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Value based pricing

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https://www.readbyqxmd.com/read/28228864/innovative-payer-engagement-strategies-will-the-convergence-lead-to-better-value-creation-in-personalized-medicine
#1
REVIEW
Ildar Akhmetov, Rostyslav V Bubnov
BACKGROUND: As reimbursement authorities are gaining greater power to influence the prescription behavior of physicians, it remains critical for life science companies focusing on personalized medicine to develop "tailor-made" payer engagement strategies to secure reimbursement and assure timely patient access to their innovative products. Depending on the types of such engagement, pharmaceutical and diagnostic companies may benefit by obtaining access to medical and pharmacy claims data, getting invaluable upfront inputs on evidence requirements and clinical trial design, and strengthening trust by payers, therefore avoiding uncertainties with regards to pricing, reimbursement, and research and development reinvestment...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/28210864/pharmacy-benefit-management-companies-do-they-create-value-in-the-us-healthcare-system
#2
Alan Lyles
Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing...
February 16, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28205150/the-potential-cost-effectiveness-of-different-dengue-vaccination-programmes-in-malaysia-a-value-based-pricing-assessment-using-dynamic-transmission-mathematical-modelling
#3
Asrul Akmal Shafie, Hui Yee Yeo, Laurent Coudeville, Lucas Steinberg, Balvinder Singh Gill, Rohani Jahis, Amar-Singh Hss
BACKGROUND: Dengue disease poses a great economic burden in Malaysia. METHODS: This study evaluated the cost effectiveness and impact of dengue vaccination in Malaysia from both provider and societal perspectives using a dynamic transmission mathematical model. The model incorporated sensitivity analyses, Malaysia-specific data, evidence from recent phase III studies and pooled efficacy and long-term safety data to refine the estimates from previous published studies...
February 15, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28202238/how-much-should-customers-be-compensated-for-interruptions-in-the-drinking-water-supply
#4
María Molinos-Senante, Ramon Sala-Garrido
Water supply interruptions directly affect customers, and customers should be compensated accordingly. However, few water regulators have applied compensation policies given the difficulty of estimating the economic value of compensation to customers. In this study, a pioneering approach based on the concept of shadow prices is proposed to determine the compensation that customers should receive for unplanned water interruptions. The Chilean water industry was selected as a case study because there is an ongoing policy discussion between the use of penalties or compensation as an incentive to prevent water supply interruptions...
February 12, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28186712/a-practical-methodology-for-disaggregating-the-drivers-of-drug-costs-using-administrative-data
#5
Elena R Lungu, Orlando J Manti, Mitchell A H Levine, Douglas A Clark, Tanya M Potashnik, Carol I McKinley
BACKGROUND: Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. OBJECTIVES: To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers...
September 1, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28182474/parenting-as-a-focus-of-recovery-a-systematic-review-of-current-practice
#6
Andrea Reupert, Rhys Price-Robertson, Darryl Maybery
OBJECTIVES: The first aim of this article was to systematically identify and review interventions that had incorporated parenting as a focus of recovery-orientated practice in adult mental health services. The second aim was to assess the strength of the extant evidence that including parenting as a focus of recovery practice was effective in terms of improving parent, child and family wellbeing. METHOD: An online search was conducted through Scopus, PsycINFO, Ovid MEDLINE, Cochrane library, and the Australian Family & Society Abstracts, for articles published between 2006 and 2015...
February 9, 2017: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/28177545/retrospective-cross-sectional-pilot-study-of-rifaximin-dosing-for-the-prevention-of-recurrent-hepatic-encephalopathy
#7
REVIEW
Kelsey C Lyon, Eric Likar, Jay L Martello, Michael Regier
Standard treatment for hepatic encephalopathy (HE) includes medications that reduce ammonia and bacterial translocation in the gut. Rifaximin can be used off-label for the reduction of overt HE. The study purpose was to determine efficacy of traditional rifaximin dosing (400 mg three times daily) compared to newer dosing (550 mg twice daily) via readmission rates for the prevention of recurrent HE. This was a retrospective, observational, cross-sectional pilot study conducted in a tertiary medical center...
February 8, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28169925/hospital-teaching-status-and-medicare-expenditures-for-complex-surgery
#8
Jason C Pradarelli, Christopher P Scally, Hari Nathan, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To evaluate the relationship between hospital teaching intensity, Medicare payments, and perioperative outcomes. BACKGROUND: Several emerging payment policies penalize hospitals for low-value healthcare. Teaching hospitals may be at a disadvantage given the perception that they deliver care less efficiently. METHODS: Using Medicare Provider and Analysis Review files, we studied patients from age 65 to 100 years who underwent abdominal aortic aneurysm (AAA) repair (n = 71,422), pulmonary resection (n = 93,056), or colectomy (n = 277,619) from 2009 to 2012...
March 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28166172/cost-and-cost-effectiveness-analysis-of-treatment-options-for-sanders-ii-and-iii-calcaneus-fractures-in-laborers
#9
R Carter Clement, Pamela J Lang, Brett J Pettett, Robert A Overman, Robert F Ostrum, Josh N Tennant
OBJECTIVE: This study compares the cost and cost-effectiveness of treatments options for Sanders II/III displaced intra-articular calcaneus fractures (DIACF's) in laborers. METHODS: Literature on Sanders type II and III fractures was reviewed to determine complication rates and utility values for each treatment option. Costs were calculated using Medicare reimbursement and implant prices from our institution. Monte Carlo simulations were used to analyze a decision-tree to determine the cost and cost-effectiveness of each treatment from a societal perspective...
January 30, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28160645/climate-change-and-the-economics-of-biomass-energy-feedstocks-in-semi-arid-agricultural-landscapes-a-spatially-explicit-real-options-analysis
#10
Courtney M Regan, Jeffery D Connor, Ramesh Raja Segaran, Wayne S Meyer, Brett A Bryan, Bertram Ostendorf
The economics of establishing perennial species as renewable energy feedstocks has been widely investigated as a climate change adapted diversification option for landholders, primarily using net present value (NPV) analysis. NPV does not account for key uncertainties likely to influence relevant landholder decision making. While real options analysis (ROA) is an alternative method that accounts for the uncertainty over future conditions and the large upfront irreversible investment involved in establishing perennials, there have been limited applications of ROA to evaluating land use change decision economics and even fewer applications considering climate change risks...
February 1, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28152824/treatment-prices-at-the-point-of-care-pilot
#11
Rebecca W Lau, Leah Tuzzio, Matthew Alan Christianson, Eric Y Chen, Thanh-Hien Phan
: 4 Background: People with cancer increasingly wish to discuss cancer care costs with clinicians. In our organization all price questions go to a central customer service line with limited capacity to address oncology-specific questions. We aimed to improve clinician access to treatment prices to assist them in responding to patient concerns about prices. METHODS: We developed, launched, and evaluated a pilot tool and accompanying workflow for four oncology clinics in an integrated delivery system in WA...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152737/financial-risk-sharing-agreements-using-options-to-make-marginal-benefits-cost-effective
#12
(no author information available yet)
: 41 Background: New cancer treatments have become increasingly costly. Although new drugs may be sufficiently cost-efficiency for a primary indication (i1) to receive funding, subsequent indications (ia) may not prove cost-effective. A financial risk-sharing agreement to increase access is proposed. A potential 2012 real-world implementation in Canada for pazopanib use in metastatic renal cell carcinoma (mRCC) as i1, and soft-tissue sarcoma (STS) as ia is presented. METHODS: The market value of an indication can be approximated by its net-present-value (NPV) of expected cash flows...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28146342/measuring-the-impact-of-the-pet-trade-on-indonesian-birds
#13
J Berton C Harris, Morgan W Tingley, Fangyuan Hua, Ding Li Yong, J Marion Adeney, Tien Ming Lee, William Marthy, Dewi M Prawiradilaga, Cagan H Sekercioglu, Suyadi, Nurul Winarni, David S Wilcove
The trade in wild animals involves one-third of the world's bird species and thousands of other vertebrate species. Although a few species are imperiled as a result of the wildlife trade, the lack of field studies makes it difficult to gauge how serious a threat it is to biodiversity. We used data on changes in bird abundances across space and time and information from trapper interviews to evaluate the effects of trapping wild birds for the pet trade in Sumatra, Indonesia. To analyze changes in bird abundance over time, we used data gathered over 14 years of repeated bird surveys in a 900-ha forest in southern Sumatra...
March 31, 2016: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/28141932/an-expanded-portfolio-of-survival-metrics-for-assessing-anticancer-agents
#14
Jennifer Karweit, Srividya Kotapati, Samuel Wagner, James W Shaw, Steffan W Wolfe, Amy P Abernethy
OBJECTIVES: With the introduction of more effective anticancer agents that prolong survival, there is a need for new methods to define the clinical value of treatments. The objective of this preliminary qualitative and quantitative analysis was to assess the utility of an expanded portfolio of survival metrics to differentiate the value of anticancer agents. STUDY DESIGN: A literature review was conducted of phase 3 trial data, reported in regulatory submissions within the last 10 years of agents for 6 metastatic cancers (breast cancer, colorectal cancer [CRC], melanoma, non-small cell lung cancer [NSCLC], prostate cancer [PC], and renal cell cancer [RCC])...
January 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28141931/the-challenge-of-paying-for-cost-effective-cures
#15
Patricia J Zettler, Erin C Fuse Brown
In this article, we consider the problem of financing highly effective and cost-effective prescription drugs within a value-based pricing system. Precisely because these drugs are highly effective, their value-based prices may be quite expensive; and moreover, the value-based price of a cure ought to be set high enough to create incentives for innovation, otherwise these beneficial therapies may be underdeveloped. However, in our fragmented health insurance system, where patients move frequently between payers, these payers generally lack the incentives to pay value-based prices for cures because they cannot ensure that they will reap the long-term economic benefits...
January 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28139090/characterising-uncertainty-in-the-assessment-of-medical-devices-and-determining-future-research-needs
#16
Claire Rothery, Karl Claxton, Stephen Palmer, David Epstein, Rosanna Tarricone, Mark Sculpher
Decisions about the adoption of medical interventions are informed by evidence on their costs and effects. For a range of reasons, evidence relating to medical devices may be limited. The decision to adopt a device early in its life cycle when the evidence base is least mature may impact on the prospects of acquiring further evidence to reduce uncertainties. Equally, rejecting a device will result in no uptake in practice and hence no chance to learn about performance. Decision options such as 'only in research' or 'approval with research' can overcome these issues by allowing patients early access to promising new technologies while limiting the risks associated with making incorrect decisions until more evidence or learning is established...
February 2017: Health Economics
https://www.readbyqxmd.com/read/28138932/drug-pricing-in-south-korea
#17
Hye-Young Kwon, Brian Godman
Between 2000 and 2013, spending on medicines in Korea increased by 275.3%. In order to curb this trend, several pricing policies and measures were introduced. This study reviews these policies and their implications based on pricing regulations as well as a literature review. New medicines now undergo both a reimbursement assessment and price negotiations. The reimbursement of new medicines is based on their cost effectiveness. The prices of new medicines are subsequently fixed through negotiations between the payer, the National Health Insurance Service, and the relevant manufacturer...
January 30, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28137850/seafood-prices-reveal-impacts-of-a-major-ecological-disturbance
#18
Martin D Smith, Atle Oglend, A Justin Kirkpatrick, Frank Asche, Lori S Bennear, J Kevin Craig, James M Nance
Coastal hypoxia (dissolved oxygen ≤ 2 mg/L) is a growing problem worldwide that threatens marine ecosystem services, but little is known about economic effects on fisheries. Here, we provide evidence that hypoxia causes economic impacts on a major fishery. Ecological studies of hypoxia and marine fauna suggest multiple mechanisms through which hypoxia can skew a population's size distribution toward smaller individuals. These mechanisms produce sharp predictions about changes in seafood markets. Hypoxia is hypothesized to decrease the quantity of large shrimp relative to small shrimp and increase the price of large shrimp relative to small shrimp...
January 30, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28125363/evaluation-of-the-asco-value-framework-for-anticancer-drugs-at-an-academic-medical-center
#19
Leslie Wilson, Tracy Lin, Ling Wang, Tanuja Patel, Denise Tran, Sarah Kim, Katie Dacey, Courtney Yuen, Lisa Kroon, Bret Brodowy, Kevin Rodondi
BACKGROUND: Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. PROGRAM DESCRIPTION: The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28121539/value-based-health-care-one-patient-s-experience-and-what-really-matters
#20
Thomas Reinke
Meet Jonathan Friedlaender, a cancer survivor whose 20-year-long struggle helps illustrate drug pricing's important role in this arena.
October 2016: Managed Care
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