In ConclusionThe economic situation has madeconfronting the rapid rise in healthcare costs an even greater challenge.Employers, insurers, leaders andconsumers all have a role toplay in healing the health caresystem. This is a big task — and abig responsibility. It will take allof us working together to meetthese challenges head-on withsmart solutions, bold plans anda strategic approach.As your partner in pharmacybenefits management, we havethe tools, technology andinformation to help you managetotal health spend. Workingtogether, we can be a vital partof the health care solution.64 Connect ● Create
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Lancet 1994;344:1383-1389.5Carey, John. “Do Cholesterol <strong>Drug</strong>s Do Any Good?” Business Week. 17 January 2008. http://www.businessweek.com/print/magazine/content/08_04/b4068052092994.htm.Accessed 6 April 2008.6Kaiser Family Foundation calculations using data from the U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey(MEPS), 2006. http://facts.kff.org/chart.aspx?ch=822.7<strong>Prime</strong> <strong>Therapeutics</strong> Efficiency Analysis, 1Q2008.8Integrated Pharmacy Management: Maximizing the Efficiency of Pharmacy Spending. <strong>Prime</strong> <strong>Therapeutics</strong> case study. February <strong>2009</strong>.9<strong>Prime</strong> <strong>Therapeutics</strong> analysis based on CMS 2006 Diagnostic Related Groups. http://www.cms.hhs.gov/medicarefeeforsvcpartsAB/downloads/drg06.pdf.10Sokol MC, McGuigan KA, Verbugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and health care cost. Med Care 2005;43:521-30.11Lorig KR, Sobel DS, Stewart AL, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial.Med Care 1999;37:5-14.12Centers for Medicare and Medicaid Services. National Health Expenditure Data. http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2008.pdf. Accessed 6 April <strong>2009</strong>.13Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomized trials. Blood Pressure LoweringTreatment Trialists’ Collaboration. Lancet 2003;362:1527-35.14Strippoli GFM, Craig M, Deeks JJ, Schena FP, Craig JC. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes indiabetic nephropathy: systematic review. BMJ. Published online first 30 September 2004. Available at: dio:10.1136/bmj.38237.585000.7C.15Shibata MC, Flather MD, Wang D. Systematic review of the impact of beta blockers on mortality and hospital admissions in heart failure. Eur J Heart 2001;3:351-7.16Anonymous. ACE Inhibitors in the treatment of chronic heart failure: Effective and cost-effective. Bandolier 1994; 8-1. Available at: http://www.medicine.ox.ac.uk/bandolier/band8/b8-1.html.17Al-Mallah MH, Tleyjeh IM, Abdel-Latif AA, Weaver WD. Angiotensin-Converting Enzyme Inhibitors in Coronary Artery Disease and Preserved Left Ventricular Systolic Function:A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Coll Cardiol 2006;47:1576-83.18Anonymous. Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 1981;304:801-7.19Centers for Medicare and Medicaid Services. National Health Expenditure Data. http://www.cms.hhs.gov/NationalHealthExpendData/downloads/highlights.pdf. Accessed 6 April <strong>2009</strong>.20Centers for Disease Control and Prevention. http://www.cdc.gov/NCCdphp/overview.htm.21U.S. Bureau of Labor Statistics. United States Department of Labor. http://www.bls.gov/home.htm.22Werner, Erica. “AARP: Prescription <strong>Drug</strong> Prices on the Rise.” Associated Press. http://seattletimes.nwsource.com/html/nationworld/<strong>2009</strong>059093_apdrugpricesaarp.html.23Kaiser Family Foundation. Prescription <strong>Drug</strong> <strong>Trend</strong>s, September 2008. http://www.kff.org/rxdrugs/upload/3057_07.pdf Accessed 9 October 2008.24Associated Press. “Prescription <strong>Drug</strong> Use in U.S. Fell Last Year.” 13 May <strong>2009</strong>. http://www.msnbc.msn.com/id/30723990/. Accessed 15 May <strong>2009</strong>.25Lau DT, Nau DP. Oral antihyperglycemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes. Diabetes Care 2004;27:2149-53.26Gehi AK, Ali S, Na B, et al. Self-reported medication adherence and cardiovascular events in patients with stable coronary heart disease: the heart and soul study. Arch Intern Med2007;167:1798-803.27Rubin, Rita. “FDA Orders Warning ‘Guides’ for ADHD <strong>Drug</strong>s.” USA Today. February 21, 2007.28Harris, Gardiner and Benedict Carey. “F.D.A. Finds Increase in Suicide Symptoms for Patients Using Seizure Medications.” New York Times. 1 February 2008.29Carey, Benedict. “Risks Found for Youths in New Anti-Psychotics.” New York Times. 15 September 2008.30Harris, Gardner. “Use of Anti-psychotics in Children is Criticized.” New York Times. 18 November 2008. http://www.nytimes.com/2008/11/19/health/policy/19fda.html.Accessed 19 January <strong>2009</strong>.31Gellene, Denise. “Sleeping Pill Use Grows as Economy Keeps People Up at Night.” Los Angeles Times. 30 March <strong>2009</strong>.32Reuters. “Shire CEO Sees Benefit from Glaxo Deal in About 2 Years” CNN Money.com. 4 June <strong>2009</strong>. http://money.cnn.com/news/newsfeeds/articles/reuters/MTFH45416_<strong>2009</strong>-06-04_21-08-55_N04234475.htm Acccessed 12 June <strong>2009</strong>.33<strong>Prime</strong> <strong>Therapeutics</strong> Health Champions pilot study, 2005.34Winslow, Ron and Johnson, Avery. “Race is On for Next Blood Thinner.” Wall Street Journal, 10 December 2007.35Peter Pitts, “Opinion: The Root Cause of Rising Health Care Costs: Chronic Disease,” Mercury News, 20 April <strong>2009</strong>. http://www.mercurynews.com/opinion/ci_12186052?nclick_check=1.36Van Dusen, Alison. “America’s Most Expensive Medical Conditions.” Forbes. 6 February 2008. http://www.forbes.com/2008/02/06/health-diseases-expensive-forbeslife-cx_avd_0206health.html Accessed 6 March <strong>2009</strong>.37Vermeire E, Hearnshaw H, Van Royen P, et al. Patient adherence to treatment: three decades of research: a comprehensive review. J Clin Pharm Ther 2001;26:331-42.38Associated Press. “Diabetes Rate Doubles in U.S. in Last 10 Years.” http://www.msnbc.msn.com/id/27457618/.39Pettypiece, Shannon. “Kids Swallow More Pills as Big Waistlines Become Growing Pain.” 3 November 2008. http://www.bloomberg.com/apps/news?pid=20601202&sid=aMDgEiRTeVh0&refer=healthcare. Accessed 20 November 2008.40New Report Shows Record Number of Medicines Currently In Development to Treat Diabetes. PhRMA press release. 19 May <strong>2009</strong>. http://www.phrma.org/news_room/press_releases/report_shows_record_number_of_medicines_in_development_to_treat_diabetes/. Accessed 5 June <strong>2009</strong>.41Associated Press. “Millions Skip Meds, Don’t Take Pills Correctly.” http://www.msnbc.msn.com/id/20039597/.42Harris Interactive Poll, March 2005. http://www.harrisi.org/news/newsletters/wsjhealthnews/WSJOnline_HI_Health-CarePoll2005vol4_iss06.pdf. 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