A primer on brand-name prescription drug contracting

The above is the title of a helpful primer from Kenney and Keast (2024). I summarize some key points below. Provide an overview of the pharmacy contracts between stakeholders in the healthcare ecosystem. How did the rise of health maintenance organizations (HMOs) impact pharmacy contracting? The Health Maintenance Organization (HMO) Act of1973 spurred the growth…

Are providers ready for biosimilars?

Perhaps more education is needed. That is the conclusion from a paper by Giovatto et al. (2024). The authors conducted an online survey of US prescribers and health system specialty pharmacists practicing in the rheumatology, dermatology, and gastroenterology. Among the 31 prescribers and 44 pharmacists who responded to the survey: Only 16.0% of prescribers and…

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Physician access limitations to those with cold or flu in Spain.  Big investments in AlphaFold’s AI.  Vaccination tipping point? New CMS legislation on prior authorization. Republican candidates on health care.

Risk aversion estimates for GRACE

Generalized risk-adjusted cost effectiveness (GRACE) aims to incorporate risk preferences into standard cost effectiveness analysis (CEA) methods. While traditional CEA assumes individuals are risk neutral, GRACE allows for risk preferences to influence value. Namely, that health gains in more severely ill health states are valued more than equivalent health gains in better health states. But…

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Workers Comp total drug spend: $2.9 billion. Will AI increase or decrease firm size? Complex systems models for public health. For-profit hospice saves money. RCT: AI vs. human in and cardiac function assessment.

Societal value of disease modifying therapy for Alzheimer’s disease

Most health technology assessment (HTA) bodies measure treatment value as benefits from reduced patient morbidity and mortality and weigh these health gains against incremental changes in treatment cost. The limitation of this approach, however, is that it may ignore broader societal value. For instance, if patients have improved functional status, caregiver time and cost burden…