Drug costs

Employers are more than just concerned about the rising costs of prescription drugs-they're ready to stem the tide, according to industry experts.

Washington, D.C.-National healthcare spending rose 6.7% in 2006 to $2.1 trillion, just slightly faster than the previous year but still fairly stable. Overall, outlays for healthcare reflected a continued slowdown from the double-digit growth rates of the 1990s. Payments for most major health services-hospitals, physicians, nursing homes, home health services-experienced slower growth than 2005.

In chronic obstructive pulmonary disease (COPD), airways in the lung are partially obstructed. It's often a mixture of two diseases, chronic bronchitis and emphysema. The condition is marked by a progressive decline in lung function.

A recent survey by the Employee Benefit Research Institute found that 70% of those enrolled in consumer-directed health plans (CDHP) say that they consider costs when deciding to see a doctor or filling a prescription as compared with fewer than 40% of those in a comprehensive plan. However, the survey also found that CDHP enrollees were twice as likely to avoid, skip or delay healthcare services.

Clinical depression is a major problem in the United States, affecting an estimated 5% to 10% of all adults. Costs for medical care and lost productivity related to depression are estimated at more than $40 billion per year.

Payers and employers can pay up to $350,000 per patient for just one year of treatment for high-cost conditions such as rheumatoid arthritis. Patients, too, share the burden, in some cases shouldering 50% of the bill in deductibles and co-pays.

Antipsychotics are the fourth largest group of medications prescribed in the United States today, with a collective cost of approximately $10 billion. Newer, second-generation medications represent 90% of the current market, and they cost considerably more than older antipsychotics.

Findings of a study released earlier this year suggest that the average cost of dispensing prescriptions may be higher than the average dispensing fees paid to pharmacies.

Employers are putting more financial burden on employees in the form of higher copays and deductibles, however, in the physician's office, patients' cost concerns usually aren't discussed in advance of a particular treatment.

Surgical site infections are a significant problem in hospitals today. They occur in 2% to 5% of patients who have clean operations outside the abdomen, and in up to 20% of patients with intra-abdominal procedures. They account for about 15% of hospital-acquired infections.

Washington, D.C.-Although campaigning Democrats promised to repeal the "non-interference" clause in the Medicare drug benefit, making such a change may not be all that easy. Democrats could push through a straight repeal of the current provision that prevents the federal government from directly negotiating drug prices with pharmaceutical companies. Such a move, however, would not necessarily alter the program under a Republican administration that believes private drug plans can negotiate prices better than bureaucrats.

Although as many as 48% of seniors were subject to some type of drug-coverage deficiency in 2006, only an estimated 4 million of the 22.5 million enrolled in Medicare drug plans were actually expected to hit the infamous donut hole. There could still be financial woes, however, for the 10.8 million Medicare beneficiaries who at least have the potential for out-of-pocket costs in the donut hole gap because they do not qualify for a subsidy, are not covered outside Part D, or did not pay for enhanced gap coverage.