Download or read book The Politics of Medicare written by Theodore R. R. Marmor and published by Routledge. This book was released on 2017-07-05 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: On July 30, 1965, President Johnson flew to Independence, Missouri to sign the Medicare bill. The new statute included two related insurance programs to finance substantial portions of the hospital and physician expenses incurred by Americans over the age of sixty-five. Public attempts to improve American health standards have typically precipitated bitter debate, even as the issue has shifted from the professional and legal status of physicians to the availability of hospital care and public health programs. In The Politics of Medicare, Marmor helps the reader understand Medicare's origins, and he interprets the history of the program and explores what happened to Medicare politically as it turned from a legislative act in the mid-1960s to a major program of American government in the three decades since. This is a vibrant study of an important piece of legislation that asks and answers several questions: How could the American political system yield a policy that simultaneously appeased anti-governmental biases and used the federal government to provide a major entitlement? How was the American Medical Association legally overcome yet placated enough to participate in the program? And how did the Medicare law emerge so enlarged from earlier proposals that themselves had caused so much controversy?
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Prescription Drug Pricing and Negotiation written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2007 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Federal Drug Price Negotiation written by and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) established a prescription drug benefit for Medicare beneficiaries under Part D, which began on January 1, 2006. One provision of MMA, the "noninterference" clause, expressly forbids the Secretary of Health and Human Services (HHS) from interfering with drug price negotiation between manufacturers and Medicare drug plan sponsors, and from instituting a formulary or price structure for prescription drugs. The framework created by the law emphasizes competition among the Medicare drug plans to obtain price discounts. The incoming Speaker and the Democratic Party have included "Affordable Health Care" as one of the "Six for '06" initiatives. As part of this effort, they propose to give the Secretary of HHS the authority to negotiate prescription drug prices for Medicare beneficiaries. The majority leader has been reported as stating that the issue will come before the House for a vote on January 12, 2007. There are a number of approaches that the federal government could adopt to affect prescription drug prices. A few rely on the power of government to dictate an outcome, such as imposing statutory mandates or establishing price ceilings. Others emphasize more market-oriented approaches, such as soliciting competitive bids from voluntary participants. A reference pricing approach combines elements of both. Some of these methods are currently employed by the Department of Veterans Affairs (VA) and the Medicaid program. The price the VA pays for a drug is the lowest price as determined through one of four methods, less an additional 5% prime vendor discount: (1) the federal ceiling price, (2) federal supply schedule, (3) performance-based incentive agreement, or (4) national standardization contract. Drug reimbursement costs under Medicaid are calculated differently for single-source (only one Food and Drug Administrationapproved product) and multiple-source drugs (more than one FDA-approved product). However, for both types of drugs, state reimbursements are determined in aggregate based on either the federal upper limit price (FUL) -- a predetermined percentage of a defined reference price -- or the estimated acquisition cost. There are many practical and legislative steps necessary before federal drug price negotiation for Medicare beneficiaries could take place. Initially, the noninterference clause would need to be repealed. However, repealing the noninterference clause may not, in itself, be sufficient to lead to federally negotiated prices. If the Secretary were to engage in activities that affect drug prices on behalf of Medicare Part D beneficiaries, there might be consequences that affect the price of drugs for Medicare beneficiaries as well as other public and private patients, the number and types of drugs that would be available to Part D beneficiaries, the amount of research and development and innovation by pharmaceutical companies, and other sectors of the industry. This report will be updated.
Download or read book Prescription Drugs An Overview of Approaches to Negotiate Drug Prices Used by Other Countries U S Private Payers Federal Programs written by and published by DIANE Publishing. This book was released on with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Negotiation of Drug Prices in Medicare Part D written by Kirchhoff and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Negotiation of drug prices in Medicare part D written by Suzanne M. Kirchhoff and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Federal Drug Price Negotiation written by Jim Hahn and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report discusses what it means for the federal government to “negotiate” drug prices under existing public programs, the arguments for and against such activities, and some implications for the pharmaceutical industry, Medicare beneficiaries, and others if similar federal involvement were to occur on behalf of the Medicare Part D program.
Download or read book Insurer Bargaining and Negotiated Drug Prices in Medicare written by Darius Lakdawalla and published by . This book was released on 2009 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: A controversial feature of Medicare Part D is its reliance on private insurers to negotiate drug prices and rebates with retail pharmacies and drug manufacturers. Central to this controversy is whether increases in market power-an undesirable feature in most settings-confer benefits in health insurance markets, where larger buyers may obtain better prices for their members. We test whether insurers that experience larger enrollment increases due to Part D negotiate lower drug prices with pharmacies. Overall, we find that 100,000 additional insureds lead to 2.5-percent lower pharmacy prices negotiated by the insurer, and 5-percent reductions in pharmacy profits earned on prescriptions filled by enrollees of that insurer. Estimated enrollment effects are much larger for drugs with therapeutic substitutes, and virtually zero for branded drugs without therapeutic substitutes. We also present evidence that most insurer savings are, on the margin, passed on as lower premiums. Out-of-sample estimation suggests that modest insurer consolidation would generate significant savings to Medicare, along with premium reductions and enrollment increases. Finally, we find that greater enrollment leads to lower pharmacy prices negotiated by insurers for their non-Part D market--an external benefit to the commercially enrolled associated with administering Part D through private insurers.
Download or read book Competition and the Cost of Medicare s Prescription Drug Program written by Anna Cook and published by . This book was released on 2014-09-03 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the Medicare Modernization Act, or MMA) substantially expanded the federal Medicare program by creating the prescription drug benefit known as Part D. In FY 2013, Medicare Part D covered 39 million people. The federal government spent $59 billion net of premiums on Part D in that year; after accounting for certain payments from states under the program, the net federal cost was $50 billion, which represented 10% of net federal spending for Medicare. A combination of broader trends in the prescription drug market and lower-than-expected enrollment in Part D has contributed to much lower spending for the program than projected when the MMA became law in 2003. This report examines the federal budgetary cost and competitive design of Medicare Part D and compares Medicare Part D and Medicaid Fee for Service. Figures and tables. This is a print on demand report.
Download or read book WHO guideline on country pharmaceutical pricing policies written by and published by World Health Organization. This book was released on 2020-09-29 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, high prices of pharmaceutical products have posed challenges in high- and low-income countries alike. In many instances, high prices of pharmaceutical products have led to significant financial hardship for individuals and negatively impacted on healthcare systems' ability to provide population-wide access to essential medicines. Pharmaceutical pricing policies need to be carefully planned, carried out, and regularly checked and revised according to changing conditions. Strong, well-thought-out policies can guide well-informed and balanced decisions to achieve affordable access to essential health products. This guideline replaces the 2015 WHO guideline on country pharmaceutical pricing policies, revised to reflect the growing body of literature since the last evidence review in 2010. This update also recognizes country experiences in managing the prices of pharmaceutical products.
Download or read book Pharmaceutical R D written by and published by DIANE Publishing. This book was released on 1993 with total page 380 pages. Available in PDF, EPUB and Kindle. Book excerpt: Analyzes the costs, risks, and economic rewards of pharmaceutical R&D and the impact of public policy on both costs and returns. Examines the rapid increase in pharmaceutical R&D that began in the 1980s in the light of trends in science, technology, drug discovery, and health insurance coverage; Government regulation; product liability; market competition; Federal tax policy; and Federal support of prescription drug research. 12 appendices, including a glossary of terms.
Download or read book Medicare Part D written by John E. Dicken and published by DIANE Publishing. This book was released on 2010-06 with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare and Medicaid Serv. (CMS) allows Part D plans to utilize different tiers with different levels of cost sharing as a way of managing drug utilization and spending. One such tier, the specialty tier, is designed for high-cost drugs (HCD) whose prices exceed a certain threshold. Beneficiaries who use these drugs typically face higher out-of-pocket costs than those who use only lower-cost drugs. This report provides info. about HCD eligible for a specialty tier incl. spending under Medicare Part D; how different cost-sharing structures could be expected to affect beneficiary out-of-pocket costs; how negotiated drug prices could be expected to affect beneficiary out-of-pocket costs; and Part D plan sponsors ability to negotiate price concessions. Illus.
Download or read book The Role of NIH in Drug Development Innovation and Its Impact on Patient Access written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-27 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: To explore the role of the National Institutes of Health (NIH) in innovative drug development and its impact on patient access, the Board on Health Care Services and the Board on Health Sciences Policy of the National Academies jointly hosted a public workshop on July 24â€"25, 2019, in Washington, DC. Workshop speakers and participants discussed the ways in which federal investments in biomedical research are translated into innovative therapies and considered approaches to ensure that the public has affordable access to the resulting new drugs. This publication summarizes the presentations and discussions from the workshop.
Download or read book Drugs Money and Secret Handshakes written by Robin Feldman and published by Cambridge University Press. This book was released on 2019-04-11 with total page 201 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Greater Access to Generic Drugs written by Michelle Meadows and published by . This book was released on 2003 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Human Cost of Federal Price Negotiations written by Benjamin Zycher and published by . This book was released on 2006 with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt:
