Long-Term VA Study Raises the Bar for BP Control

In an 8-year study comprised of 15 veteran affairs (VA) medical centers across the country, the use of automated reminders for providers to control patient blood pressure (BP) resulted in an impressive rate of patients reaching adequate BP control.

President Obama guaranteed Americans that after health reform became law they could keep their insurance plans and their doctors. It is clear that this promise cannot be kept. Insurers and physicians are already reshaping their businesses as a result of Mr Obama's plan.

It is impossible to overstate the extraordinary range and complexity of the newly enacted health reform law. Taken together, the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA) will, for better or for worse, result in thousands of changes to the coverage, financing, regulation, payment, and delivery of healthcare services in the United States.

TO THE EDITOR: In reading your March/April 2010 issue, I could not help noticing that the study "Healthcare Costs Associated with Switching from Brand to Generic Levothyroxine"1 was funded by Abbott Laboratories, and 3 of the authors are paid consultants for Abbott.1 It amazes me that your publication would not recognize that these relationships pose a serious conflict of interest and not reject the publication of such a study, because of these inherent potential biases.

As the healthcare industry seeks to reduce the cost and improve the quality of care delivery, payment reform has moved to the forefront of the conversation. Among the many factors that are driving this focus on payment reform, 3 trends stand out.

First, the industry is moving away from rewarding activity and toward paying for outcomes, supporting advocates who express the notion that rewarding results is paramount. This is part of a larger shift in healthcare from providing "sick care" to promoting health and wellness.

Generic copay incentive programs, which incentivize users of brand-name medications to choose lower-cost generic medications, have gained popularity among pharmacy plan sponsors. Strategies such as these result in a reduction of overall pharmacy costs and a change in plan member behavior.

The goals of this study were to evaluate the impact of a generic copay incentive program on State Farm plan members and to compare the effect on the generic dispensing rate (GDR) for 1 versus 2 generic copay waivers provided by mail.

At the 2010 Digestive Disease Week (DDW), several presentations highlighted new approaches to the treatment of hepatitis C virus (HCV) infection. The burden of HCV is rapidly increasing as those infected with the virus years ago are becoming symptomatic. New treatments may soon offer hope where standard treatments have been failing, but the cost is expected to soar. David R. Nelson, MD, Professor of Medicine, University of Florida, Gainesville, suggested that within a few years we could "cure 60% to 80% of HCV patients with these new treatments."

A host of new studies with implications for payers and other healthcare stakeholders were presented at the 2010 Annual Meeting of the Academy of Managed Care Pharmacy (AMCP) in April in San Diego, CA. The following summaries highlight some of the major trends presented at the meeting.

Patient Out-of-Pocket Cost Affects Adherence to Oral Oncology Medications

At the 2010 annual meeting of the American Academy of Neurology (AAN), the largest explosion of new agents in development was for multiple sclerosis (MS), the second most common neurologic disability in young and middle-aged adults.

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