How-to guide for creating drug monographs and drug class reviews for evidence-based formulary consideration.

Until 2005, irbesartan was the only ARB available on the Veterans Affairs (VA) healthcare system's national formulary. In 2005, irbesartan was removed from the formulary and was replaced with valsartan and losartan. For those patients who were to continue ARB therapy via a switch to either losartan or valsartan, dosing guidelines were created by the Veterans Integrated System Network 7 to facilitate the change. These guidelines suggested that patients taking irbesartan 150 mg once daily be treated with either valsartan 80 mg or losartan 50 mg once daily and that patients taking irbesartan 300 mg once daily be treated with either valsartan 160 mg or losartan 100 mg once daily. To determine if the dosing guidelines resulted in equal antihypertensive effectiveness, we carried out a retrospective chart review, examining the cases of 86 patients at the William Jennings Bryan Dorn VA Medical Center in Columbia, South Carolina, who had switched from irbesartan to either losartan or valsartan. therapeutic..

The blockbuster drugs of the 1990s came off-patent, became generic, and now several of them have become available OTC. Others are expected to join the ranks in the next few years.

Consumer-driven healthcare will greatly influence benefit and co-pay structures over the next decade, HealthTrans leaders predict.

As patient-based strategies promote acceptance and wider use of generic drugs, managed care organizations' (MCOs's) tools now include aggressive voucher programs that go so far as to provide preprinted prescription blanks for patients to take to their doctors.

Controlling the rate of growth in prescription drug expenses continues to be a challenge. The cost of offering healthcare insurance benefits, including prescription drug benefit programs, has increased to a rate of nearly 20% in 2003. Costs are expected to rise by double digits over the next 5 years. This daunting trend has influenced HMOs and other benefit providers to consider moving pharmacy benefit management in-house to cut costs.

J Russell Teagarden, MA, RPh, vice president of clinical practices and therapeutics at Medco Health Solutions in Franklin Lakes, NJ, explains how using an ?ethical template? for pharmacy benefit decisions can make those decisions consistent and fair, reducing patient displeasure, conflict, and litigation.

Applied Health Outcomes, Tampa, FL-Fixed-dose combination antihypertensive agents may save money for your institution or plan as well as for your patients.

Albert Einstein Healthcare Network, Philadelphia-What are the real-world consequences of inadequate beta blocker therapy in patients with congestive heart failure (CHF)? That is what this group of clinicians at Prestige Health-a 50,000 member managed care organization in Philadelphia-set out to determine.