Business

In the United States, brand-name price inflation for prescription drugs has outpaced overall prescription drug price inflation.1,2 Although certain forces in the market may account for this situation, this study focused on the lack of adequate and accurate information that is needed in the market to optimize utilization of prescription drugs and mediate costs.

Aligning Stakeholders Can Maximize the Opportunity for Cost-Savings on Drugs
We economists always think that waving money under people’s noses will make them behave according to some theoretical script. But we’ve tried that with healthcare for decades and it hasn’t worked. Healthcare isn’t just about financial incentives; it’s also about anxiety, fear, habit, guan-xi—a Chinese word that, loosely translated, means “family or business ties”—and professional pride.

Breast cancer is the most frequently diagnosed cancer in US women, and ranks second among cancer- related deaths in women, after lung cancer.1 It is estimated that $8.1 billion (in 2004 $US) in total healthcare costs are spent annually on breast cancer diagnosis and treatment in the United States.2 Chemotherapeutic agents represent a significant portion of the cost of breast cancer treatment, and health plans are managing these costs with care pathways and other utilization management strategies.

Can We Afford Improved Clinical Outcomes?

In 2006 and 2007, the Foundation of Managed Care Pharmacy (FMCP) sponsored a survey of pharmacy, clinical, and business managed care leaders that was supported by an unrestricted grant from Merck & Co and was conducted by The HSM Group, a national healthcare market research and consulting firm.

Emerging Trends in Managed Care Pharmacy: Familiar Gaps but Great Potentials

PPG Industries, headquartered in Pittsburgh, Pennsylvania, is a manufacturer of coatings, chemicals, optical products, specialty materials, glass, and fiberglass. PPG operates more than 125 manufacturing facilities in 23 countries, and has 32,200 employees globally, 20,000 of which are in the United States. From occupational health, PPG has been evolving toward comprehensive employee health.

The Evolution of Health Promotion by Employers

In the latter part of the 1990s, the annual increase rate in national spending for pharmaceutical medications ranged from 11% to 17%, overtaking the growth rates for hospital care (3%-6%) and physician services (4%-7%), which had dominated the healthcare industry in the 1970s.1 At the turn of the 21st century, this rate was expected to continue to climb but instead had reached a peak by 2001-2002.

Drug Expenditures' Impact on Benefit Design

The annual rate of increase in prescription drug spending has clearly tapered in recent years, and yet the share of prescription drug expenditures paid by public and private health insurers continues to grow.1 Pressures to effectively manage prescription drug costs remain as high as ever, given the many factors (eg, increasing demand, drug inflation rates, specialty drug development, and aggressive drug marketing) working collaboratively to drive even higher drug spending.

Maximizing Savings, Efficiency, and Quality when Contracting with a PBM

Robert Henry: By way of introduction, Gary, give us the basic direction that you would like to take on today's subject—the high costs of biologics—whether your focus is on the benefit design structures that are going to be fashioned in response to the cost of biologics or elsewhere.

Value-Based Benefit— A Joint Effort

Like the everyday person, defining value for a payor of healthcare services varies depending on your perspective and application of the meaning. For a patient or employee, value means there is some worth in the usefulness of the subject or importance to possessing it. To a clinician, value relates to a standard of quality or a principle that is not only worthwhile, but also desirable. For an attorney, value is defined in contractual terms connoting an economic exchange or equivalence in goods or services.

Value-Based Drug Benefit: Implications for Manufacturers

The data regarding healthcare costs are clear, persistent, troubling at the least, and truly frightening at worst. It is estimated that by 2014, nearly 20% of the nation's economy will be consumed by healthcare, and the growth in healthcare spending will outpace economic growth through the next decade.1 The National Institutes of Health estimated that the overall cost of cancer in 2006 was $206.3 billion. Of this total figure, $78.5 billion represents direct medical costs, including inpatient and outpatient care, drugs, and devices.2
 

AHDB Stakeholder Perspective
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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