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Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Drug Products: Biologics, Biosimilars and Interchangeables01:28

Drug Products: Biologics, Biosimilars and Interchangeables

Biologics, derived from living sources such as humans, animals, or microorganisms, represent a significant category of pharmaceuticals. These complex molecules, developed through advanced biotechnological methods or purified from natural sources, include essential medical treatments like insulin and growth hormones. The complexity of biologics arises from their large molecular structures and the intricate processes required for their production, making them distinct from conventional...
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Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
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Published on: December 11, 2016

Current issues in pharmaceutical reimbursement.

Steven Fijalka1, David Fye, Philip E Johnson

  • 1Pharmacy Services, University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, WA 98195, USA. fijalka@u.washington.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|February 9, 2008
PubMed
Summary
This summary is machine-generated.

Medicare pharmaceutical reimbursement faces challenges from rule changes and market shifts. Pharmacists can mitigate financial losses and improve patient access through strategic collaboration and advocacy.

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Area of Science:

  • Health Policy
  • Pharmaceutical Economics
  • Healthcare Management

Background:

  • Recent changes in Medicare rules and rates impact pharmaceutical reimbursement.
  • The evolving healthcare environment presents new challenges for drug coverage and payment.

Purpose of the Study:

  • To identify key issues in pharmaceutical reimbursement stemming from Medicare changes.
  • To propose strategies for addressing these reimbursement challenges.

Main Methods:

  • Analysis of current Medicare pharmaceutical reimbursement policies.
  • Review of proposed changes in Medicare rules and rates.
  • Identification of emerging trends in healthcare affecting pharmaceutical access.

Main Results:

  • Identified six critical issues: reduced reimbursement rates, specialty pharmacy growth, erythropoiesis-stimulating agent (ESA) reimbursement changes, increased need for patient assistance, clinical trial policy shifts, and pay-for-performance initiatives.
  • Proposed strategies include multidisciplinary team approaches, payer collaboration, and pharmacist advocacy.

Conclusions:

  • Understanding Medicare's evolving pharmaceutical reimbursement landscape is crucial for pharmacists.
  • Proactive engagement and strategic planning can help manage financial risks and enhance patient care.
  • Pharmacists play a vital role in advocating for favorable policies and patient access.