Pharmocoeconomics and Managed Care

The world of medicine is changing rapidly, a great deal of which change is being forced by economic considerations. We can no longer afford to wait years to decide which therapies are the most effective. It is particularly important for managed care companies to determine the best ways to treat patients since they have declared their ability to maintain their enrollees health in the least costly manner. Part of this drive for more cost-effective medical care is centered in the area of the pharmacy. As drug herapies have become more expensive, the need to use only what is necessary and efficacious has assumed greater importance. Pharmacoeconomics has become a vital part of the economic management of medical care. Keeping up with the latest information in this area is essential for providers and students and this web site can help by providing assistance in locating items that exist on the internet concerning this topic.

Documents

Center for Pharmaceutical Outcomes Research (CePOR)
This is a page set up by the School of Pharmacy at the University of North Carolina at Chapel Hill. It describes the mission of a new pharmacoeconomics group called the Center for Pharmaceutical Outcomes Research that will be doing studies to determine the costs versus benefits of various drug therapies. It is not specific to managed care but I'm sure its research and conclusions will be very important to insurers of all types. The mission statement specifically states that they are dedicated to contributing "to the improvement of patient health outcomes primarily related to potential or actual use of pharmaceuticals." Activities of the Center include setting up a short course in pharmacoeonomics for government representatives, research organizations, providers, payers, and others in the health care industry. They will also sponsor periodic seminars on research topics and publish a newsletter. While the page does not currenly contain any definitive information, the potential for the future is great and it would be an important page to monitor periodically.
Department of Pharmaceutical Policy and Economics at USC Pharmacy
This is a page that contains information about research being done on medical outcomes of drug therapy. It listed a good number of studies with abstracts of the findings. It did not specifically pertain to managed care but the results had implications for the future use of drugs in all settings. All of the studies pertained to economics of the drug therapy as well as the efficacy and provided interesting insights into the interrelationship between the two concerns.
http://www.medana.unibas.ch/eng/papers/cb9395.htm
This is a site that is a compilation of abstracts of articles on cost-effective medical practice in general. I am not sure who organized it, but it did have a great deal of relevant information about costs and benefits for all types of health care. There was an article in it on my topic of cost-benefit research on drug therapy. However, I had to scroll through a long list of article abstracts to get to it and I'm not sure the entire article was available. I think it just gave information on where the article could be found. If you are researching a topic for which it is difficult to locate information, it would be a useful site to know about. However, I would give it only two stars since the information it provides is limited and not easy to locate within it.
Maxim #5: Managed Care May Threaten The Health Of Elderly Enrollees
This is a page set up by a group called Physicians Who Care. They are obviously unhappy with the idea of managed care and present their conclusions on why managed care may threaten the health of elderly enrollees. They cite a series of investigative reports done by a South Florida newspaper that claimed to demonstrate numerous incidents in which a managed care company compromised their enrollees' health for the bottom line. One of these incidents involved a managed care company recommending the more cost-effective testicle removal for prostate cancer rather than the continued use of an expensive drug. This page is interesting more for its demonstration of physician feeling about managed care than for what it says about on costs versus benefits. I would still recommend monitoring it in the future since it presents the negative side of the search for cost-effective treatment.
What is Cost-Effective Medical Care?
This is a page set up by a company that specializes in Medical Economics. It discusses cost effectiveness analysis which is a method designed to answer the question of which treatments should be paid for to maximize a population's health if all treatments cannot be afforded. They put it in laymen's terms as the "biggest bang for the buck." The conclusions that one can draw from a study based on cost effectiveness analyis can be very chilling, since there is no emotion or ethics involved in the analysis. There would be a definite element of health care rationing involved if the results of such analyis were used to make actual health care decisions. They specifically discuss a hypothetical case where the decision to use a less effective drug for pneumonia might be made if it were determined that the dollars saved would be better spent on prenatal care. Although I don't believe the United States is ready for this kind of health care rationing, the page raises important questions that need to be discussed.

Sites

HEALTH-ECONOMICS RESOURCE PAGE
Although it is titled as a page, this would seem to me to meet the definition of a site. It contains links to many topics pertaining to the main topic of Health Economics. One such link lists Health Economics Policy and Medical Outcomes Sources which includes a page called Antibiotics Utilization Guidelines from the Medical College at the University of Wisconsin. This page provides information to promote cost-effective use of antibiotics. This site is not specific to managed care but contains valuable information on the cost-benefits of drug therapies that would be useful to any insurer. The site is easy to use moving back and forth between linked pages and contains something for everyone interested in any aspect of health care economics. I would rate it five stars for the above reasons.
Medscape
Medscape is a site with a great deal of varied information. It requires you to register in order to use it, but there is no charge involved. It was very easy to use and provided several pages of information on my topic as well as pages that referred me to other good sites. It seemed to come up no matter how I searched, since there is so much available information on it. Once you register, Medscape sends you Email on their latest articles which I have found very interesting. (You can request them not to send these messages if you wish) I would rate it five stars both for ease of use and quality of information.
Pharmacy department University of Groningen
This is a site containing lists of links to many pages involving pharmacy issues. The number of links is a manageable one and all seem to be of value. Those who set up the site appear to have actually looked at the pages or sites that are listed to make sure they should be included. The links are divided into topic areas that make it easy to find the area you are interested in researching. I found information on pharmaceutical outcomes research not necessarily linked to managed care. I would rate this site as four stars for relevance of material and ease of use.
PHARMACY, MEDICINE AND MANAGED CARE
This is a site that contains just about everything available on the internet that has anything to do with pharmacy. There is a lot of links that seem to be totally useless to anybody and this means there are a lot to wade through to find what you need. However, among the links are several that have to do with outcomes research and several that have to do with managed care. I did not find any that contained the two together, but there were so many possible pages and sites, I'm sure one existed somewhere. This is a problem that I found to be very common on the internet. People who set up sites are so intent on being comprehensive that they lose site of what their purpose is which should be to provide information to those who need it. Instead they want to be everything to everybody. This site does contain some useful information but it is too time consuming to locate. Therefore, I would give it only two stars.
Texas Department of Health
This is a page maintained by the Texas Department of Health. It describes a Medicaid program that it has instituted to manage the costs of drug therapies more economically for Medicaid recipients. The methods used to achieve this are provider education, contracts with private pharmacies to set prices, and a statewide network of pharmacists to provide assistance and consultation to clients, providers, and pharmacists. There is no information given on how the program is working even though it has been available since 1994. Because of this, the information is interesting but not very useful.

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