Understanding Pharmacy Reimbursement

Understanding Pharmacy Reimbursement
Author: F. Randy Vogenberg
Publisher: ASHP
Total Pages: 169
Release: 2006
Genre: Business & Economics
ISBN: 1585281085

As a health system pharmacist dealing with health care reform initiatives and accountable care organizations, it is important to have a fundamental understanding of health care reimbursement that has a focus on pharmacy. Understanding Pharmacy Reimbursement is the essential resource that allows you to more effectively deal with the rapidly changing and constantly emerging reimbursement issues over the next few years.

Making Medicines Affordable

Making Medicines Affordable
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 235
Release: 2018-03-01
Genre: Medical
ISBN: 0309468086

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.

Rare Diseases and Orphan Products

Rare Diseases and Orphan Products
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 442
Release: 2011-04-03
Genre: Medical
ISBN: 0309158060

Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.

The Oxford Handbook of the Economics of the Biopharmaceutical Industry

The Oxford Handbook of the Economics of the Biopharmaceutical Industry
Author: Patricia M. Danzon
Publisher: Oxford University Press
Total Pages: 618
Release: 2012-04-12
Genre: Business & Economics
ISBN: 0199909261

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.

The Changing Economics of Medical Technology

The Changing Economics of Medical Technology
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 225
Release: 1991-02-01
Genre: Medical
ISBN: 030904491X

Americans praise medical technology for saving lives and improving health. Yet, new technology is often cited as a key factor in skyrocketing medical costs. This volume, second in the Medical Innovation at the Crossroads series, examines how economic incentives for innovation are changing and what that means for the future of health care. Up-to-date with a wide variety of examples and case studies, this book explores how payment, patent, and regulatory policiesâ€"as well as the involvement of numerous government agenciesâ€"affect the introduction and use of new pharmaceuticals, medical devices, and surgical procedures. The volume also includes detailed comparisons of policies and patterns of technological innovation in Western Europe and Japan. This fact-filled and practical book will be of interest to economists, policymakers, health administrators, health care practitioners, and the concerned public.

Pharmacy Technician Certification Exam (Ptce)

Pharmacy Technician Certification Exam (Ptce)
Author: National Learning Corporation
Publisher: Admission Test
Total Pages: 0
Release: 2019
Genre: Medical
ISBN: 9780837358499

The Admission Test Series prepares students for entrance examinations into college, graduate and professional school as well as candidates for professional certification and licensure. The Pharmacy Technician Certification Exam (PTCE) Passbook(R) prepares you by sharpening the skills and abilities necessary to succeed on your upcoming entrance exam. It provides hundreds of questions and answers in the areas that will likely be covered on your upcoming exam, including but not limited to: pharmacy law and regulations; medication safety; inventory management; quality assurance; pharmacology; and more.

Medical Insurance for Pharmacy Technicians

Medical Insurance for Pharmacy Technicians
Author: Cynthia Newby, CPC
Publisher: McGraw-Hill Education
Total Pages: 0
Release: 2009-02-19
Genre: Medical
ISBN: 9780073374161

Medical Insurance for Pharmacy Technicians provides a practical, focused overview of medical insurance and billing of prescriptions in the community pharmacy setting. Each chapter is structured to give students a hands-on, practical approach to understanding and working with prescription charges and the billing process. This text is precisely tailored for a brief introduction to the fundamental understanding of claim processing principles for pharmacy technicians.

Pharmacy Benefits

Pharmacy Benefits
Author: F. Randy Vogenberg
Publisher: International Foundation of Employee benefit
Total Pages: 180
Release: 2011
Genre: Business & Economics
ISBN: 9780891546962

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.