Ongoing patent litigation and the “patent dance” in general have been thorns in the side of biosimilar drug manufacturers and payers who are anticipating lower-cost alternatives to high-cost reference biologics.
In the past 5 years, there has been a large increase in the number of employers focused on effective ways to manage the rising cost of specialty drugs. At the same time, employers have been working hard to comply with the Affordable Care Act (ACA) and are cognizant of the expected excise tax.
With the 2015 extension of time offered to employers for Affordable Care Act (ACA) compliance, many employers are back to focusing their attention on cost management efforts.
After the passage of the Affordable Care Act (ACA) in 2010, market changes beyond those already in play began to emerge. Traditional roles, responsibilities, and authority of various healthcare stakeholders could now be tested or altered as a result of some sections of the ACA.
The development of innovative medications is largely a private enterprise that relies chiefly on the investment of pharmaceutical companies in research and development (R&D).
True managed care is based on the notion of an integrated delivery system, an industrialized system of care designed to enhance population, as well as individual health status. The Affordable Care Act (ACA) and the philosophy embodied in the Triple Aim (ie, the triangle of care, population health, and costs)1 are leading the evolution toward the integrated delivery system and away from the component-based episode of care strategy or the fee-for-service method, where goods and services are applied and reimbursed individually, usually during an episode of sick care.
The increased approvals and rising costs of specialty pharmacy drugs have created a significant management challenge for health plans. The 3 primary disease areas that account for the majority of the specialty drug spending include autoimmune disorders, multiple sclerosis, and cancer.
The Affordable Care Act (ACA) is the law of the land, but its implementation so far has been fraught with serious problems. The initial launch of was a disaster. It is unclear whether the Centers for Medicare & Medicaid Services (CMS) or the office of the Department of Health and Human Services Secretary told the White House that the October 1 deadline for the launch was not doable or highly risky, or if anyone suggested a delay.
The Patient Protection and Affordable Care Act (ACA) imposes an array of new regulations on employers, as well as requiring them to report to government agencies about meeting those requirements.
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