Industry Research

Tutorials

Published in 2007

Miller S, Hoffman T, Houts J, Miller J, Pim B, Behm A. The Rise of Specialty Pharmacy Costs: Issues for Providers, Payers, and Patients. Disease Management & Health Outcomes;15(2):83-89, 2007.

The growth of specialty medication costs is having a visible impact on the market. These drugs — the products of groundbreaking scientific and technological advances in medicine — offer tremendous promise for the treatment of serious debilitating and life-threatening illnesses; however, the average treatment cost per patient for these medicines is about $18,000 per prescription per year and their use is rapidly growing. This article reviews the unique characteristics of specialty drugs, their profound medical potential, as well as how their cost, complexity, and reimbursement structure are producing unique issues for physicians, plans, and patients. Misaligned interests and incentives are identified as challenges that can affect the dynamic between these constituents whose working relationships are critical to the health system. Resulting mismanagement of specialty drugs could lead to higher costs and reduced outcomes. While society stands to benefit significantly from specialty drugs, investment is needed in programs that align interests and enhance coordination between physicians, payers, and patients. Such programs will drive clinically appropriate, cost-effective use of these medications to ensure the greatest benefit. Among these proposed programs are the development of care guidelines that are customized to patients prescribed specialty medications, the implementation of cost-management programs, timely patient support and education, and the development of effective utilization management programs that clearly define the intent of specialty drug use.

Published in 2003

Motheral BR, Brooks J, Clark MA, Crown WH, Davey P, Hutchins D, Martin BC, Stang P. A Checklist for Retrospective Database Studies—Report of the ISPOR Task Force on Retrospective Databases. Value In Health 2003;6(2):90-97.

Although health-related retrospective databases, claims databases in particular, continue to be a significant data source for outcomes research, they pose many practical challenges. A 27-question checklist was developed in regards to database research or database studies, to guide decision makers as they consider the database, the study methodology, and the study conclusions. A wide range of issues, from data linkages to data interpretation, are covered by the checklist questions.

Published in 2001

Cox ER, Schafermeyer K. Pharmacoeconomics In: R. McCarthy and K. Schafermeyer (eds.) Introduction to Health Care Delivery: A Primer for Pharmacists, 2001.

Motheral BM, Schafermeyer K. Managed Health Care In: R. McCarthy and K. Schafermeyer (eds.) Introduction to Health Care Delivery: A Primer for Pharmacists, 2001.

Published in 2000

Fairman KA, Motheral BR. Evaluating medication adherence: Which measure is right for your program? Journal of Managed Care Pharmacy 2000; 6(6):499-506.

Measuring medication adherence is becoming increasingly important to inform both clinical programs and cost containment policy debate. None of the methods for measuring medication adherence constitutes a "gold standard." Choosing an appropriate measure for a program depends largely on the program's purpose as well as on available resources. This article reviews strengths and limitations of various measures for different types of programs. For those situations in which using prescription claims data is appropriate, the article reviews techniques for dataset preparation and calculation of various claims-based measures.

Teitelbaum F, Roe CM, Fendrick AM. Pharmacy management trends: A guide for new physicians. Seminars in Medical Practice 2000;3:29-39.

Physicians entering the workforce often are unaware of the actual costs associated with pharmaceutical therapies. Although the rate of growth in healthcare spending per capita has been slowing somewhat in recent years, the rate of increase in pharmaceutical costs has been rising and is expected to continue climbing. To cope with this rising financial burden, payers have designed strategies to mitigate pharmacy costs. Many of the methods used to manage pharmaceutical costs have a direct impact on physicians, either by restricting the drugs they can prescribe or by holding them accountable for keeping drug costs down among their patients. This article reviews factors that have contributed to rising pharmacy costs and explores the impact that direct-to-consumer advertising has had on patient demand for pharmaceutical products. Current strategies used to better manage pharmacy benefits are also reviewed.

Published in 1999

Fairman KA. Going to the source: A guide to using surveys in health care research. Journal of Managed Care Pharmacy 1999;5(2):150-159.

Published in 1998

Motheral BR. Research methodology: Hypotheses, measurement, reliability, and validity. Journal of Managed Care Pharmacy. 1998;4(4):382-390.

Motheral BR, Schafermeyer KW. Managed Care. In: The U.S. Healthcare System: A Primer for Pharmacists, Aspen Publishers, 1998.

North American Menopause Society Consensus Panel. Achieving long-term continuance of menopausal ERT/HRT: Consensus opinion of the North American Menopause Society. Menopause 1998;5:69-76.

Motheral BR. Outcomes management. Hospital Pharmacy 1998;33:240-243.

Published in 1997

Fairman KA. "The doctor told me to cut the pills in half": Practical considerations in using claims databases for the outcomes research. Drug Benefit Trends 1997; 9(10): 30-35,39.

Motheral BR. Outcomes Management: The why, what, and how of data collection. Journal of Managed Care Pharmacy. 1997;3(3):345-351.

Motheral BR, Fairman KA. The use of claims databases for outcomes research: Rationale, challenges, and strategies. Clinical Therapeutics. 1997; 19(2):346-366.

 

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