These certain results; but the perception that they do is clearly there and colors any use of the information that may be made by their target audience. They also do actually seem to apply some real pressure. I saw a review article in which something like 39 articles talking about nonsteroidal anti-inflammatory drugs were reviewed. And in 95 percent of the cases or something like that, the target drug was found to be superior or great or nontoxic or whatever they were looking at. In a subsample of those studies, there were 19, I think, that were studied for toxicity. In all cases the author said the target drug was less toxic than the other drug or no more toxic than the other drug; however, the research backing it up right there in the very article didn't back it up all the time. In only 12 cases was the conclusion determined to be justified. So you have to read carefully when you're looking at research that's sponsored by somebody with an interest. Finally, many of these studies are not transparent--meaning they're not good about disclosing the methods that they use to measure things or about telling you everything that they even measured. If they're talking about cost, they didn't specify what comprised those costs. Or, in the case of some stuff we were looking at, if they said, "Yes, the ulcer rate was such and so, " they didn't say how they measured it. So you have to pick and choose among the literature if you're going to use this stuff for anything substantive. Up until now, PE research has tended to be overlooked by MCO actuaries. Many problems, as already stated, make the literature hard to deal with. Also, this field has been put together by economists. It's still coming about and is very new, but it looks very academic when you look at the research. It doesn't tend to look business-oriented, which is what people and the MCO want to see. They're running a business. So it's hard to make use of some of the articles when they're talking about dominance theory or some other sort of economic result. It's difficult to decide how to use that information. FORMULARY FORMAT The Academy for Managed Care Pharmacies recently--about a year and a half ago, I would say--put out a format for formulary submissions. This is a set of guidelines for pharmaceutical companies to use when they're preparing a dossier to submit to a MCO to try to get the new drug on the formulary. This format is a template or a guide. It's not a mandate, but it does try and codify, to some extent, what you need to be describing about new drugs when you want to get yourself out there in the market. It concentrates on five areas, the first being a description of the disease and the agent's role in treating the disease. Number two is the clinical efficacy, safety, effectiveness--typical clinical trial stuff. Healthy Exercise. Error! Bookmark not defined. What Ever Happened to Jim Fixx? . Error! Bookmark not defined. A Step-by-Step Approach. Error! Bookmark not defined. Can't I Do It Home?. Error! Bookmark not defined. What Specifically Does a Good Workout Routine Look Like?. Error! Bookmark not defined. GENERAL GUIDELINES ABOUT EXERCISE . Error! Bookmark not defined and frusemide.

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