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An article on the front page of the Wall Street Journal on October 6, 2006, thrust into the public media the otherwise esoteric controversy concerning the use of average wholesale price (AWP) as the primary basis for reimbursements to pharmacies for pharmaceuticals in the United States. Although used widely for nearly 40 years, AWP had been criticized prior(More)
Even as you read this, new monsters are being made, new items crafted, and dungeons overflowing with horrible surprises are being designed to test your bravery and intellect. 1 A sk a teenage boy the object of the on-line game Dragon Fable, the topic of the promotional description that appears above, and you will endure several moments of eye rolling(More)
Health care payers and policy makers need information about the cost and effectiveness of medical treatments. While randomized controlled trials historically are the primary source of medical information, they are expensive and labor-intensive, and often have limited utility for answering questions about "real-world" patient populations. These problems have(More)
OBJECTIVE Patients with treatment-resistant schizophrenia commonly receive nonrecommended drug regimens, including antipsychotic polypharmacy, sometimes in lieu of clozapine. This analysis compared utilization and cost outcomes for cohorts of Medicaid beneficiaries treated with clozapine monotherapy and with antipsychotic polypharmacy. METHODS Data were(More)
OBJECTIVE The study examined whether the relationship between the course of antidepressant treatment and the type of prescriber-psychiatrist or nonpsychiatrist-varied by whether a tricyclic antidepressant or a selective serotonin reuptake inhibitor (SSRI) was prescribed. METHODS Pharmacy claims from a nationwide database were analyzed retrospectively. A(More)
BACKGROUND In response to rising prescription drug costs, plan sponsors are increasingly implementing three-tiered pharmacy benefits. OBJECTIVE This study examined the effect of a three-tiered pharmacy benefit on pharmaceutical utilization and expenditures, medication continuation, and use of other medical resources in a population of continuously(More)
W hen we wrote our March, 2008 editorial in JMCP regarding the lack of evidence of value in value-based insurance design (VBID), 1 we correctly anticipated that those working in the " trenches " of managed care pharmacy would appreciate an objective evaluation of the evidence about prescription drug cost-sharing. What we did not anticipate was a query we(More)
The base of evidence for the relative harm versus benefit for commonly used prescription drugs expanded in 2010, including developments late in 2010 that reinforced the value of pharmacovigilance and the need for critical appraisal of warnings of threat to patient safety. In October 2010, the U.S. Food and Drug Administration (FDA) announced additions to(More)