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Highlights from January/February issue of <i>JMCP</i>

ALEXANDRIA, Va., Jan. 13 /PRNewswire/ -- The January/February 2004 issue of the Journal of Managed Care Pharmacy (JMCP) has been released on and in print. Among featured articles in January/February are:

Markov Economic Modeling of the Results of the MARVAL Clinical Trial Show Favorable 8-Year Health and Economic Outcomes in Patients with Type 2 Diabetes...

Use of a Markov economic model using data from the 6-month MARVAL randomized controlled clinical trial showed that over 8 years, the angiotensin II receptor blocker valsartan added an average of 7 months of quality-adjusted survival to patients with type 2 diabetes and microalbuminuria, compared with the calcium channel blocker amlodipine. Valsartan patients also incurred lower total medical costs, an average $32,412 (26%) compared with amlodipine-treated patients.

Uncomplicated Urinary Tract Infection Treated Efficiently With a New Antibiotic...

A cost-minimization economic model was applied to alternate empiric treatments of uncomplicated urinary tract infection caused by Escherichia coli. Three-day therapy with trimethoprim-sulfamethoxazole (TMP-SMX) 800/160 mg twice daily or ciprofloxacin XR 500 mg once daily were predicted to have comparable costs, depending upon local resistance rates to each antibiotic. Across the 5 cases presented by the authors, the newer antibiotic ciprofloxacin XR 500 mg had lower total medical costs compared with the older standard, first-line therapy with TMP-SMX, despite having a higher direct drug cost.

Enhancements to Cost-Effectiveness Analysis Increase the Value of Pharmacoeconomic Analyses in Formulary Decision Making...

The authors review enhancements to cost-effectiveness analysis (CEA) such as the development of software for pharmacoeconomic (PE) modeling, rank-order stability analysis, cost-consequence analysis (CCA), and budget impact analysis. The authors predict that the combined method of CCA-CEA and the use of standardized guidelines such as those contained with the AMCP Format for Formulary Submissions will result in increased use of PE analyses in drug formulary decision making by health plans and pharmacy benefit managers.

Editorialists Debate the Proper Methods to Evaluate the Cost-Effectiveness of Statins to Treat Hypercholesterolemia ...

Percentage changes in cholesterol levels do not reliably predict percentage changes in the risk of coronary events such as myocardial infarction. The absence of definitive efficacy data from randomized controlled trials in measures of ultimate coronary events makes necessary the use of cost-effectiveness models to determine relative value among alternative statins. The editorialists debate the validity and reliability of key assumptions and factors to consider such as compliance in the interpretation of the results of cost-effectiveness analyses.

Pharmacy's Framework to Cross the Quality Chasm in Pharmacy Services...

Improvement in the quality of pharmacy services will occur in incremental steps that rely on a structure-process-outcome model where the structure is provided by scientific evidence, the process by the application of evidence in the form of clinical practice guidelines, clinical practice models and the self-assessment tools such as Pharmacy's Framework for Drug Therapy Management in the 21st Century, and the outcome as measured by fulfillment of pharmacy "customer" needs in effective drug therapy and disease management. The Framework self-assessment tool can be used by individual practitioners, pharmacy service organizations, or health systems to identify opportunities for quality improvement and begin to measure performance to desired goals.

The Journal of Managed Care Pharmacy is published bimonthly and is a benefit of membership in the Academy of Managed Care Pharmacy. A peer-reviewed publication of original research for pharmacy practitioners and health care providers, JMCP is approved by the National Library of Medicine and indexed in MEDLINE/PubMed, among recognized international scientific and academic journals of distinction. Nonmembers may obtain copies of the publication by downloading articles of interest from the Journal's website at Questions about the publication may be directed to Frederic R. Curtiss, PhD, RPh, CEBS, editor-in-chief, at

Source: Academy of Managed Care Pharmacy

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