The American journal of managed care
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Globally, lung cancer is the leading cause of cancer-related mortality among both men and women, and while mortality associated with the disease has demonstrated relative stability over the years, evidence has suggested an increasing incidence and prevalence of the disease. Unfortunately, the diagnosis of lung cancer is often made late in the course of the disease, with almost 70% of patients presenting with locally advanced or metastatic disease at initial diagnosis. Non-small cell lung cancer (NSCLC) is the most common form of the malignancy, occurring in up to 85% of cases. ⋯ Enhanced understanding of the pathophysiology of NSCLC has led to substantial improvements in diagnostic, prognostic, and therapeutic interventions for NSCLC. The discovery of targetable molecular alterations in genes, such as epidermal growth factor receptor (EGFR), has driven the evolution of targeted therapies for NSCLC and shifted treatment paradigms for the disease. This article will summarize the epidemiology and pathophysiology of NSCLC, its associated gene mutations and biomarkers, and the approach to treatment, with a focus on patients whose tumors harbor EGFRactivating mutations.
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The management of prostate cancer (PrCa) and especially castration-resistant disease can be complex, challenging, and costly. Significant developments in the field of oncology have led to the further development of safe and effective therapies that are better targeted to particular tumor types and to individual patients. ⋯ It is vital that managed care clinicians and providers analyze the burden and the costs of cancer in the United States, especially those relating to PrCa and especially CRPC. This will allow a better understanding of how costs and issues relating to healthcare utilization affect the treatment of patients with CRPC, and impact individualized therapy and management decisions.
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To assess the effect of initiating antidepressant therapy with a generic prescription on adherence to antidepressant therapy among Medicare patients. A second objective is to assess how the effect might be moderated by the Medicare Part D coverage gap. ⋯ Generic initiation can be an important tool to improve adherence to antidepressant treatment among Medicare patients and to mitigate the negative effects of the Part D coverage gap.
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To assess the association between Dietary Diversity Scores (DDSs, range: 0-6 points) and medical service utilization and expenditures. ⋯ Greater dietary diversity is associated with lower emergency and hospitalization utilization and expenditures, but not lower use of ambulatory services. There is a need for health services to develop a nutrition policy for nutritionally disadvantaged groups.
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To determine the extent to which health plans were collecting and using data on the race, ethnicity, and language proficiency of network physicians and other network providers. ⋯ Even though health plans and other healthcare organizations were more likely in 2010 than in the past to collect data on member/patient race, ethnicity, and language preferences, collection and use of data on providers' race/ethnicity have not expanded in scope since 2006. Collection and use of data on providers' proficiency in languages other than English were more common.