The American Academy of Family Physicians, along with 6 other medical associations, has endorsed the framework of practice design known as the patient-centered medical home (PCMH). Included in the Patient Protection and Affordable Care Act of 2010, the PCMH is a component of changes needed to influence healthcare quality, access, continuity, and cost impact in the United States.

Results of a randomized, double-blind, double-dummy, phase 3 study [N Engl J Med. 2011;365(20):1886-1895] found that patients with active lupus who underwent 36 months of maintenance therapy with mycophenolate mofetil after successful treatment with induction therapy have superior maintenance of renal response to therapy and prevention of relapse compared with patients who undergo maintenance therapy with azathioprine.

Patients with suspected coronary artery disease (CAD) are increasingly being diagnosed using coronary computed tomography angiography (CCTA). This new technology provides anatomic information that differs from the functional information available through stress testing using electrocardiography (ECG). Among Medicare beneficiaries, the number of CCTA procedures has grown from 38,171 in 2006, when the procedure was first reimbursed, to 78,009 in 2008.

After 15 months of therapy with etanercept, a tumor necrosis factor alpha antagonist, patients with juvenile idiopathic arthritis (JIA) who had had low baseline disability scores, prior disease-modifying antirheumatic drug (DMARD) use, and developed JIA at a young age were more likely to have achieved an excellent response, according to results of a recent study [JAMA. 2011;306(21):2340-2347].

More open and transparent insurance markets is one goal of the Patient Protection and Affordable Care Act (ACA); by 2014, the act will require private insurers to provide coverage to individuals and small businesses by offering products with more comparable benefits and cost-sharing. The ACA also requires insurers to provide coverage regardless of preexisting health conditions. These and other changes included in the law will allow consumers to shop around for coverage.

The use of medications intended for the treatment of attention-deficit/hyperactivity disorder (ADHD) by adults increased more rapidly than did use of those medications by children between 2001 and 2010. A US Food and Drug Administration advisory committee on ADHD medication safety stated that >1.5 million adults were taking stimulants in 2005, and nearly 32% of all prescriptions written were for adults. Adults diagnosed with ADHD are typically treated with the stimulant classes methylphenidate and amphetamine and, increasingly, with atomoxetine, a nonstimulant agent.

Healthcare expenditures and resources are greater for children with special healthcare needs (CSHCN), but this patient population and their families are often challenged by inferior care coordination, increased financial burden due to medical illness, unmet health needs, and poor health outcomes. The pediatric, family-centered medical home model of primary care has gained momentum as an approach to remedy the shortcomings of a healthcare provider-centric system of care for CSHCN.

The Centers for Medicare & Medicaid Services publicly reports hospital-level, 30-day, risk-standardized readmission rates for patients hospitalized for congestive heart failure (CHF), acute myocardial infarction, and for patients undergoing percutaneous coronary intervention (PCI). A provision of the Patient Protection and Affordable Care Act will link quality outcomes, including 30-day readmission rates, to hospital reimbursement.

San Diego—A regimen of lenalidomide plus dexamethasone proved safe and effective in patients with relapsed or refractory multiple myeolma, according to a retrospective analysis of 2 randomized, double-blind, phase 3 trials presented in a poster session at the ASH meeting. Of the 353 patients in the studies, 18% had progression-free survival (PFS) for ≥2 years.

San Diego—Treating patients with diseases of the blood and bone marrow known as myeloproliferative neoplasms (MPNs) costs 2 to 6 times more annually compared with treating matched noncancer controls, according to a database analysis of a commercially insured population. Results were presented at the ASH meeting in a poster titled A Retrospective Observational Study of Annual Healthcare Costs for Patients with Forms of Myeloproliferative Neoplasms (MPN).

San Diego—According to a cross-sectional survey of patients with chronic myeloid leukemia (CML) in the United States and Europe, patients who took nilotinib were significantly more likely to have difficulty adhering to their treatment regimen compared with patients who took dasatinib or imatinib.

San Diego—A prospective, longitudinal, observational study found that the health-related quality of life (HRQOL) in patients with chronic lymphocytic leukemia (CLL) did not differ based on age. In addition, the most common type of first-line treatment for all patients was the combination of fludarabine, cyclophosphamide, and rituximab (FCR), although the use of that regimen decreased as patients got older. Results were presented in a poster session at the ASH meeting.

San Diego—The final, 5-year analysis of a phase 3 trial found that previously untreated patients with multiple myeloma who took bortezomib had a significant improvement in overall survival compared with patients who did not take bortezomib. Jesus F. San Miguel, MD, PhD, the study’s lead author, discussed the results in an oral abstract session at the ASH meeting.

The US Food and Drug Administration has approved bortezomib to treat patients with multiple myeolma as well as patients with mantle cell lymphoma who have received ≥1 previous treatment.

San Diego—A retrospective cohort analysis of medical claims databases found that the costs associated with treating patients with chronic myeloid leukemia (CML) were substantial, with the majority of the expenses attributed to hospitalizations.

The results were presented at the ASH meeting in a poster titled Health Care Utilization and Cost in Patients with Chronic Myeloid Leukemia in a Privately Insured Patient Population in the United States.

Orlando—Two commonly used anticlotting regimens—abciximab with unfractionated heparin and bivalirudin—were similarly effective in preventing death, subsequent myocardial infarction (MI), or need for further revascularization in patients with non–ST-segment elevation MI (non-STEMI) undergoing percutaneous coronary intervention (PCI), according to Adnan Kastrati, MD, lead researcher for the ISAR-REACT 4 (Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment) study.

Orlando—A follow-up analysis of a phase 3 trial found that patients with very high triglyceride levels who took 4 g/day of AMR101 had a significant reduction in the lipoprotein concentrations of the large very-low-density lipoprotein (VLDL), total low-density lipoprotein (LDL), small LDL, and total high-density lipoprotein (HDL) particles. The authors also concluded that AMR101 significantly reduced the VLDL particle size but did not change the LDL particle size.

Orlando—Enhanced prescription coverage improved medication adherence and rates of first major vascular events and decreased patient spending without increasing overall health costs when eliminating medication copays for patients following myocardial infarction (MI), according to the results of the MI FREE (Post-Myocardial Infarction Free Rx Event and Economic Evaluation) trial. Niteesh K. Choudhry, MD, PhD, presented the findings at the AHA meeting. This study was also reported in the New England Journal of Medicine [2011;365(22):2088-2097].

Madrid—According to an interactive tool developed to estimate the first-year cost of administering and monitoring multiple sclerosis (MS) therapies, glatiramer acetate was the cheapest treatment option, followed by interferon beta-1a intramuscular injection, interferon beta-1a subcutaneous injection, interferon beta-1b subcutaneous injection, fingolimod, and natalizumab.

The results were presented at the ISPOR European Congress in a poster titled Estimated Costs of First-Year Monitoring and Administration of Multiple Sclerosis Therapies in the United States.

A family history (FH) of Alzheimer’s disease (AD) is linked to preclinical abnormalities in disease biomarkers, independent of the risk conferred by the apolipoprotein E (APOE) susceptibility gene in cognitively normal middle- to older-aged individuals [Arch Neurol. 2011;68(10):1311-1317].

Researchers have known that using biomarkers to facilitate early detection of Alzheimer disease (AD) is crucial for developing potential treatment. Studies have shown that Aβ42 and tau protein levels in cerebrospinal fluid (CSF), region-specific fludeoxyglucose F18 (FDG) uptake using positron emission tomography, and hippocampal volume using magnetic resonance imaging (MRI) all are markers associated with AD.