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Chester B. Good - One of the best experts on this subject based on the ideXlab platform.
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Pharmacy Benefits Management in the Veterans Health Administration Revisited: A Decade of Advancements, 2004-2014
Journal of managed care & specialty pharmacy, 2016Co-Authors: Sherrie L. Aspinall, Mariscelle M. Sales, Peter A. Glassman, Chester B. Good, Vincent Calabrese, Muriel Burk, Von R. Moore, Melinda M. Neuhauser, Lori Golterman, Heather OurthAbstract:SUMMARY: Over the past decade, the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services (PBM) has enhanced its formulary Management activities and added programs to ensure that the national drug plan continues to meet the pharmacy needs of veterans and to promote safe and appropriate drug therapy in the face of rising medication expenditures. This article describes the broad range of services provided by the VA PBM that work in partnership to deliver a high-quality and sustainable pharmacy benefit for veterans. In support of formulary Management, VA PBM pharmacists prepare extensive clinical guidance documents (e.g., drug monographs and criteria for use) that are used by physicians and pharmacists with operational and clinical oversight of the VA national formulary. The VA PBM has utilized various contracting techniques and continually evaluates drug utilization data to identify opportunities for potential savings. Remarkably, since before 2004, the average acquisition cost for a 1-mo...
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Pharmacy Benefits Management in the Veterans Health Administration: 1995 to 2003.
The American journal of managed care, 2005Co-Authors: Mariscelle M. Sales, Francesca E. Cunningham, Peter A. Glassman, Michael A. Valentino, Chester B. GoodAbstract:The Department of Veterans Affairs (VA) Pharmacy Benefits Management Strategic Healthcare Group (VA PBM) oversees the formulary for the entire VA system, which serves more than 4 million veterans and provides more than 108 million prescriptions per year. Since its establishment in 1995, the VA PBM has managed pharmaceuticals and pharmaceutical-related policies, including drug safety and efficacy evaluations, pharmacologic Management algorithms, and criteria for drug use. These evidence-based practices promote, optimize, and assist VA providers with the safe and appropriate use of pharmaceuticals while allowing for formulary decisions that can result in substantial cost savings. The VA PBM also has utilized various contracting techniques to standardize generic agents as well as specific drugs and drug classes (eg, antihistamines, angiotensin-converting enzyme inhibitors, alpha-blockers, and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors [statins]). These methods have enabled the VA to save approximately dollar 1.5 billion since 1996 even as drug expenditures continued to rise from roughly dollar 1 billion in fiscal year (FY) 1996 to more than dollar 3 billion in FY 2003. Furthermore, the VA PBM has established an outcomes research section to undertake quality-improvement and safety initiatives that ultimately monitor and determine the clinical impact of formulary decisions on the VA system nationwide. The experiences of this pharmacy Benefits program, including clinical and contracting processes/procedures and their impact on the VA healthcare system, are described.
Rafiaa Nouira - One of the best experts on this subject based on the ideXlab platform.
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A Case of Nail Psoriasis Successfully Treated with Intralesional Methotrexate
Dermatology and Therapy, 2018Co-Authors: Sana Mokni, Khaoula Ameur, Najet Ghariani, Badreddine Sriha, Colandane Belajouza, Mohamed Denguezli, Rafiaa NouiraAbstract:Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. About 61% of psoriatic patients have nail involvement that can cause a significant social problem. Treating nail psoriasis is challenging but can improve the health outcomes and quality of life of patients. Treatment options available for nail psoriasis including topical therapy, intralesional injections, and systemic and biologic agents have various side effects and some Benefits. Management is currently inconclusive. Intralesional injection of methotrexate in nail psoriasis was previously documented in few cases. We present a case of nail psoriasis successfully treated with low-dose intralesional methotrexate with no significant side effects in a 48-year-old psoriatic patient. Given the various side effects of conventional topical and systemic therapies limiting their use, we conclude that intralesional methotrexate injection seems to be a safe and effective treatment option for nail psoriasis. However, large controlled studies are needed.
Jenie M. Perry - One of the best experts on this subject based on the ideXlab platform.
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Opioid Prescribing and Opioid Risk Mitigation Strategies in the Veterans Health Administration
Journal of General Internal Medicine, 2020Co-Authors: Friedhelm Sandbrink, Elizabeth M. Oliva, Tara L. Mcmullen, Amy R. Aylor, Michael A. Harvey, Melissa L. Christopher, Francesca Cunningham, Taeko Minegishi, Thomas Emmendorfer, Jenie M. PerryAbstract:Introduction The Veterans Health Administration (VHA) has taken a multifaceted approach to addressing opioid safety and promoting system-wide opioid stewardship. Aim To provide a comprehensive evaluation of current opioid prescribing practices and implementation of risk mitigation strategies in VHA. Setting VHA is the largest integrated health care system in the United States. Program Description VHA prescribing data in conjunction with implementation of opioid risk mitigation strategies are routinely tracked and reviewed by VHA’s Pharmacy Benefits Management Services (including Academic Detailing Service) and the Pain Management Program Office. Additional data are derived from the Partnered Evidence-Based Policy Resource Center (PEPReC) and from a 2019 survey of interdisciplinary pain Management teams at VHA facilities. Prescribing data are reported quarterly until first quarter fiscal year 2020 (Q1FY2020), ending December 31, 2019. Program Evaluation VHA opioid dispensing peaked in 2012 with 679,376 Veterans receiving an opioid prescription, and when including tramadol, in 2013 with 869,956 Veterans. Since 2012, the number of Veterans dispensed an opioid decreased 56% and co-prescribed opioid/benzodiazepine decreased 83%. Veterans with high-dose opioids (≥ 100 mg morphine equivalent daily dose) decreased 77%. In Q1FY2020, among Veterans on long-term opioid therapy (LTOT), 91.1% had written informed consent, 90.8% had a urine drug screen, and 89.0% had a prescription drug monitoring program query. Naloxone was issued to 217,469 Veterans and resulted in > 1,000 documented overdose reversals. In 2019, interdisciplinary pain Management teams were fully designated at 68%, partially designated at 28%, and not available at 4% of 140 VA parent facilities. Fifty percent of Veterans on opioids at very high risk for overdose/suicide received interdisciplinary team reviews. Implications VHA clinicians have greatly reduced their volume of opioid prescribing for pain Management and expanded implementation of opioid risk mitigation strategies. Impacts VHA’s integrated health care system provides a model for opioid stewardship and interdisciplinary pain care.
Mariscelle M. Sales - One of the best experts on this subject based on the ideXlab platform.
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Pharmacy Benefits Management in the Veterans Health Administration Revisited: A Decade of Advancements, 2004-2014
Journal of managed care & specialty pharmacy, 2016Co-Authors: Sherrie L. Aspinall, Mariscelle M. Sales, Peter A. Glassman, Chester B. Good, Vincent Calabrese, Muriel Burk, Von R. Moore, Melinda M. Neuhauser, Lori Golterman, Heather OurthAbstract:SUMMARY: Over the past decade, the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services (PBM) has enhanced its formulary Management activities and added programs to ensure that the national drug plan continues to meet the pharmacy needs of veterans and to promote safe and appropriate drug therapy in the face of rising medication expenditures. This article describes the broad range of services provided by the VA PBM that work in partnership to deliver a high-quality and sustainable pharmacy benefit for veterans. In support of formulary Management, VA PBM pharmacists prepare extensive clinical guidance documents (e.g., drug monographs and criteria for use) that are used by physicians and pharmacists with operational and clinical oversight of the VA national formulary. The VA PBM has utilized various contracting techniques and continually evaluates drug utilization data to identify opportunities for potential savings. Remarkably, since before 2004, the average acquisition cost for a 1-mo...
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Pharmacy Benefits Management in the Veterans Health Administration: 1995 to 2003.
The American journal of managed care, 2005Co-Authors: Mariscelle M. Sales, Francesca E. Cunningham, Peter A. Glassman, Michael A. Valentino, Chester B. GoodAbstract:The Department of Veterans Affairs (VA) Pharmacy Benefits Management Strategic Healthcare Group (VA PBM) oversees the formulary for the entire VA system, which serves more than 4 million veterans and provides more than 108 million prescriptions per year. Since its establishment in 1995, the VA PBM has managed pharmaceuticals and pharmaceutical-related policies, including drug safety and efficacy evaluations, pharmacologic Management algorithms, and criteria for drug use. These evidence-based practices promote, optimize, and assist VA providers with the safe and appropriate use of pharmaceuticals while allowing for formulary decisions that can result in substantial cost savings. The VA PBM also has utilized various contracting techniques to standardize generic agents as well as specific drugs and drug classes (eg, antihistamines, angiotensin-converting enzyme inhibitors, alpha-blockers, and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors [statins]). These methods have enabled the VA to save approximately dollar 1.5 billion since 1996 even as drug expenditures continued to rise from roughly dollar 1 billion in fiscal year (FY) 1996 to more than dollar 3 billion in FY 2003. Furthermore, the VA PBM has established an outcomes research section to undertake quality-improvement and safety initiatives that ultimately monitor and determine the clinical impact of formulary decisions on the VA system nationwide. The experiences of this pharmacy Benefits program, including clinical and contracting processes/procedures and their impact on the VA healthcare system, are described.
Heather Ourth - One of the best experts on this subject based on the ideXlab platform.
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Pharmacy Benefits Management in the Veterans Health Administration Revisited: A Decade of Advancements, 2004-2014
Journal of managed care & specialty pharmacy, 2016Co-Authors: Sherrie L. Aspinall, Mariscelle M. Sales, Peter A. Glassman, Chester B. Good, Vincent Calabrese, Muriel Burk, Von R. Moore, Melinda M. Neuhauser, Lori Golterman, Heather OurthAbstract:SUMMARY: Over the past decade, the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services (PBM) has enhanced its formulary Management activities and added programs to ensure that the national drug plan continues to meet the pharmacy needs of veterans and to promote safe and appropriate drug therapy in the face of rising medication expenditures. This article describes the broad range of services provided by the VA PBM that work in partnership to deliver a high-quality and sustainable pharmacy benefit for veterans. In support of formulary Management, VA PBM pharmacists prepare extensive clinical guidance documents (e.g., drug monographs and criteria for use) that are used by physicians and pharmacists with operational and clinical oversight of the VA national formulary. The VA PBM has utilized various contracting techniques and continually evaluates drug utilization data to identify opportunities for potential savings. Remarkably, since before 2004, the average acquisition cost for a 1-mo...