Since the 2006 launch of the Medicare Part D prescription drug benefit, the Centers for Medicare & Medicaid Services (CMS) has required all Part D sponsors, including Health Net, to offer free medication therapy management program (MTMP) services to members at high risk for drug-related problems.

Many women who are taking antidepressants discontinue therapy during pregnancy because of safety concerns. However, a study conducted in Canada demonstrates that the costs of discontinuing antidepressants are considerable. O’Brien and colleagues1 analyzed the direct medical costs associated with the discontinuation of antidepressant therapy in pregnant women in Ontario. They estimated that a relapse of depression occurred annually in about 2953 pregnant women who discontinued antidepressant therapy.

I hear from my physician friends that the “hassle factor” to obtain health plan coverage of prescribed therapy is increasing exponentially and that many of them are thinking of retiring or cutting back their practices. That is my experience and reaction as well.

As the number of biologic agents for rheumatoid arthritis (RA)-and rheumatologists’ use of these agents for RA and other rheumatological diseases-grows, getting coverage for RA treatment is taking an increasing investment of physicians’ staff time. However, the majority of respondents to a recent survey say it is an investment in patient care that is worth making.

Health care–associated pneumonia (HCAP) is a relatively new term used to describe pneumonia that develops in patients who have recently been exposed to nosocomial and drug-resistant pathogens as a result of hospitalization or residence in a nursing home, for example. A recent study found that about 25% of patients hospitalized with pneumonia had HCAP, and that the mortality rate was higher in those with HCAP than in those with community-acquired pneumonia (CAP).

The Federal Trade Commission (FTC) is strongly backing the argument that the economy is better off with competing generic drugs. In “Authorized Generics: An Interim Report,” FTC analysts report that when 2 generics are on the market immediately after a patent on a branded drug expires, wholesale prices of the drug are 6.5% lower on average than when only 1 generic is available; retail prices are 4.2% lower on average.

More than 5.5 million US adults, or nearly 2% of the adult population, have some type of paralysis,

Suicidal behavior describes not only death caused by suicide but also intentional, nonfatal, self-injurious acts committed with or without the intent to cause death. Less severe suicidal attempts are particularly characteristic of persons with borderline personality disorder (BPD).

The recent report on an HIV-positive cardiothoracic surgeon in Israel has offered a contemporary perspective on the risks of transmission of HIV in health care settings, specifically surgical settings.

Employees are making changes to improve their health and better control their own health care costs in response to the current recession, according to results of a survey conducted for the National Business Group on Health (NBGH) by Fidelity Consulting Services.

The objective of this study was to estimate the annual cost burden of Parkinson disease (PD) in the United States. Resource use and cost profiles were developed using all-payer statewide hospital discharge data from 6 states; emergency department visit, long-term–care, and national survey data; fee schedules; and published study findings. (Average direct and indirect costs per patient were calculated in 2007 US dollars.) The annual cost per patient was $21,626 (direct cost: $12,491). When applied to the US PD population (N = 500,000), the annual average cost was approximately $10.78 billion (direct costs, $6.22 billion; indirect costs, $4.56 billion). PD has substantial economic consequences for patients and their families, insurers, and society. (Drug Benefit Trends. 2009;21:179-190)

The 2 physicians who now oversee the FDA want the agency to think of itself less as a regulator and more as a part of the nation’s public health apparatus.

Medication spend for workers’ compensation claims continues to increase despite decreases in overall occupational injury rates. Medication costs increased by 5.4% in 2008 following a 3.3% rise in 2007 (Cover Figure), according to findings of the 2009 Annual Drug Trends Report for Workers’ Compensation. The report was compiled and analyzed by PMSI, Tampa, Fla.

Recently, after getting her regular prescription for Synthroid filled at the pharmacy, my mother called the physician to complain that she just didn’t feel well. The doctor was considering increasing the dosage when my mother noticed that the pills looked different. She had been given a generic version. Her prescription was changed back to Synthroid and she felt fine again.

I advise my patients who are carriers of methicillin-resistant Staphylococcus aureus (MRSA) to keep their fingernails trimmed. Long nails make the subungual spaces good havens for bacteria. S aureus, including MRSA, has been isolated from the subungual spaces of the hands of many at-risk patients who are MRSA carriers

If patients cannot overcome the gag reflex when I try to depress their tongue with a tongue blade, I simply have them stand in front of a mirror and ask them to show me the back of their throat while I hold the light.

A quick way to determine rebound tenderness and differentiate between an acute and a nonacute abdomen in a child is to ask the patient to jump up and down. Patients with nonacute abdominal pain will do this willingly. However, those with an acute abdomen will typically decline because of pain.

A 32-year-old woman complains of eye symptoms that began 3 to 6 months earlier. She first experienced increased lacrimation and a gritty feeling in the eyes.

IBM is rewarding participation in its wellness programs for US employees and dependents with cash. In October, the company added a fourth cash rebate worth $150 to its healthy living programs, first introduced in 2004. The Children's Health Rebate is designed to address the significant increase in obesity rates among children. Other $150 cash wellness incentive programs focus on healthy eating and weight loss, exercise, and smoking cessation. Employees can choose any 2 rebates to receive $300 in cash per year.

Theoretically at least, every day in any hospital should be the same. That means that every patient should be treated with the same quality and safety standards whether it be Sunday or Wednesday. In reality, however, the evidence suggests that there is a “weekend effect,” which translates into worse outcomes for patients admitted to the hospital on weekends for serious illnesses.