American Health & Drug Benefits: Reflections on the First 5 Years

January/February 2012, Vol 5, No 1 - Editorial
Gary M. Owens, MD

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. The economic woes of the past 5 years have had a profound impact on the healthcare system.

Although the recession has ended and economic indicators are improving, healthcare payers are facing significant challenges in the postrecession economy. Some of these challenges include:  

  • The potential for rapid escalation of healthcare cost resulting from the impact of healthcare reform legislation, as 41 million newly insured Americans seek services in 2014 and beyond
  • Maintaining affordability of health insurance premiums, with reasonable access to care, while healthcare costs spiral upward
  • Maintaining and growing market share in a difficult economic climate
  • Working with employers and other customers who are increasingly looking for plans to actively manage medical costs
  • Dealing with benefit design issues that may potentially increase deductibles and higher out-of-pocket costs for patients
  • Managing new and expensive specialty pharmaceuticals that must become a critical core competency of health plans.

Because of these and other pressing issues in the healthcare arena, all stakeholders need sources of information to help guide our daily activities. AHDB has consistently been one of those sources since its establishment. The first sentence of the mission statement of AHDB caught my attention from the first issue, “American Health & Drug Benefits is founded on the concept that health and drug benefits have undergone a transformation: the econometric value of a drug is of equal importance to clinical outcomes as it is to serving as the basis for securing coverage in formularies and drug benefit designs.”

The concept of balancing cost, quality, and access is a major concern for payers and the many other stakeholders in healthcare. AHDB has provided an open forum for many of the complex issues addressed in the pages of the journal, by promoting stakeholder integration and collaboration toward the mutual goals of improving health outcomes and controlling costs.

Since its establishment, AHDB has published many outstanding articles dealing with the regulatory, clinical, and business aspects of healthcare, such as the following few examples:

  • 2008: Benchmarking New Frontiers in Managed Care Pharmacy
  • 2009: Increased Patient Cost-Sharing, Weak US Economy, and Poor Health Habits: Implications for Employers and Insurers
  • 2010: A Comparison of Drug Formularies and the Potential for Cost-Savings
  • 2011: The Hickory Project: Controlling Healthcare Costs and Improving Outcomes for Diabetes Using the Asheville Project Model
  • 2012: Beyond the Cost of Biologics—Employer Survey Provides Insights into Benefit Coverage.

In addition, special issues, such as “A Wellness-Based Healthcare System for Chronic Diseases: Pre­vention, Intervention, and Innovation” published in 2010, and the special theme issue on “Cardiometabolic Health and Wellness” published in 2011, have provided guidance to AHDB’s readership on major population-based topics of concern.

Many changes in healthcare have occurred since the first issue of AHDB was published in 2008, and I am sure that many unanticipated changes will take place over the next 5 years.

During the past 5 years, AHDB has established itself as an important forum for addressing critical issues facing the US healthcare system. As an editorial board member of AHDB, I wish to congratulate all my colleagues on the board and all the many other people who have contributed to the excellent and vigorous publication standards established by the journal and help make it a useful resource for decision makers in healthcare.

I look forward to the next 5 years of having AHDB as an important resource to help keep me informed on the constantly evolving US healthcare environment.
 

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