Now there's discussion of something called "metabolic syndrome," which seems to include all the problems associated with being obese. An article in the Washington Post notes that some experts are also a bit skeptical, saying that a diagnosis of metabolic syndrome may lead doctors to rush patients into drug treatment without giving dieting and exercise a chance.... Aetna has introduced six PPOs in Connecticut (where the company is based) that are aimed at the state's uninsured and others who don't have employer sponsored health insurance. Members will be able to go out of network but will pay more out of pocket to do so, says the Hartford Currant. Those who remain in-network will not have to pay deductibles for physician visits and generic prescription drugs.... It's nearly impossible to determine whether hospital infections are rising or falling, according to the Wall Street Journal. "Infection fighters on the front lines say the situation isn't nearly as simple as consumer advocates make it seem. Hospitals don't have some 'infection rate' that they know but are keeping secret. Instead, there is no standard method" for keeping tabs on infections.... Technology sometimes creates problems as well as solves them. The Jan. 3 issue of Health Care Policy Report: "Computerized drug prescribing mistakes accounted for nearly 20 percent of all hospital and health system medication errors in 2003, a study released by the United States Pharmacopeia (USP) said. "
House Republicans come out with their ACA alternative. A continuous coverage surcharge replaces the individual mandate. But where’s the CBO score?
The biosimilar segment of the pharmaceutical industry is on fire. Some 700 biosimilars are at some stage of development, and more than 660 companies are involved in some way in the biosimilars land rush. Still, only a handful may get on the market in the next few years.
No one knows how much of an effect biosimilars will have on oncology expenditures. Pricing and market share are in a large, opaque “to be determined” cloud. But there’s certainly potential for a major impact that could lower oncology expenditures by millions, if not billions.
The future of biosimilars in this country is nothing if not uncertain. Most immediately, the U.S. Supreme Court is hearing a case that will determine the timing of the 180-day waiting period before a biosimilar can go on the market. But there are larger and longer-term issues at play as well.
While coupons help individual consumers, they are also having a major impact on the insurance industry and anyone responsible for paying health care bills. Insurers and pharmacy benefit managers complain that they foil formularies and other pricing strategies designed to steer consumers to less-expensive drugs.
The hard truth is that telehealth’s future—its size, its contours—will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
Insurers should consider covering new drug-delivery devices that can improve outcomes while lowering disease-specific pharmacy and long-term overall health care costs. Managing these devices in the pharmacy benefit will consolidate volume-based purchasing and capitalize on PBM strategies for improving adherence.
Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices.
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
If millions of Americans lose Medicaid or private health insurance coverage because of the unACAing of American health care, telehealth may seem like a gimmicky sideshow rather than a good-faith effort to bring health care into the digital century.