Managed Care - November 2008 - (Page RSVCover2)

WELCOME INTRODUCTION Care Editor JOHN MARCILLE Managing Editor FRANK DIAMOND Associate Editor TONY BERBERABE Design Director PHILIP DENLINGER MediMedia Managed Markets Publishing Editor, Custom Publications MICHAEL D. DALZELL Senior Editors, Custom Publications KATHERINE T. ADAMS AMY KRAJACIC Contributing editor to this supplement JACK MCCAIN Group Publisher TIMOTHY P. SEARCH, RPH Director of New Product Development TIMOTHY J. STEZZI Eastern Sales Manager SCOTT MACDONALD Senior Account Manager KENNETH D. WATKINS, III Director, Production Services WANETA PEART Circulation Manager JACQUELYN OTT MANAGED CARE (ISSN 1062-3388) is published monthly by MediMedia USA, 780 Township Line Road, Yardley, PA 19067. This is Supplement 12 to Vol. 17, No. 11. Periodicals postage paid at Morrisville, Pa., and additional mailing offices. POSTMASTER: Send address changes to MANAGED CARE, 780 Township Line Road, Yardley, PA 19067. Price: $10 per copy, $100 per year in the United States; $120 per year elsewhere. Phone: (267) 685-2788. E-mail: editors_mail@managedcaremag.com. Copyright 2008, MediMedia USA. M A N A G E D Managed Care Considerations: Vulnerable Populations and Prevention Strategies For Respiratory Syncytial Virus Disease STEVEN R. PESKIN, MD, MBA Chief Medical Officer The Chatham Institute, Chatham, New Jersey espiratory syncytial virus (RSV) is a source of substantial morbidity in the very young and the very old. For children younger than 1 year, serious RSV infection of the lower respiratory tract may require hospitalization for bronchiolitis or pneumonia, and for premature infants, the services of a neonatal intensive care unit. Among the elderly, RSV often is active at the same time as influenza and appears to be responsible for some of the deaths attributed to influenza. There is no treatment for RSV infection, so prophylactic measures are the key to protecting high-risk populations. For the elderly, commonsense precautions like washing hands and minimizing visits from small children can break the transmission of RSV. For infants, immunoprophylaxis with palivizumab (Synagis) is available. Palivizumab is a humanized monoclonal antibody that binds with a protein on the surface of the virus, effectively neutralizing it. The drug, however, does not elicit any immune response that confers lasting protection — palivizumab is the protection. To be effective, it must be administered prior to the beginning of an RSV season and every 30 days thereafter for the duration of the season. For high-risk infants, such as infants younger than 35 weeks gestational age, immunoprophylaxis with palivizumab should be administered before hospital discharge and then throughout the infant’s first RSV season. These considerations raise several challenges for physicians and for medical directors and pharmacists in managed care organizations: Quickly identifying those infants at high risk for whom immunoprophylaxis is appropriate; knowing when the RSV season is likely to begin in a given locale; administering the first dose prior to the RSV season; and making sure that patients adhere to therapy. These and related issues were addressed by an RSV Expert Panel convened by The Chatham Institute this past August in Chicago. The articles in this supplement are an outgrowth of that panel and present the perspectives of practicing physicians, a pediatrician, and managed care executives. R Disclosure: Steven R. Peskin, MD, MBA, has no real or apparent conflicts of interest with respect to companies, organizations, or proprietary products mentioned in this supplement. This supplement is supported by an educational grant from MedImmune. The material in this supplement has been independently peer reviewed. The grantor played no role in reviewer selection. Opinions are those of the authors and do not necessarily reflect those of the institutions that employ them, or of MedImmune; The Chatham Institute; MediMedia USA; or the publisher, editor, or editorial board of MANAGED CARE. Clinical judgment must guide each clinician in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this supplement may reflect the clinical experience of the authors or may reflect the professional literature or other clinical sources and may not be the same as indicated on the approved package insert. Please consult the complete prescribing information on any products mentioned in this publication. MediMedia USA assumes no liability for the material published herein.

Table of Contents Feed for the Digital Edition of Managed Care - November 2008

Managed Care - November 2008 Editor’s Memo Contents News and Commentary Legislation & Regulation Letters Medication Management Compensation Monitor Do It Yourself for Less Biomarkers Promise, but Do They Deliver? Oncologists Complain About Drug Payment Consider Blood Pressure Self-Monitoring Q&A: Keep Industry in the Game Formulary Files Plan Watch Tomorrow’s Medicine Outlook Respiratory Syncytial Virus Managed Care Considerations Contents Continuing Education Objectives RSV Disease in the Pediatric Population In the Trenches RSV Infection in the Adult Population Health Plan Medical Director Health Plan Pharmacy Director RSV Issues and Solutions Assessment/Evaluation/Certificate Request Post-Test

Managed Care - November 2008

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