Drug Costs
Health Care Costs
Prescription Fees
Insurance, Pharmaceutical Services
Costs and Cost Analysis
Drugs, Generic
Cost Control
Fees, Pharmaceutical
Cost Savings
Cost Sharing
Cost of Illness
Cost-Benefit Analysis
Formularies as Topic
Drug Utilization Review
Medicare Part D
Insurance Claim Review
Managed Care Programs
Models, Economic
Physicians' Offices
Pharmaceutical Services
Drug Utilization
Economics, Pharmaceutical
Health Expenditures
Financing, Personal
United States
Insurance Coverage
Pharmacists
Physician's Practice Patterns
Quality-Adjusted Life Years
Pharmacy and Therapeutics Committee
Insurance Benefits
Health Maintenance Organizations
Deductibles and Coinsurance
Pharmaceutical Preparations
Cost Allocation
Medicaid
Drug Industry
Health Resources
Markov Chains
Hospital Costs
Retrospective Studies
National Health Programs
British Columbia
Treatment Outcome
Automation
Practice Guidelines as Topic
Medicare
Canada
Great Britain
Drug Therapy, Combination
Databases, Factual
Can restrictions on reimbursement for anti-ulcer drugs decrease Medicaid pharmacy costs without increasing hospitalizations? (1/1509)
OBJECTIVE: To examine the impact of a policy restricting reimbursement for Medicaid anti-ulcer drugs on anti-ulcer drug use and peptic-related hospitalizations. DATA SOURCES/STUDY SETTING: In addition to U.S. Census Bureau data, all of the following from Florida: Medicaid anti-ulcer drug claims data, 1989-1993; Medicaid eligibility data, 1989-1993; and acute care nonfederal hospital discharge abstract data (Medicaid and non-Medicaid), 1989-1993. STUDY DESIGN: In this observational study, a Poisson multiple regression model was used to compare changes, after policy implementation, in Medicaid reimbursement for prescription anti-ulcer drugs as well as hospitalization rates between pre- and post-implementation periods in Medicaid versus non-Medicaid patients hospitalized with peptic ulcer disease. PRINCIPAL FINDINGS: Following policy implementation, the rate of Medicaid reimbursement for anti-ulcer drugs decreased 33 percent (p < .001). No associated increase occurred in the rate of Medicaid peptic-related hospitalizations. CONCLUSIONS: Florida's policy restricting Medicaid reimbursement for anti-ulcer drugs was associated with a substantial reduction in outpatient anti-ulcer drug utilization without any significant increase in the rate of hospitalization for peptic-related conditions. (+info)Reduced kidney transplant rejection rate and pharmacoeconomic advantage of mycophenolate mofetil. (2/1509)
BACKGROUND: Several multinational controlled clinical trials have shown that triple therapy immunosuppressive regimens which include mycophenolate mofetil (MMF), cyclosporin A (CSA) and steroids (S) are superior compared with conventional regimens which include azathioprine (AZA), CSA and S, mainly because MMF reduces the rate of acute rejection episodes in the first 6 months after kidney transplantation. Post-marketing studies are useful to evaluate the general applicability and costs of MMF-based immunosuppressive regimens. METHODS: Based on the excellent results of the published controlled clinical trials, we have changed the standard triple therapy immunosuppressive protocol (AZA+CSA+S) to an MMF-based regimen (MMF+CSA+S) at our centre. To analyse the impact of this change in regimen, we have monitored 6-month patient and graft survival, rejection rate, serum creatinine and CSA levels, as well as the costs of the immunosuppressive and anti-rejection treatments, in 40 consecutive renal transplant recipients (MMF group) and have compared the data with 40 consecutive patients transplanted immediately prior to the change in regimen (AZA group). RESULTS: Recipient and donor characteristics were similar in the AZA and MMF groups. Patient survival (37/40; 92.5% in the AZA group vs 38/40; 95% in the MMF group), graft survival (36/40 vs 36/40; both 90%) and serum creatinine (137+/-56 vs 139+/-44 micromol/l) after 6 months were not significantly different. However, the rate of acute rejection episodes (defined as a rise in creatinine without other obvious cause and treated at least with pulse steroids) was significantly reduced with MMF from 60 to 20% (P=0.0005). The resulting cost for rejection treatment was lowered 8-fold (from sFr. 2113 to 259 averaged per patient) and the number of transplant biopsies was lowered > 3-fold in the MMF group. The cost for the immunosuppressive therapy was increased 1.5-fold with MMF (from sFr. 5906 to 9231 per patient for the first 6 months). CONCLUSIONS: The change from AZA to MMF resulted in a significant reduction in early rejection episodes, resulting in fewer diagnostic procedures and rehospitalizations. The optimal long-term regimen in terms of patient and pharmacoeconomic benefits remains to be defined. (+info)The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants. (3/1509)
BACKGROUND: Currently, more than 600,000 immigrants enter the United States each year from countries where intestinal parasites are endemic. At entry persons with parasitic infections may be asymptomatic, and stool examinations are not a sensitive method of screening for parasitosis. Albendazole is a new, broad-spectrum antiparasitic drug, which was approved recently by the Food and Drug Administration. International trials have shown albendazole to be safe and effective in eradicating many parasites. In the United States there is now disagreement about whether to screen all immigrants for parasites, treat all immigrants presumptively, or do nothing unless they have symptoms. METHODS: We compared the costs and benefits of no preventive intervention (watchful waiting) with those of universal screening or presumptive treatment with 400 mg of albendazole per day for five days. Those at risk were defined as immigrants to the United States from Asia, the Middle East, sub-Saharan Africa, Eastern Europe, and Latin America and the Caribbean. Cost effectiveness was expressed both in terms of the cost of treatment per disability-adjusted life-year (DALY) averted (one DALY is defined as the loss of one year of healthy life to disease) and in terms of the cost per hospitalization averted. RESULTS: As compared with watchful waiting, presumptive treatment of all immigrants at risk for parasitosis would avert at least 870 DALYs, prevent at least 33 deaths and 374 hospitalizations, and save at least $4.2 million per year. As compared with watchful waiting, screening would cost $159,236 per DALY averted. CONCLUSIONS: Presumptive administration of albendazole to all immigrants at risk for parasitosis would save lives and money. Universal screening, with treatment of persons with positive stool examinations, would save lives but is less cost effective than presumptive treatment. (+info)Financial incentives and drug spending in managed care. (4/1509)
This study estimates the impact of patient financial incentives on the use and cost of prescription drugs in the context of differing physician payment mechanisms. A large data set was developed that covers persons in managed care who pay varying levels of cost sharing and whose physicians are compensated under two different models: independent practice association (IPA)-model and network-model health maintenance organizations (HMOs). Our results indicate that higher patient copayments for prescription drugs are associated with lower drug spending in IPA models (in which physicians are not at risk for drug costs) but have little effect in network models (in which physicians bear financial risk for all prescribing behavior). (+info)Who bears the burden of Medicaid drug copayment policies? (5/1509)
This DataWatch examines the impact of Medicaid prescription drug copayment policies in thirty-eight states using survey data from the 1992 Medicare Current Beneficiary Survey. Findings indicate that elderly and disabled Medicaid recipients who reside in states with copay provisions have significantly lower rates of drug use than their counterparts in states without copayments. After controlling for other factors, we find that the primary effect of copayments is to reduce the likelihood that Medicaid recipients fill any prescription during the year. This burden falls disproportionately on recipients in poor health. (+info)Problems with implementing guidelines: a randomised controlled trial of consensus management of dyspepsia. (6/1509)
OBJECTIVE: To determine the feasibility and benefit of developing guidelines for managing dyspepsia by consensus between general practitioners (GPs) and specialists and to evaluate their introduction on GPs' prescribing, use of investigations, and referrals. DESIGN: Randomised controlled trial of effect of consensus guidelines agreed between GPs and specialists on GPs' behaviour. SETTING: Southampton and South West Hampshire Health District, United Kingdom. SUBJECTS: 179 GPs working in 45 practices in Southampton district out of 254 eligible GPs, 107 in the control group and 78 in the study group. MAIN MEASURES: Rates of referral and investigation and costs of prescribing for dyspepsia in the six months before and after introduction of the guidelines. RESULTS: Consensus guidelines were produced relatively easily. After their introduction referral rates for upper gastrointestinal symptoms fell significantly in both study and control groups, but no significant change occurred in either group in the use of endoscopy or radiology, either in terms of referral rates, patient selection, or findings on investigation. No difference was observed between the control and study group in the number of items prescribed, but prescribing costs rose by 25% (from 2634 pounds to 3215 pounds per GP) in the study group, almost entirely due to an increased rate of prescription of ulcer-healing agents. CONCLUSION: Developing district guidelines for managing dyspepsia by consensus between GPs and specialists was feasible. However, their acceptance and adoption was variable and their measured effects on some aspects of clinical behaviour were relatively weak and not necessarily associated with either decreased costs or improved quality of care. (+info)Impact of an interest in asthma on prescribing costs in general practice. (7/1509)
OBJECTIVE: To examine the effect on total prescribing costs and prescribing costs for respiratory drugs for practices with at least one general practitioner with a special interest in asthma. DESIGN: Postal questionnaire survey. SETTING: General practitioners in England and Wales. SUBJECTS: 269 members of the General Practitioners in Asthma Group, of whom 103 agreed to participate. MAIN MEASURES: Individual practitioners' and their practices' PACT prescribing costs from the winter quarters of 1989-90 compared with average costs for their family health services authority (FHSA) and a notional national average of all FHSAs combined. RESULTS: The response rate was 57%; the average total prescribing costs for the practices of the 59 respondents were significantly lower than those of their respective FHSAs (mean difference 505 pounds per 1000 patients per quarter (95% confidence interval -934.0 to -76.2, p = 0.022) and lower than the national average. The average prescribing costs for respiratory drugs for the practices were significantly greater than those for their FHSA (195 pounds per 1000 patients per quarter (84.4 to 306.0, p = 0.001) and the national average. Both types of costs varied widely. CONCLUSION: An interest in asthma care in general practice is associated with higher average prescribing costs for respiratory drugs but no increase in overall prescribing costs compared with those for respective FHSAs and national averages. IMPLICATIONS: FHSAs and their medical advisors should not examine high prescribing costs for individual doctors or one therapeutic category but in the context of practice total costs. (+info)Potential savings from generic prescribing and generic substitution in South Africa. (8/1509)
Generic prescribing and generic substitution are mechanisms for reducing the cost of drugs. The purpose of this study was to assess the extent to which generic prescribing by private medical practitioners and generic substitution by private pharmacists is practised in South Africa and to estimate the potential savings from these two practices. Prescriptions from 10 pharmacists were collected on four randomly selected days. Computer printouts of all the prescriptions dispensed on these four days together with the original doctor's prescription were priced using a commercially available pharmacy dispensing computer package. A total of 1570 prescriptions with a total number of 4086 items were reviewed. Of the total prescriptions, 45.7% had at least one item for which there was a generic equivalent. Of the 961 drugs which had generic equivalents, 202 (21 %) were prescribed using the generic name of the drug. Only 0.3% of prescribers prohibited generic substitution. The cost of the prescription as dispensed was 1.4% (mean cost: R116.19 vs R117.84) below that of the original doctor's prescriptions, indicating the marginal benefit from the current low substitution rate of 13.9% by pharmacists. About 6.8% of the cost of the original doctor's prescriptions (mean cost: R117.84) could have been saved if total generic substitution (mean cost: R109.65) was practised. The cost of the prescriptions with only brand name items (mean cost: R120.49) would have been 9.9% higher than if generic drugs were used. Current restrictive prescribing and dispensing practices result in marginal cost savings from generic prescribing and generic substitution. Both these practices have a potential to reduce drug costs, if actively encouraged and practised to maximum capacity. It is noteworthy, however, that the potential savings from generic prescribing and substitution are at most 9.9% in the absence of any changes in types of drugs prescribed. (+info)"Drug costs" refer to the amount of money that must be paid to acquire and use a particular medication. These costs can include the following:
1. The actual purchase price of the drug, which may vary depending on factors such as the dosage form, strength, and quantity of the medication, as well as whether it is obtained through a retail pharmacy, mail-order service, or other distribution channel.
2. Any additional fees or charges associated with obtaining the drug, such as shipping and handling costs, insurance copayments or coinsurance amounts, and deductibles.
3. The cost of any necessary medical services or supplies that are required to administer the drug, such as syringes, needles, or alcohol swabs for injectable medications, or nebulizers for inhaled drugs.
4. The cost of monitoring and managing any potential side effects or complications associated with the use of the drug, which may include additional medical appointments, laboratory tests, or other diagnostic procedures.
It is important to note that drug costs can vary widely depending on a variety of factors, including the patient's insurance coverage, the pharmacy where the drug is obtained, and any discounts or rebates that may be available. Patients are encouraged to shop around for the best prices and to explore all available options for reducing their out-of-pocket costs, such as using generic medications or participating in manufacturer savings programs.
Health care costs refer to the expenses incurred for medical services, treatments, procedures, and products that are used to maintain or restore an individual's health. These costs can be categorized into several types:
1. Direct costs: These include payments made for doctor visits, hospital stays, medications, diagnostic tests, surgeries, and other medical treatments and services. Direct costs can be further divided into two subcategories:
* Out-of-pocket costs: Expenses paid directly by patients, such as co-payments, deductibles, coinsurance, and any uncovered medical services or products.
* Third-party payer costs: Expenses covered by insurance companies, government programs (like Medicare, Medicaid), or other entities that pay for health care services on behalf of patients.
2. Indirect costs: These are the expenses incurred as a result of illness or injury that indirectly impact an individual's ability to work and earn a living. Examples include lost productivity, absenteeism, reduced earning capacity, and disability benefits.
3. Non-medical costs: These are expenses related to caregiving, transportation, home modifications, assistive devices, and other non-medical services required for managing health conditions or disabilities.
Health care costs can vary significantly depending on factors such as the type of medical service, geographic location, insurance coverage, and individual health status. Understanding these costs is essential for patients, healthcare providers, policymakers, and researchers to make informed decisions about treatment options, resource allocation, and health system design.
A prescription fee is not a medical definition per se, but rather a term used in the context of pharmacy and healthcare services. It refers to the charge for dispensing a medication that has been prescribed by a healthcare professional. The prescription fee may cover the cost of the medication itself, as well as any additional services provided by the pharmacist, such as counseling on how to take the medication, potential side effects, and monitoring requirements.
Prescription fees may vary depending on the location, the type of medication, and the healthcare system in place. In some cases, prescription fees may be covered or subsidized by health insurance plans, while in other cases, patients may be responsible for paying the fee out of pocket. It is important for patients to understand their prescription coverage and any associated costs before filling a prescription.
Pharmaceutical services insurance refers to a type of coverage that helps individuals and families pay for their prescription medications. This type of insurance is often offered as part of a larger health insurance plan, but can also be purchased as a standalone policy.
The specifics of pharmaceutical services insurance coverage can vary widely depending on the policy. Some plans may cover only generic medications, while others may cover both brand-name and generic drugs. Additionally, some policies may require individuals to pay a portion of the cost of their prescriptions in the form of copays or coinsurance, while others may cover the full cost of medications.
Pharmaceutical services insurance can be especially important for individuals who have chronic medical conditions that require ongoing treatment with expensive prescription medications. By helping to offset the cost of these medications, pharmaceutical services insurance can make it easier for people to afford the care they need to manage their health and improve their quality of life.
Costs refer to the total amount of resources, such as money, time, and labor, that are expended in the provision of a medical service or treatment. Costs can be categorized into direct costs, which include expenses directly related to patient care, such as medication, supplies, and personnel; and indirect costs, which include overhead expenses, such as rent, utilities, and administrative salaries.
Cost analysis is the process of estimating and evaluating the total cost of a medical service or treatment. This involves identifying and quantifying all direct and indirect costs associated with the provision of care, and analyzing how these costs may vary based on factors such as patient volume, resource utilization, and reimbursement rates.
Cost analysis is an important tool for healthcare organizations to understand the financial implications of their operations and make informed decisions about resource allocation, pricing strategies, and quality improvement initiatives. It can also help policymakers and payers evaluate the cost-effectiveness of different treatment options and develop evidence-based guidelines for clinical practice.
A generic drug is a medication that contains the same active ingredients as an originally marketed brand-name drug, known as its "innovator" or "reference listed" drug. The active ingredient is the component of the drug that is responsible for its therapeutic effect. Generic drugs are required to have the same quality, strength, purity, and stability as their brand-name counterparts. They must also meet the same rigorous Food and Drug Administration (FDA) standards regarding safety, effectiveness, and manufacturing.
Generic drugs are typically less expensive than their brand-name equivalents because generic manufacturers do not have to repeat the costly clinical trials that were required for the innovator drug. Instead, they demonstrate through bioequivalence studies that their product is therapeutically equivalent to the reference listed drug. This means that the generic drug delivers the same amount of active ingredient into a patient's bloodstream in the same timeframe as the brand-name drug.
In summary, generic drugs are copies of brand-name drugs with the same active ingredients, dosage forms, strengths, routes of administration, and intended uses. They must meet FDA regulations for safety, efficacy, and manufacturing standards, ensuring that they provide patients with the same therapeutic benefits as their brand-name counterparts at a more affordable price.
Cost control in a medical context refers to the strategies and practices employed by healthcare organizations to manage and reduce the costs associated with providing patient care while maintaining quality and safety. The goal is to optimize resource allocation, increase efficiency, and contain expenses without compromising the standard of care. This may involve measures such as:
1. Utilization management: Reviewing and monitoring the use of medical services, tests, and treatments to ensure they are necessary, appropriate, and evidence-based.
2. Case management: Coordinating patient care across various healthcare providers and settings to improve outcomes, reduce unnecessary duplication of services, and control costs.
3. Negotiating contracts with suppliers and vendors to secure favorable pricing for medical equipment, supplies, and pharmaceuticals.
4. Implementing evidence-based clinical guidelines and pathways to standardize care processes and reduce unwarranted variations in practice that can drive up costs.
5. Using technology such as electronic health records (EHRs) and telemedicine to streamline operations, improve communication, and reduce errors.
6. Investing in preventive care and wellness programs to keep patients healthy and reduce the need for costly interventions and hospitalizations.
7. Continuously monitoring and analyzing cost data to identify trends, opportunities for improvement, and areas of potential waste or inefficiency.
Pharmaceutical fees are charges that healthcare professionals or institutions may impose on patients for various services related to the prescribing and dispensing of medications. These fees can include costs associated with medication therapy management, drug monitoring, medication reconciliation, and other clinical services provided by pharmacists or other healthcare providers.
It's important to note that these fees are separate from the cost of the medication itself and may not be covered by insurance. Patients should always ask about any potential fees before receiving pharmaceutical services and clarify whether they will be responsible for paying them out-of-pocket.
Cost savings in a medical context generally refers to the reduction in expenses or resources expended in the delivery of healthcare services, treatments, or procedures. This can be achieved through various means such as implementing more efficient processes, utilizing less expensive treatment options when appropriate, preventing complications or readmissions, and negotiating better prices for drugs or supplies.
Cost savings can also result from comparative effectiveness research, which compares the relative benefits and harms of different medical interventions to help doctors and patients make informed decisions about which treatment is most appropriate and cost-effective for a given condition.
Ultimately, cost savings in healthcare aim to improve the overall value of care delivered by reducing unnecessary expenses while maintaining or improving quality outcomes for patients.
Cost sharing in a medical or healthcare context refers to the portion of health care costs that are paid by the patient or health plan member, rather than by their insurance company. Cost sharing can take various forms, including deductibles, coinsurance, and copayments.
A deductible is the amount that a patient must pay out of pocket for medical services before their insurance coverage kicks in. For example, if a health plan has a $1,000 deductible, the patient must pay the first $1,000 of their medical expenses before their insurance starts covering costs.
Coinsurance is the percentage of medical costs that a patient is responsible for paying after they have met their deductible. For example, if a health plan has 20% coinsurance, the patient would pay 20% of the cost of medical services, and their insurance would cover the remaining 80%.
Copayments are fixed amounts that patients must pay for specific medical services, such as doctor visits or prescription medications. Copayments are typically paid at the time of service and do not count towards a patient's deductible.
Cost sharing is intended to encourage patients to be more cost-conscious in their use of healthcare services, as they have a financial incentive to seek out lower-cost options. However, high levels of cost sharing can also create barriers to accessing necessary medical care, particularly for low-income individuals and families.
"Cost of Illness" is a medical-economic concept that refers to the total societal cost associated with a specific disease or health condition. It includes both direct and indirect costs. Direct costs are those that can be directly attributed to the illness, such as medical expenses for diagnosis, treatment, rehabilitation, and medications. Indirect costs include productivity losses due to morbidity (reduced efficiency while working) and mortality (lost earnings due to death). Other indirect costs may encompass expenses related to caregiving or special education needs. The Cost of Illness is often used in health policy decision-making, resource allocation, and evaluating the economic impact of diseases on society.
Cost-benefit analysis (CBA) is a systematic process used to compare the costs and benefits of different options to determine which one provides the greatest net benefit. In a medical context, CBA can be used to evaluate the value of medical interventions, treatments, or policies by estimating and monetizing all the relevant costs and benefits associated with each option.
The costs included in a CBA may include direct costs such as the cost of the intervention or treatment itself, as well as indirect costs such as lost productivity or time away from work. Benefits may include improved health outcomes, reduced morbidity or mortality, and increased quality of life.
Once all the relevant costs and benefits have been identified and quantified, they are typically expressed in monetary terms to allow for a direct comparison. The option with the highest net benefit (i.e., the difference between total benefits and total costs) is considered the most cost-effective.
It's important to note that CBA has some limitations and can be subject to various biases and assumptions, so it should be used in conjunction with other evaluation methods to ensure a comprehensive understanding of the value of medical interventions or policies.
A formulary is a list of prescription drugs, both generic and brand-name, that are approved for use in a specific health plan or healthcare system. The formulary includes information on the preferred drugs within each therapeutic class, along with any restrictions or limitations on their use. Formularies are developed and maintained by a committee of healthcare professionals, including pharmacists and physicians, who evaluate the safety, efficacy, and cost-effectiveness of different medications.
The purpose of a formulary is to promote the appropriate use of medications, improve patient outcomes, and manage healthcare costs. By establishing a preferred list of drugs, health plans and healthcare systems can negotiate better prices with pharmaceutical manufacturers and ensure that patients receive high-quality, evidence-based care.
Formularies may include various types of medications, such as oral solid dosage forms, injectables, inhalants, topicals, and others. They are typically organized by therapeutic class, and each drug is assigned a tier based on its cost and clinical value. Tier 1 drugs are usually preferred generics or lower-cost brand-name medications, while Tier 2 drugs may be higher-cost brand-name medications that have no generic equivalent. Tier 3 drugs are typically specialty medications that are used to treat complex or rare conditions and are often associated with high costs.
Healthcare providers are encouraged to prescribe drugs that are listed on the formulary, as these medications have been thoroughly reviewed and deemed safe and effective for use in their patient population. However, there may be situations where a non-formulary medication is necessary to treat a particular patient's condition. In such cases, healthcare providers can request an exception or prior authorization to prescribe the non-formulary drug.
Formularies are regularly updated to reflect new drugs that come on the market, changes in clinical guidelines, and shifts in the therapeutic landscape. Health plans and healthcare systems may also modify their formularies in response to feedback from patients and providers or to address concerns about safety, efficacy, or cost.
In summary, a formulary is a comprehensive list of prescription drugs that are approved for use in a specific health plan or healthcare system. Formularies promote the appropriate use of medications, improve patient outcomes, and manage costs by encouraging the prescribing of safe and effective drugs that have been thoroughly reviewed and deemed appropriate for their patient population.
A Drug Utilization Review (DUR) is a systematic retrospective examination of a patient's current and past use of medications to identify medication-related problems, such as adverse drug reactions, interactions, inappropriate dosages, duplicate therapy, and noncompliance with the treatment plan. The goal of DUR is to optimize medication therapy, improve patient outcomes, reduce healthcare costs, and promote safe and effective use of medications.
DUR is typically conducted by pharmacists, physicians, or other healthcare professionals who review medication records, laboratory results, and clinical data to identify potential issues and make recommendations for changes in medication therapy. DUR may be performed manually or using automated software tools that can analyze large datasets of medication claims and electronic health records.
DUR is an important component of medication management programs in various settings, including hospitals, long-term care facilities, managed care organizations, and ambulatory care clinics. It helps ensure that patients receive the right medications at the right doses for the right indications, and reduces the risk of medication errors and adverse drug events.
Medicare Part D is a voluntary program within the U.S. Medicare system that provides prescription drug coverage to beneficiaries. It is offered through private insurance companies approved by and contracting with the Centers for Medicare & Medicaid Services (CMS).
Medicare Part D has two primary components: the Prescription Drug Plans (PDPs) and the Medicare Advantage Prescription Drug plans (MA-PDs). PDPs are standalone drug plans that can be added to Original Medicare or certain Medicare Cost Plans, Private Fee-for-Service Plans, and Medical Savings Account Plans. MA-PDs combine medical and prescription drug coverage in a single plan offered by private insurance companies approved by CMS.
Beneficiaries enrolled in Medicare Part D plans pay premiums, deductibles, coinsurance, or copayments for their covered medications, depending on the specific plan they choose. Additionally, there is an annual out-of-pocket spending limit called the "catastrophic coverage threshold" that provides some financial protection for beneficiaries with high drug costs.
An insurance claim review is the process conducted by an insurance company to evaluate a claim made by a policyholder for coverage of a loss or expense. This evaluation typically involves examining the details of the claim, assessing the damages or injuries incurred, verifying the coverage provided by the policy, and determining the appropriate amount of benefits to be paid. The insurance claim review may also include investigating the circumstances surrounding the claim to ensure its validity and confirming that it complies with the terms and conditions of the insurance policy.
Managed care programs are a type of health insurance plan that aims to control healthcare costs and improve the quality of care by managing the utilization of healthcare services. They do this by using a network of healthcare providers who have agreed to provide services at reduced rates, and by implementing various strategies such as utilization review, case management, and preventive care.
In managed care programs, there is usually a primary care physician (PCP) who acts as the patient's main doctor and coordinates their care within the network of providers. Patients may need a referral from their PCP to see specialists or access certain services. Managed care programs can take various forms, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Point-of-Service (POS) plans, and Exclusive Provider Organizations (EPOs).
The goal of managed care programs is to provide cost-effective healthcare services while maintaining or improving the quality of care. They can help patients save money on healthcare costs by providing coverage for a range of services at lower rates than traditional fee-for-service plans, but they may also limit patient choice and require prior authorization for certain procedures or treatments.
Prescription drugs are medications that are only available to patients with a valid prescription from a licensed healthcare professional, such as a doctor or nurse practitioner. These drugs cannot be legally obtained over-the-counter and require a prescription due to their potential for misuse, abuse, or serious side effects. They are typically used to treat complex medical conditions, manage symptoms of chronic illnesses, or provide necessary pain relief in certain situations.
Prescription drugs are classified based on their active ingredients and therapeutic uses. In the United States, the Drug Enforcement Administration (DEA) categorizes them into five schedules (I-V) depending on their potential for abuse and dependence. Schedule I substances have the highest potential for abuse and no accepted medical use, while schedule V substances have a lower potential for abuse and are often used for legitimate medical purposes.
Examples of prescription drugs include opioid painkillers like oxycodone and hydrocodone, stimulants such as Adderall and Ritalin, benzodiazepines like Xanax and Ativan, and various other medications used to treat conditions such as epilepsy, depression, anxiety, and high blood pressure.
It is essential to use prescription drugs only as directed by a healthcare professional, as misuse or abuse can lead to severe health consequences, including addiction, overdose, and even death.
Economic models in the context of healthcare and medicine are theoretical frameworks used to analyze and predict the economic impact and cost-effectiveness of healthcare interventions, treatments, or policies. These models utilize clinical and epidemiological data, as well as information on resource use and costs, to estimate outcomes such as quality-adjusted life years (QALYs) gained, incremental cost-effectiveness ratios (ICERs), and budget impacts. The purpose of economic models is to inform decision-making and allocate resources in an efficient and evidence-based manner. Examples of economic models include decision tree analysis, Markov models, and simulation models.
A drug prescription is a written or electronic order provided by a licensed healthcare professional, such as a physician, dentist, or advanced practice nurse, to a pharmacist that authorizes the preparation and dispensing of a specific medication for a patient. The prescription typically includes important information such as the patient's name and date of birth, the name and strength of the medication, the dosage regimen, the duration of treatment, and any special instructions or precautions.
Prescriptions serve several purposes, including ensuring that patients receive the appropriate medication for their medical condition, preventing medication errors, and promoting safe and effective use of medications. They also provide a legal record of the medical provider's authorization for the pharmacist to dispense the medication to the patient.
There are two main types of prescriptions: written prescriptions and electronic prescriptions. Written prescriptions are handwritten or printed on paper, while electronic prescriptions are transmitted electronically from the medical provider to the pharmacy. Electronic prescriptions are becoming increasingly common due to their convenience, accuracy, and security.
It is important for patients to follow the instructions provided on their prescription carefully and to ask their healthcare provider or pharmacist any questions they may have about their medication. Failure to follow a drug prescription can result in improper use of the medication, which can lead to adverse effects, treatment failure, or even life-threatening situations.
"Physicians' Offices" is a general term that refers to the physical location where medical doctors or physicians practice their profession and provide healthcare services to patients. These offices can vary in size and setting, ranging from a single physician's small private practice to large, multi-specialty clinics.
In a physicians' office, medical professionals typically deliver outpatient care, which means that patients visit the office for appointments rather than staying overnight. The services provided may include routine check-ups, diagnosing and treating illnesses or injuries, prescribing medications, ordering and interpreting diagnostic tests, providing preventive care, and coordinating with other healthcare providers for specialist referrals or additional treatments.
The facilities in a physicians' office usually consist of examination rooms, a waiting area, nursing stations, and administrative support spaces. Some may also have on-site laboratory or diagnostic equipment, such as X-ray machines or ultrasound devices. The specific layout and amenities will depend on the size, specialty, and patient population of the practice.
Pharmaceutical services refer to the direct patient care activities conducted by licensed pharmacists, which include but are not limited to:
1. Medication therapy management: This involves reviewing a patient's medications to ensure they are appropriate, effective, and safe. Pharmacists may make recommendations to the prescriber about changes to medication therapy as needed.
2. Patient education: Pharmacists provide education to patients about their medications, including how to take them, potential side effects, and storage instructions. They also provide information on disease prevention and management.
3. Immunizations: Many pharmacists are trained to administer vaccines, which can help increase access to this important preventive health service.
4. Monitoring and evaluation: Pharmacists monitor patients' responses to medication therapy and make adjustments as needed. They also evaluate the effectiveness of medication therapy and make recommendations for changes if necessary.
5. Clinical services: Pharmacists may provide a range of clinical services, such as managing anticoagulation therapy, providing diabetes education, or conducting medication reconciliation after hospital discharge.
6. Collaborative practice: Pharmacists work collaboratively with other healthcare providers to optimize medication therapy and improve patient outcomes. This may involve participating in multidisciplinary teams, consulting with prescribers, or sharing information with other healthcare professionals.
Overall, pharmaceutical services aim to improve patient outcomes by ensuring that medications are used safely and effectively.
Drug utilization refers to the use of medications by patients or healthcare professionals in a real-world setting. It involves analyzing and evaluating patterns of medication use, including prescribing practices, adherence to treatment guidelines, potential duplications or interactions, and outcomes associated with drug therapy. The goal of drug utilization is to optimize medication use, improve patient safety, and minimize costs while achieving the best possible health outcomes. It can be studied through various methods such as prescription claims data analysis, surveys, and clinical audits.
Pharmaceutical economics is a branch of economics that focuses on the production and distribution of pharmaceutical products and services. It involves the analysis of various factors that influence the development, pricing, and accessibility of medications, including issues related to healthcare policy, regulation, reimbursement, and market competition.
Pharmaceutical economists study topics such as:
1. The research and development (R&D) process for new drugs, including the costs, risks, and uncertainties associated with bringing a new drug to market.
2. The pricing of pharmaceuticals, taking into account factors such as production costs, R&D expenses, market competition, and the value that medications provide to patients and society.
3. The impact of government regulations and policies on the pharmaceutical industry, including issues related to intellectual property protection, drug safety, and efficacy testing.
4. The role of health insurance and other third-party payers in shaping the demand for and access to pharmaceuticals.
5. The evaluation of pharmaceutical interventions' cost-effectiveness and their impact on healthcare outcomes and patient well-being.
6. The analysis of market structures, competitive dynamics, and strategic decision-making within the pharmaceutical industry.
7. The assessment of globalization, international trade, and cross-border collaboration in the pharmaceutical sector.
Pharmaceutical economics plays a crucial role in informing healthcare policy decisions, improving patient access to essential medications, and promoting sustainable and innovative practices within the pharmaceutical industry.
Pharmacy administration refers to the management and leadership of pharmacy operations, services, and resources within healthcare systems or organizations. It involves planning, organizing, directing, and coordinating various activities related to the safe and effective use of medications, including medication therapy management, formulary management, drug utilization review, quality improvement, regulatory compliance, and financial management.
Pharmacy administrators may oversee pharmacy staff, operations, and budgets, as well as develop and implement policies and procedures that promote high-quality patient care, ensure medication safety, and optimize medication use. They may also collaborate with other healthcare professionals to develop and implement strategies for improving medication management and promoting interprofessional communication and collaboration.
Pharmacy administration is a critical component of healthcare delivery, as it helps to ensure that patients receive the right medications at the right time, in the right dose, and for the right duration. Effective pharmacy administration can help to improve patient outcomes, reduce medication errors, and lower healthcare costs.
Health expenditures refer to the total amount of money spent on health services, goods, and resources in a given period. This can include expenses for preventive care, medical treatments, medications, long-term care, and administrative costs. Health expenditures can be made by individuals, corporations, insurance companies, or governments, and they can be measured at the national, regional, or household level.
Health expenditures are often used as an indicator of a country's investment in its healthcare system and can reflect the overall health status of a population. High levels of health expenditures may indicate a strong commitment to healthcare, but they can also place a significant burden on individuals, businesses, and governments. Understanding patterns and trends in health expenditures is important for policymakers, healthcare providers, and researchers who are working to improve the efficiency, effectiveness, and accessibility of healthcare services.
Personal Financing is not a term that has a specific medical definition. However, in general terms, it refers to the management of an individual's financial resources, such as income, assets, liabilities, and debts, to meet their personal needs and goals. This can include budgeting, saving, investing, planning for retirement, and managing debt.
In the context of healthcare, personal financing may refer to the ability of individuals to pay for their own medical care expenses, including health insurance premiums, deductibles, co-pays, and out-of-pocket costs. This can be a significant concern for many people, particularly those with chronic medical conditions or disabilities who may face ongoing healthcare expenses.
Personal financing for healthcare may involve various strategies, such as setting aside savings, using health savings accounts (HSAs) or flexible spending accounts (FSAs), purchasing health insurance policies with lower premiums but higher out-of-pocket costs, or negotiating payment plans with healthcare providers. Ultimately, personal financing for healthcare involves making informed decisions about how to allocate financial resources to meet both immediate and long-term medical needs while also balancing other financial goals and responsibilities.
I'm sorry for any confusion, but "United States" is a geopolitical entity, specifically the name of the country consisting of 50 states, and it is not a medical term or concept. Therefore, I can't provide a medical definition for it. If you have any questions related to health, medicine, or biology, I would be happy to try to help answer those!
Insurance coverage, in the context of healthcare and medicine, refers to the financial protection provided by an insurance policy that covers all or a portion of the cost of medical services, treatments, and prescription drugs. The coverage is typically offered by health insurance companies, employers, or government programs such as Medicare and Medicaid.
The specific services and treatments covered by insurance, as well as the out-of-pocket costs borne by the insured individual, are determined by the terms of the insurance policy. These terms may include deductibles, copayments, coinsurance, and coverage limits or exclusions. The goal of insurance coverage is to help individuals manage the financial risks associated with healthcare expenses and ensure access to necessary medical services.
A Pharmacist is a healthcare professional who practices in the field of pharmacy, focusing on the safe and effective use of medications. They are responsible for dispensing medications prescribed by physicians and other healthcare providers, as well as providing information and counseling to patients about their medications. This includes explaining how to take the medication, potential side effects, and any drug interactions. Pharmacists may also be involved in medication therapy management, monitoring patient health and adjusting medication plans as needed. They must have a deep understanding of the properties and actions of drugs, including how they are absorbed, distributed, metabolized, and excreted by the body, as well as their potential interactions with other substances and treatments. In addition to a Doctor of Pharmacy (Pharm.D.) degree, pharmacists must also be licensed in the state where they practice.
Physician's practice patterns refer to the individual habits and preferences of healthcare providers when it comes to making clinical decisions and managing patient care. These patterns can encompass various aspects, such as:
1. Diagnostic testing: The types and frequency of diagnostic tests ordered for patients with similar conditions.
2. Treatment modalities: The choice of treatment options, including medications, procedures, or referrals to specialists.
3. Patient communication: The way physicians communicate with their patients, including the amount and type of information shared, as well as the level of patient involvement in decision-making.
4. Follow-up care: The frequency and duration of follow-up appointments, as well as the monitoring of treatment effectiveness and potential side effects.
5. Resource utilization: The use of healthcare resources, such as hospitalizations, imaging studies, or specialist consultations, and the associated costs.
Physician practice patterns can be influenced by various factors, including medical training, clinical experience, personal beliefs, guidelines, and local availability of resources. Understanding these patterns is essential for evaluating the quality of care, identifying potential variations in care, and implementing strategies to improve patient outcomes and reduce healthcare costs.
Quality-Adjusted Life Years (QALYs) is a measure of health outcomes that combines both the quality and quantity of life lived in a single metric. It is often used in economic evaluations of healthcare interventions to estimate their value for money. QALYs are calculated by multiplying the number of years of life gained by a weighting factor that reflects the quality of life experienced during those years, typically on a scale from 0 (representing death) to 1 (representing perfect health). For example, if a healthcare intervention extends a person's life by an additional five years but they experience only 80% of full health during that time, the QALY gain would be 4 (5 x 0.8). This measure allows for comparisons to be made between different interventions and their impact on both length and quality of life.
A Pharmacy and Therapeutics (P&T) Committee is a group of healthcare professionals, typically including physicians, pharmacists, and other experts, responsible for the evaluation, recommendation, and monitoring of safe and effective medication use within a healthcare system or organization. They make decisions about the formulary, which is the list of medications that are covered and approved for use within that system. The committee also develops guidelines and policies for medication prescribing, administering, and monitoring to promote quality patient care, reduce medication errors, and control costs.
Insurance benefits refer to the coverage, payments or services that a health insurance company provides to its policyholders based on the terms of their insurance plan. These benefits can include things like:
* Payment for all or a portion of medical services, such as doctor visits, hospital stays, and prescription medications
* Coverage for specific treatments or procedures, such as cancer treatment or surgery
* Reimbursement for out-of-pocket expenses, such as deductibles, coinsurance, and copayments
* Case management and care coordination services to help policyholders navigate the healthcare system and receive appropriate care.
The specific benefits provided will vary depending on the type of insurance plan and the level of coverage purchased by the policyholder. It is important for individuals to understand their insurance benefits and how they can access them in order to make informed decisions about their healthcare.
A Health Maintenance Organization (HMO) is a type of managed care organization (MCO) that provides comprehensive health care services to its members, typically for a fixed monthly premium. HMOs are characterized by a prepaid payment model and a focus on preventive care and early intervention to manage the health of their enrolled population.
In an HMO, members must choose a primary care physician (PCP) who acts as their first point of contact for medical care and coordinates all aspects of their healthcare needs within the HMO network. Specialist care is generally only covered if it is referred by the PCP, and members are typically required to obtain medical services from providers that are part of the HMO's network. This helps to keep costs down and ensures that care is coordinated and managed effectively.
HMOs may also offer additional benefits such as dental, vision, and mental health services, depending on the specific plan. However, members may face higher out-of-pocket costs if they choose to receive care outside of the HMO network. Overall, HMOs are designed to provide comprehensive healthcare coverage at a more affordable cost than traditional fee-for-service insurance plans.
A deductible is a specific amount of money that a patient must pay out of pocket before their health insurance starts covering the costs of medical services. For example, if a patient has a $1000 deductible, they must pay the first $1000 of their medical bills themselves before the insurance begins to cover the remaining costs. Deductibles are annual, meaning they reset every year.
Coinsurance is the percentage of costs for a covered medical service that a patient is responsible for paying after they have met their deductible. For example, if a patient has a 20% coinsurance rate, they will be responsible for paying 20% of the cost of each medical service, while their insurance covers the remaining 80%. Coinsurance rates vary depending on the health insurance plan and the specific medical service being provided.
Direct service costs are expenses that can be directly attributed to the delivery of a specific service or program. These costs are typically related to items such as personnel, supplies, and equipment that are used exclusively for the provision of that service. Direct service costs can be contrasted with indirect costs, which are expenses that are not easily linked to a particular service or program and may include things like administrative overhead, rent, and utilities.
Examples of direct service costs in a healthcare setting might include:
* Salaries and benefits for medical staff who provide patient care, such as doctors, nurses, and therapists
* Costs of medications and supplies used to treat patients
* Equipment and supplies needed to perform diagnostic tests or procedures, such as X-ray machines or surgical instruments
* Rent or lease payments for space that is dedicated to providing patient care services.
It's important to accurately track direct service costs in order to understand the true cost of delivering a particular service or program, and to make informed decisions about resource allocation and pricing.
Pharmaceutical preparations refer to the various forms of medicines that are produced by pharmaceutical companies, which are intended for therapeutic or prophylactic use. These preparations consist of an active ingredient (the drug) combined with excipients (inactive ingredients) in a specific formulation and dosage form.
The active ingredient is the substance that has a therapeutic effect on the body, while the excipients are added to improve the stability, palatability, bioavailability, or administration of the drug. Examples of pharmaceutical preparations include tablets, capsules, solutions, suspensions, emulsions, ointments, creams, and injections.
The production of pharmaceutical preparations involves a series of steps that ensure the quality, safety, and efficacy of the final product. These steps include the selection and testing of raw materials, formulation development, manufacturing, packaging, labeling, and storage. Each step is governed by strict regulations and guidelines to ensure that the final product meets the required standards for use in medical practice.
Cost allocation is the process of distributing or assigning costs to different departments, projects, products, or services within an organization. The goal of cost allocation is to more accurately determine the true cost of producing a product or providing a service, taking into account all related expenses. This can help organizations make better decisions about pricing, resource allocation, and profitability analysis.
There are various methods for allocating costs, including activity-based costing (ABC), which assigns costs based on the activities required to produce a product or provide a service; traditional costing, which uses broad categories such as direct labor, direct materials, and overhead; and causal allocation, which assigns costs based on a specific cause-and-effect relationship.
In healthcare, cost allocation is particularly important for determining the true cost of patient care, including both direct and indirect costs. This can help hospitals and other healthcare organizations make informed decisions about resource allocation, pricing, and reimbursement strategies.
Medicaid is a joint federal-state program that provides health coverage for low-income individuals, including children, pregnant women, elderly adults, and people with disabilities. Eligibility, benefits, and administration vary by state, but the program is designed to ensure that low-income individuals have access to necessary medical services. Medicaid is funded jointly by the federal government and the states, and is administered by the states under broad federal guidelines.
Medicaid programs must cover certain mandatory benefits, such as inpatient and outpatient hospital services, laboratory and X-ray services, and physician services. States also have the option to provide additional benefits, such as dental care, vision services, and prescription drugs. In addition, many states have expanded their Medicaid programs to cover more low-income adults under the Affordable Care Act (ACA).
Medicaid is an important source of health coverage for millions of Americans, providing access to necessary medical care and helping to reduce financial burden for low-income individuals.
The "drug industry" is also commonly referred to as the "pharmaceutical industry." It is a segment of the healthcare sector that involves the research, development, production, and marketing of medications or drugs. This includes both prescription and over-the-counter medicines used to treat, cure, or prevent diseases and medical conditions in humans and animals.
The drug industry comprises various types of organizations, such as:
1. Research-based pharmaceutical companies: These are large corporations that focus on the research and development (R&D) of new drugs, clinical trials, obtaining regulatory approvals, manufacturing, and marketing their products globally. Examples include Pfizer, Johnson & Johnson, Roche, and Merck.
2. Generic drug manufacturers: After the patent for a brand-name drug expires, generic drug manufacturers can produce and sell a similar version of the drug at a lower cost. These companies must demonstrate that their product is bioequivalent to the brand-name drug in terms of safety, quality, and efficacy.
3. Biotechnology companies: These firms specialize in developing drugs using biotechnological methods, such as recombinant DNA technology, gene therapy, or monoclonal antibodies. Many biotech companies focus on specific therapeutic areas, like oncology, immunology, or neurology.
4. Contract research organizations (CROs): CROs provide various services to the drug industry, including clinical trial management, data analysis, regulatory affairs support, and pharmacovigilance. They work with both large pharmaceutical companies and smaller biotech firms to help streamline the drug development process.
5. Drug delivery system companies: These organizations focus on developing innovative technologies for delivering drugs more effectively and safely to patients. Examples include transdermal patches, inhalers, or long-acting injectables.
6. Wholesalers and distributors: Companies that purchase drugs from manufacturers and distribute them to pharmacies, hospitals, and other healthcare providers.
The drug industry plays a crucial role in improving public health by discovering, developing, and delivering new treatments for various diseases and medical conditions. However, it is also subject to criticism and regulation due to concerns about high drug prices, marketing practices, and the potential for conflicts of interest between industry and healthcare professionals.
Health resources refer to the personnel, facilities, equipment, and supplies that are used in the delivery of healthcare services. This includes:
1. Human resources: Healthcare professionals such as doctors, nurses, pharmacists, and allied health professionals.
2. Physical resources: Hospitals, clinics, laboratories, and other healthcare facilities.
3. Technological resources: Medical equipment and technology used for diagnosis and treatment, such as MRI machines, CT scanners, and electronic health records.
4. Financial resources: Funding for healthcare services, including public and private insurance, government funding, and out-of-pocket payments.
5. Informational resources: Research findings, evidence-based practices, and health education materials that inform healthcare decision-making.
The adequate availability, distribution, and utilization of these health resources are crucial for ensuring access to quality healthcare services and improving population health outcomes.
Patient compliance, also known as medication adherence or patient adherence, refers to the degree to which a patient's behavior matches the agreed-upon recommendations from their healthcare provider. This includes taking medications as prescribed (including the correct dosage, frequency, and duration), following dietary restrictions, making lifestyle changes, and attending follow-up appointments. Poor patient compliance can negatively impact treatment outcomes and lead to worsening of symptoms, increased healthcare costs, and development of drug-resistant strains in the case of antibiotics. It is a significant challenge in healthcare and efforts are being made to improve patient education, communication, and support to enhance compliance.
I'm sorry for any confusion, but "Markov Chains" is a term from the field of mathematics and probability theory, not medicine. Markov Chains are mathematical systems that undergo transitions from one state to another according to certain probabilistic rules. They are named after Russian mathematician Andrey Markov. These chains are used in various fields, including computer science, physics, economics, and engineering, but not commonly in medical definitions or contexts.
Hospital costs are the total amount of money that is expended by a hospital to provide medical and healthcare services to patients. These costs can include expenses related to:
* Hospital staff salaries and benefits
* Supplies, such as medications, medical devices, and surgical equipment
* Utilities, such as electricity, water, and heating
* Facility maintenance and renovation
* Equipment maintenance and purchase
* Administrative costs, such as billing and insurance processing
Hospital costs can also be classified into fixed and variable costs. Fixed costs are those that do not change with the volume of services provided, such as rent or depreciation of equipment. Variable costs are those that change with the volume of services provided, such as supplies and medications.
It's important to note that hospital costs can vary widely depending on factors such as the complexity of care provided, the geographic location of the hospital, and the patient population served. Additionally, hospital costs may not always align with charges or payments for healthcare services, which can be influenced by factors such as negotiated rates with insurance companies and government reimbursement policies.
Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.
Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.
National health programs are systematic, large-scale initiatives that are put in place by national governments to address specific health issues or improve the overall health of a population. These programs often involve coordinated efforts across various sectors, including healthcare, education, and social services. They may aim to increase access to care, improve the quality of care, prevent the spread of diseases, promote healthy behaviors, or reduce health disparities. Examples of national health programs include immunization campaigns, tobacco control initiatives, and efforts to address chronic diseases such as diabetes or heart disease. These programs are typically developed based on scientific research, evidence-based practices, and public health data, and they may be funded through a variety of sources, including government budgets, grants, and private donations.
British Columbia is a province located on the west coast of Canada. It is not a medical term or concept. The province has a diverse geography, with mountains, forests, and coastal areas. Its largest city is Vancouver, and its capital is Victoria. The province is known for its natural beauty and outdoor recreational opportunities, as well as its vibrant cities and cultural attractions. It is home to a number of medical facilities and healthcare providers, and the provincial government plays a role in regulating and funding healthcare services within the province.
Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.
Automation in the medical context refers to the use of technology and programming to allow machines or devices to operate with minimal human intervention. This can include various types of medical equipment, such as laboratory analyzers, imaging devices, and robotic surgical systems. Automation can help improve efficiency, accuracy, and safety in healthcare settings by reducing the potential for human error and allowing healthcare professionals to focus on higher-level tasks. It is important to note that while automation has many benefits, it is also essential to ensure that appropriate safeguards are in place to prevent accidents and maintain quality of care.
Practice guidelines, also known as clinical practice guidelines, are systematically developed statements that aim to assist healthcare professionals and patients in making informed decisions about appropriate health care for specific clinical circumstances. They are based on a thorough evaluation of the available scientific evidence, consensus of expert opinion, and consideration of patient preferences. Practice guidelines can cover a wide range of topics, including diagnosis, management, prevention, and treatment options for various medical conditions. They are intended to improve the quality and consistency of care, reduce unnecessary variations in practice, and promote evidence-based medicine. However, they should not replace clinical judgment or individualized patient care.
Medicare is a social insurance program in the United States, administered by the Centers for Medicare & Medicaid Services (CMS), that provides health insurance coverage to people who are aged 65 and over; or who have certain disabilities; or who have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
The program consists of four parts:
1. Hospital Insurance (Part A), which helps pay for inpatient care in hospitals, skilled nursing facilities, hospices, and home health care.
2. Medical Insurance (Part B), which helps pay for doctors' services, outpatient care, medical supplies, and preventive services.
3. Medicare Advantage Plans (Part C), which are private insurance plans that provide all of your Part A and Part B benefits, and may include additional benefits like dental, vision, and hearing coverage.
4. Prescription Drug Coverage (Part D), which helps pay for medications doctors prescribe for treatment.
Medicare is funded by payroll taxes, premiums paid by beneficiaries, and general revenue. Beneficiaries typically pay a monthly premium for Part B and Part D coverage, while Part A is generally free for those who have worked and paid Medicare taxes for at least 40 quarters.
Hospitalization is the process of admitting a patient to a hospital for the purpose of receiving medical treatment, surgery, or other health care services. It involves staying in the hospital as an inpatient, typically under the care of doctors, nurses, and other healthcare professionals. The length of stay can vary depending on the individual's medical condition and the type of treatment required. Hospitalization may be necessary for a variety of reasons, such as to receive intensive care, to undergo diagnostic tests or procedures, to recover from surgery, or to manage chronic illnesses or injuries.
I apologize, but "Canada" is not a medical term or concept. It is a country located in North America, known for its vast wilderness, multicultural cities, and significant natural resources. If you have any questions related to healthcare or medical terms, I would be happy to help answer those!
I'm sorry for any confusion, but the term "Great Britain" is not a medical concept or condition. It is a geographical and political term referring to the largest island in the British Isles, on which the majority of England, Scotland, and Wales are located. It's also used to refer to the political union of these three countries, which is called the United Kingdom. Therefore, it doesn't have a medical definition.
Combination drug therapy is a treatment approach that involves the use of multiple medications with different mechanisms of action to achieve better therapeutic outcomes. This approach is often used in the management of complex medical conditions such as cancer, HIV/AIDS, and cardiovascular diseases. The goal of combination drug therapy is to improve efficacy, reduce the risk of drug resistance, decrease the likelihood of adverse effects, and enhance the overall quality of life for patients.
In combining drugs, healthcare providers aim to target various pathways involved in the disease process, which may help to:
1. Increase the effectiveness of treatment by attacking the disease from multiple angles.
2. Decrease the dosage of individual medications, reducing the risk and severity of side effects.
3. Slow down or prevent the development of drug resistance, a common problem in chronic diseases like HIV/AIDS and cancer.
4. Improve patient compliance by simplifying dosing schedules and reducing pill burden.
Examples of combination drug therapy include:
1. Antiretroviral therapy (ART) for HIV treatment, which typically involves three or more drugs from different classes to suppress viral replication and prevent the development of drug resistance.
2. Chemotherapy regimens for cancer treatment, where multiple cytotoxic agents are used to target various stages of the cell cycle and reduce the likelihood of tumor cells developing resistance.
3. Cardiovascular disease management, which may involve combining medications such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, diuretics, and statins to control blood pressure, heart rate, fluid balance, and cholesterol levels.
4. Treatment of tuberculosis, which often involves a combination of several antibiotics to target different aspects of the bacterial life cycle and prevent the development of drug-resistant strains.
When prescribing combination drug therapy, healthcare providers must carefully consider factors such as potential drug interactions, dosing schedules, adverse effects, and contraindications to ensure safe and effective treatment. Regular monitoring of patients is essential to assess treatment response, manage side effects, and adjust the treatment plan as needed.
A factual database in the medical context is a collection of organized and structured data that contains verified and accurate information related to medicine, healthcare, or health sciences. These databases serve as reliable resources for various stakeholders, including healthcare professionals, researchers, students, and patients, to access evidence-based information for making informed decisions and enhancing knowledge.
Examples of factual medical databases include:
1. PubMed: A comprehensive database of biomedical literature maintained by the US National Library of Medicine (NLM). It contains citations and abstracts from life sciences journals, books, and conference proceedings.
2. MEDLINE: A subset of PubMed, MEDLINE focuses on high-quality, peer-reviewed articles related to biomedicine and health. It is the primary component of the NLM's database and serves as a critical resource for healthcare professionals and researchers worldwide.
3. Cochrane Library: A collection of systematic reviews and meta-analyses focused on evidence-based medicine. The library aims to provide unbiased, high-quality information to support clinical decision-making and improve patient outcomes.
4. OVID: A platform that offers access to various medical and healthcare databases, including MEDLINE, Embase, and PsycINFO. It facilitates the search and retrieval of relevant literature for researchers, clinicians, and students.
5. ClinicalTrials.gov: A registry and results database of publicly and privately supported clinical studies conducted around the world. The platform aims to increase transparency and accessibility of clinical trial data for healthcare professionals, researchers, and patients.
6. UpToDate: An evidence-based, physician-authored clinical decision support resource that provides information on diagnosis, treatment, and prevention of medical conditions. It serves as a point-of-care tool for healthcare professionals to make informed decisions and improve patient care.
7. TRIP Database: A search engine designed to facilitate evidence-based medicine by providing quick access to high-quality resources, including systematic reviews, clinical guidelines, and practice recommendations.
8. National Guideline Clearinghouse (NGC): A database of evidence-based clinical practice guidelines and related documents developed through a rigorous review process. The NGC aims to provide clinicians, healthcare providers, and policymakers with reliable guidance for patient care.
9. DrugBank: A comprehensive, freely accessible online database containing detailed information about drugs, their mechanisms, interactions, and targets. It serves as a valuable resource for researchers, healthcare professionals, and students in the field of pharmacology and drug discovery.
10. Genetic Testing Registry (GTR): A database that provides centralized information about genetic tests, test developers, laboratories offering tests, and clinical validity and utility of genetic tests. It serves as a resource for healthcare professionals, researchers, and patients to make informed decisions regarding genetic testing.
Employer health costs refer to the financial expenses incurred by employers for providing healthcare benefits to their employees. These costs can include premiums for group health insurance plans, payments towards self-insured health plans, and other out-of-pocket expenses related to employee healthcare. Employer health costs also encompass expenses related to workplace wellness programs, occupational health services, and any other initiatives aimed at improving the health and well-being of employees. These costs are a significant component of overall employee compensation packages and can have substantial impacts on both employer profitability and employee access to quality healthcare services.
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Medicare54
- Meanwhile, over the recess, the Biden administration released the names of the first 10 drugs selected for the Medicare price negotiation program. (californiahealthline.org)
- This includes the cost you may pay for Trulicity if you have Medicare. (medicalnewstoday.com)
- Different insurance plans, including Medicare plans, have different costs for prescriptions. (medicalnewstoday.com)
- Costs for prescriptions are covered under Medicare Part D . If your plan doesn't include Part D coverage, your costs for prescriptions such as Trulicity may be higher. (medicalnewstoday.com)
- Some Medicare plans may help cover the cost of mail-order medications. (medicalnewstoday.com)
- As negotiations over reconciliation legislation continue, the ERISA Industry Committee ( ERIC ) and the Purchaser Business Group on Health ( PBGH ) - two trade groups representing employers - are suggesting that their support of the bill's drug pricing provisions is contingent on employers getting to benefit from any regulatory drug price reductions, not just Medicare. (brookings.edu)
- While employers understandably want to pay lower drug prices in tandem with any Medicare regulation, which in turn would also translate to lower costs and/or higher wages for workers, these employer groups (and others) are also arguing that drug manufacturers would recoup revenues lost from Medicare patients by extracting higher prices from employers and other private market purchasers. (brookings.edu)
- These plan sponsors and our plan participants financially support the overall U.S. health care system (including the prescription drug market) as critical payers, subsidizing public programs by offsetting costs that government programs, such as Medicare and Medicaid, do not fully cover. (brookings.edu)
- Further, for a subset of drugs, there are reasons to believe that the opposite is likely to be true - that reducing Medicare prices should also reduce the net prices paid by employers. (brookings.edu)
- Unfortunately, I will be going on Medicare soon and I just found out the cost of the drug thru a part D plan! (cancer.org)
- Under current law, drug prices for Medicare Part D are determined through negotiations between manufacturers, pharmacies, and prescription drug plans (PDPs). (taxfoundation.org)
- Lawmakers emphasized the steep cost of the diabetes treatment insulin and ways to use Medicare and Medicaid to discourage companies from setting high prices as Congress kicked off a series of drug price hearings Tuesday. (rollcall.com)
- The 2006 launch of Medicare Part D presents an opportunity to assess how a yearly benefit cap affects adherence to drug therapy. (rand.org)
- But right now, Medicare doesn't cover these drugs and many private insurers point to high list prices to limit access. (medpagetoday.com)
- Or could the drugs indirectly improve health in other parts of Medicare, like cardiac care, such that overall costs would remain flat or even drop significantly? (medpagetoday.com)
- The government's objective should not only be to minimize its costs -- after all, Medicare could save billions if more people would die earlier from smoking more cigarettes. (medpagetoday.com)
- But allowing Medicare to start paying for anti-obesity treatments now has the potential to kick off a true weight-loss revolution that can save lives and dramatically drive down the cost of these drugs. (medpagetoday.com)
- We believe the signs suggest that if Medicare offered coverage, the competition in anti-obesity medications would be robust due to an expanded market, more investors in search of better drugs, and more competitors. (medpagetoday.com)
- Eventually, Medicare would also likely subject these treatments to negotiation under the Inflation Reduction Act, which would leverage federal buying power, though currently there's no rule that requires Medicare drug plans to share negotiated savings with beneficiaries. (medpagetoday.com)
- Along with capping insulin prices and expanding access to adult vaccines, the law will allow Medicare, the US health program for the elderly, to negotiate prices of costly drugs made by some of the biggest pharmaceutical companies. (chicagobusiness.com)
- In a letter sent to drug chains and pharmacy associations before the meeting, White House Domestic Policy Adviser Neera Tanden, Health and Human Services Secretary Xavier Becerra and Medicare Administrator Chiquita Brooks-LaSure asked the executives to educate patients about the law and who's eligible for benefits. (chicagobusiness.com)
- This is likely related to the near universal enrollment in Medicare," she went on, "including prescription drug coverage for many, among the elderly population, and the fact that most elderly individuals without a history of cancer had two or more other chronic conditions, which may also require prescription drugs. (curetoday.com)
- FDA's approval of a drug that can slow the progression of cognitive decline in patients with Alzheimer's disease offers long-awaited hope for these patients and their families, but also raises concerns about the potential impact on Medicare spending. (kff.org)
- Now that the FDA has granted traditional approval to Leqembi, Medicare will cover it for all indicated populations - patients with mild cognitive impairment or mild dementia with confirmed amyloid plaques - outside of the randomized clinical trials required for drugs with accelerated approval under Medicare's coverage with evidence development . (kff.org)
- At the same time, the Centers for Medicare & Medicaid Services (CMS) will require physicians and other clinicians to participate in prospective data collection efforts for Leqembi users, known as registries, to inform questions about how the drug is working, including benefits and harms to patients and whether it improves health outcomes, based on real-world evidence. (kff.org)
- Notwithstanding these questions about the registry requirement and how it might affect access to Leqembi, broader access to the drug under Medicare outside of clinical trials will lead to higher Medicare spending, based on the drug's annual price of $26,500 and expected demand for it among patients with Alzheimer's disease. (kff.org)
- Yet the exact number of Medicare beneficiaries who meet the prescribing requirements for Leqembi is unknown and the take-up rate among eligible individuals for a drug like this one is difficult to estimate. (kff.org)
- Based on this estimate of take-up, which represents 1.5% of the 6.7 million older adults in the US with Alzheimer's disease , annual Medicare spending on Leqembi would be $2.7 billion (assuming all are enrolled in Part B), which would make it the third most costly drug covered by Medicare Part B, based on 2021 total spending (Figure 1). (kff.org)
- To put these amounts in context, projected Medicare spending on Leqembi would be roughly equal to spending on the top 3 Part B drugs combined in 2021 based on the 5% take-up rate. (kff.org)
- And these estimates do not include additional costs to Medicare associated with PET scans or multiple MRIs that may be needed in conjunction with use of Leqembi nor potential offsets if treatment with Leqembi helps reduce spending on other services, such as hospitalizations due to falls or skilled nursing facility stays. (kff.org)
- Higher Medicare Part B spending would likely lead to higher Medicare Part B premiums, which are set to cover roughly 25 percent of program costs. (kff.org)
- In the case of Aduhelm, the anticipation of substantially higher Medicare Part B spending due to coverage of that drug contributed to a 15% jump in the Part B premium between 2021 and 2022, an increase substantially above the norm. (kff.org)
- If you have a Medicare Part D plan, decreasing costs may keep you out of the coverage gap, also called the donut hole . (cahealthadvocates.org)
- See Prescription Drug Coverage (Medicare Part D): An Overview . (cahealthadvocates.org)
- Be sure to have your Medicare card, a list of the drugs you take and the name of your pharmacy ready when you call. (cahealthadvocates.org)
- Medicare Plan Finder - Searches for health and prescription drug plans offered in your area that meet the criteria you enter. (cahealthadvocates.org)
- Review your Medicare Part D plan annually to make sure it provides the most comprehensive coverage for your drugs at the lowest cost. (cahealthadvocates.org)
- Payment to an online pharmacy does not apply toward your Medicare Part D cost sharing, if you have a Medicare Part D plan. (cahealthadvocates.org)
- For people who live with little to no savings, any increase in Medicare premiums or drug costs is going to be a struggle. (moneyandmarkets.com)
- Medicare blamed the premium increase largely on rising spending for drugs administered in doctors' offices. (moneyandmarkets.com)
- These higher costs have a ripple effect and result in higher Part B premiums and deductible," the Centers for Medicare and Medicaid Services said in a statement. (moneyandmarkets.com)
- Pharmacy drugs are covered by another part of Medicare, the Part D prescription program. (moneyandmarkets.com)
- The White House and House Speaker Nancy Pelosi parted ways this week on her bill that calls for Medicare to negotiate drug prices. (moneyandmarkets.com)
- Meanwhile, a Trump administration regulation that would try to lower what Medicare pays for drugs administered in doctors' offices has yet to be finalized. (moneyandmarkets.com)
- A recent study found that more than half of seriously ill Medicare enrollees face financial hardships over medical bills, and prescription drugs are the leading problem. (moneyandmarkets.com)
- Medicare defines a specialty drug as one that costs at least $670 for a 30-day supply. (tcbmag.com)
- Democrats are pushing to expand Medicare benefits and lower prescription drug costs. (axios.com)
- The framework doesn't specifically call for allowing Medicare to negotiate prescription drug prices, a policy fiercely opposed by drug companies. (axios.com)
- The Coalition Against Insurance Fraud reports that Medicare and private health insurance companies pass on the cost of prescription drug abuse to consumers by raising their premiums. (cottonwooddetucson.com)
- President Joe Biden's administration will announce on Tuesday, Aug. 29, 2023, the first prescription drugs being targeted by the U.S. government for price negotiations as part of an effort to lower Medicare costs. (kron4.com)
- The drugs on the list announced Tuesday accounted for $3.4 billion in out-of-pocket costs for Medicare patients last year. (kron4.com)
- The Medicare program paid more than $50 billion for the drugs between June 1, 2022, and May 31, according to the Centers for Medicare and Medicaid Services, or CMS. (kron4.com)
- The law also calls for a $2,000 annual cap on how much people with Medicare have to pay out of pocket for drugs starting in 2025. (kron4.com)
- The Center for Medicare and Medicaid Services (CMS) recently held a public meeting to describe how it will conduct its survey of pharmacy price and acquisition costs. (drugchannels.net)
Mark Cuban Cost Plus Drug Company5
- Scripta Insights, a digital health company focused on pharmacy navigation, is teaming up with Mark Cuban Cost Plus Drug Company to bring transparent drug pricing to patients. (fiercehealthcare.com)
- We are excited to work with Scripta Insights to bring lower prescription drug prices to consumers," Alex Oshmyansky, CEO of Mark Cuban Cost Plus Drug Company, said in the announcement. (fiercehealthcare.com)
- Salt Lake City, Utah, Sept. 19, 2023 (GLOBE NEWSWIRE) -- Leading the charge to revolutionize the prescription drug industry, Salt Lake City-based Select Health ® and its Pharmacy Benefits Manager (PBM), Scripius ® , today announced that it is one of the first health plans in the United States to provide member access to Mark Cuban Cost Plus Drug Company, PBC ( Cost Plus Drugs ). (nwahomepage.com)
- As a practicing physician I saw first-hand the danger of patients not taking their medications because they couldn't afford them," Alex Oshmyansky, CEO of Mark Cuban Cost Plus Drug Company, said. (nwahomepage.com)
- The Mark Cuban Cost Plus Drug Company, PBC ( Cost Plus Drugs ) aims to fundamentally change the way the pharmaceutical industry operates. (nwahomepage.com)
Medications21
- As with all medications, the cost of Biktarvy can vary. (medicalnewstoday.com)
- In general, costs for prescription medications such as Trulicity are typically less with insurance than without insurance. (medicalnewstoday.com)
- Also, biosimilars tend to cost less than brand-name medications. (medicalnewstoday.com)
- The path from expensive innovative drugs to cheap generic medications is well known. (medpagetoday.com)
- Those medications are covered under the Part B outpatient benefit and include many cancer drugs. (moneyandmarkets.com)
- Most businesses continue to cover high-cost medications, but are taking steps to tame spending. (tcbmag.com)
- Specialty drugs are special in the sense that they're complex medications developed to treat complex or chronic conditions like rheumatoid arthritis, heart failure and cancer. (tcbmag.com)
- In 2007, the net per-capita spending on prescription medications in the U.S. was $811, with 24 percent spent on specialty drugs. (tcbmag.com)
- By 2016, the net per-capita spending on prescription medications in the U.S. rose 10.4 percent, to $895, but 43 percent was now spent on specialty drugs ( bit.ly/2tUzmN8 ). (tcbmag.com)
- A cost-effectiveness comparison in 1996 dollars was conducted among five standard antihypertensive medications and the TM ® technique over a simulated 20-year treatment period. (mapi.com)
- The drugs include the blood thinner Eliquis, diabetes treatment Jardiance and eight other medications. (kron4.com)
- Health plans have increasingly shifted costs of medical care and medications to their beneficiaries, resulting in repercussions for the management of chronic disease. (ajmc.com)
- Scripta will integrate Cost Plus Drugs' discounted pricing into its platform Med Mapper, which the company said maps every drug on the market to every possible way users can save money on their medications. (fiercehealthcare.com)
- Cost Plus Drugs and Scripta Insights share a common goal of providing consumers the lowest possible price for their prescription medications. (fiercehealthcare.com)
- As HHS has demonstrated, the rebates, discounts, and fees negotiated between pharmaceutical companies and pharmacy benefit managers (PBMs) are rarely used to lower consumer out-of-pocket costs for medications. (nclnet.org)
- Because of high out-of-pocket costs of new-to-market neurologic drugs that are of similar benefit as older agents, only a small percentage of patients with neurologic disorders have access to these cutting-edge medications, new research shows. (medscape.com)
- For new, high-cost medications that have similar effectiveness to older drugs, limited use is likely appropriate. (medscape.com)
- However, future studies are needed to look into whether the high costs are barriers to those new medications that can really make a difference for people living with neurologic disease," Callaghan said. (medscape.com)
- Using insurance claims data, the investigators compared the utilization and costs of new-to-market drugs from 2014 to 2018 to those for existing guideline-supported medications for treating 11 neurologic conditions. (medscape.com)
- Mean out-of-pocket costs were significantly higher for the new medications, although there was large variability among individual drugs. (medscape.com)
- For new-to-market medications, the distribution of out-of-pocket costs were highly variable and the trends over time were unpredictable compared to existing guideline-supported medications," the authors report. (medscape.com)
20231
- Select Health member access to Cost Plus Drugs launched on September 15, 2023. (nwahomepage.com)
Coverage18
- William M. Mercer Inc., Prescription Drug Coverage and Formulary Use in California: Different Approaches and Emerging Trends (Oakland, Calif.: California HealthCare Foundation, May 2001). (medscape.com)
- The cost may vary depending on the type of coverage you have. (medicalnewstoday.com)
- How much Biktarvy costs per pill depends on several factors such as your insurance coverage, the pharmacy you use, and your treatment plan. (medicalnewstoday.com)
- Biktarvy's cost per month can vary depending on your insurance coverage, your treatment plan, and the pharmacy you use. (medicalnewstoday.com)
- That's because her drugs had cost so much that she qualified for catastrophic coverage, under which her share of prescription costs was reduced. (aarp.org)
- Nonelderly cancer survivors are particularly vulnerable to the risk of changing their prescription drug use for financial reasons, which may be explained in part by the complex relationship between employment and insurance coverage," the article says. (curetoday.com)
- Consumer advocates fear the cost could keep some patients, particularly those who depend on public health coverage, from benefiting. (texastribune.org)
- Yet, as of 2020, due to health care reform, you must only pay 25% of your costs (same as the initial coverage period) for both brand name and generic drugs. (cahealthadvocates.org)
- If you enter the donut hole but are unlikely to spend a total of $7,400 out-of-pocket before the end of the year to receive catastrophic coverage , the cost-saving strategies below may help. (cahealthadvocates.org)
- A 2017 survey of more than 2,100 employers by the Kaiser Family Foundation and the Health Research & Education Trust found that 97 percent of employers offer specialty drug coverage, with 47 percent including a specific specialty drug tier in the benefit design ( kaiserf.am/2fcLdzS ). (tcbmag.com)
- The package could plug some of Medicare's biggest coverage holes while reducing what patients pay for prescription drugs - policies that are popular across party lines. (axios.com)
- It also calls for closing the Medicaid coverage gap in states that haven't expanded and for reducing what patients spend on drugs. (axios.com)
- The fate of some Canadians - in health and in medical coverage - is ultimately determined by the drugs that'll hopefully save them. (globalnews.ca)
- In Western Canada, it doesn't matter how the drugs are getting into your system, patients don't face the burden of paying up or waiting for coverage. (globalnews.ca)
- In 2014, the same 30-day supply will cost me $1,622 in January (I'll just round it to my full $1,500 deductible since I'm single), then $422 per month out of pocket after the 80/20 coverage kicks in. (blogspot.com)
- Over the past 15 years, many healthcare plans have increased beneficiary cost sharing for prescription drugs as a mechanism to contain healthcare spending, and literature suggests that less generous prescription drug coverage reduces drug expenditures for healthcare plans. (ajmc.com)
- Objective - To examine whether neighborhood socioeconomic status (SES) is a predictor of non-drug-related health care costs among Canadian adults with diabetes and, if so, whether SES disparities in costs are reduced after age 65 years, when universal drug coverage commences as an insurable benefit. (ices.on.ca)
- Conclusions - SES is a predictor of diabetes-related health care costs in our setting, more so among adults under age 65 years, a group that lacks universal drug coverage under Ontario's health care system. (ices.on.ca)
Prices34
- So far, the pharmacy benefit managers that control drug prices in America have not delivered on those savings. (californiahealthline.org)
- Brand-name drug prices in the U.S. - more than three times the price in other developed countries - are related neither to the amount of research and development required to bring them to market nor their therapeutic value, recent research shows. (californiahealthline.org)
- However, I argue in this piece that there is little reason to expect such effects in the near-term, and any longer-run indirect effects on drug prices in the commercial market are likely to be small. (brookings.edu)
- The United States pays by far the highest prices in the world for prescription drugs. (truthout.org)
- Indeed, recent analyses have shown that prescription drug prices in the U.S. are on average 2.6 times higher than what they are in other countries, and 3.4 times higher for brand-name drugs. (truthout.org)
- Similar to proposals previously championed by Sanders during his presidential run , the three bills would peg the price of prescription drugs to the median drug prices in five major countries, including Canada and the U.K. (truthout.org)
- Prescription drug prices are often a top concern for voters and the general concept of lowering drug prices has bipartisan buy-in. (truthout.org)
- H.R. 3 would change that by requiring the Health and Human Services (HHS) Secretary to negotiate prices for certain drugs. (taxfoundation.org)
- The drug prices in question would not be permitted to exceed 120 percent of the average international market (AIM) price in a reference group of six countries (Australia, Canada, France, Germany, Japan, and the United Kingdom). (taxfoundation.org)
- Further, the CBO explained that "The authority to establish a formulary, set prices administratively, or take other regulatory actions [emphasis added] against firms failing to offer price reductions could give the Secretary the ability to obtain significant discounts in negotiations with drug manufacturers. (taxfoundation.org)
- Hearings before the Senate Finance and the House Oversight and Reform committees featured academics and patient advocates as lawmakers in both chambers investigate why drug prices are high and what Congress can do about it. (rollcall.com)
- In other countries, the prices of branded drugs tend to go down," he said. (rollcall.com)
- Even when buyers optimized their wholesaler orders by purchasing in bulk when prices were low, Civica still had more affordable products, though the cost-savings gap shrunk to 2.7% in aggregate. (biospace.com)
- This board has the ability to lower prices that will continue throughout the supply chain from the manufacturer through whatever entity acquires the drugs, right down to my patients. (wilx.com)
- Stami Williams represents the pharmacy industry and wants to lower prescription drug prices, too. (wilx.com)
- The controversy is also being heightened by proposals to counter the rising prices for new medicines by setting price caps on the basis of the development costs actually incurred. (dkfz.de)
- In view of the wide disparity between the estimates published, ranging from US $161 million (EUR 137 million, all costs in prices from 2019) to US $4.54 billion (EUR 3.86 billion), a team of health economists and cancer researchers from the DKFZ and the German Cancer Consortium (DKTK) led by Michael Schlander and Karla Hernandez-Villafuerte undertook a comprehensive analysis of the scientific literature on this topic. (dkfz.de)
- The result: no competition and drug prices remain high. (pirg.org)
- With rising costs of everything from milk to gasoline, it's no surprise that prescription drugs are also getting more expensive, but what may surprise people is that higher drug prices help decrease the cost of other medical services. (insurancespecialists.com)
- According to the study MFA engineered, physician and clinical service prices also fell when drug costs peaked. (insurancespecialists.com)
- In contrast, prescription drug prices began climbing at double-digit rates as long ago as the 1980's and continued to do so until the increases peaked at 18.1% in 1999, and then began to descend over the next six years, through 2005. (insurancespecialists.com)
- A comparison of the percentage of increases in prescription drugs vs. other health care expenditures during the period from 1961 to 2006 shows that rising drugs costs helped offset the prices of other services. (insurancespecialists.com)
- In polling conducted in May, KFF found that 92% of U.S. adults said allowing the federal government to negotiate with drug companies for lower prices should be a top or important priority for Congress. (axios.com)
- Professor Shaunak says it is time that the monopoly on drug invention and production by multinational corporations - which charge high prices because they need to make big profits for their shareholders - was broken. (sott.net)
- PharmacyChecker.com compares drug prices and verifies pharmacies, you may want to check it out. (blogspot.com)
- A recent poll found that 80 percent of Americans believe drug prices are too high, while only 39 percent have faith in it being fixed. (physicianspractice.com)
- A recent poll from the Kaiser Family Foundation found that 80 percent of Americans believe drug prices are too high, while only 39 percent have faith in the Trump Administration to fix it. (physicianspractice.com)
- According to the poll, lowering prescription drug prices was at the very top of the public's priority list, above infrastructure, solving the opioid epidemic, immigration reform, repealing the ACA or building a border wall. (physicianspractice.com)
- The poll found that more than half of the public (52 percent) believe passing legislation to bring down drug prices should be a top priority for the administration, despite low expectations of seeing that come to fruition. (physicianspractice.com)
- The prices of prescription drugs in the U.S. have been ballooning for decades. (townhall.com)
- Fake pharmaceuticals: how they and relevant legislation or lack thereof contribute to consistently high and increasing drug prices. (nih.gov)
- We are enabling our members to have access to more affordable healthcare by assisting them in finding optimal drug prices. (nwahomepage.com)
- However, even existing prescription medication can be expensive and drug prices continue to rise. (medscape.com)
- This study adds to a growing literature indicating rising drug prices are a threat to the health care system. (medscape.com)
10,0004
- If the addition of a resource that costs $10,000 would reduce the activity's drag to five days, the drag cost would be reduced by $25,000 and the project's expected ROI would be increased by $15,000 ($25,000 minus the additional $10,000 of resource costs). (wikipedia.org)
- Outpatient programs typically cost somewhere between $5,000 to $10,000 dollars. (crescentlife.com)
- As you know from reading the papers (that's newspapers, if you don't remember), many new specialty drugs cost more than $10,000 per month. (tcbmag.com)
- The coalition says the average "doctor shopper" costs insurers between $10,000 and $15,000 per year. (cottonwooddetucson.com)
Pharmacies9
- The cost can vary between different pharmacies. (medicalnewstoday.com)
- and allow patients and pharmacies to safely import drugs from other countries like Canada. (truthout.org)
- Roy also said pharmacies should be able to substitute biosimilar drugs for brand-name biologics in the same way they can for generic pills. (rollcall.com)
- Pharmacies such as Costco sell drugs for less than others (you do not need to be a Costco member to use its pharmacy). (cahealthadvocates.org)
- Investigate internet pharmacies that sell drugs online. (cahealthadvocates.org)
- Some online pharmacies sell discounted prescription drugs from outside the United States. (cahealthadvocates.org)
- Some disreputable online pharmacies supply counterfeit drugs. (cahealthadvocates.org)
- Earlier this year, Cost Plus Drugs tapped RevSpring , maker of healthcare payment solutions, for its payment technology as part of a new program with U.S. pharmacies. (fiercehealthcare.com)
- The program is designed to make drugs more affordable and to relieve financial stress on participating pharmacies by delivering them more revenue. (fiercehealthcare.com)
Health34
- Among these employers, psychotropic drug spending as a share of total mental health spending more than doubled, from 22 percent in 1992 to 48 percent in 1999. (medscape.com)
- National Institute for Health Care Management Research and Educational Foundation, Prescription Drug Expenditures in 2001: Another Year of Escalating Costs (Washington: NIHCM Foundation, May 2002). (medscape.com)
- If you have health insurance, contact your insurance provider for the cost of your Biktarvy prescription. (medicalnewstoday.com)
- Typically, the cost of Biktarvy is higher without insurance than with health insurance. (medicalnewstoday.com)
- If you have health insurance, you can find out the cost of a month's supply of Biktarvy by contacting your insurance provider. (medicalnewstoday.com)
- Your pharmacist can tell you the monthly cost for your Biktarvy treatment if you don't have health insurance. (medicalnewstoday.com)
- Research like this has the potential to improve health and save millions of dollars annually by reducing the recall of cardiotoxic drugs. (nih.gov)
- He also said more scrutiny should be placed on who researched the drug and how it was funded, noting that the research for many drugs comes from academic centers with funding from the National Institutes of Health. (rollcall.com)
- To stem increases in prescription drug spending, pharmacy benefit managers and health plans are changing prescription drug benefits to steer patients toward less-expensive drugs or to require patients to assume a share of the costs. (rand.org)
- A systematic review of published studies analyzed how the salient cost-sharing features of prescription drug benefits may affect access to prescription drugs and synthesized what is known about how these features may affect medical spending and health outcomes. (rand.org)
- For some chronic conditions-such as congestive heart failure, lipid disorders, diabetes, and schizophrenia-increased cost sharing is clearly associated with increased use of other health care services, offsetting any potential cost savings. (rand.org)
- MDR TB patients reported to the Centers for Disease Con- of TB cases but requires lengthy regimens of toxic drugs, trol and Prevention from California, New York City, and imposes high costs on the health care system and society, Texas during 2005-2007. (cdc.gov)
- Health care policies that help cancer survivors address the financial burden of prescription drugs should target those who have multiple comorbid conditions and high-deductible health plans," the study says. (curetoday.com)
- According to industry analysts Mark Farrah Associates, as the cost of prescription drugs, which represent about 10.3% of American health-related spending, were increasing, hospital spending and other medical costs showed a "marked decline. (insurancespecialists.com)
- But the high cost of the drug has complicated efforts to get the medication to Texans who receive government-subsidized health care. (texastribune.org)
- The Part B standard premium is what many seniors use as an unofficial yardstick to track what health care is costing them. (moneyandmarkets.com)
- But for those who have to pay most of the bill, namely employers, it's another call to action to do something to control specialty drug costs, lest they break the employee health benefits bank. (tcbmag.com)
- By far the top driver of rising employee health care costs is specialty drugs, according to a 2017 survey of 148 large employers by the National Business Group on Health ( bit.ly/2vMp3yW ). (tcbmag.com)
- Some 80 percent of the employers cited specialty drugs as one of three top drivers of health spending. (tcbmag.com)
- These costs stem from emergency room visits, rehabilitation, and associated health problems, CNN Money reports. (cottonwooddetucson.com)
- In fact, it was the promise of an easy-to-take preventive measure that could supplement or even replace colon cancer screening that led Ladabaum and Scheiman to undertake the study with Mark Fendrick, M.D., associate professor of internal medicine at the U-M and co-director of the Consortium for Health Outcomes, Innovation and Cost-Effectiveness Studies, or CHOICES. (sciencedaily.com)
- The competitive nature of managed care organizations demands that providers seek cost-effective ways to maintain the health of their clients. (mapi.com)
- The health insurance costs for average Gannett workers is getting worse each year. (blogspot.com)
- Increased out-of-pocket costs for antiepileptic drugs were associated with decreased adherence, higher healthcare utilization, and higher spending among US commercial health plan beneficiaries with epilepsy. (ajmc.com)
- To examine the association between health plan out-of-pocket (OOP) costs for antiepileptic drugs and healthcare utilization (HCU) and overall plan spending among US-based commercial health plan beneficiaries with epilepsy. (ajmc.com)
- Although Biden has made efforts elsewhere to control health-related costs for Americans, his actions around prescription drugs are moving in the opposite direction and helping to preserve the status quo. (townhall.com)
- For instance, through its member app and portal, Scripta provides members with personalized savings reports that the company claims can show members all their medication options, ranging from alternative prescriptions available through their health plan or a cash pay option like Cost Plus Drugs. (fiercehealthcare.com)
- More recently, Cost Plus Drugs entered the male fertility space in partnership with Posterity Health . (fiercehealthcare.com)
- Generalized linear models were constructed to examine relative and absolute differences in health care costs (total and non-drug-related costs) across neighborhood SES quintiles, by age, with adjustment for differences in age, sex, diabetes duration, and comorbidity. (ices.on.ca)
- This landmark collaboration grants Select Health members direct access to Cuban's groundbreaking prescription drug service. (nwahomepage.com)
- Select Health, Scripius, and Cost Plus Drugs share the common goal of helping consumers understand the true cost of their prescriptions and secure the best pricing. (nwahomepage.com)
- Select Health members can visit Cost Plus Drugs online to explore benefits now. (nwahomepage.com)
- We are excited to now be working with Select Health and PBMs like Scripius to further reduce the cost to patients, and to keep the patient record complete from both a clinical and financial perspective. (nwahomepage.com)
- As a PBM dedicated to providing price clarity to plan sponsors and members, Scripius provides lowest-net cost management to health plans and employers searching for alternatives to the big three PBMs. (nwahomepage.com)
Pharmaceutical8
- The Biden administration unveiled the first 10 drugs subject to price negotiations, taking a swipe at the pharmaceutical industry. (californiahealthline.org)
- Pharmaceutical companies and the U.S. Food and Drug Administration (FDA) have a common interest in identifying and eliminating drugs that have potential cardiac toxicities before they are tested in patients. (nih.gov)
- Bloomberg) --Biden administration officials asked executives from major drug and retail chains to counter stiff opposition from the pharmaceutical industry and help promote a law intended to lower drug costs. (chicagobusiness.com)
- The pharmaceutical industry has convinced us that we have to spend billions of pounds to invent each drug," he said. (sott.net)
- New Zealand's pharmaceutical management agency PHARMAC says that promoting competition among suppers of high-cost drugs could be the key to improving patients' access to high-cost medicines for rare disorders. (pharmatimes.com)
- Therefore, the agency plans to test out a "contestable" fund for high-cost drugs to treat rare conditions, and says it could be seeking proposals for this from pharmaceutical companies by the end of this year. (pharmatimes.com)
- Forcing countries to extend lengthy patent protections for pharmaceutical drugs. (ncpssm.org)
- The final text of the intellectual property chapter requires countries to make patents available for new uses of existing drugs, a form of pharmaceutical monopoly "evergreening. (ncpssm.org)
Clinical7
- The most obvious goal of clinical trials is to demonstrate safety and efficacy to gain Food and Drug Administration (FDA) approval. (hhs.gov)
- Improving the drug development process, especially by conducting better (meaning providing more information on safety or efficacy) and faster clinical trials, can foster innovation in medical product development. (hhs.gov)
- This study models the decision-making process for a drug sponsor as a stylized decision tree that looks at the process for formulating a clinical trial from the point of view of an expected-revenue-maximizing sponsor in the face of uncertainty (or risk). (hhs.gov)
- The Clinical Journal of Pain published a study in 2011 which found prescription drug abuse led to $42 billion in costs related to lost productivity and $8.2 billion in criminal justice costs. (cottonwooddetucson.com)
- Professor Shaunak and his colleague from the London School of Pharmacy, Steve Brocchini, have linked up with an Indian biotech company which will manufacture the first drug - for hepatitis C - if clinical trials in India, sponsored by the Indian government, are successful. (sott.net)
- Once the drugs have passed through clinical trials and have been licensed in India, the same data could be used to obtain a European licence so that they could be sold to the NHS as well. (sott.net)
- These services are offered to fill specific gaps in an investigator's drug development plan as they advance their product toward clinical investigation. (nih.gov)
Centers3
- Drug practices, outcomes, and costs associated with MDR TB resistance was extensive, care was complex, treatment for cases reported to the Centers for Disease Control and completion rates were high, and treatment was expensive. (cdc.gov)
- You can use our filter above to see only recovery centers that offer one of these types of treatment as well as average costs. (crescentlife.com)
- There are a number of Alcohol and Drug Rehab Centers around you. (crescentlife.com)
Specialty8
- What's not funny, especially to employers, is the cost of these wonder drugs, called "specialty drugs" in pharma and benefits parlance. (tcbmag.com)
- Managing specialty drug costs was the top priority of nearly 300 employers recently surveyed by the Pharmacy Benefit Management Institute ( bit.ly/2j4VnZ3 ). (tcbmag.com)
- Making sure workers taking specialty drugs were satisfied was far less important to management (see chart). (tcbmag.com)
- High-cost claimants often have specific diseases or medical conditions that require specialty drugs. (tcbmag.com)
- Another tactic being used by employers is requiring workers who use specialty drugs to pick up a larger share of the tab. (tcbmag.com)
- The average co-payment for a medication covered in the specialty drug tier was $101 last year, with the average co-insurance share 27 percent. (tcbmag.com)
- If all else fails, employers can lobby the FDA, the Federal Communications Commission and the Federal Trade Commission to restrict direct-to-consumer advertising of high-cost specialty drugs by Big Pharma. (tcbmag.com)
- Some 90 percent of employers surveyed by the PBMI said DTC advertising "greatly" or "moderately" increases the pressure on physicians to prescribe a specific specialty drug. (tcbmag.com)
Utilization3
- ABSTRACT This study compared the utilization and cost of antibacterial agents in surgical units of 2 government hospitals in Palestine. (who.int)
- Utilization of new drugs was modest ― they accounted for 1 in 5 prescriptions for every condition except tardive dyskinesia (32% for valbenazine), the researchers note. (medscape.com)
- They note that potential reasons for low utilization of newer agents include delay in provider uptake and prescriber and/or patient avoidance because of high cost. (medscape.com)
20202
- Obesity and its myriad consequences cost the healthcare system a quarter trillion dollars in 2020. (medpagetoday.com)
- It comes after Social Security announced a modest cost-of-living raise for 2020 that works out to about $24 a month for the average retired worker. (moneyandmarkets.com)
Biosimilar drugs1
- Why are costs different for biologic drugs vs. biosimilar drugs? (medicalnewstoday.com)
Americans8
- Any prescription drug pricing reform which does not allow private payers to take advantage of the same cost containment mechanisms government programs enjoy will only serve to further drive up the prescription drug costs for millions of Americans in the form of additional cost-shifting. (brookings.edu)
- When drug makers like Xtandi's manufacturer, Astellas Pharma, price gouge sick Americans,' write the authors, 'the U.S. government has a responsibility to end the exclusive patents that give them their profits. (commondreams.org)
- Currently, Americans spend more than $216 billion on prescription drugs each year. (insurancespecialists.com)
- WASHINGTON (AP) - President Joe Biden touted the potential cost savings of Medicare's first-ever price negotiations for widely used prescription drugs on Tuesday as he struggles to convince Americans that he's improved their lives as he runs for reelection. (kron4.com)
- But the effort is a centerpiece of Biden's reelection pitch as the Democrat tries to show Americans he's deserving of a second term because of the work he's doing to lower costs while the country is struggling with inflation. (kron4.com)
- The latest $1.9 trillion stimulus package that was passed and signed into law includes a policy that will directly temper rising healthcare costs for some Americans. (townhall.com)
- Americans currently pay some of the highest medical costs in the world. (townhall.com)
- Although Biden talks a good game around providing Americans with more affordable healthcare, his actions thus far around prescription drugs say otherwise. (townhall.com)
Drug's cost2
- Using this type of service may help lower the drug's cost and allow you to receive your medication without leaving home. (medicalnewstoday.com)
- But he added that because of the drug's cost, it could be prioritized among inmates who have a particular degree of liver damage - an effort to be "clinically and fiscally responsible. (texastribune.org)
Pharmacy8
- The cost of the drug can differ depending on the pharmacy you use. (medicalnewstoday.com)
- If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. (medicalnewstoday.com)
- I've already talked to Diplomat pharmacy that currently supplies me with the drug. (cancer.org)
- Find out if using your plan's mail-order pharmacy would cost less. (cahealthadvocates.org)
- The administration proposed a rule that would force drug discounts already provided by manufacturers to be passed along to patients at the pharmacy counter, rather than being intercepted by PBMs. (townhall.com)
- The Average Acquisition Cost (AAC) revolution in pharmacy reimbursement is evolving rapidly. (drugchannels.net)
- Twenty-four States specified that they want a benchmark based on pharmacy acquisition costs. (drugchannels.net)
- In July, I noted that that CMS is moving ahead with a pharmacy acquisition cost survey . (drugchannels.net)
Negotiations2
- The drug negotiations, like many of Biden's biggest policy moves, will take time to play out, and his challenge is to persuade the public to be patient. (kron4.com)
- Throughout the negotiations, USTR has pursued language in trade agreements, including the TPP and the Trans-Atlantic Trade and Investment Partnership (T-TIP) that could restrict the ability of countries to manage prescription drug and medical device costs in public programs. (ncpssm.org)
Regimen2
- A recent study found that patients with a history of cancer are more prone to change their prescription drug regimen because of the cost. (curetoday.com)
- The state's prison system and the taxpayer-funded Medicaid program, which covers poor children and people with disabilities, are trying to determine who qualifies for the drug, which is 80 to 90 percent effective but can cost $84,000 for a 12-week regimen. (texastribune.org)
Medication9
- You might be able to lower your monthly cost with a 90-day supply of your medication. (medicalnewstoday.com)
- It may cost less to get a larger amount of medication at one time. (medicalnewstoday.com)
- A generic drug is an exact copy of the active drug in a brand-name medication. (medicalnewstoday.com)
- A biosimilar medication is a drug that's similar to a brand-name biologic drug (the parent drug). (medicalnewstoday.com)
- The authors called for further studies that monitor cost-related medication adherence, especially as the Affordable Care Act changes. (curetoday.com)
- For a generic drug competitor to be able to sell its lower priced version of a drug to patients, it must show that the brand-name drug company's existing patents are invalid or don't apply to their medication. (pirg.org)
- The medication in question Xtandi-developed with taxpayer dollars and used to treat prostate cancer-costs up to five times more in the U.S. than in Japan, Canada, the U.K., or France. (commondreams.org)
- Example from me: A medication that retails for just over $2,100 for a 30-day supply cost me $80 out of pocket from Caremark in 2013. (blogspot.com)
- With Cost Plus Drugs, consumers can be confident they are getting a fair price and the convenience of medication mailed directly to their homes. (fiercehealthcare.com)
Medicines7
- They often know about programs and resources that might help with the costs of medicines. (cancer.org)
- Others help people cover the whole cost of medicines they can't afford to pay for. (cancer.org)
- In January 2019, driven by strong interest from the healthcare system, Civica announced that it was bumping its initial roster up to 20 generic medicines, with the potential to expand to 100 drugs in the next three to five years. (biospace.com)
- It also highlights differences depending on the area of treatment, with the latest estimates for cancer drugs being considerably higher than those for other medicines (from $944 million to $4.54 billion or EUR 802 million to EUR 3.86 billion). (dkfz.de)
- Two UK-based academics have devised a way to invent new medicines and get them to market at a fraction of the cost charged by big drug companies, enabling millions in poor countries to be cured of infectious diseases and potentially slashing the NHS drugs bill. (sott.net)
- The full text of the agreement includes provisions that could drive up the costs of medicines in the future. (ncpssm.org)
- Washington, DC-Washington, DC - The National Consumers League encourages the Biden Administration to continue work on meaningful reforms that help drive down consumer out-of-pocket costs of medicines. (nclnet.org)
America1
- The prescription drug abuse problem in America has become out of control and the cost of dealing with the problem is more than anyone might of thought. (cottonwooddetucson.com)
50,0002
- For example, if a project's expected ROI will be reduced by $5,000 for every day of duration, then an activity that has critical path drag of ten days (i.e., is delaying project completion by ten days) will have a drag cost of $50,000. (wikipedia.org)
- Inpatient treatment costs between $20,000 - $50,000 dollars on average. (crescentlife.com)
Biologics2
- Although not a "patent" bill, the proposal would significantly impact the market for patented drugs and biologics. (patentlyo.com)
- The National Committee supports a lower exclusivity period to encourage the entry of biosimilar competition and, ultimately, lower costs for biologics. (ncpssm.org)
Plus drugs2
- Screening plus drugs was most effective, but even more costly. (sciencedaily.com)
- Cost Plus Drugs has been making noise with its unprecedented deep discounts, transparent pricing and vertically-integrated supply chain, and we couldn't be more excited to team up with them to help our clients' members get 'The Right Meds at The Best Price. (fiercehealthcare.com)
Biden3
- Resurge la hepatitis C, ¿podrá el plan de Biden eliminar este viejo flagelo en cinco años? (californiahealthline.org)
- We are asking the Biden administration to help us build a system of drug pricing that is based on justice, not greed. (commondreams.org)
- The announcement Tuesday is another significant step toward taming drug pricing under the Inflation Reduction Act, which was signed by Biden last year. (kron4.com)
Adherence1
- Increased cost sharing is associated with lower rates of prescription drug treatment, worse adherence among existing users, and more frequent discontinuation of therapy. (rand.org)
Outpatient2
- The most common types of treatment people look for in an alcohol and drug rehab center are Inpatient, Outpatient, Detox and Free or Low Cost. (crescentlife.com)
- In beneficiaries with epilepsy, higher out-of-pocket (OOP) spending was associated with significant decreases in the proportion of days covered with an antiepileptic drug and in inpatient hospitalizations, and an increase in epilepsy-related outpatient visits. (ajmc.com)
Patients11
- Many of the new drugs proved to be equally efficacious or more easily tolerated, or both, for most patients than were drugs previously available to treat the same disorders (for example, tricyclic antidepressants versus SSRIs). (medscape.com)
- Thousands of patients with autoimmune diseases who rely on Humira, with a list price of $6,600 a month, could get financial relief from new low-cost rivals. (californiahealthline.org)
- Low-income groups may be more sensitive than others to increased cost-sharing demands, but there is little evidence to support this claim, because studies conducted to date have not had access to information on patients' socioeconomic status. (rand.org)
- Nearly on surveillance data ( 1 - 6 ), which omit some cases of ac- three-quarters of patients were hospitalized, 78% complet- quired drug resistance and changes in regimens. (cdc.gov)
- Rising deductibles, copayments, co-insurance and tiered drug formularies all contribute to the increasing percentage of cancer care cost that patients must now pay for out of pocket. (curetoday.com)
- These patent thickets extend the drug company's monopoly by creating major hurdles for potential generic competitors, and ultimately cost patients and the public billions of dollars by delaying competition. (pirg.org)
- Patent thickets mean higher costs for patients. (pirg.org)
- Yet questions remain about the registry requirement for Leqembi, including whether the data collection system is ready for use, how data about the drug's benefits and risks will be collected, how easy it will be for providers to participate in the registry, the costs involved with collecting the data, and whether the registry requirement will make it harder for patients to access the drug. (kff.org)
- Those recommendations include covering the drug for certain patients with less advanced liver damage. (texastribune.org)
- Last year, treatment for hepatitis C among inmates cost the state about $2 million - a figure Murray said was low because many patients chose to delay treatment knowing that new drugs were coming. (texastribune.org)
- As recently reported in The Wall Street Journal , while the price tag of drugs continues to rise for patients at the point of sale, the companies that actually produce the products are collecting a shrinking share of revenue. (townhall.com)
Profits1
- Higher claims stemming from the Canterbury hailstorm and increased operating costs linked to closing its AMI offices has dragged down the profits of IAG New Zealand - the parent company for State and AMI. (nzherald.co.nz)
Formulary3
- Benefit caps, prior authorization requirements, and formulary restrictions also decrease prescription drug use. (rand.org)
- 2) may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs. (patentlyo.com)
- In addition, you can call individual drug plans for formulary information, although it may be difficult to get the exact information you want. (cahealthadvocates.org)
Healthcare costs2
- But they are the ones that can keep healthcare costs most in check. (patentlyo.com)
- I'd love to see you create a separate thread on healthcare costs pre- and post- "Employee Choice" program. (blogspot.com)
Legislation1
- The announcement on premiums comes amid growing uncertainty about pending legislation to rein in drug costs for seniors. (moneyandmarkets.com)
20212
- In 2021, there were an average of 74 approved patents on each of America's ten top selling drugs. (pirg.org)
- At the 10% take-up rate, projected spending on this one drug alone would exceed spending on the top 10 Part B drugs in 2021 and would represent close to half of the $40 billion spent in total on the 600+ Part B covered drugs in 2021. (kff.org)
Companies20
- Insurance companies may have different criteria for covering Biktarvy, and this may impact cost of the drug. (medicalnewstoday.com)
- Lastly, while unfortunately there does not appear to be any research to date testing for the presence of cost-shifting by drug companies empirically, I discuss the richer literature on hospital cost-shifting and how researchers can empirically test for cost-shifting in the drug pricing context. (brookings.edu)
- These efforts could also improve the safety of drugs in development, and increase the efficiency of drug development by allowing companies to focus on the safest, most promising drug candidates. (nih.gov)
- In other words, even under a 95 percent rate, the combination of taxes would lead companies to lose money if the drug in question was sold in the United States. (taxfoundation.org)
- Earlier this month, Oversight Chairman Elijah E. Cummings , D-Md., launched an investigation into 12 drug companies, including insulin makers Eli Lilly and Co., Novo Nordisk and Sanofi, over their pricing tactics. (rollcall.com)
- Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management, said drug companies should have to justify their price increases, noting that they shield most of their financial data from public view. (rollcall.com)
- Mergers will accelerate and the massive new drug companies that result will have major leverage to negotiate with governments. (patentlyo.com)
- To understand how big drug companies abuse the U.S. patent system, get a basic understanding of the U.S. patent system. (pirg.org)
- The U.S. patent system, which is critical to spurring innovation, has flaws that drug companies exploit. (pirg.org)
- To keep competitors off the market, drug companies file dozens, and sometimes even hundreds, of patent applications for the same drug. (pirg.org)
- Drug companies use patent lawsuits and other expensive, time consuming tactics to block and delay generic competition. (pirg.org)
- So, what are some of the patent abuse tactics used by drug companies? (pirg.org)
- Drug companies often file applications for secondary patents years after the primary patent is granted. (pirg.org)
- This allows drug companies to prevent competition for years or even decades past the end of a drug's primary patents. (pirg.org)
- The process has the potential to undermine the monopoly of the big drug companies and bring cheaper drugs not only to poor countries but back to the UK. (sott.net)
- Multinational drug companies put the cost of the research and development of a new drug at $800m (£408m). (sott.net)
- FDA, or the US government, has to intervene and ensure that necessary samples are available to potential generic drug companies to complete necessary studies for approval. (pharmtech.com)
- One thing I'm beginning to look into is the co-pay assistance programs offered by some of the large drug companies. (blogspot.com)
- Drug companies could use ISDS to challenge formularies and preferred drug lists, discounts and rebates and other policies in public programs that pay drug companies less than the price they demand. (ncpssm.org)
- These provisions could provide ammunition for drug companies to sue governments in international tribunals under ISDS systems. (ncpssm.org)
Innovation3
- The Small Business Innovation Research (SBIR) program of the National Heart, Lung, and Blood Institute (NHLBI) has been at the forefront of supporting research on developing novel tests to assess the heart safety of new drug candidates. (nih.gov)
- The innovation of Civica is not technological but rather structural: a new business model that injects a new type of supplier into a decades-old market for generic drugs in order to address a market failure. (biospace.com)
- Primary patents typically cover a drug's active ingredient or chemical composition - the main reason it is considered a "new" drug and the innovation which makes the drug eligible for a patent allowing monopoly pricing. (pirg.org)
Diseases2
- He also proposed granting fast-track approval to drugs for diseases with no competition. (rollcall.com)
- That was followed by high-cost claimants (69 percent) and specific diseases or conditions (55 percent). (tcbmag.com)
Sharing2
- In what follows, I first explain why the causal pathways commonly posited to give rise to cost-sharing are implausible, but raise one other plausible (albeit attenuated) pathway that could generate limited cross-market effects over the longer-run. (brookings.edu)
- For each 10 percent increase in cost sharing, prescription drug use decreases by 2 percent to 6 percent, depending on the class of drug and the condition of the patient. (rand.org)
Formularies1
- Managing Psychotropic Drug Costs: Will Formularies Work? (medscape.com)
Monopoly2
- In a win for cost containment in the United States, other countries successfully blocked the United States Trade Representative (USTR) attempt to require a 12-year regulatory "exclusivity" period (a type of marketing monopoly) for expensive biological drugs. (ncpssm.org)
- The patent holder is the only one allowed to sell a drug and can therefore demand a monopoly price for it. (ncpssm.org)
Advocates1
- LANSING, Mich. (WILX) -Wednesday, advocates and lawmakers held a committee hearing on Senate Bills 484-485 to establish a Prescription Drug Affordability Board (PDAB) and lower the cost of prescription drug costs. (wilx.com)
Treatment19
- Biktarvy contains three active drugs, so it's considered a complete HIV treatment. (medicalnewstoday.com)
- With additional NHLBI SBIR support, ChanTest scientists identified a promising drug candidate for treating atrial fibrillation , a common type of heart arrhythmia that has few treatment options. (nih.gov)
- Costs of ed treatment, and 9% died during treatment. (cdc.gov)
- in comparison, sociated with drug resistance, timely diagnosis, treatment estimated cost per non-MDR TB patient is $17,000. (cdc.gov)
- We es- characteristics and for treatment, case management, out- timated direct and productivity-loss costs and examined comes, and costs. (cdc.gov)
- In Texas, where roughly 300,000 people have chronic hepatitis C and many more may carry the virus, the treatment has raised ethical questions about who gets the drug. (texastribune.org)
- If the treatment is approved, Sovaldi could become the hepatitis drug of choice for the state's prison population, said Dr. Owen Murray, the vice president for the correctional managed care program. (texastribune.org)
- Anne Dunkelberg, associate director of the liberal Center for Public Policy Priorities , said the new hepatitis C treatment puts in "sharp focus" the ethical questions behind administering effective but expensive drugs. (texastribune.org)
- Detox is usually an extra cost on top of treatment which many people are not aware of. (crescentlife.com)
- Free and low cost rehabs generally use a sliding fee scale to help bring costs of treatment down as it is based on your income level instead of a set price. (crescentlife.com)
- According to present value analysis of treatment payments, the TM ® technique had the lowest present value cost, and thus appeared to be the most attractive alternative. (mapi.com)
- The estimated average cost of antihypertensive drug treatment ranged from $375 per year for hydrochlorothiazide to $1,051 per year for propranolol hydrochloride, whereas the estimated average cost of treatment with the TM ® technique was $286 per year. (mapi.com)
- When combined with results of controlled trials documenting the effectiveness of the TM ® technique in reducing high blood pressure, decreasing morbidity and mortality, and improving the quality of life, the present comparison suggests that this nonpharmacologic procedure may be safely used as a cost-effective treatment of hypertension in the managed care setting. (mapi.com)
- Other drugs on the list include AstraZeneca's diabetes and heart failure treatment Farxiga and three drugs from Johnson & Johnson: the blood thinner Xarelto, the blood cancer treatment Imbruvica and it's biggest seller, Stelara, an IV treatment for psoriasis and other inflammatory disorders. (kron4.com)
- How much does opioid treatment cost? (nih.gov)
- The amount paid for treatment of substance use disorders is only a small portion of the costs these disorders impose on society. (nih.gov)
- The tumor necrosis factor (TNF) blockers etanercept, adalimumab, and infliximab are approved for use in adults with any of these conditions, but predicting the annual costs of TNF-blocker treatment is complex due to differences in dosing schedules, treatment gaps, switching between TNF blockers, and dose escalation over time. (nih.gov)
- Neurologists' primary obligation is to the individual patient, but we are also compelled to support access to high quality care for all people, which requires advocacy for appropriate policy reforms to ensure value based and fair drug pricing and treatment success," Smith adds. (medscape.com)
- Non-steroidal anti-inflammatory drugs : a suitable case for treatment? (who.int)
Costly3
- Also, because generics contain the same active ingredients as brand-name drugs, they don't require the same costly testing. (medicalnewstoday.com)
- Also, because biosimilars are very similar to biologic drugs, they don't require the same costly testing. (medicalnewstoday.com)
- Our governments continue wasting more tax payers dollars when nearly every state in the union is bankrupt, our federal government bankrupt and downgraded, costly wars, etc and we advocate for more cost, more government power, and more pervasive personal invasion? (campaignforliberty.org)
Typically1
- About half the decline in U.S. deaths from coronary heart disease can be attributed to medical therapies that now typically cost a few dollars a month, merely several percent of what they cost when they were novel and branded. (medpagetoday.com)
Hepatitis5
- Se calcula que el 40% de los más de 2 millones de personas con hepatitis C en Estados Unidos ni siquiera saben que la tienen, pero el virus puede estar dañando silenciosamente su hÃgado, causando cicatrices, insuficiencia hepática o cáncer de hÃgado. (californiahealthline.org)
- The investigation by The BMJ and Cambridge and Bath universities into the availability of breakthrough hepatitis C drugs raises important questions for NHS England about access to lifesaving drugs. (bmj.com)
- In 2015, Grassley and Ron Wyden of Oregon, the Finance Committee's top Democrat, teamed up on an investigation into the high price of Hepatitis C drugs. (rollcall.com)
- Imperial College will hold the patent on the hepatitis C drug to prevent anybody attempting to block its development. (sott.net)
- The team's work on the hepatitis C drug has impeccable establishment credentials, supported by a grant from the Wellcome Trust and help and advice from the Department for Trade and Industry and the Foreign and Commonwealth Office. (sott.net)
Significantly1
- We could be one step closer to significantly lowering out-of-pocket costs, but the government has delayed action. (nclnet.org)
Prescription Costs1
- He noted that he got "no help from the other team" - meaning Republicans - when it came to lowering prescription costs. (kron4.com)
Insulin2
- Both hearings Tuesday featured witnesses whose children rationed insulin after they struggled with its costs. (rollcall.com)
- Watching the cost of a single vile of insulin skyrocket from 25 dollars to more than 300 in just the span of my diagnosis alone, is more than enough to do that. (wilx.com)
Biosimilars2
- This marketplace competition may lead to lower costs for biosimilars. (medicalnewstoday.com)
- Roy recommended Congress reduce the costs of drug approvals for manufacturers of biosimilars, which are generic versions designed to mirror brand-name biotech drugs, including vaccines. (rollcall.com)
Promising drug candidates1
- The focus of the program is to facilitate the advancement of promising drug candidates from bench to clinic. (nih.gov)
Humans1
- Over the years, ion channels have become targets of intense interest for assessing the potentially toxic effects of new drugs before they are tested in humans. (nih.gov)
Ultimately1
- How the drug-related crime in Mexico ultimately impacts the country depends in part on how multinational firms respond. (upenn.edu)
Inpatient1
- Most inpatient drug rehabs take insurance from any of the major carriers which will help offset the cost. (crescentlife.com)
Prescriptions1
- Read on to learn about the cost of Biktarvy, as well as how to save money on prescriptions. (medicalnewstoday.com)
Visits1
- Adjusted nondrug costs (primarily for hospitalizations and physician visits) were $1,569 per person-year higher among younger adults in quartile (Q)1 vs. Q5 (modeled relative cost difference: 35.7% higher) and $139.3 million per year among all individuals in Q1. (ices.on.ca)
Percentage1
- This is the period during which you used to be responsible for paying a larger percentage of your drug costs. (cahealthadvocates.org)