In November 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released together new clinical guidelines for the treatment of patients with high blood cholesterol. The 2013 guidelines provide a new paradigm for cholesterol management in the primary and secondary prevention of coronary artery disease (CAD)
Real-World Consequences of the 2013 ACC/AHA Cholesterol Guidelines for the Prevention of Cardiovascular Disease
Excessive daytime sleepiness affects nearly 20% of the general population and is associated with many medical conditions, including shift work disorder (SWD), obstructive sleep apnea (OSA), and narcolepsy. Excessive sleepiness imposes a significant clinical, quality-of-life, safety, and economic burden on society.
Out-of-Pocket Cost of Therapy Can Affect Patients’ Excessive Sleepiness and Daytime Functioning
Three distinct shortages of the generic drug leucovorin, a reduced form of folic acid used in several chemotherapy regimens, were reported by the US Food and Drug Administration (FDA) between 2008 and 2014. Levoleucovorin, an alternative therapy to leucovorin, failed to demonstrate superiority over leucovorin in clinical trials and is substantially more expensive.
Drug Shortages Are Costly to Patients and to Payers
Counterfeit drugs comprise an increasing percentage of the US drug market and even a larger percentage in less developed countries. Counterfeit drugs involve both lifesaving and lifestyle drugs.
The Hidden Market of Counterfeit Drugs a Concern for All Stakeholders
Understanding the economic implications of oral anticoagulation therapy requires careful consideration of the risks and costs of stroke and major hemorrhage. The majority of patients with atrial fibrillation (AF) are aged ≥65 years, so focusing on the Medicare population is reasonable when discussing the risk for stroke.
The Clinical Toll of Nonvalvular Atrial Fibrillation Poses Significant Economic Burden
Individual studies have assessed the impact of standard prophylactic therapy with 5-hydroxytryptamine receptor antagonists (5-HT3RAs) for chemotherapy-induced nausea and vomiting (CINV) on cost and utilization, but no synthesis of the findings exists.
The Value of Pharmaceuticals in the Prevention and Treatment of CINV
The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology.
Disruptive Innovation, Uncertain Value, and Economic Modeling in Oncology
The clinical and economic burden of chronic obstructive pulmonary disease (COPD) is significant and is increasing. COPD is now the third leading cause of death in the United States, after heart disease and cancer. COPD reached this rank in 2008, more than a decade earlier than projected by the Global Burden of Disease Study. In the United States, mortality due to COPD is the only one among the 5 leading causes of death that showed an increasing rate between 2010 and 2011.
Chronic Obstructive Pulmonary Disease Remains a Growing Population Health Concern
Schizophrenia is a serious public health problem that affects approximately 1% of the US population.1 Schizophrenia is a leading cause of disability, and is associated with an economic burden of more than $60 billion annually in direct and indirect costs in the United States.2 Schizophrenia is a severe form of mental illness broadly characterized by 3 domains of psychopathology, including negative symptoms (ie, social withdrawal, lack of motivation, and lack of emotional reactivity), positive symptoms (ie, hallucinations and delusions), and cognitive deficits (ie, working memory, attention, and executive function).3-6 In addition, serious medical conditions, such as type 2 diabetes, obesity, hypertension, and dyslipidemia, are more common in patients with schizophrenia than in the general population; in turn, these conditions may increase the risk for cardiovascular disease and lead to increased morbidity and mortality.7 Notably, the estimated prevalence of diabetes in patients with schizophrenia is 13% to 15%; dyslipidemia, 25%; obesity, 42%; and hypertension, 19% to 58%.8
Schizophrenia: “The Forgotten Illness”?

Rare diseases have recently been identified as a major source of concern for health insurance companies, with some states seeking to shift a portion of the fiscal burden of orphan drugs to patients, much to patients’ concern.1 Rare diseases and orphan drugs, which have also been referred to as “orphan medicine,” “high-cost drugs,” and “rare medicine,” are subjects of increasing and intense study in pharmacoeconomics and cost-effectiveness analysis (CEA).2-4 By current estimates, between 25 million and 30 million Americans (8%-10% of the US population) have 1 of the more than 6800 diseases deemed rare, because they affect less than 200,000 people, which is the threshold used to define a “rare disease.”5

Breakthrough Therapy, or Breakthrough Pricing?
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  •  Association for Value-Based Cancer Care
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Oncology Practice Management
  • Rheumatology Practice Management
  • Urology Practice Management
  • Inside Patient Care: Pharmacy & Clinic
  • Lynx CME