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Am Fam Physician. 2000;62(4):717-718

Major Insurers Announce Health Plan Changes

The Coalition for Affordable Quality Healthcare (CAQH), a group of 24 major insurers, began an advertising campaign on July 20 highlighting significant changes they will initiate in their health plans. The participating companies have been meeting for the past six months to discuss ways to improve health care coverage, service and quality for patients and physicians. The changes that the insurers have agreed to include administrative simplifications such as a standard procedure for physician credentialing, a Web site to help physicians identify prescription medicines covered by health plans, direct access to obstetric and gynecologic services and to pediatricians, coverage of emergency care that a reasonable person would consider an emergency, a wider choice of health plans, and full and honest communication about all treatment options, costs and outcome alternatives. The coalition will continue to work for further improvements, seeking partnerships with other health-related organizations. Specific information on the insurers' initiative may be found at

NIAID Will Fund HIV Vaccine Trials Network

The National Institute of Allergy and Infectious Diseases (NIAID) recently announced plans to fund nine U.S. clinical units of the new human immunodeficiency virus (HIV) vaccine trials network. The comprehensive, clinically based network will develop and test preventive HIV vaccines. Additional sites will be located in Africa, Asia, Latin America and the Caribbean. NIAID will contribute more than $29 million for the first year of the vaccine trials network. NIAID is also convening a National HIV Vaccine Communications Steering Group to stimulate and enhance the national dialogue concerning HIV preventive vaccines. NIAID is a component of the National Institutes of Health. NIAID conducts and supports research to prevent, diagnose and treat illnesses such as HIV infection and other sexually transmitted diseases, tuberculosis, malaria, asthma and allergies. More information on NIAID's mission is available at

Safeguards Needed to Protect Children from Dosing Errors

In a study undertaken by the Institute for Safe Medication Practices (ISMP) and the Pediatric Pharmacy Advocacy Group (PPAG), it was found that certain safety measures are not being taken to protect children from medication errors in hospitals. One such underused safeguard is the practice of including the mg-per-kg dose on all pediatric drug orders. Seventy-five percent of respondents said that prescribers failed to include the mg-per-kg dose on children's drug orders. Failing to include the dose on drug orders is dangerous because it does not allow pharmacists to perform double-checks on pediatric medication therapy. The survey is the first joint effort between ISMP and PPAG, who recently decided to collaborate on medication safety in children. “We feel strongly that pediatric pharmacy is an area where we can make a real difference in patient safety,” said ISMP President Michael R. Cohen. “By working together with PPAG we can accomplish so much to protect these, our littlest and most vulnerable patients,” he said. For more information on the survey findings, visit the ISMP Web site (

Study Finds Increase in Physicians' Use of E-mail

According to a recent study, in one year's time, physicians' use of e-mail with patients has doubled. The study, titled “Physicians' Use of the Internet,” was undertaken by Medem, a health network formed by several medical societies and the American Medical Association. According to the study data, 10 percent of physicians are using e-mail regularly to communicate with their patients. “Empowering the way physicians and patients communicate begins by providing them with the most authoritative health care information available and extends to e-mail interactions and beyond,” said Edward Fotsch, M.D., chief executive officer of Medem. In addition, the study found that up to 50 percent of practices have Web sites, more than twice that of nine months ago. For more information about the study, visit Medem's Web site (

ISMP to Publish Dosing Corrections on Its Web Site

The Institute for Safe Medication Practices (ISMP) has launched “Textbook Errata,” a new menu option on its Web site ( devoted to correcting dosage errors and other incorrect information found in published articles or books. The Web page was created by ISMP because it often receives reports about published mistakes, yet there was no central clearinghouse for practitioners to learn the corrections. ISMP is encouraging drug reference publishers and practitioners to use the free site. Authors, publishers and practitioners can submit information directly to ISMP via e-mail at ISMP is a nonprofit organization known as an educational resource for the prevention of medication-system errors.

Prescription Drug Spending Increased 17.4 Percent in 1999

A study by St. Louis-based Express Scripts found that spending on prescriptions rose a record 17.4 percent in 1999. Elderly women were hardest hit, with those 70 to 79 years of age paying 18 percent more and those 80 years and older paying 20 percent more. Men in those age groups paid 9 percent and 11 percent more, respectively. According to Express Scripts, a pharmacy benefits manager, the introduction of new drugs such as arthritis medicines contributed to the rise in spending. However, about one half of the total increase was the result of higher prescription costs. Express Scripts projects that spending on prescriptions will nearly double during the next five years.

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