Obesity is associated with many chronic diseases and is classified as a disease by several organizations, including the World Health Organization, the National Institutes of Health, the US Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC).1-4

Payers' Incentives Are Not Aligned to Address the Obesity Epidemic

Local school districts are one of the largest employers in the United States, employing roughly 8 million employees in 2008.1 Locally, they are often one of the largest (if not the largest) employers in the communities they serve. Like many large employers, school districts offer an array of benefits to their employees, including health insurance. Employee benefits comprise 34.3% of total compensation for publicsector employees,2 with health insurance representing 10.9% of total compensation.2

Public Employer Characteristics

Health Insurance Premium Increases for Large Employers

Diabetes mellitus affects 23.6 million Americans, or about 8% of the US population.1 This includes nearly 18 million persons with diagnosed disease and about 5.7 million undiagnosed cases.

Diabetes: An Epidemic of Disastrous Proportions

The prevalence of hypothyroidism in the United States is estimated at 4% to 10%, including undiagnosed cases.1,2 Higher rates have been found in women and the elderly.1,2 The most common causes of hypothyroidism are autoimmune thyroid disease and surgical or radioiodine ablation; only a small percentage of cases result from secondary causes.3,4

Health Insurance Premium Increases for Large Employers

On March 1, 2001, the Institute of Medicine (IOM) released its report, "Crossing the Quality Chasm: A New Health System for the 21st Century," in response to alarming rates of medical errors that led to thousands of unnecessary deaths. The report called for changes within information technology (IT), payment policies, and the medical workforce. By stressing a "new paradigm for healthcare delivery," the IOM identified 15 medical conditions for which improvements could be made to improve the delivery of patient care.1

The Many Challenges of Pay-for-Performance Programs

If March 2010 was any indication for the US Food and Drug Administration (FDA)'s intentions, 2010 will witness a good number of generic approvals. Compared with the meager approval record in January (1) and February (2), by March 23 the FDA approved 15 generics in that month alone.

Although promising late-stage drugs in the cardiovascular (CV) pipeline are few, increasing numbers of pharmaceutical manufacturers are taking a stab at oral, fixed-dose alternatives to warfarin, many of which are in phase 3 clinical trials. The following agents were featured at special sessions at the 2010 annual meeting of the American College of Cardiology (ACC).

Unique Factor X Inhibitor

The financial nonsustainability of the healthcare system and the use of evidence-based guidelines to guide clinical practice are on a collision course, according to cancer experts who participated in a roundtable discussion on the economic issues affecting cancer care. The panel was held during the 15th annual conference of the National Comprehensive Cancer Network (NCCN). The discussion focused on the challenging question of how to pay for the increasingly costly care of cancer. The panel included payers, physicians, patient advocates, and industry experts.

According to the updated 2010 practice guidelines of the National Comprehensive Cancer Network (NCCN), the work-up of patients with early breast cancer should not include imaging by positron-emission tomography (PET) or by PET/computed tomography (CT) scanning. This updated guideline has implications for healthcare stakeholders, especially providers and health plans.


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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
  • National Association of Specialty Pharmacy
  • Lynx CME