scholarly journals Impact of Pharmacy Benefit Managers on Oncology Practices and Patients

2020 ◽  
Vol 16 (5) ◽  
pp. 276-284 ◽  
Author(s):  
Trevor J. Royce ◽  
Caroline Schenkel ◽  
Kelsey Kirkwood ◽  
Laura Levit ◽  
Kathryn Levit ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Prescription Drugs ◽  
Business Practices ◽  
Pharmacy Benefit ◽  
Drug Benefits ◽  
Quality Cancer Care ◽  
Number Of Patients ◽  
Oncology Care ◽  
The Impact

Pharmacy benefit managers (PBMs) are thoroughly integrated into the drug supply chain as administrators of prescription drug benefits for private insurers, self-insuring business, and government health plans. As the role of PBMs has expanded, their opaque business practices and impact on drug prices have come under increasing scrutiny. PBMs are particularly influential in oncology care because prescription drugs play a major role in the treatment of most cancers and an increasing number of patients with cancer are treated with oral oncology agents managed by PBMs. There is concern that some PBM practices may threaten access to high-quality cancer care and may increase the financial and administrative burden on patients and practices. In this article, we review the role of PBMs in prescription drug coverage and reimbursement, discuss the impact of PBMs on oncology care, and present data from the 2018 ASCO Practice Survey assessing the knowledge and attitude of oncology practices toward PBMs.

scholarly journals Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Kristine Rømer Thomsen ◽  
Birgitte Thylstrup
Keyword(s):  
Side Effects ◽  
Drug Use ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Online Survey ◽  
Convenience Sample ◽  
Patient Organizations ◽  
Public Media ◽  
Prescription Drug Use ◽  
The Impact

Abstract Background The use of cannabis as medicine (CaM) both prescribed and non-prescribed has increased markedly in the last decade, mirrored in a global shift in cannabis policy towards a more permissive stance. There is some evidence that cannabis functions as a substitute for prescription drugs, particularly opioids; however, more knowledge is needed on the motives of substitution users, their patterns of use, and perceived effects of substitution use. Aims To explore who substitutes prescription drugs with cannabis, the type of prescription drugs substituted and the type of cannabis used, and the impact that substitution with cannabis has on prescription drug use as well as the motives for substitution in terms of experienced effects and side effects. Methods A self-selected convenience sample was recruited through social media, public media, and patient organizations to take part in an anonymous online survey. Inclusion criteria were 18 years or older and use of cannabis (prescribed or non-prescribed) with a medical purpose. Results The final sample included 2.841 respondents of which the majority (91%) used non-prescribed cannabis, and more than half (54.6%) had used CaM with the purpose of replacing a prescribed drug. Compared to non-substitution users, substitution users were more likely to be women and to use CaM in the treatment of chronic pain and other somatic conditions. Pain medication (67.2%), antidepressants (24.5%), and arthritis medication (20.7%) were the most common types of drugs replaced with CaM. Among substitution users, 38.1% reported termination of prescription drug use, and 45.9% a substantial decrease in prescription drug use. The most frequent type of cannabis used as a substitute was CBD-oil (65.2%), followed by ‘hash, pot or skunk’ (36.6%). More than half (65.8%) found CaM much more effective compared to prescription drugs, and 85.5% that the side effects associated with prescription drug use were much worse compared to use of CaM. Conclusion CaM is frequently used as a substitute for prescription drugs, particularly opioids. More research is needed on the long-term consequences of use of CaM, including the impact from low and high THC cannabis products on specific somatic and mental health conditions.

scholarly journals Prescription Opioid Abuse: Gleaning insights from hospital and vital records data

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Reka Sundaram-Stukel ◽  
Ousmane Diallo ◽  
Benjamin Wiseman ◽  
Richard E. Miller
Keyword(s):  
Mental Health ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
The United States ◽  
Hospital Charges ◽  
Prescription Opioids ◽  
Opioid Prescription ◽  
Discharge Data ◽  
Operative Recovery ◽  
The Impact

ObjectiveIn this paper we used hospital charges to assess costs incurred dueto prescription drug/opioid hospitalizationsIntroductionThere is a resurgence in the need to evaluate the economic burdenof prescription drug hospitalizations in the United States. We used theWisconsin 2014 Hospital Discharge data to examine opioid relatedhospitalization incidence and costs. Fentanyl, a powerful syntheticopioid, is frequently being used for as an intraoperative agent inanesthesia, and post-operative recovery in hospitals. According to a2013 study, synthetic Fentanyl is 40 times more potent than heroinand other prescription opioids; the strength of Fentanyl leads tosubstantial hospitalizations risks. Since, 1990 it has been availablewith a prescription in various forms such as transdermal patches orlollipops for treatment of serious chronic pain, most often prescribedfor late stage cancer patients. There have been reported fatal overdosesassociated with misuse of prescription fentanyl. In Wisconsin numberof total opioid related deaths increased by 51% from 2010 to 2014with the number of deaths involving prescription opioids specificallyincreased by 23% and number of deaths involving heroin increasedby 192%. We hypothesized that opioids prescription drugs, as a proxyof Fentanyl use, result in excessive health care costs.MethodsOpioid hospitalizations was defined as any mention of the ICD9codes (304,305) in any diagnostic field or the mention of (:E935.09) onthe first listed E-code. Our analysis used the Heckman 2-stage model,a method often used by Economists in absence of randomized controltrials. In presence of unobserved choice, for example opioid relatedhospitalizations, there usually is a correlation between error in anunderlying function (fentanyl prescription) and an estimated function(hospital charges) that introduces a selection bias. Heckman treats thiscorrelation between errors as an omitted variable bias. Therefore, weestimate a Heckman two step model using hospitalization: where theselection function is the probability of being hospitalized for syntheticopioid via logistic regression. Finally, we estimate the hospitalcharges realized if the patient was given opioids.ResultsMale patients are significantly more likely to be hospitalized foropioids than are female patients; while white patients are significantlymore likely to be admitted for opioid usage than other racialgroups. We also find that comorbid factors, such as mental health,significantly impact hospital charges associated with opioid use. Wefind that persons with private health insurance are associated withhigher rates of opioid use.ConclusionsUsing a Heckman two step approach we show that comorbidconditions such as mental health, Hepatitis C, injuries, etc significantlyaffect hospital charges associated with hospitalization. We usethese findings to explore the impact of the 2013 rule mandatingdoctors share opioid prescription information on the incidence ofopioid related death and hospital charges associated with opioidprescriptions. This work is policy relevant because alternatives toopioid prescription such as meditation, pain management therapiesmay be relevant.

scholarly journals A role of anesthesiologist in reducing surgical bleeding in endoscopic sinus surgery

Medicina ◽  
2010 ◽  
Vol 46 (11) ◽  
pp. 730 ◽  
Author(s):  
Darius Činčikas ◽  
Juozas Ivaškevičius ◽  
Jonas Martinkėnas ◽  
Svajūnas Balseris
Keyword(s):  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
Surgical Bleeding ◽  
Surgical Field ◽  
The Impact

Visibility in the surgical field reduced by bleeding is one of the most important problems of endoscopic sinus surgery. It causes the risk of serious complications and reduces intervention quality. Recently, an increasing number of patients undergo surgical interventions under general anesthesia. Since general anesthesia may influence surgical bleeding in physiological and pharmacological pathways, the role of an anesthesiologist is extremely important in reducing bleeding. The impact of different anesthesia methods on quality of the surgical field is being investigated, and the most effective medicines are being sought.

scholarly journals A conceptual framework for the role of leadership in financial innovation adoption in the Australian banking industry

2021 ◽  
Vol 8 (3) ◽  
pp. 192-205
Author(s):  
Qaisar Ali ◽  
Shazia Parveen
Keyword(s):  
Conceptual Framework ◽  
Professional Growth ◽  
Leadership Practices ◽  
Banking Industry ◽  
Financial Innovation ◽  
Innovation Adoption ◽  
Business Practices ◽  
Sustainable Leadership ◽  
The Impact

Despite being known as one of the most innovative countries in the world, innovation in Australia has remained stagnant since the 1990s. The main objective of this study is to analyse and evaluate the role of leadership in financial innovation adoption in the Australian banking industry. Specifically, this study focuses on exploring the drivers of innovation, testing the skill and knowledge of leaders to adopt an innovation, the impact of different leadership styles on innovation, and based on the nature of innovation propose the suitable leadership framework for Australian banks using a conceptual framework. The findings of this study are expected to allow Australian banks in evaluating their leaders’ role and formulate relevant strategies to ensure successful innovation adoption. It is projected that the findings will be robust for the businesses as the internal and external shareholders working with leaders to enhance organizational performance can befit from the insight provided in this study. Moreover, this study is projected to assist in charting directions for business leaders in the context of effective leadership practices necessary for improving employees’ retention, profitability, and growth which will ultimately contribute to business practices. The findings will help in providing a better understanding of leadership practices required for leaders’ professional growth which may create more job opportunities. The leaders may learn the ethical and sustainable leadership practices to meet the social expectations through compact strategies which may contribute to social change.

scholarly journals Non-Prescription Drug Distribution in Italy: The Role of Large-Scale Retailers

2017 ◽  
Vol 13 (31) ◽  
pp. 7 ◽  
Author(s):  
Sabina Riboldazzi
Keyword(s):  
Supply Chain ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Large Scale ◽  
Drug Distribution ◽  
Retail Market ◽  
Pharmaceutical Supply Chain ◽  
Distribution Phase ◽  
Regulatory Actions

In recent years, a series of regulatory actions have reformed the Italian pharmaceutical supply chain, particularly that of non-prescription drugs. The present study analyzes the distribution phase of non-prescription drugs. Specifically, it focuses on the retail market of pharmaceuticals in Italy, highlighting the different sales formats and the role played by those large-scale retailers that have been able to develop new pharmaceutical offerings in their point of sales through dynamic management of retailing mix levers in a competitive perspective.

The Role of Low Molecular Weight Heparin in Pregnancies of Patients with Inherited Thrombophilia that Have Presented (and) Thrombotic Complications During Previous Pregnancies

2018 ◽  
Vol 68 (12) ◽  
pp. 2970-2973
Author(s):  
Melinda Ildiko Mitranovici ◽  
Lucian Puscasiu ◽  
Marius Craina ◽  
Daniela Iacob ◽  
Veronica Daniela Chiriac ◽  
...  
Keyword(s):  
Premature Birth ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Thromboembolic Disease ◽  
Low Molecular Weight ◽  
Inherited Thrombophilia ◽  
Number Of Patients ◽  
Thrombotic Complications ◽  
The Impact

What is presently known is that thromboembolic disease represents a major cause of morbidity and mortality during pregnancy. To this we add a rare but not negligible pathology, acquired and inherited thrombophilia, which increases the predisposition for thrombotic events during pregnancy. In this article, what has been studied is the impact that LMWH has on patients with inherited thrombophilia, both the conventional FV, FII and the newly introduced MTHFR, PAI, FXII, factors which are often combined.81 patients have been taken into consideration / included in study, with the following anterior results, before the patients discovered their illnesses, thus before following treatment: first trimester or advanced pregnancy loss, IUGR, premature birth or secondary placental thrombotic complications such as: preeclampsia, DPPNI or dead fetuses, as well as maternal thrombotic accidents. The administration of LMWH decreased the rate of pregnancy loss compared to untreated pregnancies is statistical significant (p= 0.004), there were fewer DPPNI (p= 0.006), and no intrauterine deaths. We also compared the occurrence of thrombotic events during treated and untreated pregnancies and we observed significant differences in this groups (p= 0.001). There was also a sufficient number of patients with new types of thrombophilia included in the study to demonstrate the impact it has on pregnancy. LMWH improves the situation of women with thrombophilia during pregnancy.

Educating Pharmacists on a Prescription Drug Monitoring Program

2016 ◽  
Vol 29 (6) ◽  
pp. 543-548 ◽  
Author(s):  
Marc L. Fleming ◽  
Yen Phan ◽  
Erin A. Ferries ◽  
Mark D. Hatfield
Keyword(s):  
Prescription Drug ◽  
Prescription Drugs ◽  
Education Program ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Cross Sectional Survey ◽  
Prescription Drug Monitoring Program ◽  
The Impact

Objective: To provide education to community pharmacists regarding the registration and use of the Texas prescription drug monitoring program (PDMP) and to assess the impact of the education on pharmacists’ perceptions of the PDMP. Method: The study design was a descriptive, pre and post, cross-sectional survey conducted among community pharmacists attending a PDMP education program. The program was designed to present the PDMP as a public health tool available to assist pharmacists with dispensing decisions related to controlled prescription drugs. Results: Of the 24 pharmacists who completed the survey, 23 were already registered to use the PDMP. However, all 23 felt that the program successfully educated users regarding the PDMP and agreed that other community pharmacists would benefit from the program presented. After the program, 14 participants responded they would very likely use the PDMP in the next 30 days. Recognition of the use of PDMPs as a program for both pharmacists and physicians was increased from 12.5% (pre) to 73.9% (post). Conclusion: Pharmacists found the educational program beneficial and they were very likely to use the PDMP in the future. Perceptions of the Texas PDMP were changed from pre- to post-education program, with recognition that a PDMP can be a beneficial tool for pharmacy practice.

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