Drug costs

Managed care organizations are developing programs to reduce a small niche of waste associated with early discontinuation of medication therapy.

Drug abandonment can be attributed to a number of factors

OTC drugs now require a prescription for account withdrawls

Pharmacy benefit programs will clearly see operational and economic changes in 2011, from phasing out the donut hole to growth in specialty pharmacy

Seniors are satisfied with the current program (84%) because they believe it offers good value for the cost

As the first of the baby boomers become eligible for Medicare in 2011, the healthcare system is bracing itself to support added burdens on drug utilization

Many of the estimated 5.1 million Americans with Alzheimer's disease also have other serious medical conditions

Although such costs are just one indicator of underlying increases in overall healthcare spending, the data shows a clear trend

As healthcare moves from a broader clinical mentality to more personalized, tailor medicine, pharmacogenomics is emerging as a best-practice therapy.

AARP?s Public Policy Institute finds that average manufacturer price increases for brand-name and specialty prescription drugs widely used by Medicare beneficiaries continued to outstrip the price increases for other consumer goods and services.

Generic drugs have certainly made their mark, but don't count on the same savings in the specialty market.

Poor adherence is the most common cause of treatment failure. Months of treatment and observation produces improvement

Transparent models are fee-based, but do plan sponsors gain anything from such arrangements?

Only 20% of PDPs will offer gap coverage, and even then, most are limited to generics. House and Senate bills aim to help out.

State of the Industry survey results

A Cornell study finds that the true cost of cancer drugs is 30% less than a decade ago, once longevity and quality of life are considered.

Outcomes-based contracting enables risk sharing between plans and manufacturers while also allowing better patient adherence to regimens

Study finds that Americans have limited understanding when it comes to the cost and effectiveness of generic drugs.

In the wake of healthcare reform, pharmaceutical executives help take charge.

The disparity in coverage between oral and IV chemotherapy medication is a critical issue for patients and is being debated at the national and federal levels.

Prescription drug trends show that the underinsured may be voluntarily opting out of compliance due to affordability issues. Lower copayments may be key to curbing this.

Stand for Quality, a public-private coalition, has developed a quality-improvement and affordability framework.

Research must be actionable, relevant, timely, translated and transparent in its funding sources.

Two pricing bases could be identified as potential future replacements for AWP, namely average sales price (ASP) and average manufacturer price (AMP)

Pharmacogenomics offer value measures to MCOs as specialty drug costs skyrocket.

PPIs and H2 -receptor blockers are standard treatment for peptic ulcers and GERD, but lifestyle changes and OTC products can help

If MAC lists were not in place, prices for drugs would vary dramatically. Discounts for generic drugs would also decrease significantly.

Moving forward, the challenge for health plans and their clients will be to create value as opposed to simply shifting costs to enrollees. Creative solutions abound.

Will generic drugs, patent expirations, safety issues and a dry pipeline for high-incident diseases make room for a new drug paradigm?

Drug trend for 2007 was 2%, the lowest year-over-year trend since Medco began tracking it in 1999, according to the company. While the drug cost trend is small in terms of overall healthcare dollars spent, it was at one time rising at a rate more than double the rate of inflation, according to Lon Castle, MD, senior director, department of medical and analytical affairs at Medco.