Budget Criteria And Drug Value Assessments: A Case Of Apples And Oranges?
Editor’s note: For more on this topic, see Steven Pearson’s response to this post, also published today on Health Affairs Blog.
Last year, the Department of Health and Human Services (HHS) announced a historic initiative to shift Medicare’s reimbursement paradigm. Instead of paying for the “volume” of care, Medicare would now aim to pay for “value.”
Medicare’s announcement coincided with renewed interest in the private sector in finding new ways to align prices with value in health care. Both private payers and delivery systems have begun to embrace the possibilities of innovative pricing arrangements for p...
Source: Health Affairs Blog - September 22, 2016 Category: Health Management Authors: Darius Lakdawalla and Peter J. Neumann Tags: Drugs and Medical Innovation Medicaid and CHIP Medicare health technology assessment ICER Source Type: blogs
A New Health Affairs Blog Featured Topic: ‘Drugs And Medical Innovation’
Continuing in our mission to provide relevant, timely, and original content on health policy issues, Health Affairs Blog today begins a new featured topic titled “Drugs and Medical Innovation.”
These areas have long been central in health care and health policy, and recent developments have heightened their importance even more. The US health system has increasingly coalesced around transitioning from payment systems that reward high-volume care to those that reward value in health care services and technology. This has brought to the fore questions about how to evaluate and pay for prescription drugs and other medical...
Source: Health Affairs Blog - September 15, 2016 Category: Health Management Authors: Chris Fleming Tags: Drugs and Medical Innovation Source Type: blogs
Rapid Biomedical Innovation Calls For Similar Innovation In Pricing And Value Measurement
Advances in foundational science, technology, and clinical knowledge are driving a revolution in patient care. Minimally invasive surgery has reduced rates of post-surgical complications, reduced hospitalization, and dramatically accelerated recovery; direct-acting antivirals have brought a cure for hepatitis C; and novel immunotherapies have brought the promise of increased survival to late-stage cancer patients. The list goes on.
At the same time, spending on these innovative drugs and devices has increased dramatically. Between 1980 and 2010, overall personal health care expenditures in the US grew nearly four-fold, dri...
Source: Health Affairs Blog - September 15, 2016 Category: Health Management Authors: Dana Goldman, Samuel Nussbaum and Mark Linthicum Tags: Drugs and Medical Innovation Featured Comparative Effectiveness health technology assessment National Health Service National Institute for Health and Care Excellence PCORI Source Type: blogs
Liver Disease Disparities
Veterans with liver disease are a vulnerable group that faces health disparities. The Department of Veterans Affairs in conjunction wit the Office of Health Equity has created a dashboard to raise awareness of potential disparities and promote equitable diagnosis and treatment of underserved veterans with hepatitis C and advanced liver disease: https://nnlm.gov/bhic/mjq8 (Source: BHIC)
Source: BHIC - September 14, 2016 Category: Databases & Libraries Authors: Patricia Devine Tags: Veterans Resources Source Type: blogs
Memo To The President: The Pharmaceutical Monopoly Adjustment Act Of 2017
Since 1980, Congress has enacted many laws granting pharmaceutical manufacturers monopolies that no other industry enjoys. These extra monopolies were created with the expectation that monopoly profits would spur greater investment in research to find important new drugs. In fact, they have caused US consumers to pay higher prices for medicines for longer periods of time while making the pharmaceutical industry far more profitable than any other industry. I believe the next president and Congress should take several key steps, which I outline below, to roll back these costly, unnecessary monopolies.
The Current Landscape
C...
Source: Health Affairs Blog - September 13, 2016 Category: Health Management Authors: Alfred Engelberg Tags: Costs and Spending Drugs and Medical Technology Health Policy Lab Bayh-Dole Act Big Pharma Gilead Hatch-Waxman Act johnson & johnson pfizer Source Type: blogs
Medical Education Exchange Fall 2016 Regional Conferences
Medical Education Exchange (MEDX) Regional Conferences are two-day multi-topic CME conferences designed for the community-based primary care team, including physicians, physician assistants, and nurse practitioners.
MEDX Conferences feature clinically-focused, evidence-based education built on the foundation of access, quality, and cost. Attendees learn about emerging treatments, guidelines, and quality measures from top clinical experts with content delivered via interactive technology designed to enhance the learning experience.
MEDX Atlanta
The Atlanta Regional Conference will be held September 23, 2016 through Septe...
Source: Policy and Medicine - September 5, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
The Proposed 2018 Notice Of Benefit And Payment Parameters: Part 1
On August 29, 2016, the Centers for Medicare and Medicaid Services released its proposed 2018 Notice of Benefit and Payment Parameters.The proposed rule was accompanied by a fact sheet and CMS blog post. CMS also released on August 29 a draft actuarial value (AV) calculator and AV calculator methodology for 2018.
The “payment notice,” as it is called, is an annual CMS omnibus rule that pulls together in one place all the major changes the agency intends to implement for the next plan year for the marketplaces (in particular the federally facilitated exchange (FFE) and SHOP marketplaces), the premium stabilization progr...
Source: Health Affairs Blog - August 30, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Payment Policy benefit and payment parameters Source Type: blogs
Health care costs – the big problems
Physicians often wonder in what reality we have the current health care cost problem. Contrast physician payments with the pharmaceutical industry.
As an internist with over 35 years experience, my payment schedule is exactly the same as a newly minted internist. Can anyone think of another profession that does not get some credit for experience and reputation?
Can anyone imagine a payment system that encourages you to spend less time with your patient, because you payment for a 15 minute visit is likely the same as a 20 minute visit? Can you consider the implications of a system that encourages volume rather than a...
Source: DB's Medical Rants - August 27, 2016 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Capping Co-Pays Doesn ’t Lower Drug Costs
By DEVON HERRICK
Politicians are concerned about your drug costs. Unfortunately, their proposals could actually raise drug prices and force you to pay more, albeit indirectly. For instance, presidential candidate Hillary Clinton proposes to cap your prescription drug co-pays at no more than $250 per month. Rising drug costs are now a political issue because the number of diseases and conditions that can be treated using drug therapy has grown tremendously over the past 25 years. Arguably, one of the main reasons patients visit their doctors is to obtain or renew prescriptions. When they visit their doctors’ offices, Amer...
Source: The Health Care Blog - August 18, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Welcome to my World: Perpetual Alarm Fatigue
By HANS DUVEFELT, MD
Part of a series on primary care challenges and their solutions.
I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic.
The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin.
The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite honestly, I am so used to getting irrelevant warnings that it has become a reflex to bring the cursor to the spot where I can ...
Source: The Health Care Blog - August 15, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
How the System is Rigged - Johnson and Johnson Board Member Pretends to be Independent Brookings Institution Scholar
DiscussionIt is hardly news that US health care is broadly dysfunctional, that it suffers from ever rising costs, and questionable quality, while access has only somewhat improved after the 2009 Affordable Care Act. The big question is why these problems seem so intractable.Our latest case illustrates that the problem may be that health policy making is dominated by people withconflicts of interest. In the current case, one of the more influential voices on health care policy turns out not to have just a garden variety conflict of interest. He actually has a duty to uphold the corporate interests of one o...
Source: Health Care Renewal - August 10, 2016 Category: Health Management Tags: boards of directors Brookings Institution hepatitis C Johnson and Johnson revolving doors You heard it here first Source Type: blogs
‘Moderate’ Health Spending Growth Projections Exceed What We Can Afford
There are few surprises in the government’s recent 11-year projections of national health expenditures (NHE). The 5.8 percent average growth rate is the same as last year’s projection and the annual pattern is also largely the same. Over the 11-year period, gross domestic project (GDP) is projected to average 4.5 percent growth. Thus, the excess growth in NHE is projected at 1.3 percentage points or, more concisely, NHE growth is projected at GDP+1.3.
This has been referred to as “moderate” growth. Compared to our long-run historical experience, it certainly is — since 1980, NHE growth has averaged 7.8 percen...
Source: Health Affairs Blog - August 10, 2016 Category: Health Management Authors: Charles Roehrig Tags: Costs and Spending Featured ACA national health expenditures Source Type: blogs
Tennessee Inmates Sue for Hepatitis C Treatment
On July 25, 2016, inmates
incarcerated in Tennessee prisons filed a class action lawsuit against the
state’s Department of Corrections “asking the court to force the state to start treating all
inmates who have the potentially deadly disease [hepatitis C].”
The inmates are represented by several advocacy
organizations: American Civil Liberties Union, Disability Rights Tennessee, and
No Exceptions Prison Collective. The gist of the lawsuit centers on a claim
that failure to provide inmates with what now is believed to be standard of
care treatment for hepatitis C is “cruel and unusual punishme...
Source: blog.bioethics.net - August 1, 2016 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Drug Hepatitis C Inmate justice Medicaid syndicated Tennessee Source Type: blogs
Why ‘Government Patent Use’ To Lower Drug Costs Won’t Stifle Innovation
In a May article in Health Affairs, we proposed that the federal government consider using an existing law to negotiate or compel lower drug prices in the United States for certain important drugs with excessive prices. We’ve been gratified at the interest the proposal has generated on Health Affairs Blog and elsewhere. We believe it illuminates a significant opportunity to improve access to important medicines, and also to more efficiently allocate our health care dollars.
A recent commentary on this blog by Henry Grabowski, however, expresses concern about the impact of our proposal on future drug innovation. As we wil...
Source: Health Affairs Blog - July 28, 2016 Category: Health Management Authors: Amy Kapczynski and Aaron Kesselheim Tags: Costs and Spending Drugs and Medical Technology Featured Quality drug innovation hepatitis C Research and Development Source Type: blogs
Would You Inhale?
We know Bill Clinton did not inhale but Barak Obama did inhale (because that was the whole point). I might have inhaled in the past but would never consider it now. All my past experiences involved smoking and occasional batches of brownies. < br / > < br / > One friend told me that she asked her doctor about it and he told her it wasn ' t appropriate for her. She thinks she could go off all her other medications if she could go to pot. Another blogger recently revealed her problems trying to determine how much marijuana was contained in cookies she purchased. < br / > < br / > Medical marijuana has been looming outside of...
Source: Caroline's Breast Cancer Blog - July 26, 2016 Category: Cancer & Oncology Tags: ailments medical marijuana medications pain relief Source Type: blogs
