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Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.
This report addresses the concepts and controversy surrounding health technology assessment in Europe, with a particular focus on selected Member States including Sweden, the Netherlands, Finland, France, Germany and the United Kingdom. It is intended to identify and address current considerations regarding HTA methodological and process issues related to the prioritization and financing of modern health care. In particular, it describes the processes and challenges for identifying and prioritizing assessments; assesses and compares current assessment methods and procedures; and highlights the barriers to effective implementation. The report also ascertains the roles and terms of engagement of key stakeholders, and captures the opportunities and challenges for the use of HTA guidance in general priority-setting, decision-making and health-care provision.
Managing Drug Supply (MDS) is the leading reference on how to manage essential medicines in developing countries. MDS was originally published in 1982; it was revised in 1997 with over 10,000 copies distributed in over 60 countries worldwide. The third edition, MDS-3: Managing Access to Medicines and Health Technologies reflects the dramatic changes in politics and public health priorities, advances in science and medicine, greater focus on health care systems, increased donor funding, and the advent of information technology that have profoundly affected access to essential medicines over the past 14 years. Nearly 100 experts from a wide range of disciplines and virtually every corner of the world have contributed to this third edition. In addition to many new country studies, references, and extensive revisions, MDS-3 offers new chapters on areas such as pharmaceutical benefits in insurance programs, pricing, intellectual property, drug seller initiatives, and traditional and complementary medicine. The revisions and new chapters echo the wide variety of issues that are important to health practitioners and policy makers today. MDS-3 will be a valuable tool in the effort to ensure universal access to quality medicines and health technologies and their appropriate use.
Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati
Healthcare Technology Management Systems provides a model for implementing an effective healthcare technology management (HTM) system in hospitals and healthcare provider settings, as well as promoting a new analysis of hospital organization for decision-making regarding technology. Despite healthcare complexity and challenges, current models of management and organization of technology in hospitals still has evolved over those established 40-50 years ago, according to totally different circumstances and technologies available now. The current health context based on new technologies demands working with an updated model of management and organization, which requires a re-engineering perspective to achieve appropriate levels of clinical effectiveness, efficiency, safety and quality. Healthcare Technology Management Systems presents best practices for implementing procedures for effective technology management focused on human resources, as well as aspects related to liability, and the appropriate procedures for implementation. - Presents a new model for hospital organization for Clinical Engineers and administrators to implement Healthcare Technology Management (HTM) - Understand how to implement Healthcare Technology Management (HTM) and Health Technology Assessment (HTA) within all types of organizations, including Human Resource impact, Technology Policy and Regulations, Health Technology Planning (HTP) and Acquisition, as well as Asset and Risk Management - Transfer of knowledge from applied research in CE, HTM, HTP and HTA, from award-winning authors who are active in international health organizations such as the World Health Organization (WHO), Pan American Health Organization (PAHO), American College of Clinical Engineering (ACCE) and International Federation for Medical and Biological Engineering (IFMBE)
New medical technologies--pharmaceuticals, medical devices, and procedures--often allow great improvements in the outcomes of medical care, but they are also widely believed to be a major cause of increasing costs. Selective adoption of new technologies is crucial in the quest to control health care costs while preserving or enhancing the quality of care. This report focuses on evaluation and adoption of innovative procedures and medical devices by managed care organizations (MCOs). The project had two primary objectives: (1) to understand current MCO processes for making coverage, medical-necessity, and payment decisions and how device developers and manufacturers prepare for and participate in these processes; and (2) to identify ways that private, voluntary action by the managed-care and medical-device industries might improve--for the benefit of society--these processes. The core data are from confidential interviews with eight companies that develop and manufacture medical devices and medical directors of nine MCOs. The findings should be of interest to medical-device developers and manufacturers, managed care organizations, public-policy makers, and researchers and analysts. A major impediment to socially appropriate adoption of emerging medical technologies is limited information about the performance of these technologies in day-to-day medical practice. The authors discuss prospects for improving four elements of information availability: --Developing better information before market introduction --Learning more from experience after market introduction --Evaluating and synthesizing clinical information --Disseminating information. They also discuss several other issues that warrant consideration: --Aligning private incentives of MCOs and payers with social values --Enhancing MCO capabilities to evaluate technologies and make decisions --Improving decisions by physicians --Reducing use of inappropriate or obsolete technologies --Reducing costs of decisionmaking for manufacturers and MCOs --Improving manufacturer understanding of the market environment --Helping MCOs and employers anticipate what is in the pipeline.
Increasingly powerful pharmaceuticals are of increasing clinical and economic importance to managed care organizations. Expenditures on pharmaceuticals have also been increasing, a trend driven by a number of factors, including the accelerating development of more-innovative and more- expensive agents; rising pharmaceutical prices; and higher utilization due to the aging of the population, direct-to-consumer advertising, and other factors. More often today, health plans and provider organizations are responsible for managing and paying for these cost increases, which creates an incentive for them to go beyond a focus on clinical effectiveness and safety to evaluate the cost-effectiveness of new drugs. In addition, the development of drug formularies and the current focus on best practices require that each new drug be assessed relative to available alternatives. The formal controls and guidelines resulting from managed care processes can increase quality and cost efficiency, but can also be a barrier to desirable innovations. Together, these developments have caused managed care organizations to realize that making good decisions on new pharmaceuticals is to their immediate financial and clinical benefit. Accordingly, many have expressed interest in improving their ability to evaluate new pharmaceuticals.
Increasingly powerful pharmaceuticals are of increasing clinical and economic importance to managed care organizations. Expenditures on pharmaceuticals have also been increasing, a trend driven by a number of factors, including the accelerating development of more-innovative and more- expensive agents; rising pharmaceutical prices; and higher utilization due to the aging of the population, direct-to-consumer advertising, and other factors. More often today, health plans and provider organizations are responsible for managing and paying for these cost increases, which creates an incentive for them to go beyond a focus on clinical effectiveness and safety to evaluate the cost-effectiveness of new drugs. In addition, the development of drug formularies and the current focus on best practices require that each new drug be assessed relative to available alternatives. The formal controls and guidelines resulting from managed care processes can increase quality and cost efficiency, but can also be a barrier to desirable innovations. Together, these developments have caused managed care organizations to realize that making good decisions on new pharmaceuticals is to their immediate financial and clinical benefit. Accordingly, many have expressed interest in improving their ability to evaluate new pharmaceuticals.
PBMs: Reshaping the Pharmaceutical Distribution Network provides HMOs and other third-party payers with information on the new and increasingly important role of pharmaceutical benefit companies (PBMs) in the health care industry. From this text, you will learn how PBMs can maintain and deliver a quality, cost-effective drug benefit plan to your company while achieving the anticipated market share for the product. PBMs: Reshaping the Pharmaceutical Distribution Network offers you suggestions on how to choose which PBM service is correct for your business, such as what qualifications to look for in a PBM, as well as what questions you should ask a respective company. This text also offers ways on how your company can benefit from becoming a client and may make your business more competitive in the pharmaceutical industry. PBMs: Reshaping the Pharmaceutical Distribution Network also informs you about the controversies that have arisen concerning the new position of PBMs in the industry. Through research and evaluation, this text addresses these issues from many different perspectives and gives you insight into other topics concerning PBMs, including: operating methods that PBMs currently rely on for designing and overseeing a drug benefit plan how the Food and Drug Administration currently views the role of PBMs and why they are contemplating regulatory intervention alerting PBMs, pharmacies, pharmaceutical companies, and managed care organizations to new legal issues involving fraud and abuse affecting pharmacy benefit management and pharmaceutical manufacturers reasons why retail drug chains and pharmacist organizations oppose recent industry developments regarding PBMs whether or not PBMs reflect a move toward greater centralized decisionmaking in the health care systemIn addition, PBMs: Reshaping the Pharmaceutical Distribution Network offers pharmaceutical companies, health care providers, and managed care organizations several suggestions for further research, which may make your business or your business relationships more efficient and productive in the future. If you or your company are considering the services of a pharmacy benefit management, PBMs: Reshaping the Pharmaceutical Distribution Network will guide you in choosing a company that helps you deliver the most cost-effective and efficient pharmaceutical benefits to customers.
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