Plan designs that encourage the use of generic drugs over brand-name drugs: an analysis of a free generic benefit.

Objective: To evaluate the effect on adherence and medical care expenditures of a pharmacy benefit change that included free generic drugs and higher copayments for brand-name drugs.

Study Design: Quasi-experimental pre-post study of patients with ischemic heart disease (1286 control and 555 intervention) and patients with diabetes mellitus (4089 control and 1846 intervention).

Methods: Medical and pharmacy claims data were analyzed for continuously enrolled members from January 1, 2005, through December 31, 2008.

An evaluation of the relationship between the implementation of a newly designed prescription drug label at Target pharmacies and health outcomes.

Background: Medication errors represent a major public health concern, and inadequate prescription drug labels have been identified as a root cause of errors. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve health outcomes.

Objectives: To evaluate whether the new Target label influenced patient health services utilization.

Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the Target pharmacy label.

Background: Prescription medication labels contain valuable health information, and better labels may enhance patient adherence to chronic medications. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding.

Objective: We evaluated whether the new Target label influenced patient medication adherence.

Rosiglitazone and pioglitazone utilization from January 2007 through May 2008 associated with five risk-warning events.

Background: Rosiglitazone was approved by the U.S. Food and Drug Administration (FDA) for type 2 diabetes in 1999.

Clinical and economic outcomes of medication therapy management services: the Minnesota experience.

Objectives: To (1) provide medication therapy management (MTM) services to patients, (2) measure the clinical effects associated with the provision of MTM services, (3) measure the percent of patients achieving Healthcare Effectiveness Data and Information Set (HEDIS) goals for hypertension and hyperlipidemia in the MTM services intervention group in relationship to a comparison group who did not receive MTM services, and (4) compare patients' total health expenditures for the year before and after receiving MTM services.

Design: Prospective study.

Setting: Six ambulatory clinics in Minnesota from August 1, 2001, to July 31, 2002.

Utilization, cost trends, and member cost-share for self-injectable multiple sclerosis drugs--pharmacy and medical benefit spending from 2004 through 2007.

Background: In 1993, interferon beta-1b became the first of 4 self-injectable multiple sclerosis (MS) drugs to be approved by the U.S. Food and Drug Administration.

Relationship of the magnitude of member cost-share and medication persistence with newly initiated renin angiotensin system blockers.

Background: Effective treatment for chronic diseases often requires medication refill persistence. Health plans have frequently increased the amount of member cost-sharing by implementing tier-copayment pharmacy benefit designs and raising copayments. However, increased member costshare may present a barrier to the management of chronic conditions.

Telithromycin: the perils of hasty adoption and persistence of off-label prescribing.

Background: Telithromycin (Ketek) was approved in April 2004 for the treatment of acute bacterial exacerbations of chronic bronchitis (ABECB), bacterial sinusitis, and community-acquired pneumonia. The approval of telithromycin was controversial due to trial irregularities, noninferiority study designs, and use of foreign safety data. Safety concerns involving hepatotoxicity, myasthenia gravis exacerbation, and visual disturbances were increasingly documented in the literature after approval.

The effect of the fit between organizational culture and structure on medication errors in medical group practices.

Background: It is widely acknowledged that many prescription drug errors occur in the ambulatory care setting and that they have serious quality of care implications. Previous research examining this issue has focused on hospitals and on individual-level factors. This study adopts an organizational perspective to assess the effects of organizational culture, organizational structure, and their fit (i.

Effects of collaborative drug therapy management on patients' perceptions of care and health-related quality of life.

Background: It has been demonstrated that collaborative drug therapy management may result in enhanced medication adherence and improved clinical outcomes. It is not yet known whether CDTM is associated with patients' perceptions of care or self-reports of health-related quality of life.

Objectives: Examine the impact of collaborative drug therapy management (CDTM) on patients' perceptions of care and health-related quality of life in 15 ambulatory clinics (6 intervention, 9 comparison) in the Fairview system of Minneapolis-St Paul, Minn.

The DERP: is it an effective methodology?

The Drug Effectiveness Review Project (DERP) is a process with challenges as well as rewards. This Perspective explores the issues that hamper the DERP's effectiveness and discusses the changes it has generated in the drug review process for pharmacy and therapeutics (P&T) committees. The need for more timely and substantial evidence is a key barrier to all drug review processes; here I offer some alternative methods for comparing new drugs that have few comparators.

The influence of the structure and culture of medical group practices on prescription drug errors.

Background: This project was designed to identify the magnitude of prescription drug errors in medical group practices and to explore the influence of the practice structure and culture on those error rates. Seventy-eight practices serving an upper Midwest managed care (Care Plus) plan during 2001 were included in the study.

Methods: Using Care Plus claims data, prescription drug error rates were calculated at the enrollee level and then were aggregated to the group practice that each enrollee selected to provide and manage their care.

The economic effect of hypoglycemia in a health plan.

This study was undertaken to determine the incidence and economic cost of hypoglycemia in patients with diabetes taking insulin in a large mid-western health plan. Analysis of claims data identified 7,659 members with a diagnostic code for either type 1 or type 2 diabetes during a seven-year interval from 1992 to 1998. A total of 2,118 were prescribed some type of insulin regimen.