› › Pharmacy Benefit Managers

PBMs

Author : Sheila Shulman

Publisher : CRC Press

Page : 216 pages

File Size : 32,73 MB

Release : 1998-06-18

Category : Medical

ISBN : 9780789005120

Get eBook

Book Description

PBMs: Reshaping the Pharmaceutical Distribution Network provides HMOs and other third-party payers with information on the new and increasingly important role of pharmaceutical benefit companies (PBMs) in the health care industry. From this text, you will learn how PBMs can maintain and deliver a quality, cost-effective drug benefit plan to your company while achieving the anticipated market share for the product. PBMs: Reshaping the Pharmaceutical Distribution Network offers you suggestions on how to choose which PBM service is correct for your business, such as what qualifications to look for in a PBM, as well as what questions you should ask a respective company. This text also offers ways on how your company can benefit from becoming a client and may make your business more competitive in the pharmaceutical industry. PBMs: Reshaping the Pharmaceutical Distribution Network also informs you about the controversies that have arisen concerning the new position of PBMs in the industry. Through research and evaluation, this text addresses these issues from many different perspectives and gives you insight into other topics concerning PBMs, including: operating methods that PBMs currently rely on for designing and overseeing a drug benefit plan how the Food and Drug Administration currently views the role of PBMs and why they are contemplating regulatory intervention alerting PBMs, pharmacies, pharmaceutical companies, and managed care organizations to new legal issues involving fraud and abuse affecting pharmacy benefit management and pharmaceutical manufacturers reasons why retail drug chains and pharmacist organizations oppose recent industry developments regarding PBMs whether or not PBMs reflect a move toward greater centralized decisionmaking in the health care systemIn addition, PBMs: Reshaping the Pharmaceutical Distribution Network offers pharmaceutical companies, health care providers, and managed care organizations several suggestions for further research, which may make your business or your business relationships more efficient and productive in the future. If you or your company are considering the services of a pharmacy benefit management, PBMs: Reshaping the Pharmaceutical Distribution Network will guide you in choosing a company that helps you deliver the most cost-effective and efficient pharmaceutical benefits to customers.



Making Medicines Affordable

Author : National Academies of Sciences, Engineering, and Medicine

Publisher : National Academies Press

Page : 235 pages

File Size : 38,62 MB

Release : 2018-03-01

Category : Medical

ISBN : 0309468086

Get eBook

Book Description

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.



Pharmacy Benefits

Author : F. Randy Vogenberg

Publisher : International Foundation of Employee benefit

Page : 180 pages

File Size : 47,9 MB

Release : 2011

Category : Business & Economics

ISBN : 9780891546962

Get eBook

Book Description

Pharmaceuticals have become an integral component of medical treatment, with some medications completely transforming health care outcomes and delivery. Drug therapy has been proven to reduce health care costs, increase productivity and enhance the quality of life for many people. When was the last time you examined the prescription drug component of your health care benefits? This primer offers factors to consider when designing or modifying pharmacy benefits, including the pros and cons of carving benefits into a health plan as well as carving them out as a separate prescription drug plan. A practical checklist is provided in almost every chapter to help you focus on important issues, including what questions to ask potential vendors.



Handbook of Pharmaceutical Public Policy

Author : Thomas Fulda

Publisher : CRC Press

Page : 714 pages

File Size : 15,68 MB

Release : 2007-07-25

Category : Medical

ISBN : 9781439804261

Get eBook

Book Description

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



Drugs, Money, and Secret Handshakes

Author : Robin Feldman

Publisher : Cambridge University Press

Page : 201 pages

File Size : 11,54 MB

Release : 2019-04-11

Category : Law

ISBN : 1108659500

Get eBook

Book Description

In the warped world of prescription drug pricing, generic drugs can cost more than branded ones, old drugs can be relaunched at astronomical prices, and low-cost options are shut out of the market. In Drugs, Money and Secret Handshakes, Robin Feldman shines a light into the dark corners of the pharmaceutical industry to expose a web of shadowy deals in which higher-priced drugs receive favorable treatment and patients are channeled toward the most expensive medicines. At the center of this web are the highly secretive middle players who establish coverage levels for patients and negotiate with drug companies. By offering lucrative payments to these middle players (as well as to doctors and hospitals), drug companies ensure that inexpensive drugs never gain traction. This system of perverse incentives has delivered the kind of exorbitant drug prices - and profits - that everyone loves except for those who pay the bills.





Managed Care Pharmacy Practice

Author : Navarro

Publisher : Jones & Bartlett Publishers

Page : 659 pages

File Size : 20,52 MB

Release : 2008-12-11

Category : Medical

ISBN : 076378883X

Get eBook

Book Description

Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.



Pain Management and the Opioid Epidemic

Author : National Academies of Sciences, Engineering, and Medicine

Publisher : National Academies Press

Page : 483 pages

File Size : 47,45 MB

Release : 2017-09-28

Category : Medical

ISBN : 0309459575

Get eBook

Book Description

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.



The Oxford Handbook of the Economics of the Biopharmaceutical Industry

Author : Patricia M. Danzon

Publisher : Oxford University Press

Page : 618 pages

File Size : 14,31 MB

Release : 2012-04-12

Category : Business & Economics

ISBN : 0199909261

Get eBook

Book Description

The biopharmaceutical industry has been a major driver of technological change in health care, producing unprecedented benefits for patients, cost challenges for payers, and profits for shareholders. As consumers and companies benefit from access to new drugs, policymakers around the globe seek mechanisms to control prices and expenditures commensurate with value. More recently the 1990s productivity boom of new products has turned into a productivity bust, with fewer and more modest innovations, and flat or declining revenues for innovative firms as generics replace their former blockbuster products. This timely volume examines the economics of the biopharmaceutical industry, with eighteen chapters by leading academic health economists. Part one examines the economics of biopharmaceutical innovation including determinants of the costs and returns to new drug development; how capital markets finance R&D and how costs of financing the biopharmaceutical industry compare to financing costs for other industries; the effects of safety and efficacy regulation by the Food and Drug Administration (FDA) and of price and reimbursement regulation on incentives for innovation; and the role of patents and regulatory exclusivities. Part two examines the market for biopharmaceuticals with chapters on prices and reimbursement in the US, the EU, and other industrialized countries, and in developing countries. It looks at the optimal design of insurance for drugs and the effects of cost sharing on spending and on health outcomes; how to measure the value of pharmaceuticals using pharmacoeconomics, including theory, practical challenges, and policy issues; how to measure pharmaceutical price growth over time and recent evidence; empirical evidence on the value of pharmaceuticals in terms of health outcomes; promotion of pharmaceuticals to physicians and consumers; the economics of vaccines; and a review of the evidence on effects of mergers, acquisitions and alliances. Each chapter summarizes the latest insights from theory and recent empirical evidence, and outlines important unanswered questions and areas for future research. Based on solid economics, it is nevertheless written in terms accessible to the general reader. The book is thus recommended reading for academic economists and non-economists, and for those in industry and policy who wish to understand the economics of this fascinating industry.



Reasonable Rx

Author : Stan N. Finkelstein

Publisher : FT Press

Page : 212 pages

File Size : 10,74 MB

Release : 2008

Category : Business & Economics

ISBN :

Get eBook

Book Description

Explores the problem of high drug prices by taking a close look at the science of drug development, how the drug industry operates, how new drugs are discovered, and how the government affects and controls these processes. By examining recent changes in the pharmaceutical industry in more depth, the authors explain how more radical changes can both reduce prices and improve the flow of new drugs.