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How Drug Cost Influences Drug Selection
Zachary T. Bloomgarden, MD, MACE: Very few of my patients are sufficiently wealthy and have sufficiently wonderful managed care pharmacy benefit plans [such] that they can take any drug under the sun and I don’t have to worry about it.
For most individuals with diabetes, we have to realize that they’re taking 1 or 2 lipid-lowering drugs, 2 or 3 diabetes drugs, 2 or 3 blood pressure drugs, often a low-dose aspirin, [and] often a proton-pump inhibitor (although we’re learning that these have some undesirable effects). Often, because of the very high prevalence of anxiety and depression, they take psychoactive drugs. So, these are individuals [who] are not just treated with 1 drug, but they take multiple therapeutic agents.
So, cost is, of course, an issue. If you have a drug that costs $500 or $600 a month, and you expect an individual with diabetes to buy 5 or 6 of them, we’re probably going to be outside the range [within which] that individual can afford [treatment]. [Therefore], we always work very hard with managed care. We work very hard with the patient, but we have to realize that there simply are some cheap drugs that turn out to have a lot of side effects. My personal perspective is that sulfonylureas and NPH (neutral protamine Hagedorn) insulin are drugs that should not be used for treatment of type 2 diabetes.
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Pegcetacoplan for PNH More Cost-Effective Than Anti-C5 Monoclonal Antibodies
April 18th 2024A cost-utility analysis conducted from the perspective of the Italian health system found that pegcetacoplan was more effective and less costly than 2 complement 5 (C5) inhibitors for the treatment of paroxysmal nocturnal hemoglobinuria (PNH).
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Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
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Collecting SDOH Data Can Assess Risk of Medical Nonadherence, Improve HEI and Star Ratings
April 18th 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, a panel of presenters explored changes coming to Medicare that incorporate social determinants of health (SDOH) data to improve patient and health system outcomes.
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Many Patients With Psoriasis in Clinical Trials Experience Nocebo Effects, Study Finds
April 18th 2024Half of patients exposed to placebo in clinical trials experienced adverse events (AEs), which may be partially explainable by nocebo effects, according to a recent review and meta-analysis.
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