Evolving regulatory landscape with erythropoiesis-stimulating agents and impact on managed care.

Erythropoiesis-stimulating agents (ESAs) are a very effective treatment for reducing the need for transfusions in patients affected by anemia and either chronic kidney disease (CKD) or cancer. However, many clinicians remain wary of its use due to safety concerns. It has been shown that higher doses are associated with cardiovascular disease, stroke, or death.

Predictors of fixed-dose combination antihypertensive drug therapy in a Medicaid population.

Physicians may prescribe hypertension combination therapy, either with fixed-dose combination therapy or with dual-agent component-based therapy. This study evaluated the predictors of hypertensive patients receiving either type of combination therapy. Our study was based on claims data from the Maryland Medicaid Managed Care Organizations.

Physician conformity and patient adherence to ACE inhibitors and ARBs in patients with diabetes, with and without renal disease and hypertension, in a medicaid managed care organization.

Background: The American Diabetes Association (ADA) recommends using angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) in patients with diabetes and comorbid hypertension or renal disease.

Objective: To examine the use of ACE inhibitors and ARBs in members of a Medicaid managed care organization (MCO) with diabetes and a diagnosis of hypertension and/or kidney disease to determine to what extent (1) physicians are conforming to the recommended course of treatment according to ADA guidelines published in 2002 and still current and (2) patients are adhering to their prescribed therapy.

Methods: Patients with diabetes were identified using medical claims from a Medicaid MCO in Maryland of approximately 118,000 members continuously enrolled during the study period.

Drug therapy persistence and stroke recurrence.

Objective: To assess the effect of persistence of use of warfarin sodium, aspirin, or clopidogrel bisulfate on stroke recurrence in a Medicaid high-risk, largely female, African American population.

Study Design: Prospective non-concurrent cohort, longitudinal data analysis of medical and pharmacy claims of stroke patients from Medicaid managed care organizations between January 1, 2001, and December 31, 2003.

Methods: Cox proportional hazards models were used to predict the likelihood of avoiding a recurrence as a function of persistence of use of the initial medication (warfarin, aspirin, or clopidogrel) after stroke, adjusting for age, race, sex, hypertension and other comorbidities, and the pharmacotherapies prescribed.

Medicaid managed care: disparities in the use of thiazolidinediones compared with metformin.

Objective: To identify patient characteristics that are associated with the incidence of thiadolidinediones (TZDs) or metformin prescnbing in Medicaid managed care plans.

Research Design And Methods: We utilized a retrospective cohort study design. Two-and-one-half years of prescription claims of Medicaid managed care organizations (MCOs) patients who were new utilizers of metformin or TZDs were analyzed using univariate, bivariate and multivariate models.