What Will It Take to Eradicate Hepatitis C? 05/26/2017 The US health system has an unusual opportunity, which hasn’t been seen since the mass production of vaccines to prevent the outbreak of major infections, such as measles, typhoid, and malaria. This opportunity has been recognized by the academic community, as well as federal and local health authorities. As outlined in the March publication of A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report, the Institutes of Medicine, the Centers for Disease Control and
The US health system has an unusual opportunity, which hasn’t been seen since the mass production of vaccines to prevent the outbreak of major infections, such as measles, typhoid, and malaria. This opportunity has been recognized by the academic community, as well as federal and local health authorities. As outlined in the March publication of A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report, the Institutes of Medicine, the Centers for Disease Control and
The Tipping Point for TrumpCare Is a Failure in Chronic Disease 05/12/2017 The costs associated with chronic disease are not easily manageable‑by the health system or by individuals with chronic conditions. According to the Centers for Disease Control and Prevention, 117 million US adults had at least one chronic disease in 2012. The aging of the baby boomers is the main driver of health system expenditures. Although chronic disease afflicts all age groups, older people tend to accumulate more chronic diseases and comorbidities as they age. According to the Agency for
The costs associated with chronic disease are not easily manageable‑by the health system or by individuals with chronic conditions. According to the Centers for Disease Control and Prevention, 117 million US adults had at least one chronic disease in 2012. The aging of the baby boomers is the main driver of health system expenditures. Although chronic disease afflicts all age groups, older people tend to accumulate more chronic diseases and comorbidities as they age. According to the Agency for
The Absence of Real-World Measures: A Real Problem for Gauging Patient Improvement 05/05/2017 How do we “measure” patient improvement? For some diseases, like cancer, physicians can gauge tumor response to therapy. In acute infectious disorders, we speak of curing the patient. In patients with diabetes and hypertension, measurements of glycemic levels and blood pressure are good guides towards clinical success. In many other chronic diseases, objective measures of patient improvement is much more elusive. Previously, we discussed the use of PASI scores in psoriasis, and how this has
How do we “measure” patient improvement? For some diseases, like cancer, physicians can gauge tumor response to therapy. In acute infectious disorders, we speak of curing the patient. In patients with diabetes and hypertension, measurements of glycemic levels and blood pressure are good guides towards clinical success. In many other chronic diseases, objective measures of patient improvement is much more elusive. Previously, we discussed the use of PASI scores in psoriasis, and how this has
Is It Time to Reassess the Value of Pharmacy Benefit Managers? 04/28/2017 Are the days of the conventional pharmacy benefit managers (PBMs) numbered? Outside of leveraging pricing of pharmaceuticals, they lack transparency, and do not pass the majority of the savings they obtain to their employer or plan customers. The question has also been raised as to whether the savings they negotiate benefit the health system (or the PBM). Many policy makers believe the PBM model is struggling to add value to the health delivery system in terms of improving adherence. Recent
Are the days of the conventional pharmacy benefit managers (PBMs) numbered? Outside of leveraging pricing of pharmaceuticals, they lack transparency, and do not pass the majority of the savings they obtain to their employer or plan customers. The question has also been raised as to whether the savings they negotiate benefit the health system (or the PBM). Many policy makers believe the PBM model is struggling to add value to the health delivery system in terms of improving adherence. Recent
Improving Adherence for Many: The $100+ Billion Question 04/21/2017 We’ve been at battling medication nonadherence for more than 30 years. This week, an article in the New York Times called it an epidemic. However, it is harrowingly difficult to address. It is well known that half of all medications prescribed for chronic diseases are not taken by the patients who need them. Yet, we’ve tried everything under the sun, including tying provider quality measures and compensation to improve adherence. Hasn’t worked, because doctors and nurses can only do so much.
We’ve been at battling medication nonadherence for more than 30 years. This week, an article in the New York Times called it an epidemic. However, it is harrowingly difficult to address. It is well known that half of all medications prescribed for chronic diseases are not taken by the patients who need them. Yet, we’ve tried everything under the sun, including tying provider quality measures and compensation to improve adherence. Hasn’t worked, because doctors and nurses can only do so much.
Do Patients Understand the Concept of Value-Based Medicine? 04/14/2017 Patient and consumer education is a primary component of the patient journey. The success or failure of new treatment approaches, health benefit designs, and even personal therapeutic success depends heavily on the patient understanding how these efforts will improve their health care either immediately or down the road. For several years, academic institutions, payers and purchasers, and professional medical and pharmacy societies have been leading the charge for value-based medicine. The
Patient and consumer education is a primary component of the patient journey. The success or failure of new treatment approaches, health benefit designs, and even personal therapeutic success depends heavily on the patient understanding how these efforts will improve their health care either immediately or down the road. For several years, academic institutions, payers and purchasers, and professional medical and pharmacy societies have been leading the charge for value-based medicine. The
Hints of Savings on the Biologic Market, but With Little Prompting from Biosimilars 04/07/2017 Five years ago, biosimilar drugs seemed to offer so much promise in reducing the costs of specialty pharmaceuticals and increasing patient access to them. The dream of biosimilar specialty tiers, with copayments far less than that of nonpreferred biologics, still exists. Yet, only 3 biosimilar agents (Zarxio and Inflectra, and Basaglar, technically a follow-on biologic) are currently marketed. Two received approval but are awaiting resolution of patent litigation (Erelzi and Amjevita). The Food
Five years ago, biosimilar drugs seemed to offer so much promise in reducing the costs of specialty pharmaceuticals and increasing patient access to them. The dream of biosimilar specialty tiers, with copayments far less than that of nonpreferred biologics, still exists. Yet, only 3 biosimilar agents (Zarxio and Inflectra, and Basaglar, technically a follow-on biologic) are currently marketed. Two received approval but are awaiting resolution of patent litigation (Erelzi and Amjevita). The Food
The Effect of Cardiovascular Outcomes Trials in Patients with Type 2 Diabetes 03/31/2017 Only a few years ago, drug companies in the type 2 diabetes space were dogged about questions of whether their medications carried significant risks of adverse cardiovascular (CV) events. It has been long known that patients with diabetes mellitus are at risk for microvascular and macrovascular complications. The latter includes stroke, renal failure, myocardial infarction, and heart failure. The risk for myocardial infarction in patients taking Avandia prompted the Food and Drug Administration
Only a few years ago, drug companies in the type 2 diabetes space were dogged about questions of whether their medications carried significant risks of adverse cardiovascular (CV) events. It has been long known that patients with diabetes mellitus are at risk for microvascular and macrovascular complications. The latter includes stroke, renal failure, myocardial infarction, and heart failure. The risk for myocardial infarction in patients taking Avandia prompted the Food and Drug Administration
Chronic Disease, Debility, and Disability 03/24/2017 In matters of long-term chronic illnesses, few areas are more difficult to address than debility and disability caused by the treatment or the disease itself. These terms are different but closely related, and sometimes confused. Debility is a description of general weakness or enfeeblement. Disability is the inability to work or complete specific tasks. The debility may derive from a culmination of medical or surgical treatments. Major surgery is highly debilitating and its effects can last
In matters of long-term chronic illnesses, few areas are more difficult to address than debility and disability caused by the treatment or the disease itself. These terms are different but closely related, and sometimes confused. Debility is a description of general weakness or enfeeblement. Disability is the inability to work or complete specific tasks. The debility may derive from a culmination of medical or surgical treatments. Major surgery is highly debilitating and its effects can last
