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Price Setting and Price Regulation in Health Care

Price Setting and Price Regulation in Health Care PDF Author: OECD
Publisher: OECD Publishing
ISBN: 9264508864
Category :
Languages : en
Pages : 298

Book Description
The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).

Price Setting and Price Regulation in Health Care

Price Setting and Price Regulation in Health Care PDF Author: OECD
Publisher: OECD Publishing
ISBN: 9264508864
Category :
Languages : en
Pages : 298

Book Description
The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).

Price Setting and Price Regulation in Health Care

Price Setting and Price Regulation in Health Care PDF Author: Sarah L. Barber
Publisher:
ISBN: 9789241515924
Category :
Languages : en
Pages : 86

Book Description
The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).

WHO guideline on country pharmaceutical pricing policies

WHO guideline on country pharmaceutical pricing policies PDF Author:
Publisher: World Health Organization
ISBN: 9240011870
Category : Business & Economics
Languages : en
Pages : 70

Book Description
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.

Health Care Policy and Regulation

Health Care Policy and Regulation PDF Author: Thomas A. Abbott III
Publisher: Springer Science & Business Media
ISBN: 1461522196
Category : Business & Economics
Languages : en
Pages : 260

Book Description
5 care reforms. Part II: Price Regulation The second partofthis volume examines the role ofprice regulation in controlling health care costs. It contains three chapters. In chapter seven, I examine the alternatives for regulating pharmaceutical prices. In chapter eight, Jack Hadley examines the impactofvarious forms ofhospital price regulation; while in chapter nine,MarkPaulyexaminestheroleofpriceregulation incontrollingphysician fees. Chapter seven focuses on the issue of regulating pharmaceutical prices. There are two key issues examined in this paper. First, is there a clear need for price regulation, and second, can price regulation work in this industry? In response to the first question, I come to the conclusion that the proponents ofprice regulation have not really proven their case. Although the financial returns in the pharmaceu tical industry have been slightly higher than expected during the 1970s and 1980s, there is not overwhelming evidence of"price gouging" or excessive profits on the part of the industry. In response to the second question, the answer is clearly no. The traditional approaches to price regulation will not have the intended affect of eliminating excess profits from the industry while maintaining the incentives for research and development. First, rate-of-return regulation, the most natural approach, would result in many adverse incentives-includingexcessive investment in research and developmentinorderto inflatetheratebaseused tocalculatedtheallowablereturns.

Making Medicines Affordable

Making Medicines Affordable PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309468086
Category : Medical
Languages : en
Pages : 235

Book Description
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.

Equitable Access to High-Cost Pharmaceuticals

Equitable Access to High-Cost Pharmaceuticals PDF Author: Zaheer-Ud-Din Babar
Publisher: Academic Press
ISBN: 0128119624
Category : Business & Economics
Languages : en
Pages : 238

Book Description
Equitable Access to High-Cost Pharmaceuticals seeks to aid the development and implementation of equitable public health policies by pharmaco-economics professionals, health economists, and policymakers. With detailed country-by country analysis of policy and regulation, the Work compares and contrasts national healthcare systems to support researchers and practitioners identify optimal healthcare policy solutions. The Work incorporates chapters on global regulatory changes, health technology assessment guidelines, and competitive effectiveness research recommendations from international bodies such as the OECD or the EU. Novel policies such as horizon scanning, managed-entry agreement and post-launch monitoring are considered in detail. The Work also thoroughly reviews novel pharmaceuticals with particular research interest, including cancer drugs, orphan medicines, Hep C, and personalized medicines. Evaluates impact and efficacy of current access policies and pricing regulation of high-cost drugs Incorporates existing guidelines and recommendations by international organizations Compares and contrasts how different countries fund and police high-cost drug access Explores novel and emergent policies, including managed entry agreement, analysis of real world data and differential pricing Reviews novel pharmaceuticals of current research interest

The Healthcare Imperative

The Healthcare Imperative PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309144337
Category : Medical
Languages : en
Pages : 852

Book Description
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

Evidence-Based Medicine and the Changing Nature of Health Care

Evidence-Based Medicine and the Changing Nature of Health Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309113695
Category : Medical
Languages : en
Pages : 202

Book Description
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Understanding Value Based Healthcare

Understanding Value Based Healthcare PDF Author: Vineet Arora
Publisher: McGraw Hill Professional
ISBN: 007181700X
Category : Medical
Languages : en
Pages : 320

Book Description
Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .

Big Med

Big Med PDF Author: David Dranove
Publisher: University of Chicago Press
ISBN: 022682392X
Category : Business & Economics
Languages : en
Pages : 344

Book Description
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.