Off Label Drug Use

Approximately one in five prescriptions for drugs in the US are for off label use.  In some cases, this may be inapprorpiate as there is typically limited clinical evidence supporting off label use.  In other cases, off label use is approrpiate.  Clinical trials rarely enroll children or pregnant women and thus medictions are often not…

Can physicians affect medication adherence?

According to a recent study by Koulayev, Simeonova, and Skipper (2016) using data from Denmark, the answer is ‘yes’. Non-compliance with medication therapy remains an unsolved and expensive problem for healthcare systems around the world, yet we know little about the factors that affect a patient’s decision to follow treatment recommendations. In particular, there is…

Nothing NICE about ICER?

On it’s website, the Instititute for Clinical and Economic Review (ICER) claims that it is “…a trusted non-profit organization that evaluates evidence on the value of medical tests, treatments and delivery system innovations and moves that evidence into action to improve the health care system. ” A recent article in Huffington Post however, disagrees.  They make two key…

Can long acting injectables save money?

Patients with serious mental illnesses such as schizophrenia often struggle with medication adherence, due to lack of insight into their disease, medication side effects, forgetfulness, and a variety of other factors.  One solution to this problem is to use long-acting injectables or LAIs.  Whereas most antipsychotics are oral medications, LAIs are typically injectables that you need to…

US Healthcare Spending Projections

In 2016 we will hit a milestone: national health spending per capita is projected to exceed $10,000 for the first time.  This estimate is from an article by Keehan et al. (2016).  In this paper, CMS’ Office of the Actuary (OACT) estimates costs not only this year but over the coming 10 years.  According to their projects,…