Resources & Publications

Alphabetical

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

1953-2003: A Historical Retrospective
This booklet traces the first 50 years of the NPC's history in the context of major events in health care and medicine.

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Adverse Drug Reactions in Hospitalized Patients: A Critique of a Meta-analysis by Marion Kvasz, MD, MPH, et al., Medscape General Medicine, 
April 2000
A published meta-analysis of the incidence of adverse drug reactions (ADRs) in hospitalized patients concluded that ADRs rank as the fourth to sixth leading cause of death in the U.S. This conclusion generated considerable concern among health care providers, patients, and pharmaceutical manufacturers. To better understand the evidence behind this conclusion, a critical review of the source studies and the meta-analytic methods used to combine them was conducted. Findings suggest that the conclusions of the meta-analysis are invalid.

(You must log in to Medscape in order to view this article. If you do not have a free log-in to Medscape, you can create one by clicking here.)

Agitation and Depression in Frail Nursing Home Elderly Patients with Dementia: Treatment Characteristics and Service Use, by Stephen J. Bartels, MD, MS, et al., American Journal of Geriatric Psychiatry, Vol. 11, No. 2, March-April 2003
Agitation and depression are the two most common behavioral complications of dementia. Although the behavioral symptoms have received less attention than the cognitive symptoms of dementia, they have serious consequences, including caregiver stress, premature institutionalization, and compromised quality of life for patients and their families. This study suggests that dementia complicated by mixed agitation and depression is among the most clinically challenging problems in long-term care, and that effective interventions and services are needed to address the complex treatment needs of this high-risk group.

Are the Benefits of Newer Drugs Worth Their Cost? Evidence From the 1996 MEPS, by Frank R. Lichtenberg, Health Affairs, Vol. 20, No.5,
September/October 2001
Critics of pharmaceutical spending point to the increase in the pharmaceutical “line item” in our overall health spending as cause for alarm. Lichtenberg's research examines the value of this spending in its complete context by exploring whether there are cost offsets associated with using newer and, most often, more expensive drugs. Lichtenberg finds that we are paying more, but we are getting a bigger “bang for our buck.”

Annotated PowerPoint slides related to this article are available.

Assessing the Impact of Pharmaceutical Innovation: A Comprehensive Framework, by Jack A. Meyer, PhD, 2002
The key finding in this report is that new drugs are yielding a wide range of benefits to our society that more than justify the investment needed to produce them. This report develops a comprehensive framework for assessing the value of pharmaceutical innovation that encompasses both the cost of bringing new products to market and the direct and indirect benefits. Fact sheet available.

Availability of New Drugs and Americans' Ability to Work, by Frank R. Lichtenberg, PhD, Journal of Occupational and Environmental Medicine, Vol. 47, No. 4, April 2005
This work examines the extent to which the introduction of new drugs has increased society's ability to produce goods and services by increasing the number of hours worked per member of the working-age population. The study finds that the potential of medicines to increase employee productivity should be considered in the design of drug-reimbursement policies. Conversely, policies that broadly reduce the development and utilization of new drugs may ultimately reduce our ability to produce other goods and services.

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Breathing Easier: Messages for Asthma Relief, 2003
Asthma is the most common chronic disease among children, and is the leading cause of school absences due to a chronic disease. This brief article, written in partnership with the Chronic Disease Directors and published by NAPS outlines key factors for consumers about asthma, its risk factors, diagnosis, and preventive measures.

Business and Managed Care Diabetes and Health Resource Kit
More than 18.2 million Americans have diabetes, many of them the workforce. This online diabetes and health resource kit is designed to help businesses and managed care companies to assess the impact of diabetes in the workplace. It also provides easy-to-understand information for employers to help their employees manage their diabetes and take steps toward reducing the risk for diabetes-related complications such as heart disease.

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Clinical and Economic Advantages of Modern Dosage Forms: Improving Medication Adherence, by Albert Wertheimer, MBA, PhD, 2006
A substantial source of waste and inefficiency in health care is patient non-adherence with medications. Modern drug delivery technology can help improve adherence by simplifying the dosing regimen, and/or decreasing side effects. Other advantages include steadier drug concentrations in the bloodstream and targeted delivery of medication to its site of therapeutic action in the body.

A Closer Look at Allergies, 2001
Allergies are the sixth leading cause of chronic disease in the U.S., and cost the health care system over $18 billion annually. In this publication, a joint project between the Asthma and Allergy Foundation of America and NPC, we take a closer look factors influencing drug spending for allergies.

A Closer Look at Arthritis, 2002
One in six Americans suffers from arthritis, and the CDC projects that number will grow to one in five by 2020. In this six-page brochure, a collaborative project between the Arthritis Foundation and NPC, we take a closer look at the factors influencing drug spending for treating arthritis.

A Closer Look at Asthma, 2001
Asthma results in approximately 5,000 deaths annually in the U.S. and accounts for nearly half a million hospitalizations, 1.6 million emergency room visits, and over 10 million physician office visits. In this six-page brochure, a joint project between the Asthma and Allergy Foundation of America and NPC, we take a closer look at the factors influencing drug spending for the treatment of asthma.

A Closer Look at Depression, 2002
Clinical depression is a widespread and debilitating illness that cost Americans $44 billion in 1990, making it one of the nation's ten most costly diseases. In this six-page brochure, a collaboration between the National Alliance for the Mentally Ill and NPC, we take a closer look at the factors that influence drug spending for treating depression.

A Closer Look at Diabetes, 2002
The number of Americans diagnosed with diabetes jumped 49 percent from 1990 to 2000. Diabetes is the main cause of kidney failure, new cases of blindness, and lower limb amputations, and is a major risk factor for heart disease and stroke. In this six-page brochure, a joint project between the American Diabetes Association and NPC, we take a closer look at the factors that influence drug spending for the treatment of diabetes.

A Closer Look at High Blood Pressure, 2001
Roughly 50 million Americans ages six and older have high blood pressure. Left untreated, high blood pressure can lead to heart disease, kidney disease, and stroke. In this six-page brochure, a joint project between the American Heart Association and NPC, we take a closer look at the factors influencing drug spending for the treatment of high blood pressure.

A Closer Look at High Cholesterol, 2001
High cholesterol is a major risk factor in heart disease, the leading cause of death in the U.S., which claims the lives of nearly 460,000 Americans each year. In this six-page brochure, a joint project between the American Heart Association and NPC, we take a closer look at the factors influencing drug spending for the treatment of high cholesterol.

Combination Drugs: Innovation in Pharmacotherapy, by Albert Wertheimer, PhD and Alan Morrison, PhD, Pharmacy and Therapeutics, Vol. 27, No. 1, January 2002
Combination therapy with two or more agents having complimentary mechanisms of action represents a type of incremental innovation that has extended the range of therapeutic options in the treatment of almost every human disease. Combination products—combinations of two or more active drugs produced in a single tablet—provide the advantages of combination therapy while reducing the number of prescriptions and the attendant administrative costs. This article describes the advantages of combination products and discusses their role in pharmacotherapy.
Note: The CE credit option on this piece has expired. Fact sheet available.

Complexities and Variations in Pharmaceutical Therapy for Cancer: Next steps toward achieving quality care, 2000
This white paper, authored by a collaboration of cancer organization in partnership with NPC, suggests cancer patients may not be receiving appropriate pharmaceutical care. The paper's findings also indicate that there is a slow transition of new knowledge into clinical practice.

This article was updated and published in October 2003 as a supplement to the Journal of the National Comprehensive Cancer Network, Vol. 1, Suppl 2. The updated version is available from NPC in hard copy only. Click here to request a copy.

Compliance Navigator Software, 1997 (downloadable)
Access to a Meta-Analysis of Research on Improving Medication Compliance
This software enables the user to examine key compliance literature abstracts in a number of ways, including comparing the effectiveness of the intervention and sorting the data by disease. Enables the user to focus on abstracts of interest.

Component Management Fails to Save Health Care System Costs: The Case of Restrictive Formularies, Second Edition, 2000
This 81-page monograph updates and extends the information first compiled in 1996. The monograph reviews the literature through mid-1999 on the effects of restrictive formularies, caps, copays and prior authorization on total costs and treatment outcomes. Taken together, the reviewed literature makes the overwhelming case that such policies are likely to have unintended negative consequences. Fact sheet available.

Consumer Reports on the Health Effects of Direct-to-Consumer Advertising of Prescription Drugs, by Joel S. Weissman, et al., Health Affairs Web Exclusive, February 2003
This paper reports the results of a study of the health behaviors and outcomes that result when patients initiate discussions with their doctors as a result of seeing a prescription drug ad. Consumers reported that DTCA-motivated discussions with physicians frequently result in new diagnoses for clinically important conditions, and the survey found no evidence to support concerns about adverse health consequences.

Executive Summary: Coordinated Pharmaceutical Therapy in Chronic Care: Five Innovative Programs, September 2000
Numerous studies indicate the limitations of a component-based, line item approach to the management of pharmaceuticals. A much greater potential for improved treatment and overall cost savings lies in the coordination of pharmaceutical care, especially for the elderly and other chronic care patients.

Coordinated Pharmaceutical Therapy in Chronic Care: Five Innovative Programs, September 2000
Successful models of coordinated pharmaceutical care for patients at high risk for suboptimal treatment must be identified. This collection of five diverse approaches illustrates that coordinated pharmacotherapy can be implemented effectively across a variety of health care organizations. Many of the programs have resulted in improved outcomes and/or reduced overall costs of care. Fact sheet available.

Cost-Effective Opportunities for Improving Depression-Related Outcomes, by Sean Sullivan, Health & Productivity Management, Vol. 2, No.3
Depression has a clear impact on productivity. Depressed patients, particularly those not in treatment, are high-cost users of health care, consuming two to four times more resources than other patients. A May 2002 survey by the Institute for Health and Productivity Management found that mental health conditions – primarily depression – ranked second as a cause of employee absences and first as a cause of presenteeism among large American companies. The use of appropriate treatments can reduce indirect employer costs including lost productivity in the workplace.

Costs and Benefits of Pharmaceuticals: The Value Equation for Older Americans, by Richard Levy, PhD, Care Management Journals, Vol. 3, No. 3, Spring 2002
Benefits from new pharmaceuticals far outweigh their costs for many key diseases of the elderly. Even incremental improvements in drug therapies contribute substantially to improved care. Chronic illness, disability, and an aging population will drive future health care spending. Pharmaceutical innovation will be an integral part of effective strategies to address this challenge.

Cultural and Genetic Diversity in America: The Need for Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, et al., 2002
Pharmacogenetic research in the past few decades has uncovered significant differences among population groups in the metabolism, clinical effectiveness, and side effect profiles of many clinically important drugs. In addition, differences in how various populations view and respond to medicines underscores the need for an individualized approach to pharmaceutical therapy. Cost management policy design must take these differences into account in order to ensure that they are broad and flexible enough to enable rational choices and individualized treatment for all patients, regardless of racial or ethnic origin. Fact Sheet available.

Annotated PowerPoint slides related to this report are available.

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Diabetes: What You Should Know, 2003
Almost 6 million Americans have undiagnosed diabetes. This brief article, written in partnership with the Chronic Disease Directors and published by NAPS outlines key facts for consumers about diabetes, its risk factors, diagnosis, and preventive measures.

Disease Management for Asthma, 2004
Asthma, one of the first disease management targets, is often selected for managed intervention because high-cost patients can be easily identified via their frequent medication refills, consistent clinical practice guidelines and validated outcome measures are available that can help assess the effectiveness of the interventions, and educational interventions have been developed to help improve the behavior of both patients and health care practitioners. This bibliography presents 69 studies demonstrating the impact of educational interventions on asthma treatment and management. Fact sheet available.

Disease Management for Chronic Obstructive Pulmonary Disease, 2003
This bibliography of disease management and educational interventions focuses on a relatively new disease target for such programs, chronic obstructive pulmonary disease (COPD). In the year 2000, an estimated 10 million Americans were diagnosed with COPD and another 14 million were undiagnosed. The high mortality and cost associated with COPD, as well as a lack of awareness regarding the disease, are incentives to apply disease management strategies. Further education of health care providers and the public could improve the detection and treatment of COPD.

Disease Management for Depression, 2003
This monograph provides an introduction to disease management along with an analysis of penetration, trends and growth. Disease management strategies have great potential to improve therapeutic outcomes for patients with depression. Although there can be some challenges in managing depression through a disease management program, many programs have had success. While not every program included in the literature search represents a comprehensive disease management program, examples of specific educational interventions for depression are included and discussed.

Disease Management for Diabetes, 2004
This monograph presents 65 studies detailing the impact of educational interventions on diabetes treatment and management as well as information on diabetes disease management programs in development. It is intended to serve as a guide for those interested in developing disease management programs for the treatment of diabetes. Fact sheet available.

Disease Management for Heart Failure, 2004
This bibliography presents 68 studies concerning the impact of educational interventions on heart failure treatment and management. It is intended to serve as a guide for those interested in developing disease management programs for the treatment of congestive heart failure. Fact sheet available.

Disease Management for Schizophrenia, 2004
Disease management efforts for schizophrenia are less well established than are efforts for other chronic illnesses such as asthma and diabetes. Managing schizophrenia poses more of a challenge than many other chronic diseases because it usually causes greater disability than other mental and physical illnesses. However, disease management strategies have the potential to improve therapeutic outcomes for patients with schizophrenia. This monograph provides an introduction to disease management as well as examples of interventions for schizophrenia.

DM LitFinder™ Database
The Disease Management Association of America offers a query tool to search the peer-reviewed literature available on disease management for eight conditions (asthma, congestive heart failure, diabetes, COPD, coronary artery disease, end-stage renal disease, high risk pregnancy, and depression). Updated quarterly, this tool helps users identify programs that have reported medical cost savings and demonstrated improvements in clinical processes and outcomes of care such as drug compliance, reduced absenteeism and better quality of life, and what patient and physician interventions were used to achieve these outcomes.

Drug Delivery Systems Improve Pharmaceutical Profile and Facilitate Medication Adherence, by Albert I. Wertheimer, MBA, PhD, et al., Advances in Therapy, Vol. 22, No. 6, November/December 2005
Innovations in dosage forms and dose delivery systems across a wide range of medications offer substantial clinical advantages, including reduced dosing frequency and improved patient adherence; minimized fluctuation of drug concentrations and maintenance of blood levels within a desired range; localized drug delivery; and the potential for reduced adverse effects and increased safety. The advent of new large-molecule drugs for previously untreatable or only partially treatable diseases is stimulating the development of suitable delivery systems for these agents. Although advanced formulations may be more expensive than conventional dosage forms, they often have a more favorable pharmacologic profile and can be cost-effective. Inclusion of these dosage forms on drug formulary lists may help patients remain on therapy and reduce the economic and social burden of care. This file is posted here with permission of Health Communications Inc., the publisher of Advances in Therapy®. It is provided for individual use only and may not be used for commercial distribution.

Drug-Related Adverse Events: A Readers' Guide to Assessing Literature Reviews and Meta-Analyses, by Susan D. Ross, MD, Archives of Internal Medicine, Vol. 161, April 23, 2001
The objective of this article is to provide readers with a practical guide to critically appraising reviews and meta-analyses of source studies of drug-related adverse events. A critique of a highly publicized meta-analysis is used as a case study to highlight several contentious issues.

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The Effect of New Drug Approvals on HIV Mortality in the U.S., 1987-1998, by Frank R. Lichtenberg, PhD, Economics and Human Biology, Vol. 1, No. 2, June 2003
After increasing steadily from 1987 to 1995, the number of U.S. deaths cause by human immunodeficiency virus (HIV) declined sharply from 1995 to 1998. Evidence suggests that new drugs played a key role in this decline. The annual number of HIV deaths is estimated to have been reduced by over 6,000, on average, by an additional HIV drug approval.

Annotated PowerPoint slides related to this article are available.

The Effect of New Drugs on Mortality from Rare Diseases and HIV, by Frank R. Lichtenberg, NBER Working Paper W8677, December 2001
This article examines the effects of two important government policies designed to provide incentives for the development of pharmaceuticals—the Orphan Drug Act and the FDA fast track for drugs for AIDS and other diseases where current therapies are inadequate. Following implementation of these policies, introduction of new drugs for orphan diseases and HIV/AIDS was found to increase substantially and there was a dramatic, time-lagged reduction in mortality from these diseases. These results suggest that government policy can be an effective lever for stimulating innovation of pharmaceuticals having significant effects on longevity.

Effectiveness of Interventions to Improve Patient Compliance: A Meta-analysis, by Debra Roter, et al., Medical Care, Vol. 36, No. 8, August 1998
This NPC funded research found that comprehensive compliance interventions work best. The statistical analysis of 153 studies showed that combining several approaches were more effective.

An Employer's Guide to Patient-Directed Healthcare Benefits, 2001
This guide, produced by the Wye River Group on Healthcare, addresses issues surrounding the emerging consumer directed or defined contribution benefit plans. It was designed to describe and clarify evolving methods of health care financing, the current regulatory and tax environment, and the political "appetite for change" regarding consumer involvement in health care purchasing.

An Employer's Guide to Pharmaceutical Benefits, 2003
This guide, produced by the Wye River Group on Healthcare, focuses on the role of employer-purchasers in providing pharmaceutical benefits for employees, as they struggle to balance economic pressures with a need to support their workforce. It is intended to provide practical tools to assist employers in meeting those demands.

Ethnic Disparities in the Burden and Treatment of Asthma, 2005
In the United States the burden of asthma falls disproportionately on the black and Hispanic—largely Puerto Rican—populations, especially children. Much of this disparity has been attributed to unequal access to preventive care. Black and Puerto Rican children characteristically under-use routine health care services and overuse emergency care services for asthma. This report, developed in partnership with the Asthma and Allergy Foundation of America, discusses: disparities in the burden of asthma; possible hereditary, environmental, and behavioral causes of these disparities; and ways in which these asthma disparities may be lessened.

Annotated PowerPoint slides related to this report are available.

Evidence-Based Medicine (EBM), 2008
There is little consensus on what constitutes good evidence and how it is generated, evaluated and applied to benefit design. NPC is participating with other health care stakeholders in research, dialogue and education to ensure the process of evidence based medicine is inclusive, transparent and based on sound methods to best improve patient care.

Explaining Drug Spending Trends: Does Perception Match Reality? by Robert Dubois, et al., Health Affairs, Vol. 19, No. 2, March/April 2000
Using large claims databases from managed care and employer-sponsored health benefit plans, this study found increased volume, not rising pricing, accounted for drugs’ higher levels of spending. For more information about the methodology used for this study, see Measuring the Costs and Benefits of Pharmaceutical Expenditures, Expert Review of Pharmacoeconomics and Outcomes Research, October 2002.

Annotated PowerPoint slides related to this article are available.

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Finding Arthritis Strategies that Work, 2003
Arthritis and other rheumatic conditions are the leading cause of disability among adults in the U.S. This brief article, written in partnership with the Chronic Disease Directors and published by NAPS outlines key facts for consumers about arthritis, its risk factors, diagnosis, and preventive measures.

Follow the Dollar: Understanding Drug Prices and Beneficiary Costs Under Medicare Part D, by Lindy Hinman, John Richardson, and Jennifer Snow, 2006
This snapshot of the Medicare drug benefit supply chain by Avalere Health emphasizes that Medicare beneficiaries’ out-of-pocket costs are a product of negotiations that occur between many players and at multiple points along the supply chain. The report considers out-of-pocket costs as a whole – including cost-sharing via premiums, deductibles, and coverage gaps – not just the final price at the pharmacy counter. Flowcharts in the report illustrate at what point prices are negotiated and by whom.

Formulary Limitations and the Elderly: Results from the Managed Care Outcomes Project, by Susan Horn, PhD, et al., The American Journal of Managed Care, Vol. 4, No. 8, 1998
Evidence is presented that the elderly are at particular risk from formulary restrictions, an important issue as more Medicaid and Medicare patients enroll in managed care. This 1998 article by Horn shows that selecting less expensive drugs may lead to greater side effects in the elderly.

Formulary Restriction of Selective Serotonin Reuptake Inhibitors for Depression: Potential Pitfalls, by Paula L. Hensley and H. George Nurnberg, PharmacoEconomics, Vol. 19, No. 10, 2001
Psychotropic drugs and their associated costs can be a limiting factor in mental health treatment coverage. As a result, restrictive formularies are a common method of attempting to limit costs. This paper explores the intended and unintended consequences of having a single or exclusive selective serotonin reuptake inhibitor (SSRI) on a formulary and concludes that the practice of having a single SSRI on the formulary for a health care plan seems ill founded. Giving the primary care physician several antidepressant choices can provide more options to continue treatment of his or her patient in the less expensive primary care setting. In terms of cost containment, formulary restrictions are far more likely to have the opposite effect.

Fraction of Nursing Home Admissions Attributable to Urinary Incontinence, by Alan Morrison, PhD, Richard Levy, PhD, Value in Health, Vol. 9, No. 4, July/August 2006
This brief article calculates the proportion of nursing home admissions of the elderly attributable to urinary incontinence (UI) and finds that estimates of the fraction of nursing home admissions attributable to UI exceed those previously assumed and show an imbalance between the sexes. Policies that support reimbursement for treatments of UI in the community might help prevent or delay institutionalization and offset some of the costs.

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Genes, Culture, and Medicines: Bridging Gaps in Treatment for Hispanic Americans, by Carolina Reyes, MD, et al., 2004
This report brings together for the first time a growing body of scientific research demonstrating substantial disparities in pharmaceutical therapy for Hispanic Americans. These disparities in pharmaceutical treatment are substantial and often persist even after adjustment for differences in income, age, insurance coverage, and coexisting medical conditions. Emerging research demonstrates that genetic variations affect Hispanic Americans and may require dosage adjustments to achieve an optimal therapeutic effect.

Fact Sheet available.
Annotated PowerPoint slides related to this report are available.

Genetic Variations in Response to Medications: Looking at the Implications for Minority Elders, by Richard Levy and Jean Polatsek, Healthcare and Aging, Vol. 9, No. 1, Spring 2002
Genetic, environmental and cultural factors influence variations in drug response among elders from different racial and ethnic backgrounds. Racial and ethnic heritage can be an indicator of special medical needs and differing drug responses; if ignored these differences in treatment response, can lead to compromised care and greater health risks. In addition, substantial dosing adjustments may be necessary to avoid overdosing or underdosing. Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American Society on Aging San Francisco, California. Also published in Diversity Currents, Vol. 4, No. 2, Spring 2002.)

Growth in Use of Lipid-Lowering Therapies: Are We Targeting the Right Patients? by Robert W. Dubois, MD, PhD, et al., American Journal of Managed Care, Vol. 8, October 2002
This article looks at the appropriateness of statin use in 1997 (pre-DTCA guidance) and in 1999 (post-DTCA guidance). The conclusion is that although the number of people being treated with statins rose considerably from 1997 to 1999, there did not appear to be any shift towards less appropriate treatment.

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Health, Absence, Disability, and Presenteeism Cost Estimates of Certain Physical and Mental Health Conditions Affecting U.S. Employers, by Ron Z. Goetzel, PhD, et al., Journal of Occupational and Environmental Medicine, Vol. 46, No.4, April 2004
Employers are becoming increasingly aware of the productivity-related cost burden associated with certain health conditions. This study synthesizes the total cost of health, absence, short-term disability, and productivity loss for 10 conditions. The overall economic burden of illness was highest for hypertension, heart disease, depression and other mental illnesses, and arthritis. Presenteeism costs were higher than medical costs in most cases, and represented 18-60% of all costs for the 10 conditions.

The Health and Productivity Cost Burden of the “Top 10” Physical and Mental Health Conditions Affecting Six Large U.S. Employers, by Ron Z. Goetzel, et al., Journal of Occupational and Environmental Medicine, Vol. 45, No.1, January 2003
This article identifies the top 10 most costly physical and mental health conditions faced by six large employers in their health benefits programs. The research identifies costs associated with each condition including direct medical costs and the indirect costs associated with days absent from the job and short-term disability costs.

Health Care & Productivity, 2000
This newsletter, designed for employers, details how newer drug therapies have direct and profound effects on productivity and the bottom lines of employers who select and provide health benefits.

Health Care Budgeting: Tools & Techniques for State Budget Officers, May 2005
Health care is the second-largest and fastest growing item in state budgets. State health care spending includes Medicaid, state employees health benefits program, public mental health services, and public health. Many states have reached the point of cutting eligibility or benefits in order to balance their revenue deficient budgets. In a rapidly changing environment, it is essential that state budget officers keep abreast of the innovations in developing health budgets and ensure that all the many options have been considered. This webcast captures the executive fellowship held at the College of William & Mary in May 2005.

A History of Creating the Medicare Prescription Drug Benefit: Striking Compromises, Avoiding Past Mistakes, and Minding Budgetary Constraints, by Jonathan Blum, 2006
The Medicare Modernization Act of 2003 introduced new terminology that has now become commonplace among politicians, health policy analysts, and Medicare beneficiaries, including donut holes, PDPs, risk corridors, and low-income subsidies. This commentary by Avalere Health examines the confounding forces that influenced the development of this technically complex piece of legislation.

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The Impact of Disease Management on Outcomes and Cost of Care: A Study of Low-Income Asthma Patients, by Louis F. Rossiter, et al.,
Inquiry, Vol. 37, No. 2, Summer 2000
This article chronicles how concerns about the health outcomes and costs of care for Medicaid recipients with chronic diseases has led to development of a model program to enhance the quality of care and reduce overall cost of care for Medicaid patients enrolled in Virginia's primary care case management program. Fact sheet available.

The impact of increased utilization of HIV drugs on longevity and medical expenditure: an assessment based on aggregate US time-series data,  by Frank R. Lichtenberg,  Expert Review of Pharmacoeconomics & Outcomes Research,  Vol. 6, No. 4,  August 2006
The objective of this Special Report is to estimate the medical cost per life-year gained from increased utilization of HIV drugs by estimating the impact of increased drug utilization on the life expectancy and drug and hospital expenditure of HIV/AIDS patients, using aggregate (US national-level) data for the period 1982-2001.

The Impact of Tiered Co-Pays: A Survey of Patients and Pharmacists, 2003
Employers increasingly have adopted strategies to reduce prescription drug expenditures, including cost-sharing arrangements that require employees to pay a greater share of the costs. In 2002, approximately 57% of people with employer-sponsored health benefits were enrolled in multi-tier co-pay plans. The growing use of tiered benefit plans and increasing co-pay levels has prompted concern that higher co-pays may lead patients, particularly those with chronic illnesses, to reduce prescription drug compliance and, consequently, experience negative health outcomes that result in increased utilization of other health care services. To view the study instruments, click here.

The Impact on States of the Medicare Drug Benefit: Information for State Administrators, 2005
As administrators work to integrate Medicaid and state prescription assistance programs with the new drug benefit established by Part D of the Medicare Modernization Act, there will be significant savings opportunities as well as significant costs. The decisions states make must not only reflect budget considerations, but must also recognize the lead role that states have in providing a safety net to the poorest, frailest, and most vulnerable of our citizens. This issue brief identifies key decision points and factors that must be taken into consideration as states prepare for the January 1st, 2006 implementation of the new Medicare drug benefit.

The Impact on States of the Medicare Drug Benefit: Information for State Legislators, 2005
The new drug benefit established by Part D of the Medicare Modernization Act assures that all older and disabled persons have access to affordable prescription drug coverage and will subsidize many low-income persons who previously had no access to drug benefits through Medicaid or state pharmaceutical assistance programs. States have numerous policy decisions to make in implementing the Part D drug benefit, including several options to enhance the Part D program. These decisions must be made quickly in order to be ready for the January 1st, 2006 implementation date. As the safety net provider for many vulnerable individuals, the state's choices on these matters are important to the future well-being of the elderly and disabled.

The Importance of Individualized Pharmaceutical Therapy in the Treatment of Diabetes Mellitus, by David B. Nash, MD, MBA, et al., Disease Management, Vol. 4, Suppl. 1, 2001
Individualized pharmaceutical care for patients with diabetes is necessary due to the variety among the patient population, the frequency and severity of concurrent medical conditions, and other factors that influence individual health and treatment options. This 22-page supplement to the journal Disease Management emphasizes how proper care tailored to individual patient needs can improve overall health and reduce more serious complications. Fact sheet available.

The Importance of Individualizing Prescribing among Genetically and Culturally Diverse Groups, by Valentine J. Burroughs, MD, Group Practice Journal, Vol. 52, No. 3, March 2003
Addressing individual patient needs can provide better overall utilization of health care resources and improve health outcomes. Because patients differ in how their bodies process drugs due to many factors—age, gender, genetic variations, etc.— patients may experience different levels of effectiveness from drug therapies and variations in side effects associated with a particular drug. Thus individualized prescribing is key to making sure that each patient receives the right drug, in the right dose, and at the right time.

Improving the Quality of Pain Management Through Measurement and Action, 2003
This monograph addresses the application of continuous quality improvement techniques to pain management and the implementation of performance measurement processes. The use of a multidisciplinary systems point of view is described and the Cycle for Improving Performance, a structured approach to improvement activities, is outlined. Factors that influence an organization's ability to implement change and improve performance are also discussed. In addition, the real-world experience of four organizations in improving pain management is described. The examples provided encompass a diversity of settings and experience and suggest strategies for overcoming obstacles to pain management improvement initiatives.

Improving and Measuring Osteoporosis Management
In the United States, an estimated 10 million people are living with osteoporosis, also called brittle bone disease. Although osteoporosis is responsible for the majority of hip fractures, and accounts for more than eighteen billion dollars in health care expenditures annually, on average only 20% of patients are ever screened or treated for the disease. A new monograph developed by The Joint Commission through an unrestricted educational grant by NPC, is now available. The monograph contains 10 voluntary measures of care, designed for a variety of healthcare settings. "Improving and Measuring Osteoporosis Management" is intended for a professional audience and contains clinical information and practical tips for implementing an osteoporosis improvement initiative, whether clinical care is given in a hospital, emergency department, rehabilitation facility, home health agency, or doctor's office.

• Executive Summary (June 2008)
• Full Monograph (March 2008)

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The Link Between Gross Profitability and Pharmaceutical R&D Spending, by F.M. Scherer, Health Affairs, Vol. 20, No. 5, September/October 2001
Scherer points out that the new pharmaceutical discoveries benefiting consumers are being driven by the gross profit margins that pharmaceutical companies make. As profits increase, so does research and development. This ultimately yields new and promising options for consumers. In addition, Scherer finds that medical innovations are leading to longer life and improved quality of life.

View "Measuring the Value of Health Innovations: The Policy Implications of New Medical Technologies," a briefing by the Alliance for Health Reform featuring F.M. Scherer, September 7, 2001, Washington, DC

Living Right: Tips for the Ticker, 2003
More than 61 million Americans have some form of heart disease. This brief article, written in partnership with the Chronic Disease Directors and published by NAPS outlines key facts for consumers about heart disease, its risk factors, diagnosis, and preventive measures.

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Measuring the Costs and Benefits of Pharmaceutical Expenditures, by William H. Crown, Davina Ling, and Ernst Berndt, Expert Review of Pharmacoeconomics and Outcomes Research, Vol. 2, No. 5, October 2002
This paper presents a methodological approach for analyzing growth in pharmaceutical expenditures, enabling researchers to disaggregate growth into price and volume components. Research using this methodology (see Explaining Drug Spending Trends: Does Perception Match Reality?) has found increased volume, not price, is the primary driver of pharmaceutical spending growth.

MedAccess Online Bibliography on Atypical Antipsychotics
This bibliography, developed by Dr. William M. Glazer, President of Glazer Medical Solutions and Associate Clinical Professor of Psychiatry at Massachusetts General Hospital and Harvard Medical School, presents studies demonstrating the value of the atypical antipsychotic medications clozapine, olanzapine, quetiapine, and resperidone.

Medicaid 101 - Overview of Policies, Expenditures, Current Trends, and Initiatives
Medicaid 101 for State Legislators is designed to help legislators and their staffs:

• Understand the history and mission of Medicaid
• The drivers behind Medicaid budget growth (e.g., aged, blind, disabled eligibility expansions)
• The part that drugs play in the budget.

The presentation explains how barriers to care that delay effective treatment can add to long-term costs and reduce quality; examines a range of alternatives (along with their pros and cons) for managing drug expenditures; highlights extensive state-specific data on the Medicaid population.

Medicaid Disease Management Programs: Findings from Three Leading U.S. State Programs, by Jeann L. Gillespie and Louis F. Rossiter, Disease Management & Health Outcomes, Vol. 11, No. 6, June 2003
A growing number of states are beginning legislative and administrative studies, piloting disease management programs, and expanding existing programs. There is no single, correct way to implement programs across patient populations. Results will depend upon the way the program is implemented, the model used, the diseases selected, and the ability to implement purely voluntary efforts or programs with strong incentives and outcome-driven approaches.

The Medicare Drug Benefit: Impact on States, and Cost Containment
This presentation outlines key MMA issues for Medicaid, State Pharmaceutical Assistance Programs (SPAPs), other state agencies, and state employee retiree benefit plans. It also reviews Medicaid cost-containment options being considered in the states related to eligibility, benefits, unit cost, utilization, managed care, revenue enhancement and cost avoidance, and administrative efficiencies.

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National Partnership for Workplace Mental Health
A program of the American Psychiatric Foundation, the National Partnership for Workplace Mental Health delivers educational materials to employers and employees on a broad range of mental health topics, provides a forum for businesses to explore mental health issues and share innovative solutions, and serves as a clearinghouse of mental health information important to employers.

National Health Spending In 2004: Recent Slowdown Led By Prescription Drug Spending, by Cynthia Smith, Cathy Cowan, Stephen Heffler, Aaron Catlin the National Health Accounts Team, Health Affairs, Vol. 25, No. 1, 
Jan./Feb. 2006
U.S. health care spending rose 7.9 percent to $1.9 trillion in 2004, or $6,280 per person. Health spending accounted for 16 percent of gross domestic product (GDP), nearly the same as in 2003. The pace of health spending growth has slowed, compared with the 2000–2002 period, for both public and private payers. Hospital spending accounted for 30 percent of the aggregate increase between 2002 and 2004, and prescription drugs accounted for an 11 percent share—smaller than its share of the increase in recent years and much slower in absolute terms.

Newness of Drugs and Use of HMO Services by Asthma Patients, by Susan D. Horn, et al., The Annals of Pharmacotherapy, Vol. 35, No. 9, September 2001
Analyses showed an association between greater use of newer asthma drugs and lower overall drug costs and physician visits. A trend was also found between greater use of newer asthma drugs and fewer hospitalizations and emergency department visits.

Noncompliance with Medications: An Economic Tragedy with Important Implications for Health Care Reform, 1994
The economic and medical consequences of noncompliance to the U.S. health care system are examined in this 32-page NPC publication. Understand how noncompliance accounts for up to $100 billion in health care and productivity costs.

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An Overview of Two Monographs on Pain Management, 2003
In 2001, the Joint Commission on Accreditation of Healthcare Organizations and the National Pharmaceutical Council began a collaborative effort to facilitate improvements in pain management. To date, this effort has produced a set of monographs intended for those involved in pain management activities, including clinicians, quality management professionals, and others involved in pain management performance, assessment, improvement, education, and policy making.

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Pain: Current Understanding of Assessment, Management, and Treatments, 2001
Pain is the most common reason individuals seek health care and about 9 in 10 million Americans regularly suffer from pain. Each year, an estimated 25 million Americans experience acute pain due to injuries or surgery and another 50 million suffer chronic pain. The adverse consequences of undertreated pain are considerable. Poorly managed acute pain may cause serious medical complications, impair recovery from injury or procedures, and can progress to chronic pain. Undertreated chronic pain can impair an individual's ability to carry out daily activities and diminish quality of life.

An addendum, published in May 2005, updates clinical advances in pain management since the publication of this monograph.

CE Credit for nurses and nurse practitioners is available through NP Central. (Lesson Expires: 1/31/06)
CE Credit for physician assistants is available through the AAPA. (Lesson Expires: 12/1/06)
CE Credit for pharmacists is available through the APhA. (Lesson Expires: 12/15/07)
CE Credit for physicians and psychiatrists is available through the APS. (Lesson Expires: 6/30/07)

Patient Adherence to HIV Medication Regiments: A Review of Published and Abstract Reports, by Linda Fogarty, et al., Patient Education and Counseling, Vol. 46 2002
A literature search of published articles reporting correlates of HIV medication adherence or interventions designed to increase HIV medication adherence found that more complex regimens were related to decreased adherence, but were often successfully mitigated by medication aids. Social and psychological factors reflecting emotional adjustment to HIV/AIDS and provider support were related to adherence. Access to institutional resources was also associated with better adherence.

Perspectives on the Pharmaceutical Industry, by Uwe E. Reinhardt, Health Affairs, Vol. 20, No. 5, September/October 2001
Reinhardt's research shows that our nation can indeed afford spending on drugs that help us live longer, more productive lives. Spending on pharmaceuticals accounts for only a small fraction of our Gross Domestic Product (GDP). In fact, Americans spend more per capita on alcohol, tobacco, and entertainment combined than on pharmaceuticals.

Annotated PowerPoint slides related to this article are available.

Pharmaceutical Benefits Under State Medical Assistance Programs, 2005/2006 and Previous Editions
The 2005-2006 edition of Pharmaceutical Benefits Under State Medical Assistance Programs marks the 40th year that NPC has compiled and published one of the largest sources of information on pharmacy programs within the State Medical Assistance Programs (Title XIX) and expanded pharmacy programs for the elderly and disabled. Over the years, this collection of statistical data has become a standard reference in government offices, research libraries, consultancies, and numerous businesses. It incorporates information on each State pharmacy program from an annual NPC Survey of State Medicaid program administrators and pharmacy consultants, statistics from the Centers for Medicare and Medicaid Services (CMS), and information from other Federal agencies and organizations.

Pharmaceutical Diversity Serves Human Diversity: Medications for Older Adults, by Richard A. Levy, PhD, Healthcare and Aging, Vol. 7, No. 4, Winter 2000
Genetic differences in response to medicines are now known to involve some of the medications most used among elders, including drugs for high blood pressure, depression and life-threatening infections. New scientific findings about genetic influences on the effects of medications call for increased focus on subgroups of patients and on individuals. (Reprinted with permission from Healthcare and Aging, Vol. 7, No. 4, Winter 2000. Copyright © 2000 American Society on Aging, San Francisco, California.)

Pharmaceuticals and Productivity: Investing in Human Capital, 2001
(Note: ~20mb)
New therapies have the potential to produce economic savings and benefits both outside of the health care system (indirect savings) and within the system (direct savings). This report explores the question of whether spending on pharmaceuticals has a positive payoff.

Pharmaceuticals and Worker Productivity Loss: A Critical Review of the Literature, by Wayne N. Burton, MD, Alan Morrison, PhD, and Albert I. Wertheimer, PhD, Journal of Occupational and Environmental Medicine, Vol. 45, No. 6, June 2003
Many chronic illnesses that affect the working population can cause losses in productivity. The evidence is very good for about a dozen drug classes that pharmaceuticals reduce productivity losses caused by respiratory illnesses (i.e. asthma, allergic disorders, bronchitis, upper respiratory infections, and influenza), diabetes, depression, dysmenorrhea, and migraine. This article should be helpful to occupational physicians who are increasingly providing recommendations on employer benefit plan designs and pharmaceutical benefits.

Annotated PowerPoint slides related to this article are available.

Pharmaceuticals for Elders: Why Innovation Matters, by Albert Wertheimer, Healthcare and Aging, Vol. 9, No. 1 Spring 2002
The current policy debate over drug-benefit reform and improved access to needed medicines for elders has generated considerable confusion and many misperceptions regarding the nature and value of incremental pharmaceutical innovation. Cumulatively, these new medicines allow for precision treatment of the individual needs of diverse patients, which is especially important for optimal treatment of older patients, because age-related physiological changes and individual differences may produce markedly diverse responses to medications in older adults. (Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American Society on Aging San Francisco, California.)

CD-ROM Prescription Medicines: Returning Value to Patients, Payers and Society, 2003
Studies confirm that indeed, medicines are one of the fastest growing areas of health care spending. And while few can imagine life without the life improving medicines that patients with diabetes, heart disease, cancer, HIV/AIDS, and many others have come to depend on, some have questioned the value of that spending – to the health care system overall and to consumers. In this compilation of materials – much of it peer-reviewed research – we hope to help answer some of the critical questions in this debate.

Presenteeism: At Work—But Out of It, by Paul Hemp, Harvard Business Review, October 2004
As companies struggle to rein in health care costs, most overlook what may be a $150 billion problem: the nearly invisible drain on worker productivity caused by such common ailments as hay fever, headaches, and even heartburn. However, a handful of companies are recognizing the problem of presenteeism and trying to do something about it.

The Price of Progress: Prescription Drugs in the Health Care Market, by J.D. Kleinke, Health Affairs, Vol. 20, No. 5, September/October 2001
Kleinke's research tells us that increased spending on pharmaceuticals does not explain the insurance premium increases that many consumers are seeing. He points out that pharmaceuticals are a small fraction of the total equation, and that even though spending on pharmaceuticals is increasing, that rise in expenditures amounts to a small percentage of the premium increases.

View "Measuring the Value of Health Innovations: The Policy Implications of New Medical Technologies," a briefing by the Alliance for Health Reform featuring J.D. Kleinke, September 7, 2001, Washington, DC

Productivity Impact Model: Calculating the Impact of Depression in the Workplace and the Benefits of Treatment
Depression is a leading cause of absenteeism and low productivity in the workforce. It affects almost every company to some degree, and its costs are high. The Productivity Impact Model can help employers determine the incidence of depression an organization, predict the expected number of days each year employees will be absent or suffer low productivity due to depression, estimate the costs associated with this lost productivity, and project the net savings that will accrue with treatment of employees suffering from depression.

The Public Health Impact of Direct-to-Consumer Advertising of Prescription Drugs (Report to Funders), February 2003
This report contains more detailed findings from the report "Consumer Reports on the Health Effects of Direct-to-Consumer Advertising of Prescription Drugs" (see above) and includes the survey questionnaire.

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Q's and A's for State Officials, Physicians and Patients
Find out the benefits of disease management for Medicaid officials, providers and patients. State officials are briefed on how to determine high quality services and utilization management to chronically ill Medicaid patients. Other fact sheets explain how disease management benefits physicians and their patients.

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Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, Randall W. Maxey, and Richard A. Levy, Journal of the National Medical Association, Vol. 94, No. 10 (Suppl.), October 2002
It is now well documented that substantial disparities exist in the quality and quantity of medical care received by minority Americans, especially those of African, Asian, and Hispanic heritage. In addition, the special needs and responses to pharmaceutical treatment of these groups have been undervalued or ignored. This article reviews the genetic factors that underlie varying responses to medicines observed among different ethnic and racial groups.

Annotated PowerPoint slides related to this report are available.

CME credit is available through the National Medical Association.

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The Silver Book: Chronic Disease and Medical Innovation in an Aging Nation
The Silver Book, a project of the Alliance for Aging Research is an almanac of hundreds of facts, statistics, graphs, and information from close to 100 agencies, organizations and experts. It is a searchable database that is constantly updated and expanded in order to highlight the latest research and data on the burden of chronic disease and the value of investing in medical research. The Silver Book database is searchable by specific terms or by sections. The database is also interactive, allowing users to submit data from additional studies and reports.

Sources of U.S. Longevity Increase 1960-2001, by Frank R. Lichtenberg, The Quarterly Review of Economics and Finance, Vol. 44,
No. 3, July 2004
This empirical analysis provides support for the hypothesis that both medical innovation (in the form of new drug approvals) and public health expenditure contributed to longevity increase during the period 1960–2001. Longevity is viewed as the output of the health production function, and output fluctuations as the consequence of fluctuations in medical inputs (expenditure) and technology. The estimates imply that the public health expenditure needed to gain one life-year is about $9640, and that the pharmaceutical R&D expenditure needed to gain one life-year is about $926.

State Medicaid Program Issues: Preferred Drug Lists, 2003
This issue brief identifies issues, requirements and considerations relating to preferred drug lists (PDLs). Developed for state audiences, the brief addresses policy, operational and procedural issues; federal provisions for patient protection; specific case studies; provisions of the Florida Medicaid patient suit settlement agreement; evaluation methodologies; and principles to consider.

State Medicaid Resource Kit: Maintaining Quality and Patient Access to Innovative Pharmaceuticals in Challenging Economic Times, 2006
This resource kit, modeled on NCSL's "Managing Medicaid Costs: A Legislator's Toolkit," is designed to help states better identify the needs of their populations and to develop patient-focused cost management interventions while maintaining quality care. Sixteen specific strategies are addressed, providing the pros and cons, states' experiences, design and policy issues, and Federal and State involvement/constraints.

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Executive Summary: Too Many Drugs? The Clinical and Economic Value of Incremental Innovations, by Albert Wertheimer, Richard Levy and Thomas O'Connor, 2001
Some believe that incremental advances within the pharmaceutical industry are too costly and do not ultimately benefit the consumer. This is a misconception. The new agents resulting from this evolutionary process can offer advantages in terms of improved efficacy, better patient satisfaction and compliance and, in some cases, greater cost effectiveness.

Annotated PowerPoint slides related to this report are available.

Too Many Drugs? The Clinical and Economic Value of Incremental Innovations, by Albert Wertheimer, Richard Levy and Thomas O'Connor, Research in Human Capital and Development: Investing in Health: The Social and Economic Benefits of Health Care Innovation,
Vol. 14, 2001
The history of clinical pharmacology is characterized by incremental improvements in the safety, efficacy, selectivity, and utility of drugs within a given class. This report makes the case for a fully developed class of drugs to allow precision prescribing in order to achieve optimum outcomes in the most cost effective manner.

Annotated PowerPoint slides related to this article are available.

Toward Individualized Pharmaceutical Care of East Asians, by Alan Morrison, PhD, and Richard A. Levy, PhD, Pharmacogenomics, Vol. 5,
No. 6, September 2004
Research into the relationship between genetics and drug response has focused on variations in genes that encode drug-metabolizing enzymes. Much of this work has targeted East Asians, a genetically distinguishable and populous group. Variations known to inactivate a drug-metabolizing enzyme are predictive of poor metabolism of drugs processed by that pathway. Genetic tests can be used to screen for individuals who are poor metabolizers, with the ultimate goal of better predicting the clinical effects of drugs. A non-technical summary of this paper is available.

Treatment of Depression in Older Primary Care Patients in Health Maintenance Organizations, by Stephen J. Bartels, PhD, et al., Psychiatry in Medicine, Vol. 27, No. 3, 1997
Older patients enrolled in managed care plans are being prescribed older anti-depressants, indicating that this issue is an important target for improving quality of care for depression in the elderly. Authors of this 1997 journal article found that the elderly who were prescribed anti-depressants received older varieties that have more side effects.

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Urinary Incontinence: Economic Burden and New Choices in Pharmaceutical Treatment, by Richard Levy, PhD and Nancy Muller, Advances in Therapy, Vol. 23, No. 4, July/August 2006
In the year 2000, an estimated 17 million community-dwelling adults in the United States had daily urinary incontinence (UI) and an additional 33 million suffered from the overlapping condition, overactive bladder. Estimates of the total annual cost of these conditions range up to $32 billion. Until recently, pharmaceutical therapy for UI has been limited, especially because the adverse effects of available agents resulted in poor adherence to treatment regimens. Recent innovations in molecular design and new dosage forms of UI medications offer the promise of fewer and less severe adverse effects and, thus, better treatment outcomes for patients. New pharmacologic treatment options for UI have the potential to allow greater independence for older persons who reside at home and to delay or avoid the costs of admission to long-term care facilities. This file is posted here with permission of Health Communications Inc., the publisher of Advances in Therapy®. It is provided for individual use only and may not be used for commercial distribution.

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The Value of Disease Management: Balancing Cost and Quality in the Treatment of Asthma, by Jeann Lee Gillespie, PharmD, MS, Disease Management, Vol. 5, No. 4, 2002
Asthma is often selected for disease management programs because of its high prevalence and large economic impact and the frequent failure to provide appropriate patient care and achieve optimal outcomes. The article examines the value of disease management in both improving the quality of care received and managing costs associated with the treatment of asthma. Case studies from state Medicaid initiatives and private sector HMO programs are provided.

The Value of Disease Management: Balancing Cost and Quality in the Treatment of Congestive Heart Failure, by Jeann Gillespie, PharmD, MS, Disease Management, Vol. 4, No. 2, 2001
This article reviews the literature to identify reports concerning the impact of educational interventions on heart failure treatment and management. It also discusses why heart failure is often selected for disease management, outlines the management and treatment of heart failure, and provides a review of heart failure disease management literature.

The Value of Disease Management: Balancing Cost and Quality in the Treatment of Diabetes Mellitus, by Jeann Lee Gillespie, PharmD, MS, Disease Management, Vol. 5, No. 1, 2002
The article examines the value of disease management in both improving the quality of care received and managing costs associated with the treatment of diabetes. Case studies from state Medicaid initiatives and private sector HMO programs are provided, as well as a bibliography of 56 studies citing disease management interventions and outcomes for further reference.

The Value of Incremental Pharmaceutical Innovation for Older Americans, by Albert Wertheimer, PhD, MBA, Thomas W. O'Conner, Jr., PharmD, MBA, and Richard Levy, PhD, 2001
This monograph explains that small incremental improvements within drug classes provide important health benefits, especially for elderly patients. The monograph illustrates therapeutic advantages of these newer drugs in a class including: fewer side effects, improved safety and greater effectiveness; easier use, which facilitates compliance with prescribed regimens; and better tailoring to fit individual patient needs. Fact sheet available.

Executive Summary: The Value of Investment in Health Care: Better Care, Better Lives, 2004
Over the past few decades, significant advances in the U.S. health care system have helped people live longer and better lives. Both mortality and disability rates have fallen consistently since the 1970's. This report endeavors to examine costs in the context of benefits received by focusing on overall improvements in health, as well as taking a specific look at four conditions (heart attack, type 2 diabetes, breast cancer, and stroke) that are among the most common causes of death and disability.

Annotated PowerPoint slides related to this report are available.

The Value of Investment in Health Care: Better Care, Better Lives, 2004
This study looks at the value of investment in health care for overall health care expenditures as well as for expenditures for the management of four key health conditions—heart attack, type 2 diabetes, stroke, and breast cancer. Evidence from a variety of sources shows that the value of the health gains during this time period are higher than the increased health care expenditures during this time period, indicating that these additional investments in health care add value to the U.S. population.

Annotated PowerPoint slides related to this report are available.

CD-ROM The Value of Medical Innovation
This collection of materials on the increasingly important role of pharmaceuticals in health care delivery includes selected research from the Health Affairs September/October 2001 issue, video highlights from the September 7, 2001, Capitol Hill symposium held to discuss research featured in the issue, key points from the research, illustrative charts, and selected news articles covering the research and its implications.

The Virginia Health Outcomes Partnership: A Demonstration Project, 1997
Learn how to select diseases for Medicaid disease management from this 18-page NPC booklet written by Judith Jones, the Degge Group. See what Virginia considered before selecting asthma as its first targeted intervention. Fact sheet available.

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Why Investing in Health Care Enhances Employee Productivity, by Dennis Richling, MD, Workforce Management, November 2004
Yes, rising health-care costs continue to present a significant challenge to companies. Still, it's important to resist the temptation to cut back on health-care spending. Doing so can cost you dearly in terms of productivity. Businesses should recognize that human capital is an asset. Investing in that asset requires more than the traditional approaches can offer.

Why the Elderly Need Individualized Pharmaceutical Care, by David Nash, MD, MBA, et al., April 2000
A “one drug fits all” approach does not work for elderly patients because they are exposed to unique health variables that are rare in younger patients. This 18-page report explains the pharmacological, physiological and epidemiological reasons why therapy for this population must be personalized.

Annotated PowerPoint slides related to this report are available.
Fact sheet available.

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Your Pharmacy Benefit: Make it Work for You!
This 16-page booklet, available through the Federal Citizen Information Center offers helpful advice for those with prescription drug coverage through and employer, union, or other group plan, or who are eligible for prescription drug coverage under Medicare. The booklet guides readers through important questions to ask and things to consider when choosing a plan, and offers tips for troubleshooting problems filling prescriptions once enrolled in a plan. Includes a sample appeal letter. Also available in Spanish.

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