Discovery, development, regulation and marketing of the medications that are used in health care and the economics of the pharmaceutical industry.

Can New Technology Improve Medication Choices?

Feb. 23, 2021

Prescribing harmful combinations of drugs is an all-too-frequent occurrence, particularly in fragmented health care systems where a patient’s care is spread across multiple physicians and organizations. In a new analysis, my colleagues and I report on what happened to harmful prescribing when Finland implemented a new, nationwide e-prescribing system. We show that new information technology can have a substantial impact by improving information flows between different physicians involved in a patient’s care.

Regulating Prescription Drug Prices

Feb. 2, 2021

In the perennial debate over drug pricing, U.S. policymakers have proposed lowering domestic prices by tying them in some way to international prices. But policymakers seem less interested in understanding or adapting the regulatory frameworks that produce these lower prices in other countries.

Trends in Oral Anticoagulant Co-Prescription With Antiepileptic Drugs Among Adults With Epilepsy, 2010–2018

Allison Willis, MD
Dec. 1, 2020

Emily K. Acton, Michael A. Gelfand, Sean Hennessy, Sharon X. Xie, John R. Pollard, Scott E. Kasner, Allison W. Willis

Abstract [from journal]

Treatment considerations for epilepsy patients requiring anticoagulation are changing, and actual prescribing practices have not been characterized. We used the 2010-2018 Optum Clinformatics® Data Mart Database to estimate the annual prevalence and distinguish the patterns of oral anticoagulants (OACs) co-dispensed with antiepileptic drugs (AEDs) among adults with epilepsy. Monotonic trends were assessed using the Spearman rank correlation coefficient (ρ). Multivariable logistic regression models were built to evaluate the


Oral Anticoagulant Use in Patients With Atrial Fibrillation and Mitral Valve Repair

Nov. 24, 2020

Ashwin S. Nathan, Lin Yang, Zhi Geng, Elias J. DayoubSameed Ahmed M. Khatana, Paul N. Fiorilli, Howard C. Herrmann, Wilson Y. Szeto, Pavan Atluri, Michael A. Acker, Nimesh D. Desai, David S. Frankel, Francis E. Marchlinski, ...

Abstract [from journal]

Background: Patients with atrial fibrillation (AF) who have undergone mitral valve repair are at risk for thromboembolic strokes. Prior to 2019, only vitamin K antagonists were recommended for patients with AF who had undergone mitral valve repair despite the introduction of direct oral anticoagulants (DOAC) in 2010.

Objective: To characterize the use of anticoagulants in patients with AF who underwent surgical mitral valve repair (sMVR) or transcatheter mitral valve repair (tMVR).


Using Clinical Trial Data to Estimate the Costs of Behavioral Interventions for Potential Adopters: A Guide for Trialists

Nov. 20, 2020

Louise B. Russell, Laurie A. Norton, David Pagnotti, Christianne Sevinc, Sophia Anderson, Darra Finnerty Bigelow, Lauren G. Iannotte, Michael Josephs, Ryan McGilloway, Iwan Barankay, Mary E. Putt, Peter P. ReeseDavid A. Asch, Lee R. Goldberg...

Abstract [from journal]

Behavioral interventions involving electronic devices, financial incentives, gamification, and specially trained staff to encourage healthy behaviors are becoming increasingly prevalent and important in health innovation and improvement efforts. Although considerations of cost are key to their wider adoption, cost information is lacking because the resources required cannot be costed using standard administrative billing data. Pragmatic clinical trials that test behavioral interventions are potentially the best and often only source


Association of Retinal Vascular Occlusion With Women Filling a Prescription for Female Hormone Therapy

Brian L. Vanderbeek, MD, MPH
Nov. 12, 2020

Delu Song, Jennifer Nadelmann, Yinxi Yu, Brian L. VanderBeek

Abstract [from journal]

Importance: Oral contraceptives have been associated with cardiovascular disease, ischemic stroke, venous thromboembolic disease, and breast cancer. Retinal vascular occlusions share the same risk factors as cardiovascular and cerebrovascular disease.

Objective: To determine whether filling a prescription of female hormone therapy (FHT) is associated with an increased risk of retinal artery occlusion (RAO) or retinal vein occlusions (RVO).

Design, setting, and participants: 


Embedding A Linkage To Pre-exposure Prophylaxis (PrEP) Care Intervention In Social Network Strategy And Partner Notification Services: Results From A Pilot Randomized Controlled Trial

Daniel Teixeira da Silva
Oct. 22, 2020

Daniel Teixeira da Silva, Alida Bouris, Arthi Ramachandran, Olivia Blocker, Billy Davis, James Harris, Maria Pyra, Laura K. Rusie, Russell Brewer, Jade Pagkas-Bather, Anna Hotton, Jessica P. Ridgway, Moira McNulty, Ramona Bhatia, John A. Schneider

Abstract [from journal]

Background: Increased pre-exposure prophylaxis (PrEP) uptake among Black men who have sex with men and Black transgender women (BMSM/TW) is needed to end the HIV epidemic. Embedding a brief intervention in network services that engage individuals in HIV transmission networks for HIV/STI testing may be an important strategy to accelerate PrEP uptake.

Setting: Partner Services PrEP (PS-PrEP) study is a pilot randomized control trial to improve linkage to PrEP care among BMSM/TW presenting for


Association Between A National Insurer's Pay-For-Performance Program For Oncology And Changes In Prescribing Of Evidence-Based Cancer Drugs And Spending

Oct. 6, 2020

Justin E. BekelmanAtul Gupta, Ezra Fishman, David Debono, Michael J. Fisch, Ying Liu, Gosia Sylwestrzak, John Barron, Amol S. Navathe

Abstract [from journal]

Purpose: Cancer drug prescribing by medical oncologists accounts for the greatest variation in practice and the largest portion of spending on cancer care. We evaluated the association between a national commercial insurer's ongoing pay-for-performance (P4P) program for oncology and changes in the prescribing of evidence-based cancer drugs and spending.

Methods: We conducted an observational difference-in-differences study using administrative claims data covering 6.7% of US adults. We


Effect Of Patient Financial Incentives On Statin Adherence And Lipid Control: A Randomized Clinical Trial

Oct. 1, 2020

Iwan Barankay, Peter P. Reese, Mary E. Putt, Louise B. Russell, George Loewenstein, David Pagnotti, Jiali Yan, Jingsan Zhu, Ryan McGilloway, Troyen Brennan, Darra Finnerty, Karen Hoffer, Sakshum Chadha, Kevin G. Volpp

Abstract [from journal]

Importance: Financial incentives can improve medication adherence and cardiovascular disease risk, but the optimal design to promote sustained adherence after incentives are discontinued is unknown.

Objective: To determine whether 6-month interventions involving different financial incentives to encourage statin adherence reduce low-density lipoprotein cholesterol (LDL-C) levels from baseline to 12 months.

Design, setting, and participants: This 4-group, randomized


In The Era Of Direct-Acting Antivirals, Liver Transplant Delisting Due To Clinical Improvement For Hepatitis C Remains Infrequent

Therese Bitterman, MD, MSCE
Sep. 21, 2020

Therese Bittermann and K. Rajender Reddy

Abstract [from journal]

Background/aims: Studies have suggested marked increases in transplant delisting due to clinical improvement for patients with hepatitis C virus (HCV) associated cirrhosis in the era of direct acting antivirals (DAAs). This study provides a 'real world' assessment of waitlist dynamics for HCV transplant candidates in the current era.

Methods: This was a retrospective cohort study of adults waitlisted for liver transplant (LT) alone between 1/1/2005-12/31/2018 using national US data. The post-


Gaps in the Use of Long-Acting Opioids Within Intervals of Consecutive Days Among Cancer Outpatients Using Electronic Pill Caps

Salima Meghani, RN, PhD, Penn Nursing School researcher
Sep. 16, 2020

Salimah H. Meghani, Amelia L. Persico, Jeffrey Fudin, George J. Knafl

Abstract [from journal]

Objective: This study describes individual cancer patients’ nonuse of extended-release or long-acting (ER/LA) opioids, including periods of gap between opioid doses taken.

Design: Secondary analysis of a three-month observational study of prescribed ER/LA opioids monitored using electronic pill caps.

Setting: Two outpatient oncology clinics of a large health system in the Mid-Atlantic region.

Participants: Inclusion was based on self-identified African Americans and...