surement with more than one endpoint is the generation of a cardinal index/score. Without the prioritization and weighting of multiple endpoints a deduction of recommendations might be questionable. METHODS: A pilot study was conducted to elicit patients' preferences about antiviral therapy of chronic hepatitis C. For the Discrete-Choice-Experiment (DCE), 7 attributes were selected with 3 Levels each. Therefore an orthogonal, balanced and efficient design was used and results were analysed with random effects logit models. RESULTS: Patients and experts prioritized the respective endpoints in almost the same order, but weighted them differently. Sustained-Virological-Response received the highest weight followed by frequency of application (patients) or duration of therapy (experts). CONCLUSIONS: Aim was to demonstrate how DCEs can be used to empirically determine which PREs should be included in the efficiency frontier analysis. Further it is demonstrated how such methods can be used to prioritize across such multiple efficiency frontiers. The survey demonstrated how DCEs could be used to empirically determine which PREs are important in antiviral treatment of chronic hepatitis C. The results could be used for the development of innovative therapeutic schemes and new drugs which could meet patients' needs. For IQWiG purposes the weights of PREs are included in the health economic evaluation. OBJECTIVES:To determine health care provider perceptions about timing of 'rapid' warfarin reversal-related patient care events using novel survey methodology. METHODS: Forty-eight adult and pediatric trauma centers were contacted to participate in a direct-to-provider (DTP) survey. Participants were asked to provide aggregate information about patients receiving fresh-frozen plasma (FFP) for acute warfarin reversal. RESULTS: Nineteen to 25 health care professionals from 18 centers provided information by survey. Average perceptions of time needed to infuse FFP under this setting (mean 4.6 hrs from time of triage; 95% CI 1.0 -8.2 hrs) are consistent with actual, published values. In contrast, average perceptions of time needed for initial International Normalized Ratio (INR) normalization using FFP (mean 5.8 hrs; 95% CI 2.8 -8.8 hrs) underestimate actual, published values by 6 -26 hrs. Health care providers perceived that relatively little cumulative time lapses (1.6 hrs, on the average) for completing the first FFP infusion. There is little perceived time lag between ordering and beginning the first FFP infusion (0.3 hrs, on the average), consistent with actual, published values. There is substantial reported time (an additional 3.0 hrs, on the average) needed to complete subsequent FFP infusions, amounting to 52% of all perceived time lapsing for initial INR normalization in this setting. CONCLUSIONS: DTP survey methodology appears to be an efficient method for gathering clinical information for research purposes. Healthcare providers may have perceptions that are different from published studies, including inaccurate percep...

The observed variation in prescription medication use by drug class and sociodemographic characteristics suggests strategies are needed for improving current prescribing patterns in this patient population.

Patients receiving oral bisphosphonates on a monthly basis showed higher rates of medication compliance compared to weekly dosing in our study. However, compliance with bisphosphonates among all new users was suboptimal, suggesting the need for improved strategies to enhance compliance with oral bisphosphonates in the US Military Health System.

BACKGROUND: The U.S. Department of Defense (DoD) health care benefit (TRICARE) provides 9.2 million active-duty and retired uniformed services personnel and their family members with access to a comprehensive pharmacy benefit with low out-of-pocket costs. DoD's Uniform Formulary is available worldwide at DoD's 3 pharmacy points of service (military pharmacies, contracted mail order, and community [network and non-network] pharmacies). Community pharmacies, military pharmacies, and mail order accounted for 64%, 23%, and 13%, respectively, of DoD's $6.5 billion total drug expenditures during fiscal year ( CONCLUSION: As in most private-sector health plans, the DoD formulary management process (a) includes rigorous decision making that is informed by clinical literature evaluations and pharmacoeconomic analyses, (b) results in drug formulary changes that require considerable effort in communication with providers and beneficiaries, and (c) produces drug cost savings derived from increased price competition among drug manufacturers. Unlike private sector health plans, the DoD uses more disclosure of the results of evaluation of the evidence, solicits provider opinions before P&T committee deliberation, and provides the opportunity for beneficiaries to have input before implementation of formulary changes.

The economic benefits of daily migraine prevention have been subject to ongoing debate. This study was undertaken to determine if the initiation of prevention had an observable effect on ambulatory health care utilisation when compared to acute migraine treatment alone. Administrative claims data from the Military Health System were used to conduct a retrospective, longitudinal cohort study of 3762 patients with migraine. New users of daily migraine prevention were matched to a reference group of non-users using propensity score methods. This matched sample then was used to evaluate the effect of prevention on ambulatory health care expenditures. The study results showed that exposure to daily migraine prevention led to lower rates of utilisation relative to what new patients would have consumed in the absence of treatment. The results suggest that additional economic benefits could be realised by increasing the appropriate use of daily migraine prevention.