Leading employers share strategies for managing promising, high-cost biotech medications.

Companies and organizations nationwide struggle to find the best way to address the complex, multifaceted challenges involved in providing their employees with access to necessary--and often expensive--medications. The introduction of new bio-derived medications has compounded these challenges. Biotech medications offer a high level of therapeutic value, but do so at a high monthly cost per patient.

Costs of severely ill members and specialty medication use in a commercially insured population.

This study examines the overall profile and costs associated with severely ill commercially insured people. We found severely ill members to have the highest costs, from both the insurer and member perspective. Even for the most costly members where specialty medication use was highest, biologics represented less than one-third of the pharmacy spending and 6.

Reductions in individual work productivity associated with type 2 diabetes mellitus.

Background: Chronic diseases and their treatments may cause symptoms that impair performance but are too mild to affect outcome measures such as absences and workforce exit.

Objective: To assess the effect of type 2 diabetes mellitus on individuals' productivity when working, absences from work and the value of any lost work time.

Methods: Subjects were identified from claims data and enrolled over the phone.

New developments in influenza vaccine technology: a potential new prevention strategy for employers and managed care organizations.

Influenza is still one of the most wide-reaching, deadly infectious diseases in the United States, with an estimated 54 million cases and 42,000 deaths in a typical year. At $14 billion, the annual cost of influenza is also enormous. More than 80% of that figure comes from so-called indirect medical costs-eg, the productivity loss that results when a person with influenza misses work.

Metabolic risk factors for cardiovascular disease in a working population: a retrospective cohort study.

Risk factors for cardiovascular disease (CVD) appear to cluster in individuals, possibly because of a single, underlying metabolic disorder. We describe the prevalence of metabolic risk factors for CVD in a young working population and the tendency for individuals with some risk factors to acquire additional factors. This was a retrospective three-year follow-up study of baseline CVD risk factors assessing (1) incidence of risk factors and (2) fatal CVD.

The Seychelles study of fetal methylmercury exposure and child development: introduction.

Studies of outbreaks of methylmercury poisoning in Japan and Iraq from consumption of methylmercury (MeHg)-contaminated fish or bread proved that brain was the target organ, the toxic effects were dose-related, and the fetal brain was especially susceptible. Previous population studies suggested that a 5% risk of minimal fetal effect may be associated with a maternal hair mercury concentration during pregnancy of 10-20 ppm (mu g/g), a level that can be readily achieved by frequent consumers of fish. However, these studies had limitations, and as a result no definite conclusion concerning the lowest effect level could be reached and the question of a possible hazard to public health remained unanswered.

Current needs for comprehensive occupational health services support for employers.

The most valuable resource for most employers is their personnel. Maintaining the health and effective work performance of employee groups is enhanced by a strong and well-delivered occupational health program. Employers' needs in this area include access to urgent care services for on-plant medical problems that occur, regulatory compliance assistance, and medical specialty consultation to identify the contribution of workplace exposures to employee health.

Foot blister risk factors in an ROTC summer camp population.

Data that establish risk factors for foot blister morbidity among ROTC cadets at summer camp are presented. The subjective blister attack rate was 42.1 per 100 cadets.

Early ankle mobilization, Part I: The immediate effect on acute, lateral ankle sprains (a randomized clinical trial).

A random clinical trial was performed to determine the immediate effects of early ankle mobilization on active duty military members with moderate and severe lateral ankle sprains. Sixty-four subjects were randomly allocated to one of three treatments: a plaster cast, an air-stirrup (Aircast Inc., Summit, New Jersey), or an elastic wrap.

Podiatric utilization referral patterns at an Army medical center.

Presented is the first descriptive data on a large military Podiatry Clinic supporting largely combat troops. Data consist of initial podiatric problems of soldiers and other beneficiaries of podiatric care. Demographic, physician referral patterns, and other pertinent summarized survey information of outpatient utilization at the Podiatry Clinic, Madigan Army Medical Center, Fort Lewis, Washington, are examined.

The short-term impact of Army smoking policies.

A cross-sectional study was performed among soldiers of an infantry battalion to determine smoking prevalence and to assess the short-term impact of Army smoking policies instituted within the preceding 6 months. Data were collected using a structured pretested questionnaire. The response was 91.

Building-associated risk of febrile acute respiratory diseases in Army trainees.

Airborne transmission of infectious agents and associations of indoor air pollutants with respiratory illnesses are well documented. We hypothesized that energy conservation measures that tighten buildings also increase risks of respiratory infection among building occupants. At four Army training centers during a 47-month period, incidence rates of febrile acute respiratory disease were compared between basic trainees in modern (energy-efficient design and construction) and old barracks.

Occupational and geographic risk factors for hepatitis B among US Army enlisted personnel during 1980.

Hepatitis B hospitalization rates for US Army enlisted personnel were determined by occupation and geographic area for 1980. The only group in the US Army currently recommended to receive hepatitis B vaccine is medical personnel regularly exposed to blood. Other groups of Army personnel, specifically those working in areas of high hepatitis B endemicity, have been thought to be at higher risk.

Frequency of illness associated with epidemic hepatitis A virus infections in adults.

Hepatitis A virus infection is often described as mild or asymptomatic, particularly in children. The failure of most adults who are found to be immune to remember symptoms of an illness suggestive of hepatitis A virus supports this belief. In 1982, two large outbreaks occurred in well documented populations of military personnel.

Etiology of viral hepatitis in American soldiers.

To define better which types of hepatitis are prevalent among American soldiers, the authors studied 413 separate episodes of acute viral hepatitis among 412 soldiers admitted to US Army hospitals during 1978-1979. Most soldiers (68.8%) had acute hepatitis B (estimated annual hospitalization rate: 5.