P & T : a Peer-reviewed Journal for Formulary Management

Objective: Access to health care can be improved by controlling and optimizing expenditures, specifically the high-cost drugs such as atypical long-acting injectable (LAI) antipsychotics. This type of LAI is usually covered under the medical benefit and/or pharmacy benefit. We sought to compare financial outcomes of the medical benefit billing option with the pharmacy benefit billing option for atypical LAIs in an adult outpatient psychiatric clinic and to determine insurance companies' reasons for nonpayment when the medical benefit billing model was utilized...

Purpose: Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2 blockers) continue to be over utilized for stress ulcer prophylaxis (SUP). Our study aims to evaluate the effectiveness and feasibility of a pharmacist-driven termination protocol in a community teaching hospital to limit the inappropriate use of acid-suppressive medications in the non-intensive care unit (ICU) setting. Methods: Patient charts were evaluated for the appropriate use of PPIs or H2 blockers...

How does the Patient Protection and Affordable Care Act (ACA) of 2010 differ from the act as it stands today? Many changes have occurred, in Medicaid expansion, private insurance coverage, the American Health Benefit Exchanges, and the individual mandate.

Perseris: A new, long-acting, atypical antipsychotic drug-delivery system.

Approvals, new indications and formulations, and safety issues.

Using chloral hydrate carries a risk of adverse events and compounding errors, and much of the available literature recommends using alternative sedatives for pediatric patients. But evidence regarding the efficacy of chloral hydrate and of alternative agents is conflicting.

Congressional deliberations over several competing bills on drug-price transparency may generate some useful data but are unlikely to have any effect on prices.

No abstract text is available yet for this article.

We review selected sessions on the questionable benefits of fecal microbiota transplant; intrahepatic cholestasis of pregnancy; weight-loss drugs in combination with intragastric balloon endoscopy; and beta blockers in pancreatic cancer.

Carcinoid syndrome causes substantial morbidity and reduces quality of life and survival. In a recent clinical trial, 97% of patients reported bowel movement-related issues, abdominal pain, flushing, and low energy. Combining somatostatin analogs with elotristat ethyl provides a new option for managing refractory CS symptoms. Health care providers should consider strategies that take advantage of approved dosing for patients with CS-related diarrhea.

Amiodarone (Cordarone® , Pfizer Inc) is an antiarrhythmic medication with a well-known toxicity profile, including rare cases of hyponatremia as a result of syndrome of inappropriate antidiuretic hormone (SIADH). We report on such a case in which a patient was found to be hyponatremic after evaluation. An 88-year-old male who presented to the emergency department was found to be hyponatremic secondary to amiodarone-induced SIADH following a fall, with possible seizure and traumatic brain injury. He had a history of hypertension, paroxysmal atrial fibrillation, emphysema, myocardial infarction, benign prostatic hyperplasia, chronic kidney disease, Meniere's disease, anemia, and gastroesophageal reflux...

Chronic obstructive pulmonary disease can be attributed to genetic conditions and predispositions, among other factors. Alpha-1 antitrypsin deficiency (AATD) is a significant risk factor for COPD development and progression, and aggressive screening for all patients with COPD or adult-onset asthma is encouraged.

As marijuana legalization and use expands across the U.S., health care systems are struggling to keep abreast of the changes and trends in regulations. Considering marijuana's federal illegality and other restrictions on its use, the limited evidence for its clinical efficacy, and the myriad psychological adverse events, caution is recommended when establishing policies and procedures regarding coverage of marijuana and CBD products.

Shingrix, a new vaccine for herpes zoster.

Mavenclad (cladribine) tablets for relapsing MS forms; Duaklir Pressair (aclidinium bromide/formoterol fumarate) inhalant for COPD; Evenity (romosozumab-aqqg) injection for osteoporosis.

Approvals, new indications and formulations, and safety issues.

Accidental IV administration of heparinized irrigation solution occurs frequently. Two cases from ISMP Canada offer some safe practice recommendations.

Will "All of Us" provide clues on the origins of various illnesses? Congress hopes that analyzing the medical and biological data of millions of people will boost precision medicine and help predict outcomes.

No abstract text is available yet for this article.

We cover key sessions on hepatitis B, C, and D virus infections, hepatocellular carcinoma, nonalcoholic steatohepatitis, acute hepatic porphyria, and liver growth in polycystic kidney disease.