RA) in combination with methotrexate (MTX). It is also indicated for treatment of adults with active psoriatic arthritis, alone or in combination with MTX, and adults with active ankylosing spondylitis.
Roy Fleischmann, MD, Clinical Professor of Medicine, University of Texas Southwestern Medical Center, and Co-Medical Director, Metroplex Clinical Research Center, Dallas, discusses this novel agent.
Myelodysplastic Syndromes (MDS) has gained needed attention in the last few years with the development of novel therapies. The addition of stem cell malignancies to the North American Association of Central Cancer Registries has led to a better understanding of the extent and impact of the disease and a greater interest in therapeutic interventions that can slow progression, improve the hematologic defects observed in higher-risk MDS, and provide survival benefit. With progress, though, come challenges to patients, clinicians, and payers. Bart L. Scott, MD, and David Frame, PharmD, discuss novel therapies such as hypomethylating agents and their survival benefits and potential outcomes. Allan Jay Kogan, MD, and Jeffrey D. Dunn, PharmD, discuss the changing treatment paradigms and the economic considerations for health plans. Kirby Eng, RPh, discusses the role of specialty pharmacy in MDS treatment. Each article is followed by an in-depth discussion moderated by Steven R. Peskin, MD.
This supplement is based on the Managed Care Clinical Oncology Expert Roundtable held in Dallas on July 31, 2009.
There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.
They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?
A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.
More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.