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March/April 2004 Issue of the <i>Journal of Managed Care Pharmacy</i> Is Now Available

ALEXANDRIA, Va., March 16 /PRNewswire/ -- The March/April 2004 issue of the Journal of Managed Care Pharmacy (JMCP) is now available in print and online. Featured articles include:

Evaluation of the Utilization Patterns of Leukotriene Modifiers (Second- Line Asthma Drugs) in a Large Managed Care Organization...

Leukotriene modifiers (LMs) in a 444,000-member managed care organization (MCO) were used in a manner inconsistent with national treatment guidelines for asthma. At the time of the study, LMs were approved for use only in asthma. National guidelines recommend use of LMs as alternate therapy to inhaled corticosteroids (ICS) or as add-on therapy. In this MCO, 89% of new LM patients and 61% of all (new and existing) LM patients had no history of use of an ICS, and an estimated 25% of use was not for asthma (i.e., off-label use). This study suggests that there are care management opportunities to optimize the appropriate and cost-effective use of LMs. The transfer of loratadine (Claritin) to OTC availability and higher copayments for most low- sedating antihistamines (e.g., Zyrtec and Allegra) increases the importance of this study to pharmacy benefit managers in 2004.

Comparison of Risedronate, Alendronate and Calcitonin for Early Reduction of Nonvertebral Fracture Risk...

Analysis of medical claim information for nonvertebral fractures (clavicle, humerus, wrist, pelvis, hip and leg) in the first 6 and 12 months of drug therapy found an advantage for two bisphosphonates, alendronate and risderonate, compared with calcitonin in risk reduction, and an apparent slight advantage for risedronate compared with alendronate. The absolute rates of vertebral fractures in the 6-month analysis (7,081 patients) were 2.2% in patients receiving calcitonin, 1.4% for alendronate and 0.6% for risedronate. The absolute rates of vertebral fractures in the 12-month analysis (5,024 patients) were 2.9% for calcitonin, 2.4% for alendronate and 0.9% for risedronate.

Improving Antimicrobial Use: Longitudinal Assessment of an Antimicrobial Team Including a Clinical Pharmacist...

Evaluation of data over a 3-year period found that the proportion of antimicrobial treatment episodes that required antimicrobial management team (AMT) intervention was consistent over six 6-month measurement periods, from 35% to 39%. There also was no reduction in the need for the AMT with 39% of treatment episodes requiring AMT intervention in first 6-month period and 37% requiring AMT intervention in the last 6-month measurement period. Internal medicine physicians accepted 84% of AMT recommendations for changes in antimicrobial therapy and surgeons accepted 69% of AMT recommendations. These findings have important implications for resource planning, suggesting that the need for an AMT initiated as a quality improvement project may persist over an extended period of time, perhaps indefinitely. The need for continuous quality improvement in the form of an AMT may be greater in a teaching environment where there is more staff and resident turnover.

Source: Academy of Managed Care Pharmacy

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