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Potential benefits and risks of value-based pricing of prescription drugs
Abstract
Prescription drugs are becoming increasingly costly, and methods to mitigate these rising costs are not sufficient. Value-based pharmaceutical purchasing is a new option that is being increasingly used in Europe and holds promise in the US. The main potential benefits include greater access to prescription drugs and cost-containment which is less reliant on shifting the financial burden of the prescriber's choices to the patient. The main risks are that generating the contracts and collecting the data needed are so complex that miscalculations can have large financial implications. It is unclear if the administrative burden required to understand and manage this method will outpace the cost-savings it will generate.
... Payors negotiate special rates or rebates if a payor or insurer will include specific drugs or biologics on their formulary, eliminate prior authorization processes, or place the product in a lower tier that has a smaller copay or coinsurance for patients. 23 These contracts are not transparent (their content and stipulations are not shared with people) aside from the parties directly involved in the negotiations. For the biosimilars on the market, one of the main barriers to patients receiving them is lack of payor coverage. ...
After taking this continuing education activity, pharmacists will be able to • Describe the FDA process for approval of bio-similars • Recognize key terminology of biosimilarity, in-terchangeability, totality of evidence, immu-nogenicity, extrapolation, and nocebo effect • Compare biosimilars and approved reference products in inflammation for formulary decisions , patient monitoring, and delivering education to other healthcare providers • Identify state pharmacy requirements for bio-similar substitution After taking this continuing education activity, pharmacy technicians will be able to • Compare the cost savings of biosimilars to reference biologic products in inflammatory conditions • Describe the difference between a biosimilar and a generic product • Determine when to refer patients to the pharmacists for recommendations or referrals The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Pharmacists and pharmacy technicians are eligible to participate in this application-based activity and will receive up to 0.2 CEU (2 contact hours) for completing the activity, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor on-line system and your participation will be recorded with CPE Monitor within 72 hours of submission To obtain CPE credit, visit the UConn Online CE Center https://pharmacyce.uconn.edu/login.php. Use your NABP E-profile ID and the session code 21YC02-XXT33 for pharmacists or 21YC02-TXK44 for pharmacy technicians to access the online quiz and evaluation. First-time users must pre-register in the Online CE Center. Test results will be displayed immediately and your participation will be recorded with CPE Monitor within 72 hours of completing the requirements. For questions concerning the online CPE activities , email joanne.nault@uconn.edu. ABSTRACT: Although biologics were used by only 2% of the population in 2019, they constituted 48% of all drug spending. Biosimilars, which are are biosimilar to an FDA-approved reference product, have the potential to save money for health systems and patients. Patients may prioritize biologic therapy over their small molecule therapies for common asymptomatic diseases like hypertension and hyperlipidemia for financial reasons. Pharmacists and technicians who understand which biosimilars are available and applicable state and federal laws can alert patients or their prescribers of the existence of a lower cost biosimilar. They can also dispel myths and combat nocebo effect.
From service management to vendor agreements, contracts take many forms. They establish partnership and accountability between parties and often require considerable negotiation before being finalized. Traditionally, a wide variety of contract types was created to fit the needs of contractors, supplies, and clients. These types vary according to the degree of risk sharing, timing, and responsibilities assumed by the contractor for the costs of performance; and the amount and nature of the profit incentive offered to the contractor for achieving or exceeding specified standards or goals. As we delve into the digital transformation era, various business aspects have been revisited. Innovation, transformation, and change management become major players in all business relations, and they need to be considered in the contracting arena as well. This chapter is discussing various types of traditional contracts specifying the differences of each type and how and when to utilize it. It also describes the pros and cons of each one.
Objective
Instruct clinicians on counterfeit drugs and their implications for patient health.
Summary
Counterfeit drugs imperil patients around the globe, and their penetration into the United States, Canada, and Western Europe is only increasing over time. In addition to inserting counterfeit drugs in the legitimate drug supply, rogue Internet pharmacies and consumer purchases while traveling abroad allow counterfeit drugs to endanger patients. Pharmacists need to understand the nature and severity of the issue and directly counter it through personal actions to secure a legitimate drug supply, such as by using verified distributors and examining the shipment packaging, product packaging, the bottle, and the label for evidence to determine if it is counterfeit or has been tampered with. They can also indirectly counter it through patient education and by working with other key stakeholders in the health care system.
Conclusion
Given the risk to patients, pharmacists have an important role to play in limiting patient use of counterfeit drugs.
Objective:
To review the role of inflammatory suppression in patients with atherosclerotic cardiovascular disease (ASCVD) with a focus on the interleukin-1β blocker canakinumab.
Data sources:
An Ovid MEDLINE literature search (1946 to February 2018) was performed using search terms inflammation, ASCVD, atherosclerosis, C-reactive protein, canakinumab. Additional references were identified from a review of literature citations.
Study selection and data extraction:
English-language studies assessing the impact of pharmacological agents, including canakinumab, on inflammation as measured by high-sensitivity C-reactive protein (hsCRP) and the association with reducing ASCVD events were evaluated.
Data synthesis:
Nine studies were included to describe the effect of ASCVD drugs on hsCRP. Aspirin, angiotensin-converting enzyme inhibitors, gemfibrozil, and statins exhibit varying degrees of hsCRP reduction and are associated with a reduction of ASCVD events. The Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS), showed a significant reduction of ASVCD events in patients with elevated baseline hsCRP levels without affecting cholesterol.
Conclusions:
Patients with elevated inflammatory markers such as hsCRP are at risk for ASVCD events. Several drug classes have shown the ability to decrease hsCRP levels, but the extent to which this reduces ASCVD events in lieu of other drug mechanisms was not clear. Canakinumab specifically targets the inflammatory process in ASCVD and was proven to be effective in preventing ASCVD events in patients with elevated hsCRP levels.
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