United Healthcare

Diversified Pharmaceutical Services, Inc., with roots going back to the early 1970s, is credited for establishing maximum allowable cost (MAC) programs and mandatory generic drug programs.It has been associated with SmithKline Beecham Healthcare Services and was once a subsidiary of the United Healthcare Corporation, but is now part of the Express Scripts network. 

Pharmacopoeia publications provide a final important source of information for the pharmaceutical industry, regulatory authorities, and the healthcare professions. These are concerned with establishing quality standards. These publications include monographs that define specifications for the purity and identity of established pharmaceutical ingredients, both active and non-active, together with recognised analytical methods that may be used to evaluate them. The most relevant are the United States Pharmacopoeia (USP) and the European Pharmacopoeia (Ph.Eur). 

Nevertheless, the Clintons healthcare reform scheme had a deleterious effect on the hiring of new computational chemists. The job market for computational chemists in the United States fell from a then record high in 1990 to a depression in 1992-1994 [119]. This happened because pharmaceutical companies were afraid to expand until they were sure that the business climate was once again hospitable for growth. The healthcare reform proposal was defeated in the United States Congress, but it took a year or two before pharmaceutical companies started rebuilding their workforces. 

In a recent seminar, a medical expert noted that the United States has given away economic and technical dominance in industry after industry to other countries. Healthcare research is one of the few areas in which the U.S. enjoys unparalleled leadership which has enormous impact on the quality of medical care. If the healthcare industry and the academic medical enterprise falters—and this is in danger right now—I think it will be an absolute disaster for this country [40]. Many in pharmacy, medicine, and other healthcare fields would concur with the above statement. The problem is that many others in the public sector do not fully appreciate what is at stake. Pharmacists have an opportunity to help tell the story, as difficult as it sometimes is to convey. 

Center for Healthcare Technologies at Lawrence Livermore National Laboratory in Livermore, potentially capable to measure pH at or near the stroke site29. The probe is the distal end of a 125 pm fibre tapered up to a diameter of 50 pm. A fluorescent pH-indicator, seminaphthorhodamine-1-carboxylate, is embedded inside a silica sol-gel matrix which is fixed to the fibre tip. Excitation of the dye takes place at 533 nm and the emission in correspondence of the acid (580 nm) and basic (640 nm) bands are separately detected. The use of this ratiometric technique obviates worrying about source fluctuations, which have the same effects on the two detected signals. The pH sensor developed was first characterised in the laboratory, where it showed fast response time (of the order of tens of seconds) and an accuracy of 0.05 pH units, well below the limit of detection necessary for this clinical application (0.1 pH units). The pH sensor was also tested in vivo on rats, by placing the pH sensor in the brain of a Spraque-Dawley rat at a depth of approximately 5 mm30. 

As we grow older our muscle strength diminishes and the risk of developing sarcopenia increases. The meaning of the word sarcopenia is an abnormal decline in muscle strength and mass. Another word is muscle atrophy. Between early middle age and older age the mean decrease is 50% of muscle mass. Another way to calculate the loss of muscle mass is that over 50 years of age 1-2% of muscle tissue mass vanishes yearly. Between 50 and 70 years of age almost 15% of muscle strength per 10 years disappears. The resulting disability in older persons with sarcopenia has been calculated to cost approximately 900 dollars per person and year. The yearly total of healthcare expenditures for sarcopenia in the United States is estimated at 18-20 billions (Janssen et al. 2004). 

United Kingdom Medicines and Healthcare Products Regulatory Agency... 

In the United Kingdom, clinical trial applications are submitted to the Medicines and Healthcare Products Regulatory Agency (MHRA). There are several schemes for clinical trial application the major two are the Clinical Trial Certificate (CTC) and Clinical Trial Exemption (CTX) schemes. 

Scott White s Center for Advanced Medicine in Temple, Texas, is the first comprehensive, all-digital healthcare facility in the United States and opened in 2005 with the assistance of MED, as well as many other Siemens divisions. A truly integrated hospital, Scott White will utilize Siemens healthcare information technology solutions for patient monitoring and for connecting all hospital departments to allow more... 

The minimum standards for the facilities in which clinical pharmacology studies should be conducted are described in ABPl guidelines. Clearly, the same standards should apply to all organisations involved in conducting studies. In the United Kingdom, the Medicines and Healthcare products Regulatory Agency (MHRA) has instituted inspection of facilities and procedures, and a system of certification is in place. 

This chapter is written from a UK perspective and readers in coimtries outside the United Kingdom will need to make allowances for this. Some specific points may not be relevant to your country but in general, the principles apply to most healthcare systems. 

In the United States, there are several computerised healthcare systems, sometimes referred to as multipurpose databases, which have been used for post-marketing surveillance purposes. The best-known include Group Health Cooperative of Puget Sound, Kaiser-Permanente, Medicaid, Rhode Island and the Saskatchewan database in Canada. ... 

The applications for national authorisations are submitted to the national competent authority which, in the United Kingdom, is the Licensing Authority (LA), whose functions are discharged by the Medicines and Healthcare products Regulatory Agency (MHRA, previously Medicines Control Agency, MCA) of the Department of Health. The LA/MHRA are advised by the CSM, a multidisciplinary scientific body consisting of clinical, preclinical and pharmaceutical members well known for their expertise in their respective fields. Lay members are also included. 

Each Member State has designated a competent authority, which is the governmental authority responsible for implementing the Directive in that Member State. In the case of the United Kingdom, the competent authority is the Medicines and Healthcare Products Regulatory Agency (MHRA). The principal function of a competent authority in practice is to ensure the safety and health of patients and users of MDs. 

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