Serious and costly performance problems riddle the $2.4-trillion US healthcare system. Because of overuse, underuse, and misuse of healthcare, researchers estimate that roughly 30% of healthcare costs are generated by poor quality.1,2 Therefore, poor-quality medical care will cost about $720 billion in 2008.1,2
In a small, intimate room in a tired old mansion serving as a Connecticut prep school in 1966, a gentle giant of learning listened intently to a youth in his class extol Ayn Rand's theory of Objectivism. It was English class, and Joseph T. Sunega, known time out of mind to the student body as Sunny Joe for his bright eyes drooping at half mast in a perpetual Celtic half dream, dropped a quiet bombshell on the boy and the class.
The launch of American Health & Drug BenefitsTM brings with it the sentinel question: How shall we frame the healthcare debate? The answer we propose involves a vision of how healthcare standards change; who is involved in the process of care; what are their systems, needs, agendas, and incentives; and what are the evidentiary methods proper for determining success or failure.
Election years are always a great time to take our country's pulse with regard to an issue, and this year healthcare has emerged as the major topic on the nation's collective mind. We have enjoyed excellent healthcare in the United States for quite some time, yet today the system seems unstable. Record numbers of uninsured patients populate our delivery system during an era in which few would argue that access to insurance coverage is equivalent to access to good healthcare.
With US health spending expected to reach $3.6 trillion by 2014,1 all stakeholders are seeking ways to control cost while maintaining quality of and access to care. Experts agree that the US healthcare system must address current and emerging problems of inefficiency, administrative costs, rising prices, and inappropriate patient care, as the number of healthcare consumers continues to rise, with a higher disease burden. As a highly visible component of healthcare expenditure, pharmaceuticals have been a lightning rod for various forms of cost and utilization control.
The core editorial mission of American Health & Drug Benefits is to provide a forum for a managerial discussion among stakeholders about evidence in benefit design during this crucial time in which we are witnessing the transformation of healthcare to a value-based system. Our goal is to showcase trends and innovations and examine their effects on the different participants in the process of care.
Healthcare is like a team sport with active participation from a variety of position players, including patients, physicians, nurses, pharmacists, and many others. Although they each have a different responsibility, they would all agree that quality is the foundation for all their activities. The confusion arises when they are asked to define quality.
On October 10, 2008, we convened the First Annual American Health & Drug Benefits Summit on Healthcare Stakeholder Integration—The Return to Deep Science: Pharmaceutical Research & Development in a Value-Based Healthcare System. The proceedings are published in a special supplement accompanying this issue of the journal. The summit brought together leaders from many sectors to evaluate the prospects for the future of healthcare innovation, which is fundamental to the viability of the healthcare system.
Well established is the fact that prescription copayments (ie, the price paid by members) and how they are structured play a role in influencing the demand for prescription medications.1,2 Many plan sponsors are banking on the tenet of price responsiveness by lowering copayments to increase utilization of select chronic therapies.
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Results 71 - 80 of 82