Biomedical subjects

Helene Levens Lipton

Publications and source records attributed to Helene Levens Lipton.

4 recordsLinked to original sources

PubMed2005

Patient-assistance programs: assessment of and use by safety-net clinics.

PURPOSE: Safety-net clinics' use and assessment of patient-assistance programs (PAPs) were studied. METHODS: A multistate telephone survey was conducted on the basis of issues identified during 10 case-study interviews of safety-net clinics serving primarily uninsured and publicly insured patients. Interviewed were pharmacists and other staff taking primary responsibility for helping patients apply to PAPs. RESULTS: Of 339 survey candidates, 215 provided complete interviews (63% response rate). Ninety-three percent of the completed interviews were with clinics in California, Texas, and Florida. Forty percent of the clinics reported that at least 75% of their patients lacked drug insurance coverage. There was a significant positive relationship between a clinic's likelihood of using PAPs and the percentage of its patients lacking drug coverage. PAPs consumed 12 hours of pharmacist time per month and 99 hours of other staff time per month. Clinics most frequently cited program requirements changing without notice and unrealistic income-documentation rules as potential barriers to PAP use and indicated that consistent eligibility criteria and standardized application procedures were needed. CONCLUSION: A survey of safety-net clinics indicated that PAPs help fill a major gap in health insurance coverage but that consistent eligibility criteria and application procedures are needed.

Ambulatory Care↗

PubMed2005

Managing the unmanageable: the nature and impact of drug risk in physician groups.

As drug costs rose in the 1990s, health maintenance organizations (HMOs) began transferring risk for prescription drug expenditures to physician groups. With principal-agent theory as a framework for understanding drug-risk transfer, we used a multiple case-study design to examine the relationship between the level of drug risk that a physician group accepts and the physician group's adoption of drug-use management strategies. The data demonstrated that adoption of drug-use management innovations was not related to level of risk for pharmacy costs and that factors other than drug-risk level (e.g., contracting and data issues, financial and market factors, and physician group assessments of the fairness and incentives of risk contracts) can influence the principal-agent relationship. The data also revealed a novel form of information asymmetry between physicians and HMOs and unexpected failures of HMOs to fully enable their physician-agents. We believe these observations reflect the complexity of relationships in the health care system and have implications for the use of incentives. Based on principal-agent theory and our findings, we offer an alternative approach to drug-risk contracting that reduces physicians responsibility for aspects of drug use that are beyond their control while maintaining the incentives to manage drug costs and use that were the original intent of drug-risk contracting.

Drug Costs↗

PubMed2003

Electronic prescribing: ready for prime time?

Escalating drug expenditures and the prevalence of medication errors have prompted calls for drug cost control and quality improvement. E-prescribing promises to address these concerns. This study aims to describe the benefits and costs of eRx as assessed by key industry stakeholders, identify the components of a needed electronic prescribing infrastructure and the barriers to its completion, and identify potential public and private policies and initiatives that could encourage the development of an EPI and hasten eRx adoption among stakeholders.

Clinical Pharmacy Information Systems↗

PubMedDate not supplied

Oxymoron no more: the potential of nonprofit drug companies to deliver on the promise of medicines for the developing world.

Although some pharmaceutical company efforts to develop and distribute drugs in developing countries have been successful, many fall short of meeting needs in resource-poor nations. In the context of public-private partnerships, we discuss the concept of a nonprofit pharmaceutical company dedicated to developing and distributing drugs for diseases endemic in developing countries. Using the experience of the Institute for OneWorld Health, we present the vision, core elements of the product development model, and challenges confronting this model. Despite limitations, early successes raise hopes that a nonprofit drug company can exist successfully both as a global health organization and as a business.

Developing Countries↗