Approaches To Drug Insurance Design
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Approaches To Drug Insurance Design
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Author : United States. Task Force on Prescription Drugs
language : en
Publisher:
Release Date : 1969
Approaches To Drug Insurance Design written by United States. Task Force on Prescription Drugs and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1969 with Insurance, Pharmaceutical services categories.
Approaches To Drug Insurance Design
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Author : États-Unis. Department of health, education and welfare
language : en
Publisher:
Release Date : 1969
Approaches To Drug Insurance Design written by États-Unis. Department of health, education and welfare and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1969 with categories.
Approaches To Drug Insurance Design
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Author : United States. Task Force on Prescription Drugs
language : en
Publisher:
Release Date : 1969
Approaches To Drug Insurance Design written by United States. Task Force on Prescription Drugs and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1969 with Older people categories.
Approaches To Drug Insurance Design Background Papers
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Author : États-Unis. Task Force on Prescription Drugs
language : en
Publisher:
Release Date : 1969
Approaches To Drug Insurance Design Background Papers written by États-Unis. Task Force on Prescription Drugs and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1969 with categories.
Task Force On Prescription Drugs Background Papers Approaches To Drug Insurance Design
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Author : U.S. Dept. of Health, Education, and Welfare. Office of the Secretary
language : en
Publisher:
Release Date : 1969
Task Force On Prescription Drugs Background Papers Approaches To Drug Insurance Design written by U.S. Dept. of Health, Education, and Welfare. Office of the Secretary and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1969 with categories.
Making Medicines Affordable
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2018-03-01
Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-03-01 with Medical categories.
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Issues In Designing A Prescription Drug Benefit For Medicare
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Author : Joseph Antos
language : en
Publisher:
Release Date : 2002-11
Issues In Designing A Prescription Drug Benefit For Medicare written by Joseph Antos and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002-11 with categories.
Medicare offers broad insurance protection for many health needs of the nation's elderly & disabled residents, but it provides no coverage for the costs of most outpatient prescription drugs (PD). As spending for those PD has soared in recent years, adding a PD benefit to Medicare has become a top health issue for lawmakers. This study discusses an approach to estimating the costs of various designs for a Medicare PD benefit. Describes the broad choices available to policymakers, some problems raised by particular design choices, & the implications of those choices for the cost of four specific proposals, which together cover a wide spectrum of approaches for delivering a Medicare PD benefit. Charts & tables.
Approaches To Drug Insurance Design
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Author : United States. Task Force on Prescription Drugs
language : en
Publisher:
Release Date : 1969
Approaches To Drug Insurance Design written by United States. Task Force on Prescription Drugs and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1969 with categories.
Program Evaluation Of A Value Based Prescription Drug Insurance Design
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Author :
language : en
Publisher:
Release Date : 2013
Program Evaluation Of A Value Based Prescription Drug Insurance Design written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013 with categories.
Non-adherence to prescription drug therapy represents a major public health issue, and numerous studies show that poor adherence with prescribed medication regimens results in increased morbidity, mortality, hospitalizations, and healthcare costs, especially among patients with chronic diseases. Value-based insurance design (VBID) has been proposed as an approach to financing high quality, cost-effective care for the treatment of chronic diseases. The present study evaluates the short-term effects of a VBID prescription drug benefit implemented by a small managed care organization located in the Midwestern United States in 2013. The goals of this study are to examine: (1) pre-post differences in medication adherence and expenditures between members enrolled in VBID plans and a comparison group enrolled in non-VBID plans for 2012 and 2013, (2) pre-post differences in medication adherence among VBID plan enrollees and comparison group enrollees with varying baseline adherence in 2012, and (3) pre-post changes in medication adherence among VBID plan enrollees with diabetes relative to comparison group enrollees. Baseline adherence at the therapeutic class level was very high, at over 83% for both groups, and adherence to VBID drugs in 2013 remained essentially unchanged compared to 2012 in both study groups. The covariate adjusted difference-in-difference estimate was not significant, suggesting there was no difference in adherence trends between the VBID and comparison group members between 2012 and 2013. Approximately 75% of members in both study groups were in the fully adherent category at baseline, and the results of the difference-in-difference-in-difference models showed no overall policy effect of the VBID benefit. Baseline adherence to diabetes medications was high, with no statistically significant differences between the two groups in either year for any drug category. Implementation of a VBID prescription drug benefit in a small managed care organization resulted in no short-term changes in medication adherence or expenditures after six months. Various factors may have impacted these findings, including characteristics of the member population, of the benefit structure, and the communication of benefit changes to the member population. The impact of a VBID benefit on such a member population was minimal, and raises questions on whether such a benefit was needed.
Fixing An Accident Of History
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Author : Christopher George Bonnett
language : en
Publisher:
Release Date : 2020
Fixing An Accident Of History written by Christopher George Bonnett and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020 with categories.
Canada's drug insurance system remains fragmented and expensive. The plethora of private and public plans still do not adequately cover all Canadians. Demographic changes, disease profiles and the introduction of many new very high cost drugs mean Canadians will be increasingly unable to afford access to medically necessary drug therapy. The lack of adequate universal drug insurance, a policy known in Canada as national pharmacare (NPh), is an important problem. A solution must address patient needs for access and equity at a cost that is sustainable to payers. Most academic literature has identified a public single payer model as the optimal approach but despite many studies and reports, this has yet to be implemented. This suggests the need for an alternative. The Canadian alternative to a single payer plan is popularly called "fill the gaps." This approach argues that the federal government should target its funding to expand provincial coverage to cover the uninsured. A social drug insurance model, used in many European countries, retains private insurance but improves on it by regulating, structuring and aligning it with medicare. As such it is the logical proxy for those who favour "fill the gap." Social insurance may achieve adequate universal drug insurance at a much lower per capita cost. Social insurance financing relies primarily on employers and workers, which is very similar to our very large private drug insurance market. However, private drug plans are mostly tied to employment, are voluntary and face similar threats to sustainability and affordability as provincial plans. An organized mixed-financing model like social drug insurance would spread risk and is a more feasible approach than a single payer plan to achieve adequate universal drug insurance. If a comprehensive single payer NPh plan is not implemented, adopting key social insurance features and regulations would significantly improve access and quality. An extensive literature review is presented, followed by a qualitative thematic analysis of drug insurance opinion leader interviews and a comparative analysis of health and drug systems in three jurisdictions. The theoretical perspective of how a government may recognize and prioritize certain problems over others draws on John Kingdon's Agendas, Alternatives, and Public Policies (2011). Major findings are found in four chapters. Chapter 4 examines our current shared-funding model for prescription drugs and establishes that social drug insurance could work in the context of our institutionalized model. Chapter 5 provides a comparative review of social health insurance (SHI) models in Germany, the Netherlands and Quebec to help identify the form and features useful in a pan-Canadian system. Certain features warrant serious consideration in Canada. The Netherlands has created an aggressive drug price and cost control architecture. Germany's Federal Joint Committee is a participatory multi-stakeholder governance model that could improve transparency and better address system complexity and sustainability. Quebec provides 20 years of guidance on key drug system features and risks in a Canadian context. Chapters 6 and 7 present the most important findings from 26 interviews with drug plan experts and influencers in different sectors from across Canada. Thematic analysis identified five roles for the federal government: funder, coordinator/secretariat, leader, relationship manager and nation-builder. These can be operationalized as funding that ensures adequate universal access, the creation of national standards for a list of covered drugs (formulary) and for patient cost-sharing to limit personal financial risk. Most participants wanted private insurance to continue as a significant funder but private payers remain marginalized, "outside the tent" in this policy debate. Employers are important funders and have not been extensively consulted. Relationships and trust among key stakeholders are limited or weak. These are crucial constraints to progress. Kingdon's model, explored in Chapter 8, indicates the problem, policy and political streams are no longer aligned, so a window of opportunity for universal drug insurance has become far less likely. However, the window could re-open with less ideological stances by advocates supporting either model. This requires a standing forum for constructive and time-bounded dialogue to produce a strategy, funding structure, a realistic implementation plan and a modern governance model. Participants recommended the federal government play this leadership role. An influential NPh policy entrepreneur would energize this work. Related structural changes have recently been proposed to reduce drug prices and costs, such as reform of the Patented Medicine Prices Review Board, the creation of a new Canadian Drug Agency and a strategy for drugs for rare diseases. These financial changes are very important, but are not a comprehensive reform and will not in themselves assure adequate universal drug insurance. NPh is still needed and must proceed in parallel given its complexity and long gestation period. A carefully designed social drug insurance model that includes a regulated role for private drug plans would spread risk among payers, reflect our social values, provide choice in coverage and enable access to sophisticated consumer- and patient-focused insurer technology that complements public plan expertise in health technology assessment. Mitigating financial and political risk is important to governments, and moving to implementation is important to patients. Social drug insurance is still a very complex, multi-year change, meaning careful, consultative planning for implementation and transition is crucial. This model could serve as a template to achieve universal funding for other core health services, such as long-term care and community care. Kingdon notes policy change is more likely if complexity, confounding information and financial and reputational risk for governments can be reduced. Rather than a polarized, dichotomous and perpetual debate typical of decades of NPh failure, a classic Canadian compromise may be possible that allows adequate universal drug insurance to be more quickly implemented through a hybrid model.