PPIs Are Therapeutically Interchangeable and Ideal for a Managed Care Intervention Such as Therapeutic MAC
Bibliographic record
Abstract
PPIs Are Therapeutically Interchangeable and Ideal for a Managed Care Intervention Such as Therapeutic MAC Mabasa and Ma recently published a pharmacy claims database review on the effect of a therapeutic MAC intervention for proton pump inhibitors (PPIs). A therapeutic MAC program establishes a therapeutic maximum allowable cost for a drug category and, unless medical necessity exists, requires patients to pay the drug cost difference when a nonpreferred agent is dispensed. In their Canadian employer group, rabeprazole 10 mg daily was the preferred agent,2 costing Can 71� daily. They found a 22.1% reduction in drug cost per patient per year (PPPY) in the intervention therapeutic MAC group (from Can $357 to Can $278 PPPY) versus a 4.1% increase in the comparison group (from Can $293 to Can $305 PPPY). In response to this study, Peter Wahlqvist, an employee of AstraZeneca, the manufacturer of esomeprazole, has written a letter to the editors of JMCP to highlight a number of fundamental flaws.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".