Managed Competition and Pharmaceutical Care

Managed Competition and Pharmaceutical Care
Author: Alan Escovitz
Publisher: CRC Press
Total Pages: 188
Release: 1996
Genre: Managed care plans (Medical care)
ISBN: 9781560248217

As the debate on health care delivery systems in the U.S. continues, the pharmaceutical industry and pharmaceutical care delivery system may well be faced with making significant changes if new drug regulations are enacted. Because there is little discussion on the effects of managed competition on the pharmaceutical care delivery system and the education of pharmacists, those involved in providing pharmaceutical care must arm themselves with the background information and ideas explored in Managed Competition and Pharmaceutical Care. The contributors to this vital sourcebook address these key questions: What are the major components of a managed competition system? What challenges will industry and the pharmaceutical care delivery system face? How should the industry re-engineer--using systems management as opposed to components management--to meet the needs of an evolving health care system? What actions should pharmaceutical companies take to survive difficult days in the future? Why and how should pharmacists move from dispensing drugs to providing total pharmaceutical care? What do employers want for their prescription benefit dollars? How have past and present initiatives to control drug pricing affected the pharmaceutical marketplace? Why is regulating prices not a satisfactory solution to containing health care costs? What criteria are used to determine whether to include a drug in a managed care formulary? How can community pharmacists compete in the marketplace, regardless of which health care system emerges? What is the future likely to bring and how can pharmacists prepare for that future? Managed Competition and Pharmaceutical Care assists those involved in the pharmaceutical care delivery system to prepare for and embrace new, or at the least, drastically changed health care delivery in the coming years.

Making Medicines Affordable

Making Medicines Affordable
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 235
Release: 2018-03-01
Genre: Medical
ISBN: 0309468086

Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

For-Profit Enterprise in Health Care

For-Profit Enterprise in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 580
Release: 1986-01-01
Genre: Medical
ISBN: 0309036437

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Handbook of Pharmaceutical Public Policy

Handbook of Pharmaceutical Public Policy
Author: Thomas Fulda
Publisher: CRC Press
Total Pages: 714
Release: 2007-07-25
Genre: Medical
ISBN: 9781439804261

Get an invaluable view of the impact of economics and politics on pharmaceuticals in the United States Pharmacy and pharmaceutical drug use are highly regulated and the various regulatory forces interact with diverse goals. Pharmaceutical Public Policy is a comprehensive review of the legislation, trends, business developments, and policy interpretations that have shaped drug use during the last 50 years. This unique single source explains drug regulatory activity, the major insurance and payment systems, and the impact of economics and politics on drug use in the United States. Leading experts provide a thorough and objective look at public policy issues, making this text perfect for upper level undergraduate and graduate level pharmacy, medical, and public health educators and students. Pharmacists and pharmacy students must learn more than just the physical sciences and clinical aspects of the pharmaceutical industry. The rationale for policies, rules, and regulations is integral to understanding how to best serve patients and make the entire pharmaceutical sector more equitable and cost-effective. Pharmaceutical Public Policy examines the most pressing issues facing the industry, including control of the rising costs for drugs and ensuring correct drug usage by patients. This insightful text offers an in depth perspective of the policies and the debates that surround them. Chapters are well-referenced and many include helpful figures and tables to illustrate facts and ideas. Topics in Pharmaceutical Public Policy include: pharmacy law and regulation Medicare and prescription drug coverage FDA drug approval process Medicaid and prescription drugs public health pharmacy Department of Veterans Affairs pharmacy programs Department of Defense pharmacy programs innovative state drug program practices state and federal regulation of pharmacy the future of the pharmaceutical industry managed care pharmacy PBM’s (pharmacy benefit managers) risk minimization importation and reimportation biotechnology and pharmacogenetics policy and issues product promotion competition between drugs drug insurance design patient compliance abuse of prescription drugs health care systems and insurance in Europe much more Pharmaceutical Public Policy is a one-of-a-kind resource that explains just who the players are and the complexity of the issues that are examined in most pharmaceutical policy debates, and is perfect for pharmacy students, educators, other health professionals, trade association leaders, and policymakers.

Redefining Health Care

Redefining Health Care
Author: Michael E. Porter
Publisher: Harvard Business Press
Total Pages: 540
Release: 2006-04-24
Genre: Business & Economics
ISBN: 1422133362

The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Health Professions Education

Health Professions Education
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 191
Release: 2003-07-01
Genre: Medical
ISBN: 030913319X

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Equitable Access to High-Cost Pharmaceuticals

Equitable Access to High-Cost Pharmaceuticals
Author: Zaheer-Ud-Din Babar
Publisher: Academic Press
Total Pages: 240
Release: 2018-02-27
Genre: Medical
ISBN: 0128119624

Equitable Access to High-Cost Pharmaceuticals seeks to aid the development and implementation of equitable public health policies by pharmaco-economics professionals, health economists, and policymakers. With detailed country-by country analysis of policy and regulation, the Work compares and contrasts national healthcare systems to support researchers and practitioners identify optimal healthcare policy solutions. The Work incorporates chapters on global regulatory changes, health technology assessment guidelines, and competitive effectiveness research recommendations from international bodies such as the OECD or the EU. Novel policies such as horizon scanning, managed-entry agreement and post-launch monitoring are considered in detail. The Work also thoroughly reviews novel pharmaceuticals with particular research interest, including cancer drugs, orphan medicines, Hep C, and personalized medicines. - Evaluates impact and efficacy of current access policies and pricing regulation of high-cost drugs - Incorporates existing guidelines and recommendations by international organizations - Compares and contrasts how different countries fund and police high-cost drug access - Explores novel and emergent policies, including managed entry agreement, analysis of real world data and differential pricing - Reviews novel pharmaceuticals of current research interest

Pharmacy

Pharmacy
Author: William N. Kelly
Publisher: CRC Press
Total Pages: 490
Release: 2011-07-26
Genre: Medical
ISBN: 1439853053

As the first baby boomers have reached 65, more prescriptions than ever are being dispensed, and the need for properly trained pharmacists is critical. Now in its third edition, Pharmacy: What It Is and How It Works continues to provide a comprehensive review of all aspects of pharmacy, from the various roles of pharmacists to particular health care-related events to career planning information. Beginning with a brief historical perspective on the field, the book discusses the many facets of the pharmacy profession. It describes the role of pharmacists in different settings and provides information ranging from licensing requirements to working conditions, highlighting the critical role of pharmacists within the heath care system. The author examines the drug use process with sections on distribution, prescribing, dispensing, and pricing. He also discusses the role of pharmacy support personnel. An expanded chapter on informatics explores how pharmacy has evolved through information technology and automation. Additional chapters cover poison control, pharmacy schools, pharmacy organizations, the drug approval process, and career development. Designed for classroom and professional use, the book contains numerous tools to facilitate comprehension, including: Learning objectives to help readers focus on the goals of each chapter Informative tables and figures summarizing data Summary paragraphs tying in salient points Discussion questions and exercises to test assimilation "Challenges" which place the material in broader context Websites and references to encourage further study Used in many schools of pharmacy in the United States, Canada, and Europe, this volume provides a look into the profession that is both broad and deep, supplying a one-stop reference to a promising career.

Pharmaceutical Innovation, Competition and Patent Law

Pharmaceutical Innovation, Competition and Patent Law
Author: Josef Drexl
Publisher: Edward Elgar Publishing
Total Pages: 347
Release: 2013-01-01
Genre: Law
ISBN: 0857932462

Public health, safety and access to reasonably priced medicine are common policy goals of pharmaceutical regulations. As both the context for innovation and competitive structure change, industry actors dynamically challenge the balance between the incentive for protection and the achievement of those policy goals. Considering the arguments from the perspectives of innovation, competition law and patent law, this book explores the difficult question of balancing protection with access, highlighting the difficulties in harmonization and coordination. The contributors to this book, including academics, judges and practitioners from Europe, the US and Japan, explore to what extent patent strategies and life-cycle management practices take advantage of patent laws and health-care regulation and disrupt the necessary balance between incentives for innovation and access to affordable medicine and health care. Addressing fundamental questions in the field of pharmaceutical innovation, this book will appeal to scholars and practitioners in intellectual property, competition law and life sciences regulation, as well as pharmaceutical companies and regulators.