On October 29, 2009, a leadership summit on healthcare reform was in progress in Washing ton, DC. No, not Congress; the participants were not Democrats and Republicans locked in a death grip to impose, or block, government-mandated healthcare reform. This was a conference of leading healthcare authorities representing clinical, business, and policy sectors in healthcare, organizing the elements of a strategy to reform healthcare into a new paradigm that improves health, reduces costs, and encourages innovation—that endangered species of the healthcare ecosystem.
Doctors from across the country were invited to the White House on October 5, but the President did most of the talking. Medical professionals are being ignored or vilified more often than consulted in the current healthcare reform debate. To broaden the discussion, the Committee to Reduce Infection Deaths invited 16 highly regarded physicians to convene at the Grand Hyatt in New York City on October 19 to reflect on the current legislative proposals. Here's what they had to say on four key issues.
Government-Imposed Treatment Guidelines
Health Plan Retention and Pharmacy Costs of Newly Diagnosed Patients with Chronic Kidney Disease in a Managed Care Population
Maureen Kubacki, PharmD, MBA , Chureen Carter, PharmD, MS , Alan D. L. Herrera, PharmD, Jim Wang, PhD, Janice M.S. Lopez, PharmD, MPH, Catherine T. Piech, MBA
Chronic kidney disease (CKD) affects approximately 26 million people in the United States.1 Diabetes and hypertension cause up to two thirds of all new CKD cases.1,2 According to Medicare policy, health plans are financially responsible for the care of CKD patients for up to 33 months after they have reached the final stage of end-stage renal disease (ESRD).3 Data from the Institute for Health and Productivity Management 2001 database show that treatment costs nearly double from one stage of CKD to the next.4 The stages of CKD are defined based on
Alignment of Incentives along the Healthcare Payer Continuum for Patients with Kidney Disease
Many of today's healthcare concerns focus on the concept of value, which can be defined as a composite of cost, quality, and access. Expanding access through affordable healthcare insurance will only be possible if healthcare costs are contained through a focus on quality.1 Poor care quality results in costly errors, complications, and re-work. Conversely, high-quality care, namely, the right treatment at the right time, results in more cost-effective care.
The Missing Quality Standard for Medication Adherence
Economic Evaluation of Quality-of-Life Improvement with Second-Generation Antihistamines and Montelukast in Patients with Allergic Rhinitis
Allergic rhinitis (AR) has a significant detrimental effect on a patient's quality of life (QoL), affecting sleep, normal daily activities, and work.1-4 Stempel and Woolf estimated that the 50 million Americans with AR spend more than $6 billion annually on prescription and nonprescription medications to relieve AR symptoms.5,6 Despite a growing body of literature on the effect of AR on QoL, there is a paucity of studies that use QoL findings to assess the cost-effectiveness of various agents used to treat AR.
Allergic Rhinitis: A Serious Condition with Many Safe and Effective Pharmaceutical Options
Increases in Drug Utilization and Patent Expirations: A Recipe for Growth of Generics' Market Share, despite Stalling on Biosimilars
As 2009 is coming to a close, the future of generics appears brighter than ever, with many brand-name medications pending patent expiration by 2011, accounting for about $34 billion in total sales in 2008.1 The drug patent expiration outlook overshadows the recent Senate vote to extend the patent exclusivity period for biologics to 12 years, as requested by the biotechnology industry, thereby significantly delaying the introduction of potential biosimilars to the market. A biosimilars pathway now seems likely to become a reality by 2010 or 2011.
Now that gene tests, markers for tumor receptors, assays for rapid and precise diagnosis of infectious agents, and a variety of other molecular probes have created an entirely new world of personalized medicine, it is time to add new information management tools to capture and manage this knowledge.
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