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Pharmaceutical Benefits 2003 Formulary Prior Authorization Formulary: State has a formulary. Prior authorization is used to manage the formulary. Fair hearing process to appeal prior authorization decision. Prescribing or Dispensing Limitations Prescription Refill Limit: Refills to a maximum of 5 are allowed. Monthly Quantity Limit: One month's supply for non-maintenance drugs. One inhaler per fill. 8 tablets per month for erectile dysfunctions medication. Maintenance Medication: The attending physician may prescribe certain maintenance drugs of 100 tablets, capsules or pint of liquid or a 30-day supply of these drugs - whichever is greater. Monthly Dollar Limits: None Drug Utilization Review PRODUR system implemented in December 1994. State has a DUR Board that meets quarterly. Pharmacy Payment and Patient Cost Sharing Dispensing Fee: $3.40 ambulatory ; and $2.85 nursing homes ; , effective 1987. Ingredient Reimbursement Basis: EAC WAC + 5%. Prescription Charge Formula: 1. In accordance with Federal regulation the upper limit for payment for prescribed drugs will be based upon the amount allowed by the Medical Assistance Program or the usual and customary charge to the general public, whichever is lower. 2. Payment for over-the-counter drugs non-legend drugs ; will be based upon the lower of either the allowable cost of the drug plus 5 percent, the usual and customary charge to the general public, or the allowable cost plus the professional fee for service.
Suppressive therapy is intended for patients with frequently recurring genital herpes, generally for those with recurrences at least every 2 months or 6 times per year. In such patients, suppressive therapy is preferred to episode therapy14 and improves quality of life.15 For individuals with fewer than 6 recurrences per year or 1 every 2 months, episode therapy is recommended see Table 12 ; . However, suppressive therapy will probably be efficacious and may be considered on a case-by-case basis.
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Aetna has told doctors nationwide that prescriptions for the popular antihistamines allegra, clarinex or zyrtec will require special approval, beginning jan and clindamycin.
Clarinex is a new brand but with similarities to claritin.
INTRODUCTION: A predictive model was developed to identify frequent users of emergency department ED ; services among psychiatric patients for early intervention and to decrease excess resource utilization. METHODS: A retrospective cohort analysis of psychiatric patients in a Medicaid managed care organization MMCO ; was performed. Members were identified with at least one medical claim for a psychiatric disorder ICD-9 code 295.xx - 299.xx ; , and medical and pharmacy claims were compiled from the 1998 calendar year. Demographics, comorbidities, medical utilization and medications were tested as predictors for utilization of ED services. T-tests and Pearson correlation coefficients were calculated to measure associations between independent variables and ED utilization. Ordinary least squares multiple regression analysis was performed on all variables with significant associations. Variables with significant F-ratios in the regression analysis were retained as factors in a risk model, and their additive and cumulative effects were evaluated. RESULTS: Four variables were significant predictors of ED utilization: prior number of ED visits, prior number of hospitalizations, history of alcohol abuse, and history of depression. ED utilization increased as the number of risk factors increased: with no risk factors, mean ED use is 0.58 visits per 6 months ; while the cumulative effects of all four factors equal 8.5 ED visits. CONCLUSIONS: Previous resource utilization ED visits and hospitalizations ; as well as comorbidities of alcohol abuse and depression significantly increase the use of ED services among psychiatric patients. Early identification of these high risk patients may lead to improved management and reduced use of ED services. LEARNING OBJECTIVES: Audience participants will: 1. Discuss variables that may be associated with and predictive of increased use of ED services. 2. Describe risk factors correlated with excessive and costly ED use. 3. Understand the benefits of early intervention related to patient care and reduction of medical costs. 4. Increase knowledge of methods for developing predictive models using managed care claims and administrative data.
Details of forelimb and hindlimb regional and intrasynovial analgesia are given in Table 15.1.
And the decongestant efficacy of clarinex-d 24 hour, when measured by nasal congestion, was significantly greater than desloratadine during the treatment period.
Characteristic Age, mean, y Female, % Covered by Medicaid, % Canister equivalents per 12 mo, mean Reliever agent Controller medication Subjects who met HEDIS criteria, no. % ; Subjects with persistent asthma per HEDIS criteria ; who were dispensed controller medication, no. % ; n 1532 ; 8.8 60.1 7.5 n 1234 ; 8.8 61.4 8.4, for instance, claratin.
Elation, sadness, anxiety, grief--we all feel these emotions at various times in our lives. Sadness may be caused by a setback or a loss, for instance, and anxiety may be triggered by a threat or a challenge. It is perfectly natural for our emotions to wax and wane according to the ups and downs of our lives. The difficulty comes when these feelings persist--or when they occur spontaneously, seemingly out of the blue--and begin to interfere with our ability to function. When that's the case, a mood disorder which includes depression and bipolar disorder ; or an anxiety disorder may be present. In any given year, about one in four Americans develops at least one mental health disorder, according to a national assessment. Nearly one in two Americans develops a mental health disorder at some point in their lives. Luckily, effective treatments are available. Proper diagnosis and treatment of mood disorders lead to a remission of symptoms in about 80% of cases. This White Paper describes the causes, symptoms, diagnoses, and treatments of depression, bipolar disorder, and anxiety disorders.
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LEWIS, B. 2001 ; : Therapeutic guideline development for integration with general practice information systems. Realising Quality Healthcare: Health Informatics Conference. LEWIS, B. 2002 ; : Extraction of XML from relational databases. XML Based Data Management XMLDM ; , SpringerVerlag. AMERICAN SOCIETY FOR TESTING AND MATERIALS 1992 ; : Standard specification for defining and sharing modular health knowledge Bases Arden syntax for medical logic modules ; . ASTM Standards 14 1 ; : 539587. MEDLINE 1997 ; [electronic resource]. Bethesda, Md., National Library of Medicine. NOLAN, A., NORQUAY, C. et al. 1999 ; : Electronic prescribing and computer-assisted decision support systems. Medical Journal of Australia 171: 541543. OHNO MACHADO, L., GENNARI, J. H. et al. 1998 ; : The guideline interchange format: A model for representing guidelines. Journal of the American Medical Informatics Assocation 5 4 ; : 357372. PELEG, M., TU, S. et al. 2002 ; : Comparing models of decision and action for guideline-based decision support: a casestudy approach Part 1 of 2 ; , Stanform Medical Informatics. SCHWEIGER, R., HOELZER S. et al. 2002 ; : Plug-and-Play XML: A Health Care Perspective. J. Am. Med. Inform. Assoc. 9 1 ; : 3748. SHAHAR, Y., MIKSCH, S. et al. 1998 ; : The Asgaard project: a task-specific framework for the application and critiquing of time-oriented clinical guidelines. Artificial Intelligence in Medicine 14 12 ; : 2951. WANG, D., PELEG, M. et al. 2002 ; : Representation primitives, process models and patient data in computer-interpretable clinical practice guidelines: A literature review of guideline representation models. International Journal of Medical Informatics. WOLLERSHEIM, D. 2001 ; : A review of decision support formats with respect to therapeutic guidelines limited requirements. Health Informatics Conference. Canberra, Health Informatics Society of Australia Ltd. WRITING GROUP FOR THERAPEUTIC GUIDELINES: ANTIBIOTIC. THERAPEUTIC GUIDELINES LIMITED 2000 ; : Therapeutic Guidelines: Antibiotic. North Melbourne, VIC., Therapeutic Guidelines Limited.
The Panel noted that Gilead Sciences, in addition, alleged that the claim at issue was misleading as it implied that survival benefit had been demonstrated in trials other than Herbrecht et al. The Panel considered that whilst the claim was referenced only to Herbrecht et al, the use of the plural, trials, implied that there was more than one study to substantiate the claim. The Panel considered, on the evidence before it, that the claim at issue was misleading and not capable of substantiation in this regard; a breach of the Code was ruled. Gilead Sciences alleged that the claim `This survival translates into a substantial advantage for effectiveness in cost-effectiveness analysis' did not identify the product to which Vfend had been compared and thus was a hanging comparison which was misleading in breach of the Code. Additionally at present, no definitive publication or analysis had been conducted to demonstrate that a 12-week survival improvement resulted in a `substantial' advantage in cost. Gilead Sciences thus alleged that this was an exaggerated claim which could not be substantiated. The Panel noted that the claim at issue immediately followed one which compared Vfend and amphotericin B in relation to efficacy and improvement in survival. The claim at issue then began `This survival .', thus clearly referring to the comparison in the preceding sentence. The Panel thus did not consider that the claim was a hanging comparison as alleged. No breach of the Code was ruled on this point. The Panel acknowledged the difficulty of treating systemic fungal infections. Such infections were associated with a high mortality rate. Pfizer submitted that the 12 percent survival benefit over 12 weeks was a substantial and significant effectiveness advantage in the context of treating invasive aspergillosis infections. The Panel considered that whilst a 12 percent survival benefit over 12 weeks would have cost implications no data had been provided to substantiate this point. Pfizer had stated that the advertorial postulated that the efficacy advantages for Vfend observed by Herbrecht et al were likely emphasis added ; to lead to a favourable cost effectiveness ratio. The claim at issue, however, implied that a formal pharmacoeconomic evaluation had been undertaken which had shown a cost effectiveness advantage for Vfend versus amphotericin B; that was not so. The claim was incapable of substantiation, misleading and exaggerated as alleged. Breaches of the Code were ruled. Gilead Sciences alleged that the claim `Voriconazole is likely to reduce overall cost as well' implied that Vfend could potentially reduce overall cost in comparison to another agent. Neither a comparator product nor appropriate reference was cited. Gilead Sciences alleged that this statement was not capable of substantiation. Gilead Sciences also noted its general comments about pharmacoeconomic claims. In intercompany correspondence Pfizer had stated that the sentence directly beneath the claim at issue highlighted that this related to a comparison of.
Where response is slow or incomplete, the difficulty lies in the family dynamics. Healthy changes in the child's behavior and attitudes may actually precipitate negative parental response and family instability, creating insecurity that serves as a roadblock to further positive changes. Such a child would likely respond more favorably if the parents also received appropriate flower essences and or family counseling. In this way, the parents could see how their attitudes and behaviors contribute to the child's issues and hinder resolution. In seriously dysfunctional families, children often exhibit more complex imbalances such as compensation and de.
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A New Wave of Medical Humanism Andrei I. Metelitsa and Dr. Benjamin Barankin Myth Busting: Can It Make a Difference? Tony Nickonchuk.
Last but not least, the case studies show us that it is not unusual that the companies involved have had contacts prior to the takeover. Hence, the eyecare unit of Finnish Leiras had already been participating in R&D projects led by Japanese Santen Ltd. Icelandic Computer Knowledge Inc was very dependent on Eastman Kodak's Health Imaging Division for a long time before the takeover, as Health Imaging had been the exclusive distributor of the Icelandic company's product internationally. Iceland's pharmaceutical case also supports this argument.
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TRAUMEEL: 1 ampoule 2x day + ZEEL 1 ampoule or DISCUS COMP. 2x day for 5 days + 1 tablet of TRAUMEEL and 1 tablet of ZEEL 3x day. PALLIATIVE CARE WITH TOPICAL APPLICATION: Apply ZEEL Ointment to area of injury 1-2x day, optimally at night with a dressing. WHEN A NERVE IS THE MAIN PROBLEM HYPERICUM INJEEL: 1 ampoule 2x day + 1 ampoule TRAUMEEL 1x day for 5 days. If possible, and conducive to your practice, the first dose of HYPERICUM can be given s.c. around the affected area. PALLIATIVE CARE WITH TOPICAL APPLICATION: Apply TRAUMEEL Ointment or Gel to area as needed.
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