ADHD in managed care: an assessment of the burden of illness and proposed initiatives to improve outcomes.

Attention-deficit/hyperactivity disorder (ADHD) often results in persistent problems with attention and impulsivity; these problems, in turn, contribute to impairments in a wide range of functions that affect academic, social, and workplace performance. The chronic and cumulative effects of these difficulties can be overwhelming and outline the significant burden of illness associated with ADHD, which is realized in diminished quality of life for patients and their families and increasing costs or loss of revenue for payers and employers. This burden warrants significant consideration and action from managed care stakeholders to foster sound clinical practice and optimal care.

Multiple vaccines: how do we choose?

Background: As preventive medicine is a cornerstone of managed care, most health plans have traditionally featured automatic vaccine coverage routed through the medical benefit. However, with the advent of emerging vaccines, managed care stakeholders must revise decision-making processes and choose among multiple products targeting the same disease.

Objective: To review the motivating forces behind traditional vaccine coverage in managed care and discuss the need for managed care organizations (MCOs) to subject their vaccine policies to greater examination in the changing landscape of emerging vaccines.

Colorectal cancer: complexities and challenges in managed care.

Background: Managed care weighs advances and associated costs to determine whether the combination of longer life at sometimes significantly increased cost represents value. The price of treatment is only 1 factor.

Objective: To review treatment decision processes for oncologic agents in managed care environments.

Medication reconciliation: Harvard Pilgrim Health Care's approach to improving outpatient medication safety.

Hospitals and long-term care facilities have been addressing the issue of patient safety for some time. As a result of the increasing number of outpatient medication errors leading to adverse drug events (ADEs), interest in preventing outpatient medication errors has increased. Research indicates that the rate of outpatient ADEs may be about four times as high as that reported in hospital studies and that more than one third of these events are preventable (Gandhi et al.

Analysis of the current care model of the COPD patient: a health outcomes assessment and economic evaluation.

Objective: Because chronic obstructive pulmonary disease (COPD) is a common but serious illness affecting millions worldwide, we present an overview of the disease and discuss its underdiagnosis and treatment options.

Summary: COPD, a disease encompassing emphysema and chronic bronchitis, is associated with cigarette smoking, chronic exposure to environmental pollutants, and, occasionally, genetic conditions. The disease is severely underdiagnosed and underrecognized.