Because physicians and health plan members both value choice, the current weak market for Inflectra and Renflexis could be a passing phase. Attitudes could change once there is more data that show people do well after switching from Remicade to the newcomers.
David Hanekom, MD, and Steven Udvarhelyi, MD, are two former medical directors who became CEOs. Their new job means really understanding the business side of health care, the need for healthy members, and a healthy bottom line. But it also means watching costs and keeping stakeholders —which can include stock holders—happy.
Some say gene editing platforms like CRISPR are a truer version of gene therapy because they are designed to home in on a particular genomic location.
PBM consultant Linda Cahn says that if Amazon gets into the PBM business it could insist that drugmakers simultaneously submit the net discount price for each of their drugs for the subsequent six months. Amazon could then publicize every drug’s actual price, by drug and by therapeutic category.
That’s thanks to about 57 million unplanned sick days for workers. The prevalence of diabetes in the adult population grew from 10.6% in 2008 to 11.6% in 2016. It was at 11.5% for the first nine months of 2017.
The disease is endemic in Latin America, where an estimated 8 million people are affected. It is a lifelong illness and, if untreated, it can result in life-threatening health conditions. Enter benznidazole, which shows we can respond to these new threats in both a medically and an economically responsible manner.
For all the sturm und drang, experts foresee neither a hurry-up nor a halt for 2018, just a fairly steady continued rise at roughly last year’s higher-than-inflation pace. The Drug Price Forecast, for example (based on hospital and nonacute settings, but not retail pharmacy), reports that that means a tidy year-over-year increase of 7.61%.
Women make up most of the workforce, but men are in positions of power. Sexual harassment and abuse are common and deep-seated problems in American health care. Women in health care are speaking up and forcing executives and physicians to face the issue.
Training primary care physicians to identify and treat oral health problems will go a long way toward integrating care for those problems with general medical care, according to a study in the Journal of the American Board of Family Medicine.
Morality rates for inpatient hospitalizations for opioid abuse quadrupled between 2000 and 2014, according to a study in Health Affairs. The mortality rates increased from 0.43% before 2000 to 2.02% in 2014. In 2016, 15,000 Americans died from heroin overdoses and 20,000 others died from overdoses from synthetic opioids.
Some experts say that investors funding innovative startup companies can disrupt American health care, making it smarter and more efficient. Others warn that incentives must change if VC money is to make a real difference. It’s a trend no one in health care can ignore.
The document “Feature and Function Recommendations To Optimize Clinician Usability of Direct Interoperability To Enhance Patient Care” offers recommendations from the clinician point of view. Widespread adoption of even a few of these recommendations by designers and vendors would greatly enhance care.
A MedPage Today blog post suggests that they do. Industry veterans say they’re unaware of bonuses for denials but agree prior auth processes should be more transparent.
How the world looks depends on your point of view. Medical directors, some with experience as payers and providers, share their thoughts on prior authorization, value-based care, and quality measurement. One opportunity: Payers should work with specialty organizations and physician advocates to develop metrics and processes that make sense from the physician perspective.