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?

Pain is a global health problem that affects 1 of 5 adults in the community1 and occurs in 43% to 77%2-4 of the approximate 35.1 million patients who are hospitalized annually in the United States.5 Pain is ubiquitous among the nearly 30.2 million people who undergo inpatient surgery annually in the United States.5 Opioid analgesics are a mainstay of postsurgical pain management,6 but are often associated with treatment-limiting gastrointestinal (GI), central nervous system, and respiratory adverse events (AEs).7 Of these, opioid-related GI AEs are the most common,8-10 with an incidence rate of 10% to 32% for nausea and/or vomiting and 15% to 41% for constipation.7,11-14 These GI AEs are particularly troublesome after surgery, because they can exacerbate anesthesia-induced nausea and decreased GI motility, sometimes resulting in ileus.7 Furthermore, GI AEs are associated with increased healthcare resource utilization because of additional medications used to manage the GI AEs and an increase in hospital length of stay (LOS).7,10,15-17

Can Substituting Generic Drugs with Brand-Name Agents for Acute Pain Postsurgery Help to Deliver Cost-Effective, Quality Care?
The high cost of pharmaceuticals, especially biologics, has become an impor­tant issue in the battle to control healthcare costs. The Hatch-Waxman Act encourages generic competition but still provides incentives for pioneers to develop new drugs. The Biologics Price Competition and Innovation Act is intended to do the same for biologics and biosimilars.
Modeling the Future Economic Impact of Biosimilars’ Entry into the US Market
Community-acquired pneumonia (CAP) is frequently associated with the very young and the elderly but is a largely underrecognized burden among working-age adults. Although the burden of CAP among the elderly has been established, there are limited data on the economic burden of CAP in the employed population.
CAP Is a Burden for All Ages—Prevention Strategies Are Key
The incidence and prevalence of type 2 diabetes continue to grow in the United States and worldwide, along with the growing prevalence of obesity. Patients with type 2 diabetes are at greater risk for comorbid cardiovascular (CV) disease (CVD), which dramatically affects overall healthcare costs.
Innovation in Patient Engagement and Management Is Critically Needed to Change Current Trends in Type 2 Diabetes
The American population’s diversity continues to grow, and its racial and ethnic mixes are changing. The US healthcare system must confront this changing reality. The introduction of isosorbide dinitrate/hydralazine hydrochloride (BiDil) to the US marketplace was a move toward recognizing these changing consumer needs. BiDil was approved specifically as a secondary treatment for heart failure in African-American patients. It remains the first and only drug approved by the US Food and Drug Administration for a race-based indication. To ensure commercial success, a drug must be made “visible” to healthcare providers and to consumers.
Much More than Biomarkers: Sociodemographic Variables in Personalized Medicine

Prostate cancer is the most frequently diagnosed noncutaneous malignancy in males and is a leading cause of cancer-related morbidity and mortality among men in the United States.1,2 The American Cancer Society has estimated that approximately 238,600 new cases of prostate cancer will be diagnosed in 2013, and that approximately 29,700 men will die of the disease.3

Although patients with cancer represent only 1% of commercially insured patients, 10% of commercial health insurance expenditures is spent on this patient population.1 Throughout 2012, the conversation about mounting business pressures on oncology practices to address this discrepancy has been dominated by 3 topics—the viability of accountable care organizations (ACOs) as a model for delivery of oncology care, payer efforts to standardize cancer care through the implementation of oncology clinical pathways, and how these emerging care delivery systems would affect oncology

New Oncology Care Delivery Payment Models to Enhance Care Efficiency

Renal cell carcinoma (RCC) comprises 92% of all kidney cancers and has a poor prognosis, with approximately 10% of patients with metastatic disease surviving beyond 5 years.1 In 2006, the economic burden of metastatic RCC (mRCC) was estimated to be up to $1.6 billion worldwide and has since grown annually.2 A recent review reported that the economic burden of RCC in the United States ranges from $600 million to $5.19 billion, with annual per-patient medical costs of between $16,488 and $43,805.3 Furthermore, these costs will likely increase with the expanded

Cost and Effectiveness of Therapies for Advanced Kidney Cancer: The Need for Economic and Clinical Analyses
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  • Rheumatology Practice Management
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