January/February 2012, Vol 5, No 1

Advances in biotechnology have led to the development of new medical therapies for a variety of diseases, including many types of cancers and autoimmune diseases (eg, rheumatoid arthritis). Among these agents are biologics, also known as specialty pharmaceuticals. These drugs represent the fastest-growing segment of pharmaceuticals. Employers sponsor a significant proportion of plans that provide healthcare benefits, including biologics.

An Educated Consumer Is Our Best Customer

Payers generally assert that in the face of rising costs they will manage pharmaceuticals more tightly. However, many restrictions that they say they will initiate never become widespread. Why not? Payers may offer a restrictive benefit design, but often employers and other plan sponsors are reluctant to select such designs for their employees. To understand the benefit landscape, we need to look to payers as well as employers.

With total health insurance costs at approximately 17% of the US Gross Domestic Product,1 a rapid growth rate, rising rates of chronic diseases, such as diabetes, and an aging population, changing the dynamics—the fundamental drivers—of the US healthcare is key. The 2010 Census estimates 16.3% of Americans do not have health insurance, and that the percentage of people with employment-based health insurance decreased from 56.1% in 2009 to 55.3% in 2010.2

Primary Care Shortages: It Is All About the Money After All

In June 2008, my wife and I moved to downtown Asheville, NC, with our dog, Max. Max and I were out for a walk early every morning and late every evening. When I first started taking Max for walks, I would occasionally notice people who appeared homeless, and I became curious about the causes of homelessness and its solutions.

It is difficult to believe that 5 years have passed since the first issue of American Health & Drug Benefits (AHDB) arrived on my desk in 2008. In February 2008, the United States was on the verge of an economic downturn that had actually begun almost 3 months earlier. The price of oil topped $100 a barrel for the first time, and job losses were just being reported. Although most of us did not know it yet, the United States was entering the worst economic downturn since the Great Depression.

Chronic pain is experienced by more than one third of the US population.1 Regardless of disease etiology or individual characteristics, chronic pain is debilitating and has a profound impact on emotional and physical functioning.2,3 For chronic pain, which is characterized as pain lasting 3 or more months,4 opioid analgesics are considered part of a multifaceted strategy to manage moderate-to-severe pain for a number of conditions involving the musculoskeletal system (eg, osteoarthritis, low back pain), neurologic system (eg, diabetic neuropathy, spinal cord

Daily Average Consumption of 2 Long-Acting Opioids and Coverage Decisions

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  •  Association for Value-Based Cancer Care
  • Oncology Practice Management
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Rheumatology Practice Management
  • Urology Practice Management
  • Lynx CME