Peer-Reviewed Articles from Managed Care


Cost Comparison of Immediate One-Stage And Tissue-Expander Breast Reconstructions After Mastectomy in Commercially Insured Patients

There was little difference between the options in terms of the frequency and cost of return visits. Patients receiving one-stage reconstructions returned slightly less often for breast-related services during the first 18 months after reconstruction, but the difference was not statistically significant.

Navin K. Singh, MD; Nancy L. Reaven, MA; Susan E. Funk, MBA


The Incremental Value of Medical Nutrition Therapy in Weight Management

Overweight or obese patients who participated in a medical nutrition therapy benefit sponsored through their insurer were compared with individuals who did not participate. Outcomes, including weight change, body mass index, waist circumference, and physical exercise, were collected at baseline and 2 years later.

Donald W. Bradley, MD; Gwen Murphy RD, PhD; Linda G. Snetselaar, RD, PhD, LD; Esther F. Myers, PhD, RD, FADA; Laura G. Qualls, MHA


How Rebates, Copayments, and Administration Costs Affect the Cost-effectiveness of Osteoporosis Therapies

Using case studies, researchers assess the effect of rebate rates on the cost-effectiveness of two oral bisphosphonates that are competing for tier 2 positioning

Nicole C. Ferko MSc; Natalie Borisova PhD; Parisa Airia, PhD; Daniel T Grima, MSc; Melissa F Thompson, MBA


Health Care Resource Utilization and Costs Associated with Restless Legs Syndrome Among Managed Care Enrollees Treated With Dopamine Agonists

The researchers find that the costs of treating restless legs syndrome are fairly low, relative to the improved symptoms and associated health care outcomes, and are mainly attributable to prescription medication. Health plans are encouraged to expand coverage to reduce the associated suffering and costs.

Juliana Meyers, MA; Sean Candrilli, PhD; Richard Allen, PhD; Ranjani Manjunath, MPH; Michael Calloway, PhD


Comparing the Use of Intravenous Antibiotics Under the Medical Benefit With the Use of Oral Antibiotics Under the Pharmacy Benefit in Treating Skin and Soft Tissue Infections

Patients treated with oral linezolid, covered under the pharmacy benefit, had lower re-hospitalizations and emergency room visits than patients treated with vancomycin or daptomycin, covered under the medical benefit

John Barron, PharmD; Ralph Turner, PhD; Michael Jaeger, MD; Wallace Adamson, MD; Joseph Singer, MD


Hemoglobin A1c Outcomes and Health Care Resource Use In Type 2 Diabetes Mellitus Patients Treated With Combination Oral Antidiabetic Drugs Through Step Therapy And Loose-Dose and Fixed-Dose Combinations

This study verifies, as defined by current guidelines, that initial treatment with fixed dose combinations (FDC) is associated with a better likelihood of HbA1c goal attainment and lower health care resource use and costs.

Setareh A. Williams, PhD; Erin K. Buysman, MS; Erin M. Hulbert, MS; Joette Gdovin Bergeson, PhD; Bin Zhang, MD; John Graham, PharmD


Reviewing the Evidence for Using Continuous Subcutaneous Metoclopramide and Ondansetron To Treat Nausea & Vomiting During Pregnancy

A review of the available research identifies payment for services in the absence of high-quality scientific evidence and presents an opportunity to use evidence-based medicine to develop a clinical coverage guideline

James P. Reichmann, MBA; Michael S. Kirkbride, BSc, Pharm D


Clinical and Economic Outcomes of the Cincinnati Pharmacy Coaching Program for Diabetes and Hypertension

The program showed significant improvements in all diabetes and hypertension-related clinical measures

Debra Wertz, PharmD; Likun Hou, MS; Andrea DeVries, PhD; Leon Dupclay Jr., PharmD, PhD; Frannie McGowan, PharmD, CDE; Barry Malinowski, MD


Treatment Persistence & Health Care Costs of Adult MDD Patients Treated With Escitalopram Vs. Citalopram in a Medicaid Population

Escitalopram patients in a Florida Medicaid population had better treatment persistence and lower total health care costs than patients prescribed citalopram

Eric Q. Wu, PhD; Rym Ben-Hamadi, MSc; Mei Lu, MS; Nicolas Beaulieu, MA; Andrew P. Yu, PhD; M. Haim Erder, PhD


Strategies for Measuring Outcomes and ROI for Managed Care Programs

Determining return on investment and improvement of outcomes is essential when new programs are being tried, but the research method must be chosen carefully

Andrew Kolbasovsky, PsyD, MBA

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