Managed Approaches to Multiple Sclerosis in Special Populations

Development of Heart Failure in Medicaid Patients with Type 2 Diabetes Treated with Pioglitazone, Rosiglitazone, or Metformin

“…Socioeconomic and lifestyle factors not only lead to greater comorbidity but can also impact quality of care. [29][30][31] Among adults under aged 65 years, those covered by Medicaid had greater prevalence of diabetes, heart disease, and various other morbidities known to be risk factors for HF than those with private insurance or the uninsured. 32 Many patients with HF do not have symptoms or signs of HF, 33 often because of inactivity, and Medicaid patients frequently seek care in high-volume facilities where clinical focus may not include prevention of secondary complications and effective education may be limited.…”

“…32 Many patients with HF do not have symptoms or signs of HF, 33 often because of inactivity, and Medicaid patients frequently seek care in high-volume facilities where clinical focus may not include prevention of secondary complications and effective education may be limited. 29 Cultural, language, or psychosocial barriers may hinder communication between physicians and patients. 29,31,34 Furthermore, a variety of related factors influence patient adherence to prescribed therapies.…”

“…29 Cultural, language, or psychosocial barriers may hinder communication between physicians and patients. 29,31,34 Furthermore, a variety of related factors influence patient adherence to prescribed therapies. 35,36 The risks that have been associated with TZDs may be different in a Medicaid population given the prevalence of comorbidity and that medication management decisions can be impacted by factors that may be unique to the Medicaid population.…”

Evaluating Risks, Costs, and Benefits of New and Emerging Therapies to Optimize Outcomes in Multiple Sclerosis

“…8 Additionally, with the approval of several new, relatively expensive oral DMTs for MS in recent years, the average annual cost of medications for an MS patient in the United States has increased, ranging from $35,000 to $45,000 in 2011. 25 The increase in price of medication is likely to continue to rise due to the expected incorporation of even more new therapies.…”

“…Process metrics and outcomes metrics are available to pharmacists and case managers to evaluate and manage patients with MS. 25 Assessment of outcomes provides the framework for future planning, and careful and accurate assessment of outcomes of interventions may improve the ability to assist MS patients in establishing short-term and long-term goals. Health care professionals, together with managed care pharmacists and nurse case managers have the responsibility to identify and utilize meaningful outcome measures.…”