Managed Care Pharmacy or Profits in the Wilderness

Managed Care Pharmacy: Principles and Practice

Author: Albert I Wertheimer

This informative book analyzes the trends in pharmacy benefit systems to provide physicians, pharmacists, payers, benefit consultants, and pharmaceutical companies with ways to preserve quality pharmaceutical care while reducing costs. Managed Care Pharmacy offers proven suggestions that will help you choose or develop a pharmacy benefit system that will maximize the goals of managed care organizations, pharmacists, and consumers and better position your company to keep pace in this changing environment.

Amy E. Lodolce

This is an overview of various aspects of the managed care pharmacy from drug distribution systems to drug benefits and formulary management. According to the editors, the purpose is to review and describe drug benefits associated with managed care and to familiarize the reader with comprehensive managed care pharmacy. The target audience includes healthcare providers as well as other professionals involved in the pharmaceutical industry. The editors also state that benefit consultants are part of the intended audience. The editors begin by providing an overview of the types of managed care organizations and pharmacy's role in managed healthcare. In the remainder of the book contributors emphasize and extensively review specific components related to these topics. Some key topics covered include basic issues such as reimbursement methods for drugs, formulary management, distribution systems including mail order pharmacy, automation, and pharmacy benefit management companies. Additionally, the expanded cognitive role that pharmacists can assume in managed care organizations is discussed, including comprehensive management of drug therapy, drug utilization review, and applying pharmacoeconomic principles. The chapters are referenced (some more extensively than others), and each one contains a supplemental reading list. This is helpful for the reader who would like further information. The book contains a key word index to allow readers to quickly find a certain concept as well as a glossary. The glossary contains acronyms and their expanded definitions. Another unique feature of the book is the appendixes which contain templates of managed care benefit forms, notably enrollmentinformation, drug exclusions, and service agreements. This book is well written and informative. The topics covered are timely regarding the changing healthcare system and the emerging role of managed care. Besides the target audience, benefit plan administrators, healthcare administrators, and pharmacy educators would find this book beneficial.

Doody Review Services

Reviewer: Amy E. Lodolce, PharmD,BCPS (University of Illinois at Chicago College of Pharmacy)
Description: This is an overview of various aspects of the managed care pharmacy from drug distribution systems to drug benefits and formulary management.
Purpose: According to the editors, the purpose is to review and describe drug benefits associated with managed care and to familiarize the reader with comprehensive managed care pharmacy.
Audience: The target audience includes healthcare providers as well as other professionals involved in the pharmaceutical industry. The editors also state that benefit consultants are part of the intended audience.
Features: The editors begin by providing an overview of the types of managed care organizations and pharmacy's role in managed healthcare. In the remainder of the book contributors emphasize and extensively review specific components related to these topics. Some key topics covered include basic issues such as reimbursement methods for drugs, formulary management, distribution systems including mail order pharmacy, automation, and pharmacy benefit management companies. Additionally, the expanded cognitive role that pharmacists can assume in managed care organizations is discussed, including comprehensive management of drug therapy, drug utilization review, and applying pharmacoeconomic principles. The chapters are referenced (some more extensively than others), and each one contains a supplemental reading list. This is helpful for the reader who would like further information. The book contains a key word index to allow readers to quickly find a certain concept as well as a glossary. The glossary contains acronyms and their expanded definitions. Another unique feature of the book is the appendixes which contain templates of managed care benefit forms, notably enrollment information, drug exclusions, and service agreements.
Assessment: This book is well written and informative. The topics covered are timely regarding the changing healthcare system and the emerging role of managed care. Besides the target audience, benefit plan administrators, healthcare administrators, and pharmacy educators would find this book beneficial.

Rating

3 Stars from Doody

Table of Contents:

	About the Editors
	Contributors
	Foreword
	Preface
Ch. 1	Evolution of the Contemporary Health Care Delivery System	1
Ch. 2	Contemporary Managed Care Organizations (MCOs) and Their Structure	15
Ch. 3	Pharmacy in Managed Health Care	37
Ch. 4	Pharmacy Reimbursement in Managed Care	47
Ch. 5	Defining and Shaping Financing Needs	63
Ch. 6	Pharmacy Distribution Systems	83
Ch. 7	Evolving Role of Systems in Pharmacy Benefit Management (PBM)	97
Ch. 8	The Drug Formulary, the Pharmacy and Therapeutics (P&T) Committee, and Product Selection	109
Ch. 9	DUR and DUE in Managed Competition	119
Ch. 10	Data Capture and Information Reporting Systems	131
Ch. 11	Quality Assurance and Outcomes Research	149
Ch. 12	Management of Drug Therapy in Health Programs	165
Ch. 13	Pharmacoeconomics (PE): Applications for Managed Care	177
Ch. 14	Off-Label Use and Experimental Treatment	191
Ch. 15	Rx-to-OTC Conversion: Managed Care Implications	209
Ch. 16	Worldwide Review of Pharmacy Benefit Controls	229
Ch. 17	Future Trends in Managed Care Pharmacy	257
Ch. 18	Marketing and Selling to Managed Care: Pharmaceutical Industry Perspective	273
Ch. 19	Drug Benefit Design	285
Ch. 20	Measuring the Performance of Managed Pharmacy Benefit Programs	293
	Appendix	309
	Glossary of Managed Care Terms	351
	Index	389

Interesting textbook: The Magic of Digital Printing or Data Mining for Business Intelligence

Profits in the Wilderness: Entrepreneurship and the Founding of New England Towns in the Seventeenth Century

Author: John F Martin

In examining the founding of New England towns during the seventeenth century, John Frederick Martin investigates an old subject with fresh insight. Whereas most historians emphasize communalism and absence of commerce in the seventeenth century, Martin demonstrates that colonists sought profits in town-founding, that town founders used business corporations to organize themselves into landholding bodies, and that multiple and absentee landholding was common.

In reviewing some sixty towns and the activities of one hundred town founders, Martin finds that many town residents were excluded from owning common lands and from voting. It was not until the end of the seventeenth century, when proprietors separated from towns, that town institutions emerged as fully public entities for the first time.

Martin's study will challenge historians to rethink not only social history but also the cultural history of early New England. Instead of taking sides in the long-standing debate between Puritan scholars and business historians, Martin identifies strains within Puritanism and the rest of the colonists' culture that both discouraged and encouraged land commerce, both supported and undermined communalism, both hindered and hastened development of the wilderness. Rather than portray colonists one-dimensionally, Martin analyzes how several different and competing ethics coexisted within a single, complex, and vibrant New England culture.

Booknews

Instead of taking sides in the long-standing debate between Puritan scholars on the one hand and business historians on the other, Martin identifies strains within Puritanism and the rest of the colonists' culture that both discouraged and encouraged land commerce, both supported and undermined communalism, both hindered and hastened development of the wilderness. He reviews some 60 towns and the activities of 100 town founders. Paper edition (unseen), $12.95. Annotation c. Book News, Inc., Portland, OR (booknews.com)