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Biomedical subjects

P J Panzarino

Publications and source records attributed to P J Panzarino.

8 recordsLinked to original sources
PubMed2001

Cost-effective treatment of depression with selective serotonin reuptake inhibitors.

OBJECTIVE: To compare factors that influence cost of antidepressant therapy between older tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) and among drugs in the SSRI class. STUDY DESIGN: Literature review. RESULTS: Pharmacoeconomic data from the primary care and managed care settings demonstrate that the higher acquisition cost of the SSRIs is offset by reduced medical utilization because of a lower incidence of treatment-related adverse events, drug switching, and dosage adjustments than among patients taking TCAs. Analysis of pharmacy claims data suggests that drug acquisition costs, use of concomitant medications, incidence of dose titration, frequency of multitablet therapy (dose stratification), and duration of therapy are the key factors in determining the cost of SSRI therapy. Among the established SSRIs, drug acquisition costs are lowest for paroxetine and sertraline. Costs for concomitant medications may vary by healthcare plan. Recent reports indicate that paroxetine is associated with a low incidence of dose titration. Paroxetine and sertraline are available in extended dosage forms to reduce the need for multitablet therapy. Duration of therapy with all SSRIs is typically shorter than recommended. CONCLUSION: Antidepressant therapy with SSRIs has been shown to be more cost effective than treatment with TCAs when overall healthcare utilization and expenses are considered.

Antidepressive Agents↗
PubMed2001

Economic evaluation of major selective serotonin-reuptake inhibitors in a managed care population.

This study evaluated pharmaceutical charges and economic outcomes related to therapy with the three leading selective serotonin-reuptake inhibitors. Patient treatment episodes of major depression occurring between July 1, 1995 and June 30, 1996 were included for analysis (patient age range, 18-64 yr). Results showed no significant differences among direct and related medical charges for fluoxetine, paroxetine, and sertraline. Direct and related pharmaceutical charges were significantly lower for paroxetine and sertraline compared with fluoxetine. The higher drug charges observed for fluoxetine resulted in higher total treatment charges compared with paroxetine and sertraline.

Adolescent↗
PubMed2000

Psychiatric training and practice under managed care.

Today's psychiatry residents are facing many challenges that were unknown to their predecessors who received training before the managed care era. The author explores such challenges including the shift in treatment approach from psychoanalysis toward neurobiology, psychopharmacology, and cognitive and behavioral models of psychopathology and psychotherapy. Other demands that practitioners in training must deal with under managed care are accountability, loss of autonomy, and administrative burdens. Despite these challenges, managed care appears to have brought about positive changes in ways that psychiatry is practiced, such as standardization of credentialing and of authorization forms, and greater use of technology to improve administrative efficiency. Most importantly, systems of care necessarily involve people working together, not in isolation, which should be the central lesson of residency training and private practice under managed care.

Curriculum↗
PubMed1998

The costs of depression: direct and indirect; treatment versus nontreatment.

Depression is one of the most costly illnesses in the United States today. While managed care often focuses on the costs of treatment, the costs of nontreatment are usually ignored. We have potent treatments that are highly successful, but depression is often undetected or undertreated where it appears most commonly-in the primary care setting. When comorbid with other medical problems, especially cardiovascular disease, depression greatly increases mortality, morbidity, and expense. Sophisticated pharmacoeconomic analyses can guide our cost/benefit studies, but the real cost savings and highest quality care will come by investing in educating primary care physicians regarding the recognition and treatment of psychiatric illness as it presents in their clinical practices.

Antidepressive Agents↗
PubMed1995

Toward the behavioral health report card.

In this article, the authors review current organized efforts, strategies, and partnerships involved in attempts to design a behavioral health care report card that offers a comprehensive approach to obtaining performance measurements in the fields of psychiatry and chemical dependence treatment.

Data Collection↗
PubMedDate not supplied

Integrating outcomes, quality and utilization data for profiling behavioral health providers.

Profiling the performance of mental health providers can be done on the basis of performance indicators derived from outcomes research, quality assurance and utilization review. By focusing on collaboration and data-driven accountability, the authors have attempted to use provider profiling to rebalance the relationship between payor, provider and managed care organization, while avoiding the perception of a punitive grading system. Outcomes data thus are directly tied into provider profiling, in addition to their more customary uses in assessing and improving the quality of treatment results.

California↗