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in which certain therapies have adequate, even overwhelming if not unequivocal, evidence of effectiveness.5 Clinical inertia occurs, for example, when the patient fails to attain a biomarker goal (e.g., blood pressure less than 140/90 millimeters of mercury [mm Hg]) due at least in part to failure to intensify pharmacotherapy through upward dosing and/or(More)
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)
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)
According to Roman mythology, a handsome but vain young man, Narcissus, became thirsty while hunting in the woods. Kneeling down upon the banks of a stream, he became fascinated by his own reflection. Refusing to drink the water lest he damage the lovely image in the stream, and not realizing that he was in fact staring only at a reflection of himself, he(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)
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)
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)
On January 15, 2009, the U.S. Justice Department posted a notice on its website that Eli Lilly and Company had agreed to pay a criminal fine of $515 million, the largest such fine ever paid in a health care case, to resolve allegations that the company had promoted olanzapine (Zyprexa) for uses not approved by the U.S. Food and Drug Administration (FDA).1(More)
rosiglitazone within 3 months after the publication of the Nissen and Wolski meta-analysis, 13% had no prescription claims for any oral antidiabetic agent in the 90-day period following the final rosiglitazone prescription.12 Providing further insight into what actually happens following the delivery of unexpected news to the medical community, Starner et(More)