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1.  Content Analysis of False and Misleading Claims in Television Advertising for Prescription and Nonprescription Drugs 
False and misleading advertising for drugs can harm consumers and the healthcare system, and previous research has demonstrated that physician-targeted drug advertisements may be misleading. However, there is a dearth of research comparing consumer-targeted drug advertising to evidence to evaluate whether misleading or false information is being presented in these ads.
To compare claims in consumer-targeted television drug advertising to evidence, in order to evaluate the frequency of false or misleading television drug advertising targeted to consumers.
A content analysis of a cross-section of television advertisements for prescription and nonprescription drugs aired from 2008 through 2010. We analyzed commercial segments containing prescription and nonprescription drug advertisements randomly selected from the Vanderbilt Television News Archive, a census of national news broadcasts.
For each advertisement, the most-emphasized claim in each ad was identified based on claim iteration, mode of communication, duration and placement. This claim was then compared to evidence by trained coders, and categorized as being objectively true, potentially misleading, or false. Potentially misleading claims omitted important information, exaggerated information, made lifestyle associations, or expressed opinions. False claims were factually false or unsubstantiated.
Of the most emphasized claims in prescription (n = 84) and nonprescription (n = 84) drug advertisements, 33 % were objectively true, 57 % were potentially misleading and 10 % were false. In prescription drug ads, there were more objectively true claims (43 %) and fewer false claims (2 %) than in nonprescription drug ads (23 % objectively true, 7 % false). There were similar numbers of potentially misleading claims in prescription (55 %) and nonprescription (61 %) drug ads.
Potentially misleading claims are prevalent throughout consumer-targeted prescription and nonprescription drug advertising on television. These results are in conflict with proponents who argue the social value of drug advertising is found in informing consumers about drugs.
Electronic supplementary material
The online version of this article (doi:10.1007/s11606-013-2604-0) contains supplementary material, which is available to authorized users.
PMCID: PMC3889958  PMID: 24030427
direct-to-consumer advertising; over-the-counter drug advertising; over-the-counter drug; false or misleading advertising; content analysis
2.  Effects of Medicare Part D on Drug Affordability and Utilization: Are Seniors with Prior High Out-of-Pocket Drug Spending Affected More? 
Medicare Part D was expected to have differential impacts on patient drug expenditures and utilization based on beneficiaries’ levels of pre-Part D patient drug spending, but it is unknown whether these projections have borne out
We sought to evaluate whether and how the policy effect of Medicare Part D on drug expenditures and utilization was modified by levels of pre-Part D drug spending.
A quasi-experimental, pretest-posttest, nonequivalent control group design was used. Data were obtained from a regional supermarket chain for all prescriptions dispensed between January 1, 2005 and December 31, 2007 (n =1,230,612) to patients age 60 and older as of January 1, 2005 (n = 51,305) to construct 12-month pre-Part D and post-Part D periods. The treatment group was defined as individuals who were eligible via age, for Part D coverage on January 1, 2006 (ages 65+). The control group included individuals aged 60 through 62 on January 1, 2006. Annual medication utilization was measured as the total number of pill-days acquired. Annual drug expenditures were measured as total expenditures, patient out-of-pocket expenditures, and the proportion of total expenditures paid out of pocket by the patient.
Part D resulted in significantly greater reductions in absolute and relative out-of-pocket spending for individuals in the highest pre-Part D drug spending group relative to the moderate and low pre-Part D drug spending groups.
Our findings suggest that, as expected, Part D facilitated access to medications for patients who previously experienced the greatest costs without adversely increasing use and costs among those with the lowest prior cost.
PMCID: PMC4087326  PMID: 20511108
Medicare Part D; Utilization; Out-of-pocket Spending; Access
3.  Practice Characteristics of Bachelor of Science and Doctor of Pharmacy Degreed Pharmacists Based on the 2009 National Workforce Survey 
To compare practice settings and activities of pharmacists with bachelor of science (BS) in pharmacy and doctor of pharmacy (PharmD) degrees.
Data from the 2009 National Pharmacist Workforce Survey instrument were analyzed. Multivariate regression was used to examine the association of the PharmD degree with time spent in dispensing and patient care.
The survey response rate by pharmacists was 52%, and 562 usable responses met our inclusion criteria. Sixty-three percent of BS and 39% of PharmD pharmacists were employed in community pharmacies, compared with 21% of BS and 38% of PharmD pharmacists employed in hospital pharmacy settings. Practicing in a community setting had the strongest influence on time spent in dispensing and time spent in patient care. Among respondents with PharmD degrees, a residency was associated with less time in dispensing and more time in patient care.
Time spent in dispensing and patient care were influenced more by practice setting than by educational degree and residency training.
PMCID: PMC2996749  PMID: 21301593
degrees; graduates; pharmacist; workforce
4.  Development of a Scale to Measure Pharmacists’ Self-Efficacy in Performing Medication Therapy Management Services 
Measuring community pharmacists’ self-efficacy in performing medication therapy management (MTM) services can be useful for tailoring interventions and predicting participation.
To identify relevant survey constructs related to the Wisconsin Pharmacy Quality Collaborative (WPQC) MTM program and to evaluate scale validity.
The 31-item MTM Self-efficacy Scale was developed using previous research, identifying critical program components, and beta-testing. After administration to pharmacists in the 53 WPQC pilot sites, summary statistics and exploratory factor analysis (EFA) were conducted. Parallel analysis was used to determine the optimal number of factors. Internal consistency reliabilities were calculated.
Baseline participation rate was 94% (N=76). The 11-point scale (0–10) item means ranged from 2.83±3.05 to 7.82±2.19. Parallel analysis produced a 3-factor solution, accounting for 56% of the variance. Low factor loadings or unacceptably high cross-loadings resulted in 17 item deletions. The final EFA on the remaining 14 items retained the original 3-factor solution and increased the proportion of explained variance (72%). The factors relate to MTM tasks (alpha = 0.92), personal interactions (alpha = 0.86), and goal setting (alpha = 0.84). Overall Cronbach’s alpha = 0.90.
Constructs for measuring self-efficacy were identified that may aid in future research predicting whether pharmacists engage in and persist in providing MTM services.
PMCID: PMC2904078  PMID: 20511114
Self-efficacy; Medication therapy management; Community pharmacy; Scale validation; Research methods
5.  State Medicaid Pharmacy Payments and Their Relation to Estimated Costs 
Health Care Financing Review  1994;15(3):25-42.
Although prescription drugs do not appear to be a primary source of recent surges in Medicaid spending, their share of Medicaid expenditures has risen despite efforts to control costs. As part of a general concern with prescription drug policy, Congress mandated a study of the adequacy of Medicaid payments to pharmacies. In this study, several data sources were used to develop 1991 estimates of average pharmacy ingredient and dispensing costs. A simulation was used to estimate the amounts States pay. Nationally, simulated payments averaged 96 percent of estimated costs overall but were lower for dispensing costs (79 percent) and higher for ingredient costs (102 percent).
PMCID: PMC4193454  PMID: 10137796
6.  Assessing potential prescription reimbursement changes: Estimated acquisition costs in Wisconsin 
Health Care Financing Review  1989;10(3):67-75.
Potential impacts from two methods of changing prescription drug ingredient reimbursement in the Wisconsin Medicaid program were estimated. Current reimbursement amounts were compared with those resulting from either direct prices for eight manufacturers' products and average wholesale price less 10.5 percent for other products or wholesaler cost plus 5.01 percent for all products. The resulting overall average ingredient cost reimbursement reductions were 6.64 percent ($0.56 per prescription) and 6.94 percent ($0.59 per prescription) for the two methods, respectively. The results should be viewed from the perspective of both program savings and reduced pharmacists' revenues.
PMCID: PMC4192959  PMID: 10313098

Results 1-6 (6)