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It's Team Trump. But the Players Are From Think Tanks, Many With Koch Brother Roots. 这是特朗普团队。但这些参与者来自智库，其中许多人与科赫兄弟有渊源。
Managed Care Pub Date : 2018-10-01
Richard Mark Kirkner
{"title":"It's Team Trump. But the Players Are From Think Tanks, Many With Koch Brother Roots.","authors":"Richard Mark Kirkner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With no experience in elected office, President Trump came into power with a thin bench. Many of the health care officials in his administration have been recruited from think tanks funded by the Koch brothers. And the Kochs and the president don't see eye to eye (to put it mildly).</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seeking the Value in Value-Based Care. 在价值导向护理中寻找价值。
Managed Care Pub Date : 2018-10-01
Zachary Hafner
{"title":"Seeking the Value in Value-Based Care.","authors":"Zachary Hafner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The market forces pushing health care to evolve from volume to value are intensifying. At the same time, the culture change, capabilities, assets, methods, and mindset required to redefine the health care paradigm are staggering. Unlike corporate initiatives, we simply can't get there thinking quarter to quarter. But we will get there.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36576953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-World Analysis of Dispensed International Units of Coagulation Factor VIII and Resultant Expenditures for Hemophilia A Patients: A Comparison Between Standard Half-Life and Extended Half-Life Products. 血友病A患者的国际凝血因子VIII分配单位和由此产生的支出的现实世界分析:标准半衰期和延长半衰期产品的比较
Managed Care Pub Date : 2018-10-01
Amit Chhabra, Patrick F Fogarty, Bartholomew J Tortella, Dean Spurden, José Alvir, Margaret McDonald, Jennifer Hodge, Andreas M Pleil
{"title":"Real-World Analysis of Dispensed International Units of Coagulation Factor VIII and Resultant Expenditures for Hemophilia A Patients: A Comparison Between Standard Half-Life and Extended Half-Life Products.","authors":"Amit Chhabra,&nbsp;Patrick F Fogarty,&nbsp;Bartholomew J Tortella,&nbsp;Dean Spurden,&nbsp;José Alvir,&nbsp;Margaret McDonald,&nbsp;Jennifer Hodge,&nbsp;Andreas M Pleil","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To identify international units (IUs) dispensed and consequent expenditures for standard half-life (SHL) versus extended half-life (EHL) recombinant factor VIII (rFVIII) replacement products in hemophilia A patients in a real-world setting.</p><p><strong>Design: </strong>Two U.S. claims databases were analyzed.</p><p><strong>Methodology: </strong>Number of IUs dispensed and quarterly expenditures for rFVIII products were collected from the Optum Clinformatics Data Mart and Truven Health MarketScan Databases. Truven claims were also analyzed for factor IUs dispensed and expenditures for patients with data for ≥3 months before and after switching to an EHL product.</p><p><strong>Results: </strong>The Optum and Truven databases, respectively, included 276 (SHL, n=243; EHL, n=33) and 500 (SHL, n=409; EHL, n=91) hemophilia A patients. Median quarterly factor IUs dispensed in Optum were 10% higher with EHL versus SHL products over nine quarters, and 45% higher with EHL versus SHL products in Truven over 10 quarters. Median quarterly expenditures in the EHL cohort were 51% (individual quarterly medians range, 1%-101%) higher than in the SHL cohort in Optum and 122% higher (individual quarterly medians range, 1%-189%) in Truven. Twenty-nine Truven patients switched to an EHL product; median factor IUs dispensed varied quarterly. The lowest SHL and highest EHL values occurred in the quarter immediately before switching and the first quarter post-switch, respectively. Overall median quarterly expenditures were higher post-switch; this was consistent over seven quarters.</p><p><strong>Conclusion: </strong>We found higher expenditures over two years for hemophilia A patients using EHL versus SHL products. Switching to an EHL rFVIII product was associated with variable factor IUs dispensed and consistently higher expenditures.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"39-50"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36576954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rumble Over Drug Rebates As Pharma, Payers Duke It Out. 制药公司和付款人争夺药品回扣。
Managed Care Pub Date : 2018-10-01
Thomas Reinke
{"title":"Rumble Over Drug Rebates As Pharma, Payers Duke It Out.","authors":"Thomas Reinke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pharma says rebates are a primary driver of high drug prices because drug companies raise prices in response to payers' demands for rebates in exchange for preferred placement on their formularies. PBMs and payers object. They say the rebates they get from drugmakers are largely passed on to health plans and patients and save consumers billions of dollars in the form of lower premiums and copays.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"10-11"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare Expansion Steps Into the Political Limelight. 医疗保险扩张成为政治焦点。
Managed Care Pub Date : 2018-10-01
Timothy Kelley
{"title":"Medicare Expansion Steps Into the Political Limelight.","authors":"Timothy Kelley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Democrats think that they've got a winning issue. Sen. Bernie's Sanders Medicare for All bill is gaining backers, but expanding access to coverage by the public payer may be more practicable. Sander's is just one of a bunch of Medicare expansion plans. They all have pros and cons, a major con being how to pay for it.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MS Drugs: Expensive, Often Lifelong, and Not Cost Effective. 多发性硬化症药物:昂贵，通常是终身的，而且没有成本效益。
Managed Care Pub Date : 2018-10-01
Charlotte Huff
{"title":"MS Drugs: Expensive, Often Lifelong, and Not Cost Effective.","authors":"Charlotte Huff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Multiple sclerosis is an on-again, off-again condition that vexes patients and their loved ones. The unpredictability makes is difficult to manage in all respects, especially with escalating prices wreaking havoc with the cost effectiveness of the medications used to contain the disease.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"30-34"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharma APMs: A Learning Curve Awaits You, Pharma. 制药APMs:一个学习曲线等待着你，制药公司。
Managed Care Pub Date : 2018-10-01
Maggie Alston, Bruce Pyenson
{"title":"Pharma APMs: A Learning Curve Awaits You, Pharma.","authors":"Maggie Alston,&nbsp;Bruce Pyenson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are some valuable lessons for pharmaceutical manufacturers in provider alternative payment models (APMs), but whether pharmaceutical APMs succeed or fail will depend on finding solutions to operational and logistical challenges-some of which are unique to the pharmaceutical industry. Pharmaceutical APMs may require the collection of information beyond the claims data that many provider APMs depend on.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 10","pages":"36-37"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Backlash Against Copay Accumulators. 对共同付费累加器的强烈反对。
Managed Care Pub Date : 2018-09-01
Ed Silverman
{"title":"Backlash Against Copay Accumulators.","authors":"Ed Silverman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With accumulators, the value of any copay assistance cards or coupons does not count toward out-of-pocket medicine costs that are applied toward deductibles. It's a cost-shifting tool that's facing pushback from patients, providers, and others saying that accumulators will hurt public health.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 9","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36492318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hey, Big Spender! Why Does Your Quality Lag So Far Behind Other Countries? 嘿，挥金如土的家伙!为什么你们的质量远远落后于其他国家?
Managed Care Pub Date : 2018-09-01
Joseph Burns
{"title":"Hey, Big Spender! Why Does Your Quality Lag So Far Behind Other Countries?","authors":"Joseph Burns","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The United States is the world's biggest spender on health care by far. And what do we get for it? Not as much as we should. Our quality shortcomings are not for lack of knowledge: Stakeholders know what to do to close these gaps. So why aren't they doing it?</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 9","pages":"20-21"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36492320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Opaque Fight Against Price Transparency. 反对价格透明的不透明斗争。
Managed Care Pub Date : 2018-09-01
François de Brantes
{"title":"The Opaque Fight Against Price Transparency.","authors":"François de Brantes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For those who doubt the importance of transparency in price and quality to free the market, you just have to look behind the public curtain and observe the fierceness with which the opponents of transparency are trying to keep consumers in the dark.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 9","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36492323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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