February 2010

As healthcare spending continues to rise, more employers, managed care organizations, and pharmacy benefit managers are implementing novel pharmacy benefit designs and formulary management policies to control drug spending.

Multiple sclerosis (MS) is a disease of inflammatory demyelination of axons of the central nervous system that results in episodes of transient neurologic deficits, progressing to permanent neurologic deterioration over time.1 The cause of MS remains unclear, but it is thought to involve both genetic susceptibility and environmental triggers, possibly viral, which result in self-sustaining autoimmune dysfunction.

People living with chronic conditions benefit from many medical advances developed over the past 20 years. Many diseases that were once fatal diagnoses are now managed utilizing various drug therapies. However, far too often, treatments may work well for some people, while providing marginal benefits or causing significant harm to others.

In September 2009, the Pharmacy & Therapeutics Society gathered a study group of 12 managed care medical and pharmacy directors. The objective was to examine the impact that biomarker-based assays could have on the approaches payers and providers use to manage cancer.

Rising healthcare costs, lack of standardized practice and variation in practice by geographic area (including failure to follow clinical guidelines), patient nonadherence, and continued perceptions of poor value for the money that is spent continue to plague healthcare performance, according to Joshua S. Benner, PharmD, ScD, Engelberg Center for Health Care Reform, The Brookings Institution.

Among the commercially insured, pharmacy benefits define the availability, accessibility, and cost of prescription drugs.

The greater use of generic prescription medications has been widely advocated as a policy solution to rising healthcare costs.

This issue of The American Journal of Pharmacy Benefts includes several articles about neurologic conditions and the medications used to treat them. We chose to focus on this area for 2 reasons.

The proportion of Americans diagnosed with Alzheimer's disease (AD) is projected to increase almost 2-fold over the next couple of decades due to size of the Baby Boom generation compared with the total US population.